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Chronic arthritis increases tyrosine hydroxylase mRNA levels in the pontine noradrenergic cell groups.

In situ hybridization was used to examine the change of tyrosine hydroxylase(TH) mRNA levels in the pontine noradrenergic cell groups of chronic monoarthritic rats induced by adjuvant inoculation. The number of TH mRNA-expressing neurons and grains per labeled neuron in the A5,A6 and A7 cell groups on the ipsilateral and contralateral sides significantly increased 2 weeks after adjuvant inoculation into the left tibio-tarsal joint, compared to controls. These results suggest that noradrenalin in the pontine region may play a role in modulating chronic nociceptive stimuli.

Adrenergic Fibers↗

Monoarthritis induces complex changes in mu-, delta- and kappa-opioid binding sites in the superficial dorsal horn of the rat spinal cord.

Recently, an experimental model of monoarthritis was described in the rat induced by injection with Freund's adjuvant of the tibio-tarsal joint of one hindlimb. After injection, the clinical and behavioural signs of arthritis are stable from weeks 2 to 6 post-injection. Our purpose was to study the regulation of mu-, delta- and kappa-opioid binding sites in the superficial layers (laminae I-II) of the lumbar and cervical enlargements of the spinal cord 2, 4 and 6 weeks post-injection. Using quantitative receptor autoradiography and highly selective opioid ligands, we found complex changes consisting of a bilateral increase in specific [3H]DAMGO (Tyr*-D-Ala-Gly-NMe-Phe-Gly-ol) and [3H]pCl-DPDPE (Tyr*-D-Pen-Gly-Cl-Phe-D-Pen) binding at 2 weeks post-injection and a bilateral decrease in [3H]U-69593 ((5 alpha,7 alpha,8 beta)-(-)-N-methyl-N-[7-(1-pyrrolidinyl)-1- oxaspiro(4,5)dec-8-yl]) specific binding at 4 weeks post-injection. These changes were restricted to the lumbar level. At 6 weeks post-injection, there was a bilateral increase in [3H]pCl-DPDPE specific binding at both lumbar and cervical levels. Altogether, these results suggest that, after probable local changes in endogenous opioid peptides, the three types of opioid binding sites are differentially involved in the development of the pathological process. These results contrast with the lack of significant modification in mu-, delta- and kappa-opioid binding classically reported at various levels of the spinal cord in polyarthritic rats at 3 weeks post-injection and verified for 2, 4 and 6 weeks post-injection in the present study.

Animals↗

Retroviral arthritis: phenotypic analysis of cells in the synovial fluid of sheep with inflammatory synovitis associated with visna virus infection.

A phenotypic analysis on synovial fluid cells from the carpal and tarsal joints of sheep with visna virus-induced inflammatory synovitis was performed. The results showed increased representation of cells bearing lymphocyte, macrophage, and dendritic cell markers compared to equivalent synovial fluid cells from normal uninfected age-matched controls. In infected sheep, CD8+ T cells tended to predominate over CD4+ cells, while the numbers of gamma delta T cells varied from being absent in some samples to constituting the major T cell subset in others. B cells were found in relatively smaller numbers. Analysis of the large mononuclear cells showed that they stained with monoclonal antibodies that recognize macrophages and afferent lymph dendritic cells. Major histocompatibility complex (MHC) class II+ macrophage/dendritic cells were found in normal joints, but significantly elevated proportions of such cells were present in the carpal joints of infected sheep. The intensity of MHC class II staining was also significantly elevated in infected animals compared to control animals. A high proportion of these cells also stained for CD1 in both normal and infected animals, but were significantly elevated in number in the carpal joints of infected sheep. The elevated proportion of cells expressing molecules associated with accessary cell function and the increase in the numbers of accessory molecules per cell suggests an enhanced capacity for presenting antigen to a variety of T cell subsets within the joints of infected sheep, which could initiate or perpetuate potentially damaging local synovial inflammatory responses.

Animals↗

A discrete adjuvant-induced monoarthritis in the rat: effects of adjuvant dose.

Much evidence suggests an important role for the nervous system in the pathogenesis of peripheral inflammatory conditions such as arthritis. The classical adjuvant-induced arthritis model in the rat is a severe condition in which polyarthritis is accompanied by widespread systemic disease, complicating the interpretation of data. We have developed an adjuvant-induced arthritis of the tibio-tarsal joint in the rat, using a low dose of Freund's adjuvant administered locally. Initial inflammation is followed, after 14 days, by chronic monoarthritis which is maintained without generalised effects or loss of use of the limb until at least 30 days postinjection. A higher dose of adjuvant produces contralateral inflammation and arthritis, but only after 14 days, and without the complicating effects seen in classical adjuvant disease. Indirect measures of arthritis (joint circumference, inflammation score and nociceptive threshold) correlate closely with the histological state of the joint, supporting the use of these indices. This model can be easily exploited by alteration of adjuvant dose, to determine the roles of the nervous system in the pathogenesis, maintenance and symmetrical spread of inflammatory arthritis.

Animals↗

A limited arthritic model for chronic pain studies in the rat.

Freund's adjuvant induced polyarthritis in rats has been used extensively to study pain processes of long duration. There are limitations of this model for chronic studies of pain/arthritis since the severe systemic changes provoke ethical concerns and also affect behaviour, physiology and biochemistry. Attempts to limit adjuvant-induced arthritis by plantar injection of the inoculum have been made. In this model, however, the process evolved to produce widespread polyarthritis if followed for the 6-plus-weeks necessary for chronic studies. Therefore, although it offers the researcher a reliable limited model of inflammation and nociception at the outset, for longer studies it may have all the disadvantages of the polyarthritic rat. The purpose of the present study was to produce a limited arthritic process in rats, stable over 6 weeks and suitable for behavioural and neurochemical studies of various chronic pain treatment methods. Injection (0.05 ml) of complete adjuvant containing 300 micrograms Mycobacterium butyricum in the tibio-tarsal joint produces a predictable monoarthritis, stable clinically and behaviourly from weeks 2 through 6 post injection. As revealed by clinical observations and X-ray examinations, the arthritis produced was limited anatomically, pronounced, prolonged and stable. A marked increase in sensitivity to paw pressure was seen in the affected limb. Animals gained weight and remained active, indicating little systemic disturbance as opposed to polyarthritic rats. We propose this limited model of arthritis as a suitable alternative to the polyarthritic rat for prolonged studies.

Animals↗

Weight bearing as an objective measure of arthritic pain in the rat.

This study compares two methods for evaluating pain-related behavior in an animal model with carrageenan-induced monoarthritis. Rats injected with lambda-carrageenan into the right tibio-tarsal joint were videofilmed at various times after injection and later scored regarding their stance. Immediately after each videorecording session the animals were tested in a box constructed to register the weight load exerted by the hindpaws by means of force plates inserted in the floor. Following carrageenan injection (300 micrograms in 50 microL) the load on the injected paw fell from a control value of 39.3% +/- 0.4% of the body weight (mean +/- SEM, n = 6) to a minimum of 5.1% +/- 1.8% at 6 hr and then slowly increased to approach control levels at 72 hr. The weight load on the contralateral paw increased from a control value of 38.9% +/- 0.6% to 52.4% +/- 1.4% at 6 hr, whereafter it gradually decreased. The video-based stance scores also showed a maximal impairment at 4-6 hr, with a gradual return towards control values at 72 hr. However, the results based on the force plate measurements were less variable and more graded. Morphine inhibited the carrageenan-induced effect in a dose-dependent manner in both paradigms. In conclusion, the present results indicate that measurement of weight bearing as described in the present paper is a practical, useful, and objective method to assess the degree of arthritic pain in the rat.

Animals↗

Pantalar arthrodesis.

Pantalar arthrodesis is a demanding procedure that serves a useful purpose for stabilization of the ankle, rearfoot, and midfoot. These fusions should be recognized as salvage procedures in the treatment of unstable and debilitating conditions as a result of severe degenerative joint disease, rheumatoid arthritis, neuropathic joint destruction, and paralytic or flail extremity dysfunction. As with all salvage-type procedures, patient and physician expectations must be the same to afford an acceptable and functional postoperative result.

Ankle Joint↗

Revision of malaligned triple arthrodesis: a case report.

Malalignment of a triple arthrodesis can pose significant challenges to the foot and ankle surgeon. Lack of a plantigrade foot will not be well tolerated by the patient and will often require revision of the original surgery. This article presents a review of the treatment algorithm used to address this unique problem. A case study based on this approach is also presented.

Arthrodesis↗

The medial approach to triple arthrodesis. Indications and technique for management of rigid valgus deformities in high-risk patients.

Between 1995 and 2002 the authors treated 17 patients who had a rigid hindfoot valgus deformity, and for whom a triple arthrodesis was planned, using a single medial incision. The indication for surgery was pain that was refractory to shoe wear, orthotic, and brace modifications. The severity of the hindfoot deformity itself was not a sufficient indication for this procedure. All 17 patients were examined a mean of 3.5 years following surgery (1-8 years). Subtalar and talonavicular arthrodesis was achieved in all patients and calcaneocuboid arthrodesis was achieved in 15 of 17 patients (2 asymptomatic pseudoarthrosis). The medial approach to triple arthrodesis is a reliable procedure, and can be used with a predictable outcome in patients who are at risk for wound healing complications for correction of hindfoot valgus deformity.

Adult↗

The effect of tibio-talar arthrodesis on foot kinematics and ground reaction force progression during walking.

Degenerative osteoarthritis in the subtalar and mid-tarsal joints occurring after tibio-talar arthrodesis is thought to be a consequence of abnormal foot dynamics. We hypothesized that the forward tilt of the tibia during stance induces early heel-off and alteration of the progression of ground reaction force (GRF) after ankle arthrodesis. Three-dimensional gait analysis was performed on nine patients who had an ankle arthrodesis fused in a neutral position and on ten control subjects. Patients walking barefoot were compared to controls. The GRF progression was shifted forward during mid-stance, heel-off occurred earlier and was associated with less anterior tilt of the tibia and a more posterior position of the GRF with reference to the metatarsal heads. The GRF progression, heel-off and tibial tilt were not significantly different between patients and controls when walking in shoes but the GRF was still more posterior at heel-off. Increasing the walking speed worsened the anomalies of foot dynamics. These alterations of foot dynamics are thought to be associated with pathogenic stresses applied to the mid-foot.

Analysis of Variance↗

Animal models of HLA-B27-associated diseases: new outcomes.

The HLA-B27 molecule is strongly associated with the spondyloarthropathies, a group of chronic inflammatory diseases, affecting the skeleton, the bowel and the skin. This association has been largely studied, but mechanisms of pathology remain unclear. The HLA-B27 transgenic rats develop a spontaneous disease that strikingly resembles human spondyloarthropathies, dependent of bacterial flora and implicating the immune system. The presence of CD4+ T cells is required, and antigen presenting cells (APC) expressing high levels of HLA-B27 likely play an important role. Indeed, APC are defective in naive T lymphocytes stimulation. This default appears to implicate the APC/T cells contact, and may result in a loss of tolerance toward microbial flora. Two models of skeletal inflammation linked to HLA-B27 have been developed in mice. The ANKENT mice develop a spontaneous ossifying enthesitis affecting ankle and tarsal joints, with increased frequency in the presence of an HLA-B27 transgene. The HLA-B27 transgenic mice lacking endogenous beta2 microglobulin develop arthritis of hind-paws. In this model, homodimers of B27 heavy chains could be implicated in the pathogenesis by presenting exogenous peptides to CD4+ T cells.

Animals↗

Artificially produced meteorological changes aggravate pain in adjuvant-induced arthritic rats.

To examine the effects of change in meteorological parameters on pain-related behaviors in a simulated arthritic condition, rats with an injection of complete Freund's adjuvant into the tibio-tarsal joint were exposed to low barometric pressure (20 mmHg below the natural atmospheric pressure) and low ambient temperature (7 degrees C lower than 22 degrees C) in a climate-controlled room. When the arthritic rats were exposed to these environments, the already increased number of hindpaw withdrawals in response to noxious mechanical stimulation (hyperalgesia) was further increased, and a hindpaw withdrawal response to innocuous mechanical stimulation (allodynia) began to occur. Such exposures did not influence any of the pain-related behaviors of the control rats. These results show that lowering barometric pressure and ambient temperature within the range of natural environmental fluctuation intensify pain in arthritic rats.

Animals↗

Responses of C-fiber low threshold mechanoreceptors and nociceptors to cold were facilitated in rats persistently inflamed and hypersensitive to cold.

Cold allodynia is an annoying symptom in conditions of chronic inflammation such as rheumatoid arthritis. To examine whether primary afferent nerve activities are changed in association with hypersensitivity to cold, we recorded single nerve activities from the sural nerve in persistently inflamed rats in vivo. Inflammation was induced by an injection of complete Freund's adjuvant (CFA) solution into the tibio-tarsal joint. Inflamed rats showed an increased number of paw shakes to paw immersion in 25 degrees C water (pre-inflammation: 1.15+/-0.58, 2-week inflammation: 4.70+/-1.15). We also recorded cutaneous C-fiber activities under pentobarbital anesthesia and studied their responses to thermal and mechanical stimuli. The response of C-low threshold mechanoreceptors to cooling (total discharges between 27 and 23 degrees C) increased 1.8-fold (control group: 5.17+/-1.04 impulses, inflamed group: 9.38+/-1.47 impulses). In addition, the proportion of C-nociceptor units responding to cold down to 2 degrees C was significantly greater in the inflamed group (9 out of 18 units; threshold: 10.0+/-2.6 degrees C) than in the intact group (1 out of 14 units; threshold: 4.0 degrees C). These results suggest that the facilitated responses of these primary afferents are associated with cold hypersensitivity in chronically inflamed conditions.

Action Potentials↗

Effects of frequency and duration of outdoor exercise on the prevalence of hock lesions in tied Swiss dairy cows.

Injuries around the tarsal joint are common in dairy cows kept in tie stalls. This study investigated the influence of the frequency and duration of outdoor exercise on the prevalence of hock lesions in tied Swiss dairy cows. Over a 1-year period (from January to December), cows on 66 farms were examined a total of six times (once every 2 months) for the number and severity of hock lesions (hairless patches, scabs and open wounds, swellings). The prevalence of scabs and wounds (mean 2.1 scabs per cow and farm, range 0.3-4.1) was negatively associated with the duration of outdoor exercise, and positively associated with its frequency. It was also significantly affected by the time of visit and the type of bedding (straw being better than other materials). With increasing length of the lying area, the prevalence of scabs and wounds decreased. Based on the interpretation of the final model, it is suggested that a minimum of 50h spent outdoors over a 4-week period is necessary to have a marked result on the prevalence of hock lesions.

Animals↗

Antinociceptive effect of clomipramine in monoarthritic rats as revealed by the paw pressure test and the C-fiber-evoked reflex.

The antinociceptive effect of clomipramine was studied in monoarthritic rats by using the paw pressure test and the C-fiber-evoked reflex. Monoarthritis was produced by intra-articular injection of complete Freund's adjuvant into the tibio-tarsal joint. Joint circumference as well as vocalization threshold to graded paw pressure were evaluated weekly during a 14-week period after the intra-articular injection. At week 8, monoarthritic and vehicle-injected control rats were given either clomipramine or saline and both the paw pressure threshold and inhibition of the C-fiber-evoked reflex response were evaluated. Results showed that (i) 1.5, 3.0, and 6.0 mg/kg, i.v. of clomipramine induced significantly greater dose-dependent antinociception to paw pressure testing in the monoarthritic group, as compared to the control one; and (ii) 0.75, 1.5, 3.0, and 6.0 mg/kg, i.v. of clomipramine exerted significantly higher dose-dependent inhibition of the C-reflex activity in monoarthritic rats than in controls. Results suggest that the higher sensitivity to clomipramine in monoarthritic rats could be related to adaptive changes occurring in monoamine metabolism or in other neurotransmitter systems during chronic pain.

Analgesics↗

Biomechanical model of the human foot: kinematics and kinetics during the stance phase of walking.

A model of the human foot is proposed in which the foot is represented as eight rigid segments and eight monocentric, single-degree-of-freedom joints. The soft tissue under the foot is divided into seven independent sites of contact, or loading, and each of these is modelled as a nonlinear spring and a nonlinear damper in-parallel. The model was used to estimate the kinematics and kinetics of the foot during the stance phase of walking. The force sustained at each loading site was calculated from walking trials in which only portions of the foot landed on a small force platform. The position of the calcaneus was defined by surface markers, whereas the position of the distal segments were based upon chalk footprints and an estimate of the compression of the plantar soft tissue. The results suggest that the joints that constitute the longitudinal arch extend slightly when the forefoot is loaded. During push-off, these joints flex as the metatarsophalangeal joints extend. Similar kinematic results were estimated when the distal segments of the foot were defined by surface markers. The magnitude of the joint moments of force depended largely on the distribution of the load under the foot which varied considerably between subjects. The stable, yet resilient properties of the foot, as highlighted by this model, should be considered in three-dimensional dynamic models used to study human locomotion. The model provides an objective tool to quantify foot motion and loading, which may prove useful for describing foot function in normal and pathological conditions.

Adult↗

Canine atopic dermatitis in Greece: clinical observations and the prevalence of positive intradermal test reactions in 91 spontaneous cases.

Atopic dermatitis was diagnosed in a total of 91 dogs by combining the compatible historical evidence and clinical signs with the presence of one or more positive intradermal test reactions well correlated with the exposure to the aeroallergens and the seasonality of the clinical signs. Compared to the general hospital population Yorkshire terriers, Chinese Shar-Peis and cocker spaniels showed a strong predilection. No such predilection was found regarding the sex of the animals. The age of the dogs at the onset of the clinical signs ranged from 2 months to 8 years (median: 2.5 years). Moderate to severe pruritus, noticed in all the 91 dogs, was either localized (29/91) or generalized (64/91) and non-seasonal (43/91), seasonal (19/91) or of unknown seasonality (29/91). The most common cutaneous lesions included erythema, hyperpigmentation, hypotrichosis and crusts; their body distribution was generalized (64%) or localized (36%) with the feet as the most common site of involvement. Five dogs that had unlesional skin were significantly younger and had been pruritic for a shorter period of time compared to the majority of our study population. Otitis externa (43/91) and bacterial pyoderma (30/91) were the most common conditions associated with atopic dermatitis, while the prevalence of Malassezia dermatitis was very low (2/91). Of the other allergic skin diseases flea allergic dermatitis was the most common (29/91) followed by food hypersensitivity (2 out of the 15 dogs tested). The majority of the dogs demonstrated multiple sensitivities to the 50 aeroallergens tested, while domestic mites (77/91), and particularly Dermatophagoides farinae (64/91), were the most commonly implicated. The total number of the positive intradermal test reactions was increasing parallel to the age of the dogs but it was negatively associated with the presence of skin lesions on the carpal and tarsal joints.

Animals↗

Diagnostic imaging of osteochondrosis.

This article includes imaging of the glenohumeral (shoulder), elbow, stifle, and tarsal joints. The imaging modalities discussed are survey radiography, contrast arthrography, linear tomography, ultrasound, computed tomography, scintigraphy and magnetic resonance. Survey radiography is the first choice imaging modality for diagnosing osteochondrosis dissecans in dogs. In cases where survey radiography fail to demonstrate a lesion other modalities such as scintigraphy, linear tomography, computed tomography, and magnetic resonance may be helpful. Survey radiography, contrast arthrography, computed tomography, and magnetic resonance may also provide additional information contributing to early diagnosis and treatment.

Animals↗