Vascularity / Detritus / Fibrosis

Vascularity Feature:

Numbers or density of small blood vessel in the synovial tissue. (Assessment can be compared to other regions of the synovium.)

Detritus Feature:

Small fragments of bone or cartilage embedded in the synovium, with or without a cellular reaction

Fibrosis Feature:

Collagen matrix that is not anatomically part of the capsule. (Look for bands of collagen replacing the synovial fatty tissue. Avoid capsular tissue.)

Magnification: 4 – 5x

Grading:

Vascularity

0: Normal (71%)
1: Slight Increase (27%)
2: Marked Increase (2%)

Detritus

0: None (36%)
1: Mild (61%)
2: Moderate (3%)

Fibrosis

0: None (52%)
1: Focal(34%)
2: Widespread (12%)
3: Band-like (2%)

Vascularity | Detritus | Fibrosis

Increased vascularity can only really be appreciated by comparison with other regions in the section. Small vessels distributed in clusters impart a hypervascular appearance.

These small irregular particles of granular material represent debris generated within the joint and originate from bone (shown) and sometimes also articular cartilage (not shown).

Fibrosis appears as pink, fibrillary, collagenous material results in the focal, widespread, and band-like displacement of the synovial fat resulting in with obliteration of the overall architecture of the synovium.

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Synovitis Pathology