Minimally Invasive Ultrasound-guided Synovial Biopsy Using SuperCore Biopsy Instrument

BackgroundTo develop a new method for synovial biopsy with ultrasound (US) guidance and a semiautomatic SuperCore biopsy instrument.Patients and methodsTwenty-two patients [8 men and 14 women, median age: 57 years (range: 22–79 years)] with active arthritis or tenosynovitis were enrolled from April 2012 to October 2012. Each patient had one joint or tendon biopsied. US examination was performed to determine the optimal synovial site for biopsy. After skin disinfection and local anesthesia, a portal was established using a trephine needle as needed. An 18-gauge SuperCore biopsy needle was placed into the target synovial site via the portal or just percutaneously under US guidance using the freehand technique. Repeated needle passes and cuts were made to obtain 3-10 pieces of synovial tissues in each joint. The success of biopsy was defined as the identification of the synovium on histological examination.ResultsThe synovium of 21 joints (10 knees, 6 wrists, 3 ankles, 1 elbow, and 1 metacarpophalangeal joint) were biopsied. One patient had biopsy of the flexor digitorum tendon sheath. All biopsies obtained adequate amounts of synovial tissues for histologic reading with a success rate of 100%. The synovial lining was identified in 18 (85.7%) of 21 joints. All patients tolerated the procedures well, and no complication was observed during the 2-week follow-up period.ConclusionUS-guided synovial biopsy using SuperCore biopsy instrument is a promising method for synovial research. It has the advantages of being a simple method with mini-invasiveness and high success rate. The complications are rare.