Publication: Synovial histopathology in common orthopaedic joint conditions assessed with a modified Krenn synovitis score
Authors
Lew Schon ; Zijun Zhang
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Publisher
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Universidad de Murcia, Departamento de Biologia Celular e Histiologia
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DOI
https://doi.org/10.14670/HH-25-016
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info:eu-repo/semantics/article
Description
Abstract
Purpose. Synovial pathology impacts joint
disease progression and clinical outcome. The goal of
this study was to modify Krenn synovitis score for more
accurate and comprehensive evaluation of common
orthopaedic joint conditions.
Methods. A total of 31 synovial samples were
collected during foot and ankle surgery. Synovial
sections were stained with hematoxylin and eosin, and
picrosirius red. Immunohistochemistry for CD3 and α
smooth muscle actin (α-SMA) was performed for
inflammatory infiltration and fibroblast activation.
Synovitis was evaluated with Krenn synovitis score and
a modified Krenn synovitis score (MKSS), where the
original subcategories of inflammatory infiltration and
stromal cellularity were replaced with the density of
CD3+T cells and collagen intensity, respectively.
Results. Of 31 synovial samples, the average Krenn
synovitis score was 1.5±1.3 and MKSS was 1.8±1.2
(p>0.05). The two scores were positively correlated in
assessing synovial pathology (r=0.6; p<0.001). The
dominant subcategory shifted from stromal cellularity
(64%) in Krenn synovitis score to the density of CD3+T
cells (80%) in MKSS. By MKSS classification, but not
Krenn synovitis score, type III collagen intensity and the
ratio of type III over type I collagen increased in the
synovitis group. The density of α-SMA+cells did not
correlate with the intensity of synovial collagen and was
not different between synovitis and non-synovitis
samples.
Conclusion. While maintaining the concept and
basic elements of the Krenn synovitis score, MKSS
incorporated more accurate inflammatory infiltration and
detailed fibrosis. It could provide a more comprehensive
evaluation of synovial pathology in common orthopaedic
joint conditions.
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