HISTOMORPHOLOGICAL PATTERNS OF SYNOVIAL LESIONS: A STUDY AT TERTIARY CARE HOSPITAL.

Abstract

Introduction: Synovium is the soft tissue that lines the spaces of diarthrodial joints, tendon sheaths, and bursae derived from the ectoderm consisting of two components, predominantly a cellular layer, and a second layer made up of fibrous and adipose tissues. Chondrocytes being elements of hyaline cartilage secrete degenerative enzymes in inactive forms and enrich the matrix with enzyme inhibitors. Synovial lesions are characterized by the destruction of hyaline cartilage, due to the activation of degenerative enzymes and decreasing the production of their inhibitors. Materials and methods: It’s a retrospective study of 104 synovial biopsies received in 5 years at a tertiary care hospital. Synovial biopsies were obtained mainly by the open method and a few by the arthroscopic method. Lesions were classified into infective, degenerative, inflammatory, benign, tumor, and tumor-like lesions. Results: Out of 104 lesions, ganglion cyst was commonest 45 cases [43.26%] followed by chronic non-specific synovitis was 15 cases [14.42%], baker’s cyst was 11 cases [10.57%], giant tumor cells of tendon sheath was 09[8.65%], few cases such as tubercular synovitis, rheumatoid arthritis, lipoma arborescens was 2 cases each [1.92%], one case each of septic arthritis, synovial cavernous hemangioma, villonodular synovitis were also noted. The most common age group affected was 31-40 years of age [20.19 %]. Males was predominantly affected in our study [50.96%] Conclusion: Many synovial lesions show similar clinical presentation so histopathological classification is useful to identify its subtypes and the study of synovial biopsy is useful in the diagnosis of various joint diseases.