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A castrated male shar-pei was presented for episodes of lethargy, swelling of the tarsal joints, and polydipsia with polyuria. Histological examination of biopsies from skin overlying the tarsi and direct immunoperoxidase immunohistochemical staining confirmed immune complex vasculitis, suggesting a role for immune complex deposition in the pathogenesis of shar-pei fever.
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AIMS: To establish a reliable animal model of chronic arthritic inflammatory pain, to find the optimal parameters and appropriate intervals of repeated 100 Hz transcutaneous electrical nerve stimulation (TENS) for the treatment of the chronic arthritic pain, and to explore the possible central neurochemical mechanisms. THE RESULTS: (1) Injection of water-in-oil type complete Freund's adjuvant into the tibio-tarsal joint of the rat produced a reliable, reproducible monoarthritic model. (2) The interval between 2 sessions of stimulations and the intensity of stimulation were important factors determining the therapeutic effects of repeated 100 Hz TENS on both acute and stable period of monoarthritis. (a) For acute period of monoarthritis, the optimal frequency is twice a week, while in the stable period, once a week seems better. (b) The effects of TENS in three intensities: the weaker stimulation was found to produce better results. (3) In the period from 2 to 9 weeks, the levels of spinal release of SP-ir in the TENS group were lower than the control group. This may constitute one of the possible neuro-chemical mechanisms underlying the therapeutic effects of multiple TENS treatment. (4) In both acute and stable period of adjuvant-induced monoarthritis, intrathecal microinjection of Nor-BNI produced dose-dependent increase of arthritic flexion pain scores (i.e. hyperalgesia), suggesting that spinal dynorphin/kappa system plays a role in suppressing arthritic pain.
The long-term investigation of the influence of physical exercise upon the structure of human skeleton revealed certain peculiar features in the process of developmental reconstruction of joints of the upper (humeral joint, hand joints) and lower (knee joint, the joints of the foot) extremities resulting from the occupation of the persons under study. Roentgen-anatomical studies performed in 433 industrial and 430 office workers established the fact of retardation and deceleration of ageing of the extremities bone system in representatives of physical labour as compared with office workers. So the significance of spectal physical exercises compensating the progressing with age hypodynamia in persons of non-physical labour gets special importance.
BACKGROUND: Triple arthrodesis is traditionally done through a two-incision approach. In certain high-risk patients, it may be desirable to do the procedure through a single medial incision to avoid lateral wound healing problems. METHOD: A cadaver study was undertaken to determine the percentage of surface area of each hindfoot joint that could be prepared through a single medial incision. Five cadaver legs were assigned to the single-incision group, and one cadaver leg was used as the "standard" two-incision specimen. RESULTS: Through the single-incision approach, 91% of the talonavicular joint, 91% of the subtalar joint, and 90% of the calcaneocuboid joint could be prepared. These results were comparable to the two-incision cadaver specimen results. CONCLUSIONS: A single-incision medial approach for triple arthrodesis is a safe and effective technique in the management of hindfoot deformity and arthritis in certain high-risk patients.
The case report of a 28-year-old male who sustained a pure peritalar dislocation, without fracture, is presented. The injury is potentially devastating and seldom seen in clinical practice. In this discussion, the etiology and treatment protocol is reviewed to alert the practitioner for prompt evaluation and treatment.
We have recently developed, in the rat, a model with a limited arthritic process for chronic pain studies. Intra-articular 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. This model appears to be a suitable alternative for the polyarthritic rat for chronic studies based on both its ethical and scientific advantages. In the present work we report results of experiments on the effects of exercise on the pain behaviour and development of arthritis in this model. A group of rats prepared with the above protocol was submitted at 2 weeks post-inoculation to mild exercise (swimming [water 37 degrees C] three times per week) increasing from 5 to 15 min during 4 weeks. As revealed by analyses of the arthritis score, the stiffness score and the mobility score, no aggravation of arthritis occurred in these rats. However the threshold for struggle in response to paw pressure was further decreased (as compared to control arthritic rats) in these animals. These results are discussed in view of observations made in human studies.
The role of computed tomography in rheumatologic imaging is limited primarily to joints that have complex anatomy and those obscured by overlying structures. Computed tomography is useful in the evaluation of sacroiliitis, arthritis of the subtalar joints, talocalcaneal coalition, preoperative assessment of the hip and shoulder, abnormalities of the sternoclavicular joint, chondromalacia patellae, and patellofemoral joint subluxation. Although CT is useful in examining ankle tendons, magnetic resonance imaging is preferred.
The pathogenesis of bone spavin and its implications for diagnosis and therapy are reviewed. The pathogenesis of spavin can be divided into three phases, which are characterised by fibrillation of cartilage, osteolysis and ankylosis respectively. It will depend on the degree of osteolysis whether diagnostic anaesthesia should be added to standard clinical and radiological examinations. Satisfactory results of treatment in the group of patients with severe osteolysis can only be obtained by arthrodesis of the distal tarsal joints. It is expected that biomechanical investigations will provide a better understanding of the mechanical factors involved in the pathogenesis of spavin. For the time being, the only method of prevention will have to consist in strict selection and high-level rearing of the young horses.
To laboratory rats of Wistar strain (Ipcv: Wist) native collagenous types of pig cartilage--II, IX and XI and the denatured type XI were administered. The first immunization dose, 0.5 mg collagen per experimental animal, was administered in incomplete Freund adjuvant and the second immunization dose (collagen in solution) followed after 7 days and was administered by the i.p. route. Inflammatory arthritis of the small interphalangeal, metatarsophalangeal and tarsal joints developed between the 11th and 17th day of the experiment in rats immunized with native collagen type II and XI--60% of the animals were affected. The histological findings corresponded to the course of arthritis, however, the articular destructive changes after administration of collagen type XI were more severe than after type II. The changes were evaluated by X-ray and by means of thermovision. The antibody levels against different types of collagen assessed by means of the ELISA test reached peak values between the 13th and 20th day of the experiment. In the group of rats immunized by collagen type IX and the denatured type XI arthritis did not develop. The antibody response in the group of rats immunized with type IX was similar as in the group immunized with types II and XI. Histological examination confirmed some changes in the joints of rats immunized with collagen type IX, while in the joints of rats immunized with denatured collagen type XI no changes were found.
The chronic toxicity of N2-[(N-acetylmuramoyl)-L-alanyl-D-isoglutaminyl]-N6-stearoyl-L-lysine (MDP-Lys(L-18), muroctasin), a synthetic muramyl dipeptide, was investigated in mice. Leukocytosis and immunologically activated appearances of splenic white pulp and lung were seen in mice, when treated with MDP-Lys(L18) for 26 weeks. Furthermore, inflammation around the injection site and synovial epithelium hyperplasia of the tarsal joint occurred in higher incidence in the high dose group. These changes were similar to those seen in the subacute toxicity study with mice.
Infection with Borrelia burgdorferi caused arthritis, myocarditis, glomerulonephritis, and pneumonitis in a cow. Spirochetes were detected by use of immunofluorescent staining in liver and lung specimens and were isolated from the liver. The carpal, stifle, and tarsal joints had marked synovial proliferation, and synovial fluid obtained from these joints had high antibody titers against B burgdorferi. The cow was from an area of Wisconsin that is not endemic for borreliosis.
It is becoming increasingly evident that platelets play a significant role in the inflammatory process. Heterogeneity has been demonstrated among platelets, and evidence has been presented that the spleen retains the youngest and hemostatically most effective platelets. The present study was designed to determine what effect splenectomy, by removing a special population of platelets, would have on acute inflammation as manifested by carrageenan-induced murine foot pad edema. Swiss white mice (25 +/- 2 g) were anesthetized and subjected to splenectomy (Group A, n = 13) or to celiotomy only (Group B, n = 15). One week later, carrageenan (0.1 cc of 1% solution) was injected into the right hind foot pad of each animal. The mice were killed 3.5 hr later, and both hind paws amputated at the tibio-tarsal joint and weighed individually. The change in weight of the experimental hind paw relative to control was expressed as edema index for each animal. The inflammatory reaction, as manifested by carrageenan edema, was significantly (P less than 0.001) decreased in those animals subjected to splenectomy. The mean edema index in Group A was 62.8 per cent compared to 80.9 per cent in Group B. The results of this study indicate that splenectomy decreases inflammation as manifested by carrageenan-induced edema. Splenectomy eliminates a population of platelets having greater functional capabilities than those found in the peripheral circulation and impairs the organism's ability to respond to injury.
The authors have reviewed 23 fractures of the talus in children. They propose a classification based on the radiological maturity of the bone and the specific type of fracture. Group I: Children younger than 6 years (6 cases). The fracture line separates the bone into two parts. The diagnosis was difficult, with displacement being underestimated in some cases. Associated lesions in the same limb were present in 5 cases. Five fractures of the neck of the talus were treated conservatively with excellent or fair results. One comminuted fracture was treated surgically with a poor result. In all cases treatment should aim to maintain a good tibio-tarsal joint. Group II: Children older than 6 years (17 cases). Eight cases were osteochondral fractures, two were partial fractures and seven were complete fractures. Two of these developed subsequent avascular necrosis. The relationship between osteochondral fractures and osteochondritis is discussed.
Investigations were carried out with 24 sheep divided into two groups of twelve animals. The first group were infected via the lateral recessus of the tarsal joint with 2 cm3 of a 24-hour broth culture of Corynebacterium pyogenes, and the second one were infected i/v with 3 cm3 of the same culture. The changes in the total protein, protein fractions, and blood electrolites in the blood were followed up. It was found that the infection of Corynebacterium pyogenes affected the total reactivation of the animals and led to immunobiologic reconstruction changes. There were hyperproteinemia which depended on the route of infection as well as the severity of its course, and hyperglobulinemia which was "at the expense of' blood albumin. Noticed were also hypercalcemia, hyperpotassemia, and lower sodium and phosphorus levels.
Chronic nonsuppurative arthritis developed in carpal and tarsal joints of border Leicester sheep that were naturally or experimentally infected with ovine progressive pneumonia (OPP) virus. Clinical signs of arthritis began at 1 to 6.2 years of age (1 to 5.7 years after inoculation of OPP virus) and slowly progressed in severity until the sheep died or were killed. The joint lesions were characterized by edema, hyperemia, hyperplasia, and necrosis of the synovial membrane; by necrosis and erosion of articular bone; by necrosis and fibrosis of subchondral bone; and by extensive periarticular fibrosis. The OPP virus alone was isolated from arthritic joints. In 7 of 14 sheep, the arthritis was associated with interstitial pneumonitis induced by the virus. Therefore, it was concluded that OPP virus was the cause of arthritis in this group of sheep.
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