Experience of One Medical Center in the United States With Ultrasound-guided Synovial Biopsies in the Assessment of Inflammatory Arthritis

Abstract Objective Ultrasound-guided synovial biopsy (USGSB) is a simple, rapid procedure that is well-tolerated by patients and successfully collects samples of synovial tissue from both small and large joints. This retrospective analysis of 25 clinical cases examines its utility in the assessment of inflammatory arthritis.Methods USGSB can be performed as an outpatient procedure using a local anesthetic and a biopsy needle of appropriate gauge (range 14–18 gauge, depending on the size of the joint) introduced under direct ultrasound guidance.Results This procedure provides assessment of synovial thickness in grayscale and synovial vascularity with Doppler signal for biopsy site selection with an estimated 80% success rate. The histological findings of subsequent arthroscopic or surgical synovial biopsies were congruent with those of US-guided synovial biopsies, showing comparable results in large, medium, and small joints.Conclusion In recent years, ultrasound procedures have been increasingly used in routine rheumatology outpatient practice. Given its clinical feasibility, the low rate of complications or adverse events, and its diagnostic value and impact on treatment decisions, USGSB should be a more widely applied practice in the United States.