Synovial biopsy: purpose, procedure and results

What is a synovial biopsy?

Each joint in the human body contains synovial fluid. The synovial membrane secretes this fluid in the joint cavity. Lubricates joints and allows ease of movement. The synovial membrane is also the main place where inflammation occurs in joint diseases such as arthritis.

Your doctor may recommend that you perform a synovial biopsy if you can not give a diagnosis based on routine measures. They may also order a biopsy if they think you might have a synovial infection. The synovial biopsy process is becoming more common when research is done on arthritis and joints.

A synovial biopsy is also known as "a biopsy of the synovial membrane that lines the joint." This is because the process is actually to extract a piece of this membrane to examine it.

Why do I need a synovial biopsy?

Your doctor may need to perform a synovial biopsy after you have completed more routine exams, such as a physical exam. Your doctor may also perform the biopsy when you suspect that you may have an infection or gout.

Biopsy can also help diagnose other causes of joint inflammation, such as autoimmune diseases. A synovial biopsy can also be useful if a doctor suspects a metabolic disease, such as hemochromatosis, which involves iron deposition or cancer.

What happens during a synovial biopsy?

A synovial biopsy is an uncomfortable test, but with adequate local anesthesia, the pain is tolerable. You will feel a prick and a burning sensation when you receive local anesthesia to numb the area. You may feel some discomfort when your doctor removes the tissue. You may also experience some discomfort after the procedure. Your discomfort will vary depending on whether you had a closed needle procedure or an arthroscopy.

Tell your doctor before the test if you are pregnant, if you have bleeding problems or if you have allergies to medications. Also, list any medications or supplements you are currently taking.

Closed needle process

You can undergo the synovial biopsy process in your doctor's office. This is known as a closed needle process. This process does not require any incision. It is a safe and effective way to collect tissue samples.

Your doctor will inject local anesthesia on the site to limit pain and discomfort. Then, your doctor will insert an instrument called a trocar into the joint. A trocar is an instrument that is a little larger than a needle. It is normally used for aspiration and to clear fluid space. Then, your doctor will pass a tissue grab through the trocar to cut a sample from the synovial membrane.


As an alternative to a biopsy performed in your doctor's office, your doctor can perform the procedure through an arthroscopy. Arthroscopy is a surgery that is a common method used to diagnose and treat joint disorders.

The main difference between arthroscopy and a closed need procedure is that your surgeon will insert a small camera and a light source into the joint through a small incision. This allows the surgeon to see inside the joint. Another small incision allows the surgeon to insert tools to eliminate any of the following:

  • tissue

  • cartilage

  • fluid

  • bone

Arthroscopy is more complicated and expensive than a closed needle procedure. However, it allows the surgeon to obtain a larger tissue sample and see directly into the joint.

After the procedure, apply ice to the joint to reduce pain and swelling. You can start light physical activity several days after the procedure. Limit your physical activity to light activities such as walking.

What are the risks of a synovial biopsy?

Synovial biopsy is generally a safe procedure. Although it is rare, the main risks include:

  • An allergic reaction to medication or anesthesia.

  • difficult breathing

  • bleeding in the joint

  • a blood clot

  • Damage to the cartilage or ligaments of the joint.

  • an infection in the joint

  • an injury to a blood vessel or nerve

  • rigidity

  • pain

What do the results of the test mean?

An abnormal result of the test could indicate:

  • a fungal infection

  • drop

  • An abnormal accumulation of iron deposits in the joint.

  • tuberculosis

  • synovial cancer

  • Autoimmune diseases

  • Rheumatoid arthritis

Your doctor will review and discuss with you the results of your synovial biopsy. If you have abnormal results, you may need more tests to diagnose your condition.

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