Role of arthroscopy in the diagnosis of chronic monoarthritis of the knee joint

The author analyzes the arthroscopy findings of 70 knee joints in 68 patients (35 men and 33 women) suffering from chronic monoarthritis of the knee joints with a disease standing from 3 months to 12 years. According to the x-ray data the overwhelming majority of the joints (54) showed stage 0-1, 15 stage II and 1 stage III of the pathological process. In accordance with the preliminary diagnoses 32 patients had synovitis of unclear genesis, 4 rheumatoid arthritis, 3 gonarthrosis deformans, 2 psoriatic arthritis, 5 patients were afflicted with Bechterew's disease, 1 with chondromatosis, and in 21 patients the diagnosis was doubtful. Arthroscopy promoted considerable improvement of the diagnosis, since rheumatoid arthritis including juvenile one was recognized in 12 patients, psoriatic arthritis in 8, reactive synovitis due to gonarthrosis in 16, Bechterew's disease in 12, Reiter's disease in 2, chondromatosis in 4, and pigmented villous-nodular synovitis in 3. The arthroscopic appearance of the disease remained unclear in 7 patients. Therefore, arthroscopy proved a highly effectual method that permits one to differentiate between reactive synovitis and genuine inflammatory diseases and to differentiate with a great probability between rheumatoid synovitis, psoriatic arthropathy and Bechterew's disease.