CLINICAL EVALUATION OF KNEE JOINT DISEASES BY SYNOVIAL FLUID ANALYSIS AND SYNOVIAL BIOPSY

This prospective research assessed synovial fluid analysis and synovial biopsy in 50 individuals with knee joint oedema to facilitate the identification of several arthropathies. Patients aged 27 to 70 years had thorough evaluations, including morphological, microscopic, microbiological, and biochemical studies of synovial fluid, supplemented by radiographic imaging and, in certain instances, synovial biopsies. The prevalence of knee joint illnesses indicated that osteoarthritis (OA), rheumatoid arthritis (RA), and inflammatory arthritis-NOS each represented 18% of cases, whereas noninflammatory arthritis-NOS constituted 16%, and traumatic arthritis was noted in 10%. Septic arthritis, tuberculous arthritis, and pigmented villonodular synovitis (PVNS) occurred in 4% of cases each, while gout was present in 2% and non-diagnostic aspirates were observed in 6% of cases. The properties of synovial fluid differed throughout the situations. Osteoarthritis (OA) often presented with transparent fluid of normal viscosity and low leukocyte counts, aligning with degenerative joint alterations, but rheumatoid arthritis (RA) patients primarily displayed opaque, low-viscosity fluid with significantly higher leukocyte counts and fragile mucin clots, signifying severe inflammation. The radiographic findings corroborated these diagnoses, with osteoarthritis exhibiting characteristics such as sclerosis, subchondral cysts, and joint space constriction, whereas rheumatoid arthritis revealed deformities and decreased lateral joint space. Findings from the synovial biopsy, such as synovial hyperplasia, lymphoid follicles, and granulomatous inflammation, provide further diagnostic validation. The study emphasises that synovial fluid analysis, in conjunction with imaging and histological assessment, is crucial for distinguishing knee joint disorders and informing suitable therapeutic therapy. Limitations encompass the limited sample size, variability of underlying diseases, and sporadic non-diagnostic samples. Implement extensive, multicenter randomised controlled studies to corroborate these results. Investigate the adjustment of dosages for buprenorphine and fentanyl to achieve a balance between effectiveness and adverse effects. Assess patient satisfaction, opioid-associated adverse effects, and long-term recovery results in subsequent studies.