ABSTRACT
Rheumatoid arthritis (RA) frequently affects finger joints, and persistent synovitis is believed to cause not only bone destruction but also various deformities of the fingers in the long run. Synovectomy of the finger joints is carried out when chronic swelling of the synovium does not respond to any conservative treatment with medication and rehabilitation. In the present study the short-term results of finger joint synovectomy in RA were reviewed in 49 finger joints. The subjects were evaluated at two time points, with average follow-up periods of 14 and 62 months, and the results were compared between the two follow-up time points. In regard to results, pain relief, swelling abatement, and only a little loss of motion were observed in most fingers. Moreover, only a few patients demonstrated progression of bone destruction, suggesting that synovectomy has a retarding effect and tends to be effective especially in the early stages of the disease. In conclusion, we recommend synovectomy for finger joints in RA patients before bone changes occur, and when chronic synovitis of the finger joints does not respond to any other conservative treatment.
Subject(s)
Arthritis, Rheumatoid/surgery , Finger Joint/surgery , Synovectomy , Adult , Aged , Arthritis, Rheumatoid/complications , Female , Humans , Male , Middle Aged , Pain/complications , Pain/surgery , Pain Measurement , Range of Motion, Articular , Treatment OutcomeABSTRACT
The treatment of patients with severe flexion contracture of the rheumatoid knee, deprived of ambulation for long periods of time, is challenging. Based on three cases, we indicate the potential risks of posterior dislocation of the knee after total knee arthroplasty. In this pathological condition, surgeons must carefully select the type of implant in order to avoid this serious complication. We also emphasize the importance of working on disuse muscle atrophy of trunk (back, abdominal) and lower limbs, both of which play an integral role in ambulation. The personality of each rheumatoid patient should be carefully considered when considering surgical and rehabilitation options.
Subject(s)
Arthritis, Rheumatoid/surgery , Arthroplasty, Replacement, Knee/adverse effects , Contracture/surgery , Knee Joint/surgery , Arthritis, Rheumatoid/complications , Arthroplasty, Replacement, Knee/rehabilitation , Contracture/etiology , Contracture/rehabilitation , Female , Humans , Knee Joint/physiopathology , Middle Aged , Muscular Atrophy/etiology , Muscular Atrophy/surgery , Range of Motion, ArticularABSTRACT
Synovial sarcoma is a malignant mesenchymal neoplasm which commonly occurs in the extremities of adults. We report on a 13-month-old girl with synovial sarcoma in the lateral aspect of her right ankle. The tumor was treated with total excision and 50Gy of irradiation. Histopathologic examination of the excised tumor revealed a biphasic synovial sarcoma. There was no evidence of local recurrence or distant metastasis of the tumor at follow-up examination 24 months postoperatively.
