Knee joint synovitis: study of correlations and diagnostic performances of ultrasonography compared with histopathology

Najm, A. , Orr, C., Gallagher, L., Biniecka, M., Gaigneux, E., Le Goff, B., Fearson, U. and Veale, D. J. (2018) Knee joint synovitis: study of correlations and diagnostic performances of ultrasonography compared with histopathology. RMD Open, 4(1), e000616. (doi: 10.1136/rmdopen-2017-000616) (PMID:29531789) (PMCID:PMC5845411)

Abstract

Objectives: Ultrasonography (US) is a fast, available and low-cost imaging tool used for detecting knee synovitis. Our aims were to assess the relationship between US and histology findings in appraising levels of inflammation and vascularity in the knee joint in subjects with inflammatory arthropathies; to determine whether differences exist in the appraisal between varying knee compartments and to compare US performances compared with gold standard histology for knee synovitis detection. Methods: Subjects with actively inflamed knee joint having crystal arthropathies, rheumatoid arthritis, psoriatic arthritis or ostoearthritis were prospectively recruited from rheumatology clinics after giving their written consent between May and October 2015. Study was approved by the institutional ethics committee. The knee was divided into three compartments (medial, lateral, superior). Patients had a knee US followed by a knee arthroscopy with biopsies retrieval from each compartment. Biopsies were blindly scored for lining layer hyperplasia, inflammation, vascularity, CD68 and factor VIII staining. Correlation was determined using the Spearman’s correlation test. Results: 26 patients with active arthritis in a knee joint and recent onset of disease were prospectively included. Strong correlations were observed between US synovitis grade and histological inflammation score (r=0.63; P=0.002), US Doppler grade and histological score for vascularity (r=0.68; P<0.001); US measured synovial thickness and lining layer hyperplasia (r=0.61; P=0.002). Moderate correlation was found between US synovitis grade and CD68 score (r=0.49; P=0.02). Conclusion: US findings correlate with histological inflammation and vascularity scores in actively inflamed knee joints. US accurately describes knee synovitis.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Najm, Dr Aurelie
• Authors: Najm, A., Orr, C., Gallagher, L., Biniecka, M., Gaigneux, E., Le Goff, B., Fearson, U., and Veale, D. J.
• College/School: College of Medical Veterinary and Life Sciences > School of Infection & Immunity
• Journal Name: RMD Open
• Publisher: BMJ Publishing Group
• ISSN: 2056-5933
• ISSN (Online): 2056-5933
• Published Online: 08 February 2018
• Copyright Holders: Copyright © 2018 The Authors
• First Published: First published in RMD Open 4(1): e00616
• Publisher Policy: Reproduced under a Creative Commons License