Utility of arthroscopic guided synovial biopsy in understanding synovial tissue pathology in health and disease states

Mihir Wechalekar, Malcolm Smith

    Research output: Contribution to journalArticlepeer-review

    26 Citations (Scopus)


    The synovium is the soft tissue lining diarthrodial joints, tendon sheaths and bursae and is composed of intimal and subintimal layers. The intimal layer is composed of type A cells (macrophages) and type B cells (fibroblasts); in health, the subintima has few inflammatory cells. The synovium performs several homeostatic functions and is the primary target in several inflammatory arthritides. Inflammatory states are characterised by thickening of the synovial lining, macrophage recruitment and fibroblast proliferation, and an influx of inflammatory cells including lymphocytes, monocytes and plasma cells. Of the various methods employed to perform synovial biopsies arthroscopic techniques are considered the "gold standard", and have an established safety record. Synovial biopsy has been of critical importance in understanding disease pathogenesis and has provided insight into mechanisms of action of targeted therapies by way of direct evidence about events in the synovial tissue in various arthritides. It has been very useful as a research tool for proof of concept studies to assess efficacy and mechanisms of new therapies, provide tissue for in vitro studies, proteomics and microarrays and allow evaluation for biomarkers that may help predict response to therapy and identify new targets for drug development. It also has diagnostic value in the evaluation of neoplastic or granulomatous disease or infection when synovial fluid analysis is noncontributory.

    Original languageEnglish
    Pages (from-to)566-573
    Number of pages8
    JournalWorld Journal of Orthopedics
    Issue number5
    Publication statusPublished - 2014


    • Arthroscopy
    • Inflammatory arthritis
    • Synovial biopsy
    • Synovial pathology
    • Synovium


    Dive into the research topics of 'Utility of arthroscopic guided synovial biopsy in understanding synovial tissue pathology in health and disease states'. Together they form a unique fingerprint.

    Cite this