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Background <p>Synovial-joint abnormalities in children can be caused by different conditions, including autoimmune arthritis, infection, and neoplasm. An ultrasound-guided biopsy targeting the synovial membrane can aid in determining the etiology when the cause is unclear.</p> Objective <p>To determine the diagnostic performance, findings, and outcomes of ultrasound-guided joint biopsy in children.</p> Materials and method <p>This is a retrospective study on patients who underwent ultrasound-guided joint biopsy from May 2000 to December 2024. Patient demographics, clinical information, imaging, procedure details, pathology findings, adverse events, and clinical outcomes were collected and reviewed.</p> Results <p>Thirty-one patients (25 females) with a mean age of 10.2&#xa0;years underwent 34 biopsies. Presenting symptoms were pain (33/34), mobility issues (33/34), and swelling (20/34). Effusion (19/28), joint capsule thickening (24/28), and contrast enhancement (20/28) were the most common MRI findings, while joint capsule thickening (29/29) and effusion (19/29) were the most frequent ultrasound findings. The most common joints biopsied were the hip (16/34), knee (9/34), and ankle (4/34). Core needle biopsy was performed in all cases. The mean number of passes was 4.5 (SD 1.8), obtaining a mean of 4.1 cores (SD 1.9). Biopsy was diagnostic in 20/34 (59% [CI 41–76%]) joints, and only one patient required surgical biopsy. Synovitis was the most common diagnosis (14/34), followed by pigmented villonodular synovitis (2/34). No major adverse events were observed.</p> Conclusion <p>Ultrasound-guided joint biopsy in children has moderate diagnostic performance; however, it can be clinically impactful, even when non-diagnostic, helping in joint disease management, potentially preventing surgery, with low adverse event incidence.</p> Graphical abstract <p></p>

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Ultrasound-guided core needle joint biopsies in children: pathological findings, diagnostic performance, and clinical relevance

  • 期刊论文

  • 发表日期：

    2025年12月6日

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  • Vicente Oliveira,
  • Anthea Girdwood,
  • Paymun Pezeshkpour,
  • Shirley Tse,
  • Michael Temple,
  • Afsaneh Amirabadi,
  • Maria Fernanda Dien Esquivel,
  • Alessandro Gasparetto,
  • Joao Amaral,
  • George Chiramel,
  • Aisling Carroll Downey,
  • Dimitri A. Parra Rojas

摘要

Background

Synovial-joint abnormalities in children can be caused by different conditions, including autoimmune arthritis, infection, and neoplasm. An ultrasound-guided biopsy targeting the synovial membrane can aid in determining the etiology when the cause is unclear.

Objective

To determine the diagnostic performance, findings, and outcomes of ultrasound-guided joint biopsy in children.

Materials and method

This is a retrospective study on patients who underwent ultrasound-guided joint biopsy from May 2000 to December 2024. Patient demographics, clinical information, imaging, procedure details, pathology findings, adverse events, and clinical outcomes were collected and reviewed.

Results

Thirty-one patients (25 females) with a mean age of 10.2 years underwent 34 biopsies. Presenting symptoms were pain (33/34), mobility issues (33/34), and swelling (20/34). Effusion (19/28), joint capsule thickening (24/28), and contrast enhancement (20/28) were the most common MRI findings, while joint capsule thickening (29/29) and effusion (19/29) were the most frequent ultrasound findings. The most common joints biopsied were the hip (16/34), knee (9/34), and ankle (4/34). Core needle biopsy was performed in all cases. The mean number of passes was 4.5 (SD 1.8), obtaining a mean of 4.1 cores (SD 1.9). Biopsy was diagnostic in 20/34 (59% [CI 41–76%]) joints, and only one patient required surgical biopsy. Synovitis was the most common diagnosis (14/34), followed by pigmented villonodular synovitis (2/34). No major adverse events were observed.

Conclusion

Ultrasound-guided joint biopsy in children has moderate diagnostic performance; however, it can be clinically impactful, even when non-diagnostic, helping in joint disease management, potentially preventing surgery, with low adverse event incidence.

Graphical abstract