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Zahab S Ahsan, Michael Rivlin, Jesse B Jupiter
Ulnar styloid impaction syndrome involves repetitive friction between an excessively long ulnar styloid and the carpus, resulting in chondromalacia, synovitis, and pain. The arthroscopic diagnosis, evaluation, and management of this syndrome are not well characterized. We present a patient with chronic wrist pain of unknown origin, culminating with arthroscopic findings demonstrating substantial loss of articular cartilage on both the lunate and triquetrum. The patient successfully underwent operative ulnar styloid excision, ultimately resolving chronic wrist pain symptomology...
November 2016: Journal of Wrist Surgery
Marine Forien, Sébastien Ottaviani
Rheumatoid arthritis (RA) is chronic rheumatic disorder leading to joint inflammation and potential structural damages. This destruction occurs early in the disease outcome leading to the concept of window of opportunity. New diagnosis RA criteria have been proposed to allow an earlier diagnosis and subsequently a better management of the disease. Moreover, tight control of the disease was able to improve the prognosis of RA. For this, rheumatologists need routinely feasible tools and ultrasound (US) appears as the ideal imaging modality...
October 21, 2016: Joint, Bone, Spine: Revue du Rhumatisme
Andrew S Wilmot, Alexander T Ruutiainen, Prashant T Bakhru, Mark E Schweitzer, Nogah Shabshin
OBJECTIVE: Primary: to describe the presence and pattern of soft tissue edema in subchondral insufficiency fractures of the knee (SIFK). Secondary: to investigate the gender distribution and identify factors associated with disease progression. METHODS: MR images of 74 SIFKs in 74 patients were retrospectively reviewed for soft tissue edema presence and location, meniscal tears and extrusion and synovitis. The clinical records were reviewed for age, gender, and BMI...
November 2016: European Journal of Radiology
Hye Jin Yoo, Sung Hwan Hong, Hye Yeon Oh, Ja-Young Choi, Hee Dong Chae, Joong Mo Ahn, Heung Sik Kang
Purpose To determine the agreement of fat-suppressed (FS) fluid-attenuated inversion-recovery (FLAIR) magnetic resonance (MR) imaging and contrast material-enhanced (CE) T1-weighted MR imaging for the assessment of peripatellar synovitis. Materials and Methods The institutional review board approved this retrospective study and waived the requirement for patient informed consent. Thirty-three patients with knee pain underwent 3-T MR imaging. The protocol consisted of routine clinical sequences followed by the FLAIR FS sequence (inversion time, 2200 msec) and CE T1-weighted imaging...
October 24, 2016: Radiology
S Møller-Bisgaard, B J Ejbjerg, I Eshed, K Hørslev-Petersen, M L Hetland, A G Jurik, H Thomsen, T Torfing, K Stengaard-Pedersen, P Junker, N S Krogh, T Lottenburger, T Ellingsen, L S Andersen, H Skjødt, A J Svendsen, U Tarp, I T Hansen, J Pødenphant, J K Pedersen, H Lindegaard, L G Hanson, A Vestergaard, D Glinatsi, M Østergaard
OBJECTIVES: To investigate whether a treat-to-target strategy based on methotrexate (MTX) and intra-articular (IA) betamethasone suppresses magnetic resonance imaging (MRI)-determined measures of disease activity and reduces joint destruction in early rheumatoid arthritis (eRA) patients, and to investigate whether concomitant cyclosporin A (CyA) provides an additional effect. METHOD: In the 2-year randomized, double-blind, treat-to-target trial CIMESTRA, 160 patients with eRA (< 6 months) were randomized to MTX, intra-articular betamethasone and CyA, or placebo CyA...
October 24, 2016: Scandinavian Journal of Rheumatology
Antonio Manzo, Francesca Benaglio, Barbara Vitolo, Chandra Bortolotto, Francesca Zibera, Monica Todoerti, Claudia Alpini, Serena Bugatti, Roberto Caporali, Fabrizio Calliada, Carlomaurizio Montecucco
BACKGROUND: Emerging research on the mechanisms of disease chronicity in experimental arthritis has included a new focus on the draining lymph node (LN). Here, we combined clinical-serological analyses and power Doppler ultrasound (PDUS) imaging to delineate noninvasively the reciprocal relationship in vivo between the joint and the draining LN in patients with rheumatoid arthritis (RA). METHODS: Forty consecutive patients refractory to conventional synthetic disease-modifying anti-rheumatic drugs were examined through parallel PDUS of the hand-wrist joints and axillary LNs and compared with 20 healthy subjects...
October 22, 2016: Arthritis Research & Therapy
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
Jessica L Partlow, Meghann Lustgarten, W Rich Redding
To the authors' knowledge, the ultrasonographic appearance of hair shafts within a synovial structure of the horse has not been described previously. The purpose of this descriptive study was to illustrate the clinical, ultrasonographic, and arthroscopic characteristics of confirmed hair shafts within synovial structures of seven horses. A review of medical records of the Farm and Equine Veterinary Medical Center at North Carolina State University College of Veterinary Medicine identified seven horses with clinical signs suspicious for inflammatory or septic synovitis/tenosynovitis that had hair shafts identified within those structures ultrasonographically...
October 20, 2016: Veterinary Radiology & Ultrasound
Man-Chiu Poon, Adrienne Lee
Prophylaxis is considered optimal care for hemophilia patients to prevent bleeding and to preserve joint function thereby improving quality of life (QoL). The evidence for prophylaxis is irrefutable and is the standard of care in developed nations. Prophylaxis can be further individualized to improve outcomes and cost effectiveness. Individualization is best accomplished taking into account the bleeding phenotype, physical activity/lifestyle, joint status, and pharmacokinetic handling of specific clotting factor concentrates, all of which vary among individuals...
2016: Thrombosis Journal
Xin Gu, Bingjie Gu, Xianhui Lv, Zhenzhen Yu, Rong Wang, Xiaoli Zhou, Wanxin Qiao, Zhiyuan Mao, Guoping Zuo, Qing Li, Dengshun Miao, Jianliang Jin
Impaired apoptosis of fibroblast-like synoviocytes (FLSs) causes synovial hyperplasia, facilitating destruction of cartilage and bone in rheumatoid arthritis (RA). Tumor necrosis factor (TNF)-α, a dominant inflammatory mediator in RA pathogenesis, promotes progression of RA symptoms. Prevalence of 1, 25-dihydroxy-vitamin D3 (hereafter termed VD) deficiency is 30-63% in patients with RA. Whether VD leads to apoptosis or enhances TNF-α-mediated apoptosis in FLSs to ameliorate RA is unclear. To determine this, 10-week-old CYP27B1-deficient (CYP27B1(-/-)) mice with collagen-induced arthritis (CIA) were intraperitoneally treated with 1 μg/kg VD every other day for 9 weeks...
October 20, 2016: Cell Death & Disease
Behzad Heidari, Karimollah Hajian-Tilaki, Mansour Babaei
BACKGROUND: Several factors are associated with the development or exacerbation of pain in knee osteoarthritis (KOA). In this study, we reviewed this context based on relevant studies. METHODS: Recent published studies which have addressed the relationship between pain and KOA were summarized. RESULTS: Correlates of the clinical, demographic features, laboratory tests and abnormalities on radiographic as well as magnetic resonance imaging (MRI) with the knee pain have been discussed...
2016: Caspian Journal of Internal Medicine
Bryant R England, Geoffrey M Thiele, Ted R Mikuls
PURPOSE OF REVIEW: This article reviews recent literature on the origin and pathogenic role of anticitrullinated protein antibodies (ACPAs) in rheumatoid arthritis (RA). RECENT FINDINGS: ACPAs and ACPA-immune complexes interact with immune cells to facilitate articular inflammation. Findings from recent in vitro and in vivo studies are congruent with epidemiologic observations in RA supporting a pathogenic role of ACPAs. SUMMARY: ACPAs target proteins/peptides with citrullinated epitopes and serve as informative RA biomarkers...
October 13, 2016: Current Opinion in Rheumatology
Christian H Roux, Violaine Foltz, Emmanuel Maheu, Gabriel Baron, Frederique Gandjbakhch, Cédric Lukas, Daniel Wendling, Damien Loeuille, Pierre Lafforgue, Liana Euler-Ziegler, Pascal Richette, Xavier Chevalier
OBJECTIVES: To explore the relationship between clinical findings, biologic biomarkers, conventional radiography and MRI in patients with painful hand OA. METHODS: The following patient baseline data from the DORA study (evaluating anti-TNF-α agents against painful hand OA) were used: clinical assessment (pain, swelling, stiffness and function: Dreiser functional hand index [FIHOA] and Cochin hand functional scale [CHFS]); measurement of biomarkers (cartilage oligomeric matrix protein (COMP), type IIA collagen N-propeptid (PIINP), hyaluronic acid (HA), ultrasensitive C-reactive protein (usCRP), tumour necrosis factor (TNF), interleukin (IL)-6, IL-1β and urinary CTXII); radiological staging (Verbruggen, Kallman, Kellgren-Lawrence); anatomical evaluation by contrast-enhanced MRI of proximal and distal interphalangeal joints of dominant hand...
September 18, 2016: Clinical and Experimental Rheumatology
Benjamin A Fisher, Philippe Donatien, Andrew Filer, C Peter Winlove, Iain B McInnes, Christopher D Buckley, Peter C Taylor
OBJECTIVES: An important feature of rheumatoid arthritis (RA) is hypoxia-driven synovial angiogenesis, but the relationship between change in vascularity, as measured by power Doppler ultrasound (PDUS), and oxygen tensions is unaddressed. METHODS: Metacarpophalangeal (MCP) joint PDUS was assessed in 23 patients with RA, alongside arthroscopic synovitis and oxygen tension measurements, at baseline and 4 weeks after anti-tumour necrosis factor (TNF) inhibitors. RESULTS: Anti-TNF reduced PDUS scores, which were negatively correlated with rise in oxygen tensions...
September 8, 2016: Clinical and Experimental Rheumatology
Julio Ramírez, José Iniciarte-Mundo, Andrea Cuervo, Virginia Ruiz-Esquide, M Victoria Hernández, Raimón Sanmartí, Juan D Cañete
OBJECTIVES: To analyse clinical, serological and sonographic differences between rheumatoid arthritis (RA) and polyarticular psoriatic arthritis (PsA) patients on anti-TNF therapy in clinical remission. METHODS: Angiogenic and proinflammatory cytokine serum levels were determined by multiplex ELISA in patients with RA and PsA in clinical remission (DAS28-ESR<2.6), clinically-active RA patients (DAS28>3.2) and healthy controls. Ultrasound (US) scans were made of both wrists and hands...
October 7, 2016: Clinical and Experimental Rheumatology
Johannes Roth, Viviana Ravagnani, Marina Backhaus, Peter Balint, Alessandra Bruns, George A Bruyn, Paz Collado, Lorenia De la Cruz, Severine Guillaume-Czitrom, Troels Herlin, Cristina Hernandez, Annamaria Iagnocco, Sandrine Jousse-Joulin, Stefano Lanni, Vibke Lilleby, Clara Malattia, Silvia Magni-Manzoni, Consuelo Modesto, Ana Narrodi, Juan-Carlos Nieto, Sarah Ohrndorf, Linda Rossi, Anne-Marit Selvaag, Nanno Swen, Tracy Ting, Nikolay Tzaribachev, Patricia Vega-Fernandez, Jelena Vojinovic, Daniel Windschall, Maria-Antonietta D'Agostino, Esperanza Naredo
Objectives Musculoskeletal ultrasonography (US) has the potential to be an important tool in the assessment of disease activity in childhood arthritides. To assess pathology, clear definitions for synovitis need to be developed first. The aim of this study was to develop and validate these definitions through an international consensus process. Methods The decision on which US techniques to use, the components to be included in the definitions as well as the final wording were developed by 31 ultrasound experts in a consensus process...
October 16, 2016: Arthritis Care & Research
Roberto Seijas, Andrea Sallent, María Galán, Pedro Alvarez-Diaz, Oscar Ares, Ramón Cugat
BACKGROUND: Hip arthroscopy is considered a safe procedure, considering the relatively low rate of complications. Despite several complications have been described following this surgical procedure, the present event has not yet been described. The purpose of the present study is to report an unpublished complication following hip arthroscopy, after reviewing 162 hip arthroscopies and finding iliotibial band syndrome (ITBS) in the knee during followup. MATERIALS AND METHODS: A retrospective review of 162 hip arthroscopies performed between September 2007 and June 2011 was carried out, evaluating patients who presented ITBS during followup...
September 2016: Indian Journal of Orthopaedics
Robert Gabriel Coumine Riis, Marius Henriksen, Louise Klokker, Cecilie Bartholdy, Karen Ellegaard, Elisabeth Bandak, Bjarke Brandt Hansen, Henning Bliddal, Mikael Boesen
OBJECTIVE: The aims of the present knee osteoarthritis (KOA)-study were to: i) describe and compare the changes in MRI-measures of synovitis following an exercise program preceded by an intra-articular injection of either corticosteroid or isotonic saline and ii) investigate if any of the changes in patient reported outcome measures (PROMs) were associated with changes in MRI-measures of synovitis. DESIGN: We performed a randomized, double-blinded, placebo-controlled clinical trial evaluating the effects of intra-articular corticosteroid vs...
October 13, 2016: Osteoarthritis and Cartilage
Yinyin Li, Yi Shen, Philipp Hohensinner, Jihang Ju, Zhenke Wen, Stuart B Goodman, Hui Zhang, Jörg J Goronzy, Cornelia M Weyand
Immune aging manifests with a combination of failing adaptive immunity and insufficiently restrained inflammation. In patients with rheumatoid arthritis (RA), T cell aging occurs prematurely, but the mechanisms involved and their contribution to tissue-destructive inflammation remain unclear. We found that RA CD4(+) T cells showed signs of aging during their primary immune responses and differentiated into tissue-invasive, proinflammatory effector cells. RA T cells had low expression of the double-strand-break repair nuclease MRE11A, leading to telomeric damage, juxtacentromeric heterochromatin unraveling, and senescence marker upregulation...
October 10, 2016: Immunity
Sharon L Kolasinski, Andrew S Chi, Angel J Lopez-Garib
Systemic rheumatic diseases frequently pose diagnostic challenges to the clinician. The precise nature of the disorder can be obscure and different disorders can present with similar symptoms, such as joint pain. Plain radiographs provide an appropriate starting point for detection of joint abnormalities. Musculoskeletal ultrasound and MRI offer greater sensitivity in detecting synovitis, tenosynovitis and bony erosions, among other features. However, due to the rarity of these diseases and lack of prospective longitudinal trials, a broader picture of the epidemiology of these findings and their implications for treatment and outcomes remains to be determined...
November 2016: Rheumatic Diseases Clinics of North America
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