Evaluation of Mast Cells in the Synovium and the Synovial Fluid in Knee Pathologies

Abstract

Purpose: Mast cells (MC) which are mediators in inflammatory reactions, increase significantly in the synovium and the synovial fluid in various pathologies. To evaluate its value in the differential diagnosis of diagnostically difficult cases, quantitative changes of MC in the synovium and the synovial fluid were studied in inflammatory, degenerative and traumatic processes of the knee joint. Material: Synovium and synovial fluid samples were obtained from 32 patients during arthroscopic or open procedures. Basic ethiological factor for the pathology in the knee joint was traumatic in 15 inflammatory in 9, and degenerative in 6 cases.
Method: Samples were stained with toluidine blue after the fixation procedure and MC were counted in ten different areas under light microscopy.
Results: Average MC number in the synovium was 34 (1-108), while it was 71 (5-196) in the synovial fluid. No correlation was found between the MC number of two types of samples. Also no significant difference was found among the pathologic groups. However, a statistically significant increase both in the synovium and the synovial fluid was found when the pathology in the kneejoint was in the acute/active phase of any disease regardless the basic pathology.
Conclusion: In conclusion, quantitative analysis of MC in the synovium and the synovial fiuid does not contribute to the differential diagnosis in chronic knee pathologies, but, can be a good indicator of disease acfivity.