Arthroscopic synovial biopsy in definitive diagnosis of joint diseases: An evaluation of efficacy and precision

CONTEXT: Arthritis is an important cause of morbidity, presenting as monoarticular or polyarticular lesion. Arthroscopic synovial aspiration and biopsy can help in arriving specific etiological diagnosis. AIM AND OBJECTIVES: To evaluate the efficacy of arthroscopic synovial biopsy as a diagnostic aid and study the characteristics of synovial fluid in various joint diseases. MATERIALS AND METHODS: Arthroscopic synovial biopsy along with synovial fluid analysis was studied in 30 of the 50 enrolled cases arthritis. The fluid was subjected to physical, biochemical, and cytological analysis. RESULTS: Both rheumatoid (n = 14, 28%) and tubercular (n = 13, 26%) arthritis were found to be more common compared to other etiologies. Next common etiology observed was chronic nonspecific synovitis (n = 10, 20%). Clinicopathological correlation was seen in 34 out of 50 cases. As a diagnostic tool, synovial biopsy had a sensitivity of 85%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 62%. CONCLUSION: Arthroscopic synovial biopsy is a simple and easy to perform technique and is an important useful investigative adjunct that may give conclusive diagnosis where clinical diagnosis is equivocal.