title: Medical arthroscopy--emerging era of rheumatological intervention.
abstract: OBJECTIVE
  To evaluate the safety and diagnostic value of arthroscopy performed by a rheumatologist.
  
  
  METHODS
  Decisions for performing arthroscopy were taken when detailed clinical history-and relevant rheumatological investigations failed to arrive at a definite diagnosis. Arthroscopies were performed under local anesthesia as a daycare procedure. Synovial biopsies taken during procedures were subjected to histopathological examination (HPE).
  
  
  RESULTS
  Of the 50 patients enrolled, 39 were males while 11 were females with mean age of 35.5 years. In lower limb oligoarthritis group of patients, three had macroscopic picture of crystal arthropathy, rest of the 29 patients revealed gross picture indicative of non-specific synovitis. While in polyarticular group of eight patients, three had macroscopic picture suggestive of crystal arthropathy (probably polyarticlar gout) while five were indicative of rheumatoid arthritis. In monoarticular disease pattern (n= 10) macroscopic picture findings were as follows- crystal arthropathy-two, tubercular-three, synovial chondromatosis-one and non-specific synovitis-two. HPE of synovium did not correlate in many cases.
  
  
  CONCLUSIONS
  Arthroscopy using a 4 mm scope under local anesthesia in the hands of rheumatologists is a safe daycare procedure. In few cases arthroscopy helped in arriving at a final diagnosis but many patients remained undiagnosed. Both the rheumatologists and the pathologists require further experience in this field.
authors.affiliation: Army Hospital (Research and Referral), Delhi Cantt.
authors.forename: V
authors.initials: V
authors.lastname: Chaturvedi
authors.forename: G S
authors.initials: GS
authors.lastname: Chopra
authors.forename: V
authors.initials: V
authors.lastname: Dutta
authors.forename: V K
authors.initials: VK
authors.lastname: Singal
authors.forename: M L
authors.initials: ML
authors.lastname: Chawla
authors.forename: R
authors.initials: R
authors.lastname: Rai
authors.forename: J R
authors.initials: JR
authors.lastname: Bharadwaj
authors.forename: A K
authors.initials: AK
authors.lastname: Lahiri
authors.forename: B N
authors.initials: BN
authors.lastname: Shahi
mesh_terms: D000328:Adult; D000556:Ambulatory Surgical Procedures / Q000592:standards; D001182:Arthroscopy / Q000379:methods* / Q000592:standards; D001706:Biopsy / Q000379:methods; D003657:Decision Making; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012216:Rheumatic Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery*; D012219:Rheumatology / Q000379:methods / Q000639:trends*; D012449:Safety; D013583:Synovial Membrane / Q000473:pathology*