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Rheumatology (Oxford). 2015 Oct;54(10):1867-75. doi: 10.1093/rheumatology/kev128. Epub 2015 May 28.

Ultrasound-guided synovial biopsy: a systematic review according to the OMERACT filter and recommendations for minimal reporting standards in clinical studies.

Author information

1
Queen Mary University of London, Experimental Medicine and Rheumatology, William Harvey Research Institute, London, UK.
2
Université Versailles Saint Quentin en Yvelines, Service de Rhumatologie Hôpital Ambroise Paré, Boulogne-Billancourt, France.
3
Rheumatology Department, Hospital General Universitario Gregorio Marañón and Universidad Complutense, Madrid, Spain.
4
University of Birmingham, Division of Immunity and Infection, Birmingham, UK and.
5
Rheumatology Department, Mile End Hospital, Barts Health NHS Trust, London, UK Stephen.kelly@bartshealth.nhs.uk.

Abstract

OBJECTIVES:

To describe existing techniques of US-guided synovial biopsy (USG-SB) and critically appraise the literature on this technology through the OMERACT filter.

METHODS:

USG-SB techniques are described and compared. A systematic literature search of PubMed and Embase was performed for original research reports including US and SB. The subjects, procedure protocols and reported results were analysed. A future research agenda is proposed.

RESULTS:

USG-SB can be performed using a portal-and-forceps or a dedicated semi-automatic guillotine-type biopsy needle approach. Of 50 reports identified, 7 were included in the review. Large, intermediate and small joints were all amenable to USG-SB. We found great heterogeneity with regard to indications for and definition of a successful procedure and of synovitis. Adverse events were assessed in most papers with an overall major complication rate of 0.4%. However, there was a lack of construct validity using a histological comparator. Relatively few papers reported details on the technique used, tissue processing, synovitis scoring and blinding for tissue analysis.

CONCLUSION:

USG-SB can be regarded as a valuable tool for large-scale synovial tissue sampling. Standardization of the techniques of USG-SB and tissue processing is needed. Future research should focus on the reliability, responsiveness and feasibility of this procedure in prospective studies.

KEYWORDS:

histology; joint; procedure; synovial biopsy; ultrasound

PMID:
26022188
DOI:
10.1093/rheumatology/kev128
[Indexed for MEDLINE]

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