title: Computer-assisted validation of the synovitis score.
abstract: Histopathological examination of synovial specimens can contribute to the diagnosis of chronic joint diseases. A so-called synovitis score has been introduced as a standardised grading system, based on the semi-quantitative evaluation of the three determining features of chronic synovitis: enlargement of synovial lining, density of synovial stroma and inflammatory infiltrate, giving a score between 0 and 9. The present study examines the reliability of this procedure by comparison with exact measurements using computer-assisted image analysis (CAIA). Seventy-one synovial specimens from patients with osteoarthritis (OA, n=22), psoriatic arthritis (PsA, n=7), rheumatoid arthritis (RA, n=35) and from a control group (Co, n=7) were evaluated using both the synovitis score and CAIA. The measurements were transformed to semi-quantitative values analogous to the synovitis score. The differences between the transformed CAIA scores and the pathologist's scores were 0 or +/-1 in 40 cases, whereas in 31 cases the difference was greater than 1 (correlation coefficient r=0.725). The CAIA scores differed significantly between Co and RA cases (p=0.000) as well as between OA and RA (p=0.000). We conclude that the synovitis score was validated by CAIA and can be regarded a reliable grading system that contributes to the diagnostic procedure of chronic joint inflammation.
authors.affiliation: Institute of Pathology, Charité University Hospital, Charitéplatz 1, 10117 Berlin, Germany. lars.morawietz@charite.de
authors.forename: Lars
authors.initials: L
authors.lastname: Morawietz
authors.forename: Frank
authors.initials: F
authors.lastname: Schaeper
authors.forename: Joerg H
authors.initials: JH
authors.lastname: Schroeder
authors.forename: Tserenchunt
authors.initials: T
authors.lastname: Gansukh
authors.forename: Nachin
authors.initials: N
authors.lastname: Baasanjav
authors.forename: Manfred G
authors.initials: MG
authors.lastname: Krukemeyer
authors.forename: Thorsten
authors.initials: T
authors.lastname: Gehrke
authors.forename: Veit
authors.initials: V
authors.lastname: Krenn
mesh_terms: D015535:Arthritis, Psoriatic / Q000473:pathology; D001172:Arthritis, Rheumatoid / Q000473:pathology; D002908:Chronic Disease; D006801:Humans; D007091:Image Processing, Computer-Assisted; D015588:Observer Variation; D010003:Osteoarthritis / Q000473:pathology; D010338:Pathology, Clinical / Q000379:methods*; D013583:Synovial Membrane / Q000473:pathology*; D013585:Synovitis / Q000145:classification / Q000473:pathology*