Location
Philadelphia, PA
Start Date
30-4-2025 1:00 PM
End Date
30-4-2025 4:00 PM
Description
Purpose: Synovial fluid biomarker analysis is a developing modality for subcategorizing arthritis type. We examined radiographic evidence of chondrocalcinosis and osteoarthritis severity in relation to their respective biomarker levels or detection on the Synovasure® RISC panel.
Methods and Study Design: This is a monocentric, cross-sectional, non-controlled, and non-randomized, case series study. Patients with a knee effusion and planned arthrocentesis were included. 800 synovial fluid samples were obtained from consenting eligible patients as part of standard of care and sent via Synovasure specimen kits for analysis. Samples were further categorized based on biomarker results.
Results: A total of 800 synovial fluid samples were analyzed. Crystals were found to be present in 166 (N= 20.8%) of samples. Isolated crystals included calcium pyrophosphate (N=148; 18.5%) and monosodium urate (N= 17; 2.13%), with one sample screening positive for both (N=1; 0.13%). The mean Cartilage Oligomeric Matrix Protein (COMP)/Interleukin-8 (IL-8) ratio was 30.6 (SD = 26). 305 subjects (38.3%) had a Kellgren-Lawrence (KL) grade of 4 representing a plurality for the total cohort. The COMP/IL-8 ratio was found to increase with ascending KL-grade (p-value < 0.001). Chondrocalcinosis was found on radiographic review in 144 subjects (18.1%), 100 samples (60.2%) of which were noted also to be positive for intracellular and/or extracellular crystals (p-value < 0.001). A subset of the cohort (N=210) was analyzed for comorbid history of gout, with 29 (13.8%) being identified via retrospective chart review. Among the subjects with crystal positivity, 24 (14.5%) also had comorbid gout (p=0.766).
Conclusions: This study demonstrates statistically significant findings with respect to the presence of radiographic chondrocalcinosis and crystal detection positivity rates via synovial fluid analysis. It also demonstrates a significant correlation between arthritis severity, as qualified by radiographic KL grade, and the ratio of COMP to IL-8. Calcium pyrophosphate crystals were predominant in subjects with radiographic chondrocalcinosis.
Significance: This study highlights the relationship between crystals, biomarkers, and their associated conditions, emphasizing the crucial role of synovial fluid analysis in diagnosing and treating arthritis.
Acknowledgements: The study group would like to acknowledge Zimmer Biomet for its role in sample processing and data collation.
Embargo Period
6-2-2025
Included in
Crystals and biomarker analysis via synovial fluid sampling in patients with knee effusion with radiographic correlation
Philadelphia, PA
Purpose: Synovial fluid biomarker analysis is a developing modality for subcategorizing arthritis type. We examined radiographic evidence of chondrocalcinosis and osteoarthritis severity in relation to their respective biomarker levels or detection on the Synovasure® RISC panel.
Methods and Study Design: This is a monocentric, cross-sectional, non-controlled, and non-randomized, case series study. Patients with a knee effusion and planned arthrocentesis were included. 800 synovial fluid samples were obtained from consenting eligible patients as part of standard of care and sent via Synovasure specimen kits for analysis. Samples were further categorized based on biomarker results.
Results: A total of 800 synovial fluid samples were analyzed. Crystals were found to be present in 166 (N= 20.8%) of samples. Isolated crystals included calcium pyrophosphate (N=148; 18.5%) and monosodium urate (N= 17; 2.13%), with one sample screening positive for both (N=1; 0.13%). The mean Cartilage Oligomeric Matrix Protein (COMP)/Interleukin-8 (IL-8) ratio was 30.6 (SD = 26). 305 subjects (38.3%) had a Kellgren-Lawrence (KL) grade of 4 representing a plurality for the total cohort. The COMP/IL-8 ratio was found to increase with ascending KL-grade (p-value < 0.001). Chondrocalcinosis was found on radiographic review in 144 subjects (18.1%), 100 samples (60.2%) of which were noted also to be positive for intracellular and/or extracellular crystals (p-value < 0.001). A subset of the cohort (N=210) was analyzed for comorbid history of gout, with 29 (13.8%) being identified via retrospective chart review. Among the subjects with crystal positivity, 24 (14.5%) also had comorbid gout (p=0.766).
Conclusions: This study demonstrates statistically significant findings with respect to the presence of radiographic chondrocalcinosis and crystal detection positivity rates via synovial fluid analysis. It also demonstrates a significant correlation between arthritis severity, as qualified by radiographic KL grade, and the ratio of COMP to IL-8. Calcium pyrophosphate crystals were predominant in subjects with radiographic chondrocalcinosis.
Significance: This study highlights the relationship between crystals, biomarkers, and their associated conditions, emphasizing the crucial role of synovial fluid analysis in diagnosing and treating arthritis.
Acknowledgements: The study group would like to acknowledge Zimmer Biomet for its role in sample processing and data collation.
Comments
Presented by William Studt.