Prospective Follow-Up of Cortical Interruptions, Bone Density, and Micro-structure Detected on HR-pQCT: A Study in Patients with Rheumatoid Arthritis and Healthy Subjects.

OBJECTIVES: The purpose of the study was to prospectively investigate change (repair or progression) in the number, surface area and volume of cortical interruptions, bone density (vBMD) and micro-structural parameters assessed by high-resolution peripheral quantitative computed tomography (HR-pQCT) in finger joints of patients with rheumatoid arthritis (RA) treated with synthetic disease modifying anti-rheumatic drugs (sDMARDs) and/or biologic DMARDs (bDMARDs) over a 1-year follow-up period, and in comparison with healthy subjects (HS). METHODS: Thirty-two patients with RA (221 joints, 53% on bDMARDs) and 32 HS (117 joints) were assessed at baseline and after 1 year using semi-automatic analysis of HR-pQCT images. Mean changes (group level) and the proportion of joints (joint level) with changes beyond the least significant change were calculated. RESULTS: At baseline, 530 interruptions were identified in patients, and 136 in HS. The mean of the interruption parameters did not significantly change in either group Mean vBMD decreased more in patients than in HS (- 4.4 versus - 1.1 mgHA/cm3, respectively). In patients versus HS, proportionally more joints showed repair in interruption volume (6.6% versus 1.7%, respectively) and loss of vBMD (26.7% versus 12.9%, respectively). In patients on sDMARDs versus patients on bDMARDs, proportionally more joints showed progression in the number of interruptions and loss of vBMD (6.1% versus 1.8% and 31.3% versus 17.2%, respectively). CONCLUSIONS: HR-pQCT is able to quantify bone repair and progression. Cortical interruption-, vBMD-, and micro-structure were impaired in RA, of which vBMD and micro-structure further deteriorated, particularly in patients on sDMARDs.

[Functional and morphologic changes in the tendons and multimicrovacuolar collagen absorbing system of the three-phalanx fingers in disorder of arterial inflow].

Taking into account the fact, that unsatisfactory results of treatment of the thumbs traumatic damage are significantly caused by presence of anatomic disruption of the thumbs palm's own arteries with chronic tissue ischemia occurrence. One of consequences of damage of the three-phalanx thumbs interphalanx joints and the thumbs palm's own arteries is a formation of quickly progressing secondary flexing contracture of proximal interphalanx joints (PIPHJ). In the investigations accomplished there was established, that the changed tissues of the flexors tendons and their sheaths, forming cicatricial blockade distally to the primary trauma site, are taking part in a PIPHJ contracture development while arterial perfusion presence.The tissues damage severity, as well as a severity of clinical features of the tendons and their sheaths damage, depends on a degree of an arterial perfusion disorder present,

Ultrastructural study of the neuromuscular junctions of extensor digitorum longus muscle (M. extensor digitorum longus) of the mice / Estudio ultraestructural de las uniones neuromusculares del músculo extensor largo de los dedos (M. extensor digitorum longus) del ratón

The neuromuscular junction of the extensor digitorum longus muscle of fingers was analyzed in 21 young (three months) and old (from six to 25 months) mice, from both genders. Morphologic changes were found throughout the mouse life, being more frequent and visible with aging. According with the data described in the literature consulted and the observations taken in this research, it becomes clear that a continuous process of morphological remodeling occurs in all neuromuscular ultrastructural junctions of the extensor digitorum longus muscle of fingers, during the life of the animal. Theses changes are characterized by figures of myelin in the cytoplasm of Schwann cells, pleomorphic and multivesiclar bodies, mitochondrias with morphologically altered crests in the axon terminal and degenerated junction folders. Coated vesicles are common in older animals and rare in young animals.

La ultraestructura de las uniones mioneurales del músculo extensor largo de los dedos fue analizada en 21 ratones, jóvenes (tres meses) y viejos (de seis a 25 meses), de ambos sexos. Los cambios morfológicos fueron encontrados en toda la vida del ratón, siendo más frecuentes y visibles en el envejecimiento. Según los datos descritos en la literatura comsultada y las observaciones tomadas en esta investigación, se concluye que un proceso continuo de remodelación morfológica ocurre en todas las uniones mioneurales del músculo extensor largo de los dedos, durante la vida del animal. Tales cambios son caracterizados por figuras de mielina en el citoplasma de las células del neurilema, cuerpos pleomórficos y multivesiculares, mitocondrias con crestas morfologicamente cambiadas y pliegues de unión degeneradas. Las vesículas son comunes en animales más viejos y raras en animales jóvenes.

Ultrastructure of the mineralizing metacarpophalangeal joint of progressive ankylosis (ank/ank) mice.

The metacarpophalangeal joint of the progressive ankylosis mouse was examined at 4, 6 and 8 weeks of age by using electron microscopy and electron probe microanalysis. These studies describe the progression of the disorder, and they reveal three overlapping phases: pannus proliferation, chondrophyte formation and mineralization, and articular cartilage mineralization. The chondrophyte mineralized in a manner fairly similar to endochondrial bone, whereas articular cartilage mineralized by advancement of a calcification front across the cartilage. Synovial crystal phagocytosis was also observed. The progressive ankylosis mouse should be an important model for studying both crystal deposition and abnormal articular cartilage calcification.

Some observations on knuckle pads.

Although knuckle pads are histologically similar to the palmar nodules in Dupuytren's Disease, they do not produce contraction. By considering the anatomical situation of the knuckle pad overlying the joint line and comparing it with a unique case of a dorsal nodule occurring between the joint lines, an explanation is profferred for this lack of contraction by knuckle pads. That contraction in the extensor mechanism was produced by the nodule between the joint lines is used to support further the "extrinsic" hypothesis of the pathogenesis of Dupuytren's Disease.