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; Rheumatoid arthritis - synovial biopsy; Gout - synovial biopsy; Joint infection - synovial biopsy; Synovitis - synovial biopsy

How the Test is Performed

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.

During this procedure:

If you are having an arthroscopic procedure:

If you are having a needle biopsy:

How to Prepare for the Test

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.

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 such as rheumatoid arthritis, or uncommon infections like tuberculosis or fungal infections.

Normal Results

The synovial membrane structure is normal.

What Abnormal Results Mean

Synovial biopsy may identify the following conditions:

Risks

There is a very slight chance of infection and bleeding.

Considerations

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

References

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. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 56.

Johnsson H, Najm A. Synovial biopsies in clinical practice and research: current developments and perspectives. Clinical Rheumatology. 2021;40(7):2593-2600. PMID: 33274415 pubmed.ncbi.nlm.nih.gov/33274415/.

West SG. Synovial biopsies. In: West SG, Kolfenbach J, eds. Rheumatology Secrets. 4th ed. Philadelphia, PA: Elsevier; 2020:chap 9.



Review Date: 7/21/2022
Reviewed By: Diane M. Horowitz, MD, Rheumatology and Internal Medicine, Northwell Health, Great Neck, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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