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Synovial biopsy

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

  • Alternative Names
    • Biopsy - synovial membrane

  • How the Test is Performed
    • The test is done in the operating room, usually during an arthroscopy or small incision.

      After anesthesia, an instrument called a trocar is inserted into the joint space. This tool helps push fluid in and out of the area. A biopsy grasper is inserted through the trocar and turned to cut out a tissue segment.

      The tools are removed. A bandage is applied.

  • How to Prepare for the Test
    • Tell your health care provider:

      • If you are pregnant
      • If you ever had a problem with anesthesia
      • If you have any drug allergies
      • If you have bleeding problems
      • What medications you are taking (including any herbal medicines and supplements)
  • How the Test will Feel
    • With 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 general anesthesia, you will not feel the procedure.

  • Why the Test is Performed
    • Synovial biopsy helps diagnose gout and bacterial infections, or rule out other infections. It can be used to diagnose autoimmune disorders like rheumatoid arthritis, or uncommon infections like tuberculosis.

  • Normal Results
    • The synovial membrane structure is normal.

  • What Abnormal Results Mean
  • Risks
    • There is a very slight chance of infection and bleeding. Rarely, there is a chance of the needle striking a nerve or blood vessel.

  • Considerations
    • You will need to keep the wound clean and dry until your doctor or nurse says it is okay to get it wet.

  • References
    • El-Gabalawy HS. Synovial fluid analysis, synovial biopsy, and synovial pathology. In: Firestein GS, Budd RC, Harris ED Jr., et al, eds. Kelley's Textbook of Rheumatology. 8th ed. Philadelphia, PA: Saunders Elsevier; 2008:chap 48.