The Diagnosis and Course of Rheumatoid Arthritis and Benign Aseptic Arthritis in Children1

Hellström, B.

doi:10.1111/j.1651-2227.1961.tb08210.x

Cited by 16 publications

(2 citation statements)

References 19 publications

(6 reference statements)

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“…Difficulty in diagnosis often leads to indiscriminate use of steroidal and non-steroidal anti-inflammatory drugs for empirical treatment and symptom control. Whereas the utility of synovial biopsy in patients with polyarticular synovitis is questionable, patients with chronic monoarticular synovitis need histopathological examination for definite diagnosis [8][9][10]. Conventional laboratory studies and synovial fluid examination are a useful adjunct but not definitive for diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Monoarticular synovitis of knee: dealing with the dilemma

Goyal

Paul

Choudhury

et al. 2020

SICOT-J

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Introduction: Chronic synovitis involving a single large joint remains a diagnostic dilemma. We present 61 cases of chronic synovitis of the knee, followed prospectively for 2 years. The study focuses on the diagnosis, management, and histopathological correlation. Methods: We prospectively studied 61 patients with chronic mono-articular synovitis of the knee joint, between July 2016 and September 2017. All patients underwent plain radiographs, magnetic resonance imaging, and arthroscopic examination with synovial biopsy. Further treatment was based on findings of histopathological examination. Results: The average duration of symptoms was 7.72 ± 4.34 months. The mean age at presentation was 29.93 ± 15.56 years. Results of histopathological examination showed chronic nonspecific inflammation in 28 patients (46%), features suggesting tubercular infection in 19 patients (31%), pigmented villonodular synovitis in seven patients (11.5%), rheumatoid arthritis in three (5%) patients, acute inflammation in three (5%) patients and findings suggestive of synovial chondromatosis in one (1.5%) patient. Treatment was based on histopathological results. Intra-articular injections of methylprednisolone (80 mg depot preparation) were given to all patients with nonspecific synovitis and rheumatoid arthritis. Anti-tubercular treatment was started for patients with tubercular synovitis. Complete arthroscopic/open synovectomy followed by radiotherapy was carried out for patients with pigmented villonodular synovitis. Non-steroidal anti-inflammatory drugs are used for patients with acute on chronic inflammation. All patients had symptomatic relief and functional improvement in further follow-up. Discussion: Histopathological reporting remains the mainstay for diagnosis. The various differentials should always be kept in mind when approaching patients with chronic mono-articular synovitis. Specific treatment can be started once the diagnosis is confirmed.

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Section: Discussionmentioning

confidence: 99%

Monoarticular synovitis of knee: dealing with the dilemma

Goyal

Paul

Choudhury

et al. 2020

SICOT-J

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“…The commonest type of adult monarthritis, however, appears to be a nonspecific synovitis of indeterminate cause or causes comprising 49 cases (32 %). This condition was recognized and regarded as an entity in children by Hellstrom (1961). Differentiation from synovitis associated with osteoarthrosis, especially if mild, may be impossible and the part played by other factors, such as trauma or possible virus infection, difficult to determine-sedimentation rate is usually low or only moderately raised, rheumatoid serology negative, and histology shows a mild nonspecific synovitis.…”

Section: Prognosismentioning

confidence: 99%