Histodiagnosis and Clinical Correlation of Rheumatoid and Other Synovitis

Abstract

This short monograph concerns itself with the synovial tissues. Once regarded merely as the lining of the joint capsule, this tissue is now seen as an active one, most effectively eliminating or avoiding infection, participating in the immune defenses, and reacting in various as yet unexplained ways to local and remote injury. Hyperemia and increased vascularity often precede other changes, and enhanced permeability can be detected (perhaps mediated by collagenase specific to the sealing collagen). Chemotaxis brings leukocytes and lymphocytes into the perivascular tissues, which include synovia (the joint fluid or liquor synovialis). In chronic immunogenic inflammation, a greater contribution of lymphocytes and derivative plasmacytes is seen. This book focuses on the progressive changes in subacute and chronic inflammation, the elaboration of collagen and maturation of fibroblasts to fibrocytes, the continued increase in the numbers of synovial cells, and the conversion of fibrin clumps to form the nidus of villi.