Clinical and histological evaluation of synovial needle-biopsies in patients suffering from rheumatoid arthritis. I. Relationship between clinical activity and histological pattern.

In 50 patients suffering for 1-15 years from rheumatoid arthritis, needle-biopsy of the synovial membrane was carried out. The finding correlated with the general clinical activity of the disease. Each type of histological change was evaluated with regard to its diagnostic value in assessing clinical activity. Among the histological changes, oedema, synovial cell proliferation, lymphocyte-plasma cell proliferation and necrotic vasculitis showed a negative correlation with clinical activity, while a positive correlation was observed between clinical activity and the presence of fibrin (fresh and old), fibrinoid, fibrinoid basophilia, fibroblast proliferation, synovial cell desquamation, concentric perivascular sclerosis, fibrosis and hyalinosis. Vascular changes of the synovial membrane such as oedema, fresh fibrin exudate, necrotic vasculitis showed a negative correlation with clinical activity while hyalinization and concentric sclerosis and clinical activity were found to be in positive correlation. It is concluded that in the course of rheumatoid arthritis the histological changes do not necessarily run parallel with the clinical activity of the disease.