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Lukas Mangnus, Wouter P Nieuwenhuis, Hanna W van Steenbergen, Tom W J Huizinga, Monique Reijnierse, Annette H M van der Helm-van Mil
BACKGROUND: In the population a high body mass index (BMI) has been associated with slightly increased inflammatory markers. Within rheumatoid arthritis (RA), however, a high BMI has been associated with less radiographic progression; this phenomenon is unexplained. We hypothesized that the phenomenon is caused by an inverse relationship between BMI and inflammation in hand and foot joints with RA. To explore this hypothesis, local inflammation was measured using magnetic resonance imaging (MRI) in early arthritis patients presenting with RA or other arthritides and in asymptomatic volunteers...
October 22, 2016: Arthritis Research & Therapy
Jasper Stevens, Kenneth Meijer, Wouter Bijnens, Mathijs C H W Fuchs, Lodewijk W van Rhijn, Joris P S Hermus, Sander van Hoeve, Martijn Poeze, Adhiambo M Witlox
BACKGROUND: Arthrodesis of the first metatarsophalangeal (MTP1) joint is an intervention often used in patients with severe MTP1 joint osteoarthritis and relieves pain in approximately 80% of these patients. The kinematic effects and compensatory mechanism of the foot for restoring a more normal gait pattern after this intervention are unknown. The aim of this study was to clarify this compensatory mechanism, in which it was hypothesized that the hindfoot and forefoot would be responsible for compensation after an arthrodesis of the MTP1 joint...
October 21, 2016: Foot & Ankle International
Eric C Honert, Karl E Zelik
INTRODUCTION: Inverse dynamics joint kinetics are often used to infer contributions from underlying groups of muscle-tendon units (MTUs). However, such interpretations are confounded by multiarticular (multi-joint) musculature, which can cause inverse dynamics to over- or under-estimate net MTU power. Misestimation of MTU power could lead to incorrect scientific conclusions, or to empirical estimates that misguide musculoskeletal simulations, assistive device designs, or clinical interventions...
2016: PloS One
Tao Sun, Haitao Zhao, Lingxiang Wang, Wenjuan Wu, Wenhai Hu
PURPOSE: Our aim was to identify the incidence and distribution of sesamoid bones plantar to the metatarsophalangeal (MTP) joints in adults, and to evaluate patterns of coincidence among these sesamoid bones. METHODS: We conducted a retrospective review of 7949 plain radiographs obtained from patients evaluated for foot trauma or symptomology. Associations between the distributions of MTP sesamoid bones as well as the association of age, sex, and laterality with identified prevalence, distribution, and coincidence were evaluated using Spearman's correlation coefficient...
October 14, 2016: Surgical and Radiologic Anatomy: SRA
Gary M LiMarzi, Kurt F Scherer, Michael L Richardson, David R Warden, Christopher W Wasyliw, Jack A Porrino, Christopher R Pettis, Gideon Lewis, Christopher C Mason, Laura W Bancroft
A variety of surgical procedures exist for repair of both traumatic and degenerative osseous and soft-tissue pathologic conditions involving the foot and ankle. It is necessary for the radiologist to be familiar with these surgical procedures, so as to assess structural integrity, evaluate for complicating features, and avoid diagnostic pitfalls. Adequate interpretation of postoperative changes often requires access to surgical documentation to evaluate not only the surgery itself but the expected timeline for resolution of normal postoperative changes versus progressive disease...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Kaiying Shen, Haiqing Cai, Zhigang Wang, Yunlan Xu
Elastic stable intramedullary nailing (ESIN) has became a well-accepted method of osteosynthesis of diaphyseal fractures in the skeletally immature patient for many advantages, the purpose of this study is to evaluate the preliminary results of this minimally invasive treatment for severely displaced distal tibial diaphyseal metaphyseal junction (DTDMJ) fractures.This study was carried out over a 6-year period. Twenty-one severely displaced DTDMJ fractures treated using ESIN were evaluated clinically and radiographically...
September 2016: Medicine (Baltimore)
Y El Miedany, M El Gaafary, S Youssef, I Ahmed, Sami Bahlas, M Hegazi, A Nasr
This study aims to assess clinical, lab/immunological or imaging (joint ultrasonography) markers able to predict disease relapse in RA patients in sustained remission when tapering or stopping their treatment. One hundred fifty-seven RA patients in clinical remission (DAS-28 <2.6 for >6 months), receiving treatment with sDMARDs and bDMARD therapy, were randomly allocated into any of five groups: Group 1: continue full dose DMARDs and taper biologic therapy by 50 % (31 patients); Group 2: taper both DMARDs and biologic therapy dose by 50 % (32 patients); Group 3: taper DMARDs by 50 % and stop biologic therapy (31 patients); Group 4: stop both DMARDs and biologic therapy (31 patients); Group 5: continue medications without change (31 patients)...
September 22, 2016: Clinical Rheumatology
Sarang Desai
: Freiberg's infarction is a well-known condition that most commonly effects the second metatarsophalangeal joint. The etiology of Freiberg's infarction is not entirely clear and there is no consensus on treatment. The case report presents a patient successfully treated with a metatarsal shortening osteotomy, marrow stimulation, and micronized allograft cartilage matrix. This is to my knowledge the first reported case using the described technique for Freiberg's infarction. LEVELS OF EVIDENCE: Therapeutic, Level V: Expert opinion...
September 19, 2016: Foot & Ankle Specialist
Laura J S Greenlund, William J Ward
BACKGROUND: Primary care internists are often the first to see patients with an initial episode of crystalline arthritis. Timely aspiration of the affected joint for definitive diagnosis and treatment in the office is desirable but can be difficult especially if the joint is small, surrounded by soft tissue swelling distorting landmarks, and is very painful to move or palpate. METHODS: We compared the likelihood of successful aspiration of the great toe metatarsophalangeal joint by primary care internists for the diagnosis of potential crystalline arthritis by either landmark identification of the joint space or by employing ultrasound to identify the joint space...
September 14, 2016: American Journal of Medicine
Sarah Stewart, Nicola Dalbeth, Alain C Vandal, Bruce Allen, Rhian Miranda, Keith Rome
OBJECTIVE: The first metatarsophalangeal joint (1MTPJ) is frequently affected in gout. The aim of this study was to identity ultrasound features of the 1MTPJ in people with gout and people with asymptomatic hyperuricaemia compared with normouricaemic controls. METHODS: Participants with gout (n=23), asymptomatic hyperuricaemia (n=29) and age- and sex-matched normouricaemic control participants (n=34) underwent a grey-scale and power Doppler ultrasound assessment of bilateral 1MTPJs by a single musculoskeletal radiologist...
September 16, 2016: Arthritis Care & Research
Jeffrey E McAlister, Christopher F Hyer, Trevor E Black
: First metatarsophalangeal joint arthritis can stem from a biomechanical imbalance as in hallux abducto valgus, metabolic arthritidies such as rheumatoid or gout, and even in posttraumatic cases. Advanced arthritis in the foot and ankle can often become debilitating. Surgical intervention is often necessary. Revision of failed first metatarsophalangeal joint arthroplasty is often in the setting of bony erosion and lysis, cystic changes, and loss of bone stock. In this article, we describe first metatarsophalangeal distraction arthrodesis technique using tricortical calcaneus autograft with the aim of simplifying donor site graft harvesting and decreasing donor site morbidity while attaining successful osseous union...
September 9, 2016: Foot & Ankle Specialist
Taranjit Singh Tung
Metatarsophalangeal joint dislocations of lesser toes are often seen in the setting of severe claw toes. Traumatic irreducible dislocations have been reported in rare cases following both low-energy and high-energy injuries to the forefoot. In this case report, I present a previously unreported association of a metatarsal shaft fracture with metatarsophalangeal joint dislocation of a lesser toe.
2016: Case Reports in Orthopedics
Amy L Walters, Stacy A Semevolos, Rose E Baker
OBJECTIVE To determine and compare mean standing extension and maximum flexion angles of various joints in healthy adult alpacas and llamas, and determine the reliability of goniometric data within and between 2 observers for each joint of interest. SAMPLE 6 healthy adult llamas and 6 healthy adult alpacas. PROCEDURES The shoulder joint, elbow joint, carpal, and metacarpophalangeal (MCP) joints of the forelimbs and the hip joint, stifle joint, tarsal, and metatarsophalangeal (MTP) joints of the hind limbs were investigated...
September 2016: American Journal of Veterinary Research
Luis Balmore Gutierrez, Thomas Link, Krishna Chaganti, Daria Motamedi
Arterial calcification due to CD73 deficiency (ACDC) is a recently identified rare and debilitating adult-onset disorder caused by autosomal recessive NT5E gene mutations. ACDC is characterized by progressive and painful arterial calcifications primarily affecting the lower extremities, as well as calcifications affecting small joint capsules of the hands and feet. In this case report, the authors provide clinical follow-up for one of the first individuals identified by the National Institutes of Health (NIH) as having ACDC, focusing mainly on the imaging manifestations of periarticular joint mineralization, which are bilateral but slightly asymmetric, bulky up to the levels of the metacarpophalangeal and metatarsophalangeal joints, but smaller and more capsular in distribution at the proximal and distal interphalangeal joints, without erosive change or intra-articular mineralization...
November 2016: Skeletal Radiology
Daria L DiGiovanni, Nathalie Rademacher, Laura M Riggs, Rebecca A Baumruck, Lorrie Gaschen
Palmar/plantar annular desmitis is a common disease that may be associated with adhesions and structures affecting the flexor tendons, which requires tenoscopy to diagnose. The purpose of this descriptive study was to develop a dynamic sonographic technique for evaluating the motion of normal equine flexor tendons in relation to the palmar/plantar annular ligament and to compare findings with horses previously diagnosed with palmar/plantar annular desmitis. Ten healthy adult horses were examined prospectively and the images of four horses diagnosed with palmar/plantar annular desmitis were retrospectively evaluated...
August 26, 2016: Veterinary Radiology & Ultrasound
Nico M G Maas, Margot van der Grinten, Wichor M Bramer, Gert-Jan Kleinrensink
BACKGROUND: Instability of the metatarsophalangeal (MTP) joints of the lesser toes (digiti 2-5) is increasingly being treated by repair of the plantar plate (PP). This systematic review examines the anatomy of the plantar plate of the lesser toes, and the relation between the integrity of the plantar plates of the lesser toes and lesser MTP joint stability. METHODS: The databases of, Medline (Ovid), Web of Science, Scopus, Cochrane, Pubmed not medline, Cinahl (ebsco), ProQuest, Lilacs, Scielo and Google Scholar were searched in June 2015 from inception...
2016: Journal of Foot and Ankle Research
Jana M Crain, Jean-Pierre Phancao
During the advent of artificial turf and flexible footwear in football, turf toe was initially coined and described as a 1st metatarsophalangeal joint sprain injury. In the classic setting of hyperextension of the 1st metatarsophalangeal joint, turf toe is an injury to its plantar capsuloligamentous complex. Advances in MR imaging and knowledge of the complex 1st metatarsophalangeal joint help pinpoint the injured plantar structures as well as assess severity and chronicity of the injury. Detailed analysis of turf toe should highlight the best conservative and surgical options for injured athletes to reach optimal recovery...
September 2016: Radiologic Clinics of North America
Michel Chraim, Peter Bock, Hamza M Alrabai, Hans-Jörg Trnka
AIMS: This study was aimed to study the arthrodesis of the first metatarsophalangeal joint using an oblique interfragmentary lag screw and dorsal plate as an effective option for the treatment of hallux rigidus. Few researchers have studied the outcome of this surgical method over a long follow-up period. PATIENTS AND METHODS: We performed a retrospective review of 60 patients status post arthrodesis of the first metatarsophalangeal joint. The mean age was 68.5 years and average follow-up lasted for 47...
August 20, 2016: International Orthopaedics
Daigo Taniguchi, Ryo Oda, Kazuya Ikoma, Shogo Toyama, Ryota Takatori, Kan Imai, Yusuke Hara, Koshiro Sawada, Daisaku Tokunaga, Hiroyoshi Fujiwara, Toshikazu Kubo
OBJECTIVE: To examine the recurrence of deformity after silicone implant arthroplasty combined with resection arthroplasty for severe forefoot deformity in patients with rheumatoid arthritis. METHODS: We reviewed the long-term results of this procedure for 27 feet in 15 patients. Their average age and disease duration at the time of operation were 58.6 years and 17.5 years, respectively, and the average follow-up period was 10.3 years. RESULTS: An improved hallux valgus angle (45...
October 21, 2016: Modern Rheumatology
Shyamashis Das, Alakendu Ghosh, Parasar Ghosh, Debasish Lahiri, Pradyot Sinhamahapatra, Kaushik Basu
AIM: This study aimed to assess the sensitivity and specificity of ultrasonographic features of gout in intercritical and chronic stages and compared ultrasonographic features of gout between patients with persistent high serum uric acid (SUA) and patients with low SUA. METHODS: Adult patients with gout confirmed by demonstration of monosodium urate crystals were recruited, if they were in intercritical or chronic stage clinically. Ultrasonographic examination of the first metatarsophalangeal joints (MTPJs) and the knee joints of both sides were done by a blinded rheumatologist trained in musculoskeletal ultrasound...
August 16, 2016: International Journal of Rheumatic Diseases
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