<p><strong>Background:</strong> Arthritis is an important cause of morbidity, presenting as monoarticular or polyarticular lesion. Percutaneous synovial aspiration and biopsy can help in identifying specific aetiological diagnosis. The study was conducted with the objective to evaluate the efficacy of percutaneous synovial biopsy as a diagnostic aid and study the characteristics of synovial fluid in various joint diseases.</p><p><strong>Methods:</strong> Percutaneous synovial biopsy along with synovial fluid analysis was studied in all the 100 enrolled cases arthritis. The fluid was subjected to physical, biochemical, and cytological analysis.</p><p><strong>Results:</strong> Of the 100 cases, monoarticular joint involvement predominated over polyarticular (n = 80; 80%), knee joint (60%) was most commonly affected in monoarticular and polyarticular arthrthritis. Rheumatoid arthritis (RA) (n=33; 33%)is the most common aetiology followed by tuberculosis (n=22). Males predominated over females in this study (n = 61; 61%).</p><p><strong>Conclusion:</strong> The evaluation of synovial fluid and synovial biopsy in joint diseases will stimulate its use as routine investigative procedure in the diagnosis of various puzzling joint disorders. Both these procedures can be done simultaneously trough the same site of aspiration by the same needle.</p>
<p><strong>Background: </strong>Lateral epicondylitis is seen more commonly in non-athletes than athletes. Non-operative methods are the mainstay of treatment being effective in more than 95% of cases. Platelet rich plasma (PRP) has shown promising results in many studies as compared to steroid injection & other modes of conservative management. Hence, this study was done to evaluate PRP efficacy in our clinical setup and in the people of age group most commonly being affected.<strong></strong></p><p><strong>Methods: </strong>This randomized study was conducted at Narayana Medical College Hospital, Nellore, for a period of two years from December 2014 to June 2016 on 150 consenting patients diagnosed as suffering from lateral epicondylitis. Using lottery method for randomization the patients were divided into three groups, based on which the treatment was received. Group –N with 50 patients received 3 ml of normal saline as placebo. Group –P with 50 patients received 3 ml of extracted PRP injection. Group –S with 50 patients received depot preparation of 40 mg of methyl prednisiolone injected into the affected area. The data collected and recorded in the appropriate proforma. Post therapy assessment was done using with Oxford elbow score.</p><p><strong>Results: </strong>The overall mean ages of the patients in the three groups (Group P, Group S and Group N) are 38.62±7.53, 37.82±7.79 and 36.3±6.93 respectively. Female preponderance was observed in all the groups. Most common presenting complaint was elbow pain seen in 100% of cases. Most common side involved was the dominant side, right side involvement was seen in 136 cases and left side in 14 cases. The Oxford elbow score pre-treatment in all the groups was not statistically significant and the Oxford elbow score at the end of 12 weeks and 24 weeks treatment showed that PRP and steroid was better than normal saline in control of pain.<strong></strong></p><p><strong>Conclusion: </strong>Lateral epicondylitis or tennis elbow is a painful debilitating condition of elbow, which creates disturbance in functional activities. A single injection of PRP at the site of the elbow pain resulted in relief of pain in patients with longer duration as compared to local steroids to other conservative treatments.</p>
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