Minimally invasive, ultrasound-guided synovial tissue biopsies are well-tolerated, safe and feasible in children and young people with inflammatory arthritis
Year: 2026
Type: article
Study design: Observational Study
Abstract: Objective To evaluate feasibility, tolerability and acceptability of performing minimally invasive synovial tissue biopsies for the purpose of research in children and young people diagnosed with inflammatory arthritis.Methods Synovial tissue biopsies were obtained from the joints of children with arthritis undergoing intra-articular procedures performed under general anaesthetic, and embedded within routine clinical care pathways. Questionnaires pertaining to the tolerability of the procedure were completed. Tissue samples were processed for histological assessment of tissue quality and graded for synovitis.Results Synovial tissue biopsies were obtained from 62 children, aged between 1 and 17 years of age (median 7.1 years). While most children had a single joint biopsied, seven procedures involved biopsy of two different joints. At baseline, 65 knees, two ankles and two wrist joints were biopsied; seven children underwent repeat knee biopsies later in their disease. Almost 63% of biopsies (n=39/62 participants) were performed in children with oligoarticular juvenile idiopathic arthritis (JIA). Postprocedure questionnaires revealed a majority of families (80%, n=32/40) would be ‘very likely’ or ‘somewhat likely’ to consent to a repeat biopsy in the future. Histological assessment of tissue using an adapted Krenn synovitis score confirmed differences between oligoarticular and polyarticular JIA. No serious adverse events were reported.Conclusions Ultrasound-guided synovial tissue biopsies in children undergoing intra-articular procedures under general anaesthetic are feasible, safe and well-tolerated, and can be embedded within routine clinical care pathways for the procurement of tissue samples for the purpose of research.
Source: RMD Open
Authors: Elizabeth Clay, Chrissy Bolton, Annie Hackland, Charlotte G Smith, Klaudia Kupiec, James Kelly, Samantha Chippington, Zishan Sheikh, Charlene Foley, Patricia Reis Nisa, Søren Lomholt, Vicky Alexiou, Inga Turtsevich, Chadwick Pils, Sugrah Sultan, Neelam Khan, Manigandan Thyagarajan, Georgiana Neag, Christopher B Mahony, Holly R Adams, Catherine Cotter, Miriam Sadler, Huong Nguyen, Ece Beren Barklam, Luke J Jones, Paulynn Suyin Chin, Samuel Kemble, Lucy-Jayne Marsh, Penny Davis, Sunit Davda, Sandrine Compeyrot-Lacassagne, Fahim Patel, Elizabeth C Rosser, Megan M Hanlon, Will Coles, Edward Dicarlo, Ellen Gravallese, Andrew Filer, Eslam Al-Abadi, Lucy R Wedderburn, Adam P Croft
Institutions: University of Birmingham, Great Ormond Street Hospital, National Institute for Health and Care Research, University of Oxford, NIHR Great Ormond Street Hospital Biomedical Research Centre, Kennedy Institute of Rheumatology, University College London, National Health Service, Birmingham Women’s and Children’s NHS Foundation Trust, Aarhus University, Aarhus University Hospital, Brigham and Women's Hospital, Harvard University, Hospital for Special Surgery, NIHR Birmingham Biomedical Research Centre
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,391
Funders: Kennedy Trust for Rheumatology Research, National Institute for Health and Care Research, Daphne Jackson Trust, Lister Institute of Preventive Medicine, Great Ormond Street Hospital Charity, Versus Arthritis, Medical Research Council, Birmingham Biomedical Research Centre, NIHR Great Ormond Street Hospital Biomedical Research Centre
Awards: MICA: Childhood arthritis and its associated uveitis: stratification through endotypes and mechanism to deliver benefit; the CLUSTER Consortium., Centre for Adolescent Rheumatology Arthritis UK, Tissue research in childhood inflammatory arthritis (TRICIA consortium), G2563124601, G3493488282, G422857292, G4473217277, G4604040521, G4759873582, G5340677143, G6724204608, G8174179517, G8567969740
OpenAlex ID: W7221746603