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https://www.readbyqxmd.com/read/28918785/-algorithm-for-workup-of-acute-swollen-knee-without-previous-trauma
#1
Jens Olesen, Finn Elkjær Johannsen
Acute non-traumatic swelling of the knee is a common clinical challenge. The reason for the swelling has to be explored in order to give the correct treatment. This article gives an overview of possible diagnoses and suggests an algorithm for an approach to non-traumatic knee arthritis. Fundamental in the examination is a thorough patient anamnesis, which will help to differentiate between inflammatory and non-inflammatory arthritis. If there is not an obvious degenerative reason for the knee effusion, a joint aspiration followed by synovial fluid white cell count (WCC), microscopy and/or culture will add valuable information...
September 18, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28918594/the-association-of-knee-structural-pathology-with-pain-at-the-knee-is-modified-by-pain-at-other-sites-in-those-with-knee-osteoarthritis
#2
Feng Pan, Jing Tian, Dawn Aitken, Flavia Cicuttini, Tania Winzenberg, Graeme Jones
The objective of this study was to investigate the associations of knee structural abnormalities with different patterns of pain. A total of 891 participants (average age 63 years; range 50 to 80 years) participated in this study. Presence of pain at the neck, back, hands, shoulders, hips, knees, and feet was assessed by questionnaire. Participants were categorized as having no pain at any site (no pain), pain only at the knee (KP), pain at other sites but not the knee (OP), and pain at the knee and other sites (KOP)...
September 16, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28913649/improvement-in-diagnostic-and-therapeutic-arthrocentesis-via-constant-compression
#3
Tej B Bhavsar, Wilmer L Sibbitt, Philip A Band, Romy J Cabacungan, Timothy S Moore, Luis C Salayandia, Roderick A Fields, Scarlett K Kettwich, Luis P Roldan, N Suzanne Emil, Monthida Fangtham, Arthur D Bankhurst
We hypothesized that constant compression of the knee would mobilize residual synovial fluid and promote successful arthrocentesis. Two hundred and ten knees with grade II-III osteoarthritis were included in this paired design study: (1) conventional arthrocentesis was performed with manual compression and success and volume (milliliters) determined; and (2) the intra-articular needle was left in place, and a circumferential elastomeric brace was tightened on the knee to provide constant compression. Arthrocentesis was attempted again and additional fluid volume was determined...
September 14, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28899386/improved-clinical-outcome-measures-of-knee-pain-and-function-with-concurrent-resolution-of-subchondral-bone-marrow-edema-lesion-and-joint-effusion-in-an-osteoarthritic-patient-following-pentosan-polysulphate-sodium-treatment-a-case-report
#4
Matthew J Sampson, Margie Kabbani, Ravi Krishnan, Michael Nganga, Annika Theodoulou, Jeganath Krishnan
BACKGROUND: At present, there are no registered products for the treatment of subchondral Bone Marrow Edema Lesion (BML) and associated knee pain. Patients who do not respond to current anti-inflammatory therapies are left with limited treatment options, and may resort to operative management with Total Knee Arthroplasty (TKA). We report the use of Pentosan Polysulphate Sodium (PPS) for the treatment of BMLs of the knee. CASE PRESENTATION: We report the case of a 70-year-old female with knee osteoarthritis presenting with a high level of knee pain, scoring 8 on the Numerical Rating Scale (NRS), and functional limitation demonstrating a poor Lysholm Knee Score of 37...
September 12, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28871338/comparison-of-the-effectiveness-on-intra-articular-and-subcutaneous-tnf-inhibitor-in-rheumatoid-arthritis-patients
#5
Fangze Zhang, Cuili Ma
The objective of this study is to evaluate the efficacy of single intra-articular (IA) injection of tumor necrosis factor α (TNFα) inhibitor in knee joints comparing with subcutaneous injection in rheumatoid arthritis (RA) patients. Forty-eight RA patients with 73 knee arthritis were divided into three groups, group A: received a single injection of TNF inhibitor into knee joints; group B: received regular subcutaneous injection; and group C: received both of the regimen as groups A and B. Ultrasound, erythrocyte sedimentation rate, C-reactive protein (CRP), patients' global visual analogue scale (VAS), and 28-joint Disease Activity Score (DAS28) were collected pre- and post-therapy 4 weeks...
September 4, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28864651/associations-between-knee-effusion-synovitis-and-joint-structural-changes-in-patients-with-knee-osteoarthritis
#6
Xia Wang, Xingzhong Jin, Leigh Blizzard, Benny Antony, Weiyu Han, Zhaohua Zhu, Flavia Cicuttini, Anita E Wluka, Tania Winzenberg, Graeme Jones, Changhai Ding
OBJECTIVE: To describe the associations between effusion-synovitis and joint structural abnormalities in patients with knee osteoarthritis (OA) over 24 months. METHODS: A posthoc analysis using data from a randomized controlled trial in 413 patients with symptomatic OA (aged 63 ± 7 yrs, 208 women). Knee effusion-synovitis volume and score, cartilage defects, cartilage volume, and bone marrow lesions (BML) were assessed using magnetic resonance imaging. Joint space narrowing (JSN) and osteophytes were assessed using radiograph...
September 1, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28831763/relationship-between-magnetic-resonance-imaging-findings-radiological-grading-psychological-distress-and-pain-in-patients-with-symptomatic-knee-osteoarthritis
#7
Marina Carotti, Fausto Salaffi, Marco Di Carlo, Andrea Giovagnoni
BACKGROUND: Synovial hypertrophy, synovial effusions, and abnormalities in the subchondral bone play a key role in the pathogenesis of osteoarthritis (OA) and are associated with pain. Understanding and careful clinical assessment together with better imaging such as magnetic resonance imaging (MRI) of the knee may improve treatment strategies. The aim of this cross-sectional study was to investigate the associations between the structural findings on MRI (bone marrow lesions [BMLs], synovitis, cartilage defects, meniscal lesions), X-ray examination (Kellgren and Lawrence [K/L] grade), and psychological aspects with pain in patients with knee osteoarthritis (KOA)...
August 22, 2017: La Radiologia Medica
https://www.readbyqxmd.com/read/28819599/synovial-chondromatosis-a-rare-differential-diagnosis-of-hip-pain-in-a-child
#8
Manesh Chacko Philip, Sajeer Usman
INTRODUCTION: Primary synovial chondromatosis (SC) is a disease of the synovium occurring in the third to fifth decade of life with the peak incidence in the fifth decade and commonly involves the knee in 50% cases. The diagnosis of SC is primarily radiological and intraoperative. Primary SC of the hip is rare, and their prevalence is not known. CASE REPORT: A 7-year-old female child presented with pain and limp left hip for 6 weeks. She had a stiff hip gait. Clinical examination revealed a fixed abduction, flexion deformity, and restricted internal rotation with apparent lengthening of 2 cm...
March 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28796028/sleeve-fracture-of-the-adult-patella-case-report-and-review-of-the-literature
#9
Linjun Xie, Hong Xu, Lizhi Zhang, Rong Xu, Yingkun Guo
RATIONALE: The patellar fractures are common in adults, but rare in children. As a particular type of patellar fracture, however, sleeve fractures are almost always limited to children in the under 16's group. PATIENT CONCERNS: Herein, we report a rare case of a 19-year-old healthy adult female who presented sleeve fracture at the superior pole of the left patella. The clinical and radiological features are found including joint effusion, anterior tilt of the patella and a shell of bone lying proximally to the patella...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28791612/acl-rehabilitation-progression-where-are-we-now
#10
REVIEW
John T Cavanaugh, Matthew Powers
PURPOSE OF REVIEW: With the increase of publications available to the rehabilitation specialist, there is a need to identify a progression to safely progress the patient through their post-operative ACL reconstruction rehabilitation program. Rehabilitation after ACL reconstruction should follow an evidence-based functional progression with graded increase in difficulty in activities. RECENT FINDINGS: Clinicians should be discouraged not to use strict time frames and protocols when treating patients following ACL reconstruction...
August 8, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28762203/power-color-doppler-and-spectral-doppler-ultrasonography-to-evaluate-response-to-intra-articular-steroid-injection-in-knee-joints-in-juvenile-idiopathic-arthritis
#11
Tapas Baikar, Amieleena Chhabra, Tribhuvan Pal Yadav, Namrita Sachdev, Vivek Dewan
OBJECTIVE: To evaluate the role of ultrasonographic indices (Color Fraction and Resistive Index) in assessing the effect of intra-articular steroid (IAS) injection on synovial inflammation in knee joints of Juvenile Idiopathic Arthritis (JIA) patients and to determine the correlation between these ultrasonographic indices and clinical and laboratory parameters in JIA patients after IAS. METHODS: Twenty seven patients of JIA and equal number of age and sex matched healthy controls were enrolled...
July 31, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28752151/intra-articular-lipoma-of-the-knee-joint-located-in-the-posterior-compartment-a-rare-location
#12
Mujdat Bankaoglu, Ozge Yapici Ugurlar, Meric Ugurlar, Mesut Mehmet Sonmez, Osman Tugrul Eren
This report presents the case of a 51-year-old woman with intermittent left knee pain, especially during full flexion of the knee, which had been ongoing for 1 year. Magnetic resonance imaging (MRI) showed mild effusion and round mass at the posterior compartment without synovial changes. Computerized tomography (CT) indicated mass had homogeneous low attenuation and density measurement of -99.4±62.3 Hounsfield units (HU), correlated with a lipomatous lesion.
2017: Northern Clinics of Istanbul
https://www.readbyqxmd.com/read/28713102/-contemporary-use-of-radiosynoviorthesis-in-chronic-polyarthrtitis
#13
Robert Zwolak, Maria Majdan
Radiosynoviorthesis is used for local treatment of recurrent joint effusions, leads to necrosis of inflamed synovium due to beta radiation energy served after intraarticular radionuclide administration. The aim of the therapy is destruction and fibrosis of abnormal, hypertrophic synovial membrane and then full recovery of its normal function after local corticosteroids and systemic modifying drugs failure. Radiosynoviorthesis is effective in different type of peripheral arthritis like rheumatoid arthritis, inflammatory spondyloarthtropaties, gout, chondrocalcinosis, pigmented villo-nodular synovitis, recurrent knee effusion after total joint replacement, idiopathic knee joint effusion, osteoarthritis and secondary prevention of intraarticular bleeding in haemophilia...
2017: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/28678120/patient-outcomes-after-observation-versus-debridement-of-unstable-chondral-lesions-during-partial-meniscectomy-the-chondral-lesions-and-meniscus-procedures-champ-randomized-controlled-trial
#14
RANDOMIZED CONTROLLED TRIAL
Leslie J Bisson, Melissa A Kluczynski, William M Wind, Marc S Fineberg, Geoffrey A Bernas, Michael A Rauh, John M Marzo, Zehua Zhou, Jiwei Zhao
BACKGROUND: It is unknown whether unstable chondral lesions observed during arthroscopic partial meniscectomy (APM) require treatment. We examined differences at 1 year with respect to knee pain and other outcomes between patients who had debridement (CL-Deb) and those who had observation (CL-noDeb) of unstable chondral lesions encountered during APM. METHODS: Patients who were ≥30 years old and undergoing APM were randomized to receive debridement (CL-Deb group; n = 98) or observation (CL-noDeb; n = 92) of unstable Outerbridge grade-II, III, or IV chondral lesions...
July 5, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28668808/defining-flare-in-osteoarthritis-of-the-hip-and-knee-a-systematic-literature-review-omeract-virtual-special-interest-group
#15
Marita Cross, Ludovic Dubouis, Matthieu Mangin, David J Hunter, Lyn March, Gillian Hawker, Francis Guillemin
OBJECTIVE: Beyond the exacerbation of pain in describing a flare in osteoarthritis (OA), patients and health professionals add other elements that deserve to be fully elucidated, such as effusion, swelling, and mobility limitation. To define and conceptualize the construct flare in OA, the objective was to identify the key variables, or symptoms, that worsen, and to clarify how these variables are described in the literature by patients and clinicians. METHODS: A systematic review of the literature was conducted in Medline and PsychINFO...
July 1, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28638690/an-unusual-case-of-diffuse-pigmented-villonodular-synovitis-of-the-shoulder-a-multidisciplinary-approach-with-arthroscopic-synovectomy-and-adjuvant-radiotherapy
#16
Tânia Quinás Serra, João Morais, Zico Gonçalves, Francisco Agostinho, Gilberto Melo, Mónica Henriques
Pigmented villonodular synovitis (PVNS) is a rare proliferative disorder of the synovial membrane. This condition is usually monoarticular, can be locally destructive, and involves muscles, tendons, bursae, bones, and skin. The most commonly affected joints are the knee and hip, followed by the ankle and shoulder. Patients often present with pain, swelling, and joint effusion; however, the duration of symptoms varies. Total synovectomy is the preferred treatment for PVNS. Subtotal synovectomy is a factor of recurrence, and in diffuse PVNS, total excision is very difficult to achieve...
June 2017: European Journal of Rheumatology
https://www.readbyqxmd.com/read/28630845/multi-foci-salmonella-enteritis-osteomyelitis-of-thoracic-spine-with-pleural-effusion-and-fatal-outcome-a-unique-case-presentation-and-review-of-the-literature
#17
Ioannis Papaioannou, Andreas Baikousis, Panagiotis Korovessis
INTRODUCTION: A case of thoracic vertebral osteomyelitis due to Salmonella enteritis (SE) in an immunocompetent patient is reported. This is the third case in the literature of SE thoracic vertebral osteomyelitis, but the first one with this multi-foci presentation and finally fatal outcome due to meningoencephalitis. Further data that makes our case unique are the absence of fever (body temperature: 37.4°C) and gastrointestinal disorders. CASE REPORT: A 57-year-old male patient initially presented with thoracic pain, dyspnea, and knee pain...
January 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28606166/poncet-s-disease-in-human-immunodeficiency-virus-a-case-report
#18
Enoch Omonge, Fredrick Otieno, Mary Kubo, Betty Shiruli
BACKGROUND: Poncet's disease is a rare reactive polyarthritis associated with active tuberculosis and no evidence of Mycobacterium tuberculosis in the affected joint. CASE PRESENTATION: We report a case of a 35 year old Human Immunodeficiency Virus positive Kenyan male of Kikuyu ethnicity from Kiambu County who presented to hospital with a 6 day history of bilateral knee pain and swelling, bilateral ankle pain with right ankle swelling. The patient reported 6 months history of cough and weight loss...
June 12, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28602782/associations-between-serum-ghrelin-and-knee-symptoms-joint-structures-and-cartilage-or-bone-biomarkers-in-patients-with-knee-osteoarthritis
#19
J Wu, K Wang, J Xu, G Ruan, Q Zhu, J Cai, J Ren, S Zheng, Z Zhu, P Otahal, C Ding
OBJECTIVE: The roles of ghrelin in knee osteoarthritis (OA) are unclear. This study aimed to examine cross-sectional associations of ghrelin with knee symptoms, joint structures and cartilage or bone biomarkers in patients with knee OA. METHODS: This study included 146 patients with symptomatic knee OA. Serum levels of ghrelin and cartilage or bone biomarkers including cartilage oligomeric matrix protein (COMP), cross linked C-telopeptide of type I collagen (CTXI), cross linked N-telopeptide of type I collagen (NTXI), N-terminal procollagen III propeptide (PIIINP), and matrix metalloproteinase (MMP)-3, 10, 13 were measured using Enzyme-linked immunosorbent assay (ELISA)...
September 2017: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/28574941/an-accurate-full-flexion-anterolateral-portal-for-needle-placement-in-the-knee-joint-with-dry-osteoarthritis
#20
Mohamed Hussein
INTRODUCTION: Accurate delivery of an injection into the intra-articular space of the knee is achieved in only two thirds of knees when using the standard anterolateral portal. The use of a modified full-flexion anterolateral portal provides a highly accurate, less painful, and more effective method for reproducible intra-articular injection without the need for ultrasonographic or fluoroscopic guidance in patients with dry osteoarthritis of the knee. METHODS: The accuracy of needle placement was assessed in a prospective series of 140 consecutive injections in patients with symptomatic degenerative knee arthritis without clinical knee effusion...
July 2017: Journal of the American Academy of Orthopaedic Surgeons
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