Synovial histopathology in common   orthopaedic joint conditions assessed   with a modified Krenn synovitis score

Lew Schon; Zijun Zhang

Publication:
Synovial histopathology in common orthopaedic joint conditions assessed with a modified Krenn synovitis score

dc.contributor.author	Lew Schon
dc.contributor.author	Zijun Zhang
dc.contributor.department	Biología Celular e Histología
dc.contributor.editor	Universidad de Murcia, Departamento de Biologia Celular e Histiologia
dc.date.accessioned	2026-05-20T11:07:07Z
dc.date.available	2026-05-20T11:07:07Z
dc.date.issued	2026
dc.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.
dc.format	application/pdf
dc.format.extent	8
dc.identifier.doi	https://doi.org/10.14670/HH-25-016
dc.identifier.eissn	1699-5848
dc.identifier.issn	0213-3911
dc.identifier.uri	http://hdl.handle.net/10201/233462
dc.language	eng
dc.relation	Sin financiación externa a la Universidad
dc.rights	Attribution-NonCommercial-NoDerivatives 4.0 International	*
dc.rights.accessRights	info:eu-repo/semantics/openAccess
dc.rights.uri	http://creativecommons.org/licenses/by-nc-nd/4.0/	*
dc.subject	Fibrosis
dc.subject	Synovium
dc.subject	Joint
dc.subject	Score
dc.subject	Synovitis
dc.subject.ods	No relacionado con ningún objetivo de desarrollo sostenible
dc.title	Synovial histopathology in common orthopaedic joint conditions assessed with a modified Krenn synovitis score
dc.type	info:eu-repo/semantics/article
dspace.entity.type	Publication