Synovial biopsies

Abstract

Synovial tissue is the primary tissue inflamed in rheumatoid arthritis. Initial studies of synovial biopsies were obtained during arthroplasty or using a needle to biopsy the joint percutaneously. Recently, small needle arthroscopy or ultrasonography guided techniques have become more widely available to visualize and reliably obtain synovial biopsies. These techniques have allowed significant progress in the study of rheumatoid arthritis pathogenesis, even at the earliest stages of disease. Currently, research efforts are underway to use synovial biopsies to identify patients and to discover biomarkers that will enable clinicians to predict the course of the disease and perhaps to identify more appropriately the correct therapy for patients with rheumatoid arthritis. In this chapter, we describe the advances in synovial tissue biopsy research and how it has improved our knowledge of rheumatoid arthritis pathogenesis, informed our understanding of possible biomarkers for diagnosis and stratification, and potentially may aid in the prediction of disease outcome and response to treatment.