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1.
Article | IMSEAR | ID: sea-228663

ABSTRACT

Transient synovitis is a common cause of hip pain in children. COVID-19 pandemic affected pediatric cancer patients more often that general pediatric population. COVID-19 has been associated with various musculoskeletal symptoms including synovitis. Radiological assessment of these symptoms can contribute significantly in management of such patients. We report a case of transient synovitis of hip joint following COVID-19 infection in a 10-year-old boy with Hodgkins抯 lymphoma. He presented with fever and myalgia, found to be positive for COVID-19, managed conservatively. Two weeks later presented with right hip pain and limping. He was found to have restricted joint mobility and hip tenderness. Magnetic resonance imaging (MRI) pelvis was done which showed minimal right hip effusion and synovial thickening and enhancement. He was managed conservatively and recovered completely.

2.
Article in Chinese | WPRIM | ID: wpr-1016825

ABSTRACT

ObjectiveTo explore the effect and mechanism of Sishenjian on synovial lesions induced by monosodium iodoacetate (MIA) in rats with knee osteoarthritis (KOA). MethodSixty female Sprague-Dawley (SD) rats were randomly divided into the following six groups: normal group, model group, celecoxib group, and high-, medium-, and low-dose Sishenjian group. The KOA rat model was established by intra-articular injection of MIA. Celecoxib (18 mg·kg-1) and Sishenjian (14.4, 7.2, 3.6 g·kg-1) were administered by gavage according to the groups. All rats were euthanized after four weeks of continuous administration. The transverse diameter of the bilateral knee joints of rats was measured, and gross observation of the knee joint was performed. Pathological changes in knee joint synovial tissue were observed by hematoxylin-eosin (HE) staining and picrosirius red staining. Immunohistochemistry (IHC) was used to detect the expression of vascular endothelial growth factor A (VEGFA) in synovial tissue. The levels of inflammatory cytokines in the joint synovial fluid were detected by enzyme-linked immunosorbent assay (ELISA). Real-time quantitative polymerase chain reaction (Real-time PCR) and Western blot were used to detect the expression of mRNA and proteins related to the transforming growth factor-β1 (TGF-β1)/Smad2/3 pathway in knee joint synovium. ResultCompared with the normal group, the transverse diameter of the knee joint in the model group significantly increased (P<0.01). Compared with the model group, the transverse diameter of the knee joint in rats of each Sishenjian group significantly decreased (P<0.01). Compared with the normal group, the expression levels of interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) in the knee joint synovial fluid of model group significantly increased (P<0.01). Compared with the model group, the expression levels of IL-1β and TNF-α in the knee joint synovial fluid of rats in each Sishenjian group significantly decreased (P<0.01). Compared with the normal group, the expression levels of TGF-β1, Smad2/3, phosphorylation(p)-Smad2/3, type Ⅰ collagen α1 (ColⅠα1), type Ⅲ collagen α1 (ColⅢα1), VEGFA proteins and TGF-β1, Smad2/3, ColⅠα1, ColⅢα1 mRNA in knee joint synovium of model group significantly increased (P<0.01). Compared with the model group, the expression levels of TGF-β1, Smad2/3, phosphorylation (p)-Smad2/3, ColⅠα1, ColⅢα1, VEGFA proteins and TGF-β1, Smad2/3, ColⅠα1, ColⅢα1 mRNA in knee joint synovium of rats in each Sishenjian group significantly decreased (P<0.05, P<0.01). ConclusionSishenjian can inhibit synovial inflammation and angiogenesis, and may become a potential drug for treating synovial lesions in KOA by regulating the TGF-β1/Smad2/3 pathway.

3.
Article in Chinese | WPRIM | ID: wpr-1021270

ABSTRACT

BACKGROUND:Synovitis plays a leading role in the early progression of knee osteoarthritis and is a potential early therapeutic target.However,the mechanism of synovitis remains unclear.In animal models,increased systemic iron and intracellular iron uptake can induce and exacerbate osteoarthritis,but the association with ferroptosis in synovitis remains unclear.Further studies are needed to investigate the role of ferroptosis in the development and progression of synovitis in osteoarthritis. OBJECTIVE:To investigate the role of ferroptosis mediated by glutathione peroxidase 4(GPX4)in the development of synovitis in knee osteoarthritis. METHODS:The synovial tissues of 43 patients with osteoarthritis who underwent arthroscopic or joint replacement surgery and 10 patients undergoing arthroscopic treatment of meniscal injury or ligament tear were collected and divided into three groups according to the Kellgren-Lawrence grading of X-ray images:normal control group(KLG 0,n=10),early knee osteoarthritis group(KLG 1,2,n=20)and late knee osteoarthritis group(KLG 3,4,n=23).Hematoxylin-eosin staining was used to observe the severity of synovitis in each group,and iron deposition in the synovium in each group was evaluated by Prussian blue staining.The expressions of Acyl-CoA Synthetase Long Chain Family Member 4(ACSL4),GPX4,cyclooxygenase 2 and tumor necrosis factor α in the synovium were detected by immunohistochemical staining.Western blot and immunofluorescence were used to detect the expression of ferroptosis-related proteins ACSL4 and GPX4. RESULTS AND CONCLUSION:Compared with the normal control group,iron content in synovial tissue was increased in the knee osteoarthritis groups,and iron deposition in the late knee osteoarthritis group was higher than that in the early osteoarthritis group.ACSL4 was highly expressed in the synovial tissue of knee osteoarthritis compared with the normal control group(P<0.01),and GPX4 was lowly expressed in the synovial tissue of knee osteoarthritis(P<0.01).The expression level of ACSL4 increased with the progression of osteoarthritis,while the expression level of GPX4 decreased with the progression of osteoarthritis.The expression of cyclooxygenase 2 in the synovium of osteoarthritis was significantly higher than that in the normal synovium,and the expression was the highest in the early stage of osteoarthritis,which was significantly different from that in the advanced stage of osteoarthritis(P<0.01).The expression of tumor necrosis factor α in the synovium of osteoarthritis was significantly higher than that in the normal synovium,but there was no significant difference between early and late osteoarthritis groups(P>0.05).To conclude,the deposition of iron exists in the synovial tissue of osteoarthritis and ferroptosis is involved in the occurrence and progression of synovitis in knee osteoarthritis.

4.
Article in Chinese | WPRIM | ID: wpr-1021431

ABSTRACT

BACKGROUND:Previous studies have confirmed that the new compound cottonrose hibiscus leaf gel plaster has a good effect in the treatment of acute soft tissue swelling. OBJECTIVE:To observe the clinical efficacy of compound cottonrose hibiscus leaf gel plaster in the treatment of synovitis of the knee joint. METHODS:Seventy-two patients with knee synovitis were selected from Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from December 2019 to May 2021.These patients were randomly divided into a trial group and a control group,with 36 cases in each group.The trial group was treated with compound cottonrose hibiscus leaf gel plaster,once a day,12 hours each time,while the control group was treated with Diclofenac Diethylamine Emulgel,twice a day.After 28 days of treatment,visual analog scale score,WOMAC Osteoarthritis Index score,quality of life score(SF-36),thickness of knee synovium and comprehensive curative effect were compared between the two groups. RESULTS AND CONCLUSION:(1)Visual analog scale scores after treatment were lower than those before treatment(P<0.05).Visual analog scale scores in the trial group after 7,14 and 28 days of treatment were lower than those in the control group(P<0.05).The WOMAC Osteoarthritis Index scores of the two groups after treatment were lower than those before treatment(P<0.05),and the WOMAC Osteoarthritis Index scores in the trial group after 7,14 and 28 days of treatment were lower than those in the control group(P<0.05).(3)The SF-36 quality of life score in the two groups after 28 days of treatment was higher than that before treatment(P<0.05).SF-36 quality of life score in the trial group after 28 days of treatment was higher than that in the control group(P<0.05).(4)After 28 days of treatment,the thickness of knee synovium in the trial group was less than that in the control group(P<0.05),and the effective rate in the trial group was higher than that in the control group(P<0.05).(5)These findings indicate that compared with Diclofenac Diethylamine Emulgel,the compound cottonrose hibiscus leaf gel plaster can better relieve knee pain,enhance knee joint function,reduce synovial hyperplasia,and elevate the overall quality of life of patients.

5.
Braz. j. anesth ; 74(3): 844502, 2024. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1564103

ABSTRACT

Abstract Background: This study aimed to investigate the analgesic impact of S(+)-ketamine on pain behavior and synovial inflammation in an osteoarthritis (OA) model. Methods: Animals were grouped as follows: OA-Saline (n = 24) and OA-Ketamine (n = 24), OA induced via intra-articular sodium monoiodoacetate (MIA); a Non-OA group (n = 24) served as the control. On the 7th day post OA induction, animals received either saline or S(+)-ketamine (0.5 mg.kg-1). Behavioral and histopathological assessments were conducted up to day 28. Results: S(+)-ketamine reduced allodynia from day 7 to 28 and hyperalgesia from day 10 to 28. It notably alleviated weight distribution deficits from day 10 until the end of the study. Significant walking improvement was observed on day 14 in S(+)-ketamine-treated rats. Starting on day 14, OA groups showed grip force decline, which was countered by S(+)-ketamine on day 21. However, S(+)-ketamine did not diminish synovial inflammation. Conclusion: Low Intra-articular (IA) doses of S(+)-ketamine reduced MIA-induced OA pain but did not reverse synovial histopathological changes. IRB approval number: 23115 012030/2009-05.

6.
Article | IMSEAR | ID: sea-231330

ABSTRACT

Background: Hyaluronic acid (HA) has been used for many years for intra-articular treatment of knee osteoarthritis with satisfactory results. HA associated with Adelmidrol – an anti-neuroinflammatory compound – have been only recently introduced in orthopedic clinical practice with good preliminary results.Objective: To investigate whether HA associated with Adelmidrol provides better results than HA alone.Methods: Two cohorts of patients with moderate knee osteoarthritis were treated. Cohort 1 received 5 weekly intra-articular injections of HA during 2017 while Cohort 2, 4 weekly intra-articular injections of HA associated with Adelmidrol during 2018. The patients of the two Cohorts were assessed by WOMAC scale, SF-12 questionnaire and PGIC scale at 1 week (T0), 6 months (T1), 1 year (T2), and 2 years (T3) after the end of treatment. All the data were statistically analyzed. A p-value of <0.05 was considered statistically significant.Results: According to the WOMAC Scale Cohort 1 had higher mean scores than Cohort 2 at each follow-up time, with a statistically significant difference between the two cohorts at T3 (p<0.03) for all the WOMAC components, except for Stiffness. WOMAC Total mean score worsened statistically significantly only in Cohort 1, from T1 to T3 (T2 vs T1: p=0.0033; T3 vs T2: p=0.0007). The same happened for WOMAC Physical Function (T2 vs T1: p=0.0146; T3 vs T2: p=0.0046) and WOMAC Pain (T2 vs T1: p=0.0004; T3 vs T2: p=0.0002). WOMAC Stiffness worsened statistically significantly in Cohort 1 from T2 to T3 (T3 vs T2: p=0.0041), while in Cohort 2 no change on WOMAC scale was statistically significant at any time-point, for any components. The mean scores of the SF-12 questionnaire were better in Cohort 2 than in Cohort 1 at each follow-up time for both the Physical and the Mental components, with a statistically significant difference between the two groups for the latter, at T0 (p=0.0001). In both cohorts the mean score of the Physical component decreased from T0 to T3, but the difference was not statistically significant between the two groups (p=0.25). The mean score of the Mental component slightly increased in Cohort 1 and decreased in Cohort 2, without statistically significant differences between the two groups at any time-point. PGIC showed that Cohort 2 scored significantly better than Cohort 1 at T3 (p=0.0336).Conclusions: Overall, HA associated with Adelmidrol gave better long-term results than HA alone.

7.
Singap. med. j ; Singap. med. j;: 262-270, 2023.
Article in English | WPRIM | ID: wpr-984222

ABSTRACT

The temporomandibular joint (TMJ) is frequently imaged in head and neck computed tomography (CT) and magnetic resonance imaging (MRI) studies. Depending on the indication for the study, an abnormality of the TMJ may be an incidental finding. These findings encompass both intra- and extra-articular disorders. They may also be related to local, regional or systemic conditions. Familiarity with these findings along with pertinent clinical information helps narrow the list of differential diagnoses. While definitive diagnosis may not be immediately apparent, a systematic approach contributes to improved discussions between clinicians and radiologists and better patient management.


Subject(s)
Humans , Temporomandibular Joint Disorders/pathology , Incidental Findings , Temporomandibular Joint/pathology , Tomography, X-Ray Computed , Magnetic Resonance Imaging
8.
Article in Chinese | WPRIM | ID: wpr-992819

ABSTRACT

Objective:To explore the vascularity index of joints synovial quantitatively evaluate activity degree of rheumatoid arthritis(RA).Methods:From January to April 2022, 102 cases of RA patients in Henan Provincial People′s Hospital were conducted ultrasound examination of 28 joints including the bilateral metacarpophalangeal joints (1-5), 1st interphalangeal and proximal interphalangeal joints (2-5), wrist joints, elbow joints, shoulder joints and knee joints. Superb microvascular imaging (SMI) was used to visualize and calculate the vascularity index (VI) in the hyperplastic synovium. Summary Vascularity index (VIsum) was calculated by adding the VI of 28 joints. Standard vascularity index (VIstand) was obtained by dividing VIsum by the number of positive joints. The mean vascular index (VImean) was obtained by dividing the VIsum by 28, which is the number of joints examined. The disease activity score in 28 joints (DAS28) was calculated, including DAS28-CRP and DAS28-ESR. Serological results related to RA were collected. The correlation between VIsum, VIstand, VImean and the above data were analyzed respectively. DAS28-ESR and DAS28-CRP stages were used as the criteria, receiver operating curve (ROC) was used, to evaluate the diagnostic efficacy, sensitivity and specificity of VI parameters in assessing RA activity.Results:VIsum, VIstand and VImean were positively correlated with DAS28-ESR, DAS28-CRP, ESR and CRP. The r values of VIsum and DAS28-ESR, DAS28-CRP, ESR and CRP were 0.703, 0.728, 0.467 and 0.529, respectively. The r values of VIstand and DAS28-ESR, DAS28-CRP, ESR and CRP were 0.665, 0.705, 0.538 and 0.605, respectively. The r values of VImean and DAS28-ESR, DAS28-CRP, ESR and CRP were 0.677, 0.690, 0.441 and 0.501, respectively (all P<0.01). Using DAS28-ESR as grouping standard, the area of ROC curve(AUC) of VIsum, VIstand, and VImean were 0.815, 0.816 and 0.814, respectively. With the cut-off value of VIstand being 12.83, the specificity and sensitivity of VIstand diagnosis were 0.882 and 0.676, respectively. Using DAS28-CRP as grouping standard, the AUC of VIsum, VIstand, and VImean were 0.812, 0.878 and 0.811, respectively. With the cut-off value of VIstand being 13.97, the specificity and sensitivity of VIstand diagnosis were 0.997 and 0.710, respectively. Conclusions:Synovitis VI can objectively evaluate the degree of synovitis activity in patients with rheumatoid arthritis. Synovial VI has high diagnostic efficacy for the activity of RA patients.

9.
Article in Chinese | WPRIM | ID: wpr-996810

ABSTRACT

ObjectiveTo observe the effect of shikonin (SKN) on synovitis in DBA/1 mice with collagen-induced arthritis (CIA). MethodThirty-six DBA/1 mice were randomly divided into a normal group, a CIA group, low-, medium-, and high-dose SKN groups (1, 2, and 4 mg·kg-1), and a methotrexate (MTX, 0.5 mg·kg-1) group, with 6 mice in each group. Mice in the CIA group, the SKN groups, and the MTX group were immunized with an equal volume of bovine type Ⅱ collagen and complete Freund's adjuvant on day 1. On day 21, those mice received a second immunization with an equal volume of bovine type Ⅱ collagen and incomplete Freund's adjuvant to establish the CIA model. On the day of the second immunization, mice were treated with drugs by gavage. Mice in the MTX group received oral administration three times a week, while others received once per day, for 28 days. On day 22, the symptoms of arthritis, such as redness and swelling of joints, in CIA mice were observed, and arthritis scores were recorded. On day 49 after sample collation, histopathological examination of synovial inflammation in CIA mice was performed using hematoxylin-eosin (HE) staining. Immunofluorescence (IF) double labeling was used to detect the expression of vimentin and mitogen-activated protein kinase 1 (MAPK1) in the synovium of CIA mice. Network pharmacology predicted that the target of SKN in rheumatoid arthritis (RA) was MAPK1, which was verified by molecular docking. Western blot was used to detect the expression of extracellular signal-regulated kinase (ERK), c-Jun N-terminal kinase (JNK), p38, phosphorylated (p)-ERK, p-JNK, and p-p38 proteins in the synovial membrane of mice. ResultCompared with the normal group, the CIA group showed significantly higher arthritis scores, morbidity, and synovial inflammation, severely disrupted joint structure, evident articular cartilage and bone destruction, severe bone erosion (P<0.01), increased expression of vimentin and MAPK1 in the synovium of mice, and increased protein expression of p-ERK/ERK, p-JNK/JNK, and p-p38/p38 in the synovium of mice (P<0.01). Compared with the CIA group, the SKN groups and the MTX group showed relatively normal joint structure, with milder bone erosion and bone destruction, and smoother articular surfaces. Molecular docking results confirmed that the target of SKN was MAPK1. In the SKN groups and the MTX group, the expression of vimentin and MAPK1 in the synovial membrane was significantly reduced (P<0.01), and the protein expression of p-ERK/ERK, p-JNK/JNK, and p-p38/p38 in the synovium of mice was significantly reduced (P<0.01). ConclusionSKN can target MAPK1 to inhibit the protein expression of p-ERK, p-JNK, and p-p38 in CIA mice, thereby treating RA.

10.
Rev. cir. traumatol. buco-maxilo-fac ; 22(4): 20-29, out.-dez. 2022. ilus, tab
Article in Portuguese | LILACS, BBO | ID: biblio-1414512

ABSTRACT

Objetivo: Avaliar os casos nos quais os pacientes apresentassem SVNP na ATM, incluindo aspectos clínicos, imaginológicos, histopatológicos e tratamento. Metodologia: Trata-se de uma revisão integrativa com dados obtidos nas bases de dados SciELO, PubMed, Medline e Lillacs entre 1982 e 2021, através dos descritores: "Case report", "Temporomandibular Joint", "Pigmented Villonodular Synovitis". Critérios de inclusão: estudos de relato de caso, textos completos disponíveis, idiomas de publicação em inglês, português ou espanhol. Critérios de exclusão: estudos sem presença de aspectos clínicos, relatos não localizados na ATM, artigos de metanálise, revisão sistemática e de literatura, ensaios clínicos, capítulos de livro, dissertações e teses. Dos 156 resultados, apenas 23 compuseram a revisão. Resultados: Como tratamento, a ressecção total através da cirurgia aberta é recomendada. Os sintomas mais comuns foram: dor na mastigação, trismo, dor pré auricular, dormência, parestesia, perca auditiva e inchaço da glândula parótida. Conclusão: Os aspectos imaginológicos revelam erosão de fossa glenóide e côndilo, histopatologicamente, células gigantes com depósito de hemossiderina, e o tratamento recomendado, ressecção via cirurgia aberta com posterior curetagem... (AU)


Objective: To evaluate the cases in which patients presented PVNS in the TMJ, including clinical, imaging, histopathological and treatment aspects. Methodology: This is an integrative review with data obtained from the SciELO, PubMed, Medline and Lillacs databases between 1982 and 2021, using the descriptors: "Case report", "Temporomandibular Joint", "Pigmented Villonodular Synovitis". Inclusion criteria: case report studies, full texts available, languages of publication in English, Portuguese or Spanish. Exclusion criteria: studies without the presence of clinical aspects, reports not located in the TMJ, meta analysis articles, systematic and literature reviews, clinical trials, book chapters, dissertations and theses. Of the 156 results, only 23 made up the review. Results: As a treatment, total resection through open surgery is recommended. The most common symptoms were: chewing pain, trismus, pre-auricular pain, numbness, paresthesia, hearing loss and parotid gland swelling. Conclusion: The imaging findings reveal erosion of the glenoid fossa and condyle, histopathologically, giant cells with hemosiderin deposits, and the recommended treatment, resection via open surgery with subsequent curettage... (AU)


Objetivo: Evaluar los casos en que los pacientes presentaron SVNP en la ATM, incluyendo aspectos clínicos, imagenológicos, histopatológicos y tratamiento. Metodología: Se trata de una revisión integradora con datos obtenidos de las bases de datos SciELO, PubMed, Medline y Lillacs entre 1982 y 2021, utilizando los descriptores: "Caso clínico", "Articulación temporomandibular", "Sinovitis villonodular pigmentada". Criterios de inclusión: estudios de casos clínicos, textos completos disponibles, idiomas de publicación en inglés, portugués o español. Criterios de exclusión: estudios sin aspectos clínicos, informes no localizados en la ATM, artículos de metanálisis, revisiones sistemáticas y de literatura, ensayos clínicos, capítulos de libros, disertaciones y tesis. De los 156 resultados, 23 conformaron la revisión. Resultados: Como tratamiento se recomienda la resección total mediante cirugía abierta. Los síntomas más frecuentes fueron: dolor masticatorio, trismus, dolor preauricular, entumecimiento, parestesia, hipoacusia e inflamación de glándula parótida. Conclusión: Los hallazgos imagenológicos revelan erosión de fosa glenoidea y cóndilo, histopatológicamente células gigantes con depósitos de hemosiderina y el tratamiento recomendado, resección abierta con posterior curetaje... (AU)


Subject(s)
Humans , Male , Female , Synovitis, Pigmented Villonodular/surgery , Temporomandibular Joint , Giant Cells , Synovitis, Pigmented Villonodular , Curettage , Glenoid Cavity
11.
Article in English | WPRIM | ID: wpr-934981

ABSTRACT

@#Introduction: To evaluate the clinical relevance of the painful anterior apprehension test in shoulder instability. Materials and methods: We performed a retrospective study of 155 patients that underwent arthroscopic anterior Bankart repair between 2014–2016. Exclusion criteria were previous ipsilateral shoulder surgery, bony Bankart lesions, glenohumeral osteoarthritis and concomitant surgery involving rotator cuff tears, biceps tendon pathology and superior labrum from anterior to posterior (SLAP) lesions. The study cohort was divided into three groups: apprehension test with apprehension only, apprehension test with pain only, and apprehension test with both apprehension and pain. Patient demographics, clinical characteristics, radiological imaging, arthroscopy findings and surgical outcomes (Constant, American Shoulder and Elbow Surgeons (ASES), SF-36 scores) were evaluated. Results: A total of 115 (74.2%) had apprehension only, 26 (16.8%) had pain only and 14 (9.0%) had pain and apprehension with the apprehension test. Univariate analysis showed significant differences between the groups in patients with traumatic shoulder dislocation (p=0.028), patients presenting with pain (p=0.014) and patients presenting with recurrent dislocations (p=0.046). Patients with a purely painful apprehension test were more likely to have a traumatic shoulder dislocation, more likely to present only with pain, and less likely to present with recurrent shoulder dislocations. Multivariate analysis showed that none of these factors alone were significant as single predictors for shoulder instability. All three groups were otherwise similar in patient profile, MRI and arthroscopic assessments, and clinical outcomes of surgery. Excellent clinical outcomes were achieved in all groups with no difference in pre-operative and post-operative scores across all groups at all time points. Conclusion: The painful apprehension test may suggest underlying shoulder instability.

12.
Acta Pharmaceutica Sinica B ; (6): 3073-3084, 2022.
Article in English | WPRIM | ID: wpr-939953

ABSTRACT

Osteoarthritis (OA), in which M1 macrophage polarization in the synovium exacerbates disease progression, is a major cause of cartilage degeneration and functional disabilities. Therapeutic strategies of OA designed to interfere with the polarization of macrophages have rarely been reported. Here, we report that SHP099, as an allosteric inhibitor of src-homology 2-containing protein tyrosine phosphatase 2 (SHP2), attenuated osteoarthritis progression by inhibiting M1 macrophage polarization. We demonstrated that M1 macrophage polarization was accompanied by the overexpression of SHP2 in the synovial tissues of OA patients and OA model mice. Compared to wild-type (WT) mice, myeloid lineage conditional Shp2 knockout (cKO) mice showed decreased M1 macrophage polarization and attenuated severity of synovitis, an elevated expression of cartilage phenotype protein collagen II (COL2), and a decreased expression of cartilage degradation markers collagen X (COL10) and matrix metalloproteinase 3 (MMP3) in OA cartilage. Further mechanistic analysis showed thatSHP099 inhibited lipopolysaccharide (LPS)-induced Toll-like receptor (TLR) signaling mediated by nuclear factor kappa B (NF-κB) and PI3K-AKT signaling. Moreover, intra-articular injection of SHP099 also significantly attenuated OA progression, including joint synovitis and cartilage damage. These results indicated that allosteric inhibition of SHP2 might be a promising therapeutic strategy for the treatment of OA.

13.
Article in Chinese | WPRIM | ID: wpr-940666

ABSTRACT

ObjectiveTo assess the curative effects of Fangji Huangqi detumescence prescription (FHDP) on synovitis and polarization of synovial macrophages of knee osteoarthritis (KOA) model in rats induced by Hulth method. MethodThirty-six rats were randomly divided into sham operation group, model group, high-dose, medium-dose, and low-dose (29.16, 14.58, and 7.29 g·kg-1) FHDP groups, and loxoprofen sodium (16.2 mg·kg-1) group. KOA model in rats was induced by modified Hulth method. Six weeks after the operation, rats were given high, medium, and low concentrations of FHDP, normal saline (NS), and loxoprofen sodium according to the group to intervene, and sacrificed after 2-week administration. Synovium and cartilage histopathological changes were observed after hematoxylin-eosin (HE) staining. Flow cytometry (FCM) and immunofluorescence (IF) test were used to evaluate the polarization of M1/M2 macrophages. Immunohistochemistry (IMC) and enzyme-linked immunosorbent assay (ELISA) were used to detect the related protein expression levels of macrophage polarization, such as interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), interleukin-10 (IL-10), and matrix metalloproteinase-13 (MMP-13) in joint tissues and serum. ResultCompared with the sham operation group, Krenn and Mankin scores in the model group were significantly increased (P<0.01). Compared with the model group, Krenn score was decreased in all administration groups (P<0.05, P<0.01), but there was no significant difference in Mankin score in any administration groups. Compared with the sham operation group, M1/mø (CD38+) ratio in the model group was significantly increased (P<0.01), and M2/mø (CD206+) ratio in the model group was decreased (P<0.05). Compared with the model group, M1/mø ratio in the high, medium, and low-dose FHDP groups was decreased (P<0.05, P<0.01), but M2/mø ratio was increased in all administration groups (the difference had no statistical significance). Compared with the sham operation group, M1/M2 ratio in the model group was significantly increased (P<0.01). Compared with the model group, M1/M2 ratio in all FHDP groups was significantly decreased (P<0.01), and M1/M2 ratio in the high and medium-dose FHDP groups was lower than that in the loxoprofen sodium group (P<0.05). Compared with the sham operation group, the levels of TNF-α, IL-1β, and MMP-13 in synovium and cartilage of the model group were significantly increased (P<0.01), the level of IL-10 was significantly decreased (P<0.01). Compared with the model group, the levels of TNF-α and IL-1β in synovium were decreased in all administration groups (P<0.05), but the difference of the levels of MMP-13 and IL-10 in synovium had no statistical significance. The level of inflammatory mediators in cartilage was not affected in all administration groups. Compared with the sham operation group, the levels of TNF-α and IL-β in serum of the model group were significantly increased (P<0.01), the level of IL-10 was decreased (P<0.05). Compared with the model group, the level of TNF-α in the high-dose FHDP group was decreased (P<0.05), and the level of IL-10 was increased in all administration groups (P<0.05, P<0.01). The difference of the level of IL-β in all administration groups had no statistical significance. ConclusionFHDP attenuated the synovitis of KOA rats. FHDP exert the effect on the releasing of proinflammatory cytokines and MMP by inhibiting the polarization of M1 macrophages in synovium, and had no significant effect on the polarization of M2 macrophages. Modulating the imbalanced polarization of synovial macrophages was a possible mechanism of FHDP on attenuating synovitis and treating KOA.

14.
Article in English | WPRIM | ID: wpr-935063

ABSTRACT

@#Tuberculosis is known to be a great mimicker, and it can present in a myriad of ways, which often result in an incorrect diagnosis. In a country that is endemic to tuberculosis, the presentation can take many forms ranging from tumour to trauma. We present a case of Baker’s cyst that was provisionally diagnosed as pigmented villonodular synovitis (PVNS) of the knee and eventually turned out to be tuberculous arthritis. A 46-year-old male presented with an insidious swelling on the posterior aspect of his knee for one year. Magnetic resonance imaging was suggestive of PVNS as the likely diagnosis. The patient presented 21 days later with a foot drop. On following-up with further investigations, he was found to have a lesion at the level of the L4-L5 spine. Chest radiograph changes were suggestive of tuberculosis. A synovial biopsy of the knee was done, and the tuberculosis culture report was positive. The patient was started on anti-tubercular treatment and then operated on, with arthroscopic synovectomy and posterior open cyst excision. The histology report was positive for tuberculous synovitis. The patient completed the course of antitubercular drugs and had physiotherapy. He demonstrated a clinically and radiologically healed disease at the final follow-up with a good functional outcome. Clinicians must have a high index of suspicion for tuberculosis, especially in endemic areas. Getting a chest radiograph is recommended in every case. Early diagnosis with the appropriate treatment will give a good functional outcome for the patient.

15.
Article in English | WPRIM | ID: wpr-987231

ABSTRACT

@#Locked knees are commonly caused by meniscal tears, floating osteochondral bodies, ruptured anterior cruciate ligament (ACL) stump, or other mechanical origins in the knee. Some locked knees occur spontaneously, while in most cases, by a preceding knee trauma. Locked knees are rarely caused by a pathological growth in the knee. More unusually is the occurrence of locked knee caused by a pre-existing pathological entity after a traumatic event. We report a rare case of locking in the knee by a pre-existing knee condition presented only after trauma to the knee. This case emphasizes that locking in the knee can be caused by a pathology that may be asymptomatic until it is revealed by a traumatic event.

16.
Rev. colomb. reumatol ; 28(supl.1): 90-100, Dec. 2021. tab, graf
Article in English | LILACS | ID: biblio-1361005

ABSTRACT

ABSTRACT Articular involvement in Systemic Lupus Erythematosus (SLE) is well recognized as one of the most common manifestations of the disease. This article reviews the recent knowledge of the clinical manifestations, diagnostic techniques and therapies used for the treatment of joint involvement in SLE. The degree of articular involvement is characterized by widespread heterogeneity in terms of clinical presentation and severity. It may range from minor arthralgia without erosions or deformity to erosive arthropathy and severe functional disability. Inflammatory musculoskeletal manifestations are described as a major cause of pain impacting daily activities and as a major determinant of quality-of-life impairment. Thus, physicians must be aware of articular involvement in SLE. Lupus arthritis diagnosis may be challenging, due to the frequently mild synovitis. The introduction of new more sensitive imaging techniques, such as ultrasound, and MRI have contributed significantly to improving the diagnosis of osteoarticular involvement in SLE. There are several treatment options for the management of joint manifestations in patients with SLE. The choice of treatment will depend on the type and pattern of joint involvement, its severity, and the characteristics of the patient.


RESUMEN El compromiso articular en lupus eritematoso sistémico (LES) es bien reconocido como una de las manifestaciones más comunes de la enfermedad. En el presente artículo se revisa la evidencia reciente sobre las manifestaciones clínicas, las técnicas de diagnóstico y los tratamientos utilizados para tratar el compromiso articular en el LES. El grado de compromiso articular se caracteriza por la amplia heterogeneidad en su presentación clínica y su gravedad. Puede variar desde artralgia leve sin erosiones o deformidad, hasta una artropatía erosiva y discapacidad funcional. Se describen las manifestaciones inflamatorias musculoesqueléticas como la principal causa de dolor que afecta las actividades de la vida cotidiana y como uno de los principales factores determinantes del deterioro de la calidad de vida. Por lo tanto, los médicos deben estar conscientes del compromiso articular en LES. El diagnóstico de la artritis lúpica puede ser difícil debido a la sinovitis, usualmente leve. El advenimiento de nuevas técnicas de imágenes más sensibles, como la ecografía y la resonancia magnética, ha contribuido significativamente a mejorar el diagnóstico del compromiso osteoarticular en LES. Existen varias opciones de tratamiento para las manifestaciones articulares en pacientes con LES. La opción de tratamiento dependerá del tipo y del patrón del compromiso articular, así como de las características del paciente.


Subject(s)
Humans , Musculoskeletal Diseases , Arthritis , Skin and Connective Tissue Diseases , Connective Tissue Diseases , Joint Diseases , Lupus Erythematosus, Systemic
17.
Acta ortop. bras ; Acta ortop. bras;29(2): 72-75, Mar.-Apr. 2021. graf
Article in English | LILACS-Express | LILACS | ID: biblio-1248600

ABSTRACT

ABSTRACT Objective: The synovial fold is an intra-articular structure found in more than 50% of the knees, which can cause symptoms similar to meniscal injuries. These symptoms are mostly related to hypertrophy of the synovial fold resulting from inadequate physical activity. Conservative treatment with readjustment of sports activity and muscle rebalancing solves most cases. Rare cases require surgical treatment, which is indicated due to the persistence of instability, blockage and pain. We present our experience in the treatment of this pathology. Methods: 58 patients (70 knees), with 62 knees treated conservatively and 8 treated surgically exclusively for the pathological synovial fold. Results: Description of the series and treatment results are reported. Conclusion: The non-surgical treatment of the pathological synovial fold of the knee provided good results within 60 days of rehabilitation program in almost 90% of the patients. Arthroscopic resection of the synovial fold is a surgery that has a longer and laborious rehabilitation period, despite good results in most cases. Level of Evidence IV, Case series.


RESUMO Objetivo: A prega sinovial é uma estrutura intra-articular encontrada em mais de 50% dos joelhos, que pode provocar sintomas semelhantes aos da lesão meniscal. Esses sintomas estão relacionados, na maioria dos casos, à hipertrofia da prega sinovial decorrente de atividade física inadequada. O tratamento conservador com a readequação da atividade esportiva e reequilíbrio muscular resolve a maioria dos casos. Raros casos demandam tratamento cirúrgico, que é indicado pela persistência de falseios, bloqueios e dor. Apresentamos nossa experiência no tratamento dessa patologia. Métodos: 58 pacientes (70 joelhos), com 62 joelhos tratados conservadoramente e 8 tratados cirurgicamente exclusivamente para a prega sinovial patológica. Resultados: São apresentados descrição da série e resultados do tratamento. Conclusão: O tratamento não cirúrgico da prega sinovial patológica do joelho propiciou bons resultados com 60 dias de programa de reabilitação em quase 90% dos pacientes. A ressecção artroscópica da prega sinovial é uma cirurgia que tem um período de reabilitação mais longo e trabalhoso, apesar do bom resultado na maioria dos casos. Nível de Evidência IV, Série de casos.

18.
Hematol., Transfus. Cell Ther. (Impr.) ; 43(1): 15-20, Jan.-Mar. 2021. tab, ilus
Article in English | LILACS | ID: biblio-1154301

ABSTRACT

ABSTRACT Introduction: The radiosynovectomy (RS) is one treatment option for recurrent hemarthrosis in patients with hemophilia (PWH). A prospective cohort study was designed to evaluate the effects of the RS on the synovial membrane volume in the ankles and knees of PWH and patient characteristics related to the RS outcome. Methods: In a one-year follow-up, 25 joints of 22 PWH who presented 3 bleeds or more in the same joint over the last 6 months (target joints) were subjected to the RS. Two groups were compared: those who retained target joints following the RS and those who did not (less than 3 bleeds/6 months after the RS). The groups were analyzed according to age, hemophilia type/severity, joint, body mass index (BMI), inhibitor and Hemophilia Joint Health Score 2.1 (HJHS). The magnetic resonance images (MRI) of six ankles and six knees were acquired prior to, and 6 months after, the RS. The synovial membrane volume and arthropathy MRI scale were accessed and volumes were compared and correlated with the Yttrium-90 dose injected. Results: Patients with a mean age of 12 years and a mean HJHS of 6.7 (p < 0.05) retained target joints after the RS. The inhibitor, joint, type/severity of disease and BMI showed no significant differences between groups. The synovial membrane volume had a significant reduction after the RS (p = 0.03), but no correlation with the Yttrium-90 dose. In proportion to the synovial membrane volume, doses injected to the ankles were larger than those injected to the knees. Conclusion: The synovial membrane volume is reduced after the RS, regardless of the effective 90Y dose.


Subject(s)
Humans , Child , Adolescent , Adult , Synovitis , Magnetic Resonance Imaging , Synovectomy , Hemarthrosis , Hemophilia A , Joint Diseases
19.
Article in English | WPRIM | ID: wpr-923069

ABSTRACT

@#Pigmented villonodular synovitis (PVNS) is a benign but rare proliferative disorder of the synovium. It commonly occurs in the adult population and usually presents as a monoarticular disease. There are two types of PVNS, namely the localised and diffused type. The disease is often misdiagnosed due to its rarity especially in paediatric patients. Knee involvement in PVNS is the commonest form in children although other joints such as hip, foot, ankle, hip, sacroiliac joint and concurrent multiple joint involvements have also been reported. PVNS in paediatric patients is often misdiagnosed as septic arthritis, juvenile rheumatoid arthritis and bone sarcoma, and the diagnosis is usually often made late due to its vague presentation. The majority of PVNS cases are managed by surgery either via open or arthroscopic synovectomy except in a few paediatric patients as described in the literature. This case report of PVNS is of a knee in 11- year-old boy who was initially treated as septic arthritis. The synovium appearance mimicked the features of PVNS during a knee arthrotomy washout, and histopathological examination confirmed the diagnosis. The knee symptoms had significantly improved without additional surgery, and good functional knee motion was achieved, with no sign of recurrence, after two years of follow-up.

20.
Adv Rheumatol ; 61: 68, 2021. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1349909

ABSTRACT

Abstract Objectives: Assessing disease activity in rheumatoid arthritis (RA) patients requires comprehensive quantification of tender and swollen joints. We aimed to evaluate the correlation and agreement between rheumatologists after a training session dedicated to the standardization of synovitis assessment and compare its performance with a reference imaging modality such as musculoskeletal ultrasonography (MSUS). Methods: In this cross-sectional study, a total of 28 and 10 joints in RA patients were evaluated by physical examination and ultrasound (US), respectively. After participating in a training session, individual joint assessment for tenderness and swelling was performed by three rheumatologists. MSUS examination was performed separately by an experimented radiologist in a standardized manner, evaluating findings according to the Outcome Measures in Rheumatology Clinical Trial (OMERACT) guidelines. Results: A total of 80 RA patients were included, with a mean Disease Activity Score based on 28 joints (DAS28)-ESR of 4.02. The interobserver overall agreement and concordance rate in a total of 2240 joints assessed was 81.7% (k = 0.449, p < 0.0001) for tender joints and 66% (k = 0.227, p < 0.0001) for swollen joints. The overall concordance rate was fair (Fleiss' kappa = 0.21, p = 0.027) with an overall agreement of 67.18% yet, more joints were found to be swollen by the US assessment, compared to the physical examination (43% vs 39%). Conclusion: In our study population, joint tenderness showed better interobserver agreement, correlation, and concordance rate than joint swelling. When comparing the US assessment to the physical examination, a fair overall concordance rate supports the need for the implementation of training sessions dedicated to standardization in rheumatology clinics.

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