Multimodal Diagnostic Approach for Synovitis of the Wrist / 대한정형외과학회잡지

PURPOSE: The purpose of this study was to suggest a multimodal diagnostic approach to determine the cause of the disease in patients diagnosed with synovitis of the wrist and who underwent synovectomy. MATERIALS AND METHODS: Twenty-nine patients, who underwent contrast magnetic resonance imaging (MRI) preoperatively and synovectomy from January 2000 to December 2013, were reviewed retrospectively. Among them, 17 patients underwent a Tc99m white blood cell (WBC) scan preoperatively. In patients who met the diagnostic criteria of rheumatoid arthritis (RA), the diagnosis was confirmed as RA if the MRI finding or histology was compatible with RA. If the MRI finding and histology were disparate, the final diagnosis was made based on the histologic finding. RESULTS: Of the nine patients who met the diagnostic criteria of RA, seven patients were finally diagnosed as RA and two patients as tuberculous arthritis. Of the 20 patients who did not meet the diagnostic criteria of RA, the MRI findings and histology were consistent with the same disease in 12 patients. In the remaining eight patients, five were diagnosed with nonspecific chronic synovitis, one with RA, and two with tuberculous arthritis based on the clinical findings, MRI, and histology findings. CONCLUSION: MRI and a WBC scan are very useful imaging modalities for diagnosing the causative condition of the wrist synovitis. A histology evaluation after synovectomy can also be useful in cases with a difficult diagnosis or are refractory to medications.

Clinical Observation of Qizhi Qushi Jianpi Prescription in the Treatment of Chronic Synovitis of Knee Joint in Middleaged and Elderly Patients after Debridement under Arthroscope / 中国药房

OBJECTIVE:To observe clinical efficacy and safety of Qizhi qushi jianpi prescription in the treatment of chronic synovitis of knee joint in middleaged and elderly patients after debridement under arthroscope. METHODS:A total of 80 mid-dleaged and elderly inpatients with chronic synovitis of knee joint were selected and randomly divided into treatment group and con-trol group,with 40 cases in each group. Clinical efficacy,VAS,swelling score of modified Cincinnati knee joint score system, Lysholm score of knee joint function,the occurrence of ADR were observed in 2 groups. RESULTS:Total effective rate of treat-ment group(92.5%)was significantly than that of control group(77.5%),with statistical significance(P0.05). On the first day after surgery,VAS score of 2 groups decreased significantly,and there was statistical signifi-cance compared to before surgery (P<0.05). One month after surgery,VAS score of 2 groups decreased significantly,and the treatment group was significantly lower than the control group,with statistical significance(P<0.05). Swelling score of knee joint 1 month after surgery and Lysholm score 3 months after surgery increased significantly in 2 groups,and the treatment group was significantly higher than the control group,with statistical significance(P<0.05). 5 patients of treatment group suffered from stom-ach discomfort,and the symptom was relieved after adding the ingredient of comforting stomach and removing dampness through diuresis. CONCLUSIONS:Qizhi qushi jianpi prescription is effective for chronic synovitis of knee joint in middleaged and elderly patients after debridement under arthroscope,and can relieve pain, remove swelling and recover knee joint function with good safety.

Evaluación de la seguridad de una suspensión de fosfato de cromo(III) para uso en radiosinoviortesis / Evaluation of the safety a Chromium (III) Phosphate suspension for radiosynoviorthesis

Objetivo: evaluar la fuga de radiactividad de la cavidad articular después de la administración de suspensiones radiomarcadas de Fosfato de Cromo(III) y la probabilidad de inducción de genotoxicidad. Métodos: las suspensiones se obtuvieron según método reportado. Para la evaluación de la fuga articular las suspensiones marcadas se administraron por vía intraarticular en ratas y conejos. El seguimiento se realizó por medición de la actividad retenida por cámara gamma. En los estudios de genotoxicidad se determinó la frecuencia de formación de micronúcleos en eritrocitos de médula ósea de ratas para 2 dosis y 2 tiempos para cada preparado. Resultados: para las suspensiones radiomarcadas en estudio la fuga fue no significativa durante 3 semanas (< 3 por ciento para la marcada con 51Cr y ~5 por ciento con 32P). Para los preparados con 32P e 90Y se observó poca diferencia en la frecuencia de aparición de micronúcleos para el 1-er tiempo, independientemente de las dosis administradas. A tiempos mayores se produjo un incremento en la formación de micronúcleos para las dosis superiores. Conclusiones: se demostró la posibilidad del uso seguro de una suspensión de Fosfato de Cromo(III) marcada con diferentes radionúclidos, en particular que la fuga articular de la suspensión no fue significativa durante 3 semanas y se comprobó las ventajas de tener un preparado con mayor tamaño de partículas. Para las suspensiones marcadas con 90Y y 32P no se producen incrementos en la frecuencia de formación de micronúcleos para una dosis superior en aproximadamente 40 veces a la prevista a utilizar en la clínica

Objective: to evaluate the leakage of radioactivity after intraarticular administration of radioactive suspensions based on Chromium (III) Phosphate as well as the probability of induction of genotoxic effect. Methods: the suspensions were obtained in line with the published procedure. For the articular leakage evaluation, the radioactive suspensions were intraarticulary administered in rats and rabbits. The radioactivity retention was measured by gamma chamber. A comparison with commercial radiopharmaceutical labeled with 32P was made. The genotoxicity studies determined the frequency of micronuclei formation in the rats´ bone marrow erythrocytes by using 2 doses and 2 time intervals for each preparation. Results: the radiolabeled suspensions under evaluation showed that the leakage was not significant during 3 weeks (<3 percent for the suspension labeled with 51Cr and ~5 percent in the one labeled with 32P) and the advantages of having larger particle preparation were confirmed. For those suspension labeled with 32P and 90Y , no significant difference was seen in the frequency of micronuclei formation for the first time interval, regardless of the administered doses. The micronuclei formation increased for higher doses and at longer time intervals. Conclusions: the results demonstrated the possibility of the safe use of a of Chromium (III) Phosphate suspension labeled with several radionuclides for the treatment of different joints, in particular the leakage was not significant during 3 weeks and the advantages of having a larger particle radiopharmaceutical was confirmed. For the suspensions labeled with 32P and 90Y micronucleus frequency mildly increased with the time and administered doses

Arthroscopic synovectomy in chronic synovitis of the knee in patients with hemophilia A / 中国矫形外科杂志

[Objective] To introduce a method of arthroscopic synovectomy in chronic synovitis of the knee in patients with hemophilia A and to evaluate its clinical value.[Method]Arthroscopic synovectomy was performed in 25 patients with hemophilia A from Sept.2002 to Jan.2007.Sufficient factor replacement was used and systematic rehabilitation exercise was emphasized.HSS scores were used to evaluate the efficiency of the operation.Insall standard was used to determine the difference between groups according to Outerbridge grading of the cartilage.[Result]Twenty-three patients were followed up.The mean period of follow-up was 27 months.The average frequency of hemarthrosis reduced from 23.4 times per year preoperatively to 9.8 times per year postoperatively(P

THE PRELIMINARY APPLICATION OF RADIATION SYNOVECTOMY WITH ~(32)P-CHROMIC PHOSPHATE / 重庆医科大学学报

Twenty-three joints in 14 cases of chronic synovitis were treated with intra-articular injection of 32 p-chromic phosphate, including 19 knee joints, one elbow joint with rheumatoid arthritis and 3 knee joints with degenerative arthritis that was recractory to medical treatment. Results of 23 joints evaluated at end of one year were excellent in 43.5$, good in 30.5%, .fair in 13% and poor in 13%. There was a good correlation between the radiographic stage of the joints and the response to treatment. Patients in stage 1 and 2 were more likely to have good to excellent response. Cur study shows that radiation synovectomy is a simple, safe and effective treatment than other managements for chronic synovitis