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Orthopade. 2006 Aug;35(8):853-9.

[Low-grade-/high-grade-synovitis: synovitis-score as a gold standard?].

[Article in German]

Author information

1
Institut für Pathologie, Moltkestrasse 32, 54292 Trier. krenn@patho-trier.de

Abstract

BACKGROUND:

Synovectomy specimens represent important material submitted from the orthopedist to the pathologist. However, no consistent histopathological grading system for chronic synovitis has been established so far.

PATIENTS AND METHODS:

The three compartments of chronic synovitis (enlargement of lining cell layer, density of synovial stroma cells, leukocytic infiltrate) are graded semiquantitatively (from 0=absent to 3=strong), and the points for each compartment add up to the synovitis score: 0-1 = no synovitis, 2-4 = low-grade synovitis, 5-9 = high-grade synovitis. A total of 618 synovial specimens (resections n=559, biopsies n=59) from degenerative and inflammatory joint diseases were graded by two independent observers.

RESULTS:

Median synovitis scores when correlated to clinical diagnoses were: 1, control; 2, osteoarthritis and post-traumatic arthritis; 3, psoriatic arthritis; 5, reactive and rheumatoid arthritis. The differences between rheumatic and non-rheumatic diseases were significant (p<0.001). The correlation between the two observers was high (p<0.001).

CONCLUSIONS:

The proposed synovitis score enables stratification of chronic synovitis into low-grade (score 2-4) and high-grade (score >4), which is correlated to the nature of the disease (low-grade to non-rheumatic, high-grade to rheumatic), and it therefore contributes to the diagnosis of rheumatic and non-rheumatic joint diseases.

PMID:
16819616
DOI:
10.1007/s00132-006-0987-x
[Indexed for MEDLINE]

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