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Takako Miyamae, Takuma Hara, Aki Hanaya, Yumi Tani, Takayuki Kishi, Hisashi Yamanaka
A 10-year-old girl manifested persistent fever, skin rash, leg pain, fatigue, and joint pain. Based on muscle weakness, elevated muscle-derived enzymes, magnetic resonance imaging, and skin biopsy results, the diagnosis was juvenile idiopathic inflammatory myopathies (JIIM). Chest CT was normal; the anti-melanoma differentiation-associated protein-5 (anti-MDA5) autoantibody was positive. Initial manifestations subsided after prednisolone (PSL) and methotrexate treatment. After the PSL dosage was decreased, the patient presented with metacarpophalangeal (MCP) joint pain and swelling in both index fingers, synovial fluid, and signals on power Doppler ultrasound...
2018: Case Reports in Rheumatology
Karsten D Ottink, Marjan Wouthuyzen-Bakker, Greetje A Kampinga, Paul C Jutte, Joris J Ploegmakers
BACKGROUND: Diagnosing a chronic prosthetic joint infection (PJI) can be challenging. We hypothesized that obtaining preoperative tissue samples for culture in hip arthroplasty will increase the likelihood of diagnosing an infection before revision surgery. The aim of this cohort study was to determine the diagnostic accuracy of 2 tissue acquiring biopsy strategies to diagnose a PJI. METHODS: Patients with a painful hip arthroplasty, in which a chronic PJI was suspected, were included...
June 2018: Journal of Arthroplasty
Arthur M Mandelin, Philip J Homan, Alexander M Shaffer, Carla M Cuda, Salina T Dominguez, Emily Bacalao, Mary Carns, Monique Hinchcliff, Jungwha Lee, Kathleen Aren, Anjali Thakrar, Anna B Montgomery, S Louis Bridges, Joan M Bathon, John P Atkinson, David A Fox, Eric L Matteson, Christopher D Buckley, Costantino Pitzalis, Deborah Parks, Laura B Hughes, Laura Geraldino-Pardilla, Robert Ike, Kristine Phillips, Kerry Wright, Andrew Filer, Stephen Kelly, Eric M Ruderman, Vince Morgan, Hiam Abdala-Valencia, Alexander V Misharin, G Scott Budinger, Elizabeth T Bartom, Richard M Pope, Harris Perlman, Deborah R Winter
OBJECTIVE: Currently, there are no reliable biomarkers for predicting therapeutic response in patients with rheumatoid arthritis (RA). The synovium may unlock critical information for determining efficacy, since a reduction in the numbers of sublining synovial macrophages remains the most reproducible biomarker. Thus, a clinically actionable method for the collection of synovial tissue, which can be analyzed using high-throughput strategies, must become a reality. This study was undertaken to assess the feasibility of utilizing synovial biopsies as a precision medicine-based approach for patients with RA...
February 13, 2018: Arthritis & Rheumatology
Frances Humby, Vasco C Romão, Antonio Manzo, Andrew Filer, Serena Bugatti, Elsa Vieira-Sousa, Stephen Kelly, Mihir Wechalekar, Manzoor Ahmed, Vidalba Rocher, Rebecca Hands, Carlomaurizio Montecucco, Joao Fonseca, Costantino Pitzalis
OBJECTIVE: To evaluate whether the choice of synovial biopsy technique (arthroscopy, blind needle [BN] biopsy, ultrasound [US]-guided portal and forceps [P&F], or US-guided needle biopsy [NB]) translates to significant variation in synovial tissue quality and quantity, with the aim of informing recommendations for the choice of synovial sampling technique within clinical trials. METHODS: In total, 159 procedures from 5 academic rheumatology centers were evaluated...
May 2018: Arthritis & Rheumatology
Kuo-Lung Lai, Der-Yuan Chen, Mei-Chin Wen, Yi-Ming Chen, Wei-Ting Hung, Yi-Hsin Chen, Hsin-Hua Chen
To clarify the nature of power Doppler (PD) signals in rheumatoid synovium and to establish the connection between PD signals and active inflammation using synovial histopathology. Ten adult patients (median age 57.0 years, 9 women and one man) with rheumatoid arthritis (RA) were enrolled and received ultrasound (US) examinations. US-guided synovial biopsies using core needle were performed in 7 knees, 2 wrists and one elbow. Each patient had one joint biopsied. In total, 11 synovial specimens were obtained for hematoxylin and eosin staining and histopathologic examinations...
April 2018: Journal of the Chinese Medical Association: JCMA
In Tae So, Kwang Bum Cho, Ju Yup Lee, Sang Jin Kim, Hye In Jung, Jong Hwan Choi, Yoo Jin Lee, Hyun Jik Lee, Kyung Sik Park, Seung Wan Ryu, Yu Na Kang
RATIONALE: When a gastric spindle cell tumor is observed, the possibility of synovial carcinoma, besides common mesenchymal tumor, should also be considered. PRESENTING CONCERNS OF THE PATIENT: The patient is a 51-year-old American woman who underwent medical check-up at a general hospital. Upper endoscopy showed a 2-cm sized mass covered with intact mucosa, and a central depression located on the posterior wall of the mid body. Biopsy of the mass showed focal atypical cells proliferation in mucosa on hematoxylin & eosin (H&E) staining...
December 2017: Medicine (Baltimore)
Aleem K Mirza, Ian J Barrett, Animesh Rathore, Bassem T Elhassan, Peter S Rose, Thomas Shives, Thomas C Bower
Venous thoracic outlet syndrome (vTOS) usually results from compression of the subclavian vein classically as a result of narrowing of the costoclavicular space. We report 2 rare cases of soft tissue neoplasms resulting in apparent vTOS. The first case is a 46-year-old female with a 2-year history of intermittent unilateral shoulder pain, who was initially diagnosed with intervertebral disk herniation. Cervical fusion was performed; however, her symptoms progressed and she additionally developed paresthesias and venous congestion...
July 2017: Annals of Vascular Surgery
Stefano Alivernini, Barbara Tolusso, Luca Petricca, Laura Bui, Gabriele Di Sante, Giusy Peluso, Roberta Benvenuto, Anna Laura Fedele, Franco Federico, Gianfranco Ferraccioli, Elisa Gremese
OBJECTIVE: To define the synovial characteristics of patients with rheumatoid arthritis (RA) and psoriatic arthritis (PsA) in clinical and ultrasound remission achieved by combination therapy with methotrexate (MTX) and tumour necrosis factor (TNF) blockers. METHODS: Patients with RA in remission (n=25) (disease activity score (DAS)<1.6 for at least 6 months), patients with RA in low disease activity (LDA) (n=10) (1.6<DAS<2.4 for at least 6 months) and patients with PsA in remission (n=18) (DAS<1...
July 2017: Annals of the Rheumatic Diseases
Manabu Hoshi, Naoto Oebisu, Makoto Ieguchi, Yoshitaka Ban, Masatsugu Takami, Hiroaki Nakamura
INTRODUCTION: Intra-tumour haematoma is an uncommon clinical presentation in malignant soft tissue tumours. This study aimed to highlight the clinical features of patients with soft tissue sarcomas with intra-tumour haematoma. METHODS: The patient group was composed of eight men and one woman aged between 29 and 83 years (mean 44.0 ± 20.8). The average follow-up was 29.8 months. Clinical information, including clinical features, radiological information and treatment course, was retrospectively investigated...
January 2017: International Orthopaedics
Michael McConnell, Rajendra Kumar, Behrang Amini, Patrick P Lin, Wei-Lien Wang
We present the case of an 83-year-old man who had painful swelling of right knee for 6 months. Radiographs showed a large intra-articular soft-tissue mass with small calcifications, whereas MRI detected a multilobulated intra-articular tumor with bone erosions at the distal femur. Histopathology of ultrasound-guided biopsy specimen of the synovial mass revealed it to be a poorly differentiated metastatic carcinoma. Abdominal computed tomography with intravenous contrast medium administration found a heterogeneously enhancing large right renal mass with calcifications, which was shown to be a renal cell carcinoma on histopathology...
January 2017: Skeletal Radiology
Aurélie Najm, Carl Orr, Marie-Françoise Heymann, Géraldine Bart, Douglas J Veale, Benoît Le Goff
OBJECTIVE: The utility of synovial biopsy in increasing our understanding of the pathogenesis of inflammatory arthropathies, as well as in evaluating treatments, is well established. Ultrasound (US) allows synovial assessment and therefore assists in biopsying synovial tissue in a safe and well-tolerated manner. This study's objectives were to (1) determine the rate of success in retrieving synovial tissue using US guidance, (2) describe the indications for US-guided synovial biopsies in the clinical setting, (3) determine how frequently the synovial biopsy can lead to a clear diagnosis, and (4) assess the quality of the synovial tissue obtained using this technique...
December 2016: Journal of Rheumatology
Shuqiang Chen, Qing Zheng, Hui Liu, Jinshu Zeng, Zhen Ye, Yiming Su, Guorong Lv
OBJECTIVES: Progress in developing novel rational treatments for rheumatoid arthritis (RA) critically depends on preclinical work in experimental animals. However, there is lack of insight into the most appropriate mode of noninvasive measurement of disease status in experimental RA. This study compared sonography with serum biomarkers in a rabbit model of RA. METHODS: Six-month-old male New Zealand White rabbits were randomized into 2 groups: antigen-induced arthritis group (n = 25), which was subjected to ovalbumin immunization and intra-articular injection; and control group (n = 5)...
October 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Jacqueline C M Sitt, James F Griffith, Fernand M Lai, Mamie Hui, K H Chiu, Ryan K L Lee, Alex W H Ng, Jason Leung
OBJECTIVE: To investigate the diagnostic performance of ultrasound-guided synovial biopsy. METHODS: Clinical notes, pathology and microbiology reports, ultrasound and other imaging studies of 100 patients who underwent 111 ultrasound-guided synovial biopsies were reviewed. Biopsies were compared with the final clinical diagnosis established after synovectomy (n = 43) or clinical/imaging follow-up (n = 57) (mean 30 months). RESULTS: Other than a single vasovagal episode, no complication of synovial biopsy was encountered...
May 2017: European Radiology
Ilias Lazarou, Stephen Kelly, Frances Humby, Maria Di Cicco, Lu Zou, Vidalba Rocher-Ros, Rebecca Eve Hands, Nora Ng, Arti Mahto, Costantino Pitzalis
OBJECTIVES: Ultrasound-guided synovial biopsy (UGSB) is a minimally-invasive procedure capable of retrieving good quality tissue from small and large joints. The use of UGSB in prospective clinical trials poses a dilemma as to whether biopsied joints may be later included in core data sets for clinical or imagining response, as the procedure itself may alter disease activity assessment. In this study, we examine the impact of UGSB of the wrist on subsequent clinical and ultrasound (US) assessments in a cohort of rheumatoid arthritis (RA) patients prior to initiation of anti-TNF-alpha therapy...
September 2016: Clinical and Experimental Rheumatology
Francesco Massei, Gianluigi Laccetta, Monica Barrani, Luca Fabbri, Virna Zampa, Alessandro Paolicchi, Roberto Cioni, Eugenio Mario Ciancia, Michelangelo Scaglione, Rita Consolini
Osteoid osteoma (OO) is a benign osteogenic neoplasm, usually affecting children and young adults, that is typically characterized by nocturnal pain and response to non-steroidal anti-inflammatory drugs. OO is frequently misdiagnosed because it mimics juvenile idiopathic arthritis (JIA), bone infection or malignancy. Herein we report the case of a girl who presented with chronic monoarthritis of the knee mimicking JIA. After 1 year, OO of the femoral distal metaphysis was diagnosed. OO was treated with computed tomography-guided radiofrequency ablation with disappearance of the symptoms and resolution of the neoplasm...
August 2016: Pediatrics International: Official Journal of the Japan Pediatric Society
Maria Filkova, Andrew Cope, Tim Mant, James Galloway
Rheumatoid arthritis (RA) is an autoimmune disease which causes significant pain, joint deformity, functional disability. The pathological hallmark of RA is inflammation of the synovium characterized by involvement of inflammatory and resident stromal cells, soluble mediators and signalling pathways leading to irreversible joint destruction. The treatment goal in RA has evolved over the last decade towards a target of disease remission that is achieved in less than a third of patients in clinical trials. The lack of therapeutic response to current treatments is suggestive of alternative drivers of RA pathogenesis that might serve as promising therapeutic targets...
April 19, 2016: BMC Musculoskeletal Disorders
Julio Ramírez, Raquel Celis, Alicia Usategui, Virginia Ruiz-Esquide, Regina Faré, Andrea Cuervo, Raimon Sanmartí, José L Pablos, Juan D Cañete
BACKGROUND: Patients with rheumatoid arthritis (RA) in clinical remission may have ultrasound-defined synovitis according to the presence of power Doppler (PD) signal. The objective was to describe the immunopathologic characteristics of ultrasound-defined synovitis compared with synovitis in patients with clinically active RA. METHODS: We included between 6 and 8 ultrasound-guided synovial biopsies per patient from 20 patients with RA in clinical remission (DAS28-ESR <2...
March 31, 2016: Arthritis Research & Therapy
G Fitch, K Williams, J E Freeston, S Dass, A Grainger, R Hodgson, L Horton, P Whitaker, D Peckham
OBJECTIVES: Cystic fibrosis arthropathy (CFA) is a term commonly used for joint pain with and without swelling seen in some patients with CF. Early studies into CFA focused on the presence of rheumatoid factor and immunological changes on synovial biopsy, with parallels drawn between respiratory and joint activity. Identification of anti-cyclic citrullinated peptide antibodies (anti-CCP) as a marker of rheumatoid arthritis (RA), along with increased access to sensitive imaging techniques including ultrasound (US) and magnetic resonance imaging (MRI), offer great potential to investigate and more accurately understand the type(s) of inflammatory arthritis that may underlie CFA...
July 2016: Journal of Cystic Fibrosis: Official Journal of the European Cystic Fibrosis Society
M Schreiner, W Sanad, B M Pfitzner, G Baumann, F Knebel
Primary intravascular synovial sarcoma is a rare malignancy with only a few cases documented in the literature. On presentation, this tumour usually resembles a deep venous thrombosis (dvt) or pulmonary embolism (pe). Here, we report the case of a 20-year-old woman complaining of shortness of breath who had a history of dvt 6 weeks before presentation at our institution. Vascular ultrasound detected a suspicious mass in the right groin, which was identified as a monophasic synovial sarcoma by surgical biopsy...
October 2015: Current Oncology
Jacqueline C M Sitt, James F Griffith, Priscilla Wong
Ultrasound-guided needle biopsy of synovium is an increasingly performed procedure with a high diagnostic yield. In this review, we discuss the normal synovium, as well as the indications, technique, tissue handling and clinical applications of ultrasound-guided synovial biopsy.
2016: British Journal of Radiology
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