A tissue sample from the synovial membrane—a thin layer of tissue that lines most of the body’s joints—is extracted with a needle from a diseased joint and sent to a laboratory for microscopic examination. Joint biopsy can be performed on any major joint, such as the knee, shoulder, elbow, hip, ankle, or wrist. It is typically done only when the results of less invasive tests, such as arthrocentesis, are abnormal or inconclusive.
Purpose of the Joint Biopsy
- To aid in the diagnosis of disorders that damage the joints, such as joint infection, osteoarthritis, rheumatoid arthritis, systemic lupus erythematosus, and gout
- To monitor the progression of certain joint disorders
Who Performs Joint Biopsy
- A physician
Special Concerns about Joint Biopsy
- This procedure must be performed with caution in people with a bleeding disorder.
Before the Joint Biopsy
- Tell your doctor if you regularly take anticoagulants or nonsteroidal anti-inflammatory drugs (such as aspirin, ibuprofen, or naproxen). You will be instructed to discontinue them for some time before the test.
- A blood sample will be obtained and coagulation studies will be performed to ensure you are a proper candidate for this test.
- Before the procedure begins, your doctor may administer a sedative injection.
- Tell your doctor if you are pregnant or may be pregnant.
- Tell your doctor if you have any drug allergies or sensitivities.
- Tell your doctor if you have bleeding problems or a bleeding disorder.
- Tell your doctor about any medications you are currently taking, including over-the-counter medications, herbal medicines and supplements.
What You Experience during Joint Biopsy
- You are asked to remove any clothing covering the joint to be biopsied.
- The skin at the biopsy site is shaved and cleansed with an antiseptic, and a local anesthetic is injected to numb the area (you may still feel a brief pain as the biopsy needle is inserted).
- A trocar (sharp, tubelike instrument) is inserted into the joint space, and the biopsy needle is inserted through the trocar and into the joint.
- The needle is twisted to cut off a small piece of the synovial membrane. Several samples may be taken.
- The needle and trocar are withdrawn. Pressure is placed on the injection site until bleeding has stopped, and a small bandage is applied.
- The procedure usually takes 30 minutes.