Abstract
Objective
Any joint disorders can present as monoarthritis initially, which makes the range of differential diagnosis of monoarthritis extensive. Synovial biopsy may play a role in the diagnosis of monoarthritis. We reviewed the synovial biopsy findings of monoarthritis patients in order to assess its diagnostic value.
Methods
Synovial pathologic findings of 39 patients who visited the rheumatology or orthopedic surgery clinic for acute or chronic monoarthritis from Feb., 2006 to Jul., 2010 were reviewed retrospectively.
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Figure 1.
Multiple periarticular bone erosions and sclerosis with decreased joint space are noted in the elbow joint with effusion and periarticular soft tissue swelling. It was considerd in the differential diagnosis of rheumatoid arthritis, tuberculous arthritis, and septic arthritis.
![jrd-18-175f1.tif](/upload/SynapseXML/1010jrd/thumb/jrd-18-175f1.gif)
Figure 2.
Whole body bone scan of the patient who diagnosed as rheumatoid arthritis. Intense increased bone uptake in right wirst and left elbow, suggesting severe arthritis or septic arthritis.
![jrd-18-175f2.tif](/upload/SynapseXML/1010jrd/thumb/jrd-18-175f2.gif)
Figure 3.
Tuberculous arthritis of the Rt. 5th PIP joint. Radiograph demonstrated soft tissue swelling of 5 th finger. And enchondroma was shown at second proximal phalanx.
![jrd-18-175f3.tif](/upload/SynapseXML/1010jrd/thumb/jrd-18-175f3.gif)
Table 1.
Baseline characteristics (N=39)
Table 2.
Characteristics of synovial pathologies
Table 3.
Comparisons between the diagnosed group and th undiagnosed group
Diagnosed | Undiagnosed | p-value∗ | |
---|---|---|---|
Duration of synovitis (months, mean± SD) | 8.2±11.1 | 21.1±63.3 | 0.690 |
ESR (mm/hr, mean± SD) | 26.5±34.4 | 10.4±14.3 | 0.419 |
CRP (mg/L, mean± SD) | 24.7±22.8 | 6.5±8.9 | 0.207 |
Techniques | |||
Arthroscopic | 3 (8.6) | 32 (91.4) | 0.305 |
Needle | 1 (25) | 3 (75) | |
Mode | |||
Spont | 4 (16) | 21 (84) | 0.287 |
Trauma | 0 | 12 (100) | |
Postop. | 0 | 2 (100) |