ACR Meeting Abstracts

ACR Meeting Abstracts

  • Meetings
    • ACR Convergence 2024
    • ACR Convergence 2023
    • 2023 ACR/ARP PRSYM
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • ACR Meetings

Abstract Number: 1940

Immunologic Synovitis Score: A New Score for Synovial Membrane Characterization in Inflammatory and Non-Inflammatory Arthritis

Aurélie Najm1,2, Benoît Le Goff MD PhD2,3, Frédéric Blanchard1, Jérome Amiaud4, Céline Charrier5 and Veit Krenn6, 1INSERM U1238 University of medicine, PHY-OS Laboratory, Nantes, France, 2Rheumatology, Nantes University Hospital, Nantes, France, 3UNR1238 University of medicine, PHY-OS Laboratory, Nantes, France, 4UMR1238 University of medicine, PHY-OS Laboratory, Nantes, France, 5UNMR1238 University of medicine, PHY-OS Laboratory, Nantes, France, 6Zytologie und Molekulare Diagnostik, MVZ-Zentrum für Histologie, Trier, Germany

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: rheumatoid arthritis, synovial cells, synovial fluid, Synovial Immune Biology, synovitis and synovium, synovium

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print
Session Information

Date: Tuesday, November 7, 2017

Title: Biology and Pathology of Bone and Joint Poster II

Session Type: ACR Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose:

General Synovitis score (GSS) has been developed by Krenn et al in order to discriminate inflammatory arthritis (IA) and non-inflammatory arthritis (NIA) (1). This score allow to quantify inflammation by scoring 3 major components of synovitis: lining layer hyperplasia, activation of resident cells (stroma) and inflammatory infiltrate. All components are graded semi-quantitatively from 0 to 3 and the total score is on 9. High-grade synovitis is highly associated with IA and is defined by a score above 5 with a sensitivity of 61.7% and a specificity of 96.1%. As immunohistochemistry (IHC) is frequently used to better characterize synovitis, we propose to create a new IMmunologic SYnovitis SCore (IMSYC) adding 5 components to the GSS: CD68, CD3, CD20, CD31 and Ki67 immunostaining.

Our work aimed to evaluate the diagnostic performance of this new score including IHC, to define the best cut off for inflammatory arthritis recognition, and to compare its diagnostic performance with the GSS.

Methods:

Synovial samples from patients were obtained during surgical procedure (arthroplasty or synovectomy). All patients gave written consent prior surgery. Samples were cut and Hematoxylin and eosin stained. CD68, CD3, CD20, CD31 and KI67 IHC were performed. GSS was assessed for each slide and semi-quantitative 4 scale scores (0-3) were given for each immunostaining, in a blind manner. The score is calculated on 24 (GSS 0-9 points, and 0-3 score for each of the 5 immunostaining).

The 2 readers met and scored a representative amount of slides with a spearman correlation coefficient of 0.95 (p<0.0005). They then defined a consensual and reproducible scoring atlas.

Results:

53 patients were included. 25 were females (47,2%), mean age was 62.1 years (standard deviation (SD) 13.2 years). 36 had IA reparsed as follows: 28 Rheumatoid arthritis (RA), 5 had Psoriatic arthritis (Psa), 3 had Undifferentiated arthritis (UA). “Non inflammatory” arthritis group included 10 patients with Osteoarthritis (OA) and 7 with ligaments or meniscus injuries (post traumatic arthritis (PtA).

Mean Synovitis Score was significantly superior in the IA group 5.70 [SD 0.321] vs.3.51 [SD 0.351] ; p<0.001). Mean IMSYC was significantly superior in the IA group 14.94 [SD 0.747] vs. 8.50 [SD 0.639]; p<0.001). In univariate analysis by logistic regression, GSS (Odd Ratio (OR) 2.27; p<0.001), CD3 (OR 4.3; p=0.002), CD68 (OR 4.5; p=0.002), Ki67 (OR 11.8; p<0.001), CD31 scores (OR 6.5; p=0.001) and were significantly associated with IA, however CD20 score was not (OR 0.9; p=0.34).

ROC curve analysis of diagnostic performances determined the score of 10.5 out of 24 as the best cut off for discrimination between IA and non-IA with a sensitivity of 74.3% and specificity of 100%. The area under ROC curves (AUC) were nearly statistically different between GSS (0.81) and IMSYC (0.93) (p=0.05).

Conclusion: We hereby propose a new synovitis score including IHC. This score has a better sensitivity and specificity than the Synovitis score for discrimination between inflammatory and non-inflammatory arthritis. Moreover, IMSYC accurately describes synovial membrane immunophenotype and could therefore give a basis for tissue driven therapies in rheumatic diseases, especially in RA.


Disclosure: A. Najm, None; B. Le Goff MD PhD, None; F. Blanchard, None; J. Amiaud, None; C. Charrier, None; V. Krenn, None.

To cite this abstract in AMA style:

Najm A, Le Goff MD PhD B, Blanchard F, Amiaud J, Charrier C, Krenn V. Immunologic Synovitis Score: A New Score for Synovial Membrane Characterization in Inflammatory and Non-Inflammatory Arthritis [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/immunologic-synovitis-score-a-new-score-for-synovial-membrane-characterization-in-inflammatory-and-non-inflammatory-arthritis/. Accessed .
  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print

« Back to 2017 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/immunologic-synovitis-score-a-new-score-for-synovial-membrane-characterization-in-inflammatory-and-non-inflammatory-arthritis/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

All abstracts accepted to ACR Convergence are under media embargo once the ACR has notified presenters of their abstract’s acceptance. They may be presented at other meetings or published as manuscripts after this time but should not be discussed in non-scholarly venues or outlets. The following embargo policies are strictly enforced by the ACR.

Accepted abstracts are made available to the public online in advance of the meeting and are published in a special online supplement of our scientific journal, Arthritis & Rheumatology. Information contained in those abstracts may not be released until the abstracts appear online. In an exception to the media embargo, academic institutions, private organizations, and companies with products whose value may be influenced by information contained in an abstract may issue a press release to coincide with the availability of an ACR abstract on the ACR website. However, the ACR continues to require that information that goes beyond that contained in the abstract (e.g., discussion of the abstract done as part of editorial news coverage) is under media embargo until 10:00 AM ET on November 14, 2024. Journalists with access to embargoed information cannot release articles or editorial news coverage before this time. Editorial news coverage is considered original articles/videos developed by employed journalists to report facts, commentary, and subject matter expert quotes in a narrative form using a variety of sources (e.g., research, announcements, press releases, events, etc.).

Violation of this policy may result in the abstract being withdrawn from the meeting and other measures deemed appropriate. Authors are responsible for notifying colleagues, institutions, communications firms, and all other stakeholders related to the development or promotion of the abstract about this policy. If you have questions about the ACR abstract embargo policy, please contact ACR abstracts staff at [email protected].

Wiley

  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences

© Copyright 2025 American College of Rheumatology