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Evaluation of arthroscopy and macroscopic scoring

INTRODUCTION: Arthroscopy is a minimally invasive technique for retrieving synovial biopsies in rheumatology during the past 20 years. Vital for its use is continual evaluation of its safety and efficacy. Important for sampling is the fact of intraarticular variation for synovial markers. For micros...

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Autores principales: af Klint, Erik, Catrina, Anca I, Matt, Peter, Neregråd, Petra, Lampa, Jon, Ulfgren, Ann-Kristin, Klareskog, Lars, Lindblad, Staffan
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2009
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2714131/
https://www.ncbi.nlm.nih.gov/pubmed/19490631
http://dx.doi.org/10.1186/ar2714
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author af Klint, Erik
Catrina, Anca I
Matt, Peter
Neregråd, Petra
Lampa, Jon
Ulfgren, Ann-Kristin
Klareskog, Lars
Lindblad, Staffan
author_facet af Klint, Erik
Catrina, Anca I
Matt, Peter
Neregråd, Petra
Lampa, Jon
Ulfgren, Ann-Kristin
Klareskog, Lars
Lindblad, Staffan
author_sort af Klint, Erik
collection PubMed
description INTRODUCTION: Arthroscopy is a minimally invasive technique for retrieving synovial biopsies in rheumatology during the past 20 years. Vital for its use is continual evaluation of its safety and efficacy. Important for sampling is the fact of intraarticular variation for synovial markers. For microscopic measurements scoring systems have been developed and validated, but for macroscopic evaluations there is a need for further comprehensive description and validation of equivalent scoring systems. METHODS: We studied the complication rate and yield of arthroscopies performed at our clinic between 1998 and 2005. We also created and evaluated a macroscopic score set of instructions for synovitis. RESULTS: Of 408 procedures, we had two major and one minor complication; two haemarthrosis and one wound infection, respectively. Pain was most often not a problem, but 12 procedures had to be prematurely ended due to pain. Yield of biopsies adequate for histology were 83% over all, 94% for knee joints and 34% for smaller joints. Video printer photographs of synovium taken during arthroscopy were jointly and individually reviewed by seven raters in several settings, and intra and inter rater variation was calculated. A macroscopic synovial scoring system for arthroscopy was created (Macro-score), based upon hypertrophy, vascularity and global synovitis. These written instructions were evaluated by five control-raters, and when evaluated individual parameters were without greater intra or inter rater variability, indicating that the score is reliable and easy to use. CONCLUSIONS: In our hands rheumatologic arthroscopy is a safe method with very few complications. For knee joints it is a reliable method to retrieve representative tissue in clinical longitudinal studies. We also created an easy to use macroscopic score, that needs to be validated against other methodologies. We hope it will be of value in further developing international standards in this area.
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spelling pubmed-27141312009-07-22 Evaluation of arthroscopy and macroscopic scoring af Klint, Erik Catrina, Anca I Matt, Peter Neregråd, Petra Lampa, Jon Ulfgren, Ann-Kristin Klareskog, Lars Lindblad, Staffan Arthritis Res Ther Research Article INTRODUCTION: Arthroscopy is a minimally invasive technique for retrieving synovial biopsies in rheumatology during the past 20 years. Vital for its use is continual evaluation of its safety and efficacy. Important for sampling is the fact of intraarticular variation for synovial markers. For microscopic measurements scoring systems have been developed and validated, but for macroscopic evaluations there is a need for further comprehensive description and validation of equivalent scoring systems. METHODS: We studied the complication rate and yield of arthroscopies performed at our clinic between 1998 and 2005. We also created and evaluated a macroscopic score set of instructions for synovitis. RESULTS: Of 408 procedures, we had two major and one minor complication; two haemarthrosis and one wound infection, respectively. Pain was most often not a problem, but 12 procedures had to be prematurely ended due to pain. Yield of biopsies adequate for histology were 83% over all, 94% for knee joints and 34% for smaller joints. Video printer photographs of synovium taken during arthroscopy were jointly and individually reviewed by seven raters in several settings, and intra and inter rater variation was calculated. A macroscopic synovial scoring system for arthroscopy was created (Macro-score), based upon hypertrophy, vascularity and global synovitis. These written instructions were evaluated by five control-raters, and when evaluated individual parameters were without greater intra or inter rater variability, indicating that the score is reliable and easy to use. CONCLUSIONS: In our hands rheumatologic arthroscopy is a safe method with very few complications. For knee joints it is a reliable method to retrieve representative tissue in clinical longitudinal studies. We also created an easy to use macroscopic score, that needs to be validated against other methodologies. We hope it will be of value in further developing international standards in this area. BioMed Central 2009 2009-06-02 /pmc/articles/PMC2714131/ /pubmed/19490631 http://dx.doi.org/10.1186/ar2714 Text en Copyright © 2009 af Klint et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an open access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
af Klint, Erik
Catrina, Anca I
Matt, Peter
Neregråd, Petra
Lampa, Jon
Ulfgren, Ann-Kristin
Klareskog, Lars
Lindblad, Staffan
Evaluation of arthroscopy and macroscopic scoring
title Evaluation of arthroscopy and macroscopic scoring
title_full Evaluation of arthroscopy and macroscopic scoring
title_fullStr Evaluation of arthroscopy and macroscopic scoring
title_full_unstemmed Evaluation of arthroscopy and macroscopic scoring
title_short Evaluation of arthroscopy and macroscopic scoring
title_sort evaluation of arthroscopy and macroscopic scoring
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2714131/
https://www.ncbi.nlm.nih.gov/pubmed/19490631
http://dx.doi.org/10.1186/ar2714
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