Role of Arthroscopic Synovial Biopsy in Diagnosis and Management of Unilateral Synovitis Knee

Background Monoarticular synovitis is relatively difficult to diagnose and delay in diagnosis leads to poor outcomes. Long-term occurrence of synovitis can result in degeneration of the joint due to the release of inflammatory cytokines which resulted in increased synthesis of matrix metalloproteinases and decreased expression levels of inhibitors. Tubercular synovitis and early arthritis are difficult to diagnose due to the atypical clinical presentation and lack of specificity in diagnosis. Materials and Methods A prospective study was conducted on 55 patients and arthroscopic synovial biopsy was obtained and biopsy reports were evaluated. The paired t-test was used to compare serial changes in pain intensity using numeric pain rating scale. Results Out of 55, 27 (49.09 %) cases were diagnosed as inflammatory synovitis, 11 (20 %) cases as tubercular synovitis, 3 (5.45 %) cases of osteoarthritis, and 14 (25.45 %) cases of non-specific chronic synovitis. The mean age of patients was 43.21 years, As a diagnostic aid, the role of synovial biopsy was found to be significant (P less than 0.05). Conclusion Monoarticular arthritis should be thoroughly investigated rule out infectious or metabolic diseases for their destructive potential to destroy cartilage rapidly. Arthroscopic-assisted synovial biopsy has added advantage as it permits macroscopic evaluation of the synovium, and cartilage inadequacy could also be noted along with serving as therapeutic purposes in some cases.