Evaluation of different techniques for percutaneous needle biopsy of synovial membrane in the dog

Summary

Four different needles were evaluated for percutaneous needle biopsy (PNB) of the synovial membrane (SM) in six different joints (carpus, tarsus, elbow, shoulder, stifle, hip) from eight dog cadavers. Needle biopsies were retrieved with the Parker-Pearson (PP), a novel modified Parker-Pearson (PPM), the Tru-Cut (TC), and the Franklin-Silverman (FS) needles. The success rate of PNB to produce biopsies, of adequate histological quality, was assessed for each needle type and joint. The joints were subsequently surgically opened and standard open SM biopsies were harvested from an adjacent area. The articular cartilage was inspected and graded for damage caused by PNB sampling. The length of the intact synovial lining cell layer (SLCL) and the histological quality of the needle biopsies were compared to the open surgical biopsies. Success rates for the different needles were 49.2% (PPM), 37.5% (PP), 26.7% (TC), and 1.7% (FS). The highest success rates were achieved in the carpus and stifle; the lowest success rate was found in the hip joint. The intact SLCL from the PNB samples was an average of 3.4 times shorter than that of the surgical biopsies. The proportion of the samples with adequate histological quality was 81% for open surgical biopsies and 62% for PNB samples. The FS was found to produce the highest incidence of articular cartilage damage. The application of PNB for SM sampling is a valuable alternative to the open surgical biopsy in dogs. Modifications of the Parker Pearson needle by Arassy and Schumacher and novel modifications introduced by the authors, offer encouraging results, and merit further clinical and research investigations.

Keywords

Synovial membrane - percutaneous needle biopsy - joint disease - arthritis diagnosis - dog

• References

• 1 Arayssi TK, Schumacher Jr HR. Evaluation of a modified needle for small joint biopsies. J Rheumatol 1998; 25: 876-8.
• 2 Beaule V, Laredo JD, Cywiner C. et al. Synovial membrane: percutaneous biopsy. Radiology 1990; 177: 581-5.
• 3 Bely M, Ratko I, Hodinka L. et al. Clinical and histological evaluation of synovial needle-biopsies in patients suffering from rheumatoid arthritis. I. Relationship between clinical activity and histological pattern. Acta Morphol Hung 1984; 32: 57-65.
• 4 Bely M, Ratko I, Hodinka L. et al. Clinical and histological evaluation of synovial needle-biopsies in rheumatoid arthritis. II. Relationship between local clinical activity and histological pattern. Acta Morphol Hung 1984; 32: 133-42.
• 5 Cauzinille L. Le syndrome polyarthritique des carnivores domestiques. Le point Vétérinaire 2001; 32: 22-9.
• 6 Gallagher PJ, Blake DR, Lever JV. Audit of closed synovial biopsy in the diagnosis of inflammatory joint disease. Scand J Rheumatol 1985; 14: 307-14.
• 7 Galloway RH, Lester SJ. Histopathological evaluation of canine stifle joint synovial membrane collected at the time of repair of cranial cruciate ligament rupture. J Am Anim Hosp Assoc 1995; 31: 289-94.
• 8 Gedikoglu O, Bayliss MT, Ali SY. et al. Biochemical and histological changes in osteoarthritic synovial membrane. Ann Rheum Dis 1986; 45: 289-92.
• 9 Gibson T, Fagg N, Highton J. et al. The diagnostic value of synovial biopsy in patients with arthritis of unknown cause. Br J Rheumatol 1985; 24: 232-41.
• 10 Goldenberg DL, Cohen AS. Synovial membrane histopathology in the differential diagnosis of rheumatoid arthritis, gout, pseudogout, systemic lupus erythematosus, infectious arthritis and degenerative joint disease. Medicine (Baltimore) 1978; 57: 239-52.
• 11 Greisen HA, Summers BA, Lust G. Ultrastructure of the articular cartilage and synovium in the early stages of degenerative joint disease in canine hip joints. Am JVet Res 1982; 43: 1963-71.
• 12 Haraoui B, Pelletier JP, Cloutier JM. et al. Synovial membrane histology and immunopathology in rheumatoid arthritis and osteoarthritis. In vivo effects of antirheumatic drugs. Arthritis Rheum 1991; 34: 153-63.
• 13 Hardy RM, Wallace L J. Arthrocentesis and synovial membrane biopsy. Vet Clin North Am 1974; 4: 449-62.
• 14 Jacobs JC, Phillips PE, Johnston AD. Needle biopsy of the synovium of children. Pediatrics 1976; 57: 696-701.
• 15 Kennedy TD, Plater-Zyberk C, Partridge TA. et al. Morphometric comparison of synovium from patients with osteoarthritis and rheumatoid arthritis. JClin Pathol 1988; 41: 847-52.
• 16 Kennedy TD, Plater-Zyberk C, Partridge TA. et al. Representative sample ofrheumatoid synovium: a morphometric study. J Clin Pathol 1988; 41: 841-6.
• 17 Lindblad S, Hedfors E. Intraarticular variation in synovitis. Local macroscopic and microscopic signs of inflammatory activity are significantly correlated. Arthritis Rheum 1985; 28: 977-86.
• 18 Lipowitz AJ, Wong PL, Stevens JB. Synovial membrane changes after experimental transection of the cranial cruciate ligament in dogs. Am J Vet Res 1985; 46: 1166-70.
• 19 Lukoschek M, Schaffler MB, Burr DB. et al. Synovial membrane and cartilage changes in experimental osteoarthrosis. J Orthop Res 1988; 6: 475-92.
• 20 Lust G, Summers BA. Early, asymptomatic stage of degenerative joint disease in canine hip joints. Am JVet Res 1981; 42: 1849-55.
• 21 Martel-Pelletier J, Pelletier JP, Cloutier JM. et al. Neutral proteases capable of proteoglycan digesting activity in osteoarthritic and normal human articular cartilage. Arthritis Rheum 1984; 27: 305-12.
• 22 Moon MS, Kim I, Kim JM. et al. Synovial biopsy by Franklin--Silverman needle. Clin Orthop 1980; 224-8.
• 23 Myers SL, Brandt KD, Ehlich JW. et al. Synovial inflammation in patients with early osteoarthritis of the knee. J Rheumatol 1990; 17: 1662-9.
• 24 Olsson SE. Degenerative joint disease (osteoarthrosis): a review with special reference to the dog. J Small Anim Pract 1971; 12: 333-42.
• 25 Park YK. The diagnostic value of synovial biopsy by Franklin Silverman needle. J Korea Orthop Assoc 1973; 455-9.
• 26 Parker RH, Pearson CM. A Simplified Synovial Biopsy Needle. Arthritis Rheum 1963; 6: 172-5.
• 27 Pelletier JP, Martel-Pelletier J, Ghandur-Mnaymneh L. et al. Role of synovial membrane inflammation in cartilage matrix breakdown in the Pond-Nuki dog model of osteoarthritis. Arthritis Rheum 1985; 28: 554-61.
• 28 Pelletier JP, Martel-Pelletier J, Howell DS. et al. Collagenase and collagenolytic activity in human osteoarthritic cartilage. Arthritis Rheum 1983; 26: 63-8.
• 29 Polley HF, Bickel WH. Punch Biopsy of Synovial Membrane. Ann Rheum Dis 1951; 10: 277-87.
• 30 Pond MJ, Nuki G. Experimentally-induced osteoarthritis in the dog. Ann Rheum Dis 1973; 32: 387-8.
• 31 Pooya HA, Seguin B, Tucker RL. et al. Magnetic Resonance Imaging in Small Animal Medicine: Clinical Applications. Compendium on continuing Education 2004; 26: 292-301.
• 32 Ralphs S, Beale B. Canine Idiopathic erosive Polyarthritis. Compendium on continuing Education 7-7- 2000; 22: 671-7.
• 33 Revell PA, Mayston V, Lalor P. et al. The synovial membrane in osteoarthritis: a histological study including the characterisation of the cellular infiltrate present in inflammatory osteoarthritis using monoclonal antibodies. Ann Rheum Dis 1988; 47: 300-7.
• 34 Rooney M, Condell D, Quinlan W. et al. Analysis of the histologic variation of synovitis in rheumatoid arthritis. Arthritis Rheum 1988; 31: 956-63.
• 35 Saaibi DL, Schumacher Jr HR. Percutaneous needle biopsy and synovial histology. Baillieres Clin Rheumatol 1996; 10: 535-54.
• 36 Schumacher Jr. HR. The synovial membrane: studies for the 1990s – introduction to papers from the First International Symposium. Semin Arthritis Rheum 1991; 21: 175-8.
• 37 Schumacher Jr. HR, Kulka JP. Needle biopsy of the synovial membrane – experience with the Parker-Pearson technic. N Engl J Med 24-2- 1972; 286: 416-9.
• 38 Smith Jr. GN, Myers SL, Brandt KD. et al. Effect of intraarticular hyaluronan injection in experimental canine osteoarthritis. Arthritis Rheum 1998; 41: 976-85.
• 39 Spreng DE, Schawalder P. Die Osteoarthritis beim Hund. Der praktische Tierarzt 1997; 78: 364-76.
• 40 Sterba G, Meisel A. The needle: auseful technique for evaluating inflamed joints. Geriatrics 1981; 36: 113-26.
• 41 Trostel CT, McLaughlin RM, Pool RR. Canine Lameness Caused by Developemental Orthopedic Diseases: Osteochondrosis. Compendium on continuing Education 2002; 24: 836-54.
• 42 Trostel CT, Pool RR, McLaughlin RM. Canine Lameness Caused by Developmental Orthopedic Diseases: Panosteitis, Legg-Calve-Perthes Disease, and Hypertrophic Osteodystrophy. Compendium on continuing Education 2003; 25: 282-92.
• 43 van Vugt RM, van Dalen A, Bijlsma JW. Ultrasound guided synovial biopsy of the wrist. Scand J Rheumatol 1997; 26: 212-4.
• 44 Waxman BA, Sledge CB. Correlation of histo-chemical, histologic and biochemical evaluations of human synovium with clinical activity. Arthritis Rheum 1973; 16: 376-82.
• 45 Wilkinson M, Jones BS. Evaluation of needle biopsy of synovial membrane. Ann Rheum Dis 1963; 22: 100-5.
• 46 Williams P, Gumpel M. Percutaneous needle synovial biopsy of the knee. BrJHospMed 1983; 30 34, 39-40 42-3.
• 47 Youssef PP, Kraan M, Breedveld F. et al. Quantitative microscopic analysis of inflammation in rheumatoid arthritis synovial membrane samples selected at arthroscopy compared with samples obtained blindly by needle biopsy. Arthritis Rheum 1998; 41: 663-9.
• 48 Zuckner J, Uddin J. Polley-Bickel needle broken during biopsy. JAMA 1968; 206: 133-4.