WorldWideScience

Sample records for arthritis wrist joints

  1. The EULAR-OMERACT rheumatoid arthritis MRI reference image atlas: the wrist joint

    DEFF Research Database (Denmark)

    Ejbjerg, B; McQueen, F; Lassere, M;

    2005-01-01

    This paper presents the wrist joint MR images of the EULAR-OMERACT rheumatoid arthritis MRI reference image atlas. Reference images for scoring synovitis, bone oedema, and bone erosions according to the OMERACT RA MRI scoring (RAMRIS) system are provided. All grades (0-3) of synovitis are......, capitate, and a metacarpal base. In these bones, grades 0-3 of bone oedema are illustrated, and for bone erosion, grades 0-3 and examples of higher grades are presented. The presented reference images can be used to guide scoring of wrist joints according to the OMERACT RA MRI scoring system...... illustrated in each of the three wrist joint areas defined in the scoring system-that is, the distal radioulnar joint, the radiocarpal joint, and the intercarpal-carpometacarpal joints. For reasons of feasibility, examples of bone abnormalities are limited to five selected bones: the radius, scaphoid, lunate...

  2. Combined pre-injection wrist and ankle MRI protocol and steroid joint injections in juvenile idiopathic arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Kan, J.H. [Texas Children' s Hospital, Department of Radiology, Houston, TX (United States); Graham, T.B. [Monroe Carell Jr. Children' s Hospital at Vanderbilt, Department of Pediatric Rheumatology, Nashville, TN (United States)

    2011-10-15

    Precise localization of affected compartments of the wrist and ankle in children with an established diagnosis of juvenile idiopathic arthritis (JIA) is clinically challenging. The purpose of this paper is to describe our experience utilizing a pre-injection MRI protocol of the wrist and ankle for localizing disease activity followed by fluoroscopically guided joint injections in children with JIA. (orig.)

  3. Clinical significance of dynamic magnetic resonance imaging in the evaluation of wrist joint in Rheumatoid arthritis

    International Nuclear Information System (INIS)

    To assess the role of contrast-enhanced dynamic Magnetic Resonance Imaging in evaluation disease activity of rheumatoid arthritis. Forty-seven wrist joints with rheumatoid arthritis were examined prospectively. Coronal images of the wrist were obtained using fat-suppression Fast multi-planar spoiled gradient recalled (FMPSPGR) acquisition in the steady state ; TR/TE 102/6.4 msec, flip angle = 60, 4 slices per sequence, FOV = 8 cm, matrix 256 X 192 at 1.5 Tesla. Scans were carried out once before and five to eight times after an intravenous Gd-DPTA injection, at 30-second-intervals. The enhancement of synovium were measured, the enhancement ratio was calculated(postcontrast SNR/precontrast SNR) and time-enhancement ratio curves were plotted. Patients were divided into three groups according to the ratio of initial to peak enhancement : less than 30% ; 30-80% more than 80%. Differences among the three groups were statistically tested using clinical indices and laboratory data as variable. Comparing one group with another, there were no significant differences in clinical indices and laboratory data except for the parameter of grip strength. Enhancement pattern measured in a single wrist joint was not comparable to a clinical index in predicting disease activity in rheumatoid arthritis

  4. Wrist and finger joint MR imaging in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Klarlund, Mette; Østergaard, Mikkel; Gideon, P;

    1999-01-01

    PURPOSE: To elaborate the best MR imaging protocol for studies in rheumatoid arthritis (RA) and to evaluate the sensitivity and interobserver agreement with respect to detection of bone erosions (MR and radiography) and grading of synovial membrane hypertrophy (MR imaging only). MATERIAL AND...

  5. Arthritis of the Wrist

    Science.gov (United States)

    ... in the hand and wrist. It is symmetrical, meaning that it usually affects the same joint on ... swelling, pain, limited motion, and weakness. However, in contrast to OA, wrist symptoms will usually be accompanied ...

  6. Magnetic resonance imaging of soft tissue changes in rheumatoid arthritis wrist joints

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Szkudlarek, Marcin

    2001-01-01

    , tendonitis, enthesitis, joint effusions, and ligament and tendon tears, can be visualized. Unfortunately, the image resolution in most clinically available MR units is insufficient for evaluation of wrist joint cartilage. Preliminary data suggest that MRI is a valuable tool in the diagnosis and......An increasingly aggressive therapeutic strategy, improved treatment options, and encouraging preliminary results have attracted growing attention to the potential of magnetic resonance imaging (MRI) in the diagnosis, prognostication, and monitoring of rheumatoid arthritis (RA). MRI offers...... prognostication of RA. The superior sensitivity of MRI may be of major significance in both clinical trials and practice. In trials, MRI may allow reductions in the trial size and length because of its more sensitive separation of responders from nonresponders. Thus, although thorough validation is awaited...

  7. Computational Biomechanics of the Wrist Joint

    CERN Document Server

    Nazri Bajuri, Mohd

    2013-01-01

    This book presents an analysis of the stress distribution and contact stresses in severe rheumatoid wrist after total wrist arthroplasty. It assesses and compares the load transfer throughout the joint and contact pressure at the articulations. The data obtained from this study is of importance as this provide greater evidence to the benefits of total wrist arthroplasty in rheumatoid arthritis patients.

  8. Colour Doppler ultrasonography evaluation of vascularization in the wrist and finger joints in rheumatoid arthritis patients and healthy subjects

    Energy Technology Data Exchange (ETDEWEB)

    Carotti, M. [Department of Radiology, Poliytechnic University of Marche, Ancona (Italy); Salaffi, F., E-mail: fsalaff@tin.it [Department of Rheumatology, Poliytechnic University of Marche, Ospedale A. Murri - Via dei Colli 52, 60035 Jesi, Ancona (Italy); Morbiducci, J. [Department of Radiology, Poliytechnic University of Marche, Ancona (Italy); Ciapetti, A., E-mail: ciapetti.a@libero.it [Department of Rheumatology, Poliytechnic University of Marche, Ospedale A. Murri - Via dei Colli 52, 60035 Jesi, Ancona (Italy); Bartolucci, L. [Department of Radiology, Poliytechnic University of Marche, Ancona (Italy); Gasparini, S. [Department of Rheumatology, Poliytechnic University of Marche, Ospedale A. Murri - Via dei Colli 52, 60035 Jesi, Ancona (Italy); Ferraccioli, G. [Division of Rheumatology, Catholic University of the Sacred Heart, Rome (Italy); Giuseppetti, G.M. [Department of Radiology, Poliytechnic University of Marche, Ancona (Italy); Grassi, W. [Department of Rheumatology, Poliytechnic University of Marche, Ospedale A. Murri - Via dei Colli 52, 60035 Jesi, Ancona (Italy)

    2012-08-15

    Objectives: To evaluate the presence of blood flow by colour Doppler ultrasonography (CDUS) in the wrist and finger joints of rheumatoid arthritis (RA) patients and healthy subjects and to define a cut-off value of CDUS resistive index (RI). Methods: Forty-three patients with RA and 43 healthy controls were examined by CDUS. The wrists, second and third metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints were evaluated in each patient and healthy subject. Spectral Doppler analysis was performed in order to characterize the type of flow and a mean RI was measured to define a cut-off level. The area under receiver operating characteristic curve was used to evaluate the screening method's performance. Results: Flow was detected in 219 of the 430 total joints (50.9%) of RA patients (111 in the wrists, 49 in the MCP and 30 in the PIP joints). Healthy subjects had a quantifiable flow in 45 of the 430 joints (10.5%) and, in particular, 39 (86.4%) in the wrist, 5 (11.14%) in the MCP and 1 (2.2%) in the PIP joints. The intra- and inter-reader agreements for the detection of Doppler signal were very good (kappa 0.82 and 0.89, respectively). Mean RI values were 0.72 {+-} 0.06 in RA patients and 0.86 {+-} 0.06 in healthy subjects (p < 0.01). At cut-off point of RI < 0.79 the sensitivity was 89.6% and the specificity was 78.8% (positive likelihood ratio 4.22). Conclusion: DUS is a useful tool for the detection of abnormal blood flow in inflammatory joints of RA patients.

  9. Intra-articular distribution pattern after ultrasound-guided injections in wrist joints of patients with rheumatoid arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Boesen, Mikael [Parker Institute, Frederiksberg Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, Copenhagen (Denmark)], E-mail: parker@frh.regioh.dk; Jensen, Karl Erik [State Hospital, Department of Radiology, MRI Division, Copenhagen (Denmark)], E-mail: karl.erik.Jensen@rh.regionh.dk; Torp-Pedersen, Soren [Parker Institute, Frederiksberg Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, Copenhagen (Denmark); Cimmino, Marco A. [Rheumatologic Clinic, Department of Internal Medicine, University of Genoa (Italy)], E-mail: cimmino@unige.it; Danneskiold-Samsoe, Bente; Bliddal, Henning [Parker Institute, Frederiksberg Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, Copenhagen (Denmark)

    2009-02-15

    Objective: To investigate the distribution of an ultrasound-guided intra-articular (IA) injection in the wrist joint of patients with rheumatoid arthritis (RA). Methods: An ultrasound-guided IA drug injection into the wrist joint was performed in 17 patients with 1 ml methylprednisolone (40 mg/ml), 0.5 ml Lidocaine (5 mg/ml) and 0.15 ml gadolinium (Omniscan 0.5 mmol/ml). The drug solution was placed in the central proximal part of the wrist between the distal radius and the lunate bone. Coronal and axial MRI sequences were performed after the injection to visualize the distribution. Carpal distribution (radio-carpal, inter-carpal, and carpo-metacarpal) as well as radio-ulnar distribution was recorded. Full distribution in one compartment was given the value 1, partial distribution 0.5 and no distribution 0. A sum of the total distribution for all four compartments was calculated and correlated to the clinical parameters and the MRI OMERACT scores. Results: No uniform pattern was seen in the distribution of the contrast. Only two patients had full contrast distribution to all four compartments, and the mean distribution count for all patients was 2.4 (range 0.5-4). The distribution count correlated with the MRI OMERACT synovitis score (r = 0.60, p = 0.014), but not with the erosions, bonemarrow oedema scores or any clinical parameters. Conclusion: The distribution of contrast on MRI showed patient specific and random patterns after IA injections in active RA wrist joints. The degree of distribution increased with the MRI synovitis score, while no association was found with the erosion- and bonemarrow oedema score. These results indicate that a single injection into a standard injection site in the proximal part of the wrist cannot be assumed to distribute - and treat - the whole joint.

  10. Magnetic resonance imaging of wrist and finger joints in healthy subjects occasionally shows changes resembling erosions and synovitis as seen in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Ejbjerg, Bo; Narvestad, Eva; Rostrup, Egill;

    2004-01-01

    OBJECTIVE: To explore the presence of changes resembling rheumatoid arthritis erosions and synovitis in metacarpophalangeal (MCP) and wrist joints of healthy individuals on magnetic resonance imaging (MRI) and to compare the MRI findings with conventional radiographic, clinical, and biochemical...... findings. METHODS: Twenty-eight healthy individuals were studied. Contrast-enhanced MRI and conventional radiography of the dominant wrist and second through fifth MCP joints were performed, coupled with standard clinical assessments and biochemical analyses. MR images were evaluated according to the...... latest OMERACT (Outcome Measures in Rheumatology Clinical Trials) recommendations with respect to synovitis, erosions, and bone marrow edema. RESULTS: Conventional radiography revealed erosion-like changes in 1 of 224 MCP joint bones (0.4%) and in 1 of 420 wrist joint bones (0.2%). MRI depicted low...

  11. Hand and wrist arthritis of Behcet disease: Imaging features

    International Nuclear Information System (INIS)

    Background: Reports on arthritis in Behcet disease are relatively scarce, and imaging features vary. Purpose: To document the various imaging features of articular disorders of the hand and wrist in Behcet disease. Material and Methods: Four patients, four women aged 26 to 65 years, fulfilling the diagnostic criteria of Behcet disease, with imaging findings of hand and wrist arthritis, were seen in two institutions. Radiography and magnetic resonance (MR) imaging were studied to elucidate the pattern and distribution. Results: Both non-erosive arthritis and erosive arthritis of different features were noted: one with non-erosive synovitis of the wrist, one with wrist synovitis with minimal erosion, and two with erosive arthritis of the distal interphalangeal joint. Conclusion: Imaging manifestations of arthritis of Behcet disease vary, and may be similar to other seronegative arthritides

  12. Detection of bone erosions in rheumatoid arthritis wrist joints with magnetic resonance imaging, computed tomography and radiography

    DEFF Research Database (Denmark)

    Døhn, Uffe Møller; Ejbjerg, Bo J; Hasselquist, Maria;

    2008-01-01

    BACKGROUND: The objectives of the present study were, with multidetector computed tomography (CT) as the reference method, to determine the performance of magnetic resonance imaging (MRI) and radiography for the detection of bone erosions in rheumatoid arthritis wrist bones, and to test whether...... measuring volumes of erosions on CT and MRI is reproducible and correlated to semiquantitative assessments (scores) of erosions on CT, MRI and radiography. METHODS: Seventeen patients with rheumatoid arthritis and four healthy control individuals underwent CT, MRI and radiography of one wrist, performed on...... the same day. CT was performed on a Philips Mx8000IDT unit (voxel size 0.4 mm x 0.4 mm x 1 mm) and MRI was performed on a Philips Panorama 0.6T unit (voxel size 0.4 mm x 0.4 mm x 0.4 mm). Images were evaluated separately for erosions in all wrist bones and were scored according to the principles of...

  13. Magnetic resonance imaging of soft tissue changes in rheumatoid arthritis wrist joints

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Szkudlarek, Marcin

    2001-01-01

    multiplanar imaging with unprecedented soft tissue contrast and high spatial resolution. Synovitis, the primary joint lesion in RA, can be detected and monitored. By contrast, conventional radiography shows only the late signs of preceding synovitis. Other soft tissue changes, such as tenosynovitis...... prognostication of RA. The superior sensitivity of MRI may be of major significance in both clinical trials and practice. In trials, MRI may allow reductions in the trial size and length because of its more sensitive separation of responders from nonresponders. Thus, although thorough validation is awaited...

  14. Intra-articular distribution pattern after ultrasound-guided injections in wrist joints of patients with rheumatoid arthritis

    DEFF Research Database (Denmark)

    Boesen, Mikael; Jensen, Karl Erik; Torp-Pedersen, Søren;

    2007-01-01

    /ml), 0.5 ml Lidocaine (5mg/ml) and 0.15 ml gadolinium (Omniscan 0.5 mmol/ml). The drug solution was placed in the central proximal part of the wrist between the distal radius and the lunate bone. Coronal and axial MRI sequences were performed after the injection to visualize the distribution. Carpal...... to the clinical parameters and the MRI OMERACT scores. RESULTS: No uniform pattern was seen in the distribution of the contrast. Only two patients had full contrast distribution to all four compartments, and the mean distribution count for all patients was 2.4 (range 0.5-4). The distribution count...... correlated with the MRI OMERACT synovitis score (r=0.60, p=0.014), but not with the erosions, bonemarrow oedema scores or any clinical parameters. CONCLUSION: The distribution of contrast on MRI showed patient specific and random patterns after IA injections in active RA wrist joints. The degree of...

  15. Ultrasound Doppler Score Correlates with OMERACT RAMRIS Bone Marrow Oedema and Synovitis Score in the Wrist Joint of Patients with Rheumatoid Arthritis

    DEFF Research Database (Denmark)

    Boesen, M; Ellegaard, K; Boesen, L;

    2012-01-01

    low-field MRI scores with the US Doppler measurements in the wrist joint of patients with RA. MATERIAL AND METHODS: Fifty consecutive patients with RA (46 women & 4 men) completed both low-field dedicated extremity MRI (E-scan®, Esaote) and a high-end US (Sequioa®, Siemens) imaging of the wrist before......PURPOSE: MRI is considered the standard of reference for advanced imaging in rheumatoid arthritis (RA). However, in daily clinical practice ultrasound (US) imaging with Doppler information is more versatile and often used for fast and dynamic assessment of joint inflammation. The aim was to compare...... initiating either biological treatment (n = 26) or intraarticular injection of Depomedrole® (n = 24). Mean age was 56 years (range 21 - 83 years); mean disease duration 87.2 months (range 4 - 349 months), mean DAS 28 4,8 (range 2 - 7). MRI was scored according to the OMERACT RAMRIS recommendations and US...

  16. Kinematics of Hooke universal joint robot wrists

    Science.gov (United States)

    Mckinney, William S., Jr.

    1988-01-01

    The singularity problem associated with wrist mechanisms commonly found on industrial manipulators can be alleviated by redesigning the wrist so that it functions as a three-axis gimbal system. This paper discussess the kinematics of gimbal robot wrists made of one and two Hooke universal joints. Derivations of the resolved rate motion control equations for the single and double Hooke universal joint wrists are presented using the three-axis gimbal system as a theoretical wrist model.

  17. Wrist ultrasound analysis of patients with early rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    J.A. Mendonça

    2011-01-01

    Full Text Available In the present study, we evaluated 42 wrists using the semi-quantitative scales power Doppler ultrasound (PDUS and gray scale ultrasound (GSUS with scores ranging from 0 to 3 and correlated the results with clinical, laboratory and radiographic data. Twenty-one patients (17 women and 4 men with rheumatoid arthritis according to criteria of the American College of Rheumatology were enrolled in the study from September 2008 to July 2009 at Universidade Estadual de Campinas (UNICAMP. The average disease duration was 14 months. The patients were 66.6% Caucasians and 33.3% non-Caucasians, with a mean age of 42 and 41 years, respectively. A dorsal longitudinal scan was performed by ultrasound on the radiocarpal and midcarpal joints using GE LOGIQ XP-linear ultrasound and a high frequency (8-10 MHz transducer. All patients were X-rayed, and the Larsen score was determined for the joints, with grades ranging from 0 to V. This study showed significant correlations between clinical, sonographic and laboratory data: GSUS and swollen right wrist (r = 0.546, GSUS of right wrist and swelling of left wrist (r = 0.511, PDUS of right wrist and pain in left wrist (r = 0.436, PDUS of right wrist and C-reactive protein (r = 0.466. Ultrasound can be considered a useful tool in the diagnosis of synovitis in early rheumatoid arthritis mainly when the anti-cyclic citrullinated peptide and rheumatoid factor are negative, and can lead to an early change in the therapeutic decision.

  18. Denervation of the wrist joint.

    Science.gov (United States)

    Buck-Gramcko, D

    1977-01-01

    A collective review was made of the results of denervation of the wrist joint for painful restrictiorn of motion done in 313 patients and follow-up studies on 195 (average 4.1 years, ranging from 9 months to 14 years). Complete denervation was done in only 30, partial denervation in the others being done after testing with local anesthetic blocks. Sixty-nine of the patients retained a moble wrist without pain or with slight pain with heavy work. No evidence of Charcot-like joints was seen. Poorest results followed when the operation was done for sequelae of intra-articular fracture of the radius, fracture dislocations, unstable ligamentous support, joint surface destruction, or for those required to do heavy manual labor. Arthrodesis was done secondarily in nine patients. PMID:839055

  19. High-resolution MRI of the wrist and finger joints in patients with rheumatoid arthritis: comparison of 1.5 Tesla and 3.0 Tesla

    International Nuclear Information System (INIS)

    The goal of this study was to compare magnetic resonance (MR) image quality at different field strengths for evaluating lesions in wrist and finger joints of patients with rheumatoid arthritis (RA) in order to determine whether the higher field strength provides diagnostic gain. The hand mainly affected in 17 RA patients was examined at 1.5 Tesla (T) and 3.0 T with comparable MR imaging (MRI) protocols. MR images were reviewed twice by two experienced radiologists using the Rheumatoid Arthritis MRI Scoring System (RAMRIS) of the OMERACT (Outcome Measures in Rheumatoid Arthritis Clinical Trials) group. Image quality was rated on a five-point scale using Friedmann's test and Kendall's W-test for statistical analysis. Image comparison revealed better image quality at higher field strength. Image quality of T1-weighted images was rated 14-22% better at 3.0 T compared with 1.5 T by both readers. Moreover, the rating for the T2-weighted-images acquired at 3.0 T was one point better in the five-point scale used. Inter-reader correlation for image quality, bone erosions/defects, edema and synovitis ranged between 0.6 and 0.9 at 3.0 T and between 0.6 and 0.8 at 1.5 T. Intra-reader correlation for these parameters was high at 0.8-1.0. MRI image quality of RA hands is superior at 3.0 T, while an acceptable image quality is achieved at 1.5 T, which improves the evaluation of extent of bone edema, synovitis and identification of small bone erosions. (orig.)

  20. High-resolution MRI of the wrist and finger joints in patients with rheumatoid arthritis: comparison of 1.5 Tesla and 3.0 Tesla

    Energy Technology Data Exchange (ETDEWEB)

    Wieners, Gero [Otto-von-Guericke-University, Department of Radiology and Nuclear Medicin, Magdeburg (Germany); Detert, Jacqueline; Burmester, Gerd; Backhaus, Marina [Charite Universitaetsmedizin Berlin, Department of Rheumatology and Clinical Immunology, Berlin (Germany); Streitparth, Florian; Fischbach, Frank; Bruhn, Harald [Charite Universitaetsmedizin Berlin, Department of Radiology, Berlin (Germany); Pech, Maciej; Ricke, Jens [Otto-von-Guericke-University, Department of Radiology and Nuclear Medicin, Magdeburg (Germany)

    2007-08-15

    The goal of this study was to compare magnetic resonance (MR) image quality at different field strengths for evaluating lesions in wrist and finger joints of patients with rheumatoid arthritis (RA) in order to determine whether the higher field strength provides diagnostic gain. The hand mainly affected in 17 RA patients was examined at 1.5 Tesla (T) and 3.0 T with comparable MR imaging (MRI) protocols. MR images were reviewed twice by two experienced radiologists using the Rheumatoid Arthritis MRI Scoring System (RAMRIS) of the OMERACT (Outcome Measures in Rheumatoid Arthritis Clinical Trials) group. Image quality was rated on a five-point scale using Friedmann's test and Kendall's W-test for statistical analysis. Image comparison revealed better image quality at higher field strength. Image quality of T1-weighted images was rated 14-22% better at 3.0 T compared with 1.5 T by both readers. Moreover, the rating for the T2-weighted-images acquired at 3.0 T was one point better in the five-point scale used. Inter-reader correlation for image quality, bone erosions/defects, edema and synovitis ranged between 0.6 and 0.9 at 3.0 T and between 0.6 and 0.8 at 1.5 T. Intra-reader correlation for these parameters was high at 0.8-1.0. MRI image quality of RA hands is superior at 3.0 T, while an acceptable image quality is achieved at 1.5 T, which improves the evaluation of extent of bone edema, synovitis and identification of small bone erosions. (orig.)

  1. Magnetic resonance imaging-determined synovial membrane volume as a marker of disease activity and a predictor of progressive joint destruction in the wrists of patients with rheumatoid arthritis

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Hansen, M; Stoltenberg, M;

    1999-01-01

    -modifying antirheumatic drug (DMARD) therapy alone (11 patients) or DMARDs in combination with oral prednisolone (15 patients), were followed up for 1 year with contrast-enhanced MRI of the dominant wrist (months 0, 3, 6, and 12), conventional radiography (months 0 and 12), and clinical and biochemical examinations. Bone......, or with prednisolone treatment. In none of 5 wrists with baseline volumes <5 cm3, but in 8 of 10 wrists with baseline volumes > or =10 cm3, erosive progression was found by MRI and/or radiography, indicating a predictive value of synovial membrane volumes. MRI was more sensitive than radiography for......OBJECTIVE: To evaluate the synovial membrane volume, determined by magnetic resonance imaging (MRI), as a marker of joint disease activity and a predictor of progressive joint destruction in rheumatoid arthritis (RA). METHODS: Twenty-six patients with RA, randomized to receive disease...

  2. Optimised, low cost, low field dedicated extremity MRI is highly specific and sensitive for synovitis and bone erosions in rheumatoid arthritis wrist and finger joints

    DEFF Research Database (Denmark)

    Ejbjerg, B J; Narvestad, E; Jacobsen, Søren;

    2005-01-01

    To evaluate a low field dedicated extremity MRI unit for detection of bone erosions, synovitis, and bone marrow oedema in wrist and metacarpophalangeal (MCP) joints, with a high field MRI unit as the standard reference.......To evaluate a low field dedicated extremity MRI unit for detection of bone erosions, synovitis, and bone marrow oedema in wrist and metacarpophalangeal (MCP) joints, with a high field MRI unit as the standard reference....

  3. Osteoarthritis of the Wrist STT Joint and Radiocarpal Joint

    OpenAIRE

    Ronit Wollstein; Julio Clavijo; Gilula, Louis A.

    2012-01-01

    Our understanding of wrist osteoarthritis (OA) lags behind that of other joints, possibly due to the complexity of wrist biomechanics and the importance of ligamentous forces in the function of the wrist. Scaphotrapeziotrapezoidal (STT) OA is common, but its role in wrist clinical pathology and biomechanics is unclear. We identified the prevalence of radiographic STT joint OA in our hand clinic population and defined the relationship between STT and radiocarpal OA in wrist radiographs. One hu...

  4. MP Joint Arthritis

    Science.gov (United States)

    ... Therapist? Media Find a Hand Surgeon MP Joint Arthritis Email to a friend * required fields From * To * ... in to name and customize your collection. DESCRIPTION Arthritis is the wearing away of the cartilage at ...

  5. The smallest detectable difference and sensitivity to change of magnetic resonance imaging and radiographic scoring of structural joint damage in rheumatoid arthritis finger, wrist, and toe joints: a comparison of the OMERACT rheumatoid arthritis magnetic resonance imaging score applied to

    DEFF Research Database (Denmark)

    Ejbjerg, Bo Jannik; Vestergaard, Aage; Jacobsen, Søren;

    2005-01-01

    To compare 2 magnetic resonance imaging (MRI) approaches and radiographic evaluation according to the Sharp/van der Heijde method with respect to sensitivity to change in joint destruction in patients with rheumatoid arthritis (RA).......To compare 2 magnetic resonance imaging (MRI) approaches and radiographic evaluation according to the Sharp/van der Heijde method with respect to sensitivity to change in joint destruction in patients with rheumatoid arthritis (RA)....

  6. Interreader agreement in the assessment of magnetic resonance images of rheumatoid arthritis wrist and finger joints--an international multicenter study

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Klarlund, Mette; Lassere, M;

    2001-01-01

    changes on MRI among 5 centers that had not undertaken intergroup calibration. MRI of RA wrist and metacarpophalangeal (MCP) joints were scored by experienced readers in 5 centers in different countries. In substudy 1, 5 sets of 2nd-5th MCP joints from UK [Technique A: 1.5 T, coronal and axial T1 and T2...... values were in the low to moderate range, generally lowest for JSN (< 0.20), better for synovitis and bone erosions, and best for bone lesions, being generally highest for MRI with 2 planes pre- and post-Gd and in MCPjoints compared with wrists. These preliminary results suggest that the basic...... interpretation of MRI changes in RA wrist and MCP joints is relatively consistent among readers from different countries and medical backgrounds, but that further training, calibration, and standardization of imaging protocols and grading schemes will be necessary to achieve acceptable intergroup reproducibility...

  7. The state of art of MRI research on the wrist in patients with early rheumatoid arthritis

    International Nuclear Information System (INIS)

    Early diagnosis and treatment are essential for improving the outcome of rheumatoid arthritis (RA). New MRI and new scoring system, making precise and quantitative diagnosis and evaluation of RA, can be complementary to laboratory test. Wrist, metacarpophalangeal joint, carpometacarpal joint and interphalangeal joint are most often affected in RA. Early MRI features of RA include synovitis, bone marrow edema. erosions and cartilage loss. MRI can detect early signs of RA in wrist with high sensitivity and accuracy, and can easily and quantitatively monitor lesion response to the treatments. In this review, we summarized values of the wrist MRI in early diagnosis, quantitative analysis and prognosis of RA. (authors)

  8. MRI在类风湿性腕关节炎中的临床诊断价值%Clinical Value of MRI in the Diagnosis of Rheumatoid Arthritis of the Wrist Joint

    Institute of Scientific and Technical Information of China (English)

    高运英

    2014-01-01

    Objective To explore the clinical value of MRI in the diagnosis of rheumatoid arthritis of the wrist joint. Methods The magnetic resonance imaging (MRI) of 84 cases of patients with rheumatoid arthritis of the wrist joint, including 46 males and 38 females, were analyzed retrospectively. The value of diagnosis of MRI was analyzed. And a total of 168 wrist joints were scanned. Results Most of the wrist joints had signal abnormalities, including synovial thickening, bilateral pannus formation and so on. And there were 21 cases of patients with hydrops articuli, 23 cases of patients with bone marrow edema, 27 cases of patients with bone defect. Conclusion MRI has a good effect in the diagnosis of rheumatoid arthritis of the wrist joint, which can clearly reflect the abnormal signal. It is an accurate and reliable examination method and suitable for popularization and application in clinical practice.%目的:探讨MRI在诊断类风湿性腕关节炎中的临床价值。方法回顾性分析该院84例类风湿性腕关节炎患者的磁共振图像,分析其诊断效果,其中男性患者46例,女性患者38例,扫描腕关节168个。结果多数腕关节出现异常信号,包括滑膜增厚、双侧血管翳形成等。还有关节积液患者21个,骨髓水肿患者23个,骨质缺损患者27个。结论 MRI诊断类风湿性腕关节炎有很好的效果,可以清晰反映出异常信号,是一种准确可靠的检查方法,适合在临床上推广应用。

  9. The comparison of efficacy of different imaging techniques (conventional radiography, ultrasonography, magnetic resonance) in assessment of wrist joints and metacarpophalangeal joints in patients with psoriatic arthritis

    International Nuclear Information System (INIS)

    Psoriatic arthritis (PsA) is a chronic inflammatory joint disease which develops in patients with psoriasis. The rheumatoid factor is characteristically absent in the serum of PsA patients. Etiology of the disease is still unclear but a number of genetic associations have been identified. Inheritance of the disease is multilevel and the role of environmental factors is emphasized. Immunology of PsA is also quite complex. Inflammation is caused by immunological reactions leading to a release of kinins. Destructive changes in bones usually appear after a few months from the onset of clinical symptoms. PsA typically involves joints of the axial skeleton with an asymmetrical patern. The spectrum of symptoms includes inflammatory changes in attachments of articular capsules, tendons, and ligaments to bone surface. The disease can have a diverse clinical course but usually manifests as oligoarthritis. Imaging plays an important role in the diagnosis of PsA. Classical radiography has been used for this purpose for over a hundred years. It allows to identify late stages of the disease, when bone tissue is affected. In the last 20 years however many new imaging modalities, such as ultrasonography (US), computed tomography (CT) and magnetic resonance (MR), have been developed and became important diagnostic tools for evaluating rheumatoid diseases. They enable the assessment and monitoring of early inflammatory changes. As a result, patients have earlier access to modern treatment and thus formation of destructive changes in joints can be markedly delayed or even avoided

  10. Magnetic resonance imaging of wrist and finger joints in healthy subjects occasionally shows changes resembling erosions and synovitis as seen in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Ejbjerg, Bo; Narvestad, Eva; Rostrup, Egill;

    2004-01-01

    latest OMERACT (Outcome Measures in Rheumatology Clinical Trials) recommendations with respect to synovitis, erosions, and bone marrow edema. RESULTS: Conventional radiography revealed erosion-like changes in 1 of 224 MCP joint bones (0.4%) and in 1 of 420 wrist joint bones (0.2%). MRI depicted low......-grade erosion-like changes in 5 of 224 MCP joint bones (2.2%) and in 7 of 420 wrist joint bones (1.7%), but postcontrast enhancement within the lesion was detected in only 8.3% of these. MRI depicted low-grade synovitis-like changes in 10 of 112 MCP joints (8.9%) and in 8 of 84 assessed wrist areas (9.......5%), while only minimal early synovial enhancement was detected by dynamic MRI. Three subjects had elevated serum levels of C-reactive protein, and these subjects displayed 44.5% of the synovitis-like changes and 41.7% of the erosion-like changes. Bone marrow edema-like changes were not found in any joints...

  11. 21 CFR 888.3810 - Wrist joint ulnar (hemi-wrist) polymer prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Wrist joint ulnar (hemi-wrist) polymer prosthesis. 888.3810 Section 888.3810 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... (hemi-wrist) polymer prosthesis. (a) Identification. A wrist joint ulnar (hemi-wrist) polymer...

  12. Detailed analysis of contrast-enhanced MRI of hands and wrists in patients with psoriatic arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Tehranzadeh, Jamshid [University of California, Department of Radiological Sciences, Irvine (United States); University of California Medical Center, Department of Radiological Sciences R-140, Orange, CA (United States); Ashikyan, Oganes; Anavim, Arash; Shin, John [University of California, Department of Radiological Sciences, Irvine (United States)

    2008-05-15

    The objective was to perform detailed analysis of the involved soft tissues, tendons, joints, and bones in the hands and wrists of patients with psoriatic arthritis (PsA). We reviewed 23 contrast-enhanced MR imaging studies (13 hands and 10 wrists) in 10 patients with the clinical diagnosis of PsA. We obtained clinical information from medical records and evaluated images for the presence of erosions, bone marrow edema, joint synovitis, tenosynovitis, carpal tunnel, and soft tissue involvement. Two board-certified musculoskeletal radiologists reviewed all images independently. Differences were resolved during a subsequent joint session. The average duration of disease was 71.3 months, ranging from 1 month to 25 years. Eight of the 10 wrists (80%) and 6 of the 13 hands demonstrated bone erosions. Bone marrow abnormalities were shown in 5 of the 10 wrists (50%) and 4 of the 14 hands (31%). Triangular fibrocartilage tears were seen in 6 of the 10 wrists (60%). Wrist and hand joint synovitis were present in all studies (67 wrist joints and 101 hand joints). Wrist soft tissue involvement was detected in 9 of the 10 wrists (90%) and hand soft tissue involvement was present in 12 of the 13 wrists (92%). Findings adjacent to the region of soft tissue involvement included synovitis (4 wrists) and tenosynovitis (3 wrists). Bone marrow edema adjacent to the region of soft tissue involvement was seen in one wrist. Bulge of the flexor retinaculum was seen in 4 of the 10 wrists (40%) and median nerve enhancement was seen in 8 of the 10 wrists (80%). Tenosynovitis was seen in all studies (all 10 of the hands and all 13 of the wrists). The 'rheumatoid' type of distribution of bony lesions was common in our study. Interobserver agreement for various findings ranged from 83% to 100%. Contrast-enhanced MRI unequivocally demonstrated bone marrow edema, erosions, tendon and soft-tissue disease, and median nerve involvement, with good interobserver reliability in patients with

  13. A study comparing MRI with clinical examinations on wrists with rheumatoid arthritis

    International Nuclear Information System (INIS)

    Objective: To study the appearances of rheumatoid arthritis (RA) on MRI, and compare MRI with clinical examinations on wrists with RA. Methods: Fifty patients, fulfilled 1987 American Rheumatism Association (ARA) revised criteria, and 10 age-matched healthy controls entered the study. T1-weighted spin echo, short time inversion recovery (STIR) of both wrists, gadolinium contrast material-enhanced sequences of dominant wrists were performed in the coronal planes. MRl, plain wrist radiographs, clinical date, including swollen joint, patient global assessment (AIMS), and laboratory examinations including ESR, RF, APF, and AKA were obtained at the same time. Functional disability was assessed using the Health Assessment Questionnaire Disability Score. Results: In 50 patients, all had pannus on MRI of wrists, 38 patients had enhanced signal intensity for pannus, 21 patients had bone marrow edema, 37 patients had joint effusion, and 37 patients had bone erosions. There were significant difference in the ESR, HAQ, AIMS as well as swollen joint count between patients with bone marrow edema and patients without bone marrow edema (P2=5.06, P=0.025; χ2=5.59, P=0.018). Number of patients with MRI erosion of wrists was associated with the number of patients without MRI bone marrow edema of wrists (χ2=5.11, P=0.024). Conclusion: MRI can find the appearances of wrists with RA. Comparing MRI with clinical examinations on wrists with RA, authors can assess and evaluate the role of MRI on RA

  14. Interreader agreement in the assessment of magnetic resonance images of rheumatoid arthritis wrist and finger joints--an international multicenter study

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Klarlund, Mette; Lassere, M; Conaghan, P; Peterfy, C; McQueen, F; O'Connor, P; Shnier, R; Stewart, N; McGonagle, D; Emery, P; Genant, H; Edmonds, J

    2001-01-01

    iv Gd (Techniques A and C), these rates were 86% (synovitis) and 97% (bone lesions). Corresponding intraclass correlation coefficients (quadratic weighted kappas) were 0.44-0.68, mean 0.58 (synovitis), and 0.44-0.69, mean 0.62 (bone lesion), i.e., in the moderate to good range. Unweighted kappa...... interpretation of MRI changes in RA wrist and MCP joints is relatively consistent among readers from different countries and medical backgrounds, but that further training, calibration, and standardization of imaging protocols and grading schemes will be necessary to achieve acceptable intergroup reproducibility...

  15. Joint Replacement (Finger and Wrist Joints)

    Science.gov (United States)

    ... Symptom Picker Hand and Arm Conditions Carpal Tunnel Ganglion Cysts Trigger Finger Arthritis Base of the Thumb See ... Symptom Picker Hand and Arm Conditions Carpal Tunnel Ganglion Cysts Trigger Finger Arthritis Base of the Thumb See ...

  16. Prosthesis of the wrist-joint

    Energy Technology Data Exchange (ETDEWEB)

    Feldmeier, C.

    1983-02-25

    Function of the hand-joint and the well-being of patients can be severely affected by arthrosis of the wrist-joint. Therapeutically, arthrodesis usually results in a painfree status of stiffness. A painless and well functioning joint can be achieved by alloplastic joint replacement or resurfacing. The possibilities and clinical results in cases of arthrosis of the carpo-metacarpal joint of the thumb, pseudarthrosis of the scaphoid, aseptic necrosis of the Lunate and severe arthrosis of the radio-carpal joint are demonstrated.

  17. Prosthesis of the wrist-joint

    International Nuclear Information System (INIS)

    Function of the hand-joint and the well-being of patients can be severely affected by arthrosis of the wrist-joint. Therapeutically, arthrodesis usually results in a painfree status of stiffness. A painless and well functioning joint can be achieved by alloplastic joint replacement or resurfacing. The possibilities and clinical results in cases of arthrosis of the carpo-metacarpal joint of the thumb, pseudarthrosis of the scaphoid, aseptic necrosis of the Lunate and severe arthrosis of the radio-carpal joint are demonstrated. (orig.)

  18. Midcarpal Hemiarthroplasty for Wrist Arthritis: Rationale and Early Results

    OpenAIRE

    Vance, Michael C.; Packer, Greg; Tan, David; Crisco, J.J. Trey; Wolfe, Scott W.

    2012-01-01

    Midcarpal hemiarthroplasty is a novel motion-preserving treatment for radiocarpal arthritis and is an alternative to current procedures that provide pain relief at the expense of wrist biomechanics and natural motion. It is indicated primarily in active patients with a well-preserved distal row and debilitating arthritic symptoms. By resurfacing the proximal carpal row, midcarpal arthroplasty relieves pain while preserving the midcarpal articulation and the anatomic center of wrist rotation. ...

  19. Magnetic resonance imaging of the wrist in early rheumatoid arthritis: a pictorial essay

    International Nuclear Information System (INIS)

    This pictorial essay describes the changes seen in the wrist in early rheumatoid arthritis (RA) on MRI. Magnetic resonance imaging can demonstrate bone erosions, bone marrow signal changes, synovitis and tenosynovitis in early rheumatoid arthritis. Magnetic resonance imaging of the wrist can identify erosions in RA earlier than plain radiographs and can detect more erosions. Common sites include the capitate, lunate and scaphoid. Bone marrow signal changes occur frequently and are most common in the capitate, lunate and triquetrum. Synovial thickening and enhancement are clearly demonstrated with MRI and are most commonly seen in the radiocarpal joint (RCJ). Tenosynovitis can be seen in the wrist in more than half of patients presenting with RA. This most commonly involves the extensor carpi ulnaris tendon and is seen as sheath fluid, thickening and enhancement. Copyright (2001) Blackwell Science Pty Ltd

  20. Forward and inverse kinematics of double universal joint robot wrists

    Science.gov (United States)

    Williams, Robert L., II

    1991-01-01

    A robot wrist consisting of two universal joints can eliminate the wrist singularity problem found on many individual robots. Forward and inverse position and velocity kinematics are presented for such a wrist having three degrees of freedom. Denavit-Hartenberg parameters are derived to find the transforms required for the kinematic equations. The Omni-Wrist, a commercial double universal joint robot wrist, is studied in detail. There are four levels of kinematic parameters identified for this wrist; three forward and three inverse maps are presented for both position and velocity. These equations relate the hand coordinate frame to the wrist base frame. They are sufficient for control of the wrist standing alone. When the wrist is attached to a manipulator arm; the offset between the two universal joints complicates the solution of the overall kinematics problem. All wrist coordinate frame origins are not coincident, which prevents decoupling of position and orientation for manipulator inverse kinematics.

  1. WRIST ARTHRODESIS WITH MINIMAL FIXATION PRESERVING THE CARPOMETACARPAL JOINTS

    Science.gov (United States)

    Pardini, Arlindo Gomes; Pádua Gonçalves, Rodolfo Fonseca; Freitas, Afrânio Donato; Chaves, Antonio Barbosa

    2015-01-01

    Objective: Wrist arthrodesis is a surgical procedure that should always be considered in cases of pathological conditions in which anatomical and functional structures are altered. In general, the results are very satisfactory, particularly for pain relief, and in the majority of cases, there is considerable functional improvement. Various techniques have been described, with different methods of internal fixation, most of which include the carpometacarpal joints in the fusion. The objective of this study was to evaluate the results from wrist arthrodesis using a technique that is simpler, more biological, less expensive, and does not involve the carpometacarpal joints. Methods: Fifteen patients with wrist arthrodesis were evaluated (six with sequelae from trauma, four with rheumatoid arthritis, three with Kienbock grade IV, one with Preiser and one with panarthrosis). The technique consisted of using an iliac bone plate and internal fixation with Kirschner wires, avoiding the carpometacarpal joints. Results: The evaluation was based on consolidation time (93% in seven weeks); movements of the fingers and pronosupination; pinch and grasp strength; functional evaluation through the DASH, pain and patient satisfaction questionnaires. In general, the results were similar to those of other, more aggressive techniques, and the non-inclusion of the carpometacarpal joints did not affect the final result. Conclusion: Wrist arthrodesis with fixation using Kirschner wires and an iliac bone plate, preserving the carpometacarpal joints, gives good or excellent results that are not inferior to those of other techniques that have been described. However, it presents major advantages over other methods: it is less aggressive and cheaper, and does not have the inconvenience and complications associated with the use of plates and screws. PMID:27022522

  2. Scoring of synovial membrane hypertrophy and bone erosions by MR imaging in clinically active and inactive rheumatoid arthritis of the wrist

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Gideon, P; Sørensen, K;

    1995-01-01

    MRI-scores of synovial membrane hypertrophy and bone erosions of the RA-wrist are introduced. Gadolinium-DTPA enhanced magnetic resonance imaging (MRI) and conventional radiography (CR) of the wrist were performed in 16 patients with rheumatoid arthritis (RA) and 3 healthy controls. A MRI-score of...... MRI and CR with respect to bone erosions. Bone erosions were detected by MRI in 14 wrists in contrast to only 6 wrists by CR. In all patients the erosions were more numerous on MRI. The introduced methods may be useful quantitative measures of synovitis and early joint destruction in RA....... synovial membrane hypertrophy was obtained by summation of gradings of synovial hypertrophy in 6 regions of the wrist. The score was significantly higher in wrists with than in wrists without clinical signs of active arthritis. The score was 0 in all healthy controls. Each bone of the wrist was assessed by...

  3. Quantitative microfocal radiography accurately detects joint changes in rheumatoid arthritis.

    OpenAIRE

    Buckland-Wright, J C; Carmichael, I.; Walker, S R

    1986-01-01

    Microfocal radiography, producing x5 magnified images of the wrist and hands with a high spacial resolution (25 microns) in the film, permitted direct measurement of erosion area and joint space width in patients with rheumatoid arthritis. The magnitude of errors relating to direct measurement, repositioning the wrist and hand on successive x ray visits, repeated identification of erosions and their area calculation were assessed. The coefficients of variation for length and area measurements...

  4. Radiographic abnormalities of the wrist in adult-onset still disease: Comparison with juvenile chronic arthritis and rheumatoid arthritis

    International Nuclear Information System (INIS)

    Pericapitate involvement of the wrist has been described as characteristic of adult-onset Still disease, a relatively rare disorder that is often diagnosed by exclusion after extensive and frequently invasive tests. To evaluate the diagnostic value of carpal radiography in cases of adult-onset Still disease, a retrospective blinded analysis of 48 patients, 16 each with adult-onset Still disease, juvenile chronic arthritis, and rheumatoid arthritis, was performed. Pericapitate articular alterations without radiocarpal involvement were found to be frequent in the setting of adult-onset Still disease but distinctly unusual among patients with rheumatoid arthritis. In juvenile chronic arthritis, severe pericapitate involvement was frequent, but generally occurred in conjunction with radiocarpal joint abnormalities

  5. Wrist pain

    Science.gov (United States)

    Pain - wrist; Pain - carpal tunnel; Injury - wrist; Arthritis - wrist; Gout - wrist; Pseudogout - wrist ... Carpal tunnel syndrome: A common cause of wrist pain is carpal tunnel syndrome . You may feel aching, ...

  6. Clinical evaluation of joint scintigraphy in rheumatoid arthritis

    International Nuclear Information System (INIS)

    Pertechnetate (sup(99m)TcO4-) joint scintigraphy was performed on 45 patients with rheumatoid arthritis, 3 with nonspecific arthritis and 6 normal subjects. 1) The sites of radioisotopic accumulation were generally in agreement with those of clinical involvement in rheumatoid arthritis. 2) By analysis of build-up curves in the wrist joint, tracer was found to be concentrated more rapidly in rheumatoid arthritis (T 1/2 = 0.67 min.) than in nonspecific arthritis (T 1/2 = 2.66 min.) 3) The degree of radioisotopic accumulation correlated well with the value of CRP and erythrocyte sedimentation rate. It could be cosidered that pertechnetate joint scintigraphy is useful for clinical evaluation of rheumatoid arthritis. (author)

  7. Influence on MRI of Wrist Joint in Early Stage of Rheumatoid Arthritis Treated Based on Syndrome Differentiation%分型治疗早期类风湿关节炎对腕关节MRI变化的影响

    Institute of Scientific and Technical Information of China (English)

    陶娟; 徐雯; 吴斌龙; 蒋兆贯; 张志斌; 程立

    2012-01-01

    目的:观察中医药辨证分型结合基础治疗早期类风湿关节炎,观察对腕关节的MRI变化.方法:选择早期类风湿关节炎患者60例,随机分为对照组(采用基础治疗:扶他林+柳氮磺胺吡啶)、寒湿组(寒湿方+基础治疗)、湿热组(湿热方+基础治疗)各20例,每组均治疗3个月,观察MRI的改善情况.结果:寒湿组、湿热组在降低ESR、CRP、IL -6、TNF-a与对照组比较,具有统计学意义(P<0.05).但寒湿组、湿热组之间比较无统计学差异(P>0.05).寒湿组、湿热组在改善腕关节MRI滑膜增生、骨髓水肿方面与对照组比较有统计学意义.抗CCP、RF、骨侵蚀3组比较无统计学意义,且经过治疗后骨侵蚀均有不同程度的进展.结论:中医药辨证分型结合基础治疗对早期类风湿关节炎腕关节MRI滑膜增生、骨髓水肿的改善、病情活动的控制与单纯基础治疗相比,具有一定的优势.%Objective: To observe the therapeutic effect and variance on wrist joint MRI of the foundation with combinating the traditional Chinese medicine differentiation of symptoms and signs for classification of syndrome treating early rheumatoid arthritis. Methods: The early rheumatoid arthritis 60 patients were randomly divided into 3 groups; the control group( foundation treatment: Diclofenac + SASP)20 cases, the cold wetness group (foundation treatment + the cold wetness recipe) 20 cases, the moist heat group (foundation treatment + the moist heat recipe) 20 cases. We have observed the amelioration of the laboratory index and MRI after 3 months. Results: 3 groups'comparisons were of statistical significance in pretherapy and post - treatment (P 0. 05). There is a significant difference in lowering ESR,CRP,IL -6.TNF -a,synovium hyperplasia,bone marrow edema of the wrist joint MRI compared with in the control group and the differentiation of symptoms and signs for classification of syndrome group (P 0. 05). There is no significant

  8. Inflammatory arthritis-like and other MR findings in wrists of asymptomatic subjects

    International Nuclear Information System (INIS)

    To describe magnetic resonance (MR) imaging findings in the wrists of asymptomatic subjects that might be confused with pathologic findings. MR examination of the dominant wrist was performed in 30 asymptomatic volunteers aged 22-49 years using pre-contrast and post-contrast sequences in the coronal and axial planes. The bases of the metacarpals, the carpus and the distal radius and ulna were evaluated by two musculoskeletal radiologists for lesions, notches, blood vessels and synovial enhancement. There were 24 bright osseous lesions (erosions, intraosseous ganglia, oedema or cysts) in 14 subjects. Intraosseous blood vessels were seen in all but one wrist examined, most commonly in the capitate and lunate bones. Enhancement was present in 26 of 27 notches identified at the base of the second metacarpal and less commonly in the capitate, hamate and triquetral notches. A small joint effusion was present in 14 subjects. Joint or soft-tissue enhancement was identified in 16 wrists. Many MR abnormalities and variants may be detected in the wrists of asymptomatic subjects. Many of these could be confused with pathologic findings usually associated with inflammatory arthritis. (orig.)

  9. Arthritis Mechanisms May Vary by Joint

    Science.gov (United States)

    ... Kids Become Lifelong Learners Featured Website: GeneEd: Genetics, Education, Discovery Links Rheumatoid Arthritis Osteoarthritis Gout Rheumatoid Arthritis Juvenile Arthritis Feeling Out of Joint: The Aches of Arthritis CONTACT ...

  10. Ultrasound Color Doppler Image Segmentation and Feature Extraction in MCP and Wrist Region in Evaluation of Rheumatoid Arthritis.

    Science.gov (United States)

    Snekhalatha, U; Muthubhairavi, V; Anburajan, M; Gupta, Neelkanth

    2016-09-01

    The present study focuses on automatically to segment the blood flow pattern of color Doppler ultrasound in hand region of rheumatoid arthritis patients and to correlate the extracted the statistical features and color Doppler parameters with standard parameters. Thirty patients with rheumatoid arthritis (RA) and their total of 300 joints of both the hands, i.e., 240 MCP and 60 wrists were examined in this study. Ultrasound color Doppler of both the hands of all the patients was obtained. Automated segmentation of color Doppler image was performed using color enhancement scaling based segmentation algorithm. The region of interest is fixed in the MCP joints and wrist of the hand. Features were extracted from the defined ROI of the segmented output image. The color fraction was measured using Mimics software. The standard parameters such as HAQ score, DAS 28 score, and ESR was obtained for all the patients. The color fraction tends to be increased in wrist and MCP3 joints which indicate the increased blood flow pattern and color Doppler activity as part of inflammation in hand joints of RA. The ESR correlated significantly with the feature extracted parameters such as mean, standard deviation and entropy in MCP3, MCP4 joint and the wrist region. The developed automated color image segmentation algorithm provides a quantitative analysis for diagnosis and assessment of RA. The correlation study between the color Doppler parameters with the standard parameters provides moral significance in quantitative analysis of RA in MCP3 joint and the wrist region. PMID:27449351

  11. The instability of wrist joint and total wrist replacement.

    Science.gov (United States)

    Ma, Jin-Xing; Xu, Yong-Qing

    2016-02-01

    Total wrist arthroplasty are not used as widely as total knee and hip replacement. The functional hands are requiring surgeons to design a durable and functional satisfying prosthesis. This article will list the main reasons that cause the failure of the prosthesis. Some remarkable and representative prostheses are listed to show the devolvement of total wrist prosthesis and their individual special innovations to fix the problems. And the second part we will discuss the part that biomechanical elements act in the total wrist replacement (TWA). Summarize and find out what the real problem is and how we can find a way to fix it. PMID:27033274

  12. Ulnar sided wrist pain and distal radioulnar joint osteoarthritis; is surgical arthroplasty enough?

    Directory of Open Access Journals (Sweden)

    Ronit Wollstein

    2012-05-01

    Full Text Available Distal radioulnar joint (DRUJ arthritis is a common cause of ulnar wrist pain in rheumatoid and osteoarthritis. Modified arthroplasty for the DRUJ is a minimally invasive procedure for the treatment of isolated DRUJ osteoarthritis. The purpose of this study was to evaluate the efficacy of the procedure and the incidence of related ulnar wrist pathology as well as the incidence of subsequent ulnar wrist surgeries. All patients having modified arthroplasty for the DRUJ between 1994-2008 were retrospectively reviewed. Measurements included range of motion, grip strength, and subjective status. Data regarding other wrist surgeries was recorded. There were 29 patients, 23 of which had a follow-up of over 8 weeks (average 16 months (SD=24. Fourteen patients had no to minimal pain, 6 had pain with heavier activities (2 severe, and 2 reported constant pain at the surgical site. Of the 4 more painful patients, three had additional surgery after the DRUJ arthroplasty. In all 96% of the patients had another procedure involving the ulnar- wrist complex either prior to surgery, at the time of surgery or following surgery for modified arthroplasty. We suggest that pathology involving the ulnar-wrist complex is often a syndrome consisting of multiple related diagnoses including but not limited to arthritis of the DRUJ. Multiple procedures may be needed, or a more aggressive approach such as ulnar head replacement may be indicated so that pathology at both the distal radioulnar and ulnocarpal joints is addressed concomitantly.

  13. 21 CFR 888.3780 - Wrist joint polymer constrained prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Wrist joint polymer constrained prosthesis. 888.3780 Section 888.3780 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... constrained prosthesis. (a) Identification. A wrist joint polymer constrained prosthesis is a device made...

  14. Tendon involvement in rheumatoid arthritis of the wrist: MRI findings

    Energy Technology Data Exchange (ETDEWEB)

    Valeri, G.; Ferrara, C.; Ercolani, P.; De Nigris, E. [Ancona Univ. (Italy). Dept. of Radiology; Giovagnoni, A. [Modena Univ. (Italy). Dept. of Radiology

    2001-03-01

    Objective. To evaluate the distribution and extent of wrist tendon alterations in patients with active rheumatoid arthritis (RA) using magnetic resonance imaging (MRI). Design and patients. Forty-three clinically active RA patients with an illness duration of less than 4 years and no clinical evidence of tendons tears were enrolled in the study. There were 10 men and 33 women, with an average age of 52 years (range 33-63 years). MRI of both wrists, with one exception, was performed at 1.0 T using T1- and T2-weighted sequences (slice thickness 3 mm). Twelve healthy subjects (8 women, 4 men; mean age 31 years) were also evaluated as a control group. Two radiologists reviewed each of four schematic anatomical regions (volar, dorsal, ulnar, radial) for the degree of tendon and tendon sheath alterations using two progressive scales. Results. In the control group all tendons had homogeneous low signal intensity on all sequences. A small amount of fluid was found in six subjects but the diameter was always less than 1 mm. In the patient group minimal fluid (<2 mm) was found in 35 (41%) wrists, grade 2 fluid (<2>5mm) in 26 (31%) and grade 3 fluid (>5 mm) in 24 (28%). Fiftynine (69%) of the grade 1 changes were in the volar compartment but grade 2 involvement was evenly distributed. Grade 3 changes were most common in the dorsal compartment and combined grade 2 and 3 in the dorsal and ulnar compartments were 32 (38%) and 25 (30%) compared with 16 (18%) and 17 (20%) respectively in the volar and radial compartments. The tendons were normal (grade 0) in 47 (46%) wrists. A maximum tendon signal change (grade 1) was demonstrated in 28 wrists (32%). When associated with other individual tendons grades this grade was demonstrated in the dorsal compartment in 30 (35%) wrists, in the volar compartment in 12 (14%), in the radial compartment in 17 (20%) and in the ulnar compartment in 26 (30%). A partial tear (grade 2) was detected in 7 (8%) wrists, all involving the dorsal and ulnar

  15. A Standardized Protocol for Cone-Beam Computed Tomography of the Hand and Wrist in Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    D.V. Makarova

    2015-12-01

    Full Text Available The aim of the investigation was to develop a standardized protocol for description of the results of cone-beam computed tomography (CBCT of the hand and wrist in rheumatoid arthritis. Materials and Methods. The results of 112 hand and wrist CBCT examinations (n=56 were analyzed in patients aged from 36 to 67 with medium-active seropositive rheumatoid arthritis in anamnesis. The hand and wrist CBCT was carried out using a NewTom 5G cone-beam computed unit (QR s.r.l., Italy having a 200×250 mm flat-panel detector, 180×160 mm field of view (maximum, and a 360° gantry rotation around the region of interest. The hand and wrist scanning was carried out from the distal metaphysis of the forearm bones to the nail ends of the distal phalanges of the fingers. Scan mode — patient scan (exposure time — 3.6 s, X-ray tube boosting voltage — 110 kW, current — 0.6‒0.8 mA, scan pattern — regular scan, scan time — 18 s. The CBCT examinations of the wrists and hands were performed using special-purpose setups allowing complete coverage of the region of interest. Results. A standardized protocol was designed for the description of hand and wrist cone-beam examination that documents all the major changes resulting from rheumatoid arthritis: soft tissue thickening, erosions and cystic-like changes, osteoporosis, narrowing of the joint spaces, incomplete dislocations, bone deformities and areas of osteolysis. Significant changes are recorded in point form, according to the Sharp or SENS methods. Application of the standardized protocol allows unification of the structuring of the examination description, and facilitates X-ray assessment of changes in the hand and wrist during CBCT in patients with rheumatoid arthritis.

  16. Tendon involvement in rheumatoid arthritis of the wrist: MRI findings

    International Nuclear Information System (INIS)

    Objective. To evaluate the distribution and extent of wrist tendon alterations in patients with active rheumatoid arthritis (RA) using magnetic resonance imaging (MRI). Design and patients. Forty-three clinically active RA patients with an illness duration of less than 4 years and no clinical evidence of tendons tears were enrolled in the study. There were 10 men and 33 women, with an average age of 52 years (range 33-63 years). MRI of both wrists, with one exception, was performed at 1.0 T using T1- and T2-weighted sequences (slice thickness 3 mm). Twelve healthy subjects (8 women, 4 men; mean age 31 years) were also evaluated as a control group. Two radiologists reviewed each of four schematic anatomical regions (volar, dorsal, ulnar, radial) for the degree of tendon and tendon sheath alterations using two progressive scales. Results. In the control group all tendons had homogeneous low signal intensity on all sequences. A small amount of fluid was found in six subjects but the diameter was always less than 1 mm. In the patient group minimal fluid (5mm) in 26 (31%) and grade 3 fluid (>5 mm) in 24 (28%). Fiftynine (69%) of the grade 1 changes were in the volar compartment but grade 2 involvement was evenly distributed. Grade 3 changes were most common in the dorsal compartment and combined grade 2 and 3 in the dorsal and ulnar compartments were 32 (38%) and 25 (30%) compared with 16 (18%) and 17 (20%) respectively in the volar and radial compartments. The tendons were normal (grade 0) in 47 (46%) wrists. A maximum tendon signal change (grade 1) was demonstrated in 28 wrists (32%). When associated with other individual tendons grades this grade was demonstrated in the dorsal compartment in 30 (35%) wrists, in the volar compartment in 12 (14%), in the radial compartment in 17 (20%) and in the ulnar compartment in 26 (30%). A partial tear (grade 2) was detected in 7 (8%) wrists, all involving the dorsal and ulnar compartments; five underwent surgical repair and one

  17. Optimised, low cost, low field dedicated extremity MRI is highly specific and sensitive for synovitis and bone erosions in rheumatoid arthritis wrist and finger joints: comparison with conventional high field MRI and radiography

    DEFF Research Database (Denmark)

    Ejbjerg, B.J; Narvestad, E; Jacobsen, S;

    2005-01-01

    were performed. In an initial low field MRI 'sequence selection phase', based on a subset of 10 patients and 10 controls, sequences for comparison with high field MRI were selected. RESULTS: With high field, spin echo MRI considered as the reference method, the sensitivity, specificity, and accuracy of......OBJECTIVE: To evaluate a low field dedicated extremity MRI unit for detection of bone erosions, synovitis, and bone marrow oedema in wrist and metacarpophalangeal (MCP) joints, with a high field MRI unit as the standard reference. METHODS: In 37 patients with RA and 28 healthy controls MRI of the...... wrist and 2nd-5th MCP joints was performed on a low field MRI unit (0.2 T Esaote Artoscan) and a high field MRI unit (1.0 T Siemens Impact) on 2 subsequent days. MRI was performed and evaluated according to OMERACT recommendations. Additionally, conventional x ray, clinical, and biochemical examinations...

  18. Magnetic resonance imaging-determined synovial membrane volume as a marker of disease activity and a predictor of progressive joint destruction in the wrists of patients with rheumatoid arthritis

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Hansen, M; Stoltenberg, M;

    1999-01-01

    OBJECTIVE: To evaluate the synovial membrane volume, determined by magnetic resonance imaging (MRI), as a marker of joint disease activity and a predictor of progressive joint destruction in rheumatoid arthritis (RA). METHODS: Twenty-six patients with RA, randomized to receive disease-modifying a......OBJECTIVE: To evaluate the synovial membrane volume, determined by magnetic resonance imaging (MRI), as a marker of joint disease activity and a predictor of progressive joint destruction in rheumatoid arthritis (RA). METHODS: Twenty-six patients with RA, randomized to receive disease......-Pratt analysis). The rate of erosive progression on MRI was highly correlated with baseline scores and, particularly, with area under the curve (AUC) values of synovial membrane volume (Spearman's sigma = 0.69, P < 0.001), but not with baseline or AUC values of local or global clinical or biochemical parameters...

  19. Anthropometric characteristics of wrists joint surfaces depending on lunate types.

    Science.gov (United States)

    Dyankova, S

    2007-10-01

    It is well known that the lunate presents with two main types: lunate type I has one facet of its distal surface only for capitates, whereas lunate type II has two facets of the same surface for capitate and for hamate. Our previous anthropometric studies showed that the lunate type II wrists are of greater size than the lunate type I wrists. The aim of the present study was to determine whether the lunate types and the presence or absence of hamato-lunate joint correlate with anthropometric characteristics of the joint surfaces of other wrists. Sixteen sets of macerated wrists with the lunate type I and 21 with the lunate type II were studied. Two-thousand-four-hundred-and-forty-eight anthropometric measurements were done (for 68 anthropometric indicators) and 864 anthropometric indices were calculated (for 24 anthropometric indices) separately for the wrist joint surfaces. The absolute value of the anthropometric indicators of the joint surfaces of the separated wrists were greater in the wrists with the lunate type II, except for the indicators "Greatest length of the dorsal joint surface of pisiform", "Width of the proximal joint surface, measured in the middle" and "Greatest width of the proximal joint surface" for the trapezoid and "Greatest height of the ulnar joint surface" for the capitate. The enlargement of the joint surfaces for the scaphoid was mainly in proximo-distal direction. The enlargement for the triquetrum and pisiform was mainly in radio-ulnar direction. The enlargement for trapezium, trapezoid and capitate was mainly in dorso-volar direction (except for the ulnar joint surface of capitate). The enlargement for hamate was mainly in radio-ulnar and dorso-volar directions (except for the joint surfaces for capitate and triquetrum). The calculated indices illustrate the quantitative proportions of the variations mentioned above. The anthropometric differences are a good reason to make a clear distinction between both types of wrist joint

  20. MRI of the wrist and finger joints in inflammatory joint diseases at 1-year interval: MRI features to predict bone erosions

    Energy Technology Data Exchange (ETDEWEB)

    Savnik, Anette [Department of Rheumatology, Parker Institute, Frederiksberg Hospital, Copenhagen (Denmark); Department of Radiology, University Hospital at Herlev, Copenhagen (Denmark); Department of Radiology, Frederiksberg Hospital, Copenhagen (Denmark); Malmskov, Hanne; Graff, Lykke B.; Danneskiold-Samsoee, Bente; Bliddal, Henning [Department of Rheumatology, Parker Institute, Frederiksberg Hospital, Copenhagen (Denmark); Thomsen, Henrik S. [Department of Radiology, University Hospital at Herlev, Copenhagen (Denmark); Nielsen, Henrik [Department of Rheumatology, University Hospital at Herlev, Copenhagen (Denmark); Boesen, Jens [Department of Radiology, Frederiksberg Hospital, Copenhagen (Denmark)

    2002-05-01

    The aim of this study was to assess the ability of MRI determined synovial volumes and bone marrow oedema to predict progressions in bone erosions after 1 year in patients with different types of inflammatory joint diseases. Eighty-four patients underwent MRI, laboratory and clinical examination at baseline and 1 year later. Magnetic resonance imaging of the wrist and finger joints was performed in 22 patients with rheumatoid arthritis less than 3 years (group 1) who fulfilled the American College of Rheumatology (ACR) criteria for rheumatoid arthritis, 18 patients with reactive arthritis or psoriatic arthritis (group 2), 22 patients with more than 3 years duration of rheumatoid arthritis, who fulfilled the ACR criteria for rheumatoid arthritis (group 3), and 20 patients with arthralgia (group 4). The volume of the synovial membrane was outlined manually before and after gadodiamide injection on the T1-weighted sequences in the finger joints. Bones with marrow oedema were summed up in the wrist and fingers on short-tau inversion recovery sequences. These MRI features was compared with the number of bone erosions 1 year later. The MR images were scored independently under masked conditions. The synovial volumes in the finger joints assessed on pre-contrast images was highly predictive of bone erosions 1 year later in patients with rheumatoid arthritis (groups 1 and 3). The strongest individual predictor of bone erosions at 1-year follow-up was bone marrow oedema, if present at the wrist at baseline. Bone erosions on baseline MRI were in few cases reversible at follow-up MRI. The total synovial volume in the finger joints, and the presence of bone oedema in the wrist bones, seems to be predictive for the number of bone erosions 1 year later and may be used in screening. The importance of very early bone changes on MRI and the importance of the reversibility of these findings remain to be clarified. (orig.)

  1. The OMERACT-RAMRIS Rheumatoid Arthritis Magnetic Resonance Imaging Joint Space Narrowing Score

    DEFF Research Database (Denmark)

    Møller Døhn, Uffe; Conaghan, Philip G; Eshed, Iris;

    2014-01-01

    To test the intrareader and interreader reliability of assessment of joint space narrowing (JSN) in rheumatoid arthritis (RA) wrist and metacarpophalangeal (MCP) joints on magnetic resonance imaging (MRI) and computed tomography (CT) using the newly proposed OMERACT-RAMRIS JSN scoring method, and...... to compare JSN assessment on MRI, CT, and radiography....

  2. MRI of the wrist in juvenile idiopathic arthritis: erosions or normal variants? A prospective case-control study

    Energy Technology Data Exchange (ETDEWEB)

    Ording Muller, Lil-Sofie [University Hospital North Norway, Department of Radiology, Tromsoe (Norway); Great Ormond Street Hospital for Children, Department of Radiology, London (United Kingdom); Boavida, Peter [Homerton University Hospital, Department of Radiology, London (United Kingdom); Avenarius, Derk; Eldevik, Odd Petter [University Hospital North Norway, Department of Radiology, Tromsoe (Norway); Damasio, Beatrice [Ospedale Pediatrico Gaslini, Department of Radiology, Genoa (Italy); Malattia, Clara [Ospedale Pediatrico Gaslini, Department of Rhematology, Genoa (Italy); Lambot-Juhan, Karen [Hopital Necker Enfants Malades, Department of Radiology, Paris (France); Tanturri, Laura [Ospedale Pediatrico Bambino Gesu, Department of Radiology, Rome (Italy); Owens, Catherine M. [Great Ormond Street Hospital for Children, Department of Radiology, London (United Kingdom); UCL, Institute of Child Health, London (United Kingdom); Rosendahl, Karen [Great Ormond Street Hospital for Children, Department of Radiology, London (United Kingdom); UCL, Institute of Child Health, London (United Kingdom); Haukeland University Hospital, Department of Radiology, Bergen (Norway); University of Bergen, Department of Surgical Sciences, Bergen (Norway)

    2013-07-15

    Bony depressions at the wrist resembling erosions are frequently seen on MRI in healthy children. The accuracy of MRI in detecting early bony destruction is therefore questionable. We compared findings on MRI of the wrist in healthy children and those with juvenile idiopathic arthritis (JIA) to investigate markers for true disease. We compared the number and localisation of bony depressions at the wrist in 85 healthy children and 68 children with JIA, ages 5-15 years. The size of the wrist was assessed from a radiograph of the wrist performed on the same day as the MRI. No significant difference in the number of bony depressions in the carpal bones was seen between healthy children and children with JIA at any age. Depressions are found in similar locations in the two groups, except for a few sites, where bony depressions were seen exclusively in the JIA group, particularly at the CMC joints. The wrist was significantly smaller in children with JIA (P < 0.001). Using adult scoring systems and standard MR sequences in the assessment of bone destruction in children may lead to overstaging or understaging of disease. At present, standard MRI sequences cannot easily be used for assessment of early signs of erosions in children. (orig.)

  3. Rheumatoid arthritis affecting temporomandibular joint

    Directory of Open Access Journals (Sweden)

    Amandeep Sodhi

    2015-01-01

    Full Text Available Rheumatoid arthritis (RA is a chronic, systemic, autoimmune inflammatory disorder that is characterized by joint inflammation, erosive properties and symmetric multiple joint involvement. Temporomandibular joint (TMJ is very rare to be affected in the early phase of the disease, thus posing diagnostic challenges for the dentist. Conventional radiographs fail to show the early lesions due to its limitations. More recently cone-beam computed tomography (CBCT has been found to diagnose the early degenerative changes of TMJ and hence aid in the diagnosis of the lesions more accurately. Our case highlights the involvement of TMJ in RA and the role of advanced imaging (CBCT in diagnosing the bony changes in the early phase of the disease.

  4. Dynamic contrast-enhanced magnetic resonance imaging of the wrist in early arthritis

    Directory of Open Access Journals (Sweden)

    M.A. Cimmino

    2011-09-01

    Full Text Available Objectives: MRI has been proposed as the imaging method of choice to evaluate the long-term outcome in patients with early arthritis. The role of dynamic MRI, performed at presentation, in predicting the outcome of patients with early arthritis has been addressed in the present study. Methods: 39 patients with early arthritis, involving at least one wrist, were studied with clinical visits and laboratory investigations, every 3 months. Dynamic MRI was performed with a low-field (0.2T, extremity-dedicated machine (Artoscan, Esaote, Genova, Italy equipped with a permanent magnet and with a dedicated hand and wrist coil. During the intravenous injection of Gd-DTPA, twenty consecutive fast images of 3 slices of the wrist were acquired. The synovial contrast enhancement ratio was calculated both as rate of early enhancement (REE per second during the first 55” and as relative enhancement (RE at t seconds. Results: In our cohort of patients, REE and RE were significantly lower than those observed in a historical cohort of 36 patients with active rheumatoid arthritis. In univariate analysis, low RE predicted complete remission of arthritis. In multivariate analysis, fulfillment of RA criteria during follow-up was predicted by high RE. The need for immunosuppressive treatment at the end of follow-up was predicted by both low RE and high REE. Conclusions: Dynamic MRI may be used to predict several outcomes of early arthritis involving the wrist

  5. Enhanced MR imaging of tenosynovitis of hand and wrist in inflammatory arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Tehranzadeh, J.; Ashilyan, O.; Anavim, A.; Tramma, S. [Univ. of California, Orange (United States). Dept. of Radiological Sciences

    2006-11-15

    The purpose of this study is to describe the appearance of tenosynovitis in various tendon groups in the wrist and hand and to compare MR enhanced and non-enhanced imaging evaluation of tenosynovitis of hand and wrist in inflammatory arthritis. We reviewed 72 MRI studies of hands and wrists, including coronal, axial and sagittal images in 30 consecutive patients with inflammatory arthritis and tenosynovitis. We compared the degree of synovitis on T2-weighted vs contrast-enhanced T1-weighted images, using a predetermined scale. We also measured the extent of tenosynovitis in three dimensions. The tendons were assigned to volar, dorsal, ulnar and radial groups in the wrist and to extensor, flexor and thumb groups in the hand. Degree of tenosynovitis (graded 0-3), cross-sectional area and volume of the inflamed synovium in various tendon groups were then compared by statistical analysis. Review of the medical records revealed the following diagnoses in our patient population: rheumatoid arthritis (n=16), unspecified inflammatory polyarthritis (n=9), psoriatic arthritis (n=2), CREST syndrome (n=1), systemic lupus erythematosus (n=1), paraneoplastic syndrome with arthritis (n=1). The average T2 brightness scores and post-gadolinium enhancement scores were 1.0 and 1.7 respectively (P<0.001) in the wrist studies. The average T2 brightness scores and post-gadolinium enhancement scores were 0.7 and 1.4, respectively (P<0.001) in the hand studies. The average sensitivity of T2-weighted imaging for detection of tenosynovitis was 40% in the hand and 67% in the wrist tendons, when contrast-enhanced images were used as a reference. Carpal tunnel flexor tendons were the most frequently affected tendons of the wrist. The most frequently affected tendons of the hand were second and third flexor tendons. The hand flexors demonstrated higher degrees of enhancement and larger volumes of the inflamed tenosynovium than did the hand extensors and tendons of the thumb.

  6. New radiographic bone erosions in the wrists of patients with rheumatoid arthritis are detectable with magnetic resonance imaging a median of two years earlier

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Hansen, Michael; Stoltenberg, Michael;

    2003-01-01

    OBJECTIVE: In a 5-year followup study, we investigated the temporal relationship between development of wrist joint erosions as visualized by magnetic resonance imaging (MRI) versus conventional radiography (CR), in patients with rheumatoid arthritis. We also evaluated the risk of erosive...... progression on CR associated with the presence of MRI erosions. METHODS: In 10 patients with rheumatoid arthritis, MRI and CR of the dominant wrist were performed annually for 5 years. In each image set, each wrist bone (metacarpal bases, carpal bones, radius, and ulna) was assessed for the absence or...... presence of bone erosions. RESULTS: Nine bones showed radiographic erosions at baseline. Twenty-seven new radiographic erosions developed during the 5-year followup period. Of these 27 new erosions, 21 were detected 1-5 years earlier by MRI than by CR, 3 were simultaneously detected by both methods, 2 were...

  7. 21 CFR 888.3800 - Wrist joint metal/polymer semi-constrained cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... cemented prosthesis. 888.3800 Section 888.3800 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Wrist joint metal/polymer semi-constrained cemented prosthesis. (a) Identification. A wrist joint metal/polymer semi-constrained cemented prosthesis is a device intended to be implanted to replace a wrist...

  8. Septic Arthritis in the Temporomandibular Joint

    OpenAIRE

    2015-01-01

    Septic arthritis of the temporomandibular joint (TMJ) is a rare event that has only been reported a few dozen times worldwide. This case is remarkable for septic arthritis of the TMJ joint in an otherwise healthy male. Case Report: A 24-year-old male presented to the emergency department with periauricular swelling, erythema, fever, myalgia's and generalized joint pain. He had previously sought medical attention and was placed on ciprofloxacin. However, he developed facial swelling and a rash...

  9. Magnetic resonance imaging of the peripheral joints in psoriatic arthritis

    Directory of Open Access Journals (Sweden)

    M.A. Cimmino

    2011-09-01

    Full Text Available Objective: Magnetic resonance imaging (MRI has been widely used for the evaluation of rheumatoid arthritis (RA, with only a minority of studies considering other types of arthritis. This review is concerned with an evaluation of the MRI appearance of peripheral joints in psoriatic arthritis (PsA. Methods: A Medline search was performed to identify all publications from the years 1985 to 2006 concerning MRI of the peripheral joints and PsA. Additional papers were retrieved by scanning the references to the Medline-listed articles. Articles written in English, French, German, and Italian were included. Results: Most papers studied the hand and wrist, and only few of them were concerned with the knee, foot, temporomandibular joint, and elbow. Patients with PsA showed often, but not always, a pattern of joint inflammation which extended beyond the capsule into the extraarticular tissue. Bone oedema and erosions were less frequent than in RA. In particular, bone oedema at the entheseal junction was seen, especially in the knee. The degree of synovitis, assessed by dynamic MRI, was similar in PsA and RA. Discussion: Data on MRI of the peripheral joints in PsA are scanty. Only few studies were specifically designed to evaluate the pattern of arthritis in PsA, with most information deriving from papers where different types of arthritis were considered together. An enthesis-related origin of PsA has been proposed in contrast to the primarily synovial inflammation of RA. This pathogenic interpretation is likely to be true, but does not explain all cases of PsA, and needs to be confirmed by further studies.

  10. Septic arthritis of a lumbar facet joint

    International Nuclear Information System (INIS)

    Septic arthritis of the posterior lumbar joints is extremely rare. The clinical picture of the unusual site of infection can easily lead to confusion with spondylo-discitis which is more common. We report a case of a 50-year-old women with Staphylococcus aureus septic arthritis of the left L5-S1 lumbar facet joint. CT scan was helpful to establish the diagnosis and to guide the percutaneous needle biopsy. (authors)

  11. Significance of anti-cyclic citrullinated peptide antibody and magnetic resonance imaging of metacarpophalangeal joints and wrist in early rheumatoid arthritis%抗环瓜氨酸肽抗体和关节磁共振成像对早期类风湿关节炎的意义

    Institute of Scientific and Technical Information of China (English)

    岳涛; 程鹏; 范晓蕾; 孙红梅; 周嘉陵; 何东仪; 陈继红; 张湛明

    2011-01-01

    目的 研究抗环瓜氨酸肽抗体(抗CCP)和核磁共振成像(MRI)对早期类风湿关节炎(RA)的诊断价值.方法 2007年1月至2009年6月上海光华医院对早期RA组 94例、不典型单关节炎组24例及对照组35例行掌指关节及腕关节MR扫描.同时搜集患者的临床资料及抗CCP抗体、类风湿因子(RF-IgM)等实验室指标.统计并分析MRI征象及OMERACT评分同临床检查之间的关系.结果 抗CCP抗体在早期RA中敏感性55.3%,特异性88.6%.根据MRI所示,滑膜增生对早期RA的敏感性和特异性分别为100%、71.4%;骨髓水肿为25.5%、94.3%;骨侵蚀为88.3%、65.7%.其中骨髓水肿的特异性最高,表现出骨髓水肿与抗CCP抗体阳性有一定关联.关节MRI对于早期RA有很高的诊断价值,对于骨破坏及滑膜炎的的敏感性远高于传统X线检查.与掌指关节相比,腕关节的MRI骨破坏更明显.结论 早期RA的腕骨骨髓水肿与抗CCP抗体阳性相关,抗CCP抗体和MRI对于早期RA的特异性均较高,分别优于RF与X线平片,有利于RA的早期诊断.二者联合检查能减少早期RA的漏诊率.%Objective To study the diagnostic value of anti-cyclic citrullinated peptide antibody (anti-CCP) and magnetic resonance imaging (MRI) of metacarpophalangeal joints(MCP)and wrist in early rheumatoid arthritis(RA).Methods MRI of MCP and wrist joint, laboratory indices of anti-CCP and rheumatic factor (RF) were performed and recorded in the 94 early-stage RA patients, 24 non-typical monoarthritis and 35 other arthritis.The MRI findings and OMERACT (outcome measures in rheumatoid arthritis clinical trials) score were analyzed in comparison with their clinical and laboratory indices.Results The sensitivity of anti-CCP, synonitis, bone erosion and bone erosion was 55.3%, 100%, 25.5% and 88.3% respectively in early-stage RA patients.The specificity was 88.6%, 71.4%, 94.3% and 65.7% respectively.There was significant difference between early-stage RA group and other

  12. 类风湿关节炎患者腕关节超声与X线和MRI的对比研究%A comparative study of ultrasound, X-ray and magnetic resonance imaging for the detection of wrist joints in rheumatoid arthritis patients

    Institute of Scientific and Technical Information of China (English)

    周博; 朱剑; 张红; 罗贵; 张江林; 黄烽

    2013-01-01

      目的通过行腕关节超声检查,了解 RA 腕关节软组织受累情况及骨侵蚀的形态、部位。进一步与 X 线、MRI 对比,评价超声检查的优势。方法收集来自解放军总医院门诊及病房的类风湿关节炎( rheumatoid arthritis,RA )患者。分别应用超声、X 线及核磁共振( MRI )记录患者腕关节受累情况,同时收集患者临床及实验室资料。进一步分析不同检查方法间的差异及超声改变情况与临床指标的相关性。结果该研究共纳入36例 RA 患者72个腕关节。66个腕关节出现超声相关软组织病变检查阳性率为91.7%,其中63个关节(87.5%)出现关节腔内积液,57个关节(79.2%)出现腕部背侧屈肌腱腱鞘炎,61个关节(84.7%)出现滑膜炎改变。1个腕关节出现 X 线相关软组织肿胀检查阳性率为1.4%,超声在发现软组织病变方面显著优于 X 线( P=0.00)。超声发现骨侵蚀在桡骨、月骨、头状骨处分别为21、41、40,而 X 线发现骨侵蚀分别为13、10、12。超声在发现骨侵蚀病变方面显著优于 X 线( P=0.00)。早期 RA 患者超声比 X 线发现更多骨侵蚀改变(54.5%∶9.1%)。超声检查阳性而 X 线阴性的病变均由 MRI 证实为异常改变。结论腕关节超声检查不仅可早期发现骨侵蚀改变,在观察关节周围软组织病变以及价格和易得易行方面具有绝对优势,可作为 RA 患者就诊的首选影像学检查。%Objective To investigate the soft tissue involvement and the shape and position of bone erosions in the wrist joints of rheumatoid arthritis ( RA ) patients using ultrasonography, and to e valuate the advantages of ultrasonography when further compared with the X-ray and MRI. Methods RA patients from both the clinic and wards of our hospital were enrolled, and all of them underwent ultrasonography, X-ray and MRI respectively in the wrist joints to record the involvement. At the same time, the clinical

  13. Detection of Arthritis by Joint Scanning

    International Nuclear Information System (INIS)

    Detection and identification of early arthritis is frequently difficult with routine methods. Several tracers, 131I human serum albumin (25 μCi/10 lb), 99mTc human serum albumin (1-3 mCi), 131I iodipamide (40 μCi/10 lb), and 99mTc pertechnetate (10 mCi), have been employed for joint scanning to detect synovitis produced by arthritis in joints of the extremities. When administered intravenously, the 25% increase in localization of these tracers in the synovial membrane, if there is active synovitis, can be demonstrated by scintillation scanning. This ability to detect synovitis at an early stage enables the joint scan to show areas of active synovitis not demonstrated on roentgenograms. The scan may objectively confirm or disprove questionable physical findings. From this standpoint the technique has been useful in determining whether joint pain is functional or due to arthritis as a negative localization tends to rule out active synovitis as the cause of the pain. The scan demonstration of a positive localization of the tracer in several joints when only one area is symptomatic is evidence that joint pain is due to systemic disease. The short half-life tracera permit serial studies to follow the course of an arthritis process. Use of 99mTc pertechnetate and an Anger camera have made joint scanning a practical technique for clinical use. A review of the accuracy of joint scanning in 130 cases as compared to roentgenograms is presented. (author)

  14. Pre- and post-operative comorbidities in idiopathic carpal tunnel syndrome: cervical arthritis, basal joint arthritis of the thumb, and trigger digit.

    Science.gov (United States)

    Kim, J H; Gong, H S; Lee, H J; Lee, Y H; Rhee, S H; Baek, G H

    2013-01-01

    We retrospectively reviewed 633 hands in 362 patients who had idiopathic carpal tunnel syndrome and underwent carpal tunnel release between 1999 and 2009. Electrophysiological studies and simple radiographs of the wrist, cervical spine, and basal joint of the thumb were routinely checked, and patients were also assessed for the presence of trigger digit or de Quervain's disease before and after surgery. Among 362 patients, cervical arthritis was found in 253 patients (70%), and C5-C6 arthritis was the most common site. Basal joint arthritis of the thumb was observed in 216 (34%) of the 633 hands. Trigger digit or de Quervain's disease was observed in 85 of the 633 hands (13%) before surgery, and developed in 67 hands (11%) after surgery. Cervical arthritis, basal joint arthritis, and trigger digit commonly coexist with idiopathic carpal tunnel syndrome. Patient education about these disorders is very important when they coexist with idiopathic carpal tunnel syndrome. PMID:22553311

  15. 21 CFR 888.3760 - Wrist joint carpal scaphoid polymer prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Wrist joint carpal scaphoid polymer prosthesis. 888.3760 Section 888.3760 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... scaphoid polymer prosthesis. (a) Identification. A wrist joint carpal scaphoid polymer prosthesis is a...

  16. 21 CFR 888.3770 - Wrist joint carpal trapezium polymer prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Wrist joint carpal trapezium polymer prosthesis. 888.3770 Section 888.3770 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... trapezium polymer prosthesis. (a) Identification. A wrist joint carpal trapezium polymer prosthesis is a...

  17. 21 CFR 888.3750 - Wrist joint carpal lunate polymer prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Wrist joint carpal lunate polymer prosthesis. 888.3750 Section 888.3750 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... lunate polymer prosthesis. (a) Identification. A wrist joint carpal lunate prosthesis is a...

  18. 21 CFR 888.3790 - Wrist joint metal constrained cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Wrist joint metal constrained cemented prosthesis... constrained cemented prosthesis. (a) Identification. A wrist joint metal constrained cemented prosthesis is a... as cobalt-chromium-molybdenum, and is limited to those prostheses intended for use with bone...

  19. 类风湿性关节炎手腕关节MRI弥散加权成像与滑膜病理相关性分析%Magnetic resonance diffusion-weighted imaging of hand and wrist joints in rheumatoid arthritis:correlated with synovial pathology

    Institute of Scientific and Technical Information of China (English)

    陈悦熙; 张芳; 沈君

    2012-01-01

    目的 分析类风湿性关节炎手腕部MRI及弥散加权成像(DWI)表现,并与临床滑膜病理指标作相关性分析,探讨MRI对评估双手、腕类风湿关节炎的严重程度及临床活动性的价值.方法 对15例确诊RA患者行双手MRI检查,并与临床症状和实验室检查进行相关性分析,测量DWI上滑膜ADC值,与滑膜穿刺活检的病理学指标进行相关性分析.结果 MRI滑膜炎评分、骨侵蚀评分、骨髓水肿评分及总分均与C反应蛋白(CRP)、可视化量表(VAS)有相关性;DWI的ADC值与滑膜病理评分具有负相关.结论 MRI能清楚显示RA手腕部小关节的病理改变.MRI可对RA的滑膜炎、骨侵蚀、骨髓水肿进行半定量化分级评分,MRI评分与临床指标有一定相关性,对双手、腕类风湿关节炎的活动性评估具有重要价值.DWI结合ADC值测量,可更加直接地反映病变关节的活动程度.%Objective To analyze magnetic resonance imaging and diffusion-weighted imaging of hand and wrist joints in rheumatoid arthritis ( RA) patients to investigate the value of MR imaging in the evaluation the disease severity and activity by correlating the MR findings with clinical and synovium histological features. Methods Fifteen patients with RA were enrolled. All patients underwent MR examination on both wrists and the 2th to 5th metacarpophalangeals( MCP) . The clinical and laboratory parameters of each patient were record and correlated with MR parameters. On DWI, the ADC of involved joints were measured and correlated with the histological parameters that were observed on the histological examination from synovial biopsy. Results Synovitis score of MRI, bone erosion score, bone marrow edema score and the total score were correlated with CRP and VAS. ADC value measured on DWI was negatively correlated with histological synovitis score. Conclusions MRI can clearly display the pathological changes of the hand and wrist joints in RA patients. MRI can be used

  20. Septic arthritis in the temporomandibular joint

    Directory of Open Access Journals (Sweden)

    Hassan Mahdi Al-Khalisy

    2015-01-01

    Full Text Available Septic arthritis of the temporomandibular joint (TMJ is a rare event that has only been reported a few dozen times worldwide. This case is remarkable for septic arthritis of the TMJ joint in an otherwise healthy male. Case Report: A 24-year-old male presented to the emergency department with periauricular swelling, erythema, fever, myalgia′s and generalized joint pain. He had previously sought medical attention and was placed on ciprofloxacin. However, he developed facial swelling and a rash and had to discontinue the antibiotic. On physical exam the patient had a large swelling and tenderness in his left periauricular area, with erythema and deviation of the right mandible which limited his ability to open the mouth. A computed tomography showed mild asymmetric soft tissue swelling in the left pharyngeal region but did not show joint effusion. Subsequent magnetic resonance imaging did show effusion of the joint space. The effusion was drained, and the synovial fluid was submitted for gram stain, culture, and sensitivity. The cultures grew menthicillin sensitive Staphyloccocus Aureus. The patient was discharged to complete a two week course of intravenous (IV Ceftriaxone and IV Vancomycin via home infusion. Conclusion: Septic Arthritis of the TMJ is a rare event with very specific clinical symptoms. Due to the low sensitivity of the computed tomography scan, magnetic resonance imaging should be considered when computed tomography scan is negative for TMJ effusion.

  1. Effect of radiosynovectomy in patients with inflammatory joint disorders not caused by rheumatoid arthritis

    International Nuclear Information System (INIS)

    Aim: Effect of radiosynovectomy (RS) should be evaluated both by subjective and objective parameters in patients with osteoarthritis and in patients with inflammatory joint disorders not caused by rheumatoid arthritis. Methods: A total of 98 joints in 61 patients were investigated. Patients were divided into two groups. The first group included 35 patients with therapy-resistant effusions caused by severe osteoarthritis (46 joints). The second group consisted of 26 patients (52 joints) with ankylosing spondylitis, reactive arthritis, undifferentiated spondylarthropathy, psoriatic arthritis, pigmented villo-nodular synovitis, and recurrent synovitis following surgery. Effect of RS was evaluated by a standardized questionnaire and quantified by T/B-ratios derived from blood pool images prior to and after RS. Results: Within the first patient group suffering from osteoarthritis, 40% showed a good or excellent improvement of clinical symptoms, 51% were unchanged, and in 9% symptoms worsened. Similar results were found in the second patient group. The majority of unchanged results were small finger joints. In contrast, wrist and knee joints showed a better improvement. Good correlation between results of bone scan and patients subjective impression was found in 38% and 67% in the first and the second patient group, respectively. Conclusion: Radiosynovectomy might be an effective treatment in osteoarthritis and inflammatory joint disorders not caused by rheumatoid arthritis. (orig.)

  2. Validation of the OMERACT Magnetic Resonance Imaging Joint Space Narrowing Score for the Wrist in a Multireader Longitudinal Trial

    DEFF Research Database (Denmark)

    Glinatsi, Daniel; Lillegraven, Siri; Haavardsholm, Espen A; Eshed, Iris; Conaghan, Philip G; Peterfy, Charles; Gandjbakhch, Frédérique; Bird, Paul; Bøyesen, Pernille; Døhn, Uffe M; Genant, Harry K; Østergaard, Mikkel

    2015-01-01

    OBJECTIVE: To assess the intrareader and interreader agreement and sensitivity to change of the Outcome Measures in Rheumatology (OMERACT) Rheumatoid Arthritis Magnetic Resonance Imaging Joint Space Narrowing (RAMRIS-JSN) score in the rheumatoid arthritis (RA) wrist in a longitudinal multireader....... Intraclass correlation coefficients (ICC), smallest detectable change (SDC), percentage exact/close agreement (PEA/PCA), and standardized response mean (SRM) were calculated. RESULTS: Median baseline and change score was 10.3 and 1.9, respectively. Intrareader ICC for baseline and change scores was good (≥ 0.......50) to very good (≥ 0.80) for all and 3 of 4 readers, respectively. Interreader ICC was very good for change (0.93), while poor for baseline score if all 4 readers were included (0.36), but very good if 1 reader was excluded (0.87). Intrareader and interreader SDC was low (2.34-3.18), except for the...

  3. 38 CFR 4.45 - The joints.

    Science.gov (United States)

    2010-07-01

    ... (from flail joint, resections, nonunion of fracture, relaxation of ligaments, etc.). (c) Weakened... the purpose of rating disability from arthritis, the shoulder, elbow, wrist, hip, knee, and ankle...

  4. Antibodies Act Jointly to Promote Inflammation in Rheumatoid Arthritis

    Science.gov (United States)

    ... Antibodies Act Jointly to Promote Inflammation in Rheumatoid Arthritis Two types of antibody molecules act in concert to stimulate inflammation in people with rheumatoid arthritis, according to research funded in part by the ...

  5. OMERACT Rheumatoid Arthritis Magnetic Resonance Imaging Studies. Core set of MRI acquisitions, joint pathology definitions, and the OMERACT RA-MRI scoring system

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Peterfy, C; Conaghan, P;

    2003-01-01

    This article describes the 2002 OMERACT rheumatoid arthritis magnetic resonance image scoring system (RAMRIS) for evaluation of inflammatory and destructive changes in RA hands and wrists, which was developed by an international MRI-OMERACT group. MRI definitions of important RA joint pathologies......, and a 'core set' of basic MRI sequences for use in RA are also suggested......This article describes the 2002 OMERACT rheumatoid arthritis magnetic resonance image scoring system (RAMRIS) for evaluation of inflammatory and destructive changes in RA hands and wrists, which was developed by an international MRI-OMERACT group. MRI definitions of important RA joint pathologies...

  6. Evaluation of effects of different treatments for the wrist joints of subdominant hands using joint proprioception and writing time.

    Science.gov (United States)

    Hu, Chunying; Huang, Qiuchen; Yu, Lili; Hu, Yue; Rongming, Xia; Li, Zhou; Xiaojiao, Fu; Gu, Rui; Cui, Yao; Ge, Meng; Xu, Yanfeng; Liu, Jianfeng

    2016-05-01

    [Purpose] The purpose of this study was to examine immediate effects of strength training and NJF distal resistance training in wrist joints by using writing time and evaluation of proprioception using the JPE test. [Subjects and Methods] The subjects were 12 young healthy people (24.2 ± 3.1 y, 169.7 ± 6.5 cm, 65.3 ± 12.6 kg). Two isotonic contraction techniques were applied on the wrist joint: wrist joint extension muscle strength training (MST) and the wrist joint extension pattern of NJF. The uppercase English alphabet writing time and joint position errors of the left upper limb were measured before and after one intervention session of MST and NJF. [Results] The decrease in errors in wrist extension angle repetition and the writing time represented the improvement resulting from NJF. [Conclusion] This result suggests that the subdominant hands wrist joint proprioception and writing function can be improved by NJF together with proximal resistance training. PMID:27313380

  7. Wrist joint moments of walker-assisted gait:a study of biomechanics and instrumentation

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    While walkers are commonly prescribed to improve patient stability and ambulatory ability,quantitativestudy of the biomechanical and functional requirements for effective walker use is limited.To investigate the changesin wrist joint moments that occur with the use of a standard walker,a strain gauge-based walker instrumentation system was developed for the measurement of wrist joint moments.This walker dynamometer was integrated with an upper extremity biomechanical model.Preliminary system data were collected for twelve healthy,right-handed young adultsfollowing informed consent.Bilateral upper extremity kinematic data were acquired with a six-camera motion analysis system.Internal joint moments at the wrist were determined in the three clinical planes using the inverse dynamics method.Results showed that during a walker-assisted gait there were several typical demands of wrist abductor,adductor,flexor and external rotator.An interesting " bare phase " of wrist joint moments was also found in phaseangle[-30°,30°] of gait cycle.Complete description of wrist joint moments during walker-assisted gait may provide insight into walker use parameters and rehabilitative strategies.

  8. The double universal joint wrist on a manipulator: Solution of inverse position kinematics and singularity analysis

    Science.gov (United States)

    Williams, Robert L., III

    1992-01-01

    This paper presents three methods to solve the inverse position kinematics position problem of the double universal joint attached to a manipulator: (1) an analytical solution for two specific cases; (2) an approximate closed form solution based on ignoring the wrist offset; and (3) an iterative method which repeats closed form position and orientation calculations until the solution is achieved. Several manipulators are used to demonstrate the solution methods: cartesian, cylindrical, spherical, and an anthropomorphic articulated arm, based on the Flight Telerobotic Servicer (FTS) arm. A singularity analysis is presented for the double universal joint wrist attached to the above manipulator arms. While the double universal joint wrist standing alone is singularity-free in orientation, the singularity analysis indicates the presence of coupled position/orientation singularities of the spherical and articulated manipulators with the wrist. The cartesian and cylindrical manipulators with the double universal joint wrist were found to be singularity-free. The methods of this paper can be implemented in a real-time controller for manipulators with the double universal joint wrist. Such mechanically dextrous systems could be used in telerobotic and industrial applications, but further work is required to avoid the singularities.

  9. Ultrasonographic Diagnosis of the Hand and Wrist Joint

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Ik; Choi, Sang Hee [Kangnnam Sacredheart Hospital, Hallym University Medical Center, Seoul (Korea, Republic of)

    2006-12-15

    Ultrasonographic examination of the hand and wrist is simple and easy due to their superficial anatomy, and easy accessibility. Ultrasound is indicated to evaluate persistent pain and swelling when the radiographic examination is normal. Although their anatomy is simple, the pathologic conditions of the hand and wrist are quite diverse. Although plain radiographs, CT, arthrography, and MRI have traditionally been used to evaluate the hand and wrist, nowadays, ultrasound is now being ordered with increasing frequency to scan the hand and wrist as it is a cost-effective and accurate modality for the diagnosis of focal pathology in those areas. A high-frequency linear array transducer should be used to scan the upper extremity. Available transducers up to 12 MHz provide excellent resolution. Color and power Doppler images are useful in hyperemic changes and tumor vascularity. Sonographic panorama imaging also has the advantage of demonstrating the whole extension of the lesion and of enabling a dynamic study of the hand and wrist. This action during sonographic examination not only help to diagnosis to examiner to the anatomic structures, but also localize the pathologic process to a target organ. This chapter will describe the sonographic findings associated with the most common hand and wrist pathologic conditions

  10. Radiologic examination and measurement of the wrist and distal radio-ulnar joint. New aspects

    Energy Technology Data Exchange (ETDEWEB)

    Toernvall, A.H.; Ekenstam, F. af; Hagert, C.G.; Irstam, L.

    Following fractures of the distal radius, a relatively high incidence of complications is caused by malalignment in the distal radio-ulnar (DRU) joint; recent anatomic and clinical investigations have shown a congruity of that joint to be of significant importance for restoring the function of the wrist. The radius forms a moderately arched bone, which moves around the ulna in pronation and supination. Biomechanically, the ulna may be regarded as the pillar around which the radius moves. In an anatomic investigation of 5 arm specimens, we have shown that the maximum cartilage contact in the DRU joint between the ulna head and the distal radius occurs in the neutral rotation position. A proposed routine examination method of the wrist and forearm includes a true antero-posterior and a lateral projection of the radius and the ulna, performed with the forearm and wrist in a neutral rotation, a neutral wrist deviation and with the elbow angled 90 degrees. Such an examination implies a standardized and reproducible method. In a radioanatomic investigation, a series of 50 healthy wrists and forearms were examined. A simple measuring technique is presented, applicable to the DRU joint and wrist favouring the ulna as the bone through which a reproducible long axis of the forearm/wrist may be drawn. It is suggested that the length of the radius should be judged relative to the ulna. Ulnar head inclination and radio-ulnar angle are new concepts, being major characteristics of the DRU joint. These angles of the right and left wrist were equal and no difference was found between the sexes. Minor alterations of the distal radius may be revealed when estimating these angles.

  11. Radiologic examination and measurement of the wrist and distal radio-ulnar joint

    International Nuclear Information System (INIS)

    Following fractures of the distal radius, a relatively high incidence of complications is caused by malalignment in the distal radio-ulnar (DRU) joint; recent anatomic and clinical investigations have shown a congruity of that joint to be of significant importance for restoring the function of the wrist. The radius forms a moderately arched bone, which moves around the ulna in pronation and supination. Biomechanically, the ulna may be regarded as the pillar around which the radius moves. In an anatomic investigation of 5 arm specimens, we have shown that the maximum cartilage contact in the DRU joint between the ulna head and the distal radius occurs in the neutral rotation position. A proposed routine examination method of the wrist and forearm includes a true antero-posterior and a lateral projection of the radius and the ulna, performed with the forearm and wrist in a neutral rotation, a neutral wrist deviation and with the elbow angled 90 degrees. Such an examination implies a standardized and reproducible method. In a radioanatomic investigation, a series of 50 healthy wrists and forearms were examined. A simple measuring technique is presented, applicable to the DRU joint and wrist favouring the ulna as the bone through which a reproducible long axis of the forearm/wrist may be drawn. It is suggested that the length of the radius should be judged relative to the ulna. Ulnar head inclination and radio-ulnar angle are new concepts, being major characteristics of the DRU joint. These angles of the right and left wrist were equal and no difference was found between the sexes. Minor alterations of the distal radius may be revealed when estimating these angles. (orig.)

  12. Role of Scaphoid in the Abduction and Adduction Movements of Wrist Joint

    Directory of Open Access Journals (Sweden)

    Sadik I Shaikh

    2013-06-01

    Full Text Available Background: Being a carpal bone scaphoid has an important role in wrist movements. Wrist joint is a synovial modified ellipsoid joint where movements like flexion, extension and adduction, abduction take place around two axes (transverse and antero-posterior. These movements at the wrist joint are associated with considerable range of movements at the mid carpal joint, as same group of muscles act on both of these joints. Methodology: A study has been done amongst 120 persons at the tertiary care hospital during the period from 2006-07 to detect the important movements of scaphoid bone specially during the abduction and adduction of wrist joint (which occur in association with the intercarpal joints and also to detect whether such movements have any speciality in the population. Results: In fully abducted position, it was 45o among 53.3% subjects and the average among all the subjects was 60o. So, the degree of abduction was 30o. The extent of movement was more in adduction (ie, 1.90 cm - 1.03 cm = 0.87 cm than in abduction (ie, 1.03 cm - 0.72 cm = 0.31cm. Conclusion: It was found in this study that the scaphoid acts as a link bone between the two rows of carpal bones and prevents the buckling of midcarpal joint especially of the capitato- lunate joint interface. [Natl J Med Res 2013; 3(3.000: 253-256

  13. Pisotriquetral joint disorders: an under-recognized cause of ulnar side wrist pain

    Energy Technology Data Exchange (ETDEWEB)

    Moraux, A. [Hopital Roger Salengro, Service d' Imagerie Musculo-Squelettique, Centre de Consultation de l' Appareil Locomoteur, CHRU Lille (France); Imagerie Medicale Jacquemars Gielee, Lille (France); Lefebvre, G.; Pansini, V.; Aucourt, J.; Vandenbussche, L.; Cotten, A. [Hopital Roger Salengro, Service d' Imagerie Musculo-Squelettique, Centre de Consultation de l' Appareil Locomoteur, CHRU Lille (France); Demondion, X. [Hopital Roger Salengro, Service d' Imagerie Musculo-Squelettique, Centre de Consultation de l' Appareil Locomoteur, CHRU Lille (France); Pole Recherche Faculte de Medecine de Lille, Laboratoire d' Anatomie, Lille (France)

    2014-06-15

    Pisotriquetral joint disorders are often under-recognized in routine clinical practice. They nevertheless represent a significant cause of ulnar side wrist pain. The aim of this article is to present the main disorders of this joint and discuss the different imaging modalities that can be useful for its assessment. (orig.)

  14. Low Level Laser Therapy (Lllt) for Chronic Joint Pain of the Elbow, Wrist and Fingers

    OpenAIRE

    Okuni, Ikuko; Ushigome, Nobuyuki; Harada, Takashi; Ohshiro, Toshio; Musya, Yoshiro; Sekiguchi, Masayuki

    2012-01-01

    Background and Aims: In previous studies, we successfully applied Low Level Laser Therapy (LLLT) in patients with non-specific chronic pain of the shoulder joint and lower back. The purpose of the present study was to assess the effectiveness of LLLT for chronic joint pain of the elbow, wrist, and fingers.

  15. Pisotriquetral joint disorders: an under-recognized cause of ulnar side wrist pain

    International Nuclear Information System (INIS)

    Pisotriquetral joint disorders are often under-recognized in routine clinical practice. They nevertheless represent a significant cause of ulnar side wrist pain. The aim of this article is to present the main disorders of this joint and discuss the different imaging modalities that can be useful for its assessment. (orig.)

  16. Prognostic laboratory markers of joint damage in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Lindqvist, E; Henriksen, Karen Eberhardt; Bendtzen, K;

    2005-01-01

    To investigate whether determination of a set of laboratory markers at baseline provides prognostic information on joint damage in hands and feet in rheumatoid arthritis.......To investigate whether determination of a set of laboratory markers at baseline provides prognostic information on joint damage in hands and feet in rheumatoid arthritis....

  17. First Case of Lyme Arthritis Involving a Prosthetic Knee Joint

    Science.gov (United States)

    Wright, William F.; Oliverio, James A.

    2016-01-01

    Borrelia burgdorferi sensu stricto is the most common tick-borne illness in the United States. Arthritis is usually a mani­festation of late dis­ease but has not been associated with cases of periprosthetic joint infections. We report on a patient who was first diagnosed with periprosthetic joint infection and subsequently Lyme arthritis. PMID:27419168

  18. MR imaging of the wrist in rheumatoid arthritis using gadobenate dimeglumine

    International Nuclear Information System (INIS)

    Objective. To determine the dosage of gadobenate dimeglumine (Gd-BOPTA) necessary for MRI of rheumatoid arthritis of the wrist.Design and patients. Seven wrists inflamed with rheumatoid arthritis were imaged using a dedicated 0.2-T MR unit. Four cumulative dosages of 0.0125, 0.025, 0.05 and 0.1 mmol/kg body weight (BW) Gd-BOPTA were tested. Three-dimensional T1-weighted gradient-recalled echo sequences (GRE; TR: 100 ms, TE: 18 ms, flip angle 90 , 4:55 min) were acquired prior to an intravenous injection and after each additional dosage of Gd-BOPTA. Relative enhancement, signal-difference-to-noise ratios (SDNRs) and the size of the inflamed tissue were quantified. Three radiologists independently evaluated the image quality, the size and the contrast of the enhancing tissue.Results. The readers agreed on a dose of 0.05 mmol/kg BW as satisfactory for the evaluation of the size of the inflammatory tissue and for determination of bone involvement (κ=0.9, P<0.001). Highly inflammatory pannus was depicted with adequate image contrast using 0.025 mmol/kg BW Gd-BOPTA. According to the SDNR and relative enhancement findings, a dose of 0.05 mmol/kg BW suffices for both off-center and centered regions of tissue inflammation (t-test, P<0.05).Conclusion. Gadolinium-BOPTA is an alternative contrast agent for MRI of rheumatoid disease. This study shows that a dose of 0.05 mmol/kg BW suffices at low field strength. (orig.)

  19. OMERACT Rheumatoid Arthritis Magnetic Resonance Imaging Studies. Core set of MRI acquisitions, joint pathology definitions, and the OMERACT RA-MRI scoring system

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Peterfy, C; Conaghan, P;

    2003-01-01

    This article describes the 2002 OMERACT rheumatoid arthritis magnetic resonance image scoring system (RAMRIS) for evaluation of inflammatory and destructive changes in RA hands and wrists, which was developed by an international MRI-OMERACT group. MRI definitions of important RA joint pathologies......, and a 'core set' of basic MRI sequences for use in RA are also suggested...

  20. Effects of Neoprene Wrist/Hand Splints on Handwriting for Students with Joint Hypermobility Syndrome: A Single System Design Study

    Science.gov (United States)

    Frohlich, Lauren; Wesley, Alison; Wallen, Margaret; Bundy, Anita

    2012-01-01

    Purpose: Pain associated with hypermobility of wrist and hand joints can contribute to decreased handwriting output. This study examined the effectiveness of a neoprene wrist/hand splint in reducing pain and increasing handwriting speed and endurance for students with joint hypermobility syndrome. Methods: Multiple baseline, single system design…

  1. Location and incidence of localized juxta-articular demineralizations and erosions at the wrist in early rheumatoid arthritis

    International Nuclear Information System (INIS)

    In early rheumatoid arthritis the location and incidence of localized juxta-articular demineralizations and erosions were investigated at 53 points of the wrist. On the level of the metacarpal bases, the distal and proximal row of the carpal bones more changes are seen in the oblique vd. and the lateral view than in the dv. view. At the distal bones of the forearm more changes are seen at the radius than at the ulnar styloid. The most often changes at all occur at the volar middle third of the triquetrum in the oblique view and at the distal volar articular facet of the scaphoid in the lateral view. Close relations between localized juxta-articular demineralizations and erosions do not exist. If the early bone changes at the wrist in rheumatoid arthritis are to be detected additional oblique and lateral view are prerequisite. (orig.)

  2. A biomechanical model of the wrist joint for patient-specific model guided surgical therapy: Part 2.

    Science.gov (United States)

    Eschweiler, Jörg; Stromps, Jan-Philipp; Fischer, Maximilian; Schick, Fabian; Rath, Björn; Pallua, Norbert; Radermacher, Klaus

    2016-04-01

    An enhanced musculoskeletal biomechanical model of the wrist joint is presented in this article. The computational model is based on the multi-body simulation software AnyBody. Multi body dynamic musculoskeletal models capable of predicting muscle forces and joint contact pressures simultaneously would be valuable for studying clinical issues related to wrist joint degeneration and restoration. In this study, the simulation model of the wrist joint was used for investigating deeper the biomechanical function of the wrist joint. In representative physiological scenarios, the joint behavior and muscle forces were computed. Furthermore, the load transmission of the proximal wrist joint was investigated. The model was able to calculate the parameters of interest that are not easily obtainable experimentally, such as muscle forces and proximal wrist joint forces. In the case of muscle force investigation, the computational model was able to accurately predict the computational outcome for flexion and extension motion. In the case of force distribution of the proximal wrist joint, the model was able to predict accurately the computational outcome for an axial load of 140 N. The presented model and approach of using a multi-body simulation model are anticipated to have value as a predictive clinical tool including effect of injuries or anatomical variations and initial outcome of surgical procedures for patient-specific planning and custom implant design. Therefore, patient-specific multi-body simulation models are potentially valuable tools for surgeons in pre- and intraoperative planning of implant placement and orientation. PMID:26994118

  3. Early Metacarpal Bone Mineral Density Loss Using Digital X-Ray Radiogrammetry and 3-Tesla Wrist MRI in Established Rheumatoid Arthritis: A Longitudinal One-Year Observational Study

    Directory of Open Access Journals (Sweden)

    Anshul Rastogi

    2015-01-01

    Full Text Available Objectives. Early change in rheumatoid arthritis (RA is characterised by periarticular osteopenia. We investigated the relationship of early metacarpal digital X-ray radiogrammetry bone mineral density (DXR-BMD change rate (RC-BMD, mg/cm2/month to longitudinal changes in hand and feet radiographic and wrist MRI scores over 1 year. Materials and Methods. 10 RA patients completed the study and had wrist 3T-MRI and hand and feet X-rays at various time points over 1 year. MRI was scored by RAMRIS, X-ray was done by van der Heijde modified Sharp scoring, and RC-BMD was analysed using dxr-online. Results. There was good correlation amongst the two scorers for MRI measures and ICC for erosions: 0.984, BME: 0.943, and synovitis: 0.657. Strong relationships were observed between RC-BMD at 12-week and 1-year change in wrist marrow oedema (BME (r=0.78, P=0.035 but not with erosion, synovitis, or radiographic scores. Conclusion. Early RC-BMD correlates with 1-year wrist BME change, which is a known predictor of future erosion and joint damage. However, in our pilot study, early RC-BMD did not show relationships to MRI erosion or radiographic changes over 1 year. This may reflect a slower kinetic in the appearance of MRI/radiographic erosions, generating the hypothesis that RC-BMD may be a more sensitive and early structural prognostic marker in RA follow-up.

  4. Effect of Combination Therapy on Joint Destruction in Rheumatoid Arthritis

    DEFF Research Database (Denmark)

    Graudal, N.; Hubeck-Graudal, T.; Tarp, S.;

    2014-01-01

    progression of radiographic joint erosions in patients with rheumatoid arthritis (RA). Methods and Findings: The following combination drug therapies compared versus single DMARD were investigated: Double DMARD: 2 DMARDs (methotrexate, sulfasalazine, leflunomide, injectable gold, cyclosporine, chloroquine...

  5. Early rheumatoid arthritis and its differentiation from other joint abnormalities

    International Nuclear Information System (INIS)

    The introduction of disease-modifying antirheumatic drugs has created new demands on imaging to early identify patients with rheumatoid arthritis and opened new prospects in therapeutic management of patients with aggressive disease. Therefore, new imaging modalities such as magnetic resonance imaging and ultrasound have developed during the past few years in this field. In some cases, both magnetic resonance imaging and ultrasound may be also useful in making the distinction between early rheumatoid arthritis and other joints abnormalities, including early psoriatic arthritis. This article will review key aspects of important advances in imaging in rheumatoid arthritis, particularly focusing on magnetic resonance imaging and ultrasound.

  6. MRI findings of the wrist in patients with multiple osteonecrosis in large joints of the extremities

    International Nuclear Information System (INIS)

    We evaluated MRI findings of the wrist in patients who had multiple osteonecrosis in the large joints of their extremities (hips, knees, shoulders, and ankles) and compared these with the clinical symptoms and radiographical findings. Sixty wrists of 30 patients (3 males and 27 females) with multiple osteonecrosis were studied. Subjects ranged in age from 16 to 59 years. Their primary diseases were SLE in 24 patients, alcoholic osteonecrosis in two, Sjoegren's syndrome in one, dermatomyositis in one, leukemia in one, and MCTD in one patient. Using MRI, we found osteonecrosis in seven wrists of four patients. Lesions were seen in six scaphoids of three patients, in two lunates of two patients, and in one capitate. We noted a reduced range of motion in three of the seven wrists with osteonecrosis. Two of the seven complained at wrist pain at motion, although three wrists were symptom free. Radiographically, an abnormality was recognized in two of the seven wrists. Generally, osteonecrosis of the lunate (Kienboeck's disease) is more frequent than that of the scaphoid (Preiser's disease). However in the present series, we found a higher osteonecrosis rate of the scaphoid than the lunate, using MRI. The discrepancy can be explained by the vascularity. In 1986, Gelberman reported that the scaphoid, the capitate, and 8% of the lunate had either vessels entering only one surface or large areas of bone that were dependent on a single vessel. The present study is consistent with these anatomical features. In other words, the present results demonstrated that Kienboeck's disease can be induced not only by a deficient blood supply but also by some additional factors. (author)

  7. MRI findings of the wrist in patients with multiple osteonecrosis in large joints of the extremities

    Energy Technology Data Exchange (ETDEWEB)

    Saitoh, Shinobu; Ebata, Tatsuki; Abe, Kazuhiro [Chiba Univ. (Japan). School of Medicine; Imai, Katsumi; Rokkaku, Tomoyuki

    1998-02-01

    We evaluated MRI findings of the wrist in patients who had multiple osteonecrosis in the large joints of their extremities (hips, knees, shoulders, and ankles) and compared these with the clinical symptoms and radiographical findings. Sixty wrists of 30 patients (3 males and 27 females) with multiple osteonecrosis were studied. Subjects ranged in age from 16 to 59 years. Their primary diseases were SLE in 24 patients, alcoholic osteonecrosis in two, Sjoegren`s syndrome in one, dermatomyositis in one, leukemia in one, and MCTD in one patient. Using MRI, we found osteonecrosis in seven wrists of four patients. Lesions were seen in six scaphoids of three patients, in two lunates of two patients, and in one capitate. We noted a reduced range of motion in three of the seven wrists with osteonecrosis. Two of the seven complained at wrist pain at motion, although three wrists were symptom free. Radiographically, an abnormality was recognized in two of the seven wrists. Generally, osteonecrosis of the lunate (Kienboeck`s disease) is more frequent than that of the scaphoid (Preiser`s disease). However in the present series, we found a higher osteonecrosis rate of the scaphoid than the lunate, using MRI. The discrepancy can be explained by the vascularity. In 1986, Gelberman reported that the scaphoid, the capitate, and 8% of the lunate had either vessels entering only one surface or large areas of bone that were dependent on a single vessel. The present study is consistent with these anatomical features. In other words, the present results demonstrated that Kienboeck`s disease can be induced not only by a deficient blood supply but also by some additional factors. (author)

  8. Genetic Variants Influencing Joint Damage in Mexican Americans and European Americans With Rheumatoid Arthritis.

    Science.gov (United States)

    Arya, Rector; Del Rincon, Inmaculada; Farook, Vidya S; Restrepo, Jose F; Winnier, Diedre A; Fourcaudot, Marcel J; Battafarano, Daniel F; de Almeida, Marcio; Kumar, Satish; Curran, Joanne E; Jenkinson, Christopher P; Blangero, John; Duggirala, Ravindranath; Escalante, Agustin

    2015-12-01

    Joint destruction in rheumatoid arthritis (RA) is heritable, but knowledge on specific genetic determinants of joint damage in RA is limited. We have used the Immunochip array to examine whether genetic variants influence variation in joint damage in a cohort of Mexican Americans (MA) and European Americans (EA) with RA. We studied 720 MA and 424 EA patients with RA. Joint damage was quantified using a radiograph of both hands and wrists, scored using Sharp's technique. We conducted association analyses with the transformed Sharp score and the Immunochip single nucleotide polymorphism (SNP) data using PLINK. In MAs, 15 SNPs from chromosomes 1, 5, 9, 17 and 22 associated with joint damage yielded strong p-values (p CARD9 gene. We also observed suggestive evidence for some loci influencing joint damage in MAs and EAs. We identified two novel independent loci (MAP3K14 and CARD9) strongly associated with joint damage in MAs and EAs and a few shared loci showing suggestive evidence for association. PMID:26498133

  9. Declining needs for total joint replacements for rheumatoid arthritis

    OpenAIRE

    Khan, Nasim A; Sokka, Tuulikki

    2011-01-01

    This millennium brings new views to rheumatology. Total joint replacement surgery is needed less often as active treatment strategies combined with availability of new medications has led to more effective rheumatoid arthritis control. This was beautifully shown in a recent issue of Arthritis Research & Therapy by a Swedish study that uses data from national registers and compares incidence rates for total hip and knee arthroplasties before and after the establishment of biologic agents use f...

  10. Validity of a computer-assisted manual segmentation software to quantify wrist erosion volume using computed tomography scans in rheumatoid arthritis

    OpenAIRE

    Salaffi, Fausto; Carotti, Marina; Ciapetti, Alessandro; Ariani, Alarico; Gasparini, Stefania; Grassi, Walter

    2013-01-01

    Background To investigate the performance of conventional radiography (CR) for the detection of bone erosions of wrist in rheumatoid arthritis (RA) using multidetector computed tomography (CT) as the reference method and to evaluate the validity of a computer-assisted manual segmentation (outlining) technique to quantify erosion volume on CT scans. Methods Twenty five RA patients and six controls underwent CT and radiographic evaluation of the dominant wrist on the same day. CT was performed ...

  11. MRI of the hand and wrist joint of climbers. Imaging of lesions and overstrain injury

    International Nuclear Information System (INIS)

    The hands and wrists of 20 top-level rock climbers with sports injuries and overstress abnormalities were compared with the hands and wrists of 10 normal volunteers. They were all studied with MR imaging at 1.5 T. The imaging protocol included spin-echo and gradient-echo sequences with 1- to 5-mm-thick contiguous slices in the axial, coronal and/or sagittal planes, depending on the location and nature of the suspected injury. Typical hand and wrist lesions depicted with MRI in climbers consisted of annular ligament tears, lesions of the flexor tendons, tenosynovitis, ganglion cysts, joint effusion and functional carpal tunnel syndrome. The MRI findings on these abnormalities were compared to normal findings and those with ultrasound and plain films. In addition, hypertrophic changes in the muscles, tendons, ligaments, and bones of top-level rock climbers were assessed morphometrically. MRI proved to be the superior imaging modality in the diagnosis of sports injuries and overstress abnormalities of the hand the wrist in rock-climbing athletes. (orig.)

  12. Enthesopathic reactions at the wrist in psoriatic arthritis, rheumatoid arthritis and diffuse idiopathic skeletal hyperostosis. Results of low-kV radiographs in three views

    International Nuclear Information System (INIS)

    Twenty-six sites of muscle and ligament attachment around the wrist were evaluated for enthesopathic proliferative bone changes in psoriatic arthritis (PA), rheumatoid arthritis (RA), and diffuse idiopathic skeletal hyperostosis (DISH). Proliferations were found to be most frequent, most irregular, and largest in PA, followed in declining order by RA and DISH. In PA only, the bony proliferations and the underlying bone often had the appearance of mineralized woven bone, though smooth proliferations with a regular bone structure do occur in PA as well as in RA. The entheses of the trapezium, scaphoid and the radial styloid process are most frequently affected, followed by the bases of the first and fifth metacarpals and the pisiform. It is exceptional for huge bony proliferations to be observed at the entheses in DISH. (orig.)

  13. MRI of the wrist in juvenile idiopathic arthritis: proposal of a paediatric synovitis score by a consensus of an international working group. Results of a multicentre reliability study

    Energy Technology Data Exchange (ETDEWEB)

    Damasio, Maria Beatrice; Mattiuz, Chiara; Magnano, GianMichele [Ospedale Pediatrico Gaslini, Department of Radiology, Genova (Italy); Malattia, Clara; Martini, Alberto [University of Genova, Department of Paediatrics, Genova (Italy); Tanturri de Horatio, Laura; Barbuti, Domenico; Toma, Paolo [Ospedale Pediatrico Bambino Gesu, Department of Radiology, Rome (Italy); Pistorio, Angela [Ospedale pediatrico Gaslini, Department of Epidemiology and Biostatistics, Genova (Italy); Bracaglia, Claudia [Ospedale Pediatrico Bambino Gesu, Department of Rheumatology, Rome (Italy); Boavida, Peter; Ording, Lil Sophie Mueller [Great Ormond Street Hospital for Children, Department of Radiology, London (United Kingdom); Juhan, Karen Lambot [Hopital Necker Enfants Malades, Department of Radiology, Paris (France); Rosendahl, Karen [University Hospital North Norway, Department of Radiology, Tromsoe (Norway)

    2012-09-15

    MRI is a sensitive tool for the evaluation of synovitis in juvenile idiopathic arthritis (JIA). The purpose of this study was to introduce a novel MRI-based score for synovitis in children and to examine its inter- and intraobserver variability in a multi-centre study. Wrist MRI was performed in 76 children with JIA. On postcontrast 3-D spoiled gradient-echo and fat-suppressed T2-weighted spin-echo images, joint recesses were scored for the degree of synovial enhancement, effusion and overall inflammation independently by two paediatric radiologists. Total-enhancement and inflammation-synovitis scores were calculated. Interobserver agreement was poor to moderate for enhancement and inflammation in all recesses, except in the radioulnar and radiocarpal joints. Intraobserver agreement was good to excellent. For enhancement and inflammation scores, mean differences (95 % CI) between observers were -1.18 (-4.79 to 2.42) and -2.11 (-6.06 to 1.83). Intraobserver variability (reader 1) was 0 (-1.65 to 1.65) and 0.02 (-1.39 to 1.44). Intraobserver agreement was good. Except for the radioulnar and radiocarpal joints, interobserver agreement was not acceptable. Therefore, the proposed scoring system requires further refinement. (orig.)

  14. MRI of the wrist in juvenile idiopathic arthritis: proposal of a paediatric synovitis score by a consensus of an international working group. Results of a multicentre reliability study

    International Nuclear Information System (INIS)

    MRI is a sensitive tool for the evaluation of synovitis in juvenile idiopathic arthritis (JIA). The purpose of this study was to introduce a novel MRI-based score for synovitis in children and to examine its inter- and intraobserver variability in a multi-centre study. Wrist MRI was performed in 76 children with JIA. On postcontrast 3-D spoiled gradient-echo and fat-suppressed T2-weighted spin-echo images, joint recesses were scored for the degree of synovial enhancement, effusion and overall inflammation independently by two paediatric radiologists. Total-enhancement and inflammation-synovitis scores were calculated. Interobserver agreement was poor to moderate for enhancement and inflammation in all recesses, except in the radioulnar and radiocarpal joints. Intraobserver agreement was good to excellent. For enhancement and inflammation scores, mean differences (95 % CI) between observers were -1.18 (-4.79 to 2.42) and -2.11 (-6.06 to 1.83). Intraobserver variability (reader 1) was 0 (-1.65 to 1.65) and 0.02 (-1.39 to 1.44). Intraobserver agreement was good. Except for the radioulnar and radiocarpal joints, interobserver agreement was not acceptable. Therefore, the proposed scoring system requires further refinement. (orig.)

  15. Computer-aided and manual quantifications of MRI synovitis, bone marrow edema-like lesions, erosion and cartilage loss in rheumatoid arthritis of the wrist

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Haitao [The First Affiliated Hospital of Chongqing Medical University, Department of Radiology, Chongqing (China); University of California, San Francisco (UCSF), Department of Radiology and Biomedical Imaging, San Francisco, CA (United States); Rivoire, Julien; Hoppe, Michael; Link, Thomas M.; Li, Xiaojuan [University of California, San Francisco (UCSF), Department of Radiology and Biomedical Imaging, San Francisco, CA (United States); Srikhum, Waraporn [University of California, San Francisco (UCSF), Department of Radiology and Biomedical Imaging, San Francisco, CA (United States); Thammasat University, Department of Radiology, Pathumthani (Thailand); Imboden, John [San Francisco General Hospital, University of California, Department of Medicine, San Francisco and Division of Rheumatology, San Francisco, CA (United States)

    2014-12-10

    To investigate the reliability and validity of computer-aided automated and manual quantification as well as semiquantitative analysis for MRI synovitis, bone marrow edema-like lesions, erosion and cartilage loss of the wrist in rheumatoid arthritis (RA) compared to the OMERACT-RAMRIS. Wrist MRI was performed at 3 T in 16 patients with RA. Synovial volume and perfusion, bone marrow edema-like lesion (BMEL) volume, signal intensity and perfusion, and erosion dimensions were measured manually and using an in-house-developed automated software algorithm; findings were correlated with the OMERAC-RAMRIS gradings. In addition, a semiquantitative MRI cartilage loss score system was developed. Intraclass correlation coefficients (ICCs) were used to test the reproducibility of these quantitative and semiquantitative techniques. Spearman correlation coefficients were calculated between lesion quantifications and RAMRIS and between the MRI cartilage score and radiographic Sharp van der Heijde joint space narrowing scores. The intra- and interobserver ICCs were excellent for synovial, BMEL and erosion quantifications and cartilage loss grading (all >0.89). The synovial volume, BMEL volume and signal intensity, and erosion dimensions were significantly correlated with the corresponding RAMRIS (r = 0.727 to 0.900, p < 0.05). Synovial perfusion parameter maximum enhancement (Emax) was significantly correlated with synovitis RAMRIS (r = 0.798). BMEL perfusion parameters were not correlated with the RAMRIS BME score. Cartilage loss gradings from MRI were significantly correlated with the Sharp joint space narrowing scores (r = 0.635, p = 0.008). The computer-aided, manual and semiquantitative methods presented in this study can be used to evaluate MRI pathologies in RA with excellent reproducibility. Significant correlations with standard RAMRIS were found in the measurements using these methods. (orig.)

  16. Computer-aided and manual quantifications of MRI synovitis, bone marrow edema-like lesions, erosion and cartilage loss in rheumatoid arthritis of the wrist

    International Nuclear Information System (INIS)

    To investigate the reliability and validity of computer-aided automated and manual quantification as well as semiquantitative analysis for MRI synovitis, bone marrow edema-like lesions, erosion and cartilage loss of the wrist in rheumatoid arthritis (RA) compared to the OMERACT-RAMRIS. Wrist MRI was performed at 3 T in 16 patients with RA. Synovial volume and perfusion, bone marrow edema-like lesion (BMEL) volume, signal intensity and perfusion, and erosion dimensions were measured manually and using an in-house-developed automated software algorithm; findings were correlated with the OMERAC-RAMRIS gradings. In addition, a semiquantitative MRI cartilage loss score system was developed. Intraclass correlation coefficients (ICCs) were used to test the reproducibility of these quantitative and semiquantitative techniques. Spearman correlation coefficients were calculated between lesion quantifications and RAMRIS and between the MRI cartilage score and radiographic Sharp van der Heijde joint space narrowing scores. The intra- and interobserver ICCs were excellent for synovial, BMEL and erosion quantifications and cartilage loss grading (all >0.89). The synovial volume, BMEL volume and signal intensity, and erosion dimensions were significantly correlated with the corresponding RAMRIS (r = 0.727 to 0.900, p < 0.05). Synovial perfusion parameter maximum enhancement (Emax) was significantly correlated with synovitis RAMRIS (r = 0.798). BMEL perfusion parameters were not correlated with the RAMRIS BME score. Cartilage loss gradings from MRI were significantly correlated with the Sharp joint space narrowing scores (r = 0.635, p = 0.008). The computer-aided, manual and semiquantitative methods presented in this study can be used to evaluate MRI pathologies in RA with excellent reproducibility. Significant correlations with standard RAMRIS were found in the measurements using these methods. (orig.)

  17. No erosive progression revealed by MRI in rheumatoid arthritis patients treated with etanercept, even in patients with persistent MRI and clinical signs of joint inflammation

    DEFF Research Database (Denmark)

    Døhn, Uffe Møller; Skjødt, Henrik; Hetland, Merete; Vestergaard, Aage; Møller, Jakob M; Knudsen, Lene Surland; Ejbjerg, Bo Jannik; Thomsen, Henrik S; Hetland, Merete Lund; Ostergaard, Mikkel

    2007-01-01

    The aim of this study is to investigate the course of magnetic resonance imaging (MRI) signs of inflammatory and destructive changes in rheumatoid arthritis (RA) wrist and metacarpophalangeal (MCP) joints during etanercept treatment. MRI of the non-dominant wrist and second to fifth MCP joints was...... performed in five clinical active RA patients before and 4 and 16 weeks after initiation of etanercept treatment. MRI was evaluated according to the EULAR-OMERACT RA MRI reference image atlas. The median 28-joint count disease activity score (DAS28; erythrocyte sedimentation rate based) was 5.6 (range 5...... patient showed erosive regression, while no patient showed erosive progression on MRI during 16 weeks of etanercept therapy; even though clinical and MRI signs of joint inflammation remained. This small study supports that erosive progression judged by MRI is minimal in RA patients treated with etanercept...

  18. Predictive value of tender joints compared to synovitis for structural damage in rheumatoid arthritis

    Science.gov (United States)

    Cheung, Peter P; Mari, Karine; Devauchelle-Pensec, Valérie; Jousse-Joulin, Sandrine; D'Agostino, Maria Antonietta; Chalès, Gérard; Gaudin, Philippe; Mariette, Xavier; Saraux, Alain; Dougados, Maxime

    2016-01-01

    Objective To evaluate the predictive value of tender joints compared to synovitis for structural damage in rheumatoid arthritis (RA). Methods A post hoc analysis was performed on a prospective 2-year study of 59 patients with active RA starting on antitumour necrosis factor (TNF). Tenderness and synovitis was assessed clinically at baseline, followed by blinded ultrasound assessment (B-mode and power Doppler ultrasound (PDUS)) on the hands and feet (2 wrists, 10 metacarpophalangeal, 10 proximal interphalangeal and 10 metatarsophalangeal (MTP) joints). Radiographs of these joints were performed at baseline and at 2 years. The risk of radiographic progression with respect to the presence of baseline tenderness or synovitis, as well as its persistence (after 4 months of anti-TNF), was estimated by OR (95% CI). Results Baseline tender joints were the least predictive for radiographic progression (OR=1.53 (95% CI 1.02 to 2.29) pMTP joints. Non-tender joints with no synovitis were negatively predictive (OR=0.57 (95% CI 0.39 to 0.82) p=0.003). Persistence of tender joints was negatively predictive (OR=0.38 (95% CI 0.18 to 0.78) p=0.009) while persistence of synovitis was predictive (OR=2.41 (95% CI 1.24 to 4.67) p=0.01) of radiographic progression. Conclusions Synovitis is better than tenderness to predict for subsequent structural progression. However, coexistence of tenderness and synovitis at the level of an individual joint is predictive of structural damage, particularly in the MTP joints. Trial registration number NCT00444691. PMID:27042336

  19. 超声对类风湿关节炎患者腕关节病变的诊断价值%The Diagnostic Value of Ultrasound for Wrist Arthropathy of Patients with Rheumatoid Arthritis

    Institute of Scientific and Technical Information of China (English)

    张晓英; 田力; 陈荣杰; 安超

    2014-01-01

    目的:探讨超声对类风湿关节炎患者腕关节病变的诊断价值。方法:随机选取类风湿关节炎患者55例作为观察组,30例健康成年人作为对照组,分别进行腕关节超声检查,并抽取30例观察组患者对其行MRI检查。结果:超声可观察到类风湿关节炎患者腕关节不同程度滑膜增生、关节积液、肌腱腱鞘炎情况,其阳性检出率与MRI相比,差异无统计学意义(P>0.05),具有很高的一致性。MRI对类风湿关节炎患者腕关节骨侵蚀的检出率高于超声检查。结论:超声在诊断类风湿关节炎患者腕关节病变中,发挥着与MRI近乎相等的作用,可为临床对类风湿关节炎患者腕关节病变的诊断提供一种更简单经济的检查方法。%Objective:To investigate the diagnostic value of ultrasound for the wrist arthropathy of patients with rheumatoid arthritis.Methods:55 cases with rheumatoid arthritis were randomly selected as the observation group and 30 healthy adults were selected as the control group.The wrist ultrasound examination was made for them all to observe the thickness of synovium,blood lfow,joint effusion,tendons and bone cortex. 30 cases out of the observation group were selected for MRI examination.Results:Ultrasound could be used to observe synovium hyperplasia with different degree,joint effusion and tenosynovitis in patients with rheumatoid arthritis.The difference between the positive rate and the MRI was not significant (P > 0.05),while with great consistency.The detection rate of MRI for carpal bone erosion was higher than that of the ultrasonography. Conclusion:Ultrasound in the diagnosis of rheumatoid arthritis patients with carpal lesions played almost the same effect as MRI examination,which could provide a more simple and economic method for clinical diagnosis of wrist joint lesions in patients with rheumatoid arthritis.

  20. Rosai-Dorfman disease in a child with involvement of extra-nodal wrist joint

    Directory of Open Access Journals (Sweden)

    Rajjyoti Das

    2015-01-01

    Full Text Available Rosai-Dorfman Disease (RDD is a benign condition primarily affecting the lymph nodes. The term sinus histiocytosis with massive lymphadenopathy was first used. There may be extra-nodal presentation of RDD with or without constitutional symptoms. A 10-year-old boy presented with massive bilateral cervical lymphadenopathy which mimicked the diagnosis of lymphoma. We describe here a case of RDD in a child with extra-nodal bone involvement of the wrist joint, its diagnosis by histopathological examination supported by immunohistochemistry and consequent initial management. [Int J Res Med Sci 2015; 3(1.000: 357-360

  1. The joints in juvenile idiopathic arthritis

    OpenAIRE

    Ording Muller, Lil-Sofie; Humphries, Paul; Rosendahl, Karen

    2015-01-01

    Abstract Juvenile idiopathic arthritis is the most common rheumatic entity in childhood. Imaging has become an important supplement to the clinical assessment of children with JIA. Radiographs still play an important role in the workup, and long-term follow-up in children with JIA, but are not sensitive to findings in the early disease stage. Both ultrasound and MRI are more sensitive to inflammatory changes than clinical assessment alone. However, the differentiation between normal findings ...

  2. Roentgenographic study of the temporomandibular joint in rheumatoid arthritis

    International Nuclear Information System (INIS)

    For the study of the temporomandibular joint in rheumatoid arthritis 30 patients were selected who were diagnosis as rheumatoid arthritis through the clinical, radiographic examination and laboratory finding. Temporoman dibular joint involvement was evaluated through the clinical, radiographic examination. The results were as follows; 1. TMJ was involved in 15 patients of 30 patients with rheumatoid arthritis. (50% involvement). 2. Duration of rheumatoid arthritis was more longer in patients with TMJ involvement than in patients without TMJ involvement. 3. Osseous changes in TMJ were in order of frequency erosion, flattening, osteophyte, sclerosis, deformity, and most common involved site was mandibular condyle. 4. Most common positional change of condyle was forward position in centric occlusion, and restricted movement of condyle in 1 inch mouth opening. 5. TMJ involvement of rheumatoid arthritis was almost bilateral. 6. Main symptoms of TMJ were pain, stiffness, tenderness, limitation of mouth opening, crepitation. 7. There was not the case of ankylosis. 8. There was statistically insignificant correlation between mandibular deviation and TMJ involvement, but some cases showed severe deviation on mouth opening.

  3. Roentgenographic study of the temporomandibular joint in rheumatoid arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Yun, Ho Jung; You, Dong Soo [Department of Oral Radiology, College of Dentistry, Seoul National University, Seoul (Korea, Republic of)

    1984-11-15

    For the study of the temporomandibular joint in rheumatoid arthritis 30 patients were selected who were diagnosis as rheumatoid arthritis through the clinical, radiographic examination and laboratory finding. Temporoman dibular joint involvement was evaluated through the clinical, radiographic examination. The results were as follows; 1. TMJ was involved in 15 patients of 30 patients with rheumatoid arthritis. (50% involvement). 2. Duration of rheumatoid arthritis was more longer in patients with TMJ involvement than in patients without TMJ involvement. 3. Osseous changes in TMJ were in order of frequency erosion, flattening, osteophyte, sclerosis, deformity, and most common involved site was mandibular condyle. 4. Most common positional change of condyle was forward position in centric occlusion, and restricted movement of condyle in 1 inch mouth opening. 5. TMJ involvement of rheumatoid arthritis was almost bilateral. 6. Main symptoms of TMJ were pain, stiffness, tenderness, limitation of mouth opening, crepitation. 7. There was not the case of ankylosis. 8. There was statistically insignificant correlation between mandibular deviation and TMJ involvement, but some cases showed severe deviation on mouth opening.

  4. Magnetic resonance imaging for the wrist joint of the coal miners in vibration department

    Energy Technology Data Exchange (ETDEWEB)

    Zhao, X.Z.; Liu, R.L.; Hu, S.D.; Zhang, W.; Xu, W.X.; Ge, L.X. [Central Hospital of Zaozhuang Mine Corporation, Zaozhuang (China)

    2006-04-15

    To study the magnetic resonance imaging (MRI) in the wrist joint of coal miners who work in excavation and vibration department. Forty-three coal miners with the hand-arm vibration disease served as the observation group while 20 workers who were not working in the vibration department acted as the control group. The patients in the observation group were divided into five subgroups according to the time when they received vibration. The regularity of the development of signs and symptoms of MRI was observed and analyzed. The hydroarthrosis was most found in MRI. There were significant difference in hydroarthrosis osteoporosis and osteomyelitis between the observation group and the control group. The edema of bone marrow and the avascular necrosis of ossa carpi were found only in the observation group and not found in the control group. The hydroarthrosis and the edema of bone marrow occurred most in the early stage of vibration. The signal in the edema of the bone marrow of the distal end of the radius was decreased in the GE sequence with the specificity. Changes in the wrist joint occur in the early stage of the vibration work, and can be found in the MRI. The edema of the bone marrow of the distal end of the radius is of great value in the diagnosis of the hand-arm vibration disease.

  5. Technical guide to evaluate upper limb joints (shoulder, elbow and wrist) by ultrasound

    International Nuclear Information System (INIS)

    A guideline to follow is offered to radiologists and residents of radiology service of medical imaging, when evaluating by ultrasound the shoulder joints, elbow, wrist. The importance to performing of musculoskeletal ultrasound by its pathology variable is established. The use of appropriate equipment and effective application of the techniques exposed of echography exploration have made enable the valuation of many pathologies with high sensitivity and specificity. The echography has been the musculoskeletal imaging technique that more rapidly has evolved. Currently, this technique has been replaced by magnetic resonance imaging in various clinical fields and also serves as a complement to other techniques. Exposed techniques have been of great benefit for radiologists medical and residents, obtaining with its use a quick guide for the realization of upper limb musculoskeletal ultrasounds. The appropriate and easy techniques are better known for the evaluation of these structures, and so document both sports injuries, as joint and rheumatic diseases

  6. Load transfer through the radiocarpal joint and the effects of partial wrist arthrodesis on carpal bone behaviour: a finite element study.

    Science.gov (United States)

    Gíslason, M K; Stansfield, B; Bransby-Zachary, M; Hems, T; Nash, D H

    2012-11-01

    A finite element model of the wrist was developed to simulate mechanical changes that occur after surgery of the wrist. After partial arthrodesis, the wrist will experience altered force transmission during loading. Three different types of partial arthrodesis were investigated - radiolunate, radioscaphoid, and radioscapholunate - and compared with the healthy untreated wrist. The results showed that the compressive forces on the radiocarpal joint decreased compared with the untreated wrist with both radiolunate and radioscaphoid fusions. The load transmission through the midcarpal joints varied depending on arthrodesis type. The forces in the extrinsic ligaments decreased with the fusion, most noticeably in the dorsal radiotriquetral ligament, but increased in the dorsal scaphotriquetral ligament. From the results of the study it can be concluded that the radioscapholunate fusion shows the most biomechanically similar behaviour out of the three fusion types compared with the healthy wrist. The modelling described in this paper may be a useful approach to pre-operative planning in wrist surgery. PMID:22457257

  7. Rheumatoid arthritis in the knee joint

    International Nuclear Information System (INIS)

    This paper evaluates the potential value of MR imaging in rheumatoid arthritis (RA). Thirty patients with RA were examined with MR imaging before synoverctomy. Nonenhanced T2-Weighted (T1W) and T2W spin-echo (SE) images were obtained in all 30 cases, T2W gradient echo (GRE) images in 13 cases, and gadolinium-enhanced T1W images in six cases. These images were compared with each other to evaluate the detectability of articular disorders. The MR findings of synovial hypertrophy were compared with the pathologic findings of resected synovium. Articular effusion could be identified on all images, but it was impossible to distinguish between synovial hypertrophy and articular effusion on nonenhanced T1W and GRE images

  8. [Arthritis of the Medial Knee Joint Compartment].

    Science.gov (United States)

    Matziolis, G; Röhner, E

    2015-10-01

    23 % of all persons older than 65 years suffer from osteoarthritis of the medial compartment of the knee joint, a very common situation in orthopaedic practice 1. As a result of the demographic trend the number of patients is expected to increase in the future. Based on specific joint biomechanics and kinematics the medial knee joint compartment is more frequently affected than the lateral. Only an understanding of the functional anatomy and underlying pathology allows a critical evaluation of different available conservative and operative treatment options. This article gives an overview of diagnostic and therapeutic strategies of osteoarthritis of the medial knee joint. Frequently performed surgeries, e.g. high tibial osteotomy (HTO), unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA) will be presented in a comparative manner. The actual scientific evidence will be given with the goal of an evidence based therapy that is adopted to stage and pathology of osteoarthritis of the medial compartment of the knee joint. PMID:26451864

  9. Importance of scintiscanning of joints in rheumatoid arthritis

    International Nuclear Information System (INIS)

    Scintigrams of 7 large and 2 small joints were taken in 46 patients suffering from rheumatoid arthritis. The examination was carried out 2 hours after the iv. administration of sup(99m)Tc-pyrophosphate (12-16 mCi) and the results were given on the basis of subjective evaluation. Analyzing the data of all the examined joints it is concluded that in the first stage of rheumatoid arthritis scintigraphy revealed significantly more pathologic processes than either X-radiography or physical examinations. In the later stages disorders were diagnosed more frequently and more specifically by X-radiography than by scintigraphy, however, the latter can reveal the activity of the process. (L.E.)

  10. CERVICAL FACET JOINT SEPTIC ARTHRITIS: A CASE REPORT

    OpenAIRE

    Stecher, James M.; El-Khoury, Georges Y.; Hitchon, Patrick W.

    2010-01-01

    Facet joint septic arthritis is a rare but severe infection with the possibility of significant morbidity resulting from local or systemic spread of the infection. Pain is the most common complaint on presentation followed by fever, then neurologic impairment. While the lumbar spine is involved in the vast majority of cases presented in the literature, the case presented here occurred in the cervical spine. The patient presented with a three week history of neck and left shoulder pain and was...

  11. Photoacoustic imaging of inflammatory arthritis in human joints

    Science.gov (United States)

    Jo, Janggun; Xu, Guan; Marquardt, April; Francis, Sheeja; Yuan, Jie; Girish, Dhanuj; Girish, Gandikota; Wang, Xueding

    2016-02-01

    The ducal imaging with photoacoustic imaging (PAI) that is an emerging technology and clinical ultrasound imaging that is an established modality is developed for the imaging of early inflammatory arthritis. PAI is sensitive to blood volume, not limited by flow like ultrasound, holding great promise for the earliest detection of increase in blood volume and angiogenesis - a key early finding inflammation PAI has the capability of assessing inflammation in superficial human soft tissues, offering potential benefits in diagnosis, treatment and monitoring of inflammatory arthritis. PAI combined with ultrasonography (US), is a real time dual-modality system developed and tested to identify active synovitis in metacarpophalangeal (MCP) joints of 10 arthritis patients and 10 normal volunteers. Photoacoustic images of the joints were acquired at 580-nm laser wavelength, which provided the desired balance between the optical contrast of hemoglobin over bone cortex and the imaging depth. Confirmed by US Doppler imaging, the results from ten patients and ten normal volunteers demonstrated satisfactory sensitivity of PAI in assessing enhanced blood flow due to active synovitis. This preliminary study suggests that photoacoustic imaging, by identifying early increase in blood volume, related to increased vascularity, a hallmark of joint inflammation, could be a valuable supplement to musculoskeletal US.

  12. Virtual MR arthroscopy of the wrist joint: a new intraarticular perspective

    Energy Technology Data Exchange (ETDEWEB)

    Sahin, Guelden; Dogan, Basak Erguvan [Department of Radiology, Faculty of Medicine, Ankara University (Turkey); Demirtas, Mehmet [Department of Hand Surgery, Faculty of Medicine, Ankara University, Ankara (Turkey)

    2004-01-01

    The aim of this study is to investigate whether virtual MR arthroscopy could be used to visualize the internal architecture of the radiocarpal compartment of the wrist joint in comparison to surgical arthroscopy. Diluted paramagnetic contrast material was injected into the radiocarpal compartment prior to MR examination in all patients. A fat-suppressed T1-weighted three-dimensional fast spoiled gradient echo sequence was acquired in addition to our standard MR imaging protocol in each patient. Three-dimensional data sets were then transferred to an independent workstation and were postprocessed using navigator software to generate surface rendered virtual MR arthroscopic images. Nineteen patients referred for chronic ulnar-sided wrist pain were evaluated with conventional MR arthrography prospectively. Virtual MR arthroscopic images demonstrating the triangular fibrocartilage complex (TFCC) in an intraarticular perspective were achieved in 12 out of 19 patients. Our preliminary investigation suggests that although it has several limitations, virtual MR arthroscopy shows promise in visualizing the TFCC from an intraarticular perspective. (orig.)

  13. MRI bone oedema scores are higher in the arthritis mutilans form of psoriatic arthritis and correlate with high radiographic scores for joint damage

    DEFF Research Database (Denmark)

    Tan, Yu M; Østergaard, Mikkel; Doyle, Anthony;

    2009-01-01

    sequences. Scans were scored separately by two readers for bone erosion, oedema and proliferation using a PsA MRI scoring system. X-rays were scored for erosions and joint space narrowing. RESULTS: On MRI, 1013 bones were scored by both readers. Reliability for scoring erosions and bone oedema was high......INTRODUCTION: The aim of this study was to investigate the magnetic resonance imaging (MRI) features of bone disease in the arthritis mutilans (AM) form of psoriatic arthritis (PsA). METHODS: Twenty-eight patients with erosive PsA were enrolled (median disease duration of 14 years). Using x-rays of...... both hands and feet, 11 patients were classified as AM and 17 as non-AM (erosive psoriatic arthritis without bone lysis)by two observers. MRI scans (1.5T) of the dominant hand (wrist and fingers scanned separately) were obtained using standard contrast-enhanced T1-weighted and fat-saturated T2-weighted...

  14. Capitolunate Arthrodesis for Treatment of Scaphoid Nonunion Advanced Collapse (SNAC) Wrist Arthritis.

    Science.gov (United States)

    Hegazy, Galal

    2015-06-01

    The aim of the study was to evaluate results of capitolunate arthrodesis for the treatment of post traumatic degenerative SNAC wrist disorders. A capitolunate arthrodesis was performed on 12 patients, three women and nine men, of 44 years in average (28-66 years). Ten patients were manual workers; dominant side was involved in seven cases with no history of previous operation. Fixation of the arthrodesis was performed with headless compression screws. Patients were reviewed at 37.4 months of average follow up (range; 12-47 months). Mayo score equal to 82.8 points. Radiolunate and capitolunate angles were decreased of 6 and 8° respectively at the final follow up radiograph compared to preoperative values. The Ten manual worker patients were able to return to their previous professional activities and the other two patients were retired but they resume their sports and recreational activities. With the advent of headless compression screws the capitolunate arthrodesis gained a higher union rate, short operative time and short rehabilitation period. In the present study the capitolunate arthrodesis allowed restoring a stable functional wrist in the 12 patients reviewed. It is a satisfactory therapeutic alternative to four corners fusion for SNAC wrist with osteoarthritis. PMID:26078508

  15. Lower limb joint replacement in rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Clement Nicholas D

    2012-06-01

    Full Text Available Abstract Introduction There is limited literature regarding the peri-operative and surgical management of patients with rheumatoid disease undergoing lower limb arthroplasty. This review article summarises factors involved in the peri-operative management of major lower limb arthroplasty surgery for patients with rheumatoid arthritis. Methods We performed a search of the medical literature, using the PubMed search engine (http://www.pubmed.gov. We used the following terms: ‘rheumatoid’ ‘replacement’ ‘arthroplasty’ and ‘outcome’. Findings The patient should be optimised pre-operatively using a multidisciplinary approach. The continued use of methotrexate does not increase infection risk, and aids recovery. Biologic agents should be stopped pre-operatively due the increased infection rate. Patients should be made aware of the increased risk of infection and periprosthetic fracture rates associated with their disease. The surgical sequence is commonly hip, knee and then ankle. Cemented total hip replacement (THR and total knee replacement (TKR have superior survival rates over uncemented components. The evidence is not clear regarding a cruciate sacrificing versus retaining in TKR, but a cruciate sacrificing component limits the risk early instability and potential revision. Patella resurfacing as part of a TKR is associated with improved outcomes. The results of total ankle replacement remain inferior to THR and TKR. RA patients achieve equivalent pain relief, but their rehabilitation is slower and their functional outcome is not as good. However, the key to managing these complicated patients is to work as part of a multidisciplinary team to optimise their outcome.

  16. Comparison of regression models for estimation of isometric wrist joint torques using surface electromyography

    Directory of Open Access Journals (Sweden)

    Menon Carlo

    2011-09-01

    Full Text Available Abstract Background Several regression models have been proposed for estimation of isometric joint torque using surface electromyography (SEMG signals. Common issues related to torque estimation models are degradation of model accuracy with passage of time, electrode displacement, and alteration of limb posture. This work compares the performance of the most commonly used regression models under these circumstances, in order to assist researchers with identifying the most appropriate model for a specific biomedical application. Methods Eleven healthy volunteers participated in this study. A custom-built rig, equipped with a torque sensor, was used to measure isometric torque as each volunteer flexed and extended his wrist. SEMG signals from eight forearm muscles, in addition to wrist joint torque data were gathered during the experiment. Additional data were gathered one hour and twenty-four hours following the completion of the first data gathering session, for the purpose of evaluating the effects of passage of time and electrode displacement on accuracy of models. Acquired SEMG signals were filtered, rectified, normalized and then fed to models for training. Results It was shown that mean adjusted coefficient of determination (Ra2 values decrease between 20%-35% for different models after one hour while altering arm posture decreased mean Ra2 values between 64% to 74% for different models. Conclusions Model estimation accuracy drops significantly with passage of time, electrode displacement, and alteration of limb posture. Therefore model retraining is crucial for preserving estimation accuracy. Data resampling can significantly reduce model training time without losing estimation accuracy. Among the models compared, ordinary least squares linear regression model (OLS was shown to have high isometric torque estimation accuracy combined with very short training times.

  17. Quantifying forearm and wrist joint power during unconstrained movements in healthy individuals

    OpenAIRE

    Flores, Diana Castillo; Laurendeau, Simon; Teasdale, Normand; Simoneau, Martin

    2014-01-01

    Background Wrist movement-related injuries account for a large number of repetitive motion injuries. Remarkably little, if any, empirical data exist to quantify the impact of neuromuscular disorders affecting the wrist or to validate the effectiveness of rehabilitation training programs on wrist functions. The aim of this project was to develop a biomechanical model for quantifying wrist and forearm kinetics during unconstrained movements, to assess its reliability and to determine its sensit...

  18. Parvimonas micra: A rare cause of native joint septic arthritis.

    Science.gov (United States)

    Baghban, Adam; Gupta, Shaili

    2016-06-01

    Parvimonas micra is a fastidious, anaerobic, gram positive coccus, which is found in normal human oral and gastrointestinal flora. It has also been known as Peptostreptococcus micros and Micromonas micros with its most recent re-classification in 2006. It has been described in association with hematogenous seeding of prosthetic joints [1,2]. Several cases of discitis and osteomyelitis have been described in association with dental procedures and periodontal disease often with a subacute presentation. However, cases of native joint septic arthritis are limited [3-5]. Per our literature review, there is one case of native knee septic arthritis described in 1999, with a prolonged time to diagnosis and treatment due to difficulty culturing P. micra. The previously reported patient experienced significant joint destruction and morbidity [6]. Advances in culture techniques and new methods of organism identification including MALDI-TOF and 16s rRNA sequencing have lead to increased identification of this organism, which may be a more frequent bone and joint pathogen than previously realized. PMID:26911898

  19. Location and incidence of localized juxta-articular demineralizations and erosions at the wrist in early rheumatoid arthritis. Results of low kV radiography in 3 views

    Energy Technology Data Exchange (ETDEWEB)

    Fischer, E.

    1988-03-01

    In early rheumatoid arthritis the location and incidence of localized juxta-articular demineralizations and erosions were investigated at 53 points of the wrist. On the level of the metacarpal bases, the distal and proximal row of the carpal bones more changes are seen in the oblique vd. and the lateral view than in the dv. view. At the distal bones of the forearm more changes are seen at the radius than at the ulnar styloid. The most often changes at all occur at the volar middle third of the triquetrum in the oblique view and at the distal volar articular facet of the scaphoid in the lateral view. Close relations between localized juxta-articular demineralizations and erosions do not exist. If the early bone changes at the wrist in rheumatoid arthritis are to be detected additional oblique and lateral view are prerequisite.

  20. Automatic Segmentation of Wrist Bones in CT Using a Statistical Wrist Shape + Pose Model.

    Science.gov (United States)

    Anas, Emran Mohammad Abu; Rasoulian, Abtin; Seitel, Alexander; Darras, Kathryn; Wilson, David; John, Paul St; Pichora, David; Mousavi, Parvin; Rohling, Robert; Abolmaesumi, Purang

    2016-08-01

    Segmentation of the wrist bones in CT images has been frequently used in different clinical applications including arthritis evaluation, bone age assessment and image-guided interventions. The major challenges include non-uniformity and spongy textures of the bone tissue as well as narrow inter-bone spaces. In this work, we propose an automatic wrist bone segmentation technique for CT images based on a statistical model that captures the shape and pose variations of the wrist joint across 60 example wrists at nine different wrist positions. To establish the correspondences across the training shapes at neutral positions, the wrist bone surfaces are jointly aligned using a group-wise registration framework based on a Gaussian Mixture Model. Principal component analysis is then used to determine the major modes of shape variations. The variations in poses not only across the population but also across different wrist positions are incorporated in two pose models. An intra-subject pose model is developed by utilizing the similarity transforms at all wrist positions across the population. Further, an inter-subject pose model is used to model the pose variations across different wrist positions. For segmentation of the wrist bones in CT images, the developed model is registered to the edge point cloud extracted from the CT volume through an expectation maximization based probabilistic approach. Residual registration errors are corrected by application of a non-rigid registration technique. We validate the proposed segmentation method by registering the wrist model to a total of 66 unseen CT volumes of average voxel size of 0.38 mm. We report a mean surface distance error of 0.33 mm and a mean Jaccard index of 0.86. PMID:26890640

  1. Clinical study of the factors affecting radioulnar deviation of the wrist joint

    Directory of Open Access Journals (Sweden)

    Kanavaros Panagiotis

    2010-01-01

    Full Text Available Abstract Background The radioulnar carpal joint is critical for hand and wrist function. Radioulnar deviation indicates distal radioulnar joint flexibility and reflects the structure and function of the carpal bones, ulna, radius and ligaments. The present study examined whether radioulnar deviation is affected by gender, manual labor, playing a musical instrument, playing sport, handedness, previous fracture or prior inflammation. The study used clinical findings based on anatomical landmarks Methods The ulnar, radial and total deviations for both left and right hands were measured in 300 subjects (157 men and 143 women of mean age 21.7 years. Measurements were made with the forearm in a fixed pronated position using a novel specially designed goniometer. The gender of each subject was recorded, and information on playing of sport, playing a musical instrument, manual labor, handedness, and history of fracture or inflammation was sought. Data were analyzed using a multifactor ANOVA test. Results No statistically significant difference (p-value > 0.05 was found between those comparing groups except the total deviation of athletes' left hand versus the total deviation of non athletes' left hand (p-value 0.041 Conclusions This study was based on clinical findings using anatomical landmarks. We found that manual workers and athletes showed greater left hand flexibility. This suggests that activities that place chronic stress on the radiocarpal joint can independently affect radioulnar deviation.

  2. Low-cost, low-field dedicated extremity magnetic resonance imaging in early rheumatoid arthritis

    DEFF Research Database (Denmark)

    Lindegaard, H M; Vallø, J; Hørslev-Petersen, K;

    2006-01-01

    OBJECTIVE: To study the ability of low-cost low-field dedicated extremity magnetic resonance imaging (E-MRI) to assess and predict erosive joint damage in the wrist and metacarpophalangeal (MCP) joints of patients with early rheumatoid arthritis. METHODS: 24 previously untreated patients with...... rheumatoid arthritis with joint symptoms for <1 year were evaluated at the time of diagnosis and after 6 and 12 months of methotrexate treatment with conventional clinical or biochemical examinations, x rays of both hands and wrists, and E-MRI of the dominant wrist and MCP joints. RESULTS: At baseline, all...... arthritis who were treated uniformly, baseline E-MRI erosions in MCP or wrist bones markedly increased the risk of x ray erosions at the 1-year follow-up. Low-cost, low-field dedicated extremity MRI is promising for assessment and prognostication of early rheumatoid arthritis....

  3. 早期类风湿性关节炎腕关节病变MRI研究进展%The state of art of MRI research on the wrist in patients with early rheumatoid arthritis

    Institute of Scientific and Technical Information of China (English)

    魏志刚; 全冠民; 袁涛

    2013-01-01

    类风湿性关节炎(RA)早期诊断与治疗是改善预后的关键,MR技术与新评估系统的发展使RA诊断和分析精细化,弥补了实验室检查的不足腕关节和掌指关节、近侧指间关节是RA最典型和最常累及的部位.RA早期MR征象包括滑膜炎、骨髓水肿、骨侵蚀、软骨丧失.MR对早期RA腕关节病变检出及诊断准确率均较高,且易于定量评价和纵向比较,能敏感地发现活动性病变与治疗后病变的减轻或吸收.对早期RA腕关节病变的MR检查技术、早期诊断、定量分析及预后评价进行综述.%Early diagnosis and treatment are essential for improving the outcome of rheumatoid arthritis (RA).New MRI and new scoring system,making precise and quantitative diagnosis and evaluation of RA,can be complementary to laboratory test.Wrist,metacarpophalangeal joint,carpometacarpal joint and interphalangeal joint are most often affected in RA.Early MRI features of RA include synovitis,bone marrow edema,erosions and cartilage loss.MRI can detect early signs of RA in wrist with high sensitivity and accuracy,and can easily and quantitatively monitor lesion response to the treatments.In this review,we summarized values of the wrist MRI in early diagnosis,quantitative analysis and prognosis of RA.

  4. Development of a biomechanical model of the wrist joint for patient-specific model guided surgical therapy planning: Part 1.

    Science.gov (United States)

    Eschweiler, Jörg; Stromps, Jan-Philipp; Fischer, Maximilian; Schick, Fabian; Rath, Björn; Pallua, Norbert; Radermacher, Klaus

    2016-04-01

    An enhanced musculoskeletal biomechanical model of the wrist joint is presented in this article. The developed computational model features the two forearm bones radius and ulna, the eight wrist bones, the five metacarpal bones, and a soft tissue apparatus. Validation of the model was based on information taken from the literature as well as own experimental passive in vitro motion analysis of eight cadaver specimens. The computational model is based on the multi-body simulation software AnyBody. A comprehensive ligamentous apparatus was implemented allowing the investigation of ligament function. The model can easily patient specific personalized on the basis of image information. The model enables simulation of individual wrist motion and predicts trends correctly in the case of changing kinematics. Therefore, patient-specific multi-body simulation models are potentially valuable tools for surgeons in pre- and intraoperative planning of implant placement and orientation. PMID:26994117

  5. Arthritis Advice

    Science.gov (United States)

    ... Connected Home » Arthritis Advice Heath and Aging Arthritis Advice Common Kinds of Arthritis Warning Signs Treating ... cause damage to your joints. Common Kinds of Arthritis Arthritis is one of the most common diseases ...

  6. Digital tomosynthesis of hand joints for arthritis assessment

    International Nuclear Information System (INIS)

    The two principal forms of hand arthritis, rheumatoid arthritis (RA) and osteoarthritis (OA) have large clinical and economic costs. Radiography has been shown to be a useful tool to assess the condition of the disease. A hand radiograph, however, is a two-dimensional projection of a three-dimensional object. In this report we present the results of a study that applied digital tomosynthesis to hand radiography in order to extract three-dimensional outcome measures that should be more sensitive to arthritis progression. The study was performed using simulated projection radiographs created using micro computed tomography (μCT) and a set of five dry-bone hand skeletons. These simulated projection images were then reconstructed into tomographic slices using the matrix inversion tomosynthesis (MITS) algorithm. The accuracy of the tomosynthesis reconstruction was evaluated by comparing the reconstructed images to a gold standard created using the μCT data. A parameter from image registration science, normalized mutual information, provided a quantifiable figure of merit. This study examined the effects of source displacement, number of reconstructed planes, number of acquisitions, noise added to the gray scale images, and errors in the location of a fiducial marker. We also optimized the reconstruction as a function of two variables k and α, that controlled the mixing of MITS with conventional shift-and-add tomosynthesis. A study using hand delineated joint margins demonstrated that MITS images provided a better measurement of average joint space width. We found good agreement between the MITS slices and the true planes. Both joint margins and trabecular structure were visible and the reconstructed slices showed additional structures not visible with the standard projection image. Using hand-delineated joint margins we compared the average joint space width of the gold standard slices to the MITS and projection images. A root-mean square deviation (RMSD), calculated

  7. Joint Preservation of the Wrist Using Articulated Distraction Arthroplasty: A Case Report of a Novel Technique

    OpenAIRE

    Fletcher, Matt D.A.

    2015-01-01

    Distraction arthroplasty of the ankle, elbow, and hip has become widely accepted and used within the orthopaedic community with excellent initial results which appear sustained. To date it has not been applied to the wrist in the same manner. A novel technique, drawn upon past success of articulated ankle distraction and static wrist distraction, was devised and evaluated by application of articulated wrist distraction performed over a 12-week period in a patient with poor functional outcome ...

  8. Reducing invasiveness, duration, and cost of magnetic resonance imaging in rheumatoid arthritis by omitting intravenous contrast injection -- Does it change the assessment of inflammatory and destructive joint changes by the OMERACT RAMRIS?

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Ostergaard, Mikkel; Conaghan, Philip G;

    2009-01-01

    . We explored to what extent RA joint pathologies in wrists and metacarpophalangeal (MCP) joints can be reliably assessed by unenhanced MRI images compared with Gd-enhanced MRI as the reference method. METHODS: MRI data sets from 2 RA substudies were scored according to preliminary OMERACT RA MRI...... images, whereas complete image sets were available for the second reading. RESULTS: Gd contrast injection appeared unimportant to MRI scores of bone erosions and bone edema in RA wrist and MCP joints. However, when post-Gd MRI was considered the standard reference, MRI without Gd provided only moderate......OBJECTIVE: Gadolinium (Gd)-enhanced magnetic resonance imaging (MRI) provides highly sensitive assessment of inflammatory and destructive changes in rheumatoid arthritis (RA) joints, but intravenous (IV) Gd injection prolongs examination time and increases cost, invasiveness, and patient discomfort...

  9. Quantification of colour Doppler activity in the wrist in patients with rheumatoid arthritis - the reliability of different methods for image selection and evaluation

    DEFF Research Database (Denmark)

    Ellegaard, K.; Torp-Pedersen, S.; Lund, H.;

    2008-01-01

    Purpose: The amount Of colour Doppler activity in the inflamed synovium is used to quantity inflammatory activity. The measurements may vary due to image selection, quantification method, and point in cardiac cycle. This study investigated the test-retest reliability Of ultrasound colour Doppler...... measurements in the wrist of patients with rheumatoid arthritis (RA) using different selection and quantification methods. Materials and Methods: 14 patients with RA had their wrist scanned twice by the same investigator with an interval of 30 Minutes, The images for analysis were selected either by the...... anatomical position only or by the anatomical position with maximum colour Doppler activity. Subsequently, the amount of colour Doppler was measured in an area defined by either the synovial tissue or by specific anatomical structures surrounding the synovial tissue. Results: The best test-retest reliability...

  10. Quantification of colour Doppler activity in the wrist in patients with rheumatoid arthritis--the reliability of different methods for image selection and evaluation

    DEFF Research Database (Denmark)

    Ellegaard, K; Torp-Pedersen, S; Lund, Hans;

    2008-01-01

    PURPOSE: The amount of colour Doppler activity in the inflamed synovium is used to quantify inflammatory activity. The measurements may vary due to image selection, quantification method, and point in cardiac cycle. This study investigated the test-retest reliability of ultrasound colour Doppler...... measurements in the wrist of patients with rheumatoid arthritis (RA) using different selection and quantification methods. MATERIALS AND METHODS: 14 patients with RA had their wrist scanned twice by the same investigator with an interval of 30 minutes. The images for analysis were selected either by the...... anatomical position only or by the anatomical position with maximum colour Doppler activity. Subsequently, the amount of colour Doppler was measured in an area defined by either the synovial tissue or by specific anatomical structures surrounding the synovial tissue. RESULTS: The best test-retest reliability...

  11. Ultrasound-detected activity in rheumatoid arthritis on methotrexate therapy: Which joints and tendons should be assessed to predict unstable remission?

    Science.gov (United States)

    Janta, Iustina; Valor, Lara; De la Torre, Inmaculada; Martínez-Estupiñán, Lina; Nieto, Juan Carlos; Ovalles-Bonilla, Juan Gabriel; Martínez-Barrio, Julia; Bello, Natalia; Hinojosa, Michelle; Montoro, María; González, Carlos Manuel; López-Longo, Javier; Monteagudo, Indalecio; Carreño, Luis; Naredo, Esperanza

    2016-03-01

    The aim of the study was to investigate the predictive value of different reduced joint ultrasound (US) assessments of synovitis and tenosynovitis in relation to unstable remission in a cohort of rheumatoid arthritis (RA) patients on methotrexate therapy. Forty-seven RA patients (38 women, 9 men), being treated with methotrexate (MTX), in clinical remission as judged by their consultant rheumatologist were evaluated for disease activity according to the Disease Activity Score (DAS) 28 at baseline and 6 months. Sustained remission and unstable remission were defined according to the baseline and 6-month DAS28 and changes in RA therapy during the follow-up. Each patient underwent at baseline a B-mode and power Doppler (PD) assessment of 44 joints and 20 tendons/tendon compartments by a rheumatologist blinded to the clinical and laboratory data. B-mode synovial hypertrophy (SH), synovial PD signal, B-mode tenosynovitis, and Doppler tenosynovitis were scored 0-3. The presence and index of synovial PD signal in 44 joints [odds ratio (OR) 8.21 (p = 0.016) and OR 2.20 (p = 0.049), respectively] and in 12 joints [OR 5.82 (p = 0.041) and OR 4.19 (p = 0.020), respectively], the presence of SH in wrist and MCP joints [OR 4.79 (p = 0.045)], and the presence of synovial PD signal in wrist-MCP-ankle-MTP joints [OR 4.62 (p = 0.046)] were predictors of unstable remission. The 12-joint or wrist-hand-ankle-MTP US assessments can predict unstable remission in RA patients in apparent clinical remission being treated with MTX. PMID:26712373

  12. The use of routine wrist radiography is not useful in the evaluation of patients with a ganglion cyst of the wrist.

    Science.gov (United States)

    Wong, Andrew S; Jebson, Peter J L; Murray, Peter M; Trigg, Stephen D

    2007-09-01

    The purpose of this study was to evaluate the cost-effectiveness of routine wrist radiography in the evaluation of patients with a wrist ganglion. In the setting of a University-based hand surgery practice, 103 consecutive patients with a dorsal or volar wrist ganglion underwent posteroanterior, lateral, and oblique radiographs of the involved wrist. There were 24 men and 79 women with an average age of 34 years (range 4-67 years). A retrospective review of the medical records was performed. Abnormalities on plain radiographs were noted in only 13 patients (13%). Findings included six cases of thumb carpometacarpal joint arthritis and one case each of an enchondroma, congenital distal radioulnar joint (DRUJ) anomaly, DRUJ degenerative changes, intraosseous ganglion, carpal boss, radiocarpal arthritis, and thumb metacarpophalangeal joint osteoarthritis. In only one case (1%) did the findings alter the management. At our institution, the professional and technical charge for three views of the wrist is $172. This confers a cost of $17,716 per therapeutically significant finding in our series. We conclude that routinely performing wrist radiography is not cost-effective in the evaluation and treatment decision-making process in patients with a wrist ganglion. PMID:18780070

  13. Low-cost, low-field dedicated extremity magnetic resonance imaging in early rheumatoid arthritis: a 1-year follow-up study

    DEFF Research Database (Denmark)

    Lindegaard, H.M.; Vallø, J.; Hørslev-Petersen, K.;

    2006-01-01

    OBJECTIVE: To study the ability of low-cost low-field dedicated extremity magnetic resonance imaging (E-MRI) to assess and predict erosive joint damage in the wrist and metacarpophalangeal (MCP) joints of patients with early rheumatoid arthritis. METHODS: 24 previously untreated patients with...... rheumatoid arthritis with joint symptoms for <1 year were evaluated at the time of diagnosis and after 6 and 12 months of methotrexate treatment with conventional clinical or biochemical examinations, x rays of both hands and wrists, and E-MRI of the dominant wrist and MCP joints. RESULTS: At baseline, all...... arthritis who were treated uniformly, baseline E-MRI erosions in MCP or wrist bones markedly increased the risk of x ray erosions at the 1-year follow-up. Low-cost, low-field dedicated extremity MRI is promising for assessment and prognostication of early rheumatoid arthritis. Udgivelsesdato: 2006-Sep...

  14. Streptococcus agalactiae Septic Arthritis of the Shoulder and the Sacroiliac Joints: A Case Report

    OpenAIRE

    Imam, Yahia Z.; Housam Aldeen Sarakbi; Nagui Abdelwahab; Issa Mattar

    2012-01-01

    Invasive group beta-streptococcal arthritis is being increasingly diagnosed as suggested by recent data. We report a case of a middle-aged lady from Sri Lanka who developed septic arthritis of the right shoulder and the left sacroiliac joint as well as an iliopsoas collection caused by Streptococcus agalactiae shortly after labor at Hamad General Hospital in Doha, Qatar. We conclude that Streptococcus agalactiae septic arthritis is rare. It can present with invasive disease in adults. It usua...

  15. Psoriatic arthritis and temporomandibular joint involvement – literature review with a reported case

    OpenAIRE

    Badel, Tomislav; Savić Pavičin, Ivana; Krapac, Ladislav; Zadravec, Dijana; Rosić, Davorka

    2014-01-01

    In addition to psoriasis, between 5% and 24% of patients will develop psoriatic arthritis simultaneously after or even prior to skin manifestations. Psoriatic arthritis belongs to the group of seronegative spondyloarthritis. Collaboration between a dermatologist and a rheumatologist plays a more important role in cases where there is a complete absence of clinical signs of psoriasis. Since rheumatic diseases may also involve the temporomandibular joints (TMJ), psoriatic arthritis can cause pr...

  16. Effect of radiosynovectomy in patients with inflammatory joint disorders not caused by rheumatoid arthritis; Wirksamkeit der Radiosynoviorthese bei degenerativ-entzuendlichen und chronisch-entzuendlichen Gelenkerkrankungen

    Energy Technology Data Exchange (ETDEWEB)

    Kroeger, S.; Klutmann, S.; Bohuslavizki, K.H.; Clausen, M. [Universitaetskrankenhaus Eppendorf, Hamburg (Germany). Abt. fuer Nuklearmedizin; Sawula, J.A.; Brenner, W.; Henze, E. [Kiel Univ. (Germany). Klinik fuer Nuklearmedizin

    1999-07-01

    Aim: Effect of radiosynovectomy (RS) should be evaluated both by subjective and objective parameters in patients with osteoarthritis and in patients with inflammatory joint disorders not caused by rheumatoid arthritis. Methods: A total of 98 joints in 61 patients were investigated. Patients were divided into two groups. The first group included 35 patients with therapy-resistant effusions caused by severe osteoarthritis (46 joints). The second group consisted of 26 patients (52 joints) with ankylosing spondylitis, reactive arthritis, undifferentiated spondylarthropathy, psoriatic arthritis, pigmented villo-nodular synovitis, and recurrent synovitis following surgery. Effect of RS was evaluated by a standardized questionnaire and quantified by T/B-ratios derived from blood pool images prior to and after RS. Results: Within the first patient group suffering from osteoarthritis, 40% showed a good or excellent improvement of clinical symptoms, 51% were unchanged, and in 9% symptoms worsened. Similar results were found in the second patient group. The majority of unchanged results were small finger joints. In contrast, wrist and knee joints showed a better improvement. Good correlation between results of bone scan and patients subjective impression was found in 38% and 67% in the first and the second patient group, respectively. Conclusion: Radiosynovectomy might be an effective treatment in osteoarthritis and inflammatory joint disorders not caused by rheumatoid arthritis. (orig.) [German] Ziel: Der Therapieerfolg der Radiosynoviorthese (RSO) sollte bei aktivierter Arthrose und anderen chronisch-entzuendlichen Gelenkerkrankungen anhand der subjektiven Befindlichkeit und objektiver Parameter evaluiert werden. Methoden: Es wurden insgesamt 98 Gelenke bei 61 Patienten behandelt. Entsprechend der Grunderkrankung umfasste die erste Gruppe 35 Patienten mit einer therapieresistenten, aktivierten Arthrose (46 Gelenke). Die zweite Patientengruppe beinhaltete 26 Patienten (52

  17. Characterization of nitrotyrosine as a biomarker for arthritis and joint injury

    DEFF Research Database (Denmark)

    Misko, T P; Radabaugh, M R; Highkin, M; Abrams, M; Friese, O; Gallavan, R; Bramson, C; Hellio Le Graverand, M P; Lohmander, Stefan; Roman, D

    2013-01-01

    OBJECTIVES: To characterize the utility of nitrotyrosine (NT) as a biomarker for arthritis and joint injury. DESIGN: Synovial fluid, plasma, and urine from patients diagnosed with osteoarthritis (OA), rheumatoid arthritis (RA), anterior cruciate ligament (ACL) injury, meniscus injury and pseudogout...... ratios were elevated in OA patients. Synovial fluid from patients with ACL and meniscus injury and pseudogout had increased levels of NT (P ...

  18. Patterns of magnetic resonance imaging bone erosion in rheumatoid arthritis--which bones are most frequently involved and show the most change?

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Møller Døhn, Uffe; Duer-Jensen, A;

    2011-01-01

    To investigate by magnetic resonance imaging (MRI) which bones in wrists and metacarpophalangeal (MCP) joints most frequently show bone erosions, and which most frequently demonstrate erosive progression, in early and established rheumatoid arthritis (RA).......To investigate by magnetic resonance imaging (MRI) which bones in wrists and metacarpophalangeal (MCP) joints most frequently show bone erosions, and which most frequently demonstrate erosive progression, in early and established rheumatoid arthritis (RA)....

  19. Patterns of magnetic resonance imaging bone erosion in rheumatoid arthritis - which bones are most frequently involved and show the most change?

    DEFF Research Database (Denmark)

    Ostergaard, Mikkel; Møller Døhn, Uffe; Duer-Jensen, Anne;

    2011-01-01

    To investigate by magnetic resonance imaging (MRI) which bones in wrists and metacarpophalangeal (MCP) joints most frequently show bone erosions, and which most frequently demonstrate erosive progression, in early and established rheumatoid arthritis (RA).......To investigate by magnetic resonance imaging (MRI) which bones in wrists and metacarpophalangeal (MCP) joints most frequently show bone erosions, and which most frequently demonstrate erosive progression, in early and established rheumatoid arthritis (RA)....

  20. 早期类风湿性关节炎腕关节磁共振的诊断价值%Diagnostic Value of Wrist MRI in Early Rheumatoid Arthritis

    Institute of Scientific and Technical Information of China (English)

    余宁; 李岩; 李建军; 陈峰

    2012-01-01

    目的:观察早期类风湿性关节炎(RA)手腕关节的滑膜改变、骨质侵蚀及关节腔积液等在MRI上的表现.同时探讨MRI表现与血清学检查指标相关性.方法:将根据临床症状及血清学检查结果确诊为类风湿性关节炎,而其腕关节行X线平片检查未见骨质破坏的28例患者作为研究对象.分析早期RA关节病变MRI影像学表现的特点.对MRI所见滑膜评分与血清学检查结果之间的关系进行相关性分析.结果:MRI发现16例手腕关节有骨质侵蚀或骨髓水肿,其中骨质侵蚀共26处,12例无骨质侵蚀或骨髓水肿.所有病例腕关节均见有不同程度滑膜增厚,增强扫描可见血管翳强化.并发现腕关节滑膜评分分值与临床血清检查结果(RF、IgA、IgG、IgM)相关性有统计学意义(P均<0.05),而与CRP相关性无统计学意义(r=0.26,P>0.05).此外,MRI还可显示早期RA的骨髓水肿、关节积液等征象.结论:MRI能清楚显示早期RA手腕部小关节病变,且明显优于传统X线平片检查.MRi可以对早期RA的滑膜炎进行半定量化分级评分,为早期RA滑膜炎的诊断及活跃程度的深入研究提供了新方法.%Objective: To observe the MRI manifestations of wrist joints' synovitis changes, bone erosion and articular cavity effusion in rheumatoid arthritis (RA) patients, and to explore the correlation between MRI manifestations and serological testing indices. Methods: RA were diagnosed in 28 patients according to clinical symptoms and serological testing results, but no bone damage in wrist joints was found in X-ray examination. Correlation between synovitis scores in MRI and serological indices were analyzed. Results: Of all the 28 cases, MRI showed 26 lesions from 16 patients as bone erosion or bone marrow edema. The other 12 patients had neither of the problems. All the patients' synovium in wrist joint were thickened in varying degrees, and the correlation between synovitis scores in wrist joints

  1. Acute septic arthritis of the acromioclavicular joint caused by Haemophilus parainfluenzae: a rare causative origin.

    Science.gov (United States)

    Hong, Myong-Joo; Kim, Yeon-Dong; Ham, Hyang-Do

    2015-04-01

    Septic arthritis of the acromioclavicular (AC) joint is a rare entity with symptoms that include erythema, swelling, and tenderness over the AC joint, fever, and limitation of shoulder motion with pain. In previous reports, Staphylococcus and Streptococcus species have been mentioned as common causative organisms. Haemophilus parainfluenzae is a normal inhabitant of the oral cavity, respiratory tract, gastrointestinal tract, and urogenital tract. However, it sometimes causes opportunistic infections leading to septic arthritis and osteomyelitis. AC joint infection associated with H.parainfluenzae is very rare, and only one case has been reported in the literature. Moreover, septic arthritis in immunocompetent patients is also very rare. Here, we report the case of a healthy patient with H. parainfluenzae-related septic arthritis of the AC joint. PMID:24584486

  2. Diagnostic performance of three-dimensional MR maximum intensity projection for the assessment of synovitis of the hand and wrist in rheumatoid arthritis: A pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Li, Xubin, E-mail: lixb@bjmu.edu.cn [Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Reseaech Center for Cancer, Tianjin, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060 (China); Liu, Xia; Du, Xiangke [Department of Radiology, Peking University People' s Hospital, Beijing 100044 (China); Ye, Zhaoxiang [Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Reseaech Center for Cancer, Tianjin, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060 (China)

    2014-05-15

    Purpose: To evaluate the diagnostic performance of three-dimensional (3D) MR maximum intensity projection (MIP) in the assessment of synovitis of the hand and wrist in rheumatoid arthritis (RA) compared to 3D contrast-enhanced magnetic resonance imaging (CE-MRI). Materials and methods: Twenty-five patients with RA underwent MR examinations. 3D MR MIP images were derived from the enhanced images. MR images were reviewed by two radiologists for the presence and location of synovitis of the hand and wrist. The diagnostic sensitivity, specificity and accuracy of 3D MIP were, respectively, calculated with the reference standard 3D CE-MRI. Results: In all subjects, 3D MIP images yielded directly and clearly the presence and location of synovitis with just one image. Synovitis demonstrated high signal intensity on MIP images. The k-values for the detection of articular synovitis indicated excellent interobserver agreements using 3D MIP images (k = 0.87) and CE-MR images (k = 0.91), respectively. 3D MIP demonstrated a sensitivity, specificity and accuracy of 91.07%, 98.57% and 96.0%, respectively, for the detection of synonitis. Conclusion: 3D MIP can provide a whole overview of lesion locations and a reliable diagnostic performance in the assessment of articular synovitis of the hand and wrist in patients with RA, which has potential value of clinical practice.

  3. Dynamic contrast-enhanced imaging of the wrist in rheumatoid arthritis: dedicated low-field (0.25-T) versus high-field (3.0-T) MRI

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ryan K.L.; Griffith, James F.; Wang, D.F.; Yeung, David K.W. [The Chinese University of Hong Kong, Department of Imaging and Interventional Radiology, Prince Of Wales Hospital, Hong Kong, SAR (China); Shi, L. [The Chinese University of Hong Kong, Department of Medicine and Therapeutics, Division of Neurology, Hong Kong, SAR (China); Li, Edmund K.; Tam, L.S. [The Chinese University of Hong Kong, Department of Medicine, Division of Rheumatology, Prince Of Wales Hospital, Hong Kong, SAR (China)

    2015-08-15

    To compare the assessment of wrist synovitis severity, synovial volume and synovial perfusion parameters on a dedicated low-field (0.25-T) to that of a high-field (3-T) whole-body MR system in patients with rheumatoid arthritis (RA). Twenty-one patients (mean age 50.0 ± 9.8 years) with active RA were recruited prospectively. Dynamic contrast-enhanced MRI examination of the most severely affected wrist was performed at both 0.25 T and 3 T. Three MRI-derived parameters, synovitis severity (RAMRIS grade), synovial volume (ml{sup 3}) and synovial perfusion indices (maximum enhancement and enhancement slope), were compared. Comparing 0.25- and 3-T MRI, there was excellent agreement for semiquantitative assessment (r: 0.80, p < 0.00001) of synovitis (RAMRIS) as well as quantitative assessment (r: 0.94, p < 0.00001) of synovial volume. Good agreement for synovial Emax (r: 0.6, p = 0.002) and fair agreement (r: 0.5, p = 0.02) for synovial Eslope was found. Imaging of the RA wrist at 0.25 T yields excellent correlation with 3 T with regard to the synovitis activity score (RAMRIS) and synovial volume measurement. Fair to good correlation between low- (0.25-T) and high-field (3-T) MR systems was found for perfusion parameters, being better for Emax than for Eslope. (orig.)

  4. Early detection of temporomandibular joint arthritis in children with juvenile idiopathic arthritis - the role of contrast-enhanced MRI

    Energy Technology Data Exchange (ETDEWEB)

    Kalle, Thekla von; Stuber, Tina; Winkler, Peter [Olgahospital Klinikum Stuttgart, Pediatric Radiology, Radiologisches Institut, Stuttgart (Germany); Maier, Jan; Hospach, Toni [Olgahospital Klinikum Stuttgart, Pediatric Rheumatology, Stuttgart (Germany)

    2015-03-01

    Early treatment of temporomandibular joint (TMJ) arthritis is crucial in children with juvenile idiopathic arthritis (JIA) to prevent permanent functional impairment. As involvement of TMJs is often asymptomatic, contrast-enhanced MRI is regarded as the most sensitive noninvasive diagnostic tool. To evaluate the degree of contrast enhancement in TMJs of children and adolescents with JIA in comparison to normal controls from a previous study. Dynamic contrast-enhanced MRI of 50 children and adolescents with JIA (6.3 to 18 years of age; mean: 12 years) were retrospectively analysed. We assessed morphological abnormalities and postcontrast time-intensity curves of the soft joint tissue and the mandibular condyle. Ratios were calculated to quantify postcontrast signal intensities (SI) in relation to precontrast SI at initial (1 min postcontrast) and maximum (6 min postcontrast) increase. Time-intensity curves followed similar biphasic patterns in normal and pathological joints. In joints with morphological signs of arthritis, mean SI ratios were on average higher than in normal joints of the reference group, but ranges of values widely overlapped. Arthritis: mean initial increase of SI 62% (±2 S.D. 18-105%), mean maximum SI 106% higher than precontrast (±2 S.D. 46-166%). Normal: mean initial increase of SI 49% (±2 S.D. 14- 85%), mean maximum of SI 73% (±2 S.D. 23-123%). Given this considerable overlap of results in dynamic contrast-enhanced MRI, the degree of contrast enhancement alone did not allow differentiation between TMJs with and without signs of inflammation. Thickening of the soft joint tissue seems to remain the earliest sign to reliably indicate TMJ arthritis. (orig.)

  5. Early detection of temporomandibular joint arthritis in children with juvenile idiopathic arthritis - the role of contrast-enhanced MRI

    International Nuclear Information System (INIS)

    Early treatment of temporomandibular joint (TMJ) arthritis is crucial in children with juvenile idiopathic arthritis (JIA) to prevent permanent functional impairment. As involvement of TMJs is often asymptomatic, contrast-enhanced MRI is regarded as the most sensitive noninvasive diagnostic tool. To evaluate the degree of contrast enhancement in TMJs of children and adolescents with JIA in comparison to normal controls from a previous study. Dynamic contrast-enhanced MRI of 50 children and adolescents with JIA (6.3 to 18 years of age; mean: 12 years) were retrospectively analysed. We assessed morphological abnormalities and postcontrast time-intensity curves of the soft joint tissue and the mandibular condyle. Ratios were calculated to quantify postcontrast signal intensities (SI) in relation to precontrast SI at initial (1 min postcontrast) and maximum (6 min postcontrast) increase. Time-intensity curves followed similar biphasic patterns in normal and pathological joints. In joints with morphological signs of arthritis, mean SI ratios were on average higher than in normal joints of the reference group, but ranges of values widely overlapped. Arthritis: mean initial increase of SI 62% (±2 S.D. 18-105%), mean maximum SI 106% higher than precontrast (±2 S.D. 46-166%). Normal: mean initial increase of SI 49% (±2 S.D. 14- 85%), mean maximum of SI 73% (±2 S.D. 23-123%). Given this considerable overlap of results in dynamic contrast-enhanced MRI, the degree of contrast enhancement alone did not allow differentiation between TMJs with and without signs of inflammation. Thickening of the soft joint tissue seems to remain the earliest sign to reliably indicate TMJ arthritis. (orig.)

  6. Pyogenic Arthritis of the Facet Joint with Concurrent Epidural and Paraspinal Abscess: A Case Report

    OpenAIRE

    Rhyu, Kee-Won; Park, Sang-Eun; Ji, Jong-Hun; Park, In; Kim, Young-Yul

    2011-01-01

    Pyogenic arthritis of lumber spinal facet joints is an extremely rare condition. There are only 40 reported cases worldwide. Most cases were associated with history of paravertebral injection, which was not found in our patient. At the time of hospital admission, he had no abnormal magnetic resonance image findings. Two weeks later, he developed pyogenic facet joint arthritis associated with paravertebral and epidural abscess. This report is the first to describe delayed presentation of pyoge...

  7. Septic arthritis of a lumbar facet joint; Arthrite septique interapophysaire posterieure lombaire

    Energy Technology Data Exchange (ETDEWEB)

    Ben Hamouda, M.; Rajhi, H.; Golli, M.; Ganouni, A.; Bergaoui, N. [Centre Hospitalier Universitaire de Monastir (Tunisia); Chaouch, A. [Centre Hospitalier Universitaire de Mahdia (Tunisia); Hassine, H. [Centre Hospitalier Universitaire de Sahloul, Sousse (Tunisia)

    1997-05-01

    Septic arthritis of the posterior lumbar joints is extremely rare. The clinical picture of the unusual site of infection can easily lead to confusion with spondylo-discitis which is more common. We report a case of a 50-year-old women with Staphylococcus aureus septic arthritis of the left L5-S1 lumbar facet joint. CT scan was helpful to establish the diagnosis and to guide the percutaneous needle biopsy. (authors). 10 refs.

  8. Radio-synoviorthesis with yttrium 90 in the knee-joint in rheumatoid arthritis

    International Nuclear Information System (INIS)

    The radio-synoviorthesis with yttrium 90 in the knee-joint in rheumatoid arthritis was performed and controlled in 106 knees of patients with rheumatoid arthritis over a span of time between 6 and 49 months. The results are similar to those of other authors. As compared to synovectomy radio-synoviorthesis seems less successful as far as long-term results are concerned. As local treatment radio-synoviorthesis seems a good supplementory element in the therapeutic plan of rheumatoid arthritis. The indication to alternative procedures has been considered carefully for each individual case and joint. (orig.)

  9. Detection of In Vivo Dynamic 3-D Motion Patterns in the Wrist Joint

    NARCIS (Netherlands)

    B. Carelsen; R. Jonges; S.D. Strackee; M. Maas; P. van Kemenade; C.A. Grimbergen; M. van Herk; G.J. Streekstra

    2009-01-01

    We present a method for measurement dynamic in vivo carpal motion patterns. The method consists of a 4-D rotational X-ray (RX) with improved image quality and image processing for accurate detection in vivo wrist motion measurements. Dynamic 3-D imaging yields a number of volume reconstructions of t

  10. Ulnar-sided wrist pain. II. Clinical imaging and treatment

    International Nuclear Information System (INIS)

    Pain at the ulnar aspect of the wrist is a diagnostic challenge for hand surgeons and radiologists due to the small and complex anatomical structures involved. In this article, imaging modalities including radiography, arthrography, ultrasound (US), computed tomography (CT), CT arthrography, magnetic resonance (MR) imaging, and MR arthrography are compared with regard to differential diagnosis. Clinical imaging findings are reviewed for a more comprehensive understanding of this disorder. Treatments for the common diseases that cause the ulnar-sided wrist pain including extensor carpi ulnaris (ECU) tendonitis, flexor carpi ulnaris (FCU) tendonitis, pisotriquetral arthritis, triangular fibrocartilage complex (TFCC) lesions, ulnar impaction, lunotriquetral (LT) instability, and distal radioulnar joint (DRUJ) instability are reviewed. (orig.)

  11. Ulnar-sided wrist pain. II. Clinical imaging and treatment

    Energy Technology Data Exchange (ETDEWEB)

    Watanabe, Atsuya; Souza, Felipe [Brigham and Women' s Hospital, Department of Radiology, Boston, MA (United States); Vezeridis, Peter S.; Blazar, Philip [Brigham and Women' s Hospital, Department of Orthopaedic Surgery, Boston, MA (United States); Yoshioka, Hiroshi [Brigham and Women' s Hospital, Department of Radiology, Boston, MA (United States); University of California-Irvine, Department of Radiological Sciences, Irvine, CA (United States); UC Irvine Medical Center, Department of Radiological Sciences, Orange, CA (United States)

    2010-09-15

    Pain at the ulnar aspect of the wrist is a diagnostic challenge for hand surgeons and radiologists due to the small and complex anatomical structures involved. In this article, imaging modalities including radiography, arthrography, ultrasound (US), computed tomography (CT), CT arthrography, magnetic resonance (MR) imaging, and MR arthrography are compared with regard to differential diagnosis. Clinical imaging findings are reviewed for a more comprehensive understanding of this disorder. Treatments for the common diseases that cause the ulnar-sided wrist pain including extensor carpi ulnaris (ECU) tendonitis, flexor carpi ulnaris (FCU) tendonitis, pisotriquetral arthritis, triangular fibrocartilage complex (TFCC) lesions, ulnar impaction, lunotriquetral (LT) instability, and distal radioulnar joint (DRUJ) instability are reviewed. (orig.)

  12. Assessment of joint pain in teenagers with juvenile arthritis

    Directory of Open Access Journals (Sweden)

    T A Shelepina

    2009-01-01

    Full Text Available Assessment of joint pain in teenagers with juvenile arthritisObjective. To assess mean total pain score in teenagers with juvenile arthritis (JA and its values in groups differing on sex, variant of course, activity measures, degree of functional disturbances. To assess advisability of application of these parameters in real clinical practice. Material and methods. 73 pts with JA (mean age 14,7±1,7 years, mean disease duration7,2±4,4 years were included. 18 from them had systemic, 42 – polyarticular and 13 – olygoarticular variant. 16 pts were examined repeatedly with interval exceeding one year. Total quantity of examinations was 94. 17 pts were examined at admission and at discharge. Pain was measured on visual analog scale (VAS and on McGill Pain Questionnaire (83 examinations including 3 scale: sensor (description of pain, affective (their influence on emotional state and evaluative (verbal assessment of pain intensity. General health assessment on VAS was performed in 59 pts (in 8 from them at admission and at discharge. Summary mean measures and their values in groups differing in sex, course variant, activity measure, functional class at pts admission to and at discharge from the Institute of Rheumatology of RAMS. Statistical treatment was performed with Biomed program(descriptive statistic, χ2, Student’s pared test. Results. Mean pain score on VAS in all teenagers with JA was 31,3±17,3. It was significantlyhigher in boys with systemic variant (in comparison with polyarticular, in pts with ESR elevation above 30, in pts with functional class 3 and higher at admission to the department. Pain score was significantly lower in pts with olygoarticular variant in comparison with mean value and with value in polyarthritis. Pain above 70 mm on VAS was found in pts with polyarticular damage in systemic and polyarticular variants in active phase of the disease and in severe functional disability. Summated (on sensor and affective scales

  13. Advances in wrist arthroscopy.

    Science.gov (United States)

    Wolf, Jennifer Moriatis; Dukas, Alex; Pensak, Michael

    2012-11-01

    Since its introduction more than three decades ago, wrist arthroscopy has continually evolved. The procedure has a wide list of indications, including diagnostic and management applications. The scope of practice for the wrist arthroscopic surgeon includes management of triangulofibrocartilage complex pathology, evaluation and management of carpal instability, assistance in fracture reduction of the radius and scaphoid, treatment of trapeziometacarpal synovitis and arthritis, distal ulnar and carpal bone excisions, and salvage procedures. In addition, innovations such as new portals and smaller arthroscopes have expanded the applications of wrist arthroscopy. PMID:23118138

  14. Triple-phase bone image abnormalities in Lyme arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Brown, S.J.; Dadparvar, S.; Slizofski, W.J.; Glab, L.B.; Burger, M. (Hahnemann Univ. Hospital, Philadelphia, PA (USA))

    1989-10-01

    Arthritis is a frequent manifestation of Lyme disease. Limited triple-phase Tc-99m MDP bone imaging of the wrists and hands with delayed whole-body images was performed in a patient with Lyme arthritis. This demonstrated abnormal joint uptake in the wrists and hands in all three phases, with increased activity seen in other affected joints on delayed whole-body images. These findings are nonspecific and have been previously described in a variety of rheumatologic conditions, but not in Lyme disease. Lyme disease should be considered in the differential diagnosis of articular and periarticular bone scan abnormalities.

  15. Triple-phase bone image abnormalities in Lyme arthritis

    International Nuclear Information System (INIS)

    Arthritis is a frequent manifestation of Lyme disease. Limited triple-phase Tc-99m MDP bone imaging of the wrists and hands with delayed whole-body images was performed in a patient with Lyme arthritis. This demonstrated abnormal joint uptake in the wrists and hands in all three phases, with increased activity seen in other affected joints on delayed whole-body images. These findings are nonspecific and have been previously described in a variety of rheumatologic conditions, but not in Lyme disease. Lyme disease should be considered in the differential diagnosis of articular and periarticular bone scan abnormalities

  16. No erosive progression revealed by MRI in rheumatoid arthritis patients treated with etanercept, even in patients with persistent MRI and clinical signs of joint inflammation

    DEFF Research Database (Denmark)

    Døhn, Uffe Møller; Skjødt, Henrik; Hetland, Merete Lund;

    2007-01-01

    The aim of this study is to investigate the course of magnetic resonance imaging (MRI) signs of inflammatory and destructive changes in rheumatoid arthritis (RA) wrist and metacarpophalangeal (MCP) joints during etanercept treatment. MRI of the non-dominant wrist and second to fifth MCP joints was...... performed in five clinical active RA patients before and 4 and 16 weeks after initiation of etanercept treatment. MRI was evaluated according to the EULAR-OMERACT RA MRI reference image atlas. The median 28-joint count disease activity score (DAS28; erythrocyte sedimentation rate based) was 5.6 (range 5.......0-6.8) at baseline and 3.5 (1.5-4.1) at week 16 (decreased in all patients compared to baseline, Wilcoxon-Pratt, p < 0.05). The median MRI synovitis score was 18 (14-21), 18 (10-20) and 16 (10-20) at baseline, week 4 and 16, respectively (decreased in all patients compared to baseline, Wilcoxon-Pratt, p < 0...

  17. Septic arthritis in a lumbar facet joint: a rare cause of an epidural abscess

    International Nuclear Information System (INIS)

    A 10-year-old boy presented with a 7-day history of back pain and pyrexia. MRI showed an epidural abscess arising from septic arthritis in a lumbar facet joint. To our knowledge, there are only two previously reported cases of septic arthritis of a facet joint leading to an epidural abscess. This case illustrates how infection in a synovial joint may extend into the extradural space and might be the route of infection in more cases than has previously been recognised. (orig.)

  18. Septic arthritis in a lumbar facet joint: a rare cause of an epidural abscess

    Energy Technology Data Exchange (ETDEWEB)

    Heenan, S.D. [Dept. of Neuroradiology, Atkinson Morley`s Hospital, London (United Kingdom); Britton, J. [Dept. of Neuroradiology, Atkinson Morley`s Hospital, London (United Kingdom)

    1995-08-01

    A 10-year-old boy presented with a 7-day history of back pain and pyrexia. MRI showed an epidural abscess arising from septic arthritis in a lumbar facet joint. To our knowledge, there are only two previously reported cases of septic arthritis of a facet joint leading to an epidural abscess. This case illustrates how infection in a synovial joint may extend into the extradural space and might be the route of infection in more cases than has previously been recognised. (orig.)

  19. Median nerve neuropathy in the forearm due to recurrence of anterior wrist ganglion that originates from the scaphotrapezial joint: Case Report

    Directory of Open Access Journals (Sweden)

    Okada Kiyoshi

    2012-01-01

    Full Text Available Abstract Background Median nerve neuropathy caused by compression from a tumor in the forearm is rare. Cases with anterior wrist ganglion have high recurrence rates despite surgical treatment. Here, we report the recurrence of an anterior wrist ganglion that originated from the Scaphotrapezial joint due to incomplete resection and that caused median nerve neuropathy in the distal forearm. Case presentation A 47-year-old right-handed housewife noted the appearance of soft swelling on the volar aspect of her left distal forearm, and local resection surgery was performed twice at another hospital. One year after the last surgery, the swelling reappeared and was associated with numbness and pain in the radial volar aspect of the hand. Magnetic resonance imaging revealed that the multicystic lesion originated from the Scaphotrapezial joint and had expanded beyond the wrist. Exploration of the left median nerve showed that it was compressed by a large ovoid cystic lesion at the distal forearm near the proximal end of the carpal tunnel. We resected the cystic lesion to the Scaphotrapezial joint. Her symptoms disappeared 1 week after surgery, and complications or recurrent symptoms were absent 13 months after surgery. Conclusions A typical median nerve compression was caused by incomplete resection of an anterior wrist ganglion, which may have induced widening of the cyst. Cases with anterior wrist ganglion have high recurrence rates and require extra attention in their treatment.

  20. Linking power Doppler ultrasound to the presence of th17 cells in the rheumatoid arthritis joint.

    Directory of Open Access Journals (Sweden)

    Nicola J Gullick

    Full Text Available BACKGROUND: Power Doppler ultrasound (PDUS is increasingly used to assess synovitis in Rheumatoid Arthritis (RA. Prior studies have shown correlations between PDUS scores and vessel counts, but relationships with T cell immunopathology have not been described. METHODOLOGY/PRINCIPAL FINDINGS: PBMC were isolated from healthy controls (HC or RA patients and stimulated ex vivo with PMA and ionomycin for 3 hours in the presence of Golgistop. Paired synovial fluid (SF or synovial tissue (ST were analysed where available. Intracellular expression of IL-17, IFNgamma, and TNFalpha by CD4+ T cells was determined by flow cytometry. Synovial blood flow was evaluated by PDUS signal at the knees, wrists and metacarpophalangeal joints of RA patients. Serum, SF and fibroblast culture supernatant levels of vascular endothelial growth factor-A (VEGF-A were measured by ELISA. The frequency of IL17+IFNgamma-CD4+ T cells (Th17 cells was significantly elevated in peripheral blood (PB from RA patients vs. HC (median (IQR 0.5 (0.28-1.59% vs. 0.32 (0.21-0.54%, p = 0.005. Th17 cells were further enriched (mean 6.6-fold increase in RA SF relative to RA PB. Patients with active disease had a higher percentage of IL-17+ T cells in ST than patients in remission, suggesting a possible role for Th17 cells in active synovitis in RA. Indeed, the percentage of Th17 cells, but not Th1, in SF positively correlated with CRP (r = 0.51, p = 0.04 and local PDUS-defined synovitis (r = 0.61, p = 0.002. Furthermore, patients with high levels of IL-17+CD4+ T cells in SF had increased levels of the angiogenic factor VEGF-A in SF. Finally, IL-17, but not IFNgamma, increased VEGF-A production by RA synovial fibroblasts in vitro. CONCLUSIONS/SIGNIFICANCE: Our data demonstrate a link between the presence of pro-inflammatory Th17 cells in SF and local PDUS scores, and offer a novel immunological explanation for the observation that rapid joint damage progression occurs in patients with

  1. Quantitative assessment of the synovial membrane in the rheumatoid wrist: an easily obtained MRI score reflects the synovial volume

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Hansen, M; Stoltenberg, M;

    1996-01-01

    Determination of the synovial membrane volume in the rheumatoid arthritis (RA) wrist by gadolinium-DTPA-enhanced MRI is introduced. Moreover, dynamic imaging and an MRI score of synovial hypertrophy, based on gradings in six regions, are evaluated as substitutes of the time-consuming volume...... swelling and/or joint tenderness than in wrists without these signs (Mann-Whitney, both P < 0.05). Suboptimal slice selection made dynamic imaging uninformative. MRI allows quantification of the synovial volume in the rheumatoid wrist. The volume is related to clinical signs of inflammation, but may also...... calculations. Twenty-six RA wrists were examined. Synovial membrane volumes ranged from 1 to 20 ml (median 9 ml). Synovial hypertrophy scores were highly correlated to synovial volumes (Spearman r = 0.88; P < 10(-8) for uncorrelated values). The volumes and scores were significantly higher in wrists with joint...

  2. A review of clinical and radiological aspects of rheumatoid arthritis of head joints

    International Nuclear Information System (INIS)

    The most important inflammations--rheumatic joint diseases of the vertebral column--are chronic polyarthritis (rheumatoid arthritis) with involvement of cervical vertebral and atlanto-axial dislocation and ankylosing spondylitis (Bechterew's disease) resp. the seronegative spondylarthritis. A decisive and important difference between both forms of disease is found in the region of the cervical part of the vertebral column. In case of a spondylarthritis (ASp.) the ankylopoietica type includes the cervical vertebrae but the chronic polyarthritis (RA) is usually limited to the cervical vertebral spine. The incidence in both types (RA) is usually limited to the cervical vertebral spine. The incidence in both types (RA and ASp.) of cervical involvement is about 30%. The authors present an account of the underlying disease process. A description of rheumatoid cervical arthritis is given. The destructive and dislocating arthritis of the cranio-cervical function (arthritis of the head and neck joints) is described

  3. Infectious Arthritis

    Science.gov (United States)

    Most kinds of arthritis cause pain and swelling in your joints. Joints are places where two bones meet, such as your elbow or knee. Infectious arthritis is an infection in the joint. The infection ...

  4. Diagnosis and control for treatment of chronic arthritis and arthrosis of temporomandibular joint

    International Nuclear Information System (INIS)

    A study was made of anatomy and functions of temperomandibular joint in age aspect in patients with chronic arthritis and arthrosis using comprehensive clinicoroentgenological investigations. Such methods as X-ray examination, electromyography and diplography were important. The verification of results of treatment was also conducted on the base of clinicoroentgenological methods. It was shown that it was expedient to individual approach to treatment of petints with arthritis and arthrosis taking into account age-associated features

  5. Influence of disease activity and treatment on rate of joint destruction in rheumatoid arthritis

    OpenAIRE

    D V Goryachev; O A Krichevskaya; A. P. Zornyak; N V Chichasova; Sh. F. Erdes

    2008-01-01

    Severity of hands and feet joint destruction is the most objective marker of rheumatoid arthritis (RA) progression determining functional disability. The main aim of RA treatment is suppression of joint destruction. Objective. To study dependence of joint erosions forming speed on disease modifying anti-rhcumatic drugs (DMARD) administration and RA activity. Material and methods. Retrospective analysis of 451 cases of RA treatment was performed. Erosions were counted according to modified Sha...

  6. OMERACT Rheumatoid Arthritis Magnetic Resonance Imaging Studies. Exercise 3: an international multicenter reliability study using the RA-MRI Score

    DEFF Research Database (Denmark)

    Lassere, M; McQueen, F; Østergaard, Mikkel;

    2003-01-01

    We examined inter-reader agreement of the revised OMERACT 5 Rheumatoid Arthritis MRI Score (RAMRIS v3). Magnetic resonance (MR) images of 10 sets of metacarpophalangeal (MCP) joints 2-5 and 8 sets of rheumatoid arthritis (RA) wrists [1.5 T, coronal and axial T1 and T2 spin-echo, +/- fat saturation...

  7. Dexterous Humanoid Robotic Wrist

    Science.gov (United States)

    Ihrke, Chris A. (Inventor); Bridgwater, Lyndon (Inventor); Reich, David M. (Inventor); Wampler, II, Charles W. (Inventor); Askew, Scott R. (Inventor); Diftler, Myron A. (Inventor); Nguyen, Vienny (Inventor)

    2013-01-01

    A humanoid robot includes a torso, a pair of arms, a neck, a head, a wrist joint assembly, and a control system. The arms and the neck movably extend from the torso. Each of the arms includes a lower arm and a hand that is rotatable relative to the lower arm. The wrist joint assembly is operatively defined between the lower arm and the hand. The wrist joint assembly includes a yaw axis and a pitch axis. The pitch axis is disposed in a spaced relationship to the yaw axis such that the axes are generally perpendicular. The pitch axis extends between the yaw axis and the lower arm. The hand is rotatable relative to the lower arm about each of the yaw axis and the pitch axis. The control system is configured for determining a yaw angle and a pitch angle of the wrist joint assembly.

  8. Mycobacterium avium-intracellulare cellulitis occurring with septic arthritis after joint injection: a case report

    Directory of Open Access Journals (Sweden)

    Murdoch David M

    2007-02-01

    Full Text Available Abstract Background Cellulitis caused by Mycobacterium avium-intracellulare has rarely been described. Mycobacterium avium-intracellulare is a rare cause of septic arthritis after intra-articular injection, though the causative role of injection is difficult to ascertain in such cases. Case presentation A 57-year-old with rheumatoid arthritis treated with prednisone and azathioprine developed bilateral painful degenerative shoulder arthritis. After corticosteroid injections into both acromioclavicular joints, he developed bilateral cellulitis centered over the injection sites. Skin biopsy showed non-caseating granulomas, and culture grew Mycobacterium avium-intracellulare. Joint aspiration also revealed Mycobacterium avium-intracellulare infection. Conclusion Although rare, skin and joint infections caused by Mycobacterium avium-intracellulare should be considered in any immunocompromised host, particularly after intra-articular injection. Stains for acid-fast bacilli may be negative in pathologic samples even in the presence of infection; cultures of tissue specimens should always be obtained.

  9. Computer Simulation Tests of Feedback Error Learning Controller with IDM and ISM for Functional Electrical Stimulation in Wrist Joint Control

    Directory of Open Access Journals (Sweden)

    Takashi Watanabe

    2010-01-01

    Full Text Available Feedforward controller would be useful for hybrid Functional Electrical Stimulation (FES system using powered orthotic devices. In this paper, Feedback Error Learning (FEL controller for FES (FEL-FES controller was examined using an inverse statics model (ISM with an inverse dynamics model (IDM to realize a feedforward FES controller. For FES application, the ISM was tested in learning off line using training data obtained by PID control of very slow movements. Computer simulation tests in controlling wrist joint movements showed that the ISM performed properly in positioning task and that IDM learning was improved by using the ISM showing increase of output power ratio of the feedforward controller. The simple ISM learning method and the FEL-FES controller using the ISM would be useful in controlling the musculoskeletal system that has nonlinear characteristics to electrical stimulation and therefore is expected to be useful in applying to hybrid FES system using powered orthotic device.

  10. Bone marrow oedema assessment by magnetic resonance imaging in rheumatoid arthritis wrist and metacarpophalangeal joints

    DEFF Research Database (Denmark)

    Krabbe, Simon; Eshed, Iris; Pedersen, Susanne Juhl;

    2014-01-01

    OBJECTIVE: The aim of this study was to examine the influence of different MRI unit field strengths, coil types and image resolutions on the OMERACT RA MRI scoring system (RAMRIS) of bone marrow oedema (BME) and image quality. METHODS: Forty-one patients and 12 healthy controls participated in this...... STIR image sets were anonymized and scored according to RAMRIS and parameters of image quality were measured. RESULTS: The BME sum scores were similar overall when comparing the different MRI units, coil types and voxel sizes, yet significantly higher at the higher resolution of 1.5T Extr compared with...... resolutions, suggesting that these are equally suited for assessment of BME in RA. However, parameters of image quality and intrareader reliability (favouring 0.6, 1.5 and 3T) should be considered when selecting the MRI acquisition strategy....

  11. Septic Arthritis of the Temporomandibular Joint--Unusual Presentations.

    Science.gov (United States)

    Lohiya, Sapna; Dillon, Jasjit

    2016-01-01

    This report describes 2 patients whose septic arthritis of the temporomandibular joint (SATMJ) presented atypically, resulting in treatment delay and complications. A 49-year-old man developed left-side facial allodynia, which was first treated unsuccessfully as trigeminal neuralgia. On day 21, the patient sustained facial trauma from a fall and presented to the emergency department (ED). Maxillofacial contrast-enhanced computed tomographic (CT) scan was suggestive of parotiditis, SATMJ, or hemarthrosis. His condition did not improve with empiric antibiotic treatment. On day 30, contrast-enhanced magnetic resonance imaging (MRI) confirmed SATMJ. Incision and drainage yielded 6 mL of pus and produced clinical improvement. Cultures grew methicillin-resistant Staphylococcus aureus, which was treated with amoxicillin plus clavulanate and sulfamethoxazole plus trimethoprim for 30 days. On day 59, the patient still had slight preauricular pain and CT-proved TMJ osteoarthritic changes. A 56-year-old woman developed right-side facial pain after a crown procedure on her right mandibular second molar. Oral prednisone (and clindamycin) produced partial relief. Her primary physician suspected temporal arteritis, but its biopsy result on day 11 was normal. Gradually, the patient developed trismus and malocclusion refractory to various medicines. On day 49, she presented to the ED. A contrast-enhanced maxillofacial CT scan suggested SATMJ. Incision and drainage yielded 30 mL of pus and produced clinical improvement. During days 50 to 57, the patient received intravenous ampicillin plus sulbactam and metronidazole. However, preauricular tenderness and drainage from the surgical incision persisted. On day 55, CT scan showed a residual abscess. Secondary debridement yielded 5 mL of pus. Culture grew coagulase-negative S aureus. On day 141, the patient still had slight preauricular pain and TMJ osteoarthritic changes on MRI. In these cases, the SATMJ diagnosis was delayed owing

  12. Correlation between computer-aided dynamic gadolinium-enhanced MRI assessment of inflammation and semi-quantitative synovitis and bone marrow oedema scores of the wrist in patients with rheumatoid arthritis--a cohort study

    DEFF Research Database (Denmark)

    Boesen, Mikael; Kubassova, Olga; Bouert, Rasmus;

    2012-01-01

    Objective. To test the correlation between assessment of inflammation using dynamic contrast-enhanced MRI (DCE-MRI) analysed by a novel computer-aided approach and semi-quantitative scores of synovitis and bone marrow oedema (BME) using the OMERACT-RA MRI Scoring (RAMRIS) system, in the wrist of...... patients with RA. Methods. Fifty-four RA patients had conventional and DCE-MRI of a symptomatic wrist using a low-field 0.2T extremity scanner. RAMRIS synovitis and BME of the wrist joint were done. DCE-MRI data were analysed in three ways: (i) in all images (fully automated approach), (ii) within a large...... extended region of interest (ROI) placed around the wrist joint (semi-automated approach) and (iii) within a small ROI placed in the area with most visual enhancement (semi-automated approach). Time spent on each procedure was noted. Spearman's rank correlation test was applied to assess the correlation...

  13. Septic arthritis of the adult ankle joint secondary to Salmonella enteritidis: a case report.

    LENUS (Irish Health Repository)

    Munigangaiah, Sudarshan

    2011-09-01

    Salmonella septic arthritis in healthy individuals is a rare phenomenon. However, septic arthritis of the native adult ankle joint in healthy patients has not been previously described in the published data. This is a case report of a 70-year-old farmer who presented with a 2-week history of a painful, swollen right ankle and an inability to bear weight. He had no history of ankle injury or any predisposing conditions. Joint aspirations were positive for Salmonella enteritidis that was successfully treated with right ankle arthrotomy and washout, along with a 6-week course of intravenous antibiotic therapy.

  14. Arthritis and IBD

    Science.gov (United States)

    ... IBD Help Center Home > Resources > Arthritis Go Back Arthritis Email Print + Share Arthritis, or inflammation of the ... joints and a reduction in flexibility. TYPES OF ARTHRITIS In IBD, arthritis may appear in three different ...

  15. Significance of radionucleid examination of joints in diagnosis of subclinical arthritis background

    International Nuclear Information System (INIS)

    Background. A large group of inflammation arthritis is represented by seronegative spondyloarthropathies (SpA), including several nosologies: psoriatic arthritis Bechterev's disease, Reiter's disease, etc. One of the most common SpA forms is Reactive arthritis (ReA). Inflammation process in joints is the most characteristic symptom, which determines severeness, course and prognosis of the disease. One of the most sensitive methods of examination of joints is radionucleid (RN) examination. Increased RNV accumulation in the joints is not a specific feature .for a concrete disease, and growth of its accumulation corresponds to the exudative component of inflammation process which reveals the early stage of joint inflammation (subclinical arthritis). Objectives: To find out how often subclinical inflammation processes (subclinical sinovitis) are observed in patients with minimal systemic activity of ReA. To detect in which joints subclinical sinovitis localizes most commonly. To evaluate significance of radionucleid examinations in diagnosis of subclinical arthritis. Material and methods. RN examination of joints was performed in 41 patient with ReA in I stage of activity and in 35 patients with ReA in II stage of activity, when the causative agent of infection - Chlamydia trachomatis - is localized in the urogenital tract. ReA was diagnosed according to diagnostic criteria of French Rheumatologists Association. For clinical description of joints index was used, characterized by pain intensity during joint palpation, and expressed by gradation degree from 0-3. In 76 patients with ReA I activity degree (ReA I) and ReA II activity degree (ReA II) radionucleid examination was done with marked 99Tc and analysis of the obtained joint scintigrams for SI area. In the control group, 90 joint scintigrams were analyzed for patients with degenerative joint diseases without palpation pain in the examined joints, determining Tc index (Tc ind) in separate joints and summary Tc ind

  16. Proximal Row Carpectomy Combined with Wrist Hemiarthroplasty

    OpenAIRE

    Culp, Randall W.; Bachoura, Abdo; Gelman, Scott E.; Jacoby, Sidney M.

    2012-01-01

    Proximal row carpectomy (PRC) combined with distal radius hemiarthroplasty is a relatively novel procedure that rivals total wrist arthrodesis and offers a new surgical treatment option for select patients with painful, end-stage wrist disease. We present our early experience with this procedure. A retrospective chart review was conducted for nonrheumatoid patients diagnosed with wrist arthritis and subsequently treated with wrist hemiarthroplasty combined with PRC. The minimum follow-up dura...

  17. Thermal imaging in screening of joint inflammation and rheumatoid arthritis in children

    International Nuclear Information System (INIS)

    Potential of modern thermal imaging for screening and differentiation of joint inflammation has not been assessed in child and juvenile patient populations, typically demanding groups in diagnostics of musculoskeletal disorders. We hypothesize that thermal imaging can detect joint inflammation in patients with juvenile idiopathic arthritis or autoimmune disease with arthritis such as systemic lupus erythematosus. To evaluate the hypothesis, we studied 58 children exhibiting symptoms of joint inflammation. First, the patients’ joints were examined along clinical procedure supplemented with ultrasound imaging when deemed necessary by the clinician. Second, thermal images were acquired from patients’ knees and ankles. Results of thermal imaging were compared to clinical evaluations in knee and ankle. The temperatures were significantly (pmax = 0.044, pmean < 0.001) higher in inflamed ankle joints, but not in inflamed knee joints. No significant difference was found between the skin surface temperatures of medial and lateral aspects of ankle joints. In knee joints the mean temperatures of medial and lateral aspect differed significantly (p = 0.004). We have demonstrated that thermal imaging may have potential for detecting joint inflammation in ankle joints of children. For knee joints our results are inconclusive and further research is warranted. (paper)

  18. Outcomes following double knot suspension arthroplasty for basal joint arthritis of the thumb

    International Nuclear Information System (INIS)

    Various surgical options used in the treatment of osteoarthritis of the basal joint of the thumb that are refractory to non-surgical management. This study was conducted to provide short term functional outcomes using the mentioned technique in treating basal joint arthritis of the thumb. Methods: We treated basal joint arthritis of the thumb by trapeziumectomy and volar oblique ligament reconstruction using flexor carpi radialis tendon and suspension interposition arthroplasty using the entire tendon split along its length and tied as a double knot at the base of the thumb metacarpal. Through a questionnaire based survey, we reviewed 24 thumbs in 24 patients with basal joint arthritis of the thumb who were followed up with the hand therapist. Postal questionnaires were sent to these patients to record DASH scores and satisfaction. Results: The mean time from surgery to discharge by the hand therapist following rehabilitation was 10 weeks. The DASH score averaged 25 points at 12 weeks postoperatively. There was statistical significance (p-value=0.0001) between the DASH score compared with time spent with the hand therapist. The postoperative net difference in grip strength and pinch grip compared with non-operated had was 9 kg and 3 kg respectively and the net difference in web span was 2 cm. Conclusion: We suggest this technique of suspension arthroplasty is a safe and effective method in treating basal joint arthritis of the thumb with good short-term functional outcomes and minimal complications. (author)

  19. Suggested MR staging classification of early rheumatoid arthritis at the metacarpophalangeal and proximal interphalangeal joints

    International Nuclear Information System (INIS)

    Purpose: MRI can demonstrate pathology of joint disease in the early course of rheumatoid arthritis prior to destructions seen on conventional radiographs. In a prospective study, we tried to develop a systematical classification of joint pathology demonstrated by MRI, which would be essential for scoring the course of the disease. Patients and method: Metacarpophalangeal and interphalangeal joints of 48 patients suffering from early rheumatoid arthritis (mean disease duration: 6.4 months) were evaluated by MRI using a high-resolution transmitter-receiver coil. Examinations included 2 mm sliced T2-, T1- and gadolinium enhanced T1-SE sequences in coronal and axial orientation. In consideration of pathological findings on MRI and histopathogenetical pathways of destruction in rheumatoid arthritis a MR-score (0-5) was established. Results: This allowed to score each joint examined: Score 0 (normal) in 47.8%/49.5%, score 1 in 35.5%/50.5%, score 2 in 4.2%/0%, score 3 in 10.8%/0%, score 4 in 1.5%/0% of the metacarpophalangeal/interphalangeal joints, respectively. Conclusions: Using the MR-score a relative individual destruction number can be calculated, which may be used to follow up patients in the early course of rheumatoid arthritis (e.g. drug therapy studies). The presented MR scoring system has to be evaluated further in longitudinal studies and must be correlated to radiographical and clinical findings. (orig.)

  20. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... is Happening to the Joints? Rheumatoid Arthritis: Gaining Control – Working with your Rheumatologist Rheumatoid Arthritis: Additional Conditions ... Arthritis Nutrition & Rheumatoid Arthritis Arthritis and Health-related Quality of Life Rehabilitation Management for Rheumatoid Arthritis Patients ...

  1. Ultrasonographic abnormalities and inter-reader reliability in Danish patients with systemic lupus erythematosus - a comparison with clinical examination of wrist and metacarpophalangeal joints

    DEFF Research Database (Denmark)

    Dreyer, L; Jacobsen, Søren; Juul, L; Terslev, L

    2015-01-01

    OBJECTIVES: We aimed to determine 1) ultrasound (US) abnormalities in patients with systemic lupus erythematosus (SLE) with and without hand arthralgia at the day of examination compared with clinical evaluation and healthy controls, and 2) inter-observer reliability of the US abnormalities....... METHODS: Thirty-three female SLE patients were twice examined with US by three trained examiners. Using B-mode and Doppler US, unilateral wrist and metacarpophalangeal (MCP) joints were examined for synovitis and erosions as well as signs of hand tenosynovitis using a GE Logiq 9 US machine with Doppler...... settings for slow flow. All patients also underwent clinical joint evaluation and were compared with 11 healthy controls (HC). RESULTS: Among the patients with SLE 16 (48%) had signs of wrist synovitis, which was only observed in one HC (p = 0.03). Corresponding figures for any MCP joint were 12 (36%) and...

  2. Bone scan and joint scan of hands and feet in rheumatoid arthritis

    International Nuclear Information System (INIS)

    The aim of this study was to determine the ability of joint scan and bone scan of hands and feet, in patients with rheumatoid arthritis, to localize the altered joints. The sensitivity, the specificity, the positive predictive value (PPV) and the negative predictive value (NPV) of joint scan were determined in comparison with clinical joint assessment. Fifteen patients (780 joints) were clinically examined (pain and synovitis); during the same day, a bone scan and a joint scan were realized by oxidronate 99mTc intravenous injection. Patients were scanned 5 minutes (tissual time, Tt) and 3 hours 1/4 (bone time, T0) after the administration. The uptake of the bi-phosphonate was evaluated with a qualitative method using a grey scale. The uptake of 99mTc oxidronate was quantitated using an extra-articular region of interest. The sensitivity, specificity, PPV and NPV of the scan at Tt were 46%, 96%, 85% et 78%. The same parameters were 75%, 66%, 53% and 84% for the scan realized at T0. The joint scan has showed 22% of false positive. These false positives could be a consequence of an earlier detection of joint alterations by scan. The joint scan should forecast the evolution of joints in patients with rheumatoid arthritis. (author)

  3. Ultrasound colour Doppler measurements in a single joint as measure of disease activity in patients with rheumatoid arthritis--assessment of concurrent validity

    DEFF Research Database (Denmark)

    Ellegaard, K; Torp-Pedersen, S; Terslev, L;

    2009-01-01

    investigated if the amount of CDU activity in a single joint can be used to quantify disease activity in RA. METHODS: A total of 109 patients with RA and affection of the wrist joint underwent a standardized CDU examination assessing three positions in their most affected wrist at start up in biological...

  4. Magnetic resonance imaging of the temporomandibular joint in children with juvenile idiopathic arthritis.

    Science.gov (United States)

    Meyers, Arthur B; Laor, Tal

    2013-12-01

    For more than a century, it has been known that juvenile idiopathic arthritis (JIA) can affect the temporomandibular joint. With advances in medical imaging in more recent decades, there has been an increase in awareness of the spectrum of pathology that can affect the temporomandibular joint in children with JIA. This pathology can lead to symptoms ranging from decreased chewing ability, jaw and facial pain, headaches and malocclusion to craniofacial morphological changes such as a retrognathic mandible. The purpose of this review is to suggest an MR imaging protocol for the temporomandibular joint and to illustrate normal and abnormal appearances of the joint in children with JIA. PMID:24257698

  5. Bilateral sternoclavicular joint septic arthritis secondary to indwelling central venous catheter: a case report

    Directory of Open Access Journals (Sweden)

    Pradhan Charita

    2008-04-01

    Full Text Available Abstract Introduction Septic arthritis of the sternoclavicular joint is rare, comprising approximately 0.5% to 1% of all joint infections. Predisposing causes include immunocompromising diseases such as diabetes, HIV infection, renal failure and intravenous drug abuse. Case presentation We report a rare case of bilateral sternoclavicular joint septic arthritis in an elderly patient secondary to an indwelling right subclavian vein catheter. The insidious nature of the presentation is highlighted. We also review the literature regarding the epidemiology, investigation and methods of treatment of the condition. Conclusion SCJ infections are rare, and require a high degree of clinical suspicion. Vague symptoms of neck and shoulder pain may cloud the initial diagnosis, as was the case in our patient. Surgical intervention is often required; however, our patient avoided major intervention and settled with parenteral antibiotics and washout of the joint.

  6. Juvenile Arthritis

    Science.gov (United States)

    Juvenile arthritis (JA) is arthritis that happens in children. It causes joint swelling, pain, stiffness, and loss of motion. It can affect any joint, but ... of JA that children get is juvenile idiopathic arthritis. There are several other forms of arthritis affecting ...

  7. Lyme disease in the differential diagnosis of rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Ahmet Karadağ

    2016-03-01

    Full Text Available Clinically, there are some differences between rheumatoid arthritis (RA and Lyme disease. Although Lyme arthritis exhibits marked differences from RA, it can cause erosion at joint due to chronic proliferative synovitis as similar to RA. In the literature, a case was reported where both entities were seen together. In this manuscript, we aimed to present a case with symmetric arthritis at small hand joints and arthralgia at wrist that mimicked RA but diagnosed as Lyme disease by history, clinical presentation and laboratory findings, and successfully treated.

  8. Ultrasonography and color Doppler in juvenile idiopathic arthritis

    DEFF Research Database (Denmark)

    Laurell, Louise; Court-Payen, Michel; Nielsen, Susan; Zak, Marek; Fasth, Anders

    2012-01-01

    The wrist region is one of the most complex joints of the human body. It is prone to deformity and functional impairment in juvenile idiopathic arthritis (JIA), and is difficult to examine clinically. The aim of this study was to evaluate the role of ultrasonography (US) with Doppler in diagnosis...

  9. Arthritis of the sternoclavicular joint masquerading as rupture of the cervical oesophagus: a case report

    Directory of Open Access Journals (Sweden)

    Katsoulis Iraklis E

    2009-01-01

    Full Text Available Abstract Introduction Sternoclavicular septic arthritis is a rare condition and accounts only for 1% of cases of septic arthritis in the general population. The most common risk factors are intravenous drug use, central-line infection, distant-site infection, immunosuppression, trauma and diabetes mellitus. This is a report of an unusual case where this type of arthritis was masquerading as rupture of the cervical oesophagus. Case presentation A 63-year-old man presented complaining of right neck pain and dysphagia following a bout of violent coughing. Physical examination revealed cellulitis extending from the right sternoclidomastoid region to the anterior upper chest. Computed tomography showed inflammatory changes behind the right sternoclavicular joint with mediastinitis and ipsilateral pleural effusion. These findings raised the suspicion of spontaneous rupture of the cervical oesophagus. Management involved jejunal feeding along with broad-spectrum antibiotics. The inflammation, however, relapsed after discontinuation of the antibiotics and this time, computed tomography pointed to a diagnosis of arthritis of the sternoclavicular joint. The patient responded completely to a 6-week course of oral penicillin, flucloxacillin and metronidazole. Conclusion Sternoclavicular arthritis is a rare condition that has been associated with a variety of predisposing factors. It may, however, occur in otherwise completely healthy individuals and should be included in the differential diagnosis of other inflammatory conditions of the neck and upper chest.

  10. Investigations in the scintiscanning of joints of animals with experimental and rheumatoid arthritis

    International Nuclear Information System (INIS)

    In 69 guinea pigs with experimental hyperergic arthritis scintiscanning was done to study the course of the inflammation and the deposition of the radionuclides used. During the first days there was an added storage in the inflamed joints of those animals on whom scintiscanning with Tc99m04 had been performed. The accumulation of Tc99m04 in the joints was due to its uptake by synovial tissue and hydrarthrosis as shown by scintiscanning after haemorrhage and perfusion, macroscopic autoradiography and measurements of radioactivity in tissue samples. In 13 animals with rheumatoid arthritis scintiscanning was done twice with Tc99m04 and three times with Tc99mMDP over a period of 13 to 21 months; concomitantly laboratory tests and X-rays were conducted. After Tc99m04 there was a fall in the scintigraphic inflammation index during treatment. That index was determined by forming the quotient from the activities established above the proximal interphalangeal joints and the tibial head. Scintiscanning with Tc99mMDP led to a fall of the inflammation index in animals with classical rheumatoid arthritis, whereas in the ones with probable rheumatoid arthritis it again rose after an initial fall. Unlike x-ray investigation, scintiscanning permits an early diagnosis and course control. (orig.)

  11. Pyogenic arthritis of native joints due to Bacteroides fragilis: Case report and review of the literature.

    Science.gov (United States)

    Nolla, Joan M; Murillo, Oscar; Narvaez, Javier; Vaquero, Carmen Gómez; Lora-Tamayo, Jaime; Pedrero, Salvador; Cabo, Javier; Ariza, Javier

    2016-06-01

    Pyogenic arthritis of native joints due to Bacteroides fragilis seems to be an infrequent disease. We analyzed the cases diagnosed in a tertiary hospital during a 22-year period and reviewed the literature to summarize the experience with this infectious entity.In our institution, of 308 patients with pyogenic arthritis of native joints, B fragilis was the causative organism in 2 (0.6%) cases. A MEDLINE search (1981-2015) identified 19 additional cases.Of the 21 patients available for review (13 men and 8 women, with a mean age, of 54.4 ± 17 years), 19 (90%) presented a systemic predisposing factor for infection; the most common associated illness was rheumatoid arthritis (8 patients). Bacteremia was documented in 65% (13/20) of cases. In 5 patients (24%), 1 or more concomitant infectious process was found. Metronidazole was the most frequently used antibiotic. Surgical drainage was performed in 11 cases (52%). The overall mortality rate was 5%.Pyogenic arthritis of native joints due to B fragilis is an infrequent disease that mainly affects elderly patients with underlying medical illnesses and in whom bacteremia and the presence of a concomitant infectious process are frequent conditions. PMID:27336895

  12. Modes of Presentation of Reactive Arthritis Based on the Affected Joints

    OpenAIRE

    Lahu, Ali; Backa, Teuta; Ismaili, Jehona; Lahu, Vendenis; Saiti, Valton

    2015-01-01

    Introduction: Reactive arthritis is an autoimmune condition that occurs as a reaction against an infection site elsewhere in the body. Reactive arthritis affects mostly young ages, mainly group age 20-40 y.o., mostly males with ratio 2:1 against females, sometimes 3:1, and even 14:1. The purpose of the study was to observe the mode of illness presentation based on the number of affected joints. Material and Methods: During the 01.03.2012 – 01.03.2014 in the Clinic for Rheumatology and O.S.I.R...

  13. Effect of Chinese traditional treatment to abate the wrist joint's rigidity after Colles fracture%中医手法改善Colles骨折后腕关节僵硬的疗效观察

    Institute of Scientific and Technical Information of China (English)

    胡晓芳; 孟冬娅

    2001-01-01

    @@ Background:The wrist joint's rigidity is commonly seen in the following conditions: absence of early correct dirigation after reposition and fixation or fixation for too long time, caused patients' functional activities to be limited.

  14. MRI pattern of arthritis in systemic lupus erythematosus: a comparative study with rheumatoid arthritis and healthy subjects

    International Nuclear Information System (INIS)

    In this study we aimed to describe the magnetic resonance imaging (MRI) pattern of the distribution of bone marrow edema (BME) and joint erosion in hands and wrists of patients with systemic lupus erythematosus (SLE) with arthritis in comparison with rheumatoid arthritis (RA) and healthy subjects (H). SLE patients with arthritis (n = 50), patients with RA (n = 22), and H (n = 48) were enrolled. Every patient underwent a non-dominant hand (2nd-5th metacarpophalangeal joints) and wrist MRI without contrast injection with a low-field extremity dedicated 0.2-Tesla instrument. BME was observed in two SLE patients in the hand (4 %) and in 15 in the wrist (13 %) versus three (30 %), and 14 (63 %) RA patients. No BME was found in H. Erosions were observed in the hand in 24 SLE patients (48 %), 15 RA patients (68 %), and 9 H (18 %); in the wrist, in 41 (82 %) SLE, all RA and 47 (97 %) H. The cumulative erosive burden in SLE was significantly higher than in H (c = 0.002) but similar to RA patients. Joint involvement of the wrist in SLE is similar to RA and is not as rare as expected, as shown by the comparison with healthy subjects. On the contrary, the involvement of the hand in SLE is significantly lower compared to RA. (orig.)

  15. MRI pattern of arthritis in systemic lupus erythematosus: a comparative study with rheumatoid arthritis and healthy subjects

    Energy Technology Data Exchange (ETDEWEB)

    Tani, Chiara; Possemato, Niccolo; Delle Sedie, Andrea; Bombardieri, Stefano; Mosca, Marta [University of Pisa, Rheumatology Unit, Department of Clinical and Experimental Medicine, Pisa (Italy); D' aniello, Dario; Caramella, Davide [Radiology Unit, University of Pisa, Pisa (Italy)

    2014-10-24

    In this study we aimed to describe the magnetic resonance imaging (MRI) pattern of the distribution of bone marrow edema (BME) and joint erosion in hands and wrists of patients with systemic lupus erythematosus (SLE) with arthritis in comparison with rheumatoid arthritis (RA) and healthy subjects (H). SLE patients with arthritis (n = 50), patients with RA (n = 22), and H (n = 48) were enrolled. Every patient underwent a non-dominant hand (2nd-5th metacarpophalangeal joints) and wrist MRI without contrast injection with a low-field extremity dedicated 0.2-Tesla instrument. BME was observed in two SLE patients in the hand (4 %) and in 15 in the wrist (13 %) versus three (30 %), and 14 (63 %) RA patients. No BME was found in H. Erosions were observed in the hand in 24 SLE patients (48 %), 15 RA patients (68 %), and 9 H (18 %); in the wrist, in 41 (82 %) SLE, all RA and 47 (97 %) H. The cumulative erosive burden in SLE was significantly higher than in H (c = 0.002) but similar to RA patients. Joint involvement of the wrist in SLE is similar to RA and is not as rare as expected, as shown by the comparison with healthy subjects. On the contrary, the involvement of the hand in SLE is significantly lower compared to RA. (orig.)

  16. MRI对早期类风湿性关节炎手及腕部关节的诊断价值分析%value analysis of MRI in the diagnosis of early rheumatoid arthritis hand and wrist

    Institute of Scientific and Technical Information of China (English)

    王长河

    2015-01-01

    ObJective To investigate the clinical value of MRI on the diagnosis of early rheuma-toid arthritis hand and wrist. Methods The 114 patients with multi-joint pain in the central hospital of Zhumadian from February 2011 to April 2014 were ranclomly selectecl,and conducted hand and wrist MRI scan,the scan signs were observed,and compare with the clinical diagnosis results. Results When used enhance or thickening of the synovial symmetry as a diagnostic standard,the sensitivity,specificity and accuracy had significant advantages,which was 85. 2%,86. 4%,85. 5% respectively;when there was any of symmetry synovial thickening or enhance,the incidence of RA increased significantly. Conclu-sions Symmetry is a thickening of the synovial enhancement or MRI signs of RA-specific,clinical diag-nosis should improve patients for the presence of the signs of vigilance,and combined with other MRI findings confirm the diagnosis.%目的:探讨手、腕部关节MRI对于诊断类风湿性关节炎的临床价值。方法随机选取驻马店市中心医院2011年2月至2014年4月收治的主诉多关节痛患者114例,对患者进行手及腕部关节MRI扫描,对患者的MRI扫描征象进行观察,并同临床诊断结果进行分析对比。结果将对称性滑膜增强或增厚作为诊断标准时,其灵敏度、特异度和准确度具有显著优势,分别为85.2%、86.4%、85.5%;当患者存在对称性滑膜增厚或增强合并任一MRI征象时,其RA的发生率明显上升。结论对称性滑膜增强或增厚是一种RA特异性MRI征象,临床诊断时应提高对于存在该征象患者的警惕性,并结合其他MRI征象明确诊断。

  17. Arthroscopic findings in patients with painful wrist ganglia.

    Science.gov (United States)

    Povlsen, B; Peckett, W R

    2001-09-01

    The aetiology of painful dorsal wrist ganglia remains obscure. In a prospective study we investigated the link between a painful dorsal wrist ganglion and wrist joint abnormality with wrist arthroscopy before excision of the ganglion. Of 16 wrists arthroscoped 12 were abnormal, 10 had an abnormal scapholunate joint, and two had abnormal lunatetriquetral joints. We think that painful dorsal wrist ganglia, like popliteal cysts in the knee, are markers of underlying joint abnormalities. Surgeons who treat painful ganglia should be aware of a possible underlying cause so that they can target treatment more accurately, particularly in recurrent cases and those patients with persistent wrist pain after excision of the ganglion. PMID:11680404

  18. 手腕关节类风湿关节炎影像学诊断及对比分析%Contrastive analysis and diagnosis of rheumatoid arthritis in wrist and hand

    Institute of Scientific and Technical Information of China (English)

    赵彤; 刘威; 张媛媛

    2015-01-01

    Objective To observe the changes of synovial membranes,morphological erosion findings and locations of hands and wrists in rheumatoid arthritis ( RA) patients and analyze those findings found in magnetic resonance imaging ( MRI) , ultrasonography ( US) , and X-ray contrastively.Methods Thirty patients who were diagnosed as RA were selected from Marth 2010 to September 2014 in Beijing Shangdi Hospital.The affected conditions of patients ’ hands and wrists were observed and recorded by MRI, US, and X-ray images, and the differences were analyzed among the three examination methods. Results In X-ray images, eight patients were normal.Hands and wrists were affected in 20 patients;osteoporosis was found in 12 patients;swelling of proximal interphalangeal ( PIP) joint were found in seven patients and simple swelling of metacarpal phalangeal ( MCP) joint was found in one patient, bone erosion was found in one patient.In US examination, all the patients showed affected soft tissue with US signs:four of them were affected with bone erosion, 27 of them were hydrarthrosis,19 patients were peritendinitis of dorsal extensor tendon, 28 patients were synovitis.In MRI images, bone erosion or bone marrow edema was presented in 11 patients:six of them were bone erosion including one PIP joint, four MCP joints, and one wrist;both bone erosion and bone marrow edema were presented in five patients.Thickened synovial membrane was found in all the patients including eight MCP joints, 10 PIP joint;four patients were affected in both MCP and PIP joints.Conclusion MRI and US can display the pathological changes of early RA accurately, and can present abnormal synovial membrane and bone erosion better than X-ray images.%目的:观察类风湿关节炎(RA)手腕关节的滑膜改变及骨质侵蚀的形态、部位等在核磁共振( MRI)、关节超声( US)及X线上的表现,同时进行对比分析。方法从2010年3月至2014年9月在北京市上地

  19. Radiographic temporomandibular joint abnormality in adults with micrognathia and juvenile rheumatoid arthritis

    International Nuclear Information System (INIS)

    Radiographic findings of the upper and lower jaw bone of 20 adult patients with micrognathia, bird face, and juvenile rheumatoid arthritis are reported. In all patients a symmetrically underdeveloped mandible with the chin posteriorly positioned was found at cephalometry. Arthritic lesion of the temporomandibular joint, mostly symmetric, with limitation of movement and secondary arthrosis, was observed in all patients. Complete absence of the mandibular head was frequent (75%). The fossa was generally flat, probably due to growth disturbance of the tubercle. Abnormal anterior position of the mandibular head occurred in almost half of the patients. The degree of mandibular growth disturbance seemed to be correlated to the severity of the arthritis, indicating the arthritis to be a causal mechanism of micrognathia. (Auth.)

  20. Radiographic temporomandibular joint abnormality in adults with micrognathia and juvenile rheumatoid arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Larheim, T.A.; Haanaes, H.R.; Dale, K. (Oslo Univ. (Norway))

    1981-01-01

    Radiographic findings of the upper and lower jaw bone of 20 adult patients with micrognathia, bird face, and juvenile rheumatoid arthritis are reported. In all patients a symmetrically underdeveloped mandible with the chin posteriorly positioned was found at cephalometry. Arthritic lesion of the temporomandibular joint, mostly symmetric, with limitation of movement and secondary arthrosis, was observed in all patients. Complete absence of the mandibular head was frequent (75%). The fossa was generally flat, probably due to growth disturbance of the tubercle. Abnormal anterior position of the mandibular head occurred in almost half of the patients. The degree of mandibular growth disturbance seemed to be correlated to the severity of the arthritis, indicating the arthritis to be a causal mechanism of micrognathia.

  1. Wrist pain

    Science.gov (United States)

    ... the wrist that allows feeling and movement to parts of the hand. Swelling can occur if you: Do repetitive movements with your wrist, such as typing on a computer keyboard, using a computer mouse, playing racquetball or ...

  2. Radiosynovectomy of the knee joint in chronic arthritis

    International Nuclear Information System (INIS)

    185 MBq (5 mCi) colloidal 198-aurothioglucose (198Au) or colloidal yttrium-90-silicate (90Y) in 10 ml 0.9% NaCl was injected into knee joint cavity after aspiration of joint fluid. After that the patient stayed in bed for 3 days. Clinical examination, erythrocyte sedimentation rate, 99mTc-pertechnetate uptake measurements and radiographs of the knee joints were performed at baseline and during follow-up. Main results, group 1. evaluation after 6 months and after 3 years showed significantly better results in the group of knee joints with no minimal pre-existing radiological abnormalities compared with the group of knee joints with moderate or severe radiological abnormalities (p90Y, 50% of the treated knees showed clinical improvement of the synovitis. Group 3. a significant reduction of haemarthrotic episodes of all 6 joints treated and a reduction of pain in 4 during a follow-up of 2.5 years.It is concluded that radiosynovectomy is a valuable and simple form of treatment for therapy-resistant chronic synovitis. (author). 20 refs.; 3 tabs

  3. MRI of the hand and wrist joint of climbers. Imaging of lesions and overstrain injury. Die MRT von Hand und Handgelenk bei Sportkletterern. Darstellung von Verletzungen und Ueberlastungsfolgen

    Energy Technology Data Exchange (ETDEWEB)

    Heuck, A. (Technische Univ. Muenchen (Germany). Inst. und Poliklinik fuer Strahlentherapie und Radiologische Onkologie); Hochholzer, T.; Keinath, C. (Technische Univ. Muenchen (Germany). Klinik und Poliklinik fuer Sportverletzungen)

    1992-05-01

    The hands and wrists of 20 top-level rock climbers with sports injuries and overstress abnormalities were compared with the hands and wrists of 10 normal volunteers. They were all studied with MR imaging at 1.5 T. The imaging protocol included spin-echo and gradient-echo sequences with 1- to 5-mm-thick contiguous slices in the axial, coronal and/or sagittal planes, depending on the location and nature of the suspected injury. Typical hand and wrist lesions depicted with MRI in climbers consisted of annular ligament tears, lesions of the flexor tendons, tenosynovitis, ganglion cysts, joint effusion and functional carpal tunnel syndrome. The MRI findings on these abnormalities were compared to normal findings and those with ultrasound and plain films. In addition, hypertrophic changes in the muscles, tendons, ligaments, and bones of top-level rock climbers were assessed morphometrically. MRI proved to be the superior imaging modality in the diagnosis of sports injuries and overstress abnormalities of the hand the wrist in rock-climbing athletes. (orig.).

  4. MRI bone oedema is the strongest predictor of subsequent radiographic progression in early rheumatoid arthritis. Results from a 2 year randomized controlled trial (CIMESTRA)

    DEFF Research Database (Denmark)

    Hetland, Merete Lund; Ejbjerg, Bo Jannik; Hørslev-Petersen, Kim;

    2008-01-01

    OBJECTIVE: To identify predictors of radiographic progression in a 2-year randomized, double-blind clinical study (CIMESTRA) of patients with early rheumatoid arthritis (RA). METHODS: Early RA patients (N=130) were treated with methotrexate, intra-articular betamethasone and cyclosporine...... predictor of delta-TSS (wrist+MCP-group: coefficient=0.75 (95%CI: 0.56-0.97), p<0.00001; wrist-only-group: coefficient=0.56 (0.41-0.77), p<0.00001). Bone oedema score explained 41% of the variation in the progression of TSS (wrist+MCP-group), 25% in wrist-only-group, (Pearson's r=0.64 and r=0.......50, respectively). The results were confirmed by sensitivity analyses. CONCLUSION: In a RCT aiming at remission in early RA patients, baseline RAMRIS MRI bone oedema score of MCP and wrist joints (and of wrist only) was the strongest independent predictor of radiographic progression in hands, wrists and forefeet...

  5. Lumbar Facet Joint Arthritis Is Associated with More Coronal Orientation of the Facet Joints at the Upper Lumbar Spine

    OpenAIRE

    Thorsten Jentzsch; James Geiger; Zimmermann, Stefan M.; Ksenija Slankamenac; Thi Dan Linh Nguyen-Kim; Clément M. L. Werner

    2013-01-01

    We retrospectively analyzed CT scans of 620 individuals, who presented to our traumatology department between 2008 and 2010. Facet joint (FJ) arthritis was present in 308 (49.7%) individuals with a mean grade of 1. It was seen in 27% of individuals ≤40 years and in 75% of individuals ≥41 years (P < 0.0001) as well as in 52% of females and 49% of males (P = 0.61). Mean FJ orientation was 30.4° at L2/3, 38.7° at L3/4, 47° at L4/5, and 47.3° at L5/S1. FJ arthritis was significantly associated wi...

  6. Lumbar facet joint arthritis is associated with more coronal orientation of the facet joints at the upper lumbar spine

    OpenAIRE

    Jentzsch, Thorsten; Geiger, James; Zimmermann, Stefan M.; Slankamenac, Ksenija; Nguyen-Kim, Thi Dan Linh; Werner, Clément M. L.

    2013-01-01

    We retrospectively analyzed CT scans of 620 individuals, who presented to our traumatology department between 2008 and 2010. Facet joint (FJ) arthritis was present in 308 (49.7%) individuals with a mean grade of 1. It was seen in 27% of individuals ≤40 years and in 75% of individuals ≥41 years (P < 0.0001) as well as in 52% of females and 49% of males (P = 0.61). Mean FJ orientation was 30.4° at L2/3, 38.7° at L3/4, 47° at L4/5, and 47.3° at L5/S1. FJ arthritis was significantly associated wi...

  7. Local Gene Transfer of OPG Prevents Joint Damage and Disease Progression in Collagen-Induced Arthritis

    OpenAIRE

    Qingguo Zhang; Weiming Gong; Bin Ning; Lin Nie; Paul H. Wooley; Shang-You Yang

    2013-01-01

    This study examined the influence of osteoprotegerin (OPG) gene transfer on a murine collagen-induced arthritis model. A single periarticular injection of AAV-OPG or AAV-LacZ on the arthritic paw successfully incorporated the exogenous gene to the local tissue and resulted in marked transgene expression in the joint homogenate for at least three weeks. Clinical disease scores were significantly improved in OPG treated mice starting at 28-day post-treatment (P < 0.05). Histological assessment ...

  8. Primary septic arthritis of the manubriosternal joint in a heroin user

    International Nuclear Information System (INIS)

    A 20-year-old heroin user developed staphylococcus septic arthritis of the manubrium joint. The diagnosis was established by a culture of the infected tissue and blood culture. The clinical impression was aided by 99mTc radionuclide scintimetry. Early diagnosis localized the infection. Immediate antibiotic therapy solved a problem in the sternum that seems not to have been reported in the English literature

  9. Temporomandibular joint involvement in juvenile idiopathic arthritis: treatment with an orthodontic appliance

    OpenAIRE

    Gattinara, M; Gerloni, V; P. Ghiringhelli; C. Bellintani; G. Farronato; F. Fantini

    2011-01-01

    Introduction and purpose: About 65% of children suffering from juvenile idiopathic arthritis (JIA) shows a more or less marked involvement of temporo-mandibular joint (TMJ) with altered mandibular growth, resorption of the condyles, occlusary instability, reduced chewing ability and facial dysmorphia. The purpose of our study is to prevent and to treat the progressive evolution of JIA on craniofacial growth and morphology with a functional appliance; surgery should be considered only in so fa...

  10. Rubella-associated arthritis. II. Relationship between circulating immune complex levels and joint manifestations.

    OpenAIRE

    Singh, V. K.; Tingle, A J; Schulzer, M

    1986-01-01

    The role played by raised circulating immune complex (CIC) levels in the pathogenesis of rubella-associated joint reactions has been assessed during the course of RA 27/3 rubella immunisation and epidemic wild rubella infection. CIC levels were evaluated by C1q microplate enzyme-linked immunosorbent assay (ELISA) and Raji cell ELISA techniques. Mean CIC levels were generally higher both before and after immunisation among individuals developing vaccine-associated arthritis than among those de...

  11. Septic arthritis of unilateral lumbar facet joint with contiguous abscess, without prior intervention

    OpenAIRE

    Harries, Luke William; Watura, Roland

    2012-01-01

    A 40-year-old female patient presented with persistent severe back pain radiating to the right leg, abdominal pain and constipation. Other clinical symptoms included nausea, vomiting and high-grade fever. Clinical examination showed generalised abdominal and lower back tenderness. There was no sensory loss or motor weakness in lower limbs, however investigations showed raised inflammatory markers. Radiographs of the lumbar spine and hip joint were normal. MRI revealed a septic arthritis of th...

  12. Radiation investigations to assess of the results of radiosynoviorthesis of the knee joints in patients with rheumatoid arthritis

    International Nuclear Information System (INIS)

    Fifty-two patients with rheumatoid arthritis were examined, to whom colloid solution of gold-198 was injected with therapeutic purposes in 100 knee joints. Clinical and laboratory studies, roentgenography, sonography, arthropneumography, scintigraphy using 113mIn-DTPA, and radionuclide scanning of the joints after injection of gold-198 were carried out before and a year after radiosynoviorthesis of the knee joints The findings indicate a high efficacy of comprehensive examinations of the knee joints in patients with rheumatoid arthritis in the course of therapy with colloid gold-198. 6 refs., 5 tabs

  13. Lumbar Facet Joint Arthritis Is Associated with More Coronal Orientation of the Facet Joints at the Upper Lumbar Spine

    International Nuclear Information System (INIS)

    We retrospectively analyzed CT scans of 620 individuals, who presented to our traumatology department between 2008 and 2010. Facet joint (FJ) arthritis was present in 308 (49.7%) individuals with a mean grade of 1. It was seen in 27% of individuals ≤40 years and in 75% of individuals ≥41 years ( Ρ <0.0001) as well as in 52% of females and 49% of males ( Ρ=0.61). Mean FJ orientation was 30.4° at L2/3, 38.7° at L3/4, 47° at L4/5, and 47.3° at L5/S1. FJ arthritis was significantly associated with more coronal (increased degree) FJ orientation at L2/3 (Ρ=0.03) with a cutoff point at ≥32°. FJs were more coronally oriented (48.8°) in individuals ≤40 years and more sagittally oriented (45.6°) in individuals ≥41 years at L5/S1 (Ρ=0.01). Mean FJ asymmetry was 4.89° at L2/3, 6.01° at L3/4, 6.67° at L4/5, and 7.27° at L5/S1, without a significant difference for FJ arthritis. FJ arthritis is common, increases with age, and affects both genders equally. More coronally oriented FJs (≥32°) in the upper lumbar spine may be an individual risk factor for development of FJ arthritis.

  14. Arthritis and the Feet

    Science.gov (United States)

    ... RSS Home » Learn About Feet » Foot Health Information Arthritis What is Arthritis? Arthritis, in general terms, is inflammation and swelling of ... an increase in the fluid in the joints. Arthritis has multiple causes; just as a sore throat ...

  15. Ultrasound-guided wrist radio synovectomy: Case report and topic review

    International Nuclear Information System (INIS)

    Radio synovectomy is a local form of radiotherapy used as second-line treatment in the management of inflammatory and non-inflammatory arthropathies with unsatisfactory response to local or systemic corticosteroid therapy. Its efficacy is similar to that of surgical synovectomy, with the advantages of being a low-cost and minimally- invasive treatment that requires a shorter recovery time. Its efficacy is greater in the treatment of inflammatory arthritis characterized by synovitis, such as rheumatoid arthritis and juvenile chronic arthritis with mono/ oligo articular involvement, especially in upper extremity joints. A number of isotopes can be used in colloidal suspensions. Rhenium-186-sulphide colloid is currently indicated for the treatment of medium-sized joints. The ultrasound-guided injection is suitable for small joints, such as wrist. For proper and safe use and administration of this technique the collaboration of a trained and experienced radiologist is critical to successful treatment

  16. /sup 133/Xe clearance of the knee joint of patients suffering from arthritis and osteoarthrosis

    Energy Technology Data Exchange (ETDEWEB)

    Balint, G.; Reviczky, L.A.; Lendvay, J.; Boehm, U.; Kucsera, K.; Genti, Gy. (Orszagos Reuma es Fizioterapias Intezet, Budapest (Hungary))

    1982-01-01

    65 inflammed and 13 non-inflammed knee joints of patients suffering from osteoarthrosis were examined by the Xe/sup 133/ clearance method. The control group consisted of 27 patients with exsudative arthritis of the knee. The counts of 80 ..mu..C /sup 133/Xe given intraarticcularly were measured above the knee joint by NK 350 energy selective counter. The time needed to halve the count rate measured in the 4th minute after administration (biological half life (T1/2)) was significantly different in the three groups. It was the longest in the non-inflammed arthrosis, the shortest in the exsudative arthritis group. Significant differences were apparent regarding joint pain and tenderness in all the three groups. Though the synovial protein level and the C/sub 3/ complement level were significantly different, in the three groups no relationship was found between the T1/2 and synovial/serum protein ratio or between the synovial/serum C/sub 3/ ratio. The authors concluded that /sup 133/Xe clearance, which measures the perfusion of the synovial membrane, can be used for measuring the inflammatory activity of knee joint synovitis.

  17. The value of MRI in the diagnosis of early rheumatoid arthritis on hand and wrist%双手、腕关节MRI对早期类风湿性关节炎的诊断价值

    Institute of Scientific and Technical Information of China (English)

    刘艳杰; 蔡跃增; 陈月芹; 孔维惠; 王小强; 孙本政

    2013-01-01

    目的 探讨MRI对早期类风湿性关节炎(rheumatoid arthritis,RA)的诊断价值.方法 对40例早期RA患者(26例为临床确诊,14例为随访确诊)行双手、腕关节MR扫描,观察有无滑膜增厚/血管翳强化、骨侵蚀、骨髓水肿、腱鞘炎和关节积液等征象,同时收集患者的临床症状和实验室指标,分析各种MR征象和临床指标在临床诊断和随访诊断RA的诊断价值.选取10例正常志愿者作对照.结果 MR表现在临床确诊RA组和随访确诊RA组间比较差异无统计学意义(P>0.05);对称性关节肿胀、3处及以上关节肿胀、内分湿因子(RF)及C反应蛋白(CRP)在2组比较差异有统计学意义(P<0.05).结论 早期RA临床症状、实验室指标不具特征性是延误病情的主要原因,MR增强可显示早期RA的滑膜改变和骨侵蚀,为临床正确诊断和早期治疗提供可靠的依据.%Objective To investigate the value of the MRI in the diagnosis of early rheumatoid arthritis (RA). Methods Both hands and wrists of all the 40 patients with early RA (26 patients with clinical diagnosed RA, the other 14 with 6-12 months follow-up diagnosed RA) underwent MR examination. MRI appearances including synovial hyperplasia and/or enhanced pannus, bone erosion, bone marrow edema, tenosynovitis and joint effusion were observed. The clinical data and laboratory examinations were also collected from all subjects. The value of MRI and clinical data were analyzed in diagnosis of RA. Ten healthy volunteers were selected as control group. Results All the MRI features had no significant difference between the clinical diagnosed group and the following diagnosed group(P>0. 05). The differences of symmetric swelling joints, three or more swelling joints, CRP and RF had statistical significant difference between the two groups(P<0. 05). Conclusion The main reason of misdiagnosis of early RA is that the clinical and laboratory tests are not characteristic. The post-contrast medium

  18. Gadolinium-enhanced MRI features of acute gouty arthritis on top of chronic gouty involvement in different joints

    NARCIS (Netherlands)

    Emad, Yasser; Ragab, Yasser; El-Naggar, Ahmed; El-Shaarawy, Nashwa; Abd-Allah, Mayada A.; Gamal, Rania M.; Fathy, Ahmed; Hawass, Mona; Rasker, Hans

    2015-01-01

    The aims of the current study are to describe gadolinium-enhanced MRI features of an acute flare of established gouty arthritis in different joints and to examine a possible association between serum uric acid and MRI signs indicative of ongoing inflammation and/or structural joint damage as well as

  19. Arthroscintigraphy in diagnosis of relapses after early synovectomy of the knee joints in patients with rheumatoid arthritis

    International Nuclear Information System (INIS)

    The authors studied differential diagnostic possibilities of scintigraphy with the use of sup(99m)Tc-pyrophosphate to reveal relapses after early synovectomy of the knee joints in 40 patients with rheumatoid arthritis. High informativeness of the method was established. The authors succeded in diagnosing the subclinical variant of rheumatoid synovitis in the operated joints by means of scintigraphy. The computer-arthroscintigraphy method with sup(99m)Tc-pyrophosphate is recommended for a wide use in arthrological practice to ensure an objective assessment of the condition of the operated joints in patients with rheumatoid arthritis and to conduct timely adequate therapy for the prevention of the relapses

  20. Diagnosis and treatment of intraosseous ganglion cysts of the wrist joint%腕关节骨内腱鞘囊肿的诊断与治疗

    Institute of Scientific and Technical Information of China (English)

    刘坤; 田文; 刘波; 杨勇; 田光磊

    2014-01-01

    目的:探讨腕关节骨内腱鞘囊肿的临床特点和治疗方法。方法2008年7月至2012年7月,收治18例(20侧)腕关节骨内腱鞘囊肿患者。男5例,女13例,平均33.5岁。月骨11例,舟骨6例,三角骨、大多角骨和小多角骨各1例。主要症状为腕部酸胀不适、疼痛,伴握力下降和活动度降低。X 线平片显示腕骨内圆形或类圆形骨密度减低区,边界清楚,有硬化缘。CT 及 MRI 显示病灶内为液体。均采用病灶刮除+自体松质骨移植术治疗,术后腕关节功能位固定4周。结果18例获3个月至4年的随访,平均15个月。病理证实为腱鞘囊肿者18例。术后疼痛消失10例,减轻7例,3例无缓解。16例握力下降者有14例得到改善。6例术后腕关节屈伸活动度下降。复发1例。术后改良Mayo腕关节评分优10例,良8例,一般2例。结论腕关节骨内腱鞘囊肿是慢性腕关节疼痛原因之一,其确诊需将临床症状、影像学表现、术中所见和病理结果相结合,手术效果满意。%Objective To investigate the clinical characteristics and treatment methods of intraosseous ganglion cysts of the wrist joint. Methods From July 2008 to July 2012, 18 patients ( 20 wrists ) with intraosseous ganglion cysts in the wrist joint were adopted. There were 5 males and 13 females, whose average age was 33.5 years old. There were 11 cases in the lunate, 6 cases in the scaphoid, 1 case in the triangular bone, 1 case in the large multangular bone and 1 case in the small multangular bone. The main complaint was chronic wrist pain, decreased grip strength and limitation of wrist extension-lfexion movement. The X-ray showed circular and quasi-circular areas of reduced bone mineral density within the carpal bone with a clear boundary and slightly sclerotic margin. The CT and MRI revealed the liquid content. All the patients were treated by curettage of the ganglion cysts and autologous cancellous bone

  1. Potential of optical spectral transmission measurements for joint inflammation measurements in rheumatoid arthritis patients

    Science.gov (United States)

    Meier, A. J. Louise; Rensen, Wouter H. J.; de Bokx, Pieter K.; de Nijs, Ron N. J.

    2012-08-01

    Frequent monitoring of rheumatoid arthritis (RA) patients enables timely treatment adjustments and improved outcomes. Currently this is not feasible due to a shortage of rheumatologists. An optical spectral transmission device is presented for objective assessment of joint inflammation in RA patients, while improving diagnostic accuracy and clinical workflow. A cross-sectional, nonrandomized observational study was performed with this device. In the study, 77 proximal interphalangeal (PIP) joints in 67 patients have been analyzed. Inflammation of these PIP joints was also assessed by a rheumatologist with a score varying from 1 (not inflamed) to 5 (severely inflamed). Out of 77 measurements, 27 were performed in moderate to strongly inflamed PIP joints. Comparison between the clinical assessment and an optical measurement showed a correlation coefficient r=0.63, p<0.001, 95% CI [0.47, 0.75], and a ROC curve (AUC=0.88) that shows a relative good specificity and sensitivity. Optical spectral transmission measurements in a single joint correlate with clinical assessment of joint inflammation, and therefore might be useful in monitoring joint inflammation in RA patients.

  2. Fungal arthritis

    Science.gov (United States)

    ... and irritation (inflammation) of a joint by a fungal infection. It is also called mycotic arthritis. Causes Fungal ... symptoms of fungal arthritis. Prevention Thorough treatment of fungal infections elsewhere in the body may help prevent fungal ...

  3. Thumb Arthritis

    Science.gov (United States)

    ... Hand Therapist? Media Find a Hand Surgeon Thumb Arthritis Email to a friend * required fields From * To * ... A joint is where bones connect and move. Arthritis is thinning of the cartilage, which is the ...

  4. Association between condylar morphology and inflammation in experimental temporomandibular joint TMJ arthritis

    DEFF Research Database (Denmark)

    Kristensen, Kasper Dahl; Stoustrup, Peter bangsgaard; Küseler, Annelise;

      Background: In juvenile idiopathic arthritis involvement of the temporomandibular joints (TMJs) is often associated with severe mandibular growth deviations. The relation between condylar growth deviations, inflammation severity, the micro-architectural composition, and the bone quality has...... arthritis treated with intraarticular saline, intra-articular etanercept (an anti-TNF-α drug) or subcutaneous etanercept. One TMJ from each animal was scanned using micro-computed tomography and structural parameters were calculated. Three-dimensional reconstructions of the mandibular condyle were scored......: Abnormal morphology was seen in 15 of 32 animals available for data analysis and was strongly related to the degree of inflammation. However, no differences in trabecular structural parameters or mineral apposition rate were seen according to treatment. Erosions were an uncommon finding. Abnormal condylar...

  5. Therapeutic effects of TNF-α antagonist etanercept and methotrexate on antigen-induced arthritis of the temporomandibular joint

    OpenAIRE

    Rafayelyan, Smbat

    2015-01-01

    Background: Juvenile idiopathic arthritis (JIA) of the temporomandibular joint (TMJ) can cause severe growth disturbances of the craniomandibular system. Antigen-induced arthritis (AIA) of the rabbit TMJ is simulating the inflammatory process of the TMJ in JIA. In the first two studies of the present thesis the effect of a systemic administration of the tumor necrosis factor-alpha (TNF-α) antagonist etanercept and methotrexate (MTX) on AIA in young rabbits should be investigate...

  6. Hip joint structures assessment in juvenile idiopathic (chronic arthritis with ultrasound TOC \\o "1-5" \\h \\z examination

    Directory of Open Access Journals (Sweden)

    G. R. Movsisyan

    2004-01-01

    Full Text Available Sonographic (SG examination of hip joints was performed in 100 pts with juvenile chronic arthritis (JCA with different forms, activity and duration. SG signs of hip joint inflammation in JCA were identified. SG features in pts with different disease duration, form and activity were revealed. SG changes of clinically unchanged hip joints were noted which may be of important significance for early diagnosis of coxitis. More wide use of arthrosonography in pediatric rheumatology was proved.

  7. A Patient-Specific Foot Model for the Estimate of Ankle Joint Forces in Patients with Juvenile Idiopathic Arthritis

    OpenAIRE

    Prinold, J.A.I.; Mazza, C; Di Marco, R.; Hannah, I.; Malattia, C; Magni-Manzoni, S; Petrarca, M.; Ronchetti, A.B.; de Horatio, L.T.; van Dijkhuizen, E.H.P.; Wesarg, S; Viceconti, M.

    2015-01-01

    Juvenile idiopathic arthritis (JIA) is the leading cause of childhood disability from a musculoskeletal disorder. It generally affects large joints such as the knee and the ankle, often causing structural damage. Different factors contribute to the damage onset, including altered joint loading and other mechanical factors, associated with pain and inflammation. The prediction of patients’ joint loading can hence be a valuable tool in understanding the disease mechanisms involved in structural...

  8. Distal radioulnar joint injuries.

    Science.gov (United States)

    Thomas, Binu P; Sreekanth, Raveendran

    2012-09-01

    Distal radioulnar joint is a trochoid joint relatively new in evolution. Along with proximal radioulnar joint, forearm bones and interosseous membrane, it allows pronosupination and load transmission across the wrist. Injuries around distal radioulnar joint are not uncommon, and are usually associated with distal radius fractures,fractures of the ulnar styloid and with the eponymous Galeazzi or Essex_Lopresti fractures. The injury can be purely involving the soft tissue especially the triangular fibrocartilage or the radioulnar ligaments. The patients usually present with ulnar sided wrist pain, features of instability, or restriction of rotation. Difficulty in carrying loads in the hand is a major constraint for these patients. Thorough clinical examination to localize point of tenderness and appropriate provocative tests help in diagnosis. Radiology and MRI are extremely useful, while arthroscopy is the gold standard for evaluation. The treatment protocols are continuously evolving and range from conservative, arthroscopic to open surgical methods. Isolated dislocation are uncommon. Basal fractures of the ulnar styloid tend to make the joint unstable and may require operative intervention. Chronic instability requires reconstruction of the stabilizing ligaments to avoid onset of arthritis. Prosthetic replacement in arthritis is gaining acceptance in the management of arthritis. PMID:23162140

  9. Distal radioulnar joint injuries

    Directory of Open Access Journals (Sweden)

    Binu P Thomas

    2012-01-01

    Full Text Available Distal radioulnar joint is a trochoid joint relatively new in evolution. Along with proximal radioulnar joint , forearm bones and interosseous membrane, it allows pronosupination and load transmission across the wrist. Injuries around distal radioulnar joint are not uncommon, and are usually associated with distal radius fractures,fractures of the ulnar styloid and with the eponymous Galeazzi or Essex_Lopresti fractures. The injury can be purely involving the soft tissue especially the triangular fibrocartilage or the radioulnar ligaments.The patients usually present with ulnar sided wrist pain, features of instability, or restriction of rotation. Difficulty in carrying loads in the hand is a major constraint for these patients. Thorough clinical examination to localize point of tenderness and appropriate provocative tests help in diagnosis. Radiology and MRI are extremely useful, while arthroscopy is the gold standard for evaluation. The treatment protocols are continuously evolving and range from conservative, arthroscopic to open surgical methods. Isolated dislocation are uncommon. Basal fractures of the ulnar styloid tend to make the joint unstable and may require operative intervention. Chronic instability requires reconstruction of the stabilizing ligaments to avoid onset of arthritis. Prosthetic replacement in arthritis is gaining acceptance in the management of arthritis.

  10. Septic arthritis of a lumbar facet joint: Detection with bone SPECT imaging

    International Nuclear Information System (INIS)

    We present a rare case of septic arthritis of a lumbar facet joint with an associated epidural abscess resulting from Staphylococcus aureus. The infection was initially detected with planar bone scintigraphy and precisely localized with single photon emission computed tomography bone scintigraphy, despite an initially negative radiologic evaluation that included radiographs of the lumbar spine, lumbar myelography, and a postmyelography x-ray computed tomography scan. In the appropriate clinical setting, a bone scan demonstrating unilateral increased activity within the spine should raise the suspicion of inflammatory involvement of the posterior elements

  11. Abscess Formation after Septic Arthritis in the Sternoclavicular Joint of Two Healthy Men

    DEFF Research Database (Denmark)

    Henriksen, Jeppe; Tang, Mariann; Hjortdal, Vibeke

    2015-01-01

    Abscess formation after septic arthritis in the sternoclavicular joint is a rare phenomenon in healthy people without immune suppression, intravenous drug abuse, or diabetes. Here we report two cases with formation of abscess in two middle-aged men, with no relevant comorbidities and no obvious...... sites of infection. The abscesses were both treated surgically with debridement followed by negative pressure wound therapy and antibiotics. The cases differ in diagnostic procedures and delay of diagnosis and broach the issues of handling a rare disease....

  12. Automated quantification and analysis of facial asymmetry in children with arthritis in the temporomandibular joint

    DEFF Research Database (Denmark)

    Darvann, Tron A.; Hermann, Nuno V.; Demant, Sune;

    2011-01-01

    We present an automated method of spatially detailed 3D asymmetry quantification of face surfaces obtained in a stereophotogrammetric system, and the method was applied to a population of children with juvenile idiopathic arthritis (JIA) who have involvement of one temporomandibular joint (TMJ......). Non-rigid registration of a patient face surface to a mirrored version of the same face surface provided a spatially dense map of left-right point correspondences that were used in the asymmetry calculation. For inter-patient comparison and modeling, detailed point correspondence was obtained by non...

  13. Radiographic changes in the condyle of the temporomandibular joint in psoriatic arthritis

    International Nuclear Information System (INIS)

    One hundred and ten patients with psoriatic arthritis (PA) and 100 matched control patients were examined by using orthopantomography to discover radiographic changes in the condyle of the temporomandibular joint (TMJ). 31% of the PA patients and 13% of the control patients had radiographic changes in the condyle of the TMJ. The most common radiographic finding in PA patients was unilateral erosion of the condyle. Of the radiographic changes in the PA group, cortical erosions correlated negatively with age, whereas osteophytes correlated positively with the duration of PA. (orig.)

  14. Radiographic changes in the condyle of the temporomandibular joint in psoriatic arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Koenoenen, M.

    One hundred and ten patients with psoriatic arthritis (PA) and 100 matched control patients were examined by using orthopantomography to discover radiographic changes in the condyle of the temporomandibular joint (TMJ). 31% of the PA patients and 13% of the control patients had radiographic changes in the condyle of the TMJ. The most common radiographic finding in PA patients was unilateral erosion of the condyle. Of the radiographic changes in the PA group, cortical erosions correlated negatively with age, whereas osteophytes correlated positively with the duration of PA.

  15. Septic arthritis of a lumbar facet joint: Detection with bone SPECT imaging

    Energy Technology Data Exchange (ETDEWEB)

    Swayne, L.C.; Dorsky, S.; Caruana, V.; Kaplan, I.L. (Morristown Memorial Hospital, NJ (USA))

    1989-08-01

    We present a rare case of septic arthritis of a lumbar facet joint with an associated epidural abscess resulting from Staphylococcus aureus. The infection was initially detected with planar bone scintigraphy and precisely localized with single photon emission computed tomography bone scintigraphy, despite an initially negative radiologic evaluation that included radiographs of the lumbar spine, lumbar myelography, and a postmyelography x-ray computed tomography scan. In the appropriate clinical setting, a bone scan demonstrating unilateral increased activity within the spine should raise the suspicion of inflammatory involvement of the posterior elements.

  16. Facet joint septic arthritis due to community acquired methicillin resistant Staphylococcus aureus (MRSA) - A case report.

    Science.gov (United States)

    Purushothaman, Rajesh; Inassi, Jojo; Marthya, Anwar

    2015-10-01

    Septic arthritis of facet joint (SAFJ) is extremely rare. Only about sixty cases have been reported so far. A single case of SAFJ in a series of 491 cases of spinal infections was first reported by David-Chaussé in 1981. A case report of SAFJ was published by Halpin in 1987. With the growing availability and use of MRI, more and more cases are being reported. The most common organism that causes SAFJ is Staphylococcus aureus. We are reporting a case of SAFJ caused by community acquired, methicillin resistant S aureus (MRSA) successfully treated by Linezolid. PMID:26719620

  17. The use of joint imaging with 99mTc labeled human immunoglobulin G in rheumatoid arthritis

    International Nuclear Information System (INIS)

    PURPOSE: To evaluate the usefulness of 99mTc-HIG joint imaging in rheumatoid arthritis (RA). METHODS: 99mTc-HIG joint imaging was performed in 37 patients with arthritis. Among them, 25 cases were studied in comparison with 99mTc-MDP imaging. RESULTS: Abnormal images were observed in 24 active RAS. There were 118 joints with abnormal images in 137 clinically active joints. The rate of coincidence was 86.1%. The clinical score of each patient correlated well with the image score of all joints and significant correlations were found between joints uptake score and clinical scores of pain, tenderness and swelling (P99mTc-HIG scintigrams of four RA patients before and after therapy or reduction of drug dose were parallel with changes in clinical and laboratory (ESR) findings. the comparison between 99mTc-HIG and 99mTc-MDP imagings demonstrated: (1) The sites of activity accumulation were different. 99mTc-HIG scintigraphy revealed increased uptake in inflamed synovial membranes of joint capsules, while 99mTc-MDP showed accumulation of tracer in joint bones. (2) For detection of arthritis activity in RA, 99mTc-HIG was superior to 99mTc-MDP. conclusions: 99mTc-HIG joint imaging is a noninvasive and objective method to evaluate synovitis in RA. It is more sensitive than 99mTc-MDP bone imaging

  18. Wrist Sprains

    Science.gov (United States)

    ... Symptom Picker Hand and Arm Conditions Carpal Tunnel Ganglion Cysts Trigger Finger Arthritis Base of the Thumb See ... Symptom Picker Hand and Arm Conditions Carpal Tunnel Ganglion Cysts Trigger Finger Arthritis Base of the Thumb See ...

  19. Wrist Arthroscopy

    Science.gov (United States)

    ... Symptom Picker Hand and Arm Conditions Carpal Tunnel Ganglion Cysts Trigger Finger Arthritis Base of the Thumb See ... Symptom Picker Hand and Arm Conditions Carpal Tunnel Ganglion Cysts Trigger Finger Arthritis Base of the Thumb See ...

  20. Wrist Fractures

    Science.gov (United States)

    ... Symptom Picker Hand and Arm Conditions Carpal Tunnel Ganglion Cysts Trigger Finger Arthritis Base of the Thumb See ... Symptom Picker Hand and Arm Conditions Carpal Tunnel Ganglion Cysts Trigger Finger Arthritis Base of the Thumb See ...

  1. Development and preliminary validation of a magnetic resonance imaging joint space narrowing score for use in rheumatoid arthritis: potential adjunct to the OMERACT RA MRI scoring system

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Bøyesen, Pernille; Eshed, Iris;

    2011-01-01

    To develop and validate a magnetic resonance imaging (MRI) method of assessment of joint space narrowing (JSN) in rheumatoid arthritis (RA).......To develop and validate a magnetic resonance imaging (MRI) method of assessment of joint space narrowing (JSN) in rheumatoid arthritis (RA)....

  2. Tuberculous osteomyelitis/arthritis of the first costoclavicular joint and sternum

    Institute of Scientific and Technical Information of China (English)

    Prasan; Patel; Robin; R; Gray

    2014-01-01

    A young Somali immigrant presents with a two-year history of a large, firm, painful right anterolateral chest wall sternal mass. The patient denied any history of trauma or infection at the site and did not have a fever, erythematous lesion at the site, clubbing, or lymphadenopathy. A lateral chest radiograph demonstrated a low density mass isolated to the subcutaneous soft tissue overlying the sternum, ribs and clavicle. Computed tomography(CT) with contrast demonstrated a cystic lesion in the right anterolateral chest wall deep to the pectoralis muscle. Enhanced CT of the chest demonstrated sclerosis and destruction of the rib and costochondral joint and manubrio-sternal joint narrowing. Ultrasound-guided biopsy and aspiration returned 500 cc of purulent, cloudy yellow, foul-smelling fluid. Acidfact bacilli stain and the nucleic acid amplification test identified and confirmed Mycobacterium tuberculosis. A diagnosis of tuberculous osteomyelitis/septic arthritis was made and antibiotic coverage for tuberculosis was initiated.

  3. Atlantoaxial joint distraction for treatment of basilar invagination secondary to rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Goel Atul

    2005-01-01

    Full Text Available We present our experience of treating two cases of rheumatoid arthritis involving the craniovertebral junction and having marked basilar invagination by an alternative treatment method. In both the cases, the facets were osteoporotic and were not suitable for screw implantation. The patients were 66 and 72 years of age and both patients were females. Both the patients presented with complaints of progressively increasing spastic quadriparesis. Surgery involved attempts to reduce the basilar invagination and restore the height of the ′collapsed′ lateral mass by manual distraction of the facets of the atlas and axis and forced impaction of titanium spacers in the joint in addition to bone graft harvested from the iliac crest. The procedure also provided stabilization of the region. No other fixation procedure involving wires, screws, plate and rods was carried out simultaneously. Following surgery both the patients showed symptomatic improvement and partial restoration of craniovertebral alignments. Follow-up is of 2 and 24 months. Distraction of the facets of atlas and axis and impaction of metal implant and bone graft in the facet joint can assist in reduction of basilar invagination and fixation of the region in selected cases of rheumatoid arthritis involving the craniovertebral junction.

  4. Correlation studies of Mg concentration in Joint fluid of Arthritis patients under the treatment of Indigenous and Modern medicinal system

    Directory of Open Access Journals (Sweden)

    Hemlata Kapil Bagla

    2012-12-01

    Full Text Available Magnesium (Mg, an essential cation is abundantly found in skeletal and cardiac muscle cells. It is necessary to investigate the role of essential elements in joint effusion as they may serve as non-invasive diagnostic tool for the characterization of joint diseases. In the present paper, the concentration of Mg localized in joint fluid of arthritis patients under the treatment of Allopathy and Polyherbal formulations has been carried out. The quantitative assessment of Mg was determined by Inductively Coupled Plasma Atomic emission spectroscopy (ICP-AES. The patients with cases of proved Osteoarthritis (OA, Rheumatoid arthritis (RA and Bursitis were included for the study. Synovial (SF and Bursal fluid (BF samples were aspirated by arthrocentesis. The levels of Mg were found to be significantly lesser (P<0.05 in arthritis patients under the treatment of modern medicines when compared to controls. However patients under the treatment of PF showed levels of Mg highly comparable to controls. Subsequently the possible prevalence of dwindling Mg in joint effusions has been inferred as a potential diagnostic biomarker in etiology of arthritis. Furthermore the therapeutic impact of PF due to bioavailable form of Mg implicates a stimulus for adept joint health.

  5. Significance of arthrosonography for knee joint damage diagnosis in patients with early rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    L V Sizova

    2008-01-01

    Full Text Available Objective. To assess significance of arthrosonography in diagnosis of in knee joint changes in patients with early rheumatoid arthritis (RA. Material and methods. 44 patients with early RA aged 19 to 73 years were examined. 29,5% of pts had early RA without primary osteoarthritis (OA, 70,5% had early RA with primary OA. Ultrasonography of knee joints was performed with Diasonics (USA, 1997 by the linear sensor with frequency of 7 MHz. The protocol of ultrasonic examination of knee joints was filled for each pt. Results. Clinical signs of of knee joint synovitis have been revealed in 61,5% of pts with early RA without primary OA, and in 80,6% of pts with early RA with primary OA, ultrasonic - in 100% of pts. Intraarticular knee joint effusion resulted in increase of suprapatellar bursa and lateral recesses size. Extraarticular inflammation was frequently shown by thickening of semymemranous muscles tendons, especially in pts with the early RA with primary OA (p<0,005. Degenerative changes in the group of pts with primary OA were more expressed in early RA and usually accompanied by non-uniform decrease of cartilage thickness and occurrence of osteophytes while cartilage in pts with early RA without primary OA had normal thickness or thickening because of swelling, and osteophytes were absent. Conclusion. Prevalence of knee joint intraarticular and extraarticular inflammatory changes over degenerate changes (symmetric thickening of the synovium, primary increase of the sizes of suprapatellar bursa and lateral recesses because of effusion, thickening of tendons of knee joints at the normal or increased thickness of cartilage because of inflammation can be considered sonographic sign of early RA. In pts with early RA coincided with primary OA these changes were usually found in combination with non-uniform decrease of cartilage thickness. In case of cartilage inflammatory edema, detection of osteophytes allows to confirm presence of OA in pts with

  6. Arthritis of the Hand

    Science.gov (United States)

    ... of hand and wrist arthritis. (Note: The U.S. Food and Drug Administration does not test dietary supplements. These compounds may cause negative interactions with other medications. Always consult your doctor before taking dietary supplements.) ...

  7. Computer-aided classification of rheumatoid arthritis in finger joints using frequency domain optical tomography

    Science.gov (United States)

    Klose, C. D.; Kim, H. K.; Netz, U.; Blaschke, S.; Zwaka, P. A.; Mueller, G. A.; Beuthan, J.; Hielscher, A. H.

    2009-02-01

    Novel methods that can help in the diagnosis and monitoring of joint disease are essential for efficient use of novel arthritis therapies that are currently emerging. Building on previous studies that involved continuous wave imaging systems we present here first clinical data obtained with a new frequency-domain imaging system. Three-dimensional tomographic data sets of absorption and scattering coefficients were generated for 107 fingers. The data were analyzed using ANOVA, MANOVA, Discriminant Analysis DA, and a machine-learning algorithm that is based on self-organizing mapping (SOM) for clustering data in 2-dimensional parameter spaces. Overall we found that the SOM algorithm outperforms the more traditional analysis methods in terms of correctly classifying finger joints. Using SOM, healthy and affected joints can now be separated with a sensitivity of 0.97 and specificity of 0.91. Furthermore, preliminary results suggest that if a combination of multiple image properties is used, statistical significant differences can be found between RA-affected finger joints that show different clinical features (e.g. effusion, synovitis or erosion).

  8. Joint-specific DNA methylation and transcriptome signatures in rheumatoid arthritis identify distinct pathogenic processes

    Science.gov (United States)

    Ai, Rizi; Hammaker, Deepa; Boyle, David L.; Morgan, Rachel; Walsh, Alice M.; Fan, Shicai; Firestein, Gary S.; Wang, Wei

    2016-01-01

    Stratifying patients on the basis of molecular signatures could facilitate development of therapeutics that target pathways specific to a particular disease or tissue location. Previous studies suggest that pathogenesis of rheumatoid arthritis (RA) is similar in all affected joints. Here we show that distinct DNA methylation and transcriptome signatures not only discriminate RA fibroblast-like synoviocytes (FLS) from osteoarthritis FLS, but also distinguish RA FLS isolated from knees and hips. Using genome-wide methods, we show differences between RA knee and hip FLS in the methylation of genes encoding biological pathways, such as IL-6 signalling via JAK-STAT pathway. Furthermore, differentially expressed genes are identified between knee and hip FLS using RNA-sequencing. Double-evidenced genes that are both differentially methylated and expressed include multiple HOX genes. Joint-specific DNA signatures suggest that RA disease mechanisms might vary from joint to joint, thus potentially explaining some of the diversity of drug responses in RA patients. PMID:27282753

  9. Arthrotomy and arthrodesis in the treatment of complicated arthritis of the fetlock joint in adult cattle.

    Science.gov (United States)

    Starke, A; Kehler, W; Rehage, J

    2006-12-01

    One Galloway bull and three German Holstein-Friesian cows aged between three and five years with complicated arthritis of the fetlock joint were treated by arthrotomy (on the bull and two of the cows) or by arthrodesis (on the other cow). Arthrotomy involved four vertical dorsolateral/dorsomedial and palmolateral/palmomedial incisions 5 cm long to give access to the joint cavities and allow fibrin, debris and necrotic tissue to be removed. Arthrodesis consisted of lateral and medial (abaxial) horizontal 5 cm incisions along the joint space. After debridement, the joint surfaces (cartilage and superficial bone tissue) of the metacarpus and first phalanx were completely abraded with a high-speed surgical drill. The interdigital region, palmar and dorsal tendons, vessels and nerves were conserved during both arthrotomy and arthrodesis, and the pouches were flushed during the surgery. The incisions were sutured and a casting tape was applied. Six weeks later, the cast was removed and a supporting bandage was applied. Each animal received 10 mg/kg ampicillin subcutaneously twice a day from one day before surgery until a mean (sd) of 23 (4) days after the arthrotomies and 36 days after the arthrodesis. After a recovery period of at least one year, all the animals could be used without restrictions. PMID:17142625

  10. Genetics Home Reference: psoriatic arthritis

    Science.gov (United States)

    ... Understand Genetics Home Health Conditions psoriatic arthritis psoriatic arthritis Enable Javascript to view the expand/collapse boxes. Print All Open All Close All Description Psoriatic arthritis is a condition involving joint inflammation (arthritis) that ...

  11. Reduction of Monocyte Chemoattractant Protein-1 Expression in Rheumatoid Arthritis Rat Joints with Light-Emitting Diode Phototherapy

    OpenAIRE

    Kuboyama, Noboru; Abiko, Yoshimitsu

    2012-01-01

    Background: Rheumatoid arthritis (RA) is a systemic autoimmune disorder that involves inflammation and pain of the joints. Light-Emitting Diode (LED) irradiation is being evaluated for treating RA; however, the mechanism is unclear. Monocyte chemotaxis protein (MCP)-1 is a key chemokine in the inflammatory status of RA, and MCP-1 levels in plasma are described as a marker for joint inflammation in RA.

  12. Diagnosing Psoriatic Arthritis

    Science.gov (United States)

    ... to find out more! Email * Zipcode Diagnosing Psoriatic Arthritis Psoriatic arthritis can develop slowly with mild symptoms, or it ... severe. Early recognition, diagnosis and treatment of psoriatic arthritis can help prevent or limit extensive joint damage ...

  13. Treating Psoriatic Arthritis

    Science.gov (United States)

    ... to find out more! Email * Zipcode Treating Psoriatic Arthritis Treatment for psoriatic arthritis can relieve pain, reduce swelling, help keep joints ... recommend treatments based on the type of psoriatic arthritis, its severity and your reaction to treatment. Download ...

  14. Arthritis: Frequently Asked Questions

    Science.gov (United States)

    ... to complications from the flu? 1. What is arthritis? The word arthritis actually means joint inflammation, but ... for you. 2. Who is at risk for arthritis? Certain factors are associated with a greater risk ...

  15. Radiosynovectomy in the treatment of arthritis

    International Nuclear Information System (INIS)

    Full text: Radiosynovectomy is a useful therapeutic option that involves radiopharmaceutical injections into joints, especially to treat rheumatoid arthritis. The indications included different kinds of arthritis, such as rheumatoid arthritis, psoriatic arthritis, Bechterew's disease, hemophiliac arthritis, osteoarthritis, but also patients with joint prosthesis and synovial effusion. There are three commercial available radiopharmaceuticals for the treatment: yttrium-90 for the knee (185 to 250 MBq), rhenium-186 for larger joints (shoulder and hip with 111 MBq; elbow, wrist, ankle joint with can also rederbium-169 for smaller joints (acromioclavicular joint with 37 MBq, thumb base and MTP I with 30 MBq, MCP and MTP II-V with 22 MBq, PIP with 18.5 MBq, and DIP with 15 MBq, respectively). Decisive for the treatment is a positive sign for arthritis in the two-phase bone scan with 99mTc-HMDP (high uptake in the blood pool phase). Only for radiosynovecotmy in the knee an ultrasound with an evidence of effusion is sufficient. Side effects by the treatment are rare, such as temporary radiation or crystal synovitis, tissue necrosis (extra articular fraction or intra-articular), joint infection (1 of 35,000 joints) or effects due to the immobilisation (thrombosis, pulmonary embolism (immobilization of the knee), lymphoedema or loss of motion. In the treatment of the knee a prophylaxis with heparin is necessary to protect the patients for a pulmonary embolism. The clinical outcome is depending from the primary disease and the stage of arthrosis. Kresnik at al reported in 2190 treated joints an overall response rate of 73 ± 17%. A higher response rate was observed in patients with early stage of arthrosis (73 ± 12%) to patients with advance stage (52 ± 24%). The best results had patients with hemophiliac arthritis (91 ± 4%). In our hospital were treated up to 10.000 joints with a mean response rate of 70-80%. There was a higher response rate in larger joints with 81 ± 5

  16. Disk abnormality coexists with any degree of synovial and osseous abnormality in the temporomandibular joints of children with juvenile idiopathic arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Kirkhus, Eva; Smith, Hans-Joergen [Oslo University Hospital, Rikshospitalet, Department of Radiology and Nuclear Medicine, Oslo (Norway); University of Oslo, Institute of Clinical Medicine, Oslo (Norway); Arvidsson, Linda Z.; Larheim, Tore A. [University of Oslo, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, Oslo (Norway); Flatoe, Berit; Hetlevik, Siri O. [Oslo University Hospital, Rikshospitalet, Department of Rheumatology, Oslo (Norway); University of Oslo, Institute of Clinical Medicine, Oslo (Norway)

    2016-03-15

    MRI manifestation of temporomandibular joint arthritis is frequently reported in children with juvenile idiopathic arthritis. However, little attention has been paid to temporomandibular joint disk abnormalities. To assess combinations of MRI findings in the symptomatic temporomandibular joint in children with juvenile idiopathic arthritis with focus on disk abnormalities. This was a retrospective study of 46 patients with juvenile idiopathic arthritis, mean age 12 years (range: 5-17 years). Mean disease duration was 70 months (standard deviation: 61 months). MR images of 92 temporomandibular joints were scored for thickness of abnormally enhancing synovium (synovitis), joint effusion, bone marrow oedema, abnormal bone shape, bone erosion and disk abnormalities. The 92 temporomandibular joints were categorized as A: No synovitis and normal bone shape (30/92; 33%), B: Synovitis and normal bone shape (14/92: 15%), C: Synovitis and abnormal bone shape (38/92; 41%) and D: No synovitis but abnormal bone shape (10/92; 11%). Thirty-six of the 46 patients (78%) had synovitis and 33/46 (72%) had abnormal bone shape, most frequently in combination (30/46; 65%). Disk abnormalities (flat disk, fragmented disk, adherent disk and displaced disk) were found in 29/46 patients (63%). Disk abnormalities were found in all categories of juvenile idiopathic arthritis involved temporomandibular joints (B: 8/14 [57%]; C: 25/38 [66%] and D: 7/10 [70%]). Disk displacement was found in half of the joints (7/14) in category B. Synovitis was most pronounced in this category. Disk abnormalities were frequent. Disk displacement also occurred in joints with early temporomandibular joint arthritis, i.e., with normal bone shape. Other disk abnormalities were found in joints with bone abnormalities. Attention should be paid to disk abnormalities both in early and long-standing temporomandibular joint arthritis in children with juvenile idiopathic arthritis. (orig.)

  17. Disk abnormality coexists with any degree of synovial and osseous abnormality in the temporomandibular joints of children with juvenile idiopathic arthritis

    International Nuclear Information System (INIS)

    MRI manifestation of temporomandibular joint arthritis is frequently reported in children with juvenile idiopathic arthritis. However, little attention has been paid to temporomandibular joint disk abnormalities. To assess combinations of MRI findings in the symptomatic temporomandibular joint in children with juvenile idiopathic arthritis with focus on disk abnormalities. This was a retrospective study of 46 patients with juvenile idiopathic arthritis, mean age 12 years (range: 5-17 years). Mean disease duration was 70 months (standard deviation: 61 months). MR images of 92 temporomandibular joints were scored for thickness of abnormally enhancing synovium (synovitis), joint effusion, bone marrow oedema, abnormal bone shape, bone erosion and disk abnormalities. The 92 temporomandibular joints were categorized as A: No synovitis and normal bone shape (30/92; 33%), B: Synovitis and normal bone shape (14/92: 15%), C: Synovitis and abnormal bone shape (38/92; 41%) and D: No synovitis but abnormal bone shape (10/92; 11%). Thirty-six of the 46 patients (78%) had synovitis and 33/46 (72%) had abnormal bone shape, most frequently in combination (30/46; 65%). Disk abnormalities (flat disk, fragmented disk, adherent disk and displaced disk) were found in 29/46 patients (63%). Disk abnormalities were found in all categories of juvenile idiopathic arthritis involved temporomandibular joints (B: 8/14 [57%]; C: 25/38 [66%] and D: 7/10 [70%]). Disk displacement was found in half of the joints (7/14) in category B. Synovitis was most pronounced in this category. Disk abnormalities were frequent. Disk displacement also occurred in joints with early temporomandibular joint arthritis, i.e., with normal bone shape. Other disk abnormalities were found in joints with bone abnormalities. Attention should be paid to disk abnormalities both in early and long-standing temporomandibular joint arthritis in children with juvenile idiopathic arthritis. (orig.)

  18. Ultrasonographic Assessment of Fifth Metatarsophalangeal Joint Erosion in Rheumatoid Arthritis: Which Aspect Is Better?

    Science.gov (United States)

    Inanc, Nevsun; Ozen, Gulsen; Aydin, Sibel Zehra; Kasapoglu-Gunal, Esen; Direskeneli, Haner

    2016-04-01

    In this study, the best ultrasound (US) aspect for detection of fifth metatarsophalangeal (MTP) joint erosions, the most frequently eroded joint, in rheumatoid arthritis (RA) patients is investigated. Forty-eight RA patients (F/M = 35/13, mean age and disease durations 50.3 ± 11.8 and 7.9 ± 6.9 y, respectively) were evaluated by B-mode US for erosion. Images were obtained from the dorsal, lateral and plantar aspect of the fifth MTP joint, in longitudinal and transverse scans. The fifth MTP erosions were detected in 36 of 48 patients (75%) and 67 of 96 feet (69.8%). Of the erosions, 15 (22.4%), 53 (79.1%) and 59 (88.0%) were observed at dorsal, lateral and plantar aspects, respectively. Despite not being statistically different, the detection rate of fifth MTP erosions was numerically higher in the plantar aspect than both the lateral and dorsal aspects. In conclusion, the fifth MTP erosions in RA patients are more commonly detected in the plantar aspect US than in dorsal and lateral assessments. PMID:26742892

  19. Talonavicular joint abnormalities and walking ability of patients with rheumatoid arthritis.

    Directory of Open Access Journals (Sweden)

    Miyamoto N

    2004-04-01

    Full Text Available Rheumatoid arthritis (RA is often associated with deformities of the feet, and foot pain often arises in the talonavicular joint of patients with RA. The object of this study was to assess the relationship between magnetic resonance imaging (MRI findings of the talonavicular joint and walking ability. The subjects were 35 RA patients (10 feet in 5 males and 56 feet in 30 females aged 34-87 years (mean: 70 years +/- 12.1, with a disease duration from 1-54 years (mean: 14 years +/- 12.1. MRI findings were classified as follows: Grade 1, almost normal; Grade 2, early articular destruction; Grade 3, moderate articular destruction; Grade 4, severe articular destruction; and Grade 5, bony ankylosis dislocation. Walking ability was classified into one of 9 categories ranging from normal gait to bedridden status according to the system of Fujibayashi. As the grade of MRI images became higher the walking ability decreased, and these parameters showed a correlation by Spearman's rank correlation coefficient analysis (P = 0.003. Thus, in the present cohort group of patients with RA, the deterioration of walking ability increased with the severity of destruction of the talonavicular joint.

  20. Influence of disease activity and treatment on rate of joint destruction in rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    D V Goryachev

    2008-10-01

    Full Text Available Severity of hands and feet joint destruction is the most objective marker of rheumatoid arthritis (RA progression determining functional disability. The main aim of RA treatment is suppression of joint destruction. Objective. To study dependence of joint erosions forming speed on disease modifying anti-rhcumatic drugs (DMARD administration and RA activity. Material and methods. Retrospective analysis of 451 cases of RA treatment was performed. Erosions were counted according to modified Sharp method. Erosions forming speed was counted as ratio of erosion number increase to a year’s time space. Averaged disease activity was calculated as arithmetic mean for all DAS28 values obtained during disease course. Considering close relationship between disease activity and DMARD administration two-factor analysis was used. DMARD administration (>3 months and mean activity of RA were considered as factors. Results. Variance analysis (ANOVA with covariant showed that mean RA activity is a significant factor influencing erosions forming speed (F=12,5; p=4xl0 4. Character of DMARD, fact of its administration and disease duration did not significantly influence erosions forming speed considering disease activity covariant. Regression model with inclusion disease duration factor mean disease activity and DMARD administration at the moment of assessment allowed to explain 42% of dispersion (determination coefficient. Conclusion. Activity of RA is the main factor influencing erosions forming speed. Therapy not decreasing activity of RA does not change erosions forming speed

  1. Artrodese do punho com fixação mínima preservando as articulações carpometacarpianas Wrist arthrodesis with minimal internal fixation preserving the carpometacarpal joints

    Directory of Open Access Journals (Sweden)

    Arlindo Gomes Pardini Júnior

    2010-01-01

    structures. In general, the results are very satisfactory, particularly for pain relief, and in the majority of cases, there is considerable functional improvement. Various techniques are described, with different methods of internal fixation, most of which include the carpometacarpal joints (CMJ in the fusion. The objective of this study is to evaluate the results of wrist arthrodesis through a technique which is simpler, more biological, more inexpensive, and does not involve the carpometacarpal joints. METHODS: 15 patients with wrist arthrodesis were evaluated (6 with sequelae of trauma, 4 Rheumatoid Arthritis, 3 Kienbock's grade IV, 1 Preiser and 1 panarthrosis. The technique consisted of the use of an iliac bone plate and internal fixation with Kirschner wires, avoiding the carpometacarpal joints. RESULTS: The evaluation was based on consolidation time (93% in 7 weeks; movements of the fingers and pronosupination; pinch and grasp strength; functional evaluation through the DASH questionnaire, pain and patient satisfaction. In general, the results were similar to those of other, more aggressive techniques, and the non-inclusion of the carpometacarpal joints did not affect the final result. CONCLUSION: wrist arthrodesis with fixation using Kirschner wires and the use of an iliac bone plate, preserving the carpometacarpal joints, gives good or excellent results which are similar to those of other techniques described. However it presents major advantages over other methods: it is less aggressive, less expensive, and does not have the inconvenience and complications associated the use of plates and screws.

  2. MAGNETIC RESONANCE IMAGING OF THE SACROILIAC JOINT IN DIFFERENTIAL DIAGNOSIS OF EARLY POLYARTICULAR PSORIATIC AND RHEUMATOID ARTHRITIS (STUDY DATA REMARKA)

    OpenAIRE

    Elena Yu Loginova; T. V. Korotaeva; E L Luchihina; Smirnov, A. V.; A A Glazkov; D E Karateev

    2014-01-01

    Diagnosis of lesions of the spine and sacroiliac joints may be helpful in discrimination between early psoriatic arthritis (ePsA) and early rheumatoid arthritis (eRA).Objective. To assess the significance of inflammatory back pain (IBP), HLA-B27, and active sacroiliitis (ASI) confirmed by magnetic resonance imaging (MRI) for differential diagnosis of polyarticular ePsA and eRA.Materials and Methods. The study included 29 patients with ePsA (13 males and 16 females, mean age 36.52 ± 11.27 year...

  3. The anatomy and pathophysiology of the wrist.

    Science.gov (United States)

    Hooper, Geoffrey

    2006-04-28

    A basic knowledge of the anatomy and the interrelationships of the structures that make up the joint is a prerequisite for understanding the pathomechanics of the wrist. In the paper, the anatomy (especially including carpal ligaments) and the mechanics of wrist movements, also under load, are described. The features of the common wrist disorders that occur as a result of injury are also explained. PMID:17603435

  4. Detection of rheumatoid arthritis bone erosions by two different dedicated extremity MRI units and conventional radiography

    DEFF Research Database (Denmark)

    Duer-Jensen, A.; Vestergaard, A.; Dohn, U.M.;

    2008-01-01

    Objectives: To compare the ability of two different dedicated extremity MRI (E-MRI) units and conventional radiography (CR) for identifying bone erosions in rheumatoid arthritis (RA) metacarpophalangeal (MCP) and wrist joints. Methods: CR and two MRI examinations (using 0.2 T Esaote Artoscan and 0...... 15.8% of large erosions in wrists. Conclusions: Both E-MRI units detected more erosions than CR, in particular due to a higher sensitivity in metacarpal heads and carpal bones. The MagneVu unit detected fewer erosions than the Artoscan unit due to a lower average image quality and a smaller.......2 T portable MagneVu MV1000 units) of 418 bones in the dominant wrist and second to fifth MCP joints of 15 patients with RA and 4 healthy controls were performed and evaluated blindly for bones being visible and for erosions. Results: In MCP joints, MagneVu visualised 18.5% of bones entirely and 71...

  5. OMERACT Rheumatoid Arthritis Magnetic Resonance Imaging Studies. Exercise 3: an international multicenter reliability study using the RA-MRI Score

    DEFF Research Database (Denmark)

    Lassere, M; McQueen, F; Østergaard, Mikkel;

    2003-01-01

    We examined inter-reader agreement of the revised OMERACT 5 Rheumatoid Arthritis MRI Score (RAMRIS v3). Magnetic resonance (MR) images of 10 sets of metacarpophalangeal (MCP) joints 2-5 and 8 sets of rheumatoid arthritis (RA) wrists [1.5 T, coronal and axial T1 and T2 spin-echo, +/- fat saturation......ICC 0.58, avICC 0.89, %SDD +/- 27), wrist bone erosion scores (0.72, 0.94, +/- 31%), the wrist synovitis global (0.74, 0.94, +/- 32%), and synovial maximal thickness (0.6, 0.94, +/- 32%) met these conditions. MCP joint synovitis global (0.76, 0.95, +/-35%), MCP joint bone edema (0.63, 0.91, +/- 34......%), and wrist bone edema (0.78, 0.95, +/- 38%) performed marginally less well. Bone defects performed poorly (MCP joint 0.18, 0.46, +/- 56%; wrist 0.06, 0.24, +/- 55%). The revised OMERACT 5 RAMRIS has acceptable inter-reader reliability for measures of disease activity (synovitis global and bone edema...

  6. Easing Arthritis: Research offers new hope for people with common joint disease.

    Science.gov (United States)

    ... Navigation Bar Home Current Issue Past Issues Easing Arthritis: Research offers new hope for people with common ... likely help with that. Need more information on Arthritis? From www.MedlinePlus.gov : For a slideshow with ...

  7. Ultrasonography of the metatarsophalangeal joints in rheumatoid arthritis: comparison with magnetic resonance imaging, conventional radiography, and clinical examination

    DEFF Research Database (Denmark)

    Szkudlarek, Marcin; Narvestad, Eva; Klarlund, Mette; Court-Payen, Michel; Thomsen, Henrik S.; Østergaard, Mikkel

    2004-01-01

    OBJECTIVE: To compare ultrasonography (US) with magnetic resonance imaging (MRI), conventional radiography, and clinical examination in the evaluation of bone destruction and signs of inflammation in the metatarsophalangeal (MTP) joints of patients with rheumatoid arthritis (RA). METHODS: Two...... hundred MTP joints of 40 patients with RA and 100 MTP joints of 20 healthy control subjects were assessed with B-mode US, contrast-enhanced MRI, conventional radiography, and clinical examination for signs of bone destruction and joint inflammation. RESULTS: With MRI considered the reference method, the......-based gradings on US. CONCLUSION: US enables detection and grading of destructive and inflammatory changes in the MTP joints of patients with RA. By comparison with MRI, US was found to be markedly more sensitive and accurate than clinical examination and conventional radiography. Considering the early and...

  8. The diagnostic accuracy of unenhanced MRI in the assessment of joint abnormalities in juvenile idiopathic arthritis

    International Nuclear Information System (INIS)

    To assess the diagnostic accuracy and reliability of MRI without contrast enhancement in the evaluation of JIA knee joint abnormalities. JIA patients with clinically active knee involvement were prospectively studied using an 1-T open-bore magnet. MRI features were independently evaluated by two readers using the JAMRIS system. The first reading included unenhanced images, whereas complete image sets were available for the second reading. Imaging findings from 73 patients were analysed. Agreement between Gd-enhanced (+Gd) and Gd-unenhanced (-Gd) MRI scores of bone marrow changes, cartilage lesions and bone erosions was good concerning sensitivity, specificity, negative predictive value and positive predictive value. Inter-observer agreement was good for both -Gd and +Gd scores (ICC = 0.91-1.00, 0.93-1.00, respectively). Regarding the assessment of synovial hypertrophy, specificity of -Gd was high (0.97), but the sensitivity of unenhanced MRI was only 0.62. Inter-reader agreement for +Gd MRI was ICC = 0.94; however, omitting post-Gd acquisitions increased inter-reader variation (ICC = 0.86). If Gd-enhanced MRI is the reference standard, omitting Gd contrast medium is irrelevant for the assessment of bone marrow changes, cartilage lesions and bone erosions as joint abnormalities in JIA. Omitting intravenous Gd in the MRI assessment of joints in JIA is inadvisable, because it decreases the reliability of detecting synovial disease. circle Magnetic resonance imaging is increasingly used to assess juvenile idiopathic arthritis. circle Synovial hypertrophy, a marker of JIA activity, is well shown by MRI. (orig.)

  9. The diagnostic accuracy of unenhanced MRI in the assessment of joint abnormalities in juvenile idiopathic arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Hemke, Robert [University of Amsterdam, Department of Radiology (G1-235), Academic Medical Center, Amsterdam (Netherlands); University of Amsterdam, Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children' s Hospital AMC, Amsterdam (Netherlands); Kuijpers, Taco W.; Veenendaal, Mira van [University of Amsterdam, Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children' s Hospital AMC, Amsterdam (Netherlands); Berg, J.M. van den; Rossum, Marion A.J. van [University of Amsterdam, Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children' s Hospital AMC, Amsterdam (Netherlands); Reade, Department of Pediatric Rheumatology, Amsterdam (Netherlands); Dolman, Koert M. [Reade, Department of Pediatric Rheumatology, Amsterdam (Netherlands); St. Lucas Andreas Hospital, Department of Pediatric Rheumatology, Amsterdam (Netherlands); Maas, Mario [University of Amsterdam, Department of Radiology (G1-235), Academic Medical Center, Amsterdam (Netherlands)

    2013-07-15

    To assess the diagnostic accuracy and reliability of MRI without contrast enhancement in the evaluation of JIA knee joint abnormalities. JIA patients with clinically active knee involvement were prospectively studied using an 1-T open-bore magnet. MRI features were independently evaluated by two readers using the JAMRIS system. The first reading included unenhanced images, whereas complete image sets were available for the second reading. Imaging findings from 73 patients were analysed. Agreement between Gd-enhanced (+Gd) and Gd-unenhanced (-Gd) MRI scores of bone marrow changes, cartilage lesions and bone erosions was good concerning sensitivity, specificity, negative predictive value and positive predictive value. Inter-observer agreement was good for both -Gd and +Gd scores (ICC = 0.91-1.00, 0.93-1.00, respectively). Regarding the assessment of synovial hypertrophy, specificity of -Gd was high (0.97), but the sensitivity of unenhanced MRI was only 0.62. Inter-reader agreement for +Gd MRI was ICC = 0.94; however, omitting post-Gd acquisitions increased inter-reader variation (ICC = 0.86). If Gd-enhanced MRI is the reference standard, omitting Gd contrast medium is irrelevant for the assessment of bone marrow changes, cartilage lesions and bone erosions as joint abnormalities in JIA. Omitting intravenous Gd in the MRI assessment of joints in JIA is inadvisable, because it decreases the reliability of detecting synovial disease. circle Magnetic resonance imaging is increasingly used to assess juvenile idiopathic arthritis. circle Synovial hypertrophy, a marker of JIA activity, is well shown by MRI. (orig.)

  10. Pyogenic Arthritis of the Ankle Joint Following a High-Voltage Electrical Burn in the Lower Extremity: A Case Report

    International Nuclear Information System (INIS)

    A high-voltage electrical burn caused extensive deep muscle injuries beneath a relatively small skin wound at the contact point. Hidden, undetected deep muscle injuries have a tendency for progressive tissue necrosis, which can lead to major amputations or sepsis. The radiologic features of this rare, sometimes life-threatening injury have occasionally been described in the literature. However, to the best of our knowledge, there have been no reports on a case of pyogenic arthritis of the ankle joint following a high-voltage electrical burn involving the lower extremity. We report a case of the pyogenic arthritis of the ankle joint following a high-voltage electrical burn involving the lower extremity.

  11. Pyogenic Arthritis of the Ankle Joint Following a High-Voltage Electrical Burn in the Lower Extremity: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kuk Seon; Lee, Gyung Kyu; Kang, Ik Won; Hwang, Dae Hyun; Lee, Eil Seong; Min, Seon Jung; Han, You Mie [Dept. of Radiology, Hangang Scared Heart Hospital, Hallym University College of Medicine, Seoul (Korea, Republic of); Lee, Eil Seong [Dept.of Radiology, Gyeongju Hospital, Dongguk University College of Medicine, Gyeongju (Korea, Republic of)

    2011-04-15

    A high-voltage electrical burn caused extensive deep muscle injuries beneath a relatively small skin wound at the contact point. Hidden, undetected deep muscle injuries have a tendency for progressive tissue necrosis, which can lead to major amputations or sepsis. The radiologic features of this rare, sometimes life-threatening injury have occasionally been described in the literature. However, to the best of our knowledge, there have been no reports on a case of pyogenic arthritis of the ankle joint following a high-voltage electrical burn involving the lower extremity. We report a case of the pyogenic arthritis of the ankle joint following a high-voltage electrical burn involving the lower extremity.

  12. Aiming for a simpler early arthritis MRI protocol

    DEFF Research Database (Denmark)

    Stomp, Wouter; Krabben, Annemarie; van der Heijde, Désirée;

    2015-01-01

    PURPOSE: To evaluate whether intravenous gadolinium (Gd) contrast administration can be eliminated when evaluating synovitis and tenosynovitis in early arthritis patients, thereby decreasing imaging time, cost, and invasiveness. MATERIALS AND METHODS: Wrist MRIs of 93 early arthritis patients were...... evaluated by two readers for synovitis of the radioulnar, radiocarpal, and intercarpal joints, according to the Rheumatoid Arthritis MRI Scoring method (RAMRIS), and for tenosynovitis in ten compartments. Scores of MRI images without Gd contrast enhancement were compared to scores obtained when evaluating...... all, including contrast-enhanced, MRI images as reference. Subsequently, a literature review and pooled analysis of data from the present and two previous studies were performed. RESULTS: At the individual joint/tendon level, sensitivity to detect synovitis without Gd contrast was 91 % and 72 % for...

  13. The correlation between MR imaging of hand and wrist and serological testing index of early rheumatoid arthritis%早期类风湿性关节炎手腕关节的MRI表现与血清学的相关性

    Institute of Scientific and Technical Information of China (English)

    袁文昭; 李伟雄; 戴旖; 叶伟

    2013-01-01

    目的 利用MRI探讨早期类风湿性关节炎(RA)手腕关节滑膜炎及骨质侵蚀的表现与血清学检查指标的相关性.方法 对经临床诊断为早期RA的30例患者的手腕关节进行MRI平扫及增强扫描,对滑膜进行评分分级,并对骨质侵蚀进行计数,同时收集患者血清学(CRP、IgA、IgG、IgM)检查结果.结果 30例患者腕关节均出现不同程度的滑膜增厚、强化.掌指关节共有7例滑膜增厚.30例患者腕关节滑膜评分为4.0~9.0(2~3级),第2~5掌指关节滑膜评分为0~8.0 (0~3级).MRI发现21例患者手腕关节出现共48处骨质侵蚀,其中掌指关节11例11处,腕关节18例共37处.发现手、腕关节总滑膜评分分值与临床血清检查结果(CRP、IgA、IgG、IgM)相关性均有统计学意义(P均<0.05).对手、腕关节骨质侵蚀组与骨质正常组之间的临床血清学检查结果进行统计学分析,发现CRP、IgA、IgG的差异性具有统计学意义(P<0.05),而IgM的差异性没有统计学意义(P>0.05).结论 MRI能清楚显示早期RA手腕部关节的滑膜炎及骨质改变,可以利用MRI对早期RA的滑膜炎进行半定量化分级评分.早期RA的病理改变严重程度可以通过血清学检测CRP、IgA、IgG反映出来,且呈正相关,这为早期RA的诊断及活跃程度的深入研究提供了新的方法.%Objective To observe the synovitis change and bone erosion of the early rheumatoid arthritis( RA) of the hand and wrist,and to explore the correlation between MRI imaging and serological testing index. Methods MR routine scan and enhanced scan of the hand and wrist were performed in 30 patients with clinically diagnosed early RA . Graded and scored synovitis on MRI, calculated the bone erosions on hand and wrist. At the same time, scrology examinations including CRP,IgA,IgG and IgM were obtained. Results All the patients' synovium in wrist joint and seven patients' synovium in mctacarpophalangcals( MCP) thickened and

  14. Temporomandibular joint involvement in Juvenile Idiopathic Arthritis: reliability and validity of a screening protocol for the rheumatologist.

    OpenAIRE

    Steenks, M.H.; Giancane, G; Leeuw, R.R. de; Bronkhorst, E.M.; van Es, R J; Koole, R; Bruggen, H.W. van; Wulffraat, N.M.

    2015-01-01

    BACKGROUND: In Juvenile Idiopathic Arthritis (JIA) the temporomandibular joint (TMJ) can be involved leading to pain, dysfunction and growth disturbances of the mandible and associated structures. There may be value to a three minute screening protocol allowing the rheumatologist to detect TMJ involvement systematically. Reliability and validity of the TMJ protocol for detecting TMJ co-morbidity were determined in 74 consecutive JIA patients. METHODS: The assessments of the rheumatologist and...

  15. Temporomandibular joint involvement in Juvenile Idiopathic Arthritis : reliability and validity of a screening protocol for the rheumatologist

    OpenAIRE

    Steenks, Michel H.; Giancane, G; de Leeuw, Rob R. J.; Bronkhorst, Ewald M.; van Es, Robert J. J.; Koole, Ron; van Bruggen, H. Willemijn; Wulffraat, NM

    2015-01-01

    Background: In Juvenile Idiopathic Arthritis (JIA) the temporomandibular joint (TMJ) can be involved leading to pain, dysfunction and growth disturbances of the mandible and associated structures. There may be value to a three minute screening protocol allowing the rheumatologist to detect TMJ involvement systematically. Reliability and validity of the TMJ protocol for detecting TMJ co-morbidity were determined in 74 consecutive JIA patients. Methods: The assessments of the rheumatologist and...

  16. The characteristics of bony ankylosis of the facet joint of the upper cervical spine in rheumatoid arthritis patients

    OpenAIRE

    Iizuka, Haku; Nishinome, Masahiro; Sorimachi, Yasunori; Ara, Tsuyoshi; Nakajima, Takashi; Iizuka, Yoichi; Takagishi, Kenji

    2009-01-01

    This study investigated the bony ankylosis of the upper cervical spine facet joints in patients with a cervical spine involvement due to rheumatoid arthritis (RA) using computed tomography (CT) and then examined the characteristics of the patients showing such ankylosis. Forty-six consecutive patients who underwent surgical treatment for RA involving the cervical spine were reviewed. The radiographic diagnoses included atlanto-axial subluxation in 30 cases, vertical subluxation (VS) in 10 cas...

  17. Associations between APOE Genotypes and Disease Susceptibility, Joint Damage and Lipid Levels in Patients with Rheumatoid Arthritis

    OpenAIRE

    Maehlen, Marthe T.; Provan, Sella A.; de Rooy, Diederik P. C.; van der Helm-van Mil, Annette H. M.; Annemarie Krabben; Tore Saxne; Elisabet Lindqvist; Anne Grete Semb; Till Uhlig; Désirée van der Heijde; Inger Lise Mero; Olsen, Inge C.; Kvien, Tore K; Lie, Benedicte A.

    2013-01-01

    Objective: Apolipoprotein E (APOE) genotypes are associated with cardiovascular disease (CVD) and lipid levels. In rheumatoid arthritis (RA), an association has been found with disease activity. We examined the associations between APOE genotypes and disease susceptibility and markers of disease severity in RA, including radiographic joint damage, inflammatory markers, lipid levels and cardiovascular markers. Method: A Norwegian cohort of 945 RA patients and 988 controls were genotyped for tw...

  18. AUTOANTIBODY LEVELS INFLUENCES THE NUMBER AND PHENOTYPE OF INFILTRATING NEUTROPHILS IN INFLAMED JOINTS OF PATIENTS WITH RHEUMATOID ARTHRITIS

    OpenAIRE

    Rodrigo Fernando Blas; Alicia Munarriz; Hector Tamashiro; Rodolfo A Pardo Hidalgo; Maria Cristina Pistoresi-Palencia; Maria Silvia Di Genaro

    2015-01-01

    Rheumatoid arthritis (RA) manifests with persistent synovial inflammation, cellular infiltration and pro-inflammatory cytokine production, and results in progressive joint destruction. Although the etiology and pathogenesis of RA are still unclear, there are many inflammatory cells accumulated in the synovial fluid (SF) which are involved in the pathogenesis of RA. Of all the cell types implicated in the pathology of RA, neutrophils are the most abundant cells present either in the SF of the ...

  19. Increased pelvic incidence may lead to arthritis and sagittal orientation of the facet joints at the lower lumbar spine

    OpenAIRE

    Jentzsch, Thorsten; Geiger, James; Bouaicha, Samy; Slankamenac, Ksenija; Nguyen-Kim, Thi Dan; Werner, Clément M. L.

    2013-01-01

    BACKGROUND: Correct sagittal alignment with a balanced pelvis and spine is crucial in the management of spinal disorders. The pelvic incidence (PI) describes the sagittal pelvic alignment and is position-independent. It has barely been investigated on CT scans. Furthermore, no studies have focused on the association between PI and facet joint (FJ) arthritis and orientation. Therefore, our goal was to clarify the remaining issues about PI in regard to (1) physiologic values, (2) age, (3) gende...

  20. The research of micro-coil MR imaging of wrist joint%显微线圈腕关节MRI成像实验研究

    Institute of Scientific and Technical Information of China (English)

    杨明; 余建明; 柳曦; 赵虎; 刘定西

    2011-01-01

    Objective:To study the value of 47mm Micro-coil (MC) MR high resolution technology in the diagnosis of wrist joint. Methods: Five adult cadaver wrists were chosen and examined with Siemens Magnetom Verio 3. OT MR scanner, CP flex small coil and 47mm microscopy coil were used separately. The MR sequences included TSE T1WI and FS PDWI, the signal-noise ratio (SNR) of images were measured and rated by three senior radiologist, the image quality were compared. Results:Of the images acquired by the 2 different coils,the SNR of the cuboid bone,lunate bone and radius bone were measured and the image quality were scored. The images which were unsatisfactory for diagnosis were scored as 0; fulfilled the requirement of diagnosis were scored as 1 and excellent as 2. Wilcoxon Signed Rank Test was done,the results showed that the image quality of 47mm MC were significantly superior to that of flex small coil (P<0. 05). Conclusions: The anatomy of the wrist could be clearly displayed by 47mm micro-coil,which could be used as routine approach of wrist imaging.%目的:探讨47 mm显微线圈(MC)在腕关节成像中的应用价值.方法:选取成人尸体腕关节5个,分别使用矩形表面小线圈(CP flex small coil)、47 mm显微线圈,利用Siemens Magnetom Veri0 3.0T磁共振扫描仪检查,MR序列包括快速自旋回波T1加权(TSE T1 WI)和质子密度加权(PDW),对扫描所得图像信噪比进行测量,并由3位高年资放射科医生进行评分,比较其成像质量有无差异.结果:对扫描所得图像中心层面的骰骨、月骨和桡骨信噪比进行测量,同时分别对两种线圈所得图像进行评分:不能满足诊断要求为0分;满足诊断要求为1分;图像质量好为2分,并对评分进行配对资料的符号秩和检验.结果显示47 mm MC图像质量明显优于矩形表面小线圈组图像,不同线圈扫描时图像质量有显著性差异(P<0.05).结论:47 mm显微线圈能更加清晰的显示腕关节解剖结构,可

  1. Studies on YKL-40 in knee joints of patients with rheumatoid arthritis and osteoarthritis. Involvement of YKL-40 in the joint pathology

    DEFF Research Database (Denmark)

    Volck, B; Johansen, J S; Stoltenberg, M; Garbarsch, C; Price, P A; Østergaard, Mikkel; Ostergaard, K; Løvgreen-Nielsen, P; Sonne-Holm, Stig; Lorenzen, I

    2001-01-01

    OBJECTIVE: The presence of YKL-40 (human cartilage glycoprotein 39) in synovium, cartilage and synovial fluid (SF) from knee joints of patients with rheumatoid arthritis and osteoarthritis (OA) were related to histopathological changes in synovium and cartilage and to serum YKL-40 and other...... chondrocytes. YKL-40 levels in SF were higher in RA patients with moderate/severe or none/slight synovitis of the knee joint compared to OA patients with moderate/severe or none/slight synovitis. SF YKL-40 correlated with the synovial membrane and the joint effusion volumes determined by magnetic resonance......, which increased again at clinical relapse. CONCLUSIONS: YKL-40 in SF is derived from cells in the inflamed synovium, chondrocytes and SF neutrophils. Joint derived YKL-40 influences serum YKL-40. YKL-40 may be involved in the pathophysiology of the arthritic processes and reflect local disease activity....

  2. Reduced articular cartilage thickness in joints without a history of active arthritis in children with juvenile idiopathic arthritis

    DEFF Research Database (Denmark)

    Pradsgaard, Dan Østergaard; Spannow, Anne Helene; Heuck, Carsten;

    joint cartilage thickness (Cth) between healthy children and JIA children measured by US (1). But are there any differences in Cth measured by US between healthy children and joints without a history of activity among JIA children’s. Aim: To investigate a possible effect of the inflammatory process on......, and 189 2nd PIP joints. Cartilage thickness was measured perpendicular to the bone surface. History of joint activity was found by review of medical records. An age-, and sex-matched healthy cohort investigated in a previous study served as a control group (2), age, 10.9 (6-16), girls/boys (177...... joints never directly affected by arthritic activity during the history of the child’s disease course. Furthermore we wanted to compare joint cartilage thickness within the JIA group in joints with or without a history of activity. Methods: We included 95 Danish JIA children. Age, mean (range) 10...

  3. A comparative study of the value of four imaging methods for the diagnosis of rheumatoid arthritis of the shoulder joint

    International Nuclear Information System (INIS)

    The shoulder joint becomes involved later than the peripheral joints of the lower and upper limb in rheumatoid arthritis. The aim of the current study is to determine the value of plain radiography (PR), ultrasonography (US), computed tomography (CT) and magnetic resonance imaging (MRI) in detecting bone erosions and soft tissue changes of the shoulder joint in patients with rheumatoid arthritis. 27 patients - 21 women and 6 men, mean age 59 years (range 39 - 78) with confirmed rheumatoid arthritis and a painful shoulder are included in the study. The mean duration of the disease is 10 years and the mean duration of the shoulder symptoms is 4 years. In every patient all the imaging modalities were performed within 30 days. PR shows depicted changes in 20 patients (74%), US - in 25 patients (93%), CT - in 23 patients (85%) and MRI - in 26 patients (96%). US and MRI are more sensitive than CT in depicting small erosions of the humeral head and soft tissue changes. MRI and CT are the best methods for the diagnosis of subchondral and intraosseous bone lesions. The traditionally used PR is less sensitive than the other methods, especially in the evaluation of the soft tissues and the small erosions. (authors)

  4. Arthritis, a complex connective and synovial joint destructive autoimmune disease: animal models of arthritis with varied etiopathology and their significance.

    Science.gov (United States)

    Naik, S R; Wala, S M

    2014-01-01

    Animal models play a vital role in simplifying the complexity of pathogenesis and understanding the indefinable processes and diverse mechanisms involved in the progression of disease, and in providing new knowledge that may facilitate the drug development program. Selection of the animal models has to be carefully done, so that there is morphologic similarity to human arthritic conditions that may predict as well as augment the effective screening of novel antiarthritic agents. The review describes exclusively animal models of rheumatoid arthritis (RA) and osteoarthritis (OA). The development of RA has been vividly described using a wide variety of animal models with diverse insults (viz. collagen, Freund's adjuvant, proteoglycan, pristane, avridine, formaldehyde, etc.) that are able to simulate/trigger the cellular, biochemical, immunological, and histologic alterations, which perhaps mimic, to a great extent, the pathologic conditions of human RA. Similarly, numerous methods of inducing animal models with OA have also been described (such as spontaneous, surgical, chemical, and physical methods including genetically manipulated animals) which may give an insight into the events of alteration in connective tissues and their metabolism (synovial membrane/tissues along with cartilage) and bone erosion. The development of such arthritic animal models may throw light for better understanding of the etiopathogenic mechanisms of human arthritis and give new impetus for the drug development program on arthritis, a crippling disease. PMID:25121375

  5. Arthritis, a complex connective and synovial joint destructive autoimmune disease: Animal models of arthritis with varied etiopathology and their significance

    Directory of Open Access Journals (Sweden)

    S R Naik

    2014-01-01

    Full Text Available Animal models play a vital role in simplifying the complexity of pathogenesis and understanding the indefinable processes and diverse mechanisms involved in the progression of disease, and in providing new knowledge that may facilitate the drug development program. Selection of the animal models has to be carefully done, so that there is morphologic similarity to human arthritic conditions that may predict as well as augment the effective screening of novel antiarthritic agents. The review describes exclusively animal models of rheumatoid arthritis (RA and osteoarthritis (OA. The development of RA has been vividly described using a wide variety of animal models with diverse insults (viz. collagen, Freund′s adjuvant, proteoglycan, pristane, avridine, formaldehyde, etc. that are able to simulate/trigger the cellular, biochemical, immunological, and histologic alterations, which perhaps mimic, to a great extent, the pathologic conditions of human RA. Similarly, numerous methods of inducing animal models with OA have also been described (such as spontaneous, surgical, chemical, and physical methods including genetically manipulated animals which may give an insight into the events of alteration in connective tissues and their metabolism (synovial membrane/tissues along with cartilage and bone erosion. The development of such arthritic animal models may throw light for better understanding of the etiopathogenic mechanisms of human arthritis and give new impetus for the drug development program on arthritis, a crippling disease.

  6. Static and dynamic analysis of patellofemoral joint arthritis using computed tomography

    International Nuclear Information System (INIS)

    Twelve parameters of the knee were evaluated using computed tomography to analyze possible etiological mechanisms leading to patello-femoral arthritis (PF-OA). Sixteen normal knees and 14 knees with PF-OA were tested. CT scans were taken at the level of the femoral epicondyles, the tibial tubercle and the malleoli of the ankle joint at full extension and 30deg of flexion. The slices were superimposed and three parameters; tibial tubercle rotation angle (TT angle), malleolar line rotation angle (ML angle) and tibial tubercle and lateral condyle angle (TT-LC angle) were measured with the central point of the medial and lateral epicondyle line as the fiducial point. Differences in each parameter between full extension and 30deg of flexion were also evaluated as dynamic factors. Three other parameters, lateral condyle rotation angle (LC angle). Lateral and medial condyle angle (LC-MC angle) and lateral condyle and patellar groove angle (LC-S) were also measured to evaluate the anatomical configuration. The position of the tibial tubercle at full extension relative to the femoral condyle was almost the same in both groups. The results, however, demonstrated that, in the PF-OA knee, the tibial tubercle stayed more lateral compared with the normal knee at 30deg of flexion. It is obvious that the tibial tubercle exists laterally in knee flexion and the patella impinges against the lateral femoral condyle in knee flexion which will cause PF-OA. (author)

  7. Temporomandibular joint involvement in juvenile idiopathic arthritis: treatment with an orthodontic appliance

    Directory of Open Access Journals (Sweden)

    M. Gattinara

    2011-09-01

    Full Text Available Introduction and purpose: About 65% of children suffering from juvenile idiopathic arthritis (JIA shows a more or less marked involvement of temporo-mandibular joint (TMJ with altered mandibular growth, resorption of the condyles, occlusary instability, reduced chewing ability and facial dysmorphia. The purpose of our study is to prevent and to treat the progressive evolution of JIA on craniofacial growth and morphology with a functional appliance; surgery should be considered only in so far as the adequacy of TMJ movement is concemed. Methods: From 1992 until now 72 children with proved JIA and TMJ involvement have been treated (50 females, 22 males, aged 6 to 16 years old. TMJ involvement was bilateral in 61% and unilateral in 39% of patients. A diagnostic workup was carried out involving tomograms of TMJ and cephalometric radiograph and analysis. The authors used a bimaxillary activator in the attempt to modify the unfavourable growth pattern and provide a gradual ante-rotation of the jaw. Results: Almost all JIA patients showed satisfactory long term results, easing of pain, reduced skeletal discrepancy, increased function and good facial profile. Conclusions: The long term results of this study indicate that orthopaedic therapy might control the vicious circle of the malocclusion in children with JIA, preventing exacerbation of mandibular clockwise rotation. Surgical intervention for the improvement of TMJ function should be considered only if a severe restricted state is imminent.

  8. The application of quantitative MRI analysis in wrist bone erosion of rheumatoid arthritis%磁共振定量分析在类风湿关节炎手腕部骨侵蚀中的应用

    Institute of Scientific and Technical Information of China (English)

    王颖芳; 朱小春; 杜红卫; 吴红华; 蔡晓笑

    2012-01-01

    OBJECTIVE To analyse and evaluate the application of magnetic resonance quantitative analysis in wrist bone erosion of rheumatoid arthritis, to provide reference for future clinical applications. METHODS Randomly sampled 108 cases with wrist scans by MRI from January 2007 to October 2011, after 1 week, patients diagnosed with rheumatoid arthritis were as the research objects. All the research objects were grouped according to sex, age, course of disease, rheumatoid factor, anti-cyclic citrullinated peptide, C reactive protein, erythrocyte sedimentation rate and other indices, the used Mann-Whitney method to analyze the difference of bone erosion. RESULTS The results in this study showed 73 patients met the criteria as RA, accounted for about 67.59%; bone erosion scores in CRP positive/negative group, early/late period in RA group and ESR positive/negative groups were significantly different (P< 0.05); the bone erosion scores in CCP positive/negative groups were significantly different (P< 0.05). CONCLUSION MRI quantitative analysis provides an effective basis to diagnosis and prognosis of wrist bone erosion of rheumatoid arthritis, and could be widely used in clinical work in the future.%目的 对磁共振定量分析在类风湿关节炎手腕部骨侵蚀中的应用进行分析与评价,为今后的临床应用提供参考.方法 随机抽取在2007年1月~2011年10月这段时间里采用MRI对手腕部进行扫描的临床患者病例108例,在1周之后均进行了实验室检查,将确诊为类风湿关节炎(RA)的患者作为本次研究的研究对象.将所有研究对象按照性别、年龄、病程、类风湿因子、抗环瓜氨酸肽、C反应蛋白、血沉等观察指标进行分组,采用Mann-Whimey方法对各组间骨侵蚀的差异进行分析.结果 在本次研究中所接受检查的108名患者中有73例符合RA标准,约占67.59%;对于CRp阳/阴性组、早期/中晚期RA组以及ESR阳/阴性组间的骨侵蚀评分之间存

  9. Ganglions of the hand and wrist.

    Science.gov (United States)

    Young, L; Bartell, T; Logan, S E

    1988-06-01

    The ganglion is the most common soft tissue tumor of the hand and wrist, originating from the joint capsule or tendon sheath. Accurate diagnosis and proper treatment of these entities require a thorough knowledge of the anatomy of the wrist and hand as well as of the ganglion itself. Definitive therapy is based on total surgical removal of the cyst and its connections to the joint or tendon sheath. PMID:3287641

  10. Technetium-99m human polyclonal immunoglobulin g studies and conventional bone scans to detect active joint inflammation in chronic rheumatoid arthritis

    International Nuclear Information System (INIS)

    Rheumatoid arthritis is a chronic polyarthritis in which active inflammed joints coexist with joints in remission. We performed bone scans (99mTc-DPD) and 99mTc human polyclonal immunoglobulin G scans (99mTc-IgG) in 18 patients with rheumatoid arthritis to assess the uptake in actively inflammed joints and in joints in which remission after inflammation had occurred. A quantitative analysis of tracer uptake in each joint was performed on both scans. In 123 joints without current active inflammation, an increased 99mTc-DPD uptake was observed (2.31±1.27), whereas no 99mTc-IgG uptake was noted (1.18±0.32). Some 78 joints with mild pain or swelling exhibited increased 99mTc-DPD uptake (2.48±1.14) and increased 99mTc-IgG uptake (1.76±0.50; P99mTc-DPD uptake (2.39±0.93) and increased 99mTc-IgG uptake (1.79±0.51; P99mTc-IgG scans distinguish between joints with and without active inflammation in chronic rheumatoid arthritis, whereas bone scans do not. Thus, 99mTc-IgG scans may be useful in identifying joints with current active inflammation in rheumatoid arthritis. (orig.)

  11. The effect of isometric exercise of the hand on the synovial blood flow in patients with rheumatoid arthritis measured by color Doppler ultrasound

    DEFF Research Database (Denmark)

    Ellegaard, Karen; Torp-Pedersen, Søren; Lund, Hans;

    2013-01-01

    In 90% of patients with rheumatoid arthritis (RA), the joints of the hand are affected. Studies of grip strength training have not indicated a negative effect on disease activity after training. Introduction of ultrasound Doppler (USD) to measure increased blood flow induced by inflammation has...... made it possible to investigate the direct effect on blood supply in the synovium after training. In this case-control study, 24 patients with RA with USD activity in the wrist joint participated. The USD activity was measured by the color fraction (CF) (CF = colored pixels/total number of pixels in...... ROI). Twenty-four patients were assigned to an 8-week grip strength training program. At baseline and after 8 weeks of training, an USD examination of the wrist joint was performed. In the training group, we measured grip strength and pain in the wrist joint. Six patients withdrew from the training...

  12. SHOULD DISEASE-MODIFYING THERAPY BE STOPPED IN PATIENTS WITH RHEUMATOID ARTHRITIS BEFORE ENDOPROSTHETIC JOINT REPLACEMENT?

    Directory of Open Access Journals (Sweden)

    N. A. Savenkova

    2011-06-01

    Full Text Available Objective: to analyze disease activity, functional state, quality of life (QL, and the frequency of infectious complications in methotrexate (MT – or leflunomide (LF-treated patients with rheumatoid arthritis (RA who had undergone endoprosthetic replacement of the large joints of the lower limbs. Subjects and methods. One hundred and fourteen patients with RA who had undergone endoprosthetic replacement of the knee and hip joints were divided into 3 groups: 1 36 patients who continuously received MT or LF in the perioperative period; 2 42 patients who dis- continued MT or LF 2 and 4 weeks, respectively, prior to surgery; 3 36 patients who took no disease-modifying anti-rheumatic drugs (DMARDs within 12 months before surgery. Disease activity was estimated by the DAS28 index. QL was determined using the EQ-5D questionnaire and functional capacity was estimated by the HAQ index. Results and discussion. In all the groups, there was a preponderance of patients with moderate RA activity (more than 60%. In Groups 1 and 2, the mean dose of MT was about 10 mg weekly and that of LF was 20 mg daily. The use duration of glucocorticoids (GC and their doses were comparable in all the groups. Twelve months after surgery, DAS28 significantly reduced from 4.22±1.08 to 3.58±1.07 months in Group 1 (p = 0.01; in Group 2, the decrease was insignificant: from 4.17±1.17 to 3.80±1.15 (p > 005; in Group 3, RA activity remained as before. All the groups achieved 50% functional improvement; better results were obtained in the group of patients who continued to use DMARDs in the perioperative period (∆HAQ=-0.67. The difference in the Eq-5D index corresponded to a moderate QL improvement: ∆EQ-5D = 0.28, 0.29, and 0.31 in Groups 1, 2, and 3, respectively (p < 0.05. There were no significant group differences. Deep infection in the endoprosthetic replacement area was detected in 2.8, 2.4, and 8.3% of cases, respectively (p > 005. Conclusion. Continuous use of MT

  13. Assessment of disease activity in juvenile idiopathic arthritis. The number and the size of joints matter

    DEFF Research Database (Denmark)

    Berntson, Lillemor; Wernroth, Lisa; Fasth, Anders;

    2007-01-01

    Variables for assessment of disease activity of juvenile idiopathic arthritis (JIA) were studied, in order to develop a disease activity score for children with JIA.......Variables for assessment of disease activity of juvenile idiopathic arthritis (JIA) were studied, in order to develop a disease activity score for children with JIA....

  14. Intra-articular vs. systemic administration of etanercept in antigen-induced arthritis in the temporomandibular joint. Part II: mandibular growth

    OpenAIRE

    Gelineck John; Pedersen Thomas K; Küseler Annelise; Kristensen Kasper D; Stoustrup Peter; Herlin Troels

    2009-01-01

    Abstract Background Temporomandibular joint (TMJ) arthritis in children causes alterations in the craniomandibular growth. Resultant abnormalities include; condylar erosions, a posterior mandibular rotation pattern, micrognathia, malocclusion with an anterior open bite, altered joint and muscular function occasionally associated with pain. These alterations may be prevented by early aggressive anti-inflammatory intervention. Previously, we have shown that intra-articular (IA) corticosteroid r...

  15. A randomized, double-blind, controlled study of ultrasound-guided corticosteroid injection into the joint of patients with inflammatory arthritis.

    LENUS (Irish Health Repository)

    Cunnington, Joanna

    2010-07-01

    Most corticosteroid injections into the joint are guided by the clinical examination (CE), but up to 70% are inaccurately placed, which may contribute to an inadequate response. The aim of this study was to investigate whether ultrasound (US) guidance improves the accuracy and clinical outcome of joint injections as compared with CE guidance in patients with inflammatory arthritis.

  16. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Rheumatoid Arthritis (RA). You will learn how the diagnosis of RA is made, what happens to your ... Link Below To Play Rheumatoid Arthritis: Symptoms and Diagnosis Rheumatoid Arthritis: What is Happening to the Joints? ...

  17. Temporomandibular joint alterations and their orofacial complications in patients with juvenile idiopathic arthritis.

    Science.gov (United States)

    Carvalho, Renata Teixeira de; Braga, Flávia Silva Farah Ferreira; Brito, Fernanda; Capelli Junior, Jonas; Figueredo, Carlos Marcelo; Sztajnbok, Flávio Roberto

    2012-12-01

    Patients with juvenile idiopathic arthritis (JIA) can have alterations in bone metabolism and skeletal growth, as well as damage to the temporomandibular joint (TMJ), which can generate extra and/or intraoral alterations, resulting in craniofacial disorders. Our goal is to carry out a review of the literature on orofacial alterations in patients with JIA. Among the orofacial disorders in patients with JIA, alterations in mandibular growth, caused by dysfunctions in the TMJ region, seem highly prevalent in these patients. The most often found alterations are: retrognathia, micrognathia, anterior open bite, dental crowding, facial asymmetry and mouth opening limitation. Thus, the rheumatologist becomes a key agent in the early detection of these disorders, helping with patient referral to a dentist. The diagnosis, in turn, should be performed by the orthodontist, using clinical examination and imaging methods, allowing early treatment and a favorable prognosis. TMJ disorders should be treated by a multidisciplinary team, including pharmacological treatment for pain control and dental care through functional appliance and/or orthodontic therapy, physical therapy and sometimes, speech therapy. We conclude that among the orofacial disorders in patients with JIA, alterations in mandibular growth generated by dysfunctions in the TMJ region seem highly prevalent. Such dysfunctions can cause mainly open bite, mandibular retrusion, micrognathia, dental crowding and facial asymmetry. The rheumatologist can detect these alterations at an early stage, with immediate patient referral to a team that should preferably be a multidisciplinary one, consisting of an orthodontist, physical therapist and speech therapist, to reduce future occlusal and mandibular growth complications. PMID:23223701

  18. An unusual case of gout in the wrist: the importance of monitoring medication dosage and interaction. A case report

    Directory of Open Access Journals (Sweden)

    Stern Paula J

    2007-10-01

    Full Text Available Abstract Background Gouty arthritis of the wrist is uncommon although gout itself is the most common inflammatory arthritis in older patients. Some known risk factors for the development of gout include trauma, alcohol use, obesity, hyperuricaemia, hypertension and diabetes mellitus. As well, certain medications have been shown to promote the development of gout. These include thiazide diuretics, low dose salicylates and cyclosporine. We present a case of gouty wrist pain possibly precipitated by a medication dosage increase as well as medication interactions. Case presentation A 77 year old male presented with right wrist pain. Redness and swelling was present at the dorsal aspect of his wrist and range of motion was full with pain at end range upon examination. One week prior, his anti-hypertensive medication dosage had been increased. The patient's situation continued to worsen. Radiographic examination revealed changes consistent with gouty arthritis. Conclusion It is important for clinicians treating joint conditions to be aware of patients' comorbidities, medication usage and changes in dosages. Education of patients with gout is of prime importance. Clinicians should educate patients that gout may occur at any joint in the body not only the lower limb. Patients should be aware of the signs and symptoms of an acute gouty attack and be made aware that changes in certain medication dosages may precipitate an attack. Awareness of radiographic changes associated with gout is still of importance although these changes are not seen as frequently as they have been in the past due to better control of the disease.

  19. Effects of low dosage Co-60 irradiation in the course of aseptic arthritis of the knee joint of rabbits

    International Nuclear Information System (INIS)

    Purpose: Numerous clinical observations demonstrate the efficacy of low radiation doses in the treatment of painful osteoarthritis. Experimental investigations remain scarce. We investigated the effects of locally daily 5 times 1.0 Gy 60-Co irradiation on an artificially induced aseptic gonarthritis in rabbits. Material and methods: Three separate experiments (EV) were performed (10 rabbits per experiment, 5 treated/5 controls; duration: EV1: 18 days; EV2: 6 days; EV3: 29 days). An aseptic arthritis in the right knee joint of rabbits was induced by intraarticular injection of 0.5 ml papain solution (3%, 30,000 USP/mg) on day 0. The arthritic knee joint of the anesthesized animals was irradiated daily from day 1 to 5 with 5 times 1.0 Gy. The controls were sham-irradiated under the same conditions. The time course of arthritis in treated animals and sham-treated controls was evaluated by clinical, laboratory-chemical and histological criteria. The clinical investigation was performed daily, the puncture of the knee-joints was carried out several times in EV1, and at the end of experiments in EV2 and EV3. At the end of the observation period, animals were killed and the knee joints excised for histological analysis. Results: The intraarticular injection of papain caused a peracute inflammatory response in all animals. After 1 week the chronical stage was reached, and the experimental arthritis resolved slowly within several weeks. Local irradiation accelerated the decrease of inflammatory joint swelling, being significant by day 4. On day 6 the volume of synovial fluid in irradiated knee-joints was significantly smaller. The morphometric data indicated a reduction in thickness of synovial membrane, a decrease in number of synovial cell layers, and a decrease in distance between capillaries and the synovial membrane surface following irradiation of arthritic joints. Due to considerable individual variability, the morphometric data partially did not reach statistically

  20. A Patient-Specific Foot Model for the Estimate of Ankle Joint Forces in Patients with Juvenile Idiopathic Arthritis.

    Science.gov (United States)

    Prinold, Joe A I; Mazzà, Claudia; Di Marco, Roberto; Hannah, Iain; Malattia, Clara; Magni-Manzoni, Silvia; Petrarca, Maurizio; Ronchetti, Anna B; Tanturri de Horatio, Laura; van Dijkhuizen, E H Pieter; Wesarg, Stefan; Viceconti, Marco

    2016-01-01

    Juvenile idiopathic arthritis (JIA) is the leading cause of childhood disability from a musculoskeletal disorder. It generally affects large joints such as the knee and the ankle, often causing structural damage. Different factors contribute to the damage onset, including altered joint loading and other mechanical factors, associated with pain and inflammation. The prediction of patients' joint loading can hence be a valuable tool in understanding the disease mechanisms involved in structural damage progression. A number of lower-limb musculoskeletal models have been proposed to analyse the hip and knee joints, but juvenile models of the foot are still lacking. This paper presents a modelling pipeline that allows the creation of juvenile patient-specific models starting from lower limb kinematics and foot and ankle MRI data. This pipeline has been applied to data from three children with JIA and the importance of patient-specific parameters and modelling assumptions has been tested in a sensitivity analysis focused on the variation of the joint reaction forces. This analysis highlighted the criticality of patient-specific definition of the ankle joint axes and location of the Achilles tendon insertions. Patient-specific detection of the Tibialis Anterior, Tibialis Posterior, and Peroneus Longus origins and insertions were also shown to be important. PMID:26374518

  1. Prediction of Impact Shock Vibrations at Tennis Player's Wrist Joint: Comparison between Conventional Weight Racket and Light Weight Racket with Super Large Head Size

    Science.gov (United States)

    Kawazoe, Yoshihiko; Takeda, Yukihiro; Nakagawa, Masamichi; Casolo, Federico; Tomosue, Ryoso; Yoshinari, Keiko

    The lightweight racket with handle-light configuration and large head size is recent tendency of high-tech tennis rackets, increasing power or post-impact ball velocity with an increasing racket swing speed. This paper investigated the performance of lightweight tennis racket with super-large head size in terms of feel or comfort. It predicted the effect of the mass and mass distribution of super-large sized rackets on the impact shock vibrations of the racket handle and the player's wrist joint when a player hits a flat forehand drive. The prediction is based on the identification of the racket characteristics, the damping of the racket-arm system, equivalent mass of the player's arm system and the approximate nonlinear impact analysis in tennis. A super-light weight balanced racket (mass: 292 g, the center of gravity LG: 363 mm from the butt end) and a conventional weight and weight balanced racket (349 g, LG: 323 mm) are selected as representatives. They are the super-large sized rackets made of carbon graphite with a head size of 120 square inches and the same geometry. The result showed that the shock vibration of the super-light weight balanced racket with super-large sized head is much larger than that of the conventional weight balanced type racket. It also showed that the sweet area of the former in terms of the shock vibration shifts from the center to the topside on the racket face compared to the latter. This is because the location of the grip on the racket handle is further from the location of the node on the handle of the first mode of super-light racket than that of the conventional weight racket.

  2. Carpal instability of the wrist.

    Science.gov (United States)

    Caggiano, Nicholas; Matullo, Kristofer S

    2014-01-01

    The scaphoid is stabilized by the scapholunate ligament (directly) and lunotriquetral ligament (indirectly). Disruption of either of these ligaments leads to a pattern of instability that, left untreated, leads to altered mechanics of the wrist and ultimately debilitating arthritis and collapse. Although arthroscopy remains the gold standard for diagnosis of these injuries, plain films and advanced imaging are useful adjuncts. In the acute setting, conservative treatment may be attempted, but recalcitrant cases require surgical stabilization. Salvage procedures are also available for those patients who fail initial stabilization or present with late degeneration. PMID:24267214

  3. Spinal Epidural Abscess with Pyogenic Arthritis of Facet Joint Treated with Antibiotic-Bone Cement Beads - A Case Report -

    OpenAIRE

    Lee, Bong-Jin; Lee, Sung-Rak; Kim, Seong-Tae; Kim, Tae-Ho; Lee, Sang-Hoon

    2007-01-01

    Most epidural abscesses are a secondary lesion of pyogenic spondylodiscitis. An epidural abscess associated with pyogenic arthritis of the facet joint is quite rare. To the best of our knowledge, there is no report of the use of antibiotic-cement beads in the surgical treatment of an epidural abscess. This paper reports a 63-year-old male who sustained a 1-week history of radiating pain to both lower extremities combined with lower back pain. MRI revealed space-occupying lesions, which were l...

  4. Easing Arthritis: Research offers new hope for people with common joint disease.

    Science.gov (United States)

    ... so much benefit from physical therapy that the physical therapist suggested it would be good for me to ... Felson, they may well prevent more than arthritis. Fall 2006 Issue: Volume 1 Number 1 Pages 14 - ...

  5. Objectification of a Choice of a Spa Treatment Plan for Arthritis of the Hip Joint

    Czech Academy of Sciences Publication Activity Database

    Och, F.; Medonos, J.; Hanzlíček, P.; span class="emphasis">Valenta, Zdeněkspan>; Dvořák, V.; span class="emphasis">Zvárová, Janaspan>

    Prague, 2013, nestr. [EFMI 2013 Special Topic Conference. Prague (CZ), 17.04.2013-19.04.2013] Institutional support: RVO:67985807 Keywords : decision-support * spa treatment * hip arthritis * statistical analysis Subject RIV: IN - Informatics, Computer Science

  6. Trends in Wrist Arthroscopy

    Science.gov (United States)

    Obdeijn, Miryam C.; Tuijthof, Gabrielle J. M.; van der Horst, Chantal M. A. M.; Mathoulin, Christophe; Liverneaux, Philippe

    2013-01-01

    Background Wrist arthroscopy plays a role in both the diagnosis and the treatment of wrist pathology. It has evolved in the last three decades. Questions The present status of wrist arthroscopy was investigated by answering the following questions: -What is its current position in the treatment wrist pathologies according to the literature? -What is its current position according to hand surgeons? Methods Analysis of the number of publications on wrist arthroscopy was performed and compared with the number of publications on other arthroscopy topics to assess the current position of wrist arthroscopy. The members of the EWAS (European Wrist Arthroscopy Society) and the members of eight national hand surgery societies were questioned on wrist arthroscopy in daily practice. Results From 1975 till now, 925 papers on wrist arthroscopy were found. The publications on wrist arthroscopy increased from an average of 8/year (1986) to 26/year (2012). More than half (56.9%) of the respondents of the EWAS perform fewer than 5 wrist arthroscopies per month, and only 7 (10.8%) indicate the performance of more than 10 wrist arthroscopies per month. Seventy-four percent of the orthopedic hand surgeons perform wrist arthroscopy (in 48.5% for therapeutic indications) against 36.8% of plastic surgery hand surgeons (in 23.1% for therapeutic indications). Conclusion Wrist arthroscopy has taken up a place in the armamentarium of the hand surgeon. The place of wrist arthroscopy in daily practice is related to the background of the hand surgeon. PMID:24436823

  7. Imaging in Psoriatic Arthritis

    DEFF Research Database (Denmark)

    Poggenborg, René Panduro; Østergaard, Mikkel; Terslev, Lene

    2015-01-01

    Psoriatic arthritis (PsA) is an inflammatory joint disease characterized by arthritis and often enthesitis in patients with psoriasis, presenting a wide range of manifestations in various patterns. Imaging procedures are primarily conventional radiography, ultrasonography (US), and magnetic...

  8. Anti-xanthine oxidase antibodies in sera and synovial fluid of patients with rheumatoid arthritis and other joint inflammations

    International Nuclear Information System (INIS)

    Objective was to study anti-bovine milk xanthine oxidoreductase XOPR antibody levels in synovial fluid as well as in serum of patients suffering from rheumatoid affections to assess a possible correlation between antibody titres and severity of disease. Sera and synovial fluids were collected from volunteer donors at Setif University Hospital, Setif, Algeria from 2001-2007 with the consent of patients. Human IgG and IgM levels of free and bound anti-bovine milk XOR antibodies were determined using bovine XOR as antigen, with enzyme-linked immunosorbent assay ELISA. Serum IgG anti-bovine milk XOR titres in 30 healthy normal subjects 2.74+-2.31 microgram/mL are in agreement with that reported in the literature. Immunoglobulin G and IgM anti-bovine milk XOR antibody titres were found to be significantly higher in serum from patients with rheumatoid arthritis RA and latex positives subjects. Synovial IgM antibody titres to bovine XOR were found to be significantly higher in rheumatoid arthritis patients compared to patients with other joint inflammations. In rheumatoid arthritis patients, high concentrations of antibodies against XOR were noticed. These antibodies may play a major role in RA by inhibiting both xanthine and NADH oxidase activities of XOR. They may also play a key role in eliminating XOR from serum and synovial fluid positive role but unfortunately, immune complex formation could also activate complement and participate in self maintenance of inflammation. (author)

  9. Radiosynovectomy in the treatment of arthritis

    International Nuclear Information System (INIS)

    Full text: Radiosynovectomy is a useful therapeutic option that involves radiopharmaceutical injections into joints, especially to treat rheumatoid arthritis. The indications included different kinds of arthritis, such as rheumatoid arthritis, psoriatic arthritis, Bechterew's disease, hemophiliac arthritis, osteoarthritis, but also patients with joint prosthesis and synovial effusion. There are three commercial available radiopharmaceuticals for the treatment: yttrium-90 for the knee (185 to 250 MBq), rhenium-186 for larger joints (shoulder and hip with 111 MBq; elbow, wrist, ankle joint with 74 MBq) and erbium- 169 for smaller joints (acromioclavicular joint with 37 MBq, thumb base and MTP I with 30 MBq, MCP and MTP II-V with 22 MBq, PIP with 18.5 MBq, and DIP with 15 MBq, respectively). Decisive for the treatment is a positive sign for arthritis in the two-phase bone scan with 99mTc- HMDP (high uptake in the blood pool phase). Only for radiosynovectomy in the knee an ultrasound with an evidence of effusion is sufficient. Side effects by the treatment are rare, such as temporary radiation or crystal synovitis, tissue necrosis (extra-articular fraction or intraarticular), joint infection (1 of 35,000 joints) or effects due to the immobilization (thrombosis, pulmonary embolism (immobilization of the knee), lymph edema or loss of motion. In the treatment of the knee, a prophylaxis with heparin is necessary to protect the patients for pulmonary embolism. The radiation absorbed dose to the patients are low because a low leakage rate from the treated joint (lymphogenic uptake of 1.8%ID (0.45 to 4.78). These leads to a radiation exposure to the testis of 0.1mSv (0.05 to 0.18) and to the ovary of 0.2 mSv (0.1 to 0.38). Significantly is the radiation exposure of the physician, here especially at the finger pulp. A high beta dose of 22.1 μSv/MBq for the forefinger was observed using only a syringe protection in treatments of knees (90Y), this resulted in a annual radiation

  10. Cartilage destruction in small joints by rheumatoid arthritis: assessment of fat-suppressed three-dimensional gradient-echo MR pulse sequences in vitro

    International Nuclear Information System (INIS)

    Purpose. To assess the accuracy of different MR sequences for the detection of articular cartilage abnormalities in rheumatoid arthritis. Design and patients. Ten metacarpophalangeal joints and 10 metatarsophalangeal joints (specimens from arthritis patients undergoing ablative joint surgery) were examined with a fat-suppressed (FS) 3D FLASH, a FS 3D FISP, a FS 2D fast spin-echo T2-weighted, and a 2D FS spin-echo T1-weighted sequence. Each cartilage lesion and each cortical lesion was graded from 0 to 4 (modified Outerbridge staging system). Subsequently, the results of each sequence were compared with the macroscopic findings and statistically tested against each other. Results. The study shows that 3D gradient-echo sequences with fat suppression were best for imaging and grading of cartilage lesions in arthritis of the small joints of the hands and feet. Using 3D techniques, all grade 2, grade 3, and grade 4 lesions of cartilage or cortical bone were detected. Conclusion. FS 3D gradient-echo techniques were best for the detection and grading of hyaline cartilage and subchondral bone lesions in rheumatoid arthritis. MRI has a great potential as an objective method of evaluating cartilage damage and bone erosions in rheumatoid arthritis. (orig.)

  11. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... of RA is made, what happens to your joints, what treatments are available, what is happening in ... Diagnosis Rheumatoid Arthritis: What is Happening to the Joints? Rheumatoid Arthritis: Gaining Control – Working with your Rheumatologist ...

  12. 早期类风湿性关节炎腕关节MRI表现%MRI FEATURES OF WRIST IN EARLY STAGE OF RHEUMATOID ARTHRITIS

    Institute of Scientific and Technical Information of China (English)

    李石玲; 郭智萍; 赵建; 朱瑾; 马晓晖; 张敏

    2006-01-01

    目的研究早期类风湿性关节炎(rheumatoid arthritis,RA)在腕关节的主要MRI表现.方法选择经临床确诊早期RA78例,进行腕关节MRI平扫和增强扫描,观察各种异常MRI征象,评价主要MRI征象对于早期RA的诊断价值.结果 78例早期RA的MRI征象:滑膜增厚78例,血管翳强化78例,骨髓水肿65例,骨侵蚀50例,关节积液54例,腱鞘炎3例.结论腕关节MRI可以反映早期RA的病理改变,是诊断早期RA重要的检查方法.

  13. MRI findings of treated bacterial septic arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Bierry, Guillaume; Huang, Ambrose J.; Chang, Connie Y.; Torriani, Martin; Bredella, Miriam A. [Massachusetts General Hospital and Harvard Medical School, Musculoskeletal Imaging and Intervention, Department of Radiology, Boston, MA (United States)

    2012-12-15

    The purpose of this study was to report the MRI findings that can be encountered in successfully treated bacterial septic arthritis. The study included 12 patients (8 male and 4 female; mean age 38 years, range 9-85) with 13 proven cases of bacterial septic arthritis. The joints involved were hip (n = 3), knee (n = 3), shoulder (n = 2), sacroiliac (n = 2), ankle (n = 1), wrist (n = 1), and elbow (n = 1). MRI examinations following surgical debridement and at initiation of antibiotic therapy and after successful treatment were compared for changes in effusion, synovium, bone, and periarticular soft tissues. Imaging findings were correlated with microbiological and clinical findings. Joint effusions were present in all joints at baseline and regressed significantly at follow-up MRI (p = 0.001). Abscesses were present in 5 cases (38 %), and their sizes decreased significantly at follow-up (p = 0.001). Synovial enhancement and thickening were observed in all joints at both baseline and follow-up MRI. Myositis/cellulitis was present in 10 cases (77 %) at baseline and in 8 cases (62 %) at follow-up MRI. Bone marrow edema was present in 10 joints (77 %) at baseline and persisted in 8 joints (62 %). Bone erosions were found in 8 joints (62 %) and persisted at follow-up MRI in all cases. The sizes of joint effusions and abscesses appear to be the factors with the most potential for monitoring therapy for septic arthritis, since both decreased significantly following successful treatment. Synovial thickening and enhancement, periarticular myositis/cellulitis, and bone marrow edema can persist even after resolution of the infection. (orig.)

  14. MRI findings of treated bacterial septic arthritis

    International Nuclear Information System (INIS)

    The purpose of this study was to report the MRI findings that can be encountered in successfully treated bacterial septic arthritis. The study included 12 patients (8 male and 4 female; mean age 38 years, range 9-85) with 13 proven cases of bacterial septic arthritis. The joints involved were hip (n = 3), knee (n = 3), shoulder (n = 2), sacroiliac (n = 2), ankle (n = 1), wrist (n = 1), and elbow (n = 1). MRI examinations following surgical debridement and at initiation of antibiotic therapy and after successful treatment were compared for changes in effusion, synovium, bone, and periarticular soft tissues. Imaging findings were correlated with microbiological and clinical findings. Joint effusions were present in all joints at baseline and regressed significantly at follow-up MRI (p = 0.001). Abscesses were present in 5 cases (38 %), and their sizes decreased significantly at follow-up (p = 0.001). Synovial enhancement and thickening were observed in all joints at both baseline and follow-up MRI. Myositis/cellulitis was present in 10 cases (77 %) at baseline and in 8 cases (62 %) at follow-up MRI. Bone marrow edema was present in 10 joints (77 %) at baseline and persisted in 8 joints (62 %). Bone erosions were found in 8 joints (62 %) and persisted at follow-up MRI in all cases. The sizes of joint effusions and abscesses appear to be the factors with the most potential for monitoring therapy for septic arthritis, since both decreased significantly following successful treatment. Synovial thickening and enhancement, periarticular myositis/cellulitis, and bone marrow edema can persist even after resolution of the infection. (orig.)

  15. Application of the Blobo bluetooth ball in wrist rehabilitation training.

    Science.gov (United States)

    Hsieh, Wei-Min; Hwang, Yuh-Shyan; Chen, Shih-Ching; Tan, Sun-Yen; Chen, Chih-Chen; Chen, Yu-Luen

    2016-01-01

    [Purpose] The introduction of emerging technologies such as the wireless Blobo bluetooth ball with multimedia features can enhance wrist physical therapy training, making it more fun and enhancing its effects. [Methods] Wrist injuries caused by fatigue at work, improper exercise, and other conditions are very common. Therefore, the reconstruction of wrist joint function is an important issue. The efficacy of a newly developed integrated wrist joint rehabilitation game using a Blobo bluetooth ball with C# software installed was tested in wrist rehabilitation (Flexion, Extension, Ulnar Deviation, Radial Deviation). [Results] Eight subjects with normal wrist function participated in a test of the system's stability and repeatability. After performing the Blobo bluetooth ball wrist physical therapy training, eight patients with wrist dysfunction experienced approximately 10° improvements in range of motion (ROM) of flexion extension, and ulnar deviation and about 6° ROM improvement in radial deviation. The subjects showed progress in important indicators of wrist function. [Conclusion] This study used the Blobo bluetooth ball in wrist physical therapy training and the preliminary results were encouraging. In the future, more diverse wrist or limb rehabilitation games should be developed to meet the needs of physical therapy training. PMID:26957723

  16. The ability of synovitis to predict structural damage in rheumatoid arthritis: a comparative study between clinical examination and ultrasound

    OpenAIRE

    Dougados, Maxime; Devauchelle-Pensec, Valérie; Ferlet, Jean françois; Jousse-Joulin, Sandrine; D'Agostino, Maria-Antonietta; Backhaus, Marina; Bentin, Jacques; Chalès, Gérard; Chary-Valckenaere, Isabelle; Conaghan, Philip; Wakefield, Richard J; Etcheparre, Frédéric; Gaudin, Philippe; Grassi, Walter; van der Heijde, Désirée

    2012-01-01

    Objectives To evaluate synovitis (clinical vs ultrasound (US)) to predict structural progression in rheumatoid arthritis (RA). Methods Patients with RA. Study design Prospective, 2-year follow-up. Data collected Synovitis (32 joints (2 wrists, 10 metacarpophalangeal, 10 proximal interphalangeal, 10 metatarsophalangeal)) at baseline and after 4 months of therapy by clinical, US grey scale (GS-US) and power doppler (PD-US); x-rays at baseline and at year 2. Analysis Measures of association (OR)...

  17. Radiosynovectomy of the elbow joint synovitis in rheumatoid arthritis treated with Lutetium - 177 labeled hydroxylapatite (Lu-177 HA) particulates; first case report and image of Lu -177 HA in the elbow joint

    International Nuclear Information System (INIS)

    Rheumatoid arthritis is a chronic disease that is mainly characterized by asymmetric erosive synovitis, particularly affecting the peripheral joints. Radiation synovectomy or radiosynovectomy, also known as radiosynoviorthesis was first described in 1950's as a adjuvant treatment for rheumatoid arthritis. Radiosynovectomy is based on the irradiation of the joint synovium by the intra-articular administration of various β-emitting radiopharmaceuticals. Lu-177 has presence of gamma photons of imagable energy with low abundance which provides the additional benefit of carrying out simultaneous scintigraphy. We describe the first case report of use of Lu-177 hydroxylapatite particulates in a 35-year-old female patient who was presented with elbow joint synovitis due to rheumatoid arthritis

  18. Distinctive radiological features of small hand joints in rheumatoid arthritis and seronegative spondyloarthritis demonstrated by contrast-enhanced (Gd-DTPA) magnetic resnance imaging

    International Nuclear Information System (INIS)

    A series of patients with clinically early inflammatory joint disease due to rheumatoid arthritis, psoriatic arthritis and Reiter's syndrome were examined by plain film radiography and magnetic resonance imaging (MRI). The spin echo T1-weighted precontrast, T2-weighted, and, especially, T1-weighted postcontrast images demonstrated distinct differences in the distribution of inflamatory changes, both within and adjacent to involved small hand joints. Two major subtypes of inflammatory arthritis were shown, thus providing a specific differential diagnosis between rheumatoid arthritis and some patients with seronegative spondyloarthritis. In particular, all the patients with Reiter's syndrome who were studied, and half of those with psoriatic arthritis, had a distinctive pattern of extra-articular desease involvement. The need for a new classification of clinical subsets in psoriatic arthritis has been recently suggested. The present findings suggest that magnetic resonance imaging could be useful in such a reclassification of seronegative spondyloarthritis, as well as offering considerable potential for a reappraisal of pathogenesis and therapy. In this series, it was also noted that juxta-articular osteoporosis on plain film did not correlate with bone marrow oedema on MRI. Hence the aetiology of this common radiographic finding also merits further consideration. (orig.)

  19. Metaphyseal osteomyelitis in children: how often does MRI-documented joint effusion or epiphyseal extension of edema indicate coexisting septic arthritis?

    International Nuclear Information System (INIS)

    Joint effusions identified by MRI may accompany osteomyelitis and determining whether the joint effusion is septic or reactive has important implications on patient care. Determine the incidence of epiphyseal marrow edema, joint effusions, perisynovial edema and epiphyseal non-enhancement in the setting of pediatric metaphyseal osteomyelitis and whether this may be used to predict coexisting septic arthritis. Following IRB approval, we retrospectively evaluated children who underwent MRI and orthopedic surgical consultation for suspected musculoskeletal infection between January 2011 and September 2013. Criteria for inclusion in the study were microbiologically/pathologically proven infection, MRI prior to surgical intervention, long bone involvement and age 0-18 years. MRI exams were independently reviewed by two faculty pediatric radiologists to confirm the presence of appendicular metaphyseal osteomyelitis, to evaluate extent of edema, to determine subjective presence of a joint effusion and to assess perisynovial edema and epiphyseal non-enhancement. Any discrepant readings were reviewed in consensus. Charts and operative notes were reviewed to confirm the diagnosis of osteomyelitis and septic arthritis. One hundred and three joints with metaphyseal osteomyelitis were identified (mean age: 7.1 years; M:F 1.3:1), of whom 53% (55/103) had joint effusions, and of those, 75% (41/55) had surgically confirmed septic arthritis. The incidence of coexisting septic arthritis was 40% in the setting of epiphyseal edema, 74% in epiphyseal edema and effusion, 75% with perisynovial edema, 76% with epiphyseal non-enhancement and 77% when all four variables were present. Of these, the only statistically significant variable, however, was the presence of a joint effusion with a P-value of <0.0001 via Fisher exact test. Statistical significance for coexisting septic arthritis was also encountered when cases were subdivided into intra-articular vs. extra-articular metaphyses (P

  20. Metaphyseal osteomyelitis in children: how often does MRI-documented joint effusion or epiphyseal extension of edema indicate coexisting septic arthritis?

    Energy Technology Data Exchange (ETDEWEB)

    Schallert, Erica K.; Kan, J.H.; Monsalve, Johanna; Zhang, Wei; Bisset, George S. [Texas Children' s Hospital, Department of Pediatric Radiology, Houston, TX (United States); Rosenfeld, Scott [Texas Children' s Hospital, Department of Pediatric Orthopedic Surgery, Houston, TX (United States)

    2015-08-15

    Joint effusions identified by MRI may accompany osteomyelitis and determining whether the joint effusion is septic or reactive has important implications on patient care. Determine the incidence of epiphyseal marrow edema, joint effusions, perisynovial edema and epiphyseal non-enhancement in the setting of pediatric metaphyseal osteomyelitis and whether this may be used to predict coexisting septic arthritis. Following IRB approval, we retrospectively evaluated children who underwent MRI and orthopedic surgical consultation for suspected musculoskeletal infection between January 2011 and September 2013. Criteria for inclusion in the study were microbiologically/pathologically proven infection, MRI prior to surgical intervention, long bone involvement and age 0-18 years. MRI exams were independently reviewed by two faculty pediatric radiologists to confirm the presence of appendicular metaphyseal osteomyelitis, to evaluate extent of edema, to determine subjective presence of a joint effusion and to assess perisynovial edema and epiphyseal non-enhancement. Any discrepant readings were reviewed in consensus. Charts and operative notes were reviewed to confirm the diagnosis of osteomyelitis and septic arthritis. One hundred and three joints with metaphyseal osteomyelitis were identified (mean age: 7.1 years; M:F 1.3:1), of whom 53% (55/103) had joint effusions, and of those, 75% (41/55) had surgically confirmed septic arthritis. The incidence of coexisting septic arthritis was 40% in the setting of epiphyseal edema, 74% in epiphyseal edema and effusion, 75% with perisynovial edema, 76% with epiphyseal non-enhancement and 77% when all four variables were present. Of these, the only statistically significant variable, however, was the presence of a joint effusion with a P-value of <0.0001 via Fisher exact test. Statistical significance for coexisting septic arthritis was also encountered when cases were subdivided into intra-articular vs. extra-articular metaphyses (P

  1. OMERACT Rheumatoid Arthritis Magnetic Resonance Imaging Studies. Summary of OMERACT 6 MR Imaging Module

    DEFF Research Database (Denmark)

    McQueen, F; Lassere, M; Edmonds, J;

    2003-01-01

    Magnetic resonance image (MRI) scanning is a new method for imaging and quantifying joint inflammation and damage in rheumatoid arthritis (RA). Over the past 4 years, the OMERACT MR Imaging Group has been developing and testing the RA-MRI scoring system (RAMRIS) for use in RA. The OMERACT filter...... space narrowing, reflecting cartilage damage, has also been excluded as reliability was low at the small joints of the hands. Anatomical coverage of the score is currently restricted to the wrists and hands but can provide a basis for a more comprehensive score. The MR measurement of synovitis...... correlates closely with histological evidence and work continues on validating MR erosions with reference to radiographic techniques. The RAMRIS has demonstrated good reliability for bone erosion and synovitis at the wrists and metacarpophalangeal joints subject to reader training, with slightly lower levels...

  2. Yttrium-90 distribution following radiosynoviorthesis of the knee joint in rheumatoid arthritis patients. A SPECT/CT study

    International Nuclear Information System (INIS)

    To examine yttrium-90 distribution 1 and 72 h following its injection into a knee joint in patients with rheumatoid arthritis (RA). In 14 RA patients we injected yttrium-90 into the affected knee joint using lateral approach. To assess the radioisotope distribution in the joint, the superimposed sequential SPECT and CT imaging was performed 1 and 72 h after the injection. We analyzed the percentage of radioisotope distribution in three predefined compartments of the knee joint (lower, upper medial, upper lateral). After 1 and 72 h, the mean percentage distributions were, respectively, 7.14 and 23.07% in lower; 21.42 and 15.38% in upper medial, and 71.42 and 61.53% in upper lateral compartment. The percentage of isotope deposition did not change significantly with time in any of the compartments (all p > 0.26). The deposition of isotope, both at 1 and 72 h, was significantly greater in upper lateral compartment, where the injection was performed, than in all other compartments (all p < 0.05). Using the SPECT/CT hybrid method, we proved that the majority of isotope is located at the compartment adjacent to the injection. Two injections targeting different compartments might improve the clinical efficacy of the procedure. (author)

  3. Wrist pulse (image)

    Science.gov (United States)

    To measure the pulse at the wrist, place the index and middle finger over the underside of the opposite wrist, below the base ... firmly with flat fingers until you feel the pulse in the radial artery.

  4. Bone scan and joint scan of hands and feet in rheumatoid arthritis; Scintigraphie osseuse et articulaire des mains et des pieds dans la polyarthrite rhumatoide

    Energy Technology Data Exchange (ETDEWEB)

    Carpentier, N.; Verbeke, S.; Perdrisot, R.; Grilo, R.M.; Quenesson, E.; Bonnet, C.; Vergne, P.; Treves, R.; Bertin, P.; Boutros-Toni, F. [Centre Hospitalier Universitaire Dupuytren, Faculte de Medecine, 87 - Limoges (France)

    2000-09-01

    The aim of this study was to determine the ability of joint scan and bone scan of hands and feet, in patients with rheumatoid arthritis, to localize the altered joints. The sensitivity, the specificity, the positive predictive value (PPV) and the negative predictive value (NPV) of joint scan were determined in comparison with clinical joint assessment. Fifteen patients (780 joints) were clinically examined (pain and synovitis); during the same day, a bone scan and a joint scan were realized by oxidronate {sup 99m}Tc intravenous injection. Patients were scanned 5 minutes (tissual time, T{sub t}) and 3 hours 1/4 (bone time, T{sub 0}) after the administration. The uptake of the bi-phosphonate was evaluated with a qualitative method using a grey scale. The uptake of {sup 99m}Tc oxidronate was quantitated using an extra-articular region of interest. The sensitivity, specificity, PPV and NPV of the scan at Tt were 46%, 96%, 85% et 78%. The same parameters were 75%, 66%, 53% and 84% for the scan realized at T{sub 0}. The joint scan has showed 22% of false positive. These false positives could be a consequence of an earlier detection of joint alterations by scan. The joint scan should forecast the evolution of joints in patients with rheumatoid arthritis. (author)

  5. Studies on ageing and the severity of radiographic joint damage in rheumatoid arthritis

    NARCIS (Netherlands)

    Mangnus, Lukas; van Steenbergen, Hanna W.; Lindqvist, Elisabet; Brouwer, Elisabeth; Reijnierse, Monique; Huizinga, Tom W. J.; Gregersen, Peter K.; Berglin, Ewa; Rantapaa-Dahlqvist, Solbritt; van der Heijde, Desiree; van der Helm-van Mil, Annette H. M.

    2015-01-01

    Introduction: The western population is ageing. It is unknown whether age at diagnosis affects the severity of Rheumatoid Arthritis (RA), we therefore performed the present study. Method: 1,875 RA-patients (7,219 radiographs) included in five European and North-American cohorts (Leiden-EAC, Wichita,

  6. Objectification of a Choice of a Spa Treatment Plan for Arthritis of the Hip Joint

    Czech Academy of Sciences Publication Activity Database

    Och, F.; Medonos, J.; Hanzlíček, P.; span class="emphasis">Valenta, Zdeněkspan>; Dvořák, V.; span class="emphasis">Zvárová, Janaspan>

    2013-01-01

    Roč. 1, č. 1 (2013), s. 10-10. ISSN 1805-8698. [EFMI 2013 Special Topic Conference. 17.04.2013-19.04.2013, Prague] Institutional support: RVO:67985807 Keywords : decision-support * spa treatment * hip arthritis * statistical analysis Subject RIV: IN - Informatics, Computer Science

  7. A Study of the Evaluation of the Joint Movement Ability of the Patients with Rheumatoid Arthritis by CT Imaging and Explore its Correlation with Rheumatoid Factor%CT运动成像评判类风湿性关节炎患者关节运动能力并探究其与类风湿因子的相关性

    Institute of Scientific and Technical Information of China (English)

    吴训华

    2016-01-01

    目的 应用320CT的运动成像功能来评判类风湿关节炎受试者的关节运动及其与类风湿因子的相关性.方法 选择类风湿性关节炎且累及其双侧腕关节者20例,应用320层动态CT运动成像研究其腕关节,检测尺侧的偏转度、桡侧的偏转度、尺桡侧的活动度以及血清中类风湿因子的水平.结果 受试者双侧腕关节的尺侧角度的配对检验结果:P=0.494;受试者桡侧的角度配对的t检验结果:P=0.309;受试者尺桡活动度的配对t检验结果:P=0.187;受试者尺侧偏转度和血清中的类风湿因子水平的相关性检验:r=-0.373,P=0.021;受试者桡侧的偏转度和血清中的类风湿因子的相关性检验:r=-0.509,P=0.003;受试者尺桡侧的活动度与血清中的类风湿因子的相关性检验:r=-0.440,P=0.007.结论 类风湿性关节炎患者双侧腕关节的运动障碍程度无统差异,患者腕关节的运动功能和类风湿因子呈负相关.%Objective To judge the joint movement of the subjects of rheumatoid arthritis and its correlation with rheumatoid factor though the application of 320CT motion imaging function.Methods Choice 20 cases of rheumatoid arthritis, and bilateral wrist joint. Study of the wrist joint, and measure the deflection of the ulnar side, the deflection of the radial side, the activity of the ulnar radial side, and the level of serum rheumatoid factor though the application of 320CT motion imaging function.Results Paired test results of the ulnar side of the wrist of the participants: P=0.494. T test results from the angle of the radial side of the receiver: P=0.309. Paired t test results of the ulnar radial activity of the subjects: P=0.187. Correlation test between the ulnar deflection and the serum levels of rheumatoid factor: r=-0.373, P=0.021. The correlation between the radial side of the test and the test of rheumatoid factor in the radial side of the test: r=-0.509, P=0.003. The correlation between the level of

  8. Antigen handling in antigen-induced arthritis in mice: an autoradiographic and immunofluorescence study using whole joint sections

    International Nuclear Information System (INIS)

    Antigen localization after intraarticular antigen injection was studied in immune and nonimmune mice using autoradiographic and immunofluorescence techniques on whole joint sections. After intraarticular injection of radiolabeled methylated bovine serum albumin (125I-mBSA) in immune mice, labeling in the synovium and synovial exudate diminished rapidly, apart from some deposits in fibrinlike material present in the joint cavity. Long-term antigen retention was found in avascular and hypovascular structures lining the joint cavity, albeit not along the whole surface; eg, labeling remained present at the edges of the femoral condyle hyaline cartilage but not at the central weight-bearing region; long-term retention at ligaments was only found at the insertion sites. Immunofluorescence data in immune animals showed antigen retention together with the presence of immunoglobulins and complement, indicating that antigen is retained at least in part in the form of immune complexes. Nonimmune mice showed even higher long-term antigen retention than immune animals, probably related to physico-chemical properties of the antigen enabling nonimmune binding to articular structures, but also indicating that the presence of joint inflammation in the immune animals enhances antigen clearance. Histologic examination of the ligaments and patellar cartilage of immune mice did reveal that long-term antigen retention was not anatomically related to nearby inflammation or to local tissue damage. The importance of long-term antigen retention for the chronicity of arthritis may lie in the leakage of small amounts of this antigen to joint compartments where it does behave as an inflammatory stimulus; it may further be that it renders the joint a specifically hypersensitive area

  9. New advances in wrist arthroscopy.

    Science.gov (United States)

    Bain, Gregory I; Munt, Justin; Turner, Perry C

    2008-03-01

    Wrist arthroscopy is a commonly used procedure that has undergone many modifications and improvements since it was first described. The advent of new portals (both dorsal and volar) means that the wrist joint can be viewed from virtually any perspective ("box concept"). Indications for wrist arthroscopy have continued to expand and include diagnostic and reparative procedures and, more recently, reconstructive, soft-tissue, and bony procedures. Arthroscopic grading of Kienböck's disease better describes articular damage compared with plain radiographs and can help guide surgical treatment options. Triangular fibrocartilage complex injury diagnosis, classification, and treatment can be performed arthroscopically, including distal ulna resection (wafer procedure). Assessment of fracture reduction of the distal radius and scaphoid is superior to that obtained with fluoroscopy, with the advantage of being able to look for associated soft-tissue and chondral injuries. Arthroscopic assessment of intercarpal ligament injuries and instability is now considered the gold standard by many authors. Arthroscopy can also aid us in the management of post-traumatic capsular contraction, resection of ganglia, and the relatively rare isolated ulna styloid impaction. Complications of wrist arthroscopy are relatively uncommon. With the ever-expanding list of indications and procedures that can be performed with this technique, it exists as an essential diagnostic and therapeutic tool for the orthopaedic surgeon. PMID:18308189

  10. Reactive arthritis.

    Science.gov (United States)

    Keat, A

    1999-01-01

    Reactive arthritis is one of the spondyloarthropathy family of clinical syndromes. The clinical features are those shared by other members of the spondyloarthritis family, though it is distinguished by a clear relationship with a precipitating infection. Susceptibility to reactive arthritis is closely linked with the class 1 HLA allele B27; it is likely that all sub-types pre-dispose to this condition. The link between HLA B27 and infection is mirrored by the development of arthritis in HLA B27-transgenic rats. In this model, arthritis does not develop in animals maintained in a germ-free environment. Infections of the gastrointestinal, genitourinary and respiratory tract appear to provoke reactive arthritis and a wide range of pathogens has now been implicated. Although mechanistic parallels may exist, reactive arthritis is distinguished from Lyme disease, rheumatic fever and Whipple's disease by virtue of the distinct clinical features and the link with HLA B27. As in these conditions both antigens and DNA of several micro-organisms have been detected in joint material from patients with reactive arthritis. The role of such disseminated microbial elements in the provocation or maintenance of arthritis remains unclear. HLA B27-restricted T-cell responses to microbial antigens have been demonstrated and these may be important in disease pathogenesis. The importance of dissemination of bacteria from sites of mucosal infection and their deposition in joints has yet to be fully understood. The role of antibiotic therapy in the treatment of reactive arthritis is being explored; in some circumstances, both the anti-inflammatory and anti-microbial effects of certain antibiotics appear to be valuable. The term reactive arthritis should be seen as a transitory one, reflecting a concept which may itself be on the verge of replacement, as our understanding of the condition develops. Nevertheless it appropriately describes arthritis that is associated with demonstrable

  11. Computer assisted planning and custom-made surgical guide for malunited pronation deformity after first metatarsophalangeal joint arthrodesis in rheumatoid arthritis: A case report

    OpenAIRE

    Hirao, Makoto; Ikemoto, Sumika; Tsuboi, Hideki; Akita, Shosuke; Ohshima, Shiro; Saeki, Yukihiko; Yoshikawa, Hideki; Sugamoto, Kazuomi; Murase, Tsuyoshi; Hashimoto, Jun

    2014-01-01

    Arthrodesis of the first metatarsophalangeal (MTP-1) joint is a widely used procedure for the treatment of hallux valgus in patients with MTP-1 degeneration, severe or recurrent deformity, or inflammatory arthritis. In this case, ten years earlier, the patient’s MTP-1 joint had been fused in a severe pronation deformity position. Subsequently, a laterally shifted tibial sesamoid and osseous rising of the phalanx base caused painful callosities. To correct the pronated deformity accurately, a ...

  12. Magnetic resonance imaging-determined synovial membrane and joint effusion volumes in rheumatoid arthritis and osteoarthritis: comparison with the macroscopic and microscopic appearance of the synovium

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Stoltenberg, M; Løvgreen-Nielsen, P;

    1997-01-01

    OBJECTIVE: To evaluate the relationship between synovial membrane and joint effusion volumes determined by magnetic resonance imaging (MRI) and macroscopic and microscopic synovial pathologic findings in patients with rheumatoid arthritis (RA) and osteoarthritis (OA). METHODS: Synovial biopsies...... membrane and effusion volumes may be sensitive markers and/or predictors of disease activity and treatment outcome in RA....

  13. Lack of effect of doxycycline on disease activity and joint damage in patients with rheumatoid arthritis. A double blind, placebo controlled trial

    NARCIS (Netherlands)

    Laan, W. van der; Molenaar, E.; Ronday, K.; Verheijen, J.; Breedveld, F.; Greenwald, R.; Dijkmans, B.; Tekoppele, J.

    2001-01-01

    Objective. To investigate the effects of doxycycline on disease activity and joint destruction in patients with rheumatoid arthritis (RA). Methods. A 36 week double blind, placebo controlled crossover trial was conducted. Patients (n = 66) received 50 mg doxycycline or placebo twice a day during 12,

  14. Joint pain

    Science.gov (United States)

    ... or conditions. It may be linked to arthritis , bursitis , and muscle pain . No matter what causes it, ... Autoimmune diseases such as rheumatoid arthritis and lupus Bursitis Chondromalacia patellae Crystals in the joint: gout (especially ...

  15. Differential diagnostic approach to paraneoplastic arthritis of the knee joint associated with rectal carcinoma

    International Nuclear Information System (INIS)

    Paraneoplastic syndromes are associated with clinical, radiological or biological manifestations of malignancy without direct invasion of the tumour. The pathogenesis is unclear and different mechanisms have been implicated to explain the various manifestations induced by the cancer like deposition of immune complexes consisting of tumour antigens or production of hormones, immunoglobulins and cytokines. Articular symptoms associated with cancer are nonspecific and include various clinical manifestations. We present a very rare case of paraneoplastic arthritis associated with rectal carcinoma. Clinical characteristics of the disease as well as differential diagnostics are discussed. Recognition of certain musculoskeletal symptoms that may herald an underlying malignancy may allow for earlier diagnosis of a potentially curable malignancy and appropriate treatment of the arthritis. Proper differential diagnostic approach is of paramount importance in such cases. (authors)

  16. Analysis of Accumulating Clonotypes of T Cell in Joints of a Spontaneous Murine Model of Rheumatoid Arthritis

    Institute of Scientific and Technical Information of China (English)

    WenmingZhao; LipingZhang; YukageKobari; YoshikataMisaki; KazuhikoYamamoto

    2004-01-01

    SKG mouse, as a model of spontaneous rheumatoid arthritis (RA) bred recent years, is similar to the patients with RA. We analyzed the clonotypes of T cell infiltrating into joints of SKG mice in initial stage and late stage of RA by using reverse transcriptase-polymerase chain reaction (RT-PCR) and subsequent single-strand conformation polymorphism (SSCP). The results indicated that the percentages of clonotypes TCR Vβ2 and Vβ8.2 of T cell clonotypes increased obviously to 72.3% and 60.2%, respectively. Mice number with identical TCR Vβ2 and Vβ8.2 clonotypes also clearly increased in late stage of disease to 100% and 75%, respectively. These results mean that T cells with TCR Vβ2 and Vβ8.2 clonotypes probably play an important role in RA progression of SKG mouse. Sequencing of the extracted DNA verified that common bands on SSCP gel were derived from the same T cell clones among samples from different joints. The results we obtained implied that RT-PCR/SSCP method was a sensitive and credible method for analyzing T cell clonotypes. When the T cells of SKG mouse were adoptively transferred to a nude mouse, it was verified that the T cells infiltrating into joints were related to morbid formation of RA. Cellular & Molecular Immunology.

  17. Spinal GABA-B receptor modulates neutrophil recruitment to the knee joint in zymosan-induced arthritis.

    Science.gov (United States)

    Bassi, Gabriel S; do C Malvar, David; Cunha, Thiago M; Cunha, Fernando Q; Kanashiro, Alexandre

    2016-08-01

    Recent studies have demonstrated that the central nervous system controls inflammatory responses by activating complex efferent neuroimmune pathways. The present study was designed to evaluate the role that central gamma-aminobutyric acid type B (GABA-B) receptor plays in neutrophil migration in a murine model of zymosan-induced arthritis by using different pharmacological tools. We observed that intrathecal administration of baclofen, a selective GABA-B agonist, exacerbated the inflammatory response in the knee after zymosan administration characterized by an increase in the neutrophil recruitment and knee joint edema, whereas saclofen, a GABA-B antagonist, exerted the opposite effect. Intrathecal pretreatment of the animals with SB203580 (an inhibitor of p38 mitogen-activated protein kinase) blocked the pro-inflammatory effect of baclofen. On the other hand, systemic administration of guanethidine, a sympatholytic drug that inhibits catecholamine release, and nadolol, a beta-adrenergic receptor antagonist, reversed the effect of saclofen. Moreover, saclofen suppressed the release of the pro-inflammatory cytokines into the knee joint (ELISA) and pain-related behaviors (open field test). Since the anti-inflammatory effect of saclofen depends on the sympathetic nervous system integrity, we observed that isoproterenol, a beta-adrenergic receptor agonist, mimics the central GABA-B blockade decreasing knee joint neutrophil recruitment. Together, these results demonstrate that the pharmacological manipulation of spinal GABAergic transmission aids control of neutrophil migration to the inflamed joint by modulating the activation of the knee joint-innervating sympathetic terminal fibers through a mechanism dependent on peripheral beta-adrenergic receptors and central components, such as p38 MAPK. PMID:27106212

  18. Atlantoaxial joint distraction for treatment of basilar invagination secondary to rheumatoid arthritis

    OpenAIRE

    Goel Atul; Pareikh S; Sharma P

    2005-01-01

    We present our experience of treating two cases of rheumatoid arthritis involving the craniovertebral junction and having marked basilar invagination by an alternative treatment method. In both the cases, the facets were osteoporotic and were not suitable for screw implantation. The patients were 66 and 72 years of age and both patients were females. Both the patients presented with complaints of progressively increasing spastic quadriparesis. Surgery involved attempts to reduce the basilar i...

  19. Abnormal PTPN11 enhancer methylation promotes rheumatoid arthritis fibroblast-like synoviocyte aggressiveness and joint inflammation

    Science.gov (United States)

    Maeshima, Keisuke; Stanford, Stephanie M.; Hammaker, Deepa; Sacchetti, Cristiano; Zeng, Li-fan; Ai, Rizi; Zhang, Vida; Boyle, David L.; Aleman Muench, German R.; Feng, Gen-Sheng; Whitaker, John W.; Zhang, Zhong-Yin; Wang, Wei; Bottini, Nunzio; Firestein, Gary S.

    2016-01-01

    The PTPN11 gene, encoding the tyrosine phosphatase SHP-2, is overexpressed in rheumatoid arthritis (RA) fibroblast-like synoviocytes (FLS) compared with osteoarthritis (OA) FLS and promotes RA FLS invasiveness. Here, we explored the molecular basis for PTPN11 overexpression in RA FLS and the role of SHP-2 in RA pathogenesis. Using computational methods, we identified a putative enhancer in PTPN11 intron 1, which contained a glucocorticoid receptor– binding (GR-binding) motif. This region displayed enhancer function in RA FLS and contained 2 hypermethylation sites in RA compared with OA FLS. RA FLS stimulation with the glucocorticoid dexamethasone induced GR binding to the enhancer and PTPN11 expression. Glucocorticoid responsiveness of PTPN11 was significantly higher in RA FLS than OA FLS and required the differentially methylated CpGs for full enhancer function. SHP-2 expression was enriched in the RA synovial lining, and heterozygous Ptpn11 deletion in radioresistant or innate immune cells attenuated K/BxN serum transfer arthritis in mice. Treatment with SHP-2 inhibitor 11a-1 reduced RA FLS migration and responsiveness to TNF and IL-1β stimulation and reduced arthritis severity in mice. Our findings demonstrate how abnormal epigenetic regulation of a pathogenic gene determines FLS behavior and demonstrate that targeting SHP-2 or the SHP-2 pathway could be a therapeutic strategy for RA.

  20. Facial morphology in children and adolescents with juvenile idiopathic arthritis and moderate to severe temporomandibular joint involvement

    DEFF Research Database (Denmark)

    Hsieh, Yuh-Jia; Darvann, Tron A; Hermann, Nuno V;

    2016-01-01

    INTRODUCTION: The aims of this study were to (1) assess lateral facial morphology in children and adolescents with juvenile idiopathic arthritis and moderate to severe temporomandibular joint (TMJ) involvement, (2) compare the lateral facial morphology of these subjects with and without TMJ...... morphologies between the groups. Lateral projections of oriented 3D photographs were superimposed on the lateral cephalograms. The results of the lateral 3D photographic analysis were correlated with those of lateral cephalometric analysis. RESULTS: Group 3 showed the most severe growth disturbances, including...... more retrognathic mandible and retruded chin, steep occlusal and mandibular planes, and more hyperdivergent type (P <0.01). Group 2 showed similar growth disturbances, but to a lesser extent than did group 3. Photographic variables were significantly correlated with the soft tissue and skeletal...

  1. 类风湿关节炎手腕部骨侵蚀的磁共振定量分析%MRI quantitative analysis of bone erosions in wrists and hands in patients with rheumatoid arthritis

    Institute of Scientific and Technical Information of China (English)

    周海燕; 刘鹏程; 王成林; 罗莉丽; 戚玉龙; 冯飞

    2011-01-01

    目的:通过类风湿关节炎手腕部骨侵蚀MRI表现及临床指标对照研究,探讨两者在评价类风湿关节炎诊断及预后中的价值。方法:随机选取行手腕部MRI扫描的患者80例,患者均在1周内行相关实验室检查,其中符合类风湿诊断标准的入选为研究对象。采用OMERACT的RA评分系统为类风湿关节炎骨质破坏的评分标准,对磁共振图像进行分析及评分。分别按性别、年龄、病程、晨僵、类风湿因子(RF)、抗环瓜氨酸肤(抗CCP)、抗“O”(ASO)、C反应蛋白(CRP)、血沉(ESR)予以分组,使用Mann-Whitney方法分析各组间骨侵蚀的差异。结果:符合RA诊断标准的共54例,共发现238处骨质侵蚀,最多的1例累及13处骨质。腕部骨侵蚀最常累及三角骨(36/54),其次为头状骨(31/54);手部最常累及第三掌骨头(7/54),其次为第二掌骨头(6/54)。早期/中晚期RA组、CRP阳/阴性组、ESR阳/阴性组间骨侵蚀评分差异具有高度统计学意义(P<0.01)。抗CCP阳/阴性组间的骨侵蚀评分差异具有统计学意义(P<0.05)。性别、年龄、晨僵、RF、ASO的组间骨侵蚀评分差异无统计学意义(P>0.05)。结论:MRI可为骨侵蚀的诊断及评估预后提供最直观的依据,抗CCP抗体、CRP、ESR可在一定程度上提示骨侵蚀。%Objective:To evaluate MRI,clinical manifestations and laboratory examination in the diagnosis and prognosis of rheumatoid arthritis. Methods:80 patients with hand or wrist pain were selected randomly in this study. All patients had laboratory examinations in a week before or after they accepted MRI examinations. Patients who met the diagnostic criteria would be scored corresponding to OMERACT system. Patients were divided by gender,age,disease duration,morning stiffness,RF, ACCP, ASO and ESR respectively. Bone erosion scores were analyzed using Mann-Whitney. Results:There were 238 bone erosions in 54 cases with RA. 13 bone

  2. The knee joint in early juvenile idiopathic arthritis: An ROC study for evaluating the diagnostic accuracy of contrast-enhanced MR imaging

    International Nuclear Information System (INIS)

    Diagnosis of juvenile idiopathic arthritis (JIA) remains difficult due to unspecific clinical and laboratory findings, especially in early stages of the disease. The purpose of our study was to determine the sensitivity and specificity of MR imaging in diagnosing JIA of the knee joints. Forty children (3 - 17 years old) clinically diagnosed with JIA (follow-up >1 year) of a knee joint and a control group of 40 children with painful knee joints (MR diagnosis: bone bruise of the knee (n=7), normal knee joint (n=12), osteomyelitis (n=6), septic arthritis (n=2), bone tumor (n=7) and miscellaneous bone lesions (n=6)) were examined using a 1.5 T MR unit. T1-weighted spin-echo (SE), T2-weighted fast SE, contrast-enhanced Tz1-weighted SE and 2D gradient echo sequences were performed. The receiver operating characteristic (ROC) curves evaluation was conducted by 5 independent radiologists. The positive criteria for diagnosing JIA were joint effusions (n=40), contrast-enhancing synovitis (n=39), cartilage lesions (n=15), subchondral erosions and bony destruction (n=1). Sensitivity and specificity were 93.5% and 92.5%, respectively. Both cases of septic arthritis were misdiagnosed as JIA by all radiologists. Contrast-enhanced MR imaging seems to be a highly sensitive tool in establishing the diagnosis of JIA

  3. Genetics Home Reference: juvenile idiopathic arthritis

    Science.gov (United States)

    ... Home Health Conditions juvenile idiopathic arthritis juvenile idiopathic arthritis Enable Javascript to view the expand/collapse boxes. ... All Open All Close All Description Juvenile idiopathic arthritis refers to a group of conditions involving joint ...

  4. Contrast-enhanced power Doppler ultrasonography of the metacarpophalangeal joints in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Szkudlarek, Marcin; Court-Payen, Michel; Strandberg, Charlotte; Klarlund, Mette; Klausen, Tom; Østergaard, Mikkel

    2003-01-01

    calculated from dynamic contrast-enhanced MR images obtained the same day. Prior to ultrasonography, the joint was evaluated clinically. Levovist increased the flow signal in 7 of 9 joints with pre-contrast flow-signal and in 0 of 9 without pre-contrast signal. No healthy controls showed CE PDUS signal. The...

  5. Associations between APOE genotypes and disease susceptibility, joint damage and lipid levels in patients with rheumatoid arthritis.

    Directory of Open Access Journals (Sweden)

    Marthe T Maehlen

    Full Text Available OBJECTIVE: Apolipoprotein E (APOE genotypes are associated with cardiovascular disease (CVD and lipid levels. In rheumatoid arthritis (RA, an association has been found with disease activity. We examined the associations between APOE genotypes and disease susceptibility and markers of disease severity in RA, including radiographic joint damage, inflammatory markers, lipid levels and cardiovascular markers. METHOD: A Norwegian cohort of 945 RA patients and 988 controls were genotyped for two APOE polymorphisms. We examined longitudinal associations between APOE genotypes and C-reactive protein (CRP, erythrocyte sedimentation rate (ESR as well as hand radiographs (van der Heijde Sharp Score(SHS in 207 patients with 10 year longitudinal data. Lipid levels, cardiovascular markers and history of CVD were compared across genotypes in a cross sectional study of 136 patients. Longitudinal radiological data of cohorts from Lund and Leiden were available for replication. (N = 935, with 4799 radiographs. RESULTS: In the Norwegian cohort, associations between APOE genotypes and total cholesterol (TC and low-density lipoproteins (LDL were observed (ε2 < ε3/ε3 < ε4, p = 0.03 and p = 0.02, respectively. No association was present for acute phase reactant or CVD markers, but a longitudinal linear association between APOE genotypes and radiographic joint damage was observed (p = 0.007. No association between APOE genotypes and the severity of joint destruction was observed in the Lund and Leiden cohorts, and a meta- analysis combining all data was negative. CONCLUSION: APOE genotypes are associated with lipid levels in patients with RA, and may contribute to dyslipidemia in some patients. APOE genotypes are not consistently associated with markers of inflammation or joint destruction in RA.

  6. Associations between APOE Genotypes and Disease Susceptibility, Joint Damage and Lipid Levels in Patients with Rheumatoid Arthritis

    Science.gov (United States)

    Maehlen, Marthe T.; Provan, Sella A.; de Rooy, Diederik P. C.; van der Helm - van Mil, Annette H. M.; Krabben, Annemarie; Saxne, Tore; Lindqvist, Elisabet; Semb, Anne Grete; Uhlig, Till; van der Heijde, Désirée; Mero, Inger Lise; Olsen, Inge C.; Kvien, Tore K.; Lie, Benedicte A.

    2013-01-01

    Objective Apolipoprotein E (APOE) genotypes are associated with cardiovascular disease (CVD) and lipid levels. In rheumatoid arthritis (RA), an association has been found with disease activity. We examined the associations between APOE genotypes and disease susceptibility and markers of disease severity in RA, including radiographic joint damage, inflammatory markers, lipid levels and cardiovascular markers. Method A Norwegian cohort of 945 RA patients and 988 controls were genotyped for two APOE polymorphisms. We examined longitudinal associations between APOE genotypes and C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) as well as hand radiographs (van der Heijde Sharp Score(SHS)) in 207 patients with 10 year longitudinal data. Lipid levels, cardiovascular markers and history of CVD were compared across genotypes in a cross sectional study of 136 patients. Longitudinal radiological data of cohorts from Lund and Leiden were available for replication. (N = 935, with 4799 radiographs). Results In the Norwegian cohort, associations between APOE genotypes and total cholesterol (TC) and low-density lipoproteins (LDL) were observed (ε2<ε3/ε3<ε4, p = 0.03 and p = 0.02, respectively). No association was present for acute phase reactant or CVD markers, but a longitudinal linear association between APOE genotypes and radiographic joint damage was observed (p = 0.007). No association between APOE genotypes and the severity of joint destruction was observed in the Lund and Leiden cohorts, and a meta- analysis combining all data was negative. Conclusion APOE genotypes are associated with lipid levels in patients with RA, and may contribute to dyslipidemia in some patients. APOE genotypes are not consistently associated with markers of inflammation or joint destruction in RA. PMID:23613766

  7. Current innovations in wrist arthroscopy.

    Science.gov (United States)

    Slutsky, David J

    2012-09-01

    It has become clear that the stability of the scapholunate joint does not depend wholly on the scapholunate interosseous ligament, but rather on both primary and secondary stabilizers, which form a scapholunate ligament complex. Each case of scapholunate instability is unique and should be treated with tissue-specific repairs, which may partly explain why one procedure cannot successfully restore joint stability in every case. Wrist arthroscopy has a pivotal role in both the assessment and treatment of the scapholunate ligament complex derangements. Tears of the foveal attachment of the triangular fibrocartilaginous complex can be an underdiagnosed cause of distal radioulnar joint instability, because the foveal fibers cannot be visualized using the standard radiocarpal arthroscopy portals. Distal radioulnar joint arthroscopy allows for direct visualization and assessment of these fibers, which in turn has spawned a number of open and arthroscopic repair methods. Wrist arthroscopy has gained wider acceptance as a method to fine-tune articular reduction during open and percutaneous fixation of distal radius fractures, and simplifies intra-articular osteotomies for malunion. It can facilitate percutaneous bone grafting of scaphoid nonunions and has a role in the diagnosis and treatment of associated soft tissue lesions. These and other recent developments will be discussed in the following article. PMID:22916867

  8. Reliability and sensitivity to change of the OMERACT rheumatoid arthritis magnetic resonance imaging score in a multireader, longitudinal setting

    DEFF Research Database (Denmark)

    Haavardsholm, ea; Østergaard, Mikkel; Kvan, NP;

    2005-01-01

    OBJECTIVE: To assess the intra- and interreader reliability and the sensitivity to change of the Outcome Measures in Rheumatology Clinical Trials (OMERACT) Rheumatoid Arthritis Magnetic Resonance Imaging Score (RAMRIS) system on digital images of the wrist joints of patients with early or...... established rheumatoid arthritis (RA). METHODS: Ten sets of baseline and 1-year followup MR images of the wrists of patients with progressive changes on conventional hand radiographs were scored independently by 4 readers on 2 consecutive days, preceded by reader training and calibration. The MR images were...... acquired and scored according to the recommendations from the OMERACT MRI group. The intra- and interreader agreement (evaluated by intraclass correlation coefficients [ICCs]) and the sensitivity to change (evaluated by the smallest detectable difference [SDD]) were determined for scores of synovitis...

  9. The clinical significance of Epitrochlear lymphadenopathy on elbow radiographs in rheumatoid arthritis

    International Nuclear Information System (INIS)

    To evaluate the radiographic findings of epitrochlear lymphadenopathy with regard to the distribution and severity of the disease and clinal parameters in patients with rheumatoid arthritis. Forty six patients with rheumatoid arthritis in whom epitrochlear oval-shaped densities were seen on radiographs were involved in this study. There were 14 cases of unilateral epitrochlear lymphadenopathy in which bilateral arthritic evidence was revealed by radiographs (mixed group), and 32 of bilateral lymphadenopathy in which there was arthritic evidence (positive group). Twenty-three patients in whom lymphadenopathy was not seen on radiographs of the elbow and who were diagnosed as suffering from rheumatoid arthritis functioned as controls (negative group).For scoring the degree of arthritis using the simplified scoring method proposed by Kaye et al., joints were divided into six groups, as follows: Joint 1, elbow; Joint 2, wrist; Joint 3, radial (1st and 2nd) PIP and MCP; Joint 4, ulnar (3rd, 4th, 5th) PIP and MCP; Joint 5, Joints 1 + 2+ 3 + 4; Joint 6, Joints 1 + 4. For each joint, scores were compared with those on the contralateral side in the mixed group. Differences in clinical parameters ( disease duration, rheumatoid factor, ESR, and CRP), and scores for each joint in each arm were statistically compared between be positive and negative group. The number, mean diameter, and maximal diameter of epitrochlear lymph nodes were calculated and correlated with clinical parameters and scores for each joint. To evaluate the incidence of epitrochlear lymphadenopathy without radiographic evidence of arthritis in 46 patients (78 arms) with lymphadenopathy, the frequency of cases in which the score for the joint was zero was assessed. In the mixed group, the mean score for Joint 6 of the arm with epitrochlear lymphadenopathy was significantly higher than that for the contralateral side in the mixed group (p=3D0.022). Only CRP was significantly higher in the positive group than

  10. The clinical significance of Epitrochlear lymphadenopathy on elbow radiographs in rheumatoid arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Bae Ju; Joo, Kyung Bin; Lee, Hak Soo; Song, Ho Taek; Park, Dong Woo; Lee, Seung Ro; Hahm, Chang Kok [College of Medicine, Hanyang University, Seoul (Korea, Republic of)

    2000-07-01

    To evaluate the radiographic findings of epitrochlear lymphadenopathy with regard to the distribution and severity of the disease and clinal parameters in patients with rheumatoid arthritis. Forty six patients with rheumatoid arthritis in whom epitrochlear oval-shaped densities were seen on radiographs were involved in this study. There were 14 cases of unilateral epitrochlear lymphadenopathy in which bilateral arthritic evidence was revealed by radiographs (mixed group), and 32 of bilateral lymphadenopathy in which there was arthritic evidence (positive group). Twenty-three patients in whom lymphadenopathy was not seen on radiographs of the elbow and who were diagnosed as suffering from rheumatoid arthritis functioned as controls (negative group).For scoring the degree of arthritis using the simplified scoring method proposed by Kaye et al., joints were divided into six groups, as follows: Joint 1, elbow; Joint 2, wrist; Joint 3, radial (1st and 2nd) PIP and MCP; Joint 4, ulnar (3rd, 4th, 5th) PIP and MCP; Joint 5, Joints 1 + 2+ 3 + 4; Joint 6, Joints 1 + 4. For each joint, scores were compared with those on the contralateral side in the mixed group. Differences in clinical parameters ( disease duration, rheumatoid factor, ESR, and CRP), and scores for each joint in each arm were statistically compared between be positive and negative group. The number, mean diameter, and maximal diameter of epitrochlear lymph nodes were calculated and correlated with clinical parameters and scores for each joint. To evaluate the incidence of epitrochlear lymphadenopathy without radiographic evidence of arthritis in 46 patients (78 arms) with lymphadenopathy, the frequency of cases in which the score for the joint was zero was assessed. In the mixed group, the mean score for Joint 6 of the arm with epitrochlear lymphadenopathy was significantly higher than that for the contralateral side in the mixed group (p=3D0.022). Only CRP was significantly higher in the positive group than

  11. MRI-identified abnormalities and wrist range of motion in asymptomatic versus symptomatic computer users

    Directory of Open Access Journals (Sweden)

    Pavlosky William F

    2010-11-01

    Full Text Available Abstract Background Previous work has shown an association between restricted wrist range of motion (ROM and upper extremity musculoskeletal disorders in computer users. We compared the prevalence of MRI-identified wrist abnormalities and wrist ROM between asymptomatic and symptomatic computer users. Methods MR images at 1.5 T of both wrists were obtained from 10 asymptomatic controls (8 F, 2 M and 14 computer users (10 F, 4 M with chronic wrist pain (10 bilateral; 4 right-side. Maximum wrist range of motion in flexion and radioulnar deviation was measured with an electrogoniometer. Results Extraosseous ganglia were identified in 66.6% of asymptomatic wrists and in 75% of symptomatic wrists. Intraosseous ganglia were identified in 45.8% of asymptomatic wrists and in 75% of symptomatic wrists, and were significantly (p p Conclusions This appears to be the first MRI study of wrist abnormalities in computer users. This study demonstrates that a variety of wrist abnormalities are common in computer users and that only intraosseous ganglia prevalence and size differed between asymptomatic and symptomatic wrists. Flexion was restricted in the dominant wrist of the symptomatic group, but the correlation between wrist flexion and intraosseous ganglion burden did not reach significance. Flexion restriction may be an indicator of increased joint loading, and identifying the cause may help to guide preventive and therapeutic interventions.

  12. Interobserver agreement in ultrasonography of the finger and toe joints in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Szkudlarek, Marcin; Court-Payen, Michel; Jacobsen, Søren;

    2003-01-01

    the same day by 2 ultrasound investigators (an experienced musculoskeletal radiologist and a rheumatologist with limited ultrasound training). Joint effusion, synovial thickening, bone erosions, and power Doppler signal were evaluated in accordance with an introduced 4-grade semiquantitative scoring...... and/or swelling in 64 joints. CONCLUSION: An experienced radiologist and a rheumatologist with limited ultrasound training achieved high interobserver agreement rates for the identification of synovitis and bone erosions, using an introduced semiquantitative scoring system for ultrasonography of...... finger and toe joints in RA. Signs of inflammation were more frequently detected with ultrasound than with clinical examination. Ultrasonography may improve the assessment of RA patients by radiologists and rheumatologists...

  13. Bony pathologies of the metacarpophalangeal joints in early rheumatoid arthritis. Comparison of MRI and high-resolution SPECT

    International Nuclear Information System (INIS)

    Aim: comparison of MRI with a newly developed high-resolution multi-pinhole single photon emission computed tomography (MPH-SPECT) regarding the detection of bony pathologies of the metacarpophalangeal (MCP) joints in patients with early rheumatoid arthritis (ERA). Materials and methods: the clinically dominant hand of 15 patients with ERA (disease duration 6 months) was examined using MRI and MPH-SPECT. The evaluation of MRI was achieved according to RAMRIS criteria and for the MPH SPECT regarding pathological tracer uptake and distribution. Image fusions of MRI and MPH-SPECT were provided and the two methods were compared. Results: in MRI 12 of 15 patients showed arthritic joint pathologies, while 8 patients exhibited soft tissue and bony changes. 4 patients had only soft tissue inflammation (synovitis) with a normal bone signal. In MPH-SPECT 10 of 15 patients showed pathologically increased bone metabolism. The fusion images presented a high agreement of the pathological changes in both methods, while areas with increased bone metabolism were not only present in the case of erosions, but also in the case of bone edema. In 2 patients increased bone metabolism was detectable in areas of MR tomographic normal bone, while a clear surrounding synovitis was present in each case here. (orig.)

  14. Correlation Analysis of Serological Markers with Wrist Synovium MRI Findings in Early Rheumatoid Arthritis%早期类风湿性关节炎血清学指标与腕关节滑膜MRI表现的相关性研究

    Institute of Scientific and Technical Information of China (English)

    符水; 高振华; 崔洪涛; 王东

    2013-01-01

    目的:探讨早期类风湿性关节炎血清学指标与腕关节滑膜MRI表现之间的相关性。方法:对经临床诊断为早期类风湿性关节炎的24例患者的腕关节MRI和血清学检查资料进行总结,根据MRI上腕关节滑膜病变评分分值来分组比较血清学指标(CRP、IgA、IgG和IgM值)之间有无差异性。结果:24例早期类风湿性关节炎腕关节MRI上滑膜不同程度增厚并明显强化。滑膜病变评分值≥1.5分组(11例)和分值0.05)。结论:早期类风湿性关节炎的血清IgA、IgG和IgM值与腕关节MRI滑膜病变评分分值密切相关,而CRP值与腕关节MRI滑膜病变评分分值无关。%Objective:To investigate the correlation of serological markers with wrist synovium MRI findings in early rheumatoid arthritis(RA). Method:The data of wrist MRI and serological examinations were reviewed in 24 cases of clinically diagnosed early RA patient. The difference of the value of serological markers,including CRP,IgA,IgG and IgM,were compared in the patients with different wrist synovial scores on MRI. Result:The wrists MRI showed the synovial thickening in varying degrees and significant enhancement after Gd-DTPA injection in 24 cases of early RA. The group of synovial scores≥1.5(11 cases)and the group of scores0.05). Conclusion:The serum IgA,IgG and IgM values are associated with wrist synovial scores on MRI. However,the serum CRP levels have no correlation with wrist synovial scores on MRI in the early RA.

  15. 类风湿性关节炎血清学指标与腕关节动态增强MRI表现的相关性分析%Correlation Analysis of Serological Markers with Wrist Dynamic Contrast-enhanced MRI Findings in Rheumatoid Arthritis

    Institute of Scientific and Technical Information of China (English)

    王忠英; 高振华; 王东; 孙卫民

    2012-01-01

      目的:探讨类风湿性关节炎(RA)血清学检查指标与腕关节滑膜动态增强MRI表现之间的相关性.方法:对经临床诊断为RA的26例患者的腕关节动态增强MRI和血清学检查资料进行总结,根据MRI上腕关节滑膜动态增强表现不同来分组,比较血清学指标(CRP、IgA、IgG和IgM值)之间有无差异性.结果:26例腕关节MRI均显示有滑膜增厚,其动态增强曲线类型包括快升平台型14例和慢升型12例.快升平台型患者的血清CRP值高于慢升型患者的CRP值(P0.05).结论:血清CRP值与腕关节滑膜MRI动态增强曲线类型相关,而血清IgA、IgG和IgM值与动态增强MRI曲线类型无关.%  Objective:To investigate the correlation of serological markers with wrist dynamic contrast-enhanced MRI findings in rheumatoid arthritis(RA). Method:The data of wrist dynamic contrast-enhanced MRI and serological examinations were reviewed in 26 cases of clinically diagnosed RA patients. The difference of the value of serological markers,including CRP,IgA,IgG and IgM,was compared in the patients with different dynamic enhanced MRI findings of the wrist synovium. Result:The wrist MRI showed the synovial thickening in 26 cases. The dynamic contrast-enhanced MRI curve types included fast-increasement-platform type(14 cases)and slow-increasement type(12 cases). The CRP value in the fast-increasement-platform curve type garoup was significantly higher than that in the slow-increasement type garoup(P0.05). Conclusion:The serum CRP levels are associated with wrist synovial dynamic contrast-enhanced MRI curve types,however,the serum IgA,IgG and IgM values have no correlation with wrist synovial dynamic enhanced MRI curve types.

  16. Arthritis of the subtalar joint associated with sustentaculum tali facet configuration.

    OpenAIRE

    Drayer-Verhagen, F

    1993-01-01

    The articular facets of the sustentaculum tali have a variety of configurations that are generally viewed as nonmetric traits of little functional significance. Bruckner (1987), in contrast, has hypothesised that sustentaculum tali facet variations are functionally important because they influence subtalar joint stability. To test this hypothesis, 191 calcanei were analysed for correlations between sustentaculum tali facet morphology and osteoarthritis of the subtalar joint. Calcanei with 2 s...

  17. Phenotypic alterations of neuropeptide Y and calcitonin gene-related peptide-containing neurons innervating the rat temporomandibular joint during carrageenan-induced arthritis

    Directory of Open Access Journals (Sweden)

    J.P. Damico

    2012-10-01

    Full Text Available The aim of this study was to identify immunoreactive neuropeptide Y (NPY and calcitonin gene-related peptide (CGRP neurons in the autonomic and sensory ganglia, specifically neurons that innervate the rat temporomandibular joint (TMJ. A possible variation between the percentages of these neurons in acute and chronic phases of carrageenan-induced arthritis was examined. Retrograde neuronal tracing was combined with indirect immunofluorescence to identify NPY-immunoreactive (NPY-IR and CGRP- immunoreactive (CGRP-IR neurons that send nerve fibers to the normal and arthritic temporomandibular joint. In normal joints, NPY-IR neurons constitute 78±3%, 77±6% and 10±4% of double-labeled nucleated neuronal profile originated from the superior cervical, stellate and otic ganglia, respectively. These percentages in the autonomic ganglia were significantly decreased in acute (58±2% to superior cervical ganglion and 58±8% to stellate ganglion and chronic (60±2% to superior cervical ganglion and 59±15% to stellate ganglion phases of arthritis, while in the otic ganglion these percentages were significantly increased to 19±5% and 13±3%, respectively. In the trigeminal ganglion, CGRP-IR neurons innervating the joint significantly increased from 31±3% in normal animals to 54±2% and 49±3% in the acute and chronic phases of arthritis, respectively. It can be concluded that NPY neurons that send nerve fibers to the rat temporomandibular joint are located mainly in the superior cervical, stellate and otic ganglia. Acute and chronic phases of carrageenan-induced arthritis lead to an increase in the percentage of NPY-IR parasympathetic and CGRP-IR sensory neurons and decrease in the percentage of NPY-IR sympathetic neurons related to TMJ innervation.

  18. Pan-regional (cervico-thoraco-lumbo-sacral spinal epidural abscess with multi-level discitis, vertebral body osteomyelitis and facet joint septic arthritis: complete resolution with non-operative management

    Directory of Open Access Journals (Sweden)

    Appukutty Manickam, MRCS

    2014-12-01

    Conclusion: Even pan-regional CTLS SEA with multi-level discitis, vertebral body osteomyelitis and facet joint septic arthritis can be managed non-operatively. A complete clinical and radiological resolution can be achieved with antibiotics alone.

  19. Rheumatoid Arthritis

    Science.gov (United States)

    ... Institutes Office of the Director 27 Institutes and Centers that make up the NIH About Mission The NIH ... arthritis is an inflammatory disease affecting about 1.3 million adults, and causes pain, swelling, stiffness, and loss of function in the joints. Several ...

  20. Tuberculous Tenosynovitis Presenting as Ganglion of Wrist

    Directory of Open Access Journals (Sweden)

    Shahaji Chavan

    2012-01-01

    Full Text Available Tuberculosis (TB is still endemic in many developed countries. Involvement of the hand and wrist at presentation is extremely rare, and the diagnosis is often missed. A 57 years old male presented with swelling over the left wrist since 3 years Three swellings over dorsal aspect of the left wrist Soft in consistency Non tender Non compressible Mobile at right angles to the plane of the wrist joint. ESR: 45 mm in 1 hr and rest blood investigations were normal. Ultrsonography showed giant cell tumor of Extensor Digitorum sheath. X-ray: soft tissue swelling and MRI was suggestive of extensor tendon sheath extraskeletal synovial Koch’s, or giant cell tumor of tendon sheath. Excision of swelling was planned and intraoperatively, rice bodies were seen inside it. Histopathological examination showed caseous necrosis with granuloma formation. Patient was put on DOT1 therapy. Tuberculous tenosynovitis was first described by Acrel in 1777. Rice bodies occurring in joints affected by tuberculosis were first described in 1895 by Reise. Rice bodies will be diagnosed on plain radiographs when mineralization occurs. More than 50% of cases recur within 1 year of treatment. The currently recommended 6-month course is often adequate with extensive curettage lavage and synovectomy should be performed. Surgery is essential, but the extent of surgical debridement is still debatable. The surgeon has to be aware of the significance of loose bodies when performing routine excision of innocuous looking wrist ganglia.

  1. Metatarsophalangeal joint pain in psoriatic arthritis: a cross-sectional study

    OpenAIRE

    Turner, Deborah E; Hyslop, Elaine; Barn, Ruth; McInnes, Iain B; Steultjens, Martijn P. M.; Woodburn, James

    2014-01-01

    Objective. The aim of this study was to identify independent predictors of pain at the MTP joints in patients with PsA. Methods. Thirty-four consecutive patients with PsA (mean age 45.3 years, 65% female, mean disease duration 9.9 years) and 22 control participants (mean age 37.9 years, 64% female) underwent clinical and US examination to determine the presence of pain, swelling, synovitis, erosions, effusions and submetatarsal bursae at the MTP joints. Mean barefoot peak plantar pressure...

  2. Erosive osteoarthritis, psoriatic arthritis and pseudogout; a casual association?

    Science.gov (United States)

    Hoxha, Ariela; Ruffatti, Amelia; Alberioli, Enrico; Lorenzin, Mariagrazia; Oliviero, Francesca; Mattia, Elena; Punzi, Leonardo; Ramonda, Roberta

    2016-07-01

    According to recent hypothesis, the inflammation has a pivotal role in the onset and progression of erosive hand osteoarthritis (EHOA), psoriatic arthritis (PsA) and chondrocalcinosis (CC)/pseudogout. Albeit, it has been recognised for years as an association between EHOA and radiographic evidence of CC, but there are few reports of coexistence of microcrystalline arthritis and PsA. This is the first report that described a clinical experience concerning two consecutive cases of patients presented with EHOA, PsA and pseudogout. Two Caucasian women of 71 and 85 years old with a history of OA and mild psoriasis are presented with tenderness and swelling of first interphalangeal (IP) and wrist joint, respectively. Arthrocentesis performed at the first IP and wrist joint, respectively, showed an inflammatory synovial fluid with presence of calcium pyrophosphate dehydrate crystals. X-rays of hands, feet and knees showed characteristic features of EHOA, PsA and CC. Furthermore, HLA typing evinces the presence of HLA C*06; DRB*01 07 and HLA C*07; DRB*01 *11 alleles, respectively, predisposing factors of these inflammatory diseases. The relationship between these aggressive rheumatic diseases along with their clinical, radiographic, laboratory and genetic features is discussed. PMID:25833145

  3. Comparative evaluation of low-level laser and systemic steroid therapy in adjuvant-enhanced arthritis of rat temporomandibular joint: A histological study

    OpenAIRE

    Khozeimeh, Faezeh; Moghareabed, Ahmad; Allameh, Maryam; Baradaran, Shahrzad

    2015-01-01

    Background: Low-level laser therapy (LLLT) has shown a promising effect in ameliorating symptoms of rheumatoid arthritis (RA). The aim of this investigation was to compare the early and late anti-inflammatory effects of LLLT and betamethasone in RA. Materials and Methods: In this animal experimental study, after inducing a model of RA in temporomandibular joint (TMJ) of 37 Wistar rats using adjuvant injection, they were randomly distributed into three experimental groups of 12 animals each: (...

  4. Isolated septic facet joint arthritis as a rare cause of acute and chronic low back pain – a case report and literature review

    International Nuclear Information System (INIS)

    The most common cause of low back pain is degenerative disease of the intervertebral disc and other structures of the lumbar spine. However, in some cases other less frequent causes of such pain can be seen, for example septic facet joint arthritis. Until now, only 40 cases of such inflammatory changes within the spine have been reported in the literature. The disease is probably underestimated due to improper diagnostic pathway. The authors describe a case of a 53-year-old woman who was repeatedly hospitalized during a five-month period because of an acute, severe low back pain, with sphincter dysfunction, partially resembling sciatic symptoms. Physical examinations revealed also focal tenderness in the area of the lumbar spine. Inflammatory markers (ESR – erythrocyte sedimentation rate, CRP – C-reactive protein) were elevated. Conservative analgetic treatment brought only partial and temporary relief of the pain and symptoms. The final accurate diagnosis of isolated septic facet joint arthritis at the level of L5/S1 was established after several months from the onset of the first symptoms, after performing various imaging examinations, including bone scintigraphy as well as CT and MRI of the lumbosacral spine. The patient fully recovered after antibiotic therapy and surgery, which was proven in several follow-up examinations showing no relevant pathology of the lumbar spine. The authors broadly describe the etiology and clinical symptoms of the septic facet joint arthritis as well as the significant role of imaging methods, especially MRI, in diagnostic process. The authors also discuss currently available treatment options, both conservative and surgical. The diagnostic procedure of septic facet joint arthritis requires several steps to be taken. Establishing a correct diagnosis may be difficult, that is why it is important to remember about rare causes of low back pain and to perform detailed physical examination, laboratory tests and choose appropriate

  5. Isolated septic facet joint arthritis as a rare cause of acute and chronic low back pain – a case report and literature review

    Science.gov (United States)

    Klekot, Dominika; Zimny, Anna; Czapiga, Bogdan; Sąsiadek, Marek

    2012-01-01

    Summary Background: The most common cause of low back pain is degenerative disease of the intervertebral disc and other structures of the lumbar spine. However, in some cases other less frequent causes of such pain can be seen, for example septic facet joint arthritis. Until now, only 40 cases of such inflammatory changes within the spine have been reported in the literature. The disease is probably underestimated due to improper diagnostic pathway. Case Report: The authors describe a case of a 53-year-old woman who was repeatedly hospitalized during a five-month period because of an acute, severe low back pain, with sphincter dysfunction, partially resembling sciatic symptoms. Physical examinations revealed also focal tenderness in the area of the lumbar spine. Inflammatory markers (ESR – erythrocyte sedimentation rate, CRP – C-reactive protein) were elevated. Conservative analgetic treatment brought only partial and temporary relief of the pain and symptoms. The final accurate diagnosis of isolated septic facet joint arthritis at the level of L5/S1 was established after several months from the onset of the first symptoms, after performing various imaging examinations, including bone scintigraphy as well as CT and MRI of the lumbosacral spine. The patient fully recovered after antibiotic therapy and surgery, which was proven in several follow-up examinations showing no relevant pathology of the lumbar spine. The authors broadly describe the etiology and clinical symptoms of the septic facet joint arthritis as well as the significant role of imaging methods, especially MRI, in diagnostic process. The authors also discuss currently available treatment options, both conservative and surgical. Conclusions: The diagnostic procedure of septic facet joint arthritis requires several steps to be taken. Establishing a correct diagnosis may be difficult, that is why it is important to remember about rare causes of low back pain and to perform detailed physical

  6. Sternoclavicular joint septic arthritis following paraspinal muscle abscess and septic lumbar spondylodiscitis with epidural abscess in a patient with diabetes: a case report

    OpenAIRE

    Shioya Nobuki; Ishibe Yoriko; Kan Shigenori; Masuda Takayuki; Matsumoto Naoya; Takahashi Gaku; Makabe Hideyuki; Yamada Yasuhiko; Endo Shigeatsu

    2012-01-01

    Abstract Background Septic arthritis of the sternoclavicular joint (SCJ) is extremely rare, and usually appears to result from hematogenous spread. Predisposing factors include immunocompromising diseases such as diabetes. Case presentation A 61-year-old man with poorly controlled diabetes mellitus presented to our emergency department with low back pain, high fever, and a painful mass over his left SCJ. He had received two epidural blocks over the past 2 weeks for severe back and leg pain se...

  7. Isolated septic facet joint arthritis as a rare cause of acute and chronic low back pain – a case report and literature review

    OpenAIRE

    Klekot, Dominika; Zimny, Anna; Czapiga, Bogdan; Sąsiadek, Marek

    2012-01-01

    Summary Background: The most common cause of low back pain is degenerative disease of the intervertebral disc and other structures of the lumbar spine. However, in some cases other less frequent causes of such pain can be seen, for example septic facet joint arthritis. Until now, only 40 cases of such inflammatory changes within the spine have been reported in the literature. The disease is probably underestimated due to improper diagnostic pathway. Case Report: The authors describe a case of...

  8. Intra-articular vs. systemic administration of etanercept in antigen-induced arthritis in the temporomandibular joint. Part II: mandibular growth

    Directory of Open Access Journals (Sweden)

    Gelineck John

    2009-02-01

    Full Text Available Abstract Background Temporomandibular joint (TMJ arthritis in children causes alterations in the craniomandibular growth. Resultant abnormalities include; condylar erosions, a posterior mandibular rotation pattern, micrognathia, malocclusion with an anterior open bite, altered joint and muscular function occasionally associated with pain. These alterations may be prevented by early aggressive anti-inflammatory intervention. Previously, we have shown that intra-articular (IA corticosteroid reduces TMJ inflammation but causes additional mandibular growth inhibition in young rabbits. Local blockage of TNF-α may be an alternative treatment approach against TMJ involvement in juvenile idiopathic arthritis (JIA. We evaluated the anti-inflammatory effect of IA etanercept compared to subcutaneous etanercept in antigen-induced TMJ-arthritis in young rabbits in terms of mandibular growth. This article (Part II presents the data and discussion on the effects on facial growth. In Part I the anti-inflammatory effects of systemic and IA etanercept administration are discussed. Methods Arthritis was induced and maintained in the TMJs of 10-week old pre-sensitized rabbits (n = 42 by four repeated IA TMJ injections with ovalbumin, over a 12-week period. One group was treated weekly with systemic etanercept (0.8 mg/kg (n = 14, another group (n = 14 received IA etanercept (0.1 mg/kg bilaterally one week after induction of arthritis and one group (n = 14 served as an untreated arthritis group receiving IA TMJ saline injections. Head computerized tomographic scans were done before arthritis was induced and at the end of the study. Three small tantalum implants were inserted into the mandible, serving as stable landmarks for the super-impositions. Nineteen variables were evaluated in a mandibular growth analysis for inter-group differences. All data was evaluated blindedly. ANOVA and T-tests were applied for statistical evaluation using p Results Significant larger

  9. CT-guided intradiscal ozone injection combined with intervertebral facet joint steroid injection for lumbar disk herniation accompanied with intervertebral arthritis

    International Nuclear Information System (INIS)

    Objective: To compare the clinical effectiveness of ozone (O3) nucleus pulposus ablation only with that of O3 nucleus pulposus ablation combined with intervertebral facet joint injection of compound Betamethasome in treating lumbar disk herniation accompanied with intervertebral facet arthritis. Methods: Eighty patients with lumbar disk herniation and intervertebral facet arthritis were equally and randomly divided into two groups. Under CT guidance, O3 nucleus pulposus ablation was performed in patients of group A(n=40), while O3 nucleus pulposus ablation combined with intervertebral facet joint injection of compound Betamethasome (0.5-1 ml) was carried out in patients of group B(n=40). Using double blind method the therapeutic effectiveness was evaluated before and 1 week,3,6-months after the procedure by an Oswestry Low Back Pain Disability Questionnaire. Results: One week after the procedure the effective rate of group A and group B was 65% and 82.5% respectively. Three and six months after the treatment, the effective rate was 75% and 70% respectively for group A, while it was 90% and 92.5% respectively for group B. The difference between two groups was significant (P 3 combined with intervertebral facet joint injection of compound Betamethasome is an effective and safe treatment for lumbar disk herniation accompanied with intervertebral facet arthritis.It is worth popularizing this technique in clinical practice. (authors)

  10. Is Swollen to Tender Joint Count Ratio aNew and Useful Clinical Marker for BiologicDrug Response in Rheumatoid Arthritis?

    DEFF Research Database (Denmark)

    Kristensen, Lars Erik; Bliddal, Henning; Christensen, Robin;

    2014-01-01

    OBJECTIVE: To study the impact of swollen to tender joint count ratio (STR) and other baseline characteristics on treatment response to a first course of anti-tumor necrosis factor (anti-TNF) therapy in rheumatoid arthritis (RA) patients. METHODS: Patients with RA initiating their first course...... of anti-TNF treatment were included in a structured clinical followup protocol. Based on pragmatic thresholds and plausibility, patients were categorized as having low (STR 1.0) joint count ratios. The data were collected and followed during the period......50 response with odds ratios of 1.93 (P

  11. Validity and Agreement between the 28-Joint Disease Activity Score Based on C-Reactive Protein and Erythrocyte Sedimentation Rate in Patients with Rheumatoid Arthritis

    DEFF Research Database (Denmark)

    Nielung, Louise; Christensen, Robin; Danneskiold-Samsøe, Bente;

    2015-01-01

    Objective. To validate the agreement between the 28-joint disease activity score based on erythrocyte sedimentation rate (DAS28-ESR) and the 28-joint disease activity score based on C-reactive protein (DAS28-CRP) in a group of Danish patients with rheumatoid arthritis (RA). Methods. Data from 109...... Danish RA patients initiating biologic treatment were analysed at baseline and following one year of treatment. Participants were retrospectively enrolled from a previous cohort study and were considered eligible for this project if CRP and ESR were measured at baseline and at the follow-up visit. To...

  12. Clinical value of MRI combined with X-ray in diagnosis of wrist joint instability%MRI联合X线诊断腕关节不稳定的临床价值

    Institute of Scientific and Technical Information of China (English)

    吴伟智; 张家雄; 陈兴明; 朱冬梅; 梁培生

    2016-01-01

    目的 探讨MRI联合X线诊断腕关节不稳定的临床价值.方法 选择我院2013年8月至2014年6月腕关节不稳定患者100例,根据入院先后顺序分为观察组和对照组,每组50例,观察组进行MRI联合X线诊断检查,对照组仅进行X线检查,分析各组的影像学特征并比较两组的特异性、灵敏性、阳性预测值等临床指标.结果 对照组的阳性检出率为56.0%(28/50),明显低于观察组的88.0%(44/50),差异具有统计学意义(P<0.05);观察组的阳性预测值为86.0%(43/50)、特异性为88.0%(44/50)、灵敏性为80%(40/50),对照组的阳性预测值为46.0%(23/50)、特异性为56.0%(28/50)、灵敏性为42.0%(21/50),观察组的阳性预测值、特异性、灵敏性等指标显著优于对照组,差异具有统计学意义(P<0.05);腕骨病变MRI检查结果中,T1WI轴位像:掌指关节周围滑膜显著增厚,信号减低,呈长或稍长T1信号改变;T1WI冠状位:近端指间关节、掌指关节及双侧腕关节周围滑膜增厚,呈等或稍长T1信号;STIR冠状位像:病灶呈高或稍高信号,病灶部位、形态、范围较T2WI、T1WI像显示更清晰,指骨近端及腕关节、双侧掌骨远端构成骨信号增高,提示骨髓水肿.结论 腕关节不稳定进行MRI与X线联合诊断可提高其检测的特异性、灵敏性,提高其阳性诊断率.%Objective To discuss the clinical value of magnetic resonance imaging (MRI) combined with X-ray in diagnosis of wrist joint instability. Methods One hundred patients with wrist joint instability from August 2013 to June 2014 were selected in our hospital, which were divided into the study group and the control group, accord-ing to the order of admission. The study group (n=50) underwent MRI combined with X-ray examination, while the con-trol group was only performed X-ray examination. The imaging characteristics of each group were analyzed, and the specificity, sensitivity and positive predictive value of the two groups were

  13. HLA-B27 positive juvenile arthritis with cardiac involvement preceding sacroiliac joint changes

    OpenAIRE

    Lee, S; Im H, Y; Schueller, W

    2001-01-01

    While cardiovascular disease develops in up to 50% of adult patients with ankylosing spondylitis, it is very uncommon in its juvenile counterpart. Regarding the early stage of the disease, before onset of sacroiliac joint changes, only two cases with aortic incompetence have been published while reports of mitral valve involvement are not available. A 13 year old boy is described with an HLA-B27 positive asymmetric oligoarthritis and enthesitis, without back pain or radiographic evidence of s...

  14. ARTHRITIS OF THE SUBTALAR JOINT ASSOCIATED WITH SUSTENTACULUM TALI FACET CONFIGURATION

    OpenAIRE

    K.S. Nemade; Meshram, M. M.; A. P. Kasote; N. Y. Kamdi

    2014-01-01

    Variation in the articular facet of the sustenticulum tali have been described by many authors. Most researchers view these differences in facet configuration as anatomical variations of no functional significance. Bruckner (1987), for the time argued that these facet configurations affect joint stability. The purpose of this study was to determine the talar facet configuration of calcanei in India, measure the angle between the anterior and middle facet planes of these calcanei, and asses...

  15. Structural features and assessment of zymosan-induced arthritis in rat temporomandibular joint model using sulfated polysaccharide

    Directory of Open Access Journals (Sweden)

    José Ariévilo Gurgel Rodrigues

    2014-05-01

    Full Text Available The green seaweed Caulerpa cupressoides var. lycopodium contains three SPs fractions (Cc-SP1, Cc-SP2 and Cc-SP3. Cc-SP1andCc-SP2 had anticoagulant (in vitro, pro- and antithrombotic, antinociceptive and/or anti-inflammatory (in vivo effects. This study analyzed structural features and the antinociceptive and anti-inflammatory effects of Cc-SP1 on zymosan-induced acute arthritis of the rat temporomandibular joint (TMJ. Cc-SP1 was investigated by infrared technique. Male Wistar rats (200-240 g received subcutaneously (s.c. Cc-SP1 1h prior to intra-articular (i.art. injection of zymosan (2 mg joint-1 or saline (0.9% into the left TMJ. Mechanical hypernociception was measured by the electronic Von Frey method in the basal and 4h after zymosan injection. Animals were euthanized 6h after zymosan injection and the TMJ cavity was removed for total leukocyte counts from the synovial fluid and myeloperoxidase (MPO activity assessment. Cc-SP1 (1, 3 or 9 mg kg-1 containing sulfate ester, galactose-6-sulfate, uronic acid and glycosidic linkages reduced zymosan-induced hypernociception (78.12, 81.13 and 87.43%, respectively, p < 0.01, and inhibited the total leukocyte influx (85, 88.14 and 89.95%, respectively, p < 0.01, being confirmed by MPO activity (p < 0.05. Therefore, Cc-SP1 reveals a pharmacological tool for treating inflammatory arthropathies.

  16. ARTHRITIS OF THE SUBTALAR JOINT ASSOCIATED WITH SUSTENTACULUM TALI FACET CONFIGURATION

    Directory of Open Access Journals (Sweden)

    K.S. Nemade

    2014-11-01

    Full Text Available Variation in the articular facet of the sustenticulum tali have been described by many authors. Most researchers view these differences in facet configuration as anatomical variations of no functional significance. Bruckner (1987, for the time argued that these facet configurations affect joint stability. The purpose of this study was to determine the talar facet configuration of calcanei in India, measure the angle between the anterior and middle facet planes of these calcanei, and assess the relation between the above parameters and the degenerative changes in the subtalar joints. Study was conducted in 220 calcanei of unknown age & sex. The facet patterns observed were fused anterior and middle facets (Type I, three separate facets (Type II, absence of the anterior facet (Type III and three merged facets (Type IV. Osteoarthritic changes studied are lipping, eburnation on visual inspection and subchondral sclerosis on radiographs. Present study reveals that the talar facet configuration of calcanei and the angle between the anterior and middle facets influence the stability of the subtalar joints and development of osteoarthritis.

  17. Conventional radiography requires a MRI-estimated bone volume loss of 20% to 30% to allow certain detection of bone erosions in rheumatoid arthritis metacarpophalangeal joints

    DEFF Research Database (Denmark)

    Ejbjerg, B.; Vestergaard, Aage Steen; Jacobsen, S.; Thomsen, H.S.; Østergaard, Mikkel

    2006-01-01

    The aim of this study was to demonstrate the ability of conventional radiography to detect bone erosions of different sizes in metacarpophalangeal (MCP) joints of rheumatoid arthritis (RA) patients using magnetic resonance imaging (MRI) as the standard reference. A 0.2 T Esaote dedicated extremity...... MRI unit was used to obtain axial and coronal T1-weighted gradient echo images of the dominant 2nd to 5th MCP joints of 69 RA patients. MR images were obtained and evaluated for bone erosions according to the OMERACT recommendations. Conventional radiographs of the 2nd to 5th MCP joints were obtained...... in posterior-anterior projection and evaluated for bone erosions. The MRI and radiography readers were blinded to each other's assessments. Grade 1 MRI erosions (1% to 10% of bone volume eroded) were detected by radiography in 20%, 4%, 7% and 13% in the 2nd, 3rd, 4th and 5th MCP joint, respectively...

  18. Involvement of the Inconstant Bursa of the Fifth Metatarsophalangeal Joint in Psoriatic Arthritis: A Clinical and Ultrasonographic Study

    Directory of Open Access Journals (Sweden)

    Giovanni Ciancio

    2014-01-01

    Full Text Available Objective. To evaluate the involvement of the bursa located next to the head of the 5th metatarsal bone in patients with psoriatic arthritis (PsA in comparison with the other seronegative spondyloarthritis (SpA. Methods. All patients with PsA seen during a period of 24 months were enrolled. The control group included healthy subjects and patients with the other SpA. All subjects underwent clinical and ultrasound (US examination of the lateral surface of the 5th metatarsal. Results. 150 PsA patients (88 M; 62 F, 172 SpA (107 M; 65 F, and 95 healthy controls (58 M; 37 F were evaluated. Based on clinical and US evaluation, bursitis was diagnosed in 17/150 (11.3% PsA patients but in none of the SpA (P<0.0001 and healthy (P=0.0002 controls. In detecting bursitis, US was more sensitive than clinical examination, although the difference did not reach statistical significance (P=0.09. Conclusion. The bursa of the 5th metatarsophalangeal joint appears to be involved in PsA more frequently than by chance. If confirmed by other studies, this finding could be considered as a distinctive clinical sign of PsA, useful for differential diagnosis with the other SpA. In asymptomatic patients, US proved to be more sensitive in the detection of bursitis.

  19. Low-level laser therapy stimulates tissue repair and reduces the extracellular matrix degradation in rats with induced arthritis in the temporomandibular joint.

    Science.gov (United States)

    Lemos, George Azevedo; Rissi, Renato; de Souza Pires, Ivan Luiz; de Oliveira, Letícia Prado; de Aro, Andrea Aparecida; Pimentel, Edson Rosa; Palomari, Evanisi Teresa

    2016-08-01

    The objective of this study was to characterize morphological and biochemistry action of low-level laser therapy (LLLT) on induced arthritis in the temporomandibular joint (TMJ) of rats. Twenty-four male Wistar rats were randomly divided into groups with 12 animals each: (AG) group with arthritis induced in the left TMJ and (LG) group with arthritis induced in the left TMJ and treated with LLLT (830 nm, 30 mW, 3 J/cm(2)). Right TMJs in the AG group were used as noninjected control group (CG). Arthritis was induced by intra-articular injection of 50 μl Complete Freund's Adjuvant (CFA) and LLLT began 1 week after arthritis induction. Histopathological analysis was performed using sections stained with hematoxylin-eosin, Toluidine Blue, and picrosirius. Biochemical analysis was determined by the total concentration of sulfated glycosaminoglycans (GAGs) and evaluation of matrix metalloproteinases (MMP-2 and MMP-9). Statistical analysis was performed using paired and unpaired t tests, with p < 0.05. Compared to AG, LG had minor histopathological changes in the TMJ, smaller thickness of the articular disc in the anterior (p < 0.0001), middle (p < 0.0001) and posterior regions (p < 0.0001), high birefringence of collagen fibers in the anterior (p < 0.0001), middle (p < 0.0001) and posterior regions (p < 0.0001) on the articular disc, and statistically lower activity of MMP-2 latent (p < 0.0001), MMP-2 active (P = 0.02), MMP-9 latent (p < 0.0001), and MMP-9 active (p < 0.0001). These results suggest that LLLT can increase the remodeling and enhancing tissue repair in TMJ with induced arthritis. PMID:27147076

  20. Bone pathology inpsoriatic arthritis

    OpenAIRE

    V. V. Badokin

    2007-01-01

    Objective. To study different variants of osteolysis in pts with psoriatic arthritis (PA) and to reveal their relationship with other clinico-radiological features of joint damage. Material and methods. 370 pts with definite PA having different variants of joint damage were included. Radiological examination of bones and joints (in some cases large picture frame) was performed. Morphological evaluation of synovial biopsies was done in 34 pts with PA and 10 pts with rheumatoid arthritis (RA). ...

  1. Detection of rheumatoid arthritis bone erosions by 2 different dedicated extremity MRI units and conventional radiography

    DEFF Research Database (Denmark)

    Duer, Anne; Vestergaard, Aage; Døhn, Uffe Møller;

    2008-01-01

    OBJECTIVES: To compare the ability of 2 different dedicated extremity magnetic resonance imaging (E-MRI) units and conventional radiography (CR) for identifying bone erosions in rheumatoid arthritis (RA) metacarpophalangeal (MCP) and wrist joints. METHODS: CR and 2 MRI-examinations (on 0.2T Esaote...... carpal bones. MagneVu and CR detected 100% and 89%, respectively, of large erosions (OMERACT-RAMRIS-score > 1 on Artoscan) in MCP-joints, and 69% and 15.8% of large erosions in wrists. CONCLUSIONS: Both E-MRI units detected more erosions than CR, particularly due to a higher sensitivity in metacarpal...... Artoscan and 0.2T portable MagneVu MV1000 units) of 418 bones in the dominant wrist and 2.-5. MCP-joints of 15 RA patients and 4 healthy controls were performed and blindedly evaluated for bones being visible and for erosions. RESULTS: In MCP-joints, MagneVu visualized 18.5% of bones entirely and 71...

  2. Hand and Wrist Tumors

    Science.gov (United States)

    ... Symptom Picker Hand and Arm Conditions Carpal Tunnel Ganglion Cysts Trigger Finger Arthritis Base of the Thumb See ... Symptom Picker Hand and Arm Conditions Carpal Tunnel Ganglion Cysts Trigger Finger Arthritis Base of the Thumb See ...

  3. 75 FR 10490 - Joint Meeting of the Arthritis Drugs Advisory Committee and the Drug Safety and Risk Management...

    Science.gov (United States)

    2010-03-08

    ... the Drug Safety and Risk Management Advisory Committee; Notice of Meeting AGENCY: Food and Drug...: Arthritis Drugs Advisory Committee and the Drug Safety and Risk Management Advisory Committee....

  4. [Arthroscopic resection of dorsal wrist ganglia].

    Science.gov (United States)

    Borisch, N

    2014-10-01

    In arthroscopic wrist surgery, the resection of dorsal wrist ganglia has become a well accepted practice. As advantages for the minimally invasive procedure the low complication rate and low postoperative morbidity, less postoperative pain and faster recovery over open techniques are discussed. The possibility to assess accompanying joint pathology is considered as another advantage. The importance of identifying a so-called ganglion cyst stalk seems to have been overstated. Regarding the technique, the main discussion points are the size and localisation of the capsular window and the necessity of additional midcarpal arthroscopy. The possibility and results of treatment of recurrent ganglion cysts are still controversial. Our own experience and that of some authors are positive. Hardly mentioned in the literature is the treatment of occult dorsal wrist ganglia and its results, which is considered as very successful by the authors. PMID:25290273

  5. Idiopathic septic arthritis of a lumbar facet joint associated with paraspinal abscess.

    Science.gov (United States)

    Kitova-John, Margarita Borislavova; Azim-Araghi, Ali; Sheikh, Faraz Tariq; Kitov, Borislav Dimitrov

    2015-01-01

    A 48-year-old woman presented with a 1-month history of severe lower back pain on a background of 24 h of mild fever and general tiredness with an associated right-sided foot drop. Five weeks after the onset and with no improvement in symptoms in spite of analgesia and physiotherapy, the patient had a lumbar spine MRI which demonstrated a collection extending from the facet joints of L5 and L6 to the iliacus muscle on the right. A CT-guided aspiration was performed with a lengthy hospital stay for intravenous antibiotic treatment. The culture and sensitivity study of the aspirate isolated Streptococcus pneumoniae. PMID:26272966

  6. 手腕部MRI联合抗环瓜氨酸肽抗体检测在早期RA诊断中的应用价值%Application of wrist MRI combined anti-cyclic citrullinated peptide antibody detection in the diagnosis of early rheumatoid arthritis

    Institute of Scientific and Technical Information of China (English)

    王旭荣; 王军; 金聂; 吕金纯; 蒋晓彬; 陈晓军; 邱乾德

    2015-01-01

    目的 探讨手腕部MRI联合抗环瓜氨酸肽抗体(抗-CCP抗体)检测在早期类风湿性关节炎(RA)诊断中的应用价值.方法 选取本院风湿免疫科早期RA患者45例作为RA组,非RA患者45例作为非RA组,健康体检者43例作为对照组,全部行手腕部MRI检查并采用ELISA方法检测抗-CCP抗体,同时搜集患者临床症状、体征、实验室指标及MRI表现,对结果进行统计学分析.结果 RA组患者MRI阳性率和血清抗-CCP抗体阳性率明显高于非RA组和对照组,差异具有统计学意义(P<0.05);MRI与抗-CCP抗体对早期RA的灵敏度和特异度分别是88.88%和68.88%、82.22%和91.11%,两者联合检测灵敏度(64.44%)较单独检测有所降低,但特异度高达100%;MRI滑膜评分分值与抗-CCP抗体水平呈正相关(rs=0.612,P<0.05);MRI异常征象与关节疾病活动性评分(DAS28)呈正相关(rs=0.521,P<0.05),抗-CCP抗体阳性率与DAS28呈正相关(rs=0.541,P<0.05).结论 MRI和抗-CCP抗体联合检测可提高RA早期诊断的准确性,亦为动态评估RA病情变化提供了检测依据.%Objective To study the clinical value of wrist magnetic resonance imaging (MRI) combined anti-cyclic citrullinated peptide antibody detection in the diagnosis of early rheumatoid arthritis (RA).Methods Forty five patients with early RA were selected as RA group,45 cases of patients without rheumatoid arthritis as non-RA group,and 43 cases of people with normal examination as control group.All subjects were given wrist MRI and anti-cyclic citrullinated peptide (CCP) antibody with the enzyme linked immunosorbent assay (ELISA).At the same time,clinical symptoms,physical signs,MRI manifestations,and laboratory indicators were collected.All results were statistically analyzed.Results Positive rate of MRI lesions and serum anti-CCP antibody in RA group were significantly higher than non-RA group and control group (P <0.05).The sensitivity and specificity of MRI (or anti

  7. Magnetic resonance imaging of the wrist ligaments

    International Nuclear Information System (INIS)

    The advent of small arthroscopes has enabled the hand surgeon to visualize the ligaments of the wrist directly with resultant increased accuracy in diagnosing and treating pathology. Orthopaedists are now demanding a preoperative assessment and this, in turn, has necessitated that radiologists have a comprehensive understanding of wrist anatomy. High resolution MR imaging can identify the wrist ligaments reliably and provide information concerning their integrity. Interpretation is not straightforward; there is considerable anatomic variation, and there are perforations, defects and degenerative tears that can be troublesome in diagnosing injury. However, with experience and attention to anatomic detail, the radiologist can provide useful information regarding structural abnormalities. When injured, the ligaments of the wrist behave as other joint ligaments do. Findings following injury include discontinuity of normal striated bands, incomplete disruption, irregularities and alteration in normal signal. Fluid pooling around a ligament and concomitant bone injury are other clues to injury. The identification of such structural abnormalities may help to explain altered biomechanics and improve the management of patients following wrist injury. Copyright (2001) Blackwell Science Pty Ltd

  8. MAGNETIC RESONANCE IMAGING OF THE SACROILIAC JOINT IN DIFFERENTIAL DIAGNOSIS OF EARLY POLYARTICULAR PSORIATIC AND RHEUMATOID ARTHRITIS (STUDY DATA REMARKA

    Directory of Open Access Journals (Sweden)

    Elena Yu Loginova

    2014-01-01

    Full Text Available Diagnosis of lesions of the spine and sacroiliac joints may be helpful in discrimination between early psoriatic arthritis (ePsA and early rheumatoid arthritis (eRA.Objective. To assess the significance of inflammatory back pain (IBP, HLA-B27, and active sacroiliitis (ASI confirmed by magnetic resonance imaging (MRI for differential diagnosis of polyarticular ePsA and eRA.Materials and Methods. The study included 29 patients with ePsA (13 males and 16 females, mean age 36.52 ± 11.27 years, average duration of the disease 13.03 ± 9.77 months and 25 patients with eRA (7 males and 18 females, mean age 52.68 ± 14.7 years, average duration of the disease 4.0 ± 1.72 months. Presence of IBP (according to the ASAS criteria and HLA-B27 were assessed (in 27 patients with PsA and in 20 patients with RA; ASI signs were assessed based on the MRI data (bone marrow edema/osteitis. DAS, DAS28, M ± SD, Fisher's exact test, t-test, χ2, the Yule coefficients of association (Q: level from -1 to +1 and Phi were calculated; differences were considered to be statistically significant at p <0.05.Results. In patients with ePsA, ASI was detected by MRI significantly more frequently than in patients with eRA (41.4% and 12% of cases respectively, p < 0.016. No correlation between the presence of ASI and DAS28 was observed in both groups. In the ePsA group, IBP was detected in 17 patients (58.6%; it was long-term in 10 (58.8% of the patients and episodic – in 7 (41.2% patients. Back pain with mechanical rhythm was observed in 3 (12% patients with eRA. HLA-B27 was detected in 9 (33.3% of 27 patients with ePsA and in 3 (15% of 20 patients with eRA (p < 0.014. In patients with ePsA, a very high level of association between ASI and IBP (Q = 0.91, Phi = 0.56; p < 0.003 and a high level of association between ASI and HLA-B27 (Q = 0.75, Phi = 0.56; p < 0.039 were detected. MRI showed no association between the presence of HLA-B27 and ASI signs in patients with RA

  9. Simplified Radiographic Damage Index for Affected Joints in Chronic Gouty Arthritis.

    Science.gov (United States)

    Son, Chang-Nam; Kim, Tae Eun; Park, Kyungmin; Hwang, Jun Hyun; Kim, Seong-Kyu

    2016-03-01

    The aim of this study was to develop and validate a new radiographic damage scoring method (DAmagE index of GoUt; DAEGU) in chronic gout using plain radiography. Two independent observers scored foot x-rays from 15 patients with chronic gout according to the DAEGU method and the modified Sharp/van der Heijde (SvdH) method. The 10 metatarsophalangeal (MTP) and 2 interphalangeal (IP) joints of the first toes of both feet were scored to assess the degrees of erosion and joint space narrowing (JSN). The intraobserver and interobserver reliabilities were analyzed by calculating the intraclass correlation coefficient (ICC) and minimal detectable change (MDC). The correlation between the DAEGU and SvdH methods was analyzed by calculating the Spearman's rho correlation coefficients and Kappa coefficients. The DAEGU method was found to be highly reproducible (0.945-0.987 for the intraobserver and 0.993-0.996 for the interobserver ICC values). The erosion, JSN, and total scores exhibited strong positive correlations between the DAEGU and SvdH methods and also within each method (r = 0.860-0.969, P < 0.001 for all parameters). The DAEGU and SvdH methods were in very good agreement as determined by Kappa coefficient analysis [0.732 (0.387-1.000) for erosion and 1.000 (1.000-1.000) for JSN]. In conclusion, this study revealed that DAEGU method was a reliable and feasible tool in the assessment of radiographic damage in chronic gout. The DAEGU method may provide a more easy assessment of structural damage in chronic gout in the real clinical practice. PMID:26955246

  10. Arthritis - resources

    Science.gov (United States)

    Resources - arthritis ... The following organizations provide more information on arthritis : American Academy of Orthopaedic Surgeons -- orthoinfo.aaos.org/menus/arthritis.cfm Arthritis Foundation -- www.arthritis.org Centers for Disease Control and Prevention -- www. ...

  11. MRI of the wrist

    Energy Technology Data Exchange (ETDEWEB)

    Dick, Elizabeth A. [Department of MRI, St Mary' s Hospital, Praed St, London W2 1NY (United Kingdom)], E-mail: dickelizabeth@hotmail.com; Burnett, Carole; Gedroyc, Wladyslaw M.W. [Department of MRI, St Mary' s Hospital, Praed St, London W2 1NY (United Kingdom)

    2008-08-15

    Magnetic resonance imaging of the wrist is increasingly recognised as the imaging modality of choice in wrist disorders as image resolution improves and clinicians realise its potential. Consequently the ability to confidently interpret such imaging will become more important to both general and musculoskeletal radiologists. This article reviews current optimal imaging protocols and describes common abnormalities with a particular emphasis on less well understood topics such as intercalated segment instability, the triangular fibrocartilage complex and carpal tunnel syndrome.

  12. Does low-field dedicated extremity MRI (E-MRI) reliably detect bone erosions in rheumatoid arthritis? A comparison of two different E-MRI units and conventional radiography with high-resolution CT scanning

    DEFF Research Database (Denmark)

    Duer-Jensen, A; Ejbjerg, B; Albrecht-Beste, E;

    2008-01-01

    OBJECTIVES: To compare the ability of two different E-MRI units and conventional radiography (CR) to identify bone erosions in rheumatoid arthritis (RA) metacarpophalangeal (MCP) and wrist joints with CT scanning as the standard reference method. METHODS: 20 patients with RA and 5 controls...... underwent CR, CT and two E-MRI examinations (Esaote Biomedica Artoscan and MagneVu MV1000) of one hand during a 2-week period. In all modalities, each bone of the wrist and MCP joints was blindly evaluated for erosions. MagneVu images were also assessed for the proportion of each bone being visualised.......57, respectively; wrists: 0.50, 0.23 and 0.29). Corresponding specificities for detecting erosions were 0.94, 0.93 and 0.99, respectively, in the MCP joints and 0.92, 0.98 and 0.98 in the wrist. The MagneVu allowed visualisation of 1.5 cm of the ventral-dorsal diameter of the bone. In the wrist, 31.6% of bones...

  13. Septic arthritis due to tubercular and Aspergillus co-infection

    Directory of Open Access Journals (Sweden)

    Mukesh Kumar

    2016-01-01

    Full Text Available Aspergillus septic arthritis is a rare and serious medical and surgical problem. It occurs mainly in immunocompromised patients. Aspergillus fumigatus is the most common causative organism followed by Aspergillus flavus. The most common site affected is knee followed by shoulder, ankle, wrist, hip and sacroiliac joint. Debridement and voriconazole are primary treatment of articular aspergilosis. To the best of our knowledge, there are no reported cases of co-infection of tuberculosis (TB and Aspergillus infecting joints. We report a case of co-infection of TB and A. flavus of hip and knee of a 60-year-old male, with type 2 diabetes mellitus. He was treated with debridement, intravenous voriconazole, and antitubercular drugs.

  14. Early detection of bony alterations in rheumatoid and erosive arthritis of finger joints with high-resolution single photon emission computed tomography, and differentiation between them

    International Nuclear Information System (INIS)

    To evaluate high-resolution multi-pinhole single photon emission computed tomography (MPH-SPECT) for the detection of bony alterations in early rheumatoid arthritis (ERA), early osteoarthritis (EOA) of the fingers and healthy controls. The clinically dominant hands of 27 patients (13 ERA, nine EOA, five healthy controls) were examined by MPH-SPECT and bone scintigraphy. Additionally, magnetic resonance imaging (MRI) was performed in the ERA patients. Number of affected joints, localisation, pattern of tracer distribution and joint involvement were scored. Quantitative analysis was achieved by measurement of the region of interest (ROI) in all patients. The MPH-SPECT and MR images were fused in the ERA group. Bone scintigraphy detected fewer joints (26 joints,13/22 patients) with increased tracer uptake than did MPH-SPECT (80 joints, 21/22 patients). Bone scintigraphy did not show recognisable uptake patterns in any group of patients. With MPH-SPECT central tracer distribution was typical in ERA (10/13 patients, EOA 2/9). In contrast, an eccentric pattern was found predominantly in EOA (7/9, ERA 2/13). Normalised counts were 4.5 in unaffected joints and up to 222.7 in affected joints. The mean uptake values in affected joints were moderately higher in the EOA patients (78.75, and 62.16 in ERA). The mean tracer uptake in affected joints was approximately three-times higher than in unaffected joints in both groups (ERA 3.64-times higher, EOA 3.58). Correlation with MR images revealed that bone marrow oedema and erosions matched pathological tracer accumulation of MPH-SPECT in 11/13. MPH-SPECT demonstrated increased activity in 2/13 patients with normal bone marrow signal intensity and synovitis seen on MR images. MPH-SPECT is sensitive to early changes in ERA and EOA and permits them to be distinguished by their patterns of uptake. (orig.)

  15. Use of technetium-99m methylene diphosphonate and gallium-67 citrate scans after intraarticular injection of Staphylococcus aureus into knee joints of rabbits with chronic antigen-induced arthritis

    International Nuclear Information System (INIS)

    Numerous clinical studies have questioned the ability of radionuclide scans to differentiate septic from aseptic joint inflammation. A clinical study may not be able to document an underlying disease process or duration of infection and, thus, may make conclusions about the accuracy of scan interpretations open to debate. In this study, the Dumonde-Glynn model of antigen-induced arthritis in rabbits was used as the experimental model to study technetium and gallium scans in Staphylococcus aureus infection of arthritic and normal joints. Gallium scans were negative in normal rabbits, usually negative in antigen-induced arthritis, but positive in septic arthritis. The bone scan was usually negative in early infection but positive in late septic arthritis, a finding reflecting greater penetration of bacteria into subchondral bone because of the underlying inflammatory process

  16. Rheumatoid wrist deformity and risk of extensor tendon rupture evaluated by 3DCT imaging

    Energy Technology Data Exchange (ETDEWEB)

    Ishikawa, Hajime; Abe, Asami; Murasawa, Akira; Nakazono, Kiyoshi; Horizono, Hidehiro; Ishii, Katsushi; Seki, Eiko [Niigata Rheumatic Center, Department of Rheumatology, Shibata city, Niigata (Japan)

    2010-05-15

    Extensor tendon rupture on the dorsum of the wrist is commonly seen in patients with rheumatoid arthritis (RA). It causes immediate dysfunction of the hand and surgical reconstruction is usually required. The purpose of this study was to clarify the risk of extensor tendon rupture by quantifying wrist deformity on three-dimensional computed tomography (3DCT) images. Three-dimensional CT images of 108 wrists in 102 patients with RA and 38 wrists in 38 healthy volunteers were analyzed retrospectively. All of the rheumatoid wrists had caused persistent pain for more than 6 months despite ongoing medical treatment. Extensor tendon rupture was noted in 49 wrists in 47 patients, and no rupture was noted in 59 wrists in 56 patients. The dorsal subluxation ratio (DSR) of the ulnar head and the carpal supination angle (CSA) were measured utilizing a new technique. The average DSR and CSA in the rupture group (n = 49), the non-rupture group (n = 59), and the normal wrist group (n = 38) were 37%, 19%, and 26%, and 15 , 11 , and 6 respectively. The cut-off values for extensor tendon rupture in the wrists of patients with RA were 32% (sensitivity; 70%, specificity; 75%) in the DSR, and 14 (71%, 68%) in the CSA. By utilizing 3DCT imaging of the rheumatoid wrist, these parameters can help improve our ability to predict extensor tendon rupture. (orig.)

  17. Evaluation of MR imaging guided steroid injection of the sacroiliac joints for the treatment of children with refractory enthesitis-related arthritis

    International Nuclear Information System (INIS)

    To test the hypothesis that MR imaging guided triamcinolone acetonide injection into the sacroiliac joints of children with enthesitis-related arthritis is feasible, accurate and safe; and effectively reduces sacroiliac inflammation and disease progression. A retrospective analysis of 14 children (6/14 [43%] female, 8/14 (57%) male; mean age, 13.2 years; range, 6-16 years) who received MR imaging guided sacroiliac joint injections at 0.2 Tesla or 1.5 Tesla for enthesitis-related arthritis and acute sacroilitis refractory to medical therapy was performed. 20 mg triamcinolone acetonide were injected. Assessed were intra-articular drug delivery; image quality, duration, and complications. Success of therapy was defined by change of sacroiliac inflammation. Remission time and erosions were assessed by follow-up MRI (range, 10-22 months). Twenty four procedures resulted in intra-articular injection. Image quality was sufficient. No complications occurred. Procedure time was 40 min. Sedation time was 22 min. Success of therapy was achieved in 11/14 (79%) children. Sacroiliac inflammation decreased significantly (-59%). Median remission time was 13.7 months. No erosions occurred. MR imaging guided steroid injection of the sacroiliac joints is feasible, accurate, and safe and can effectively reduce sacroiliac inflammatory activity and may therefore aid in the prevention of disease progression. (orig.)

  18. Ultrasound-guided synovial biopsy: a safe, well-tolerated and reliable technique for obtaining high-quality synovial tissue from both large and small joints in early arthritis patients.

    OpenAIRE

    Kelly, S; Humby, F; Filer, A; Ng, N.; Di Cicco, M; Hands, RE; Rocher, V; Bombardieri, M; D'Agostino, MA; McInnes, IB; Buckley, CD; Taylor, PC; Pitzalis, C

    2013-01-01

    OBJECTIVE: To determine the tolerability, safety and yield of synovial tissue in an early arthritis cohort using a minimally invasive, ultrasound (US)-guided, synovial biopsy technique in small, medium and large joints. METHODS: 93 sequential biopsy procedures were assessed from a total of 57 patients (baseline and 36 repeat biopsies at 6 months) recruited as part of the 'Pathobiology of Early Arthritis Cohort' study. Patients completed a tolerability questionnaire prior to and following the ...

  19. Juvenile idiopathic arthritis

    Science.gov (United States)

    ... This form of JIA may turn into rheumatoid arthritis. It may involve five or more large and small joints of the legs and arms, as well as the jaw and neck. Pauciarticular JIA involves 4 or less ...

  20. Ulnar variance in children - standard measurements for evaluation of ulnar shortening in juvenile rheumatoid arthritis, hereditary multiple exostosis and other bone or joint disorders in childhood

    International Nuclear Information System (INIS)

    Measurements for radioulnar variance in adults cannot be used in children because the epiphyses are not fully ossified. We describe a method of determining ulnar variance in children by using the distance from the distal metaphysis of the radius to the distal metaphysis of the ulna. Standards for this measurement are presented for ages 1.5 to 15.5 years in boys and girls. These measurements change little with age and may be helpful in establishing shortening of the ulna which may be seen in juvenile rheumatoid arthritis, hereditary multiple exostosis, or other bone and joint diseases with childhood onset. (orig.)

  1. Detection of rheumatoid arthritis using infrared imaging

    Science.gov (United States)

    Frize, Monique; Adéa, Cynthia; Payeur, Pierre; Di Primio, Gina; Karsh, Jacob; Ogungbemile, Abiola

    2011-03-01

    Rheumatoid arthritis (RA) is an inflammatory disease causing pain, swelling, stiffness, and loss of function in joints; it is difficult to diagnose in early stages. An early diagnosis and treatment can delay the onset of severe disability. Infrared (IR) imaging offers a potential approach to detect changes in degree of inflammation. In 18 normal subjects and 13 patients diagnosed with Rheumatoid Arthritis (RA), thermal images were collected from joints of hands, wrists, palms, and knees. Regions of interest (ROIs) were manually selected from all subjects and all parts imaged. For each subject, values were calculated from the temperature measurements: Mode/Max, Median/Max, Min/Max, Variance, Max-Min, (Mode-Mean), and Mean/Min. The data sets did not have a normal distribution, therefore non parametric tests (Kruskal-Wallis and Ranksum) were applied to assess if the data from the control group and the patient group were significantly different. Results indicate that: (i) thermal images can be detected on patients with the disease; (ii) the best joints to image are the metacarpophalangeal joints of the 2nd and 3rd fingers and the knees; the difference between the two groups was significant at the 0.05 level; (iii) the best calculations to differentiate between normal subjects and patients with RA are the Mode/Max, Variance, and Max-Min. We concluded that it is possible to reliably detect RA in patients using IR imaging. Future work will include a prospective study of normal subjects and patients that will compare IR results with Magnetic Resonance (MR) analysis.

  2. MR imaging of the early rheumatoid arthritis: usefulness of contrast enhanced fat suppressed SPGR imaging

    International Nuclear Information System (INIS)

    To evaluate value of post-contrast 3-Dimensional fat suppressed Spoiled GRASS (FS SPGR) in detecting subtle bony erosion and tenosynovitis of hands and wrists due to early rheumatoid arthritis. Fourteen MR imagings of the hands and wrists were performed in 7 early rheumatoid arthritis without any abnormalities in plain radiography and in 7 healthy volunteers. All subjects underwent MR sequence of coronal 3D FS SPGR with and without contrast enhancement in 1.5T MR unit. We evaluated the number of the bony erosion and tenosynovitis respectively in pre-and post-contrast FS SPGR images. The abnormal enhancing areas were not demonstrated in 7 healthy volunteers. Seven patients had 25 bony erosions in pre-contrast FS SPGR and 52 bony erosions with tenosynovitis (n = 10) in post-contrast FS SPGR. Enhancing joint spaces were shown in 8 cases. Post-contrast FS SPGR was better than pre-contrast FS SPGR in the evaluation of early rheumatoid arthritis and is valuable as a baseline study

  3. Magnetic resonance imaging, radiography, and scintigraphy of the finger joints: one year follow up of patients with early arthritis. The TIRA Group

    DEFF Research Database (Denmark)

    Klarlund, Mette; Østergaard, Mikkel; Jensen, K E;

    2000-01-01

    OBJECTIVES: To evaluate synovial membrane hypertrophy, tenosynovitis, and erosion development of the 2nd to 5th metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints by magnetic resonance imaging in a group of patients with rheumatoid arthritis (RA) or suspected RA followed up for one...... for RA at baseline, five fulfilled the criteria only after one year's follow up, whereas eight maintained the original diagnosis of early unclassified polyarthritis. The following MRI variables were assessed at baseline and one year: synovial membrane hypertrophy score, number of erosions, and......, scores of MR synovial membrane hypertrophy, tenosynovitis, and scintigraphic tracer accumulation had not changed significantly from baseline; in contrast, swollen and tender joint counts had declined significantly (p<0.05). CONCLUSIONS: MRI detected more erosions than radiography. MR synovial membrane...

  4. Radiosynoviorthesis of small and medium joints with Rhenium-186 sulfide and Erbium-169 citrate

    International Nuclear Information System (INIS)

    This paper presents our experience and results of treatment of medium and small joints in the patients with rheumatoid arthritis. The efficacy and adverse effects of radiosynoviorthesis (RSO) are presented. Before RSO, all patients were subjected to detailed clinical examinations to assess degree of pain, joint swelling and joint mobility. All patients were also subjected to Ultrasonography (US), Xray and three-phase bone scintigraphy as a routine prior to therapy. A total of fifty seven patients (age range = 8 to 89 years; average age = 47 years; Male : Female = 26: 31) with rheumatoid arthritis of medium joints were treated with Rhenium-186 Sulfide. All in all a total number of 76 medium sized joints including 14 shoulders, 7 elbows, 41 wrists and 14 ankles were treated. On the other hand a total of twenty nine patients (age range = 31 to 60 years; average age = 47 years; Male : Female = 23: 6) with rheumatoid arthritis of small joints were also treated using Erbium-169 citrate. A total of 80 small joints including 65 metacarpophalangeal (MCP) and 15 proximal interphalangeal (PIP) joints were treated. The radiosynoviorthesis procedures were carried out under US control. About 70-110 MBq Re-186 Sulfide was injected into the joints in case of medium sized joints; while about 20-40 MBq of Erbium-169 Citrate was used to treat smaller joints. Following administration of radiopharmaceuticals into the joints, the joints were immobilized for 2-3 days. Repeat clinical and US examinations were performed at 6 and 12 months following therapy. Excellent results were obtained with regard to pain relief, resolution of swelling and synovial reaction, as well as improvement in joint mobility. With regard to effect on shoulder joints, excellent results were obtained resulting in reduction in pain, swelling and synovial reaction in almost all joints (100%); while improved mobility was noted in 60% joints. In case of elbow joints also excellent results were obtained with regard to

  5. Destructive wrist arthropathy of pseudogout

    Energy Technology Data Exchange (ETDEWEB)

    Smathers, R.L.; Keats, T.E.; Stelling, C.B.

    1982-01-01

    The wrist is a frequent site of arthropathy in the pseudogout syndrome (calcium pyrophosphate dihydrate crystal deposition disease). Three cases of severe wrist arthropathy are presented to emphasize the destructive changes which may occur, including necrosis or collapse of the lunate and navicular bones. The roentgenographic findings characteristic of pseudogout in the wrist are discussed.

  6. X-Ray Exam: Wrist

    Science.gov (United States)

    ... Tropical Delight: Melon Smoothie Pregnant? Your Baby's Growth X-Ray Exam: Wrist KidsHealth > For Parents > X-Ray Exam: Wrist Print A A A Text Size ... español Radiografía: muñeca What It Is A wrist X-ray is a safe and painless test that uses ...

  7. Enteropathic Arthritis

    Science.gov (United States)

    ... Info For Teens Message Boards & Forums Donate Enteropathic Arthritis Learn About Spondylitis / Enteropathic Arthritis Overview For The ... Work and Spondylitis Spondylitis Awareness Month Overview: Enteropathic Arthritis Enteropathic (en-ter-o-path-ic) arthritis is ...

  8. Ganglion cysts in the paediatric wrist: magnetic resonance imaging findings

    International Nuclear Information System (INIS)

    The majority of published literature on ganglion cysts in children has been from a surgical perspective, with no dedicated radiologic study yet performed. Our aim was to assess the magnetic resonance (MR) imaging appearance of ganglion cysts in a series of paediatric MR wrist examinations. Ninety-seven consecutive paediatric MR wrist examinations were retrospectively reviewed for the presence of ganglion cysts. Only those studies with wrist ganglia were included. Cysts were assessed for location, size, internal characteristics and secondary effect(s). Forty-one ganglion cysts (2-32 mm in size) were seen in 35/97 (36%) patients (24 female, 11 male), mean age: 13 years 11 months (range: 6 years 3 months-18 years). The majority were palmar (63.4%) with the remainder dorsal. Of the cysts, 43.9% were related to a wrist ligament(s), 36.6% to a joint and 17.1% to the triangular fibrocartilage complex. Of the patients, 91.4% had wrist symptoms: pain (n=29, 82.9%), swelling (n=7, 20%) and/or palpable mass (n=4, 11.4%); 71.4% patients had significant additional wrist abnormalities. Ganglion cysts were frequently found in children referred for wrist MRI. (orig.)

  9. Ganglion cysts in the paediatric wrist: magnetic resonance imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Bracken, Jennifer; Bartlett, Murray [Royal Children' s Hospital, Medical Imaging Department, Melbourne, VIC (Australia)

    2013-12-15

    The majority of published literature on ganglion cysts in children has been from a surgical perspective, with no dedicated radiologic study yet performed. Our aim was to assess the magnetic resonance (MR) imaging appearance of ganglion cysts in a series of paediatric MR wrist examinations. Ninety-seven consecutive paediatric MR wrist examinations were retrospectively reviewed for the presence of ganglion cysts. Only those studies with wrist ganglia were included. Cysts were assessed for location, size, internal characteristics and secondary effect(s). Forty-one ganglion cysts (2-32 mm in size) were seen in 35/97 (36%) patients (24 female, 11 male), mean age: 13 years 11 months (range: 6 years 3 months-18 years). The majority were palmar (63.4%) with the remainder dorsal. Of the cysts, 43.9% were related to a wrist ligament(s), 36.6% to a joint and 17.1% to the triangular fibrocartilage complex. Of the patients, 91.4% had wrist symptoms: pain (n=29, 82.9%), swelling (n=7, 20%) and/or palpable mass (n=4, 11.4%); 71.4% patients had significant additional wrist abnormalities. Ganglion cysts were frequently found in children referred for wrist MRI. (orig.)

  10. Effects of low dosage Co-60 irradiation in the course of aseptic arthritis of the knee joint of rabbits; Effekte einer niedrig dosierten Co-60-Bestrahlung auf den Verlauf einer aseptischen Arthritis am Kniegelenk des Kaninchens

    Energy Technology Data Exchange (ETDEWEB)

    Fischer, U.; Koch, F.; Ludewig, E. [Univ. Leipzig (Germany). Veterinaermedizinische Fakultaet; Kamprad, F.; Melzer, R.; Hildebrandt, G. [Leipzig Univ. (Germany). Klinik fuer Strahlentherapie und Radioonkologie

    1998-12-01

    Purpose: Numerous clinical observations demonstrate the efficacy of low radiation doses in the treatment of painful osteoarthritis. Experimental investigations remain scarce. We investigated the effects of locally daily 5 times 1.0 Gy 60-Co irradiation on an artificially induced aseptic gonarthritis in rabbits. Material and methods: Three separate experiments (EV) were performed (10 rabbits per experiment, 5 treated/5 controls; duration: EV1: 18 days; EV2: 6 days; EV3: 29 days). An aseptic arthritis in the right knee joint of rabbits was induced by intraarticular injection of 0.5 ml papain solution (3%, 30,000 USP/mg) on day 0. The arthritic knee joint of the anesthesized animals was irradiated daily from day 1 to 5 with 5 times 1.0 Gy. The controls were sham-irradiated under the same conditions. The time course of arthritis in treated animals and sham-treated controls was evaluated by clinical, laboratory-chemical and histological criteria. The clinical investigation was performed daily, the puncture of the knee-joints was carried out several times in EV1, and at the end of experiments in EV2 and EV3. At the end of the observation period, animals were killed and the knee joints excised for histological analysis. Results: The intraarticular injection of papain caused a peracute inflammatory response in all animals. After 1 week the chronical stage was reached, and the experimental arthritis resolved slowly within several weeks. Local irradiation accelerated the decrease of inflammatory joint swelling, being significant by day 4. On day 6 the volume of synovial fluid in irradiated knee-joints was significantly smaller. The morphometric data indicated a reduction in thickness of synovial membrane, a decrease in number of synovial cell layers, and a decrease in distance between capillaries and the synovial membrane surface following irradiation of arthritic joints. Due to considerable individual variability, the morphometric data partially did not reach statistically

  11. Easing Joint Pain: Are NSAIDs Right for You?

    Medline Plus

    Full Text Available Easing Joint Pain: Are NSAIDs Right for You? What are NSAIDs? When you have pain from arthritis or muscle ... NSAIDs work. If you have arthritis in your joints (osteo- arthritis) or another kind of chronic pain, ...

  12. Joint Replacement Surgery

    Science.gov (United States)

    ... a Clinical Trial Journal Articles Arthritis July 2014 Joint Replacement Surgery: Health Information Basics for You and Your Family What Is Joint Replacement Surgery? Joint replacement surgery is removing a ...

  13. The post-arthro-CT of the wrist clinical evaluation

    CERN Document Server

    Scheurecker, G

    2001-01-01

    To compare the diagnostic effectiveness of post-arthro-CT (PACT) and 3-compartment wrist arthrography (AG) both separate and combined versus wrist arthroscopy for scapho-lunate ligament (SLL), luno-triquetral ligament (LTL) and triangular fibrocartilage (TFC) defects and chondromalacia of the carpal bones. Material and methods: in 58 patients (16-69 years) the affected wrist was examined initially by conventional 3-compartment wrist arthrography with digital subtraction technique during injection followed by digital stress images. Afterwards spiral arthro-CT was performed in the semi-coronal and axial plane with 1 mm slice thickness and secondary true-coronal and sagittal reconstructions. Within 1 month arthroscopy was performed in general anesthesia utilizing standard joint entry points combined with routine digital picture archiving. All examinations were evaluated for SLL, LTL and TFC defects, PACT and AS for ChM too. Results: AG versus AS: the following detection rates were observed (AG and AS positive/AG...

  14. 75 FR 17417 - Joint Meeting of the Arthritis Advisory Committee and the Drug Safety and Risk Management...

    Science.gov (United States)

    2010-04-06

    ... Management Advisory Committee. This meeting was announced in the Federal Register of March 8, 2010 (75 FR... Drug Safety and Risk Management Advisory Committee; Amendment of Notice AGENCY: Food and Drug... meeting of the Arthritis Advisory Committee and the Drug Safety and Risk Management Advisory...

  15. 75 FR 36427 - Joint Meeting of the Arthritis Advisory Committee and the Drug Safety and Risk Management...

    Science.gov (United States)

    2010-06-25

    ... Drug Safety and Risk Management Advisory Committee; Notice of Meeting AGENCY: Food and Drug...: Arthritis Advisory Committee and the Drug Safety and Risk Management Advisory Committee. ] General Function... and efficacy findings for sodium oxybate in the fibromyalgia population and the proposed...

  16. Foot and ankle kinematics in rheumatoid arthritis: influence of foot and ankle joint and leg tendon pathologies

    NARCIS (Netherlands)

    Dubbeldam, R.; Baan, H.; Nene, A.V.; Drossaers-Bakker, K.W.; Laar, van de M.A.F.J.; Hermens, H.J.; Buurke, J.H.

    2013-01-01

    Objective From early onset of the disease, patients with rheumatoid arthritis (RA) experience walking impairments. Pathologic effects of RA on foot and ankle structures have been studied clinically, but little is known as to how they relate to kinematic changes during gait. The aim of this study was

  17. Joint Disorders

    Science.gov (United States)

    A joint is where two or more bones come together, like the knee, hip, elbow, or shoulder. Joints can be damaged by many types of injuries or diseases, including Arthritis - inflammation of a joint. It causes pain, stiffness, and swelling. Over time, ...

  18. Cessation of neutrophil influx in C5a-induced acute experimental arthritis is associated with loss of chemoattractant activity from the joint space

    International Nuclear Information System (INIS)

    Neutrophil emigration is a critical component of the inflammatory process and is generally thought to play a role in host defense as well as in the tissue injury that often accompanies inflammation. Most inflammatory reactions exhibit a sequence of emigrating cell types, thus clearly demonstrating that the neutrophil influx eventually ceases and that the neutrophils are then removed from the lesion. It has been our premise that in order to understand the processes that lead to the progressive inflammatory reactions that underly so many disease processes, it is important to determine the mechanism by which the ''normal'' inflammatory response resolves. The purpose of this study was to identify the time of cessation of neutrophil influx in experimental arthritis induced by the injection of C5 fragments (C5f) and to investigate mechanisms underlying the cessation process. The migration of i.v. delivery pulses to inflamed joints was assessed by lavage of the joint space and by external scintigraphy. We found no evidence for the development of inhibitory systems against chemotactic factors or ''desensitization'' of the inflamed site, because a second injection of C5f into joints which had been injected previously with C5f resulted in enhancement rather than inhibition of migration. Neither was evidence found for altered tissue barriers to migration or for desensitization of neutrophils as possible explanations for cessation of influx. The major mechanism appeared to be a loss of chemoattractant activity in the joint space between 2 h and 6 h after C5f injection which was detected by transfer into a fresh joint. Radiolabeled C5a des-Arg had a t1/2 of disappearance from the joint of less than 1 h, which suggested that the transferred chemoattractant must, in part, have been due to the generation of new chemotaxins by C5f injection

  19. AN ASSOCIATION OF CYTOKINE LEVELS WITH DISEASE ACTIVITY, AUTOANTIBODY LEVELS, AND JOINT DESTRUCTIVE CHANGES IN EARLY RHEUMATOID ARTHRITIS

    Directory of Open Access Journals (Sweden)

    A. S. Avdeeva

    2015-09-01

    Full Text Available Objective: to assess the association of cytokine profile measures with disease activity, autoantibody levels, and joint destructive changes in patients with early rheumatoid arthritis (RA.Subjects and methods. Forty-five patients, including 35 women, with early RA were examined. Their median age was 53.5 [46; 59.5] years; the duration of the disease – 7.0 [4.0; 11.5] months; DAS28 – 5.8 [4.9; 6.4]; 91 and 96% of the patents were positive for rheumatoid factor (RF and anticyclic citrullinated peptide antibodies, respectively. Serum cytokine concentrations were estimated using the xMAP multiplex technology. The modified Sharp method was employed to quantify radiographic changes.Results and discussion. A group of 30 patients with high disease activity (DAS28 >5.1 had higher levels of interleukin (IL-6 (62.3 [36.1; 127.5] pg/ml and IP-10 (6367.8 [3682.7; 10691.3] pg/ml than 15 patients with moderate/low disease activity (DAS28 ≤5.1 (35.8 [13.4; 64.2] and 3222.6 [1881.0; 5671.9] pg/ml, respectively, p < 0.05. The patients highly positive for IgM RF had higher levels (pg/ml of proinflammatory cytokines, such as IL-1β, IL-2, IL-6, IL-12, IL-15, interferon-γ, and tumor necrosis factor-α; the chemokine monocyte chemotactic protein-1 and the growth factors IL-7 and vascular endothelial growth factor (4.8 [2.8; 19.3], 23.0 [7.1; 55.8], 64.2 [41.6; 170.5], 52.2 [30.9; 126.9], 2.4 [0.2; 11.2], 210.8 [119.9; 584.2], 90.7 [42.7; 307/9], 57.5 [26.1; 93.8], 54.9 [37.1; 123.7], and 143.3 [70.6; 249.6] pg/ml than those who were negative/lowly positive for IgM RF (2.3 [1.9; 3.1], 4.9 [2.9; 16.8], 24.9 [20.4; 45.4], 25.6 [19.9; 57.1], 0.2 [0.01; 1.65], 94.4 [86.3; 138.9], 37.3 [23.6; 47.7], 20.9 [12.3; 33.9], 32.6 [28.1; 37.8], 74.2 [53.5; 147.6], respectively (p < 0.05.Conclusion. There are significant differences in cytokine profile measures in patients with early RA in relation to disease activity and serum autoantibody levels.

  20. 多层螺旋CT与核磁共振成像联合诊断腕关节损伤的探析%Multi-slice spiral CT combined with magnetic resonance imaging in diagnose of wrist joint injury

    Institute of Scientific and Technical Information of China (English)

    郭侨阁; 王顺利; 牛军杰; 刘彦; 唐楠; 周龙

    2015-01-01

    Objective To explore significance of multi-slice spiral CT combined with magnetic resonance imaging in the diagnose of wrist joint injury.Methods 168 patients with wrist joint injury admitted into our hospital from January,2012 to September,2014 were investigated.Their clinical data were analyzed.According the different examination methods,the patients were randomly divided into three groups,56 cases for each group.These 3 groups were given multi-slice spiral CT examination,magnetic resonance imaging examination,and multi-slice spiral CT combined with magnetic resonance imaging examination,respectively.The diagnosis situations and the advantages of different examination methods of the three groups were analyzed.Results The detection rate of multi-slice spiral CT was 73.21%,that of magnetic resonance imaging 75.00%,and that of the combination group 96.43%.The statistical analysis showed that there were no significant differences (P> 0.05).However,the detection rate of the combination group was significantly higher than those multi-slice spiral CT and magnetic resonance imaging (P <0.05);The detection rate of the combination of multi-slice spiral CT and magnetic resonance imaging was significantly higher than that of just one of these two examination methods(P <0.05).Conclusions Multi-slice spiral CT combined with magnetic resonance imaging in the diagnosis of wrist joint injury is most effective.It synthesizes the advantages of the two examination methods,improves the detection rate,and makes the specific injury situation clear.It's worth being clinically generalized.%目的 探究采用多层螺旋CT与核磁共振成像联合诊断腕关节损伤的情况.方法 调查研究我院在2012年1月至2014年9月间收治的168例腕关节损伤患者,分析其临床资料,根据检查方法的不同,将本组患者随机分成三组,各56例,分别给予多层螺旋CT检查、核磁共振成像检查和多层螺旋CT联合核磁共振成像检查.分析

  1. Wrist range of motion and motion frequency during toy and game play with a joint-specific controller specially designed to provide neuromuscular therapy: A proof of concept study in typically developing children.

    Science.gov (United States)

    Crisco, Joseph J; Schwartz, Joel B; Wilcox, Bethany; Brideau, Holly; Basseches, Benjamin; Kerman, Karen

    2015-08-20

    Upper extremities affected by hemiplegic cerebral palsy (CP) and other neuromuscular disorders have been demonstrated to benefit from therapy, and the greater the duration of the therapy, the greater the benefit. A great motivator for participating in and extending the duration of therapy with children is play. Our focus is on active motion therapy of the wrist and forearm. In this study we examine the wrist motions associated with playing with two toys and three computer games controlled by a specially-designed play controller. Twenty children (ages 5-11) with no diagnosis of a muscular disorder were recruited. The play controller was fitted to the wrist and forearm of each child and used to measure and log wrist flexion and extension. Play activity and enjoyment were quantified by average wrist range of motion (ROM), motion frequency measures, and a discrete visual scale. We found significant differences in the average wrist ROM and motion frequency among the toys and games, yet there were no differences in the level of enjoyment across all toys and games, which was high. These findings indicate which toys and games may elicit the greater number of goal-directed movements, and lay the foundation for our long-term goal to develop and evaluate innovative motion-specific play controllers that are engaging rehabilitative devices for enhancing therapy and promoting neural plasticity and functional recovery in children with CP. PMID:25935686

  2. Comparison of magnetic resonance imaging signs and clinical findings in follow-up examinations in children and juveniles with temporomandibular joint involvement in juvenile idiopathic arthritis

    International Nuclear Information System (INIS)

    The aim of this study was to analyze the extent to which pathological findings of temporomandibular joint (TMJ) in magnetic resonance imaging (MRI) follow-up examinations are correlated with clinical symptoms in patients with TMJ involvement in juvenile ideopathic arthritis (JIA) over time. Data from 34 patients with TMJ involvement in JIA was retrospectively examined. Shortly after two clinical examinations, the first MRI and the follow-up MRI were performed. The MRI examinations took place with 1.5 T MRI. In both MRI examinations alterations on the condyle (MRI1: 88 %, MRT2: 91 %) and contrast enhancement (MRT1: 76 %, MRT2 65 %) were found most frequently. TMJ pain (65 %) and lower mouth opening capacity (65 %) were the number one finding in the first clinical examination. A statistically significant correlation was found between the alterations on the condyle and TMJ pain (p = 0.025) and between the alterations on the condyle and lower mouth opening capacity (p = 0.019). By comparing the results of the first MRI with the results of the follow-up MRI, we identified a trend towards a progression of TMJ arthritis, while the clinical follow-up showed an improvement in most patients. We found a discrepancy between the progressive or stable trends of pathological findings in follow-up MRI and the decrease in clinical symptoms over time. Therefore, follow-up examination by MRI shows important information for correct evaluation about the stage of TMJ arthritis and about the need for treatment. Consequently, follow-up examination by MRI is an appropriate addition to clinical examination in the therapeutic concept. (orig.)

  3. The use of dynamic bone scanning in the evaluation of wrist and hand pain

    International Nuclear Information System (INIS)

    Twenty-seven patients with complaints of wrist and/or hand pain were evaluated using a quantitative technique of dynamic (blood flow analysis) and static bone scan. The patients were divided in two groups according to their clinical history. Group A included 13 patients with a history of trauma. Seven patients had scaphoid fracture and 6 of them were scanned to determine non-union and/or avascular necrosis of the joint. One patient was scanned to determine the viability of a graft for non-union fracture. In all cases the scan gave a correct diagnosis as confirmed by later x-ray changes. Six patients in this group had negative x-rays. The scan demonstrated 4 cases of occult fractures, 4 had early Kienbock's Disease (KD) and 1 a soft tissue tumor. Group B included 14 patients with no known history of trauma. Nine had positive x-rays including 3 with KD that were scanned to determine their viability for surgical replacement of the lunate. The scan could distinguish between isolated involvement of the lunate and secondary degenerative changes of the surrounding carpal bones and radiocarpal joint. Two patients with tumor were correctly diagnosed by the scan, one as benign and one malignant. Four other patients with nonspecific changes on x-ray showed early arthritis (3 cases) and a cyst of the triquetrum ( 1 case) on the bone scan. Four patients in Group B had negative x-rays and the scan showed degenerative changes (3 cases) and an occult fracture of the hamate (1 case). The use of dynamic and static bone scanning appears to be a very valuable technique in the evaluation of patients with wrist and hand pain

  4. Bony pathologies of the metacarpophalangeal joints in early rheumatoid arthritis. Comparison of MRI and high-resolution SPECT; Knoecherne Pathologien der Metacarpophalangeal-Gelenke bei frueher rheumatoider Arthritis. Vergleich zwischen MRT und hochaufloesender SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Scherer, Axel; Blondin, D.; Reichelt, D.; Moedder, U. [Radiologie, Heinrich-Heine Univ., Duesseldorf (Germany); Wirrwar, A.; Mattes-Gyoergy, K.; Mueller, H.W. [Nuklearmedizin, Heinrich-Heine Univ., Duesseldorf (Germany); Schneider, M. [Rheumatologie, Klinik fuer Endokrinologie, Diabetologie und Rheumatologie, Heinrich-Heine Univ., Duesseldorf (Germany); Ostendorf, B. [Radiologie, Heinrich-Heine Univ., Duesseldorf (Germany); Rheumatologie, Klinik fuer Endokrinologie, Diabetologie und Rheumatologie, Heinrich-Heine Univ., Duesseldorf (Germany)

    2009-09-15

    Aim: comparison of MRI with a newly developed high-resolution multi-pinhole single photon emission computed tomography (MPH-SPECT) regarding the detection of bony pathologies of the metacarpophalangeal (MCP) joints in patients with early rheumatoid arthritis (ERA). Materials and methods: the clinically dominant hand of 15 patients with ERA (disease duration 6 months) was examined using MRI and MPH-SPECT. The evaluation of MRI was achieved according to RAMRIS criteria and for the MPH SPECT regarding pathological tracer uptake and distribution. Image fusions of MRI and MPH-SPECT were provided and the two methods were compared. Results: in MRI 12 of 15 patients showed arthritic joint pathologies, while 8 patients exhibited soft tissue and bony changes. 4 patients had only soft tissue inflammation (synovitis) with a normal bone signal. In MPH-SPECT 10 of 15 patients showed pathologically increased bone metabolism. The fusion images presented a high agreement of the pathological changes in both methods, while areas with increased bone metabolism were not only present in the case of erosions, but also in the case of bone edema. In 2 patients increased bone metabolism was detectable in areas of MR tomographic normal bone, while a clear surrounding synovitis was present in each case here. (orig.)

  5. Ultrasound Assessment of Synovial Thickness of Some of the Metacarpophalangeal Joints of Hand in Rheumatoid Arthritis Patients and the Normal Population

    Science.gov (United States)

    Hussain Manik, Zuhudha; George, John; Sockalingam, Sargunan

    2016-01-01

    Objective. To compare ultrasound synovial thickness of the 2nd, 3rd and 4th metacarpophalangeal joints (MCPJ) in a group of patients with proven rheumatoid arthritis (RA) and a control group of normal individuals. Materials and Methods. This is a cross-sectional study comprising 30 rheumatoid arthritis patients and 30 healthy individuals. Ultrasound scans were performed at the dorsal side of 2nd, 3rd, and 4th MCPJ of both hands in RA patients and the healthy individuals. Synovial thickness was measured according to quantitative method. The synovial thickness of RA patients and healthy individuals was compared and statistical cut-off was identified. Results. Maximum synovial thickness was most often detected at the radial side of the 2nd MCPJ and 3rd MCPJ and ulnar side of the 4th MCPJ of both hands which is significantly higher (p ulnar side of the 4th MCPJ. Conclusion. Patients with early RA appear to exhibit a characteristic pattern of synovitis which shows radial side predominance in the 2nd and 3rd MCPJ and ulnar side in the 4th MCPJ.

  6. Familial disease, the HLA-DRB1 shared epitope and anti-CCP antibodies influence time at appearance of substantial joint damage in rheumatoid arthritis.

    Science.gov (United States)

    Rojas-Villarraga, Adriana; Diaz, Francisco J; Calvo-Páramo, Enrique; Salazar, Juan C; Iglesias-Gamarra, Antonio; Mantilla, Ruben D; Anaya, Juan-Manuel

    2009-02-01

    Rheumatoid arthritis (RA) progresses more rapidly in some patients than in others and diverse factors influence radiographic progression in a specific population. Thus, we searched for variables that are associated with an early appearance of substantial joint damage in patients with RA by using radiographic assessments. A cohort of 157 consecutively enrolled Colombian RA patients was followed for an average of 3.2+/-3.1 years. Information on patient demographics and cumulative clinical and laboratory manifestations over the course of the disease was registered, including family history of RA in first-degree relatives, extra-articular manifestations, rheumatoid factor, anti-CCP3 antibodies, TNF single nucleotide polymorphism at -308 position, and HLA-DRB1 status. Radiographs were scored according to the Sharp-van der Heijde method. Survival analyses of the time at appearance of substantial joint damage were performed by using Weibull models. A review of literature about the influence of familial RA on the progression of disease was done. Our results show that family history of RA is consistently associated with joint damage (i.e. erosive and joint narrowing disease). This effect was not found in all the populations reviewed. In addition, we confirm the effect of HLA-DRB1 shared epitope and anti-CCP seropositivity on erosive disease. Family history of RA is a key risk factor for joint damage and depends on the investigated population because variations in both additive and non-additive genetic factors and the environmental variance are specific to the population. Our results emphasize the usefulness of assessing familial disease, testing anti-CCP antibodies and genotyping HLA-DRB1 gene in patients with RA because these factors may be used to predict clinical outcomes and guide therapeutic interventions. PMID:19117726

  7. Animation of Phoenix's Wrist Unlatching

    Science.gov (United States)

    2008-01-01

    This animation shows what happened underneath Phoenix's Robotic Arm wrist on Sol 3. The pin that goes through the loop is what holds the wrist in place. The rotation of the wrist pops the pin free. The Phoenix Mission is led by the University of Arizona, Tucson, on behalf of NASA. Project management of the mission is by NASA's Jet Propulsion Laboratory, Pasadena, Calif. Spacecraft development is by Lockheed Martin Space Systems, Denver.

  8. Evaluating automated dynamic contrast enhanced wrist 3 T MRI in healthy volunteers: One-year longitudinal observational study

    Energy Technology Data Exchange (ETDEWEB)

    Rastogi, Anshul, E-mail: anshul.rastogi@bartshealth.nhs.uk [Kennedy Institute of Rheumatology, Imperial College London (United Kingdom); Kubassova, Olga, E-mail: olga@imageanalysis.org.uk [Image Analysis, Leeds (United Kingdom); Krasnosselskaia, Lada V., E-mail: solaguz@yahoo.com [Imaging Sciences Department, Imperial College London (United Kingdom); Lim, Adrian K.P., E-mail: a.lim@imperial.ac.uk [Department of Radiology, Imperial College Healthcare NHS Trust, London (United Kingdom); Satchithananda, Keshthra, E-mail: keshthra.satchithananda@imperial.nhs.uk [Department of Radiology, Imperial College Healthcare NHS Trust, London (United Kingdom); Boesen, Mikael, E-mail: mikael.boesen@gmail.com [Department of Radiology and the Parker Institute, Frederiksberg and Bispebjerg Hospitals (Denmark); Binks, Michael, E-mail: michael.h.binks@gsk.com [GlaxoSmithKline, Stevenage, SG1 2NY (United Kingdom); Hajnal, Joseph V., E-mail: jo.hajnal@kcl.ac.uk [Imaging Sciences Department, Imperial College London (United Kingdom); Taylor, Peter C., E-mail: peter.taylor@kennedy.ox.ac.uk [Kennedy Institute of Rheumatology, Imperial College London (United Kingdom)

    2013-08-15

    Rational and Objective: Dynamic contrast enhanced (DCE)-MRI has great potential to provide quantitative measure of inflammatory activity in rheumatoid arthritis. There is no current benchmark to establish the stability of signal in the joints of healthy subjects when imaged with DCE-MRI longitudinally, which is crucial so as to differentiate changes induced by treatment from the inherent variability of perfusion measures. The objective of this study was to test a pixel-by-pixel parametric map based approach for analysis of DCE-MRI (Dynamika) and to investigate the variability in signal characteristics over time in healthy controls using longitudinally acquired images. Materials and Methods: 10 healthy volunteers enrolled, dominant wrists were imaged with contrast enhanced 3T MRI at baseline, week 12, 24 and 52 and scored with RAMRIS, DCE-MRI was analysed using a novel quantification parametric map based approach. Radiographs were obtained at baseline and week 52 and scored using modified Sharp van der Heidje method. RAMRIS scores and dynamic MRI measures were correlated. Results: No erosions were seen on radiographs, whereas MRI showed erosion-like changes, low grade bone marrow oedema and low-moderate synovial enhancement. The DCE-MRI parameters were stable (baseline scores, variability) (mean ± st.dev); in whole wrist analysis, ME{sub mean} (1.3 ± 0.07, −0.08 ± 0.1 at week 24) and IRE{sub mean} (0.008 ± 0.004, −0.002 ± 0.005 at week 12 and 24). In the rough wrist ROI, ME{sub mean} (1.2 ± 0.07, 0.04 ± 0.02 at week 52) and IRE{sub mean} (0.001 ± 0.0008, 0.0006 ± 0.0009 at week 52) and precise wrist ROI, ME{sub mean} (1.2 ± 0.09, 0.04 ± 0.04 at week 52) and IRE{sub mean} (0.001 ± 0.0008, 0.0008 ± 0.001 at week 24 and 52). The Dynamic parameters obtained using fully automated analysis demonstrated strong, statistically significant correlations with RAMRIS synovitis scores. Conclusion: The study demonstrated that contrast enhancement does occur in

  9. Evaluating automated dynamic contrast enhanced wrist 3 T MRI in healthy volunteers: One-year longitudinal observational study

    International Nuclear Information System (INIS)

    Rational and Objective: Dynamic contrast enhanced (DCE)-MRI has great potential to provide quantitative measure of inflammatory activity in rheumatoid arthritis. There is no current benchmark to establish the stability of signal in the joints of healthy subjects when imaged with DCE-MRI longitudinally, which is crucial so as to differentiate changes induced by treatment from the inherent variability of perfusion measures. The objective of this study was to test a pixel-by-pixel parametric map based approach for analysis of DCE-MRI (Dynamika) and to investigate the variability in signal characteristics over time in healthy controls using longitudinally acquired images. Materials and Methods: 10 healthy volunteers enrolled, dominant wrists were imaged with contrast enhanced 3T MRI at baseline, week 12, 24 and 52 and scored with RAMRIS, DCE-MRI was analysed using a novel quantification parametric map based approach. Radiographs were obtained at baseline and week 52 and scored using modified Sharp van der Heidje method. RAMRIS scores and dynamic MRI measures were correlated. Results: No erosions were seen on radiographs, whereas MRI showed erosion-like changes, low grade bone marrow oedema and low-moderate synovial enhancement. The DCE-MRI parameters were stable (baseline scores, variability) (mean ± st.dev); in whole wrist analysis, MEmean (1.3 ± 0.07, −0.08 ± 0.1 at week 24) and IREmean (0.008 ± 0.004, −0.002 ± 0.005 at week 12 and 24). In the rough wrist ROI, MEmean (1.2 ± 0.07, 0.04 ± 0.02 at week 52) and IREmean (0.001 ± 0.0008, 0.0006 ± 0.0009 at week 52) and precise wrist ROI, MEmean (1.2 ± 0.09, 0.04 ± 0.04 at week 52) and IREmean (0.001 ± 0.0008, 0.0008 ± 0.001 at week 24 and 52). The Dynamic parameters obtained using fully automated analysis demonstrated strong, statistically significant correlations with RAMRIS synovitis scores. Conclusion: The study demonstrated that contrast enhancement does occur in healthy volunteers but the inherent

  10. Extensor tendon rupture and three-dimensional computed tomography imaging of the rheumatoid wrist

    Energy Technology Data Exchange (ETDEWEB)

    Abe, Asami; Ishikawa, Hajime; Murasawa, Akira; Nakazono, Kiyoshi [Niigata Rheumatic Center, Department of Rheumatology, Shibata, Niigata (Japan)

    2010-04-15

    Extensor tendon rupture on the dorsum of the wrist is commonly seen in patients with rheumatoid arthritis (RA). The diagnosis of tendon rupture is usually straightforward, but it is sometimes difficult in the hand with complex deformity. The purposes of this study were to investigate the reliability of three-dimensional computed tomography (3DCT) imaging of extensor tendons in the rheumatoid wrist and in the normal wrist and to clarify the validity of its clinical application to the diagnosis of tendon rupture in the rheumatoid wrist. Preoperative 3DCT images of 48 wrists of 45 patients with RA and 3DCT images of 38 wrists of 38 healthy volunteers were reviewed retrospectively by six orthopaedic surgeons who were unaware of all other study data. Extensor tendon rupture was verified by operation on 20 rheumatoid wrists. Regarding interobserver and intra-observer reliabilities of 3DCT imaging of the extensor tendons, agreement with respect to tendon rupture in this study group was high, and Cohen's kappa ({kappa}) coefficient was variable, depending on the individual tendon. Positive predictive value (PPV) of tendon rupture in the extensor digiti minimi (EDM), extensor digitorum communis (EDC) V and IV and extensor pollicis longs (EPL) tendons was more than 60%, but those for the other extensor tendons were less than 50%. Negative predictive value (NPV) was more than 96% in all extensor tendons, in both rheumatoid and normal wrists. Extensor tendons in normal and rheumatoid wrists were well depicted by 3DCT imaging. In the rheumatoid wrists, extensors of the ring and little fingers and the thumb were depicted more accurately than those to the other fingers. 3DCT imaging was clinically applicable to wrists for which it was difficult to diagnose by physical examination a definite cause for the loss of extension of the fingers. (orig.)

  11. Viral arthritis

    Science.gov (United States)

    Infectious arthritis - viral ... Arthritis may be a symptom of many virus-related illnesses. It usually disappears on its own without ... the rubella vaccine, only a few people develop arthritis. No risk factors are known.

  12. High-energy injuries of the wrist.

    Science.gov (United States)

    Obert, L; Loisel, F; Jardin, E; Gasse, N; Lepage, D

    2016-02-01

    High-energy injuries to the wrist gather complex fractures of the distal radius, radiocarpal dislocations, perilunate dislocations, and other intracarpal dislocations. Depending on the energy of the injury and the position of the wrist at the time of impact, the patient, often a young male with a high functional demand, presents one of these injuries associating fracture(s) and ligament injury. The trauma is often bilateral, with proximal lesions (elbow) very often associated with contusion or compression of the median nerve. Diagnosis is confirmed by wrist X-rays, which are sufficient to determine treatment for radiocarpal and perilunate dislocations. In cases of distal radius fractures or other intracarpal dislocations, a preoperative CT is necessary. Reduction of the dislocation and relief of neurovascular compression are performed immediately. The final treatment of each lesion (bone fixation, ligament repair) can be undertaken simultaneously or delayed, depending on the patient and the lesions. Cartilage lesions, resulting from the high-energy injury, can be estimated using arthroscopy but cannot be repaired and determine the prognosis. The surgeon's objective is to restore joint congruence, which does not prevent stiffness, the main complication of these rare injuries, which the surgeon must know how to recognize and treat. PMID:26782706

  13. Validity and reproducibility of self-administered joint counts. A prospective longitudinal followup study in patients with rheumatoid arthritis

    NARCIS (Netherlands)

    Prevoo, MLL; Kuper, IH; vantHof, MA; vanLeeuwen, MA; vandePutte, LBA; vanRiel, PLCM

    1996-01-01

    Objective. To investigate the reproducibility and validity of self-administered joint counts (JC), measuring tenderness, swelling and the combination of both, in a longitudinal study, Methods. At the outpatient department a form self-administered by patients (SAI-form), was used to measure joint inv

  14. Volar Stabilization of the Distal Radioulnar Joint for Chronic Instability Using the Pronator Quadratus.

    Science.gov (United States)

    Lee, Sang Ki; Lee, Jae Won; Choy, Won Sik

    2016-04-01

    In cases of chronic distal radioulnar joint (DRUJ) instability without DRUJ arthritis, reconstruction of the mechanical integrity of the radioulnar ligaments of the triangular fibrocartilage complex has been considered an ideal surgical treatment. However, reconstructive methods have several disadvantages.We evaluated volar stabilization of the DRUJ for chronic instability using the pronator quadratus (PQ) to determine whether it provided (1) proper stability, (2) restored wrist function, (3) was relatively convenient, and (4) was associated with a low complication rate. Altogether, 21 patients with chronic DRUJ instability (12 men, 9 women) with a mean age of 34 years (range, 17-65 years) were enrolled in the study. The diagnostic criteria were as follows: 3 months after the injury, greater than 8 mm of palmar-dorsal translation of the ulna relative to the radius, there was a lack of clear end point resistance compared with the contralateral side, and nonstressed computed tomographic scans provided supporting evidence. Follow-up was at least 12 months (range, 12-38 months). Palmar-dorsal translation of the ulna relative to the radius was decreased significantly from 10 to 4 mm (P = 0.028) and epicenter was increased significantly at the last follow-up [P = 0.015/0.026 (70 degrees of supination/neutral, respectively)]. Wrist range of motion was not significantly different, but grip strength had increased from 72% to 91%. Disabilities of the arm, shoulder, and hand and patient-rated wrist evaluation were also decreased compared with preoperative measurements [34.4 to 12.5/42.7 to 14.7 (disabilities of the arm, shoulder, and hand/patient-rated wrist evaluation, respectively)]. Pronator quadratus advancement volar stabilization provided proper stability, restored wrist function, was relatively convenient, and was associated with few complications. Our experience indicates that it is an acceptable, effective treatment option to reverse DRUJ instability in patients

  15. Clinical and Serological Findings in Juvenile Patients with Idiopathic Arthritis in Southwestern of Iran

    Directory of Open Access Journals (Sweden)

    Soheila Alyasin

    2014-10-01

    Full Text Available Introduction: The purpose of this study was to describe clinical features and serological findings of children with idiopathic arthritis in south-western Iran.Methods: This descriptive study included 60 patients with juvenile idiopathic arthritis who were referred to a pediatric rheumatology clinic at a university hospital during 6-month period. Initial manifestations, first laboratory tests and clinical course of patients were reviewed.Results: Sixty children (32 boys and 28 girls with idiopathic arthritis ranged in age from 1.5 to 16 years. The mean age at the first presentation was 4.92 years (SD= 3.68. Oligoarthritis was the most common subtype in 27 (45%, followed by systemic- onset in 17 (28.3% and polyarthritis in 16 (26.7% of patients. The most commonly involved joints were knee 53(88.3%, ankle 28(46.6% and wrist 27(45%. Uveitis was detected in two patients, and positivity for ANA titer was revealed in one patient. Conclusions: In this study, the pattern of most clinical features in different subtypes of juvenile idiopathic arthritis resembles to other studies. Positive ANA was less; however, the low numbers of Iranian patients with uveitis was noteworthy.

  16. Epidemiology of acute wrist trauma

    DEFF Research Database (Denmark)

    Larsen, C F; Lauritsen, Jens

    1993-01-01

    Epidemiological data on wrist injuries in a population can be used for planning by applying them to criteria for care and thus deriving estimates of provisions for care according to currently desirable standards. In a 1-year study all patients > or = 15 years with acute wrist trauma and treated...... in the emergency room were examined according to an algorithm until a diagnosis was established. The overall incidence of wrist trauma was 69 per 10,000 inhabitants per year. Incidence of wrist trauma requiring x-ray examination was 58 per 10,000 per year. The incidence of distal radius fractures was 27 per 10...... using data from a population-based study. A completeness rate of 0.56 (95% confidence interval: 0.31-0.78) was found. An x-ray had been taken for all patients reporting a fracture thus justifying the use of fractures as an incidence measure when comparing groups of patients with wrist trauma....

  17. Aiming for a simpler early arthritis MRI protocol: can Gd contrast administration be eliminated?

    International Nuclear Information System (INIS)

    To evaluate whether intravenous gadolinium (Gd) contrast administration can be eliminated when evaluating synovitis and tenosynovitis in early arthritis patients, thereby decreasing imaging time, cost, and invasiveness. Wrist MRIs of 93 early arthritis patients were evaluated by two readers for synovitis of the radioulnar, radiocarpal, and intercarpal joints, according to the Rheumatoid Arthritis MRI Scoring method (RAMRIS), and for tenosynovitis in ten compartments. Scores of MRI images without Gd contrast enhancement were compared to scores obtained when evaluating all, including contrast-enhanced, MRI images as reference. Subsequently, a literature review and pooled analysis of data from the present and two previous studies were performed. At the individual joint/tendon level, sensitivity to detect synovitis without Gd contrast was 91 % and 72 % for the two readers, respectively, with a specificity of 51 % and 81 %. For tenosynovitis, the sensitivity was 67 % and 54 %, respectively, with a specificity of 87 % and 91 %. Pooled data analysis revealed an overall sensitivity of 81 % and specificity of 50 % for evaluation of synovitis. Variations in tenosynovitis scoring systems hindered pooled analyses. Eliminating Gd contrast administration resulted in low specificity for synovitis and low sensitivity for tenosynovitis, indicating that Gd contrast administration remains essential for an optimal assessment. (orig.)

  18. Aiming for a simpler early arthritis MRI protocol: can Gd contrast administration be eliminated?

    Energy Technology Data Exchange (ETDEWEB)

    Stomp, Wouter; Bloem, Johan L.; Reijnierse, Monique [Leiden University Medical Center, Department of Radiology, P.O. Box 9600, Leiden (Netherlands); Krabben, Annemarie; Heijde, Desiree van der; Huizinga, Tom W.J.; Helm-van Mil, Annette H.M. van der [Leiden University Medical Center, Department of Rheumatology, P.O. Box 9600, Leiden (Netherlands); Oestergaard, Mikkel [University of Copenhagen, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spinal Diseases, Glostrup Hospital, Glostrup (Denmark)

    2015-05-01

    To evaluate whether intravenous gadolinium (Gd) contrast administration can be eliminated when evaluating synovitis and tenosynovitis in early arthritis patients, thereby decreasing imaging time, cost, and invasiveness. Wrist MRIs of 93 early arthritis patients were evaluated by two readers for synovitis of the radioulnar, radiocarpal, and intercarpal joints, according to the Rheumatoid Arthritis MRI Scoring method (RAMRIS), and for tenosynovitis in ten compartments. Scores of MRI images without Gd contrast enhancement were compared to scores obtained when evaluating all, including contrast-enhanced, MRI images as reference. Subsequently, a literature review and pooled analysis of data from the present and two previous studies were performed. At the individual joint/tendon level, sensitivity to detect synovitis without Gd contrast was 91 % and 72 % for the two readers, respectively, with a specificity of 51 % and 81 %. For tenosynovitis, the sensitivity was 67 % and 54 %, respectively, with a specificity of 87 % and 91 %. Pooled data analysis revealed an overall sensitivity of 81 % and specificity of 50 % for evaluation of synovitis. Variations in tenosynovitis scoring systems hindered pooled analyses. Eliminating Gd contrast administration resulted in low specificity for synovitis and low sensitivity for tenosynovitis, indicating that Gd contrast administration remains essential for an optimal assessment. (orig.)

  19. Radiographic findings in wrists and hands of patients with leprosy

    International Nuclear Information System (INIS)

    Leprosy, like other neuropathic disorders, can involve the skeleton, affecting both bone and joints, especially those segments that have to withstand weight. To asses the osteoarticular involvement of the wrist and hand in 58 patients with leprosy. The radiographic images of wrist and hand of 58 patients with Hansen's disease were reviewed. The entire spectrum of specific and nonspecific bone lesions described in the literature is presented. Despite the fact that the upper limbs do not have to withstand the weight that the feet and ankles do, radiographic images show that gripping and other common motions can also produce lesions compatible with those of neuropathic arthropathy. (Author) 20 refs

  20. Handout on Health: Rheumatoid Arthritis

    Science.gov (United States)

    ... of, and surgery for, bone and joint diseases. Physical therapists: Health professionals who work with patients to improve ... heart. Pericarditis can be caused by rheumatoid arthritis. Physical therapist. A health professional who works with patients to ...

  1. Real-time magnetic resonance imaging (MRI during active wrist motion--initial observations.

    Directory of Open Access Journals (Sweden)

    Robert D Boutin

    Full Text Available BACKGROUND: Non-invasive imaging techniques such as magnetic resonance imaging (MRI provide the ability to evaluate the complex anatomy of bone and soft tissues of the wrist without the use of ionizing radiation. Dynamic instability of wrist--occurring during joint motion--is a complex condition that has assumed increased importance in musculoskeletal medicine. The objective of this study was to develop an MRI protocol for evaluating the wrist during continuous active motion, to show that dynamic imaging of the wrist is realizable, and to demonstrate that the resulting anatomical images enable the measurement of metrics commonly evaluated for dynamic wrist instability. METHODS: A 3-Tesla "active-MRI" protocol was developed using a bSSFP sequence with 475 ms temporal resolution for continuous imaging of the moving wrist. Fifteen wrists of 10 asymptomatic volunteers were scanned during active supination/pronation, radial/ulnar deviation, "clenched-fist", and volarflexion/dorsiflexion maneuvers. Two physicians evaluated distal radioulnar joint (DRUJ congruity, extensor carpi ulnaris (ECU tendon translation, the scapholunate (SL interval, and the SL, radiolunate (RL and capitolunate (CL angles from the resulting images. RESULTS: The mean DRUJ subluxation ratio was 0.04 in supination, 0.10 in neutral, and 0.14 in pronation. The ECU tendon was subluxated or translated out of its groove in 3 wrists in pronation, 9 wrists in neutral, and 11 wrists in supination. The mean SL interval was 1.43 mm for neutral, ulnar deviation, radial deviation positions, and increased to 1.64 mm during the clenched-fist maneuver. Measurement of SL, RL and CL angles in neutral and dorsiflexion was also accomplished. CONCLUSION: This study demonstrates the initial performance of active-MRI, which may be useful in the investigation of dynamic wrist instability in vivo.

  2. Power Doppler sonography with and without echo-enhancing contrast agent and contrast-enhanced MRI for the evaluation of rheumatoid arthritis of the shoulder joint: differentiation between synovitis and joint effusion

    International Nuclear Information System (INIS)

    To evaluate patients with clinically active rheumatoid arthritis (RA) of the shoulder for joint effusion and synovitis using conventional sonography, power Doppler (PD) sonography with and without echo-enhancing contrast agent, and contrast-enhanced MRI.Design and patients Twenty-four patients (mean age 64 years) with known RA had one symptomatic shoulder evaluated by conventional gray-scale sonography and PD sonography before and after intravenous administration of the echo-enhancing contrast agent Levovist (300 mg/ml, 2.5 g). The degree and extent of the altered echo pattern in the subacromial bursa, axillary recess and glenohumeral joint seen by conventional gray-scale sonography and the intensity of vascular signals of PD sonography were compared with the findings of MRI obtained with T2-weighted turbo spin-echo sequences and contrast-enhanced T1-weighted fat-saturated spin-echo sequences. MRI was evaluated by two readers in consensus without knowledge of the sonographic findings. MRI, which was used as the reference examination, detected joint effusion in 71% (17/24) and synovitis in 92% (22/24) of the patients. Conventional sonography revealed an abnormal articular echo pattern in 96% (23/24) of the patients, especially in the axillary recess and subacromial bursa, but failed to attribute the altered echo pattern to either fluid or specific synovitis. PD sonography allowed a specific diagnosis of synovitis in 33% (8 patients), which increased to 50% (12 patients) after administration of an echo-enhancing contrast agent. In 42% (10/24) of the patients, the findings of synovitis demonstrated by MRI corresponded to an altered echo pattern by conventional sonography, but vascular signals were absent by PD sonography with or without echo-enhancing contrast agent. Using MRI as the ''gold standard,'' PD sonography with and without echo-enhancing contrast agent cannot reliably identify synovitis or distinguish synovial inflammation from effusion in the shoulder joint

  3. Volar Central Portal in Wrist Arthroscopy.

    Science.gov (United States)

    Corella, F; Ocampos, M; Cerro, M Del; Larrainzar-Garijo, R; Vázquez, T

    2016-03-01

    Background Nowadays, the wrist is not limited to a dorsal visualization; the joint can be thought of as a "box," which can be visualized from almost every perspective. The purpose of this study was to describe a new volar central portal for the wrist, following three principles: a single incision that allows access to both the radiocarpal and midcarpal joints, centered on the lunate, with the volar structures at risk protected not only by retractors, but also by tendons. Description of Technique The incision begins in the distal wrist crease and extended 1.5 cm proximally up to the proximal wrist crease, following the axis of the third intermetacarpal space. The flexor superficialis tendons are identified and retracted toward the radial side. Next, the fourth and fifth flexor digitorum profundus tendons are retracted toward the ulnar side, while the third and second tendons are retracted toward the radial side. The volar central midcarpal portal is performed under direct vision just over the anterior horn of the lunate through the Poirier space. The volar central radiocarpal portal is created under the lunate through the interval between the ulnocarpal ligaments and the short radioulnar ligament. Methods An anatomical study was performed on 14 cadaver specimens. Two data were recorded: iatrogenic injuries of the structures at risk and the distances to the structures at risk. Results The median (interquartile range [IQR]) distances from the volar central radiocarpal portal to the median nerve, palmar cutaneous branch of the median nerve, and ulnar neurovascular bundle were 10.5 (7.8-15.0), 18.5 (15.8-20.3), and 7.0 (5.0-10.5) mm, respectively. The median (IQR) distances from the volar central midcarpal portal to the median nerve, palmar cutaneous branch of the median nerve, and ulnar neurovascular bundle were 7.0 (4.8-10.3), 16.0 (14.8-19.0), and 4.5 (3.8-9.0) mm, respectively. No iatrogenic injuries were observed. Conclusion The volar central portal is

  4. Arthrographic effect induced by therapeutic ultrasound in magnetic resonance imaging of the wrist: a preliminary investigation

    International Nuclear Information System (INIS)

    To evaluate the potential arthrographic effect of therapeutic ultrasound applied before magnetic resonance imaging (MRI) of the wrist. Subjects and methods: MRI of the wrist was performed in 6 asymptomatic volunteers before and after ultrasound therapy of the carpus. For each patient, ultrasound therapy was performed by a trained physiotherapist for 10 minutes, with doses titrated to the maximum tolerated without pain. The amount of fluid within the wrist joints before and after therapy was assessed subjectively by 2 reviewers, as well as objectively by digital analysis. Results: Subjective appraisal of the images indicated that after ultrasound therapy there was an increase in joint fluid within the distal radioulnar joint in 4 volunteers, the midcarpal joint in 4 and the radiocarpal joint in 2. Computerized digital analysis of joint fluid confirmed an average volumetric increase in wrist joint fluid of 52.8% in 3 of the volunteers. The discomfort of the therapy was graded as 1/10 by 5 of the subjects and 4/10 by a single subject. Conclusions: Therapeutic ultrasound may be a useful adjuvant tool in the noninvasive induction of joint fluid before MRI of the wrist. (author)

  5. Psoriatic arthritis

    International Nuclear Information System (INIS)

    This book contains 11 chapters. Some of the titles are: The history and epidemiologic definition of psoriatic arthritis as a distinct entity; Psoriatic arthritis: Further epidemiologic and genetic considerations; The radiologic features of psoriatic arthritis; and Laboratory findings and pathology of psoriatic arthritis

  6. Psoriatic arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Gerber, L.H.; Espinoza, L.R.

    1985-01-01

    This book contains 11 chapters. Some of the titles are: The history and epidemiologic definition of psoriatic arthritis as a distinct entity; Psoriatic arthritis: Further epidemiologic and genetic considerations; The radiologic features of psoriatic arthritis; and Laboratory findings and pathology of psoriatic arthritis.

  7. Ganglions of the hand and wrist.

    Science.gov (United States)

    Thornburg, L E

    1999-01-01

    Ganglions of the hand and wrist are common benign lesions. They most frequently arise adjacent to joints and tendons, but may also be intratendinous or intraosseous. Treatment options include observation, aspiration, and surgical excision. Observation is acceptable in most instances. Indications for more aggressive treatment include pain, interference with activity, nerve compression, and imminent ulceration (in the case of some mucous cysts). The recurrence rate after puncture and aspiration is greater than 50% for cysts in most locations, but is less than 30% for cysts in the flexor tendon sheath. Surgical excision is effective, with a recurrence rate of only 5% if care is taken to completely excise the stalk of the cyst along with a small portion of joint capsule. Surgical treatment of occult ganglions is successful with accurate assessment of the source of the pain. Arthroscopic treatment of dorsal wrist ganglions is still experimental, but early results are encouraging. Ganglion surgery requires a formal operative environment and careful technique in order to minimize injury to adjacent structures and minimize the likelihood of recurrence. PMID:10434077

  8. 多层螺旋CT联合核磁共振成像在腕关节损伤诊断中的应用价值%Application value of multilayer spiral CT combined with MRI in the diagnosis of wrist joint injury

    Institute of Scientific and Technical Information of China (English)

    王传真; 王翠祥; 李强

    2013-01-01

    目的 探讨多层螺旋计(算)机断层扫描(MSCT)联合核磁共振成像(MRl)在腕关节损伤诊断中的应用价值.方法 将150例腕关节损伤患者随机分()ISCT组48例,MRI组49例及联合组53例,分别采用MSCT、MRI及MSCT + MRI检查进行诊断.比较3组患者骨折处、关节脱位例数、移位碎骨折片数量、隐匿性骨折处、腕关节处其他损伤的发现率,以及损伤范围的差异.结果 MSCT组发现骨折处、关节脱位例数、移位碎骨折片数量均显著多于MRI组;而MRI组发现隐匿性骨折处、软骨损伤及骨挫伤处均显著多于MSCT组,肌腱情况及皮下组织损伤范围的确诊情况也优于MSCT组,而联合组上述指标的确诊情况均显著优于其他2组.结论 将MSCT与MRI联合应用于腕关节损伤的诊断,可有效提高骨折、关节脱位、隐匿性骨折、软骨损伤、骨挫伤及移位碎骨折片的检出率,并有助于确诊肌腱及皮下组织损伤的范围,为临床治疗方案的制订提供更为科学的诊断依据,可在临床加以推广应用.%Objective To explore the application value of multilayer spiral CT (MSCT)combined with MRI in the diagnosis of wrist joint injury.Methods One hundred and fifty patients with wrist joint injury were divided into MSCT group (n =48),MRI group (n =49) and combination group (n =53).The three groups received MSCT,MRI,MSCT + MRI examination respectively.The numbers of fracture,joint dislocation,dislocated pieces,occult fractures,other injuries of wrist joints and injury range of the three groups were compared.Results The numbers of fractures,joint dislocation,dislocated pieces in the MSCT group were obviously bigger than those in the MRI group,while the numbers of occult fracture,cartilage injuries and other injuries of wrist joints in the MRI group were obviously bigger than those in the MSCT group,and the diagnosis condition of injury range of tendons and subcutaneous tissue was also better than the MSCT group

  9. [Joint and sensory branch block of the obturator and femoral nerves in a case of femoral head osteonecrosis and arthritis].

    Science.gov (United States)

    Cortiñas-Sáenz, M; Salmerón-Velez, G; Holgado-Macho, I A

    2014-01-01

    The sensory innervation of the hip joint is complex. The joint and sensory branch block of the obturator and femoral nerves is effective for treating the pain caused due to different hip diseases. This could be an option to be considered in certain circumstances such as, being a surgical-anaesthetic high risk, or if there is significant overweight, It could also be useful on other occasions if the traumatoligist considers that it is better to delay hip replacement for a limited period. PMID:24656423

  10. Soft-tissue approach to hand and wrist trauma

    International Nuclear Information System (INIS)

    This paper provides information that will help minimize nondiagnosis of significant injuries to the hand and wrist, currently the most common cause of litigation in radiology. Soft-tissue swelling accompanies all significant injuries. The soft-tissue anatomy determines the patterns of swelling seen in acute injuries to the hand and wrist. Knowledge of the detectable patterns of swelling logically directs attention to the region of greatest trauma, minimizing the possibility that subtle sprains, fractures, and dislocations will be overlooked. Principles of joint space evaluation, alignment assessment, and additional evaluation techniques are other tools that will minimize nondiagnosis. Common examples of trauma to the hand and wrist in all age groups have been selected to illustrate the usefulness of this technique. Subtleties are stressed and unusual injuries illustrated

  11. Psoriatic arthritis

    International Nuclear Information System (INIS)

    Psoriatic arthritis (PsA) is a chronic inflammatory joint disease which develops in patients with psoriasis. It is characteristic that the rheumatoid factor in serum is absent. Etiology of the disease is still unclear but a number of genetic associations have been identified. Inheritance of the disease is multilevel and the role of environmental factors is emphasized. Immunology of PsA is also complex. Inflammation is caused by immunological reactions leading to release of kinins. Destructive changes in bones usually appear after a few months from the onset of clinical symptoms. Typically PsA involves joints of the axial skeleton with an asymmetrical pattern. The spectrum of symptoms include inflammatory changes in attachments of articular capsules, tendons, and ligaments to bone surface. The disease can have divers clinical course but usually manifests as oligoarthritis. Imaging plays an important role in the diagnosis of PsA. Classical radiography has been used for this purpose for over a hundred years. It allows to identify late stages of the disease, when bone tissue is affected. In the last 20 years many new imaging modalities, such as ultrasonography (US), computed tomography (CT) and magnetic resonance (MR), have been developed and became important diagnostic tools for evaluation of rheumatoid diseases. They enable the assessment and monitoring of early inflammatory changes. As a result, patients have earlier access to modern treatment and thus formation of destructive changes in joints can be markedly delayed or even avoided

  12. Pan-regional (cervico-thoraco-lumbo-sacral) spinal epidural abscess with multi-level discitis, vertebral body osteomyelitis and facet joint septic arthritis: complete resolution with non-operative management

    OpenAIRE

    Appukutty Manickam, MRCS; Laurence A.G. Marshman, MD, FRACS; Ipeson P. Korah, MBBS, DMRD

    2014-01-01

    Background and importance: Pan-regional (i.e. cervico-thoraco-lumbo-sacral [CTLS]) spinal epidural abscess (SEA) is rare: only 7 cases have been reported to date. Clinical presentation: A 68 year old male, without immunosuppression, presented with severe thoracic back pain and fulminant septicaemia. CT and MRI revealed a Pan-regional CTLS SEA associated with multi-level discitis, vertebral body osteomyelitis and facet joint septic arthritis. Blood cultures grew Staphylococcus aureus sensit...

  13. Which Psoriasis Patients Develop Psoriatic Arthritis?

    OpenAIRE

    Busse, Kristine; Liao, Wilson

    2010-01-01

    Psoriatic arthritis is a major comorbidity of psoriasis that significantly impairs quality of life and physical function. Because skin lesions classically precede joint symptoms, dermatologists are in a unique position to identify patients at risk for psoriatic arthritis before irreversible joint damage occurs. Here we review the literature to identify the clinical and genetic factors most highly associated with development of psoriatic arthritis, with the goal of assisting dermatologists in ...

  14. Ulnar Neuropathy at the Wrist

    OpenAIRE

    Pearce, Carisa; Feinberg, Joseph; Wolfe, Scott W.

    2009-01-01

    A case of ulnar nerve compression at the wrist within Guyon’s canal is reported. The clinical presentation initially appeared consistent with an ulnar nerve entrapment at the elbow. The true diagnosis of an ulnar sensorimotor nerve lesion occurring within the canal of Guyon was made electrophysiologically. Magnetic resonance imaging demonstrated compression of the nerve within the canal by a ganglionic cyst, which was confirmed by surgical intervention. Ulnar nerve entrapment at the wrist is ...

  15. Small Business Innovations (Robotic Wrist)

    Science.gov (United States)

    1991-01-01

    Under a Langley Research Center Small Business Innovation Research (SBIR) contract, Ross-Hime Designs, Inc. Minneapolis, MN, developed the Omni-Wrist actuator, which has a 25-pound capacity, 180 degrees of pitch/yaw, and 360 degrees of roll. Company literature calls it "the first successful singularity-free high-precision (robotic) wrist." Applications include spray painting, sealing, ultrasonic testing, welding and a variety of nuclear industry, aerospace and military uses.

  16. Studies on YKL-40 in knee joints of patients with rheumatoid arthritis and osteoarthritis. Involvement of YKL-40 in the joint pathology

    DEFF Research Database (Denmark)

    Volck, B; Johansen, J S; Stoltenberg, M;

    2001-01-01

    , which increased again at clinical relapse. CONCLUSIONS: YKL-40 in SF is derived from cells in the inflamed synovium, chondrocytes and SF neutrophils. Joint derived YKL-40 influences serum YKL-40. YKL-40 may be involved in the pathophysiology of the arthritic processes and reflect local disease activity....... analysed. YKL-40 concentrations in serum and SF were determined by RIA and ELISA. RESULTS: In the synovium YKL-40 positive cells were found in lining and stromal cells (macrophages) and the number of YKL-40 positive cells was related to the degree of synovitis. In arthritic cartilage, YKL-40 was located to...

  17. 类风湿性腕关节炎的MRI表现及临床对比应用研究%A study comparing MRI with clinical examinations on wrists with rheumatoid arthritis

    Institute of Scientific and Technical Information of China (English)

    王峻; 马强; 牛金亮; 谢维娜; 宋志珍; 郑洁

    2004-01-01

    目的研究类风湿性(rheumatoid arthritis,RA)腕关节炎MRI表现及临床对比应用的价值.方法搜集符合1987年美国风湿病协会(ARA)诊断标准的RA患者50例,男15例,女35例,行双腕关节MR扫描.均采用常规SE T1WI、短时反转恢复(STIR)序列、增强T1WI行冠状面扫描.选取10例正常志愿者对照.同时搜集患者的临床症状、体征、实验室指标与MRI表现进行对比分析.结果 50例患者,MRI下均可见滑膜增厚、血管翳增生,38例血管翳可见MRI增强表现,骨髓水肿21例,关节积液37例 ,骨质破坏37例. 骨髓水肿组、关节积液组、血管翳强化组分别与无相应表现组在红细胞沉降率、健康评估问卷(HAQ评分)、患者的整体评估(AIMS)、肿胀关节数进行对比分析,差异均有显著性意义(P值均<0.001).骨髓水肿组与无骨髓水肿组的骨质破坏、跖趾关节(MTP)压痛、抗核周因子(APF)间差异均有显著性意义(P值分别为0.024、0.025、0.018).结论 MRI能够显示类风湿性关节炎的病理改变,通过MRI表现与临床对比研究,MRI在类风湿性腕关节炎的诊断及预后评价方面有一定应用价值.

  18. Sternoclavicular joint septic arthritis following paraspinal muscle abscess and septic lumbar spondylodiscitis with epidural abscess in a patient with diabetes: a case report

    Directory of Open Access Journals (Sweden)

    Shioya Nobuki

    2012-06-01

    Full Text Available Abstract Background Septic arthritis of the sternoclavicular joint (SCJ is extremely rare, and usually appears to result from hematogenous spread. Predisposing factors include immunocompromising diseases such as diabetes. Case presentation A 61-year-old man with poorly controlled diabetes mellitus presented to our emergency department with low back pain, high fever, and a painful mass over his left SCJ. He had received two epidural blocks over the past 2 weeks for severe back and leg pain secondary to lumbar disc herniation. He did not complain of weakness or sensory changes of his lower limbs, and his bladder and bowel function were normal. He had no history of shoulder injection, subclavian vein catheterization, intravenous drug abuse, or focal infection including tooth decay. CT showed an abscess of the left SCJ, with extension into the mediastinum and sternocleidomastoid muscle, and left paraspinal muscle swelling at the level of L2. MRI showed spondylodiscitis of L3-L4 with a contiguous extradural abscess. Staphylococcus aureus was isolated from cultures of aspirated pus from his SCJ, and from his urine and blood. The SCJ abscess was incised and drained, and appropriate intravenous antibiotic therapy was administered. Two weeks after admission, the purulent discharge from the left SCJ had completely stopped, and the wound showed improvement. He was transferred to another ward for treatment of the ongoing back pain. Conclusion Diabetic patients with S. aureus bacteremia may be at risk of severe musculoskeletal infections via hematogenous spread.

  19. Arthritis Possible Side Effect of Certain Cancer Drugs: Study

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_159602.html Arthritis Possible Side Effect of Certain Cancer Drugs: Study ... increase risk for joint and tissue disease, including arthritis, new research suggests. "We keep having referrals coming ...

  20. The use of upper limb orthoses in patients with rheumatoid arthritis: a literature review in the field of occupational therapy

    Directory of Open Access Journals (Sweden)

    Talita Silvério de Souza Silva

    2015-09-01

    Full Text Available Introduction: Rheumatoid arthritis is a chronic systemic disease that most often affects smaller joints such as hands and wrists. It may cause deformities that jeopardize hand function, thus impacting the subject occupational performance. In order to assist the hand function restoration, occupational therapists often use orthosis to improve autonomy and/or independence to perform daily activities in patients with rheumatoid arthritis. Objective: This study aimed to identify the upper limb’s orthoses used in patients with rheumatoid arthritis, who were assisted by the Occupational Therapy, featuring the population, the type of research and the outcomes obtained. Method: This study is literature review and its selection criteria consists of publications in English, Spanish and Portuguese published within the last ten years, divided between experimental, observational and case studies, all with diagnosis of rheumatoid arthritis and assisted by an occupational therapist. Twelve articles were selected for review. Findings: The literature review points out the benefits achieved through the use of the orthosis to manual dexterity, grip strength, pain relief and aspects related to comfort and patient satisfaction. Conclusion: In this context, the orthosis appears as an important assistive technology resource to keep function and restore compromised activities.

  1. Peripheral arthritis in the elderly: a hospital study.

    OpenAIRE

    Jenkinson, M L; Bliss, M R; Brain, A T; Scott, D.L.

    1989-01-01

    One hundred consecutive patients admitted to an acute geriatric unit were examined for evidence of peripheral arthritis with recognised criteria used to define osteoarthritis, rheumatoid arthritis, pyrophosphate arthropathy, gout, and disorders of the shoulder joint. The presence of arthritis and its severity were related both to functional independence and to a recognition by the patient that joint problems were impairing independence. Seventy six patients had clinical peripheral arthritis; ...

  2. An introduction to the EULAR-OMERACT rheumatoid arthritis MRI reference image atlas

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Edmonds, J; McQueen, F;

    2005-01-01

    This article gives a short overview of the development and characteristics of the OMERACT rheumatoid arthritis MRI scoring system (RAMRIS), followed by an introduction to the use of the EULAR-OMERACT rheumatoid arthritis MRI reference image atlas. With this atlas, MRIs of wrist and...

  3. 多层螺旋CT核磁共振成像诊断腕关节损伤的临床应用研究%Clinical Analysis of Multi Slice Spiral CT Magnetic Resonance Imaging in Diagnosis of Wrist Joint Injury

    Institute of Scientific and Technical Information of China (English)

    全宏卫

    2015-01-01

    目的:探讨多层螺旋CT(MSCT)与核磁共振成像(MRI)诊断腕关节损伤的价值。方法收集腕关节损伤患者112例,分别应用MSCT、MRI和联合诊断,比较三种诊断方法的诊断效能。结果骨折组中MRI对软骨损伤、骨挫伤和隐匿性骨折的检出率显著高于MSCT,而移位碎骨折片、关节脱位以及关节骨折的检出率显著低于MSCT(P<0.05);无骨折组中MRI检出隐匿性骨折、软骨损伤以及骨挫伤均显著高于MSCT,而关节脱位检出率显著低于MSCT(P<0.05)。结论 MSCT联合MRI诊断腕关节损伤具有较高的检出率以及诊断效能,值得推广应用。%Objective To evaluate multi-slice spiral CT (MSCT) and magnetic resonance imaging (MRI) of wrist injury diagnosis. Methods 112 cases of wrist injury, respectively by MSCT, MRI and combined diagnosis, diagnostic ef iciency comparison of three diagnostic methods. Results In the group of MRI fracture detection rate of cartilage, bone contusions and occult fractures were significantly higher than that of MSCT, and shift broken fracture and joint dislocation and the fracture of the joint detection rate was significantly lower than that of MSCT ( <0.05);without fracture in the group of MRI detected occult fracture, cartilage damage and bone contusion were significantly higher than MSCT, while the dislocation rate was significantly lower than that of MSCT ( <0.05). Conclusion MSCT combined with MRI in diagnosis of wrist joint injury detection rate and diagnosis ef iciency is high, it is worthy of popularization and application.

  4. Psoriatic Arthritis

    Science.gov (United States)

    ... your body. Some people with psoriasis have psoriatic arthritis. It causes pain, stiffness, and swelling of the ... physical exam and imaging tests to diagnose psoriatic arthritis. There is no cure, but medicines can help ...

  5. Radiological diagnosis in lesions of the wrist

    Energy Technology Data Exchange (ETDEWEB)

    Kob, A.; Thelen, R.; Schild, H.; Lang, A.

    1988-05-01

    To visualise the rupture of the scaphoid bone it will be sufficient - as has been proven - to perform two additional projections from the navicular series besides the standard X-rays of the wrist joint, namely, with the hand in writing-pen position and in hyperpronation. With this procedure, almost all (99%) of fractures detected during first examination can be diagnosed. To prove the occurrence of fractures of the wrist besides those of the os naviculare, specific X-rays are employed in accordance with the results of an on-target clinical examination. Such X-rays are, in particular, lateral radioulnar X-ray rotated by 10/sup 0/ in volar direction to assess the os triquetrum, lateral radioulnar X-ray in 10-30/sup 0/ supination to visualise the os pisiforme, carpal tunnel X-ray to assess the entire hollow of the hand, in particular the volar parts of os pisiforme, os hamatum (hamulus) and os trapezium. Although such fractures can partly also be diagnosed by means of a navicular series, as already stated, it is not permissible to exclude the presence of a fracture if there are no abnormal findings in the navicular quartet whereas clinical findings are positive.

  6. Radiological diagnosis in lesions of the wrist

    International Nuclear Information System (INIS)

    To visualise the rupture of the scaphoid bone it will be sufficient - as has been proven - to perform two additional projections from the navicular series besides the standard X-rays of the wrist joint, namely, with the hand in writing-pen position and in hyperpronation. With this procedure, almost all (99%) of fractures detected during first examination can be diagnosed. To prove the occurrence of fractures of the wrist besides those of the os naviculare, specific X-rays are employed in accordance with the results of an on-target clinical examination. Such X-rays are, in particular, lateral radioulnar X-ray rotated by 100 in volar direction to assess the os triquetrum, lateral radioulnar X-ray in 10-300 supination to visualise the os pisiforme, carpal tunnel X-ray to assess the entire hollow of the hand, in particular the volar parts of os pisiforme, os hamatum (hamulus) and os trapezium. Although such fractures can partly also be diagnosed by means of a navicular series, as already stated, it is not permissible to exclude the presence of a fracture if there are no abnormal findings in the navicular quartet whereas clinical findings are positive. (orig.)

  7. Basic pathologic conditions of the wrist

    International Nuclear Information System (INIS)

    Pathologic conditions of the wrist involve both musculoskeletal structure (bones and joints) and soft tissues, of which fat pads are an important diagnostic aid to recognize various disorders. The authors report their 5-year experience with Xeroradiography in the diagnosis of various pathologic conditions (e.g., inflammatory, degenerative, and tumoral conditions) of the wrist. The importance of Xeroradiography was emphatized, in the past, because of its characteristic technical properties, especially in demonstrating lower-density tissues tumors. The main advantage of Xeroradiography is the physical phenomenon known as edge effect, which increases image contrast at the borders. Other differences between xeroradiography and conventional radiography are: broader recording latitude of the former, together with its higher resolution power (100 lines/mm), and high exposition power (which makes repeats useless). Thus, Xeroradiography allows the contemporary depiction of various and different structures and densities- e.g., bones and soft tissues. Unfortunately, radiation dose to the patient is higher during Xeroradiography than during conventional radiography. That is why digital radiography has nowadays replaced Xeroradiography. In fact, the former provides images that are comparable with those obtained by means of conventional radiography and -sometimes- even with xeroradiographic images allows radiation dose to the patient to be markedly reduced, whereas recording latitude remains the same

  8. Intervention randomized controlled trials involving wrist and shoulder arthroscopy: a systematic review

    OpenAIRE

    Tadjerbashi, Kamelia; Rosales, Roberto S; Atroshi, Isam

    2014-01-01

    Background: Although arthroscopy of upper extremity joints was initially a diagnostic tool, it is increasingly used for therapeutic interventions. Randomized controlled trials (RCTs) are considered the gold standard for assessing treatment efficacy. We aimed to review the literature for intervention RCTs involving wrist and shoulder arthroscopy. Methods: We performed a systematic review for RCTs in which at least one arm was an intervention performed through wrist arthroscopy or shoulder arth...

  9. Evaluation of lesions of the internal ligaments of the wrist; conventional magnetic resonance imaging versus MR arthrography (MRA

    Directory of Open Access Journals (Sweden)

    Heba Ahmed Kamal

    2014-09-01

    Conclusion: MR arthrography is a potent additional tool facilitating the diagnosis of different pathologic entities affecting the major internal ligaments of the wrist joint and helps to reduce arthroscopic interventions.

  10. Artrite da gota tofácea crônica mimetizando artrite reumatoide Chronic tophaceous gout mimicking rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Juliana F. Sarmento

    2009-12-01

    Full Text Available A gota é um distúrbio no metabolismo das purinas, usualmente associado à ocorrência de crises recorrentes de artrite nas articulações dos membros inferiores em homens entre 40-50 anos, e com o desenvolvimento de tofos subcutâneos nos pacientes com doença de longa evolução. Casos de pacientes com artrite gotosa crônica que mimetizam quadros de artrite reumatoide e vice-versa são raros. Descrevemos o caso de um paciente de 56 anos, com quadro de artrite poliarticular, simétrica e deformante, comprometendo principalmente as articulações de mãos e punhos, com nódulos subcutâneos difusos pelo corpo, alterações radiográficas atípicas e urolitíase, que, após avaliação clínica e dos exames complementares, recebeu diagnóstico de gota tofácea crônica mutilante mimetizando artrite reumatoide.Gout is a disorder of purine metabolism, usually associated with recurrent bouts of arthritis in the joints of the lower limbs, affecting men 40 to 50 years of age, which leads to the development of subcutaneous tophi in patients with long-lasting disease. Cases of patients with chronic gouty arthritis mimicking rheumatoid arthritis, and vice-versa, are rare. This report describes the case of a 56-year old male with symmetric, deforming, and polyarticular arthritis affecting, specially, the joints of the hands and wrists, with diffuse subcutaneous nodules throughout his body, atypical radiographic findings, and urolithiasis. Following clinical evaluation and additional tests, this patient received a diagnosis of chronic tophaceous gout mimicking mutilating rheumatoid arthritis.

  11. Robot-Aided Mapping of Wrist Proprioceptive Acuity across a 3D Workspace.

    Science.gov (United States)

    Marini, Francesca; Squeri, Valentina; Morasso, Pietro; Konczak, Jürgen; Masia, Lorenzo

    2016-01-01

    Proprioceptive signals from peripheral mechanoreceptors form the basis for bodily perception and are known to be essential for motor control. However we still have an incomplete understanding of how proprioception differs between joints, whether it differs among the various degrees-of-freedom (DoFs) within a particular joint, and how such differences affect motor control and learning. We here introduce a robot-aided method to objectively measure proprioceptive function: specifically, we systematically mapped wrist proprioceptive acuity across the three DoFs of the wrist/hand complex with the aim to characterize the wrist position sense. Thirty healthy young adults performed an ipsilateral active joint position matching task with their dominant wrist using a haptic robotic exoskeleton. Our results indicate that the active wrist position sense acuity is anisotropic across the joint, with the abduction/adduction DoF having the highest acuity (the error of acuity for flexion/extension is 4.64 ± 0.24°; abduction/adduction: 3.68 ± 0.32°; supination/pronation: 5.15 ± 0.37°) and they also revealed that proprioceptive acuity decreases for smaller joint displacements. We believe this knowledge is imperative in a clinical scenario when assessing proprioceptive deficits and for understanding how such sensory deficits relate to observable motor impairments. PMID:27536882

  12. Prospective outcomes of arthroscopic treatment of dorsal wrist ganglia.

    Science.gov (United States)

    Aslani, Hamidreza; Najafi, Arvin; Zaaferani, Zohre

    2012-03-01

    The purpose of this study was to assess the results of arthroscopic resection of dorsal wrist ganglia. Between November 2002 and September 2007, all patients with dorsal wrist ganglia underwent arthroscopic resection in our institution. Average follow-up was 39.2 months (range, 24-71 months). Fifty-two patients (40 women and 12 men; mean age, 29.8 years) were treated with our operative technique. Symptoms at presentation were unpleasant appearance in 15 patients (28.8 %), pain in 30 (57.6%), and unpleasant appearance and pain in 7 (13.5%). The ganglion cyst site was in front of the midcarpal joint in 41 patients (78.8%), in front of the radiocarpal joint in 6 patients (11.5%), and in front of the radiocarpal and midcarpal joints in 5 patients (9.6%). Our surgical technique resulted in a significant improvement in flexion, extension, and grip strength (P≤.005). In patients with painful ganglia, treatment also had a significant effect. Nine (17.3%) recurrences were observed. Mean time off work was 14 days, but 19 patients returned to work immediately. According to the results of this study, we recommend the use of arthroscopy as the primary treatment method for dorsal wrist ganglion excision. PMID:22385448

  13. Current concepts in wrist arthroscopy.

    Science.gov (United States)

    Chloros, George D; Wiesler, Ethan R; Poehling, Gary G

    2008-03-01

    The purpose of this article is to review the recent literature on arthroscopic treatment of distal radius fractures (DRFs), triangular fibrocartilage complex injuries, intercarpal ligament injuries, and ganglion cysts, including the use of electrothermal devices. A major advantage of arthroscopy in the treatment of DRFs is the accurate assessment of the status of the articular surfaces and the detection of concomitant injuries. Nonrandomized studies of arthroscopically assisted reduction of DRFs show satisfactory results, but there is only 1 prospective randomized study showing the benefits of arthroscopy compared with open reduction-internal fixation. Wrist arthroscopy plays an important role as part of the treatment for DRFs; however, the treatment for each practitioner and each patient needs to be individualized. Wrist arthroscopy is the gold standard in the diagnosis and treatment of triangular fibrocartilage complex injuries. Type 1A injuries may be successfully treated with debridement, whereas the repair of type 1B, 1C, and 1D injuries gives satisfactory results. For type 2 injuries, the arthroscopic wafer procedure is equally effective as ulnar shortening osteotomy but is associated with fewer complications in the ulnar positive wrist. With interosseous ligament injuries, arthroscopic visualization provides critical diagnostic value. Debridement and pinning in the acute setting of complete ligament tears are promising and proven. In the chronic patient, arthroscopy can guide reconstructive options based on cartilage integrity. The preliminary results of wrist arthroscopy using electrothermal devices are encouraging; however, complications have been reported, and therefore, their use is controversial. In dorsal wrist ganglia, arthroscopy has shown excellent results, a lower rate of recurrence, and no incidence of scapholunate interosseous ligament instability compared with open ganglionectomy. Arthroscopy in the treatment of volar wrist ganglia has yielded

  14. The destructive wrist arthropathy of pseudogout

    International Nuclear Information System (INIS)

    The wrist is a frequent site of arthropathy in the pseudogout syndrome (calcium pyrophosphate dihydrate crystal deposition disease). Three cases of severe wrist arthropathy are presented to emphasize the destructive changes which may occur, including necrosis or collapse of the lunate and navicular bones. The roentgenographic findings characteristic of pseudogout in the wrist are discussed. (orig.)

  15. The value of quantitative evaluation of inlfammatory activity by using wrist dynamic contrast-enhanced MRI in rheumatoid arthritis%动态增强MRI定量评价类风湿性关节炎腕关节炎症活动度的价值

    Institute of Scientific and Technical Information of China (English)

    曾伟科; 莫颖倩; 张翔; 段小慧; 陈乐锋; 马剑达; 戴冽; 沈君

    2015-01-01

    目的:探讨动态增强MRI(DCE-MRI)定量评价类风湿性关节炎(RA)炎症活动度的价值。材料与方法20例经临床病理确诊的RA患者行双手腕关节DCE-MRI检查,滑膜病理Krenn评分、临床DAS28评分及血清学检查,运用动态增强专用血流动力学软件测量双腕关节滑膜病变区定量参数:容积转移常数(Ktrans)、速率常数(Kep)、血管外细胞外容积分数(Ve)、血浆容积(Vp)及半定量参数:达峰时间(TTP)、最大浓度(Cmax)、浓度-时间曲线下面积(AUC)、最大斜率(Slopemax),分析DCE-MRI定量及半定量参数与滑膜病理Krenn评分、临床DAS28评分及血清学检查各指标之间的相关性,采用t检验比较分析滑膜炎症不同活动度组间Ktrans值的差异。结果20例RA腕关节滑膜病变Ktrans值为(1.27±0.59) ml/min, Krenn评分为3.38±1.53,DAS28评分为4.80±0.94。6例滑膜炎症为重度,11例滑膜炎症为轻度。Ktrans与Krenn评分、DAS28具有正相关(r=0.698,P<0.01;r=0.510, P<0.05),Kep、Ve、Vp及TTP、Cmax、AUC、Slopemax与Krenn评分、DAS28及血清学检查各指标之间无相关性(P>0.05)。滑膜炎症重度组Ktrans值明显高于轻度组(t=4.05,P<0.01)。结论 DCE-MRI的Ktrans值可用于反映RA患者临床及滑膜病变的炎症活动程度。%Objective: To investigate the value of quantitative evaluation of inflammatory activity by using wrist dynamic contrast-enhanced MRI (DCE-MRI) in rheumatoid arthritis (RA) patients.Materials and Methods: Twenty patients with clinically and pathologically proved RA underwent wrist DCE-MRI examination, Krenn scoring of synovial inflammatory, clinical scoring of DAS28 and serological examination. Quantitative parameters including the volume transfer constant (Ktrans), rate constant (Kep), extravascular extracellular volume fraction (Ve), plasma volume (Vp) and semi-quantitative parameters including the time to peak (TTP), maximum concentration(Cmax), the

  16. 多层螺旋CT与核磁共振成像联合诊断腕关节损伤的临床应用研究%Clinical application of multi spiral computed tomography combined with magnetic resonance imaging in diagnosis of wrist joint injury

    Institute of Scientific and Technical Information of China (English)

    孙冬梅

    2016-01-01

    Objective TO study tHe vaLue Of muLti spiraL cOmputed tOmOGrapHy( MSCT)cOmbined WitH maGnetic resOnance imaGinG( MRI)in tHe diaGnOsis Of Wrist jOint injury. Methods Fifty patients WitH Wrist jOint injury frOm May 2013 tO May 2014 Were seLected. THey Were preLiminary diaGnOzed by CR:30 cases WitH carpaL bOne fractures and 20 cases WitHOut fractures. THe cLinicaL vaLue Of MSCT cOmbined WitH MRI in tHe diaGnOsis Of Wrist jOint injury Was revieWed. Re-sults AmOnG tHe 30 cases in fracture GrOup,22 cases WitH jOint disLOcatiOn and 45 fractures Were detected by MSCT,and 9 cases Of jOint disLOcatiOn and 26 fractures Were detected by MRI,tHere Were siGnificant differences(P﹤ 0. 05). TWenty-tHree pieces Of dispLaced crusHed fracture Were detected by MSCT and tHere Was nO discOvery by MRI. FOur OccuLt fractures Were detected by MSCT,and 21 OccuLt fractures Were detected by MRI. THere Were nO bOne cOntusiOn Or cartiLaGe injury by MSCT. AmOnG tHe 20 cases in tHe nOn fractures GrOup,tHere Were nO ObviOus fractures by MRI and MSCT,19 cases Of jOint disLOcatiOns Were detected by MSCT and 9 cases Were detected by MRI,tHe difference Was siGnificant(P ﹤ 0. 05). TWO OccuLt fractures Were detected by MSCT and 19 OccuLt fractures Were detected by MRI. Conclusions It can HeLp de-tect and diaGnOse bOne cOntusiOn,cartiLaGe injury and OccuLt fractures by MRI in cLinicaL diaGnOsis Of Wrist jOint injury. It can detect parts Of OccuLt fractures by MSCT,but Get tHe best effect Of diaGnOsinG dispLaced crusHed fracture. It can maKe tHe effect imprOve siGnificant and Get remarKabLe efficiency Of usinG MRI cOmbined WitH MSCT in tHe diaGnOsis Of patients WitH Wrist jOint injury.%目的:探讨腕关节损伤采用多层螺旋CT( MSCT)联合核磁共振成像( MRI)诊断的价值。方法选取郑州大学第四附属医院骨科2013年5月至2014年5月收治的腕关节损伤患者50例,经CR初步诊断,其中腕骨骨折30例,无骨折20例,采用MSCT联合MRI诊断,

  17. Significance of magnetic resonance imaging for early rheumatoid arthritis activity

    Directory of Open Access Journals (Sweden)

    E Y Pogozeva

    2009-01-01

    Full Text Available Objective. To assess possibility of magnetic resonance image (MRI application for rheu- matoid arthritis (RA activity and severity assessment.Material and methods. 100 pts with RA who fulfilled the 1987 ACR criteria with disease duration less than 12 months were included. Standard clinical examination with evaluation of tender and swollen joint counts, acute phase markers, hand and foot X-ray and hand MRI with 0,2 T Artoscan apparatus (ESAOTE Biomedica, Italy were performed.Results. MRI showed hand joint synovitis in 94,5%, erosions – in 67,3% of cases. X-ray examination revealed erosions in only 20,8% of pts. Localization of erosions revealed by X-ray and MRI coincided in 36,4% of cases and in 61,8% of pts erosions were detected only by MRI. MRI confirmed clinical conclusion about presence or absence of metacarpophalangeal and wrist joint synovitis in 64,5% and 74,5% of cases respectively. In8,2% and 21,8% MRI revealed signs of synovitis in clinically intact joints. MRI synovitis score correlated with clinical and laboratory measures of disease activity – DAS 28 (r=0,37, p=0,001, CRP(r=0,30, p=0,001, ESR (r=0,42, p=0,001, HAQ (r=0,24, p=0,001. Weak correlation was revealed between ESR and presence of erosions (r=0,29, CRP, ESR and MRI signs of bone marrow edema (r=0,27, p=0,005 and r=0,29, p=0,002 respectively. Relationship between laboratory and clinical features was weaker and referred only to CRP level and swollen joint count (p=0,05.Conclusion. MRI signs may be used as additional and independent measures of inflammatory activity (particularly synovitis score and severity of RA

  18. A comparison of ultrasound and clinical examination in the detection of flexor tenosynovitis in early arthritis

    Directory of Open Access Journals (Sweden)

    Abouqal Redouane

    2011-05-01

    Full Text Available Abstract Background Tenosynovitis is widely accepted to be common in rheumatoid arthritis (RA and postulated to be the first manifestation of RA, but its true prevalence in early disease and in particular the hand has not been firmly established. The aims of this study were first to investigate the frequency and distribution of finger flexor tenosynovitis using ultrasound in early arthritis, second to compare clinical examination with ultrasound (US using the latter as the gold standard. Methods 33 consecutive patients who had who were initially diagnosed with polyarthritis and suspected of polyarthritis and clinical suspicion of inflammatory arthritis of the hands and wrists were assessed during consecutive, routine presentations to the rheumatology outpatient clinic. We scanned a total of 165 finger tendons and subsequent comparisons were made using clinical examination. Results Flexor tenosynovitis was found in 17 patients (51.5% on ultrasound compared with 16 (48.4% of all patients on clinical examination. Most commonly damaged joint involved on US was the second finger followed by the third, fifth, and fourth. Both modalities demonstrated more pathology on the second and third metacarpophalangeal (MCP compared with the fourth and fifth MCP. A joint-by-joint comparison of US and clinical examination demonstrated that although the sensitivity, specificities and positive predictive values of clinical examination were relatively high, negative predictive value of clinical examination was low (0.23. Conclusions Our study suggest that clinical examination can be a valuable tool for detecting flexor disease in view of its high specificity and positive predictive values, but a negative clinical examination does not exclude inflammation and an US should be considered. Further work is recommended to standardize definitions and image acquisition for peritendinous inflammation for ultrasound.

  19. 中药藤莓汤对Ⅱ型胶原诱导性大鼠关节炎性病理损伤的影响%Effects of the Chinese herbal compound, Tengmei decoction, on inflammatory injury in joints of rat models of type Ⅱcollagen-induced arthritis

    Institute of Scientific and Technical Information of China (English)

    陆妍; 王洁; 孟凤仙; 王亚南; 刘慧; 马卫国; 张继胜; 谭玲; 李慧慧; 林子超; 沈志明

    2015-01-01

    Objective To explore the effects of Chinese herbal compound, Tengmei decoction, on type II collagen-induced arthritis ( CIA) in rats, and to examine the changes of arthritis index ( AI) , limb swelling, joint tissue inflammatory infiltration, and the effects on immune-inflammatory factors.Methods Sprague-Dawley rat models of arthritis were successfully established by intradermal injection of type II collagen and Freund’ s complete adjuvant.The model rats were randomly divided into model group, positive drug group, and high-and low-dose Chinese medicine groups, 6 rats in each group.The intervention and treatment period was 12 weeks.To measure weekly the anteroposterior and transverse diameters of the rear ankles and wrists, the transverse diameter of the claw foot palm pad, the thickness and the highest point width of hind limb plantar joint swelling, and to evaluate the integrated scores of joints and limbs swelling using a vernier caliper.Results ①Compared with the normal group, the total arthritis scores and hind limbs AI scores of the model group were significantly increased ( P <0.05 or P <0.01 ) .The left forelimb AI scores were significantly increased during 10 -12 weeks ( P <0.05 ) .The anteroposterior and transverse diameters of the left hind limb, the thickness of the highest point measurement of the left hind foot pad metatarsal were significantly increased ( P<0.05 or P<0.01) in different time periods between 1-12 weeks.Compared with the model group, the total scores and the left hind limb joints AI scores of the high-and low-dose drug groups were decreased after 6 weeks (P<0.05).②Compared with the normal control group, levels of mRNA transcription and protein expression of IL-6 and TNF-αwere significantly up-regulated ( P<0.01 ) in the model group.Compared with the model group, the levels of mRNA transcription and the expression of IL-6 and TNF-αproteins were significantly down-regulated in the positive group and Chinese medicine groups ( P <0

  20. What Is Reactive Arthritis?

    Science.gov (United States)

    ... Arthritis PDF Version Size: 69 KB November 2014 What is Reactive Arthritis? Fast Facts: An Easy-to- ... Information About Reactive Arthritis and Other Related Conditions What Causes Reactive Arthritis? Sometimes, reactive arthritis is set ...