滑膜活检

定义

A synovial biopsy is the removal of a piece of tissue lining a joint for examination. The tissue is called the synovial membrane.

选择的名字

Biopsy - synovial membrane; 类风湿性关节炎 - synovial biopsy; 痛风 - synovial biopsy; Joint infection - synovial biopsy; Synovitis - synovial biopsy

如何执行测试

The test can be done in the operating room or in the physician's office. There are multiple techniques used for synovial biopsy including surgery, arthroscopy or ultrasound guided needle biopsy.

在此过程中:

• Depending on the type of procedure, you may receive 全身麻醉, 区域麻醉 or local anesthesia. 与 全身麻醉, you'll be pain free and asleep during the procedure. 与 区域麻醉, you'll be awake, but the part of the body with the involved joint will be numb. 与 local anesthesia, only the joint is numbed and you will be awake during the procedure.

If you are having an arthroscopic procedure:

• The surgeon makes a tiny cut in the skin near the joint.
• An instrument called a trocar is inserted through the cut into the joint.
• A tiny camera with a light is used to look inside the joint.
• A tool called a biopsy grasper is then inserted through the trocar. The grasper is used to cut a small piece of tissue.
• The surgeon removes the grasper along with the tissue. The trocar and any other instruments are removed. The skin cut is closed and a bandage is applied.
• The sample will be sent to the laboratory for evaluation.

如果你正在做穿刺活检:

• The physician (radiologist, orthopedist or rheumatologist) will identify the site using ultrasound.
• The site of the biopsy will be cleaned and numbed.
• A needle sized trochar is inserted into the joint.
• A tool called a biopsy needle will be inserted through the trochar. The physician will use the ultrasound to determine where to obtain the tissue from for biopsy. The physician will cut a small piece of tissue with the biopsy needle. Multiple samples may be taken based on the clinical case. The biopsy needle will be removed from the joint and the tissue will be sent to the laboratory for examination.
• 将转子取出.
• A small bandage will be applied and stitches are not needed.
• Your physician will determine which method is best given your clinical case.

如何准备考试

Follow your health care provider's instructions on how to prepare. This may include not eating and drinking anything for several hours before the procedure.

考试的感觉如何

与 the local anesthetic, you will feel a prick and a burning sensation. As the trocar is inserted, there will be some discomfort. If the surgery is performed under regional or 全身麻醉, you will not feel the procedure.

为什么要进行测试

滑膜活检有助于诊断 痛风 and bacterial infections, or rule out other infections. It can be used to diagnose autoimmune disorders such as rheumatoid arthritis, or uncommon infections like tuberculosis or fungal infections.

正常的结果

The synovial membrane structure is normal.

异常结果意味着什么

滑膜活检 may identify the following conditions:

• Long-term (chronic) synovitis (inflammation of the synovial membrane)
• 球孢子菌病 (真菌感染)
• 真菌关节炎
• 痛风
• 假性痛风
• 血色沉着病 (铁矿异常堆积)
• 系统性红斑狼疮 (autoimmune disease that affects the skin, joints, and other organs)
• 结节病
• 肺结核
• Synovial cancer (very rare type of soft tissue cancer)
• 类风湿性关节炎

风险

There is a very slight chance of infection and bleeding.

注意事项

Follow instructions for keeping the wound clean and dry until your provider says it is OK to get it wet.

参考文献

El-Gabalawy HS, Tanner S. Synovial fluid analyses, synovial biopsy, and synovial pathology. In: Firestein GS, Budd RC, Gabriel SE, Koretzky GA, McInnes IB, O'Dell JR, eds. Firestein and Kelley's Textbook of Rheumatology. 11日艾德. Philadelphia, PA: Elsevier; 2021:chap 56.

约翰逊H，纳杰姆A. 滑膜活检 in clinical practice and research: current developments and perspectives. 临床风湿病学. 2021;40(7):2593-2600. PMID: 33274415 pubmed.ncbi.nlm.国家卫生研究院.gov / 33274415 /.

西方SG. 滑膜活检. 见:西方SG, Kolfenbach J编. 风湿病的秘密. 第四版. Philadelphia, PA: Elsevier; 2020:chap 9.