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At least 397 records · Page 22Linked to original sources
PubMed1998

The correlation of comorbidity with function of the shoulder and health status of patients who have glenohumeral degenerative joint disease.

We studied the effect of comorbidities on function of the shoulder and health status in a group of eighty-five consecutive patients who had glenohumeral degenerative joint disease of sufficient severity to meet one surgeon's criteria for the performance of shoulder arthroplasty. A questionnaire was used to identify the comorbidities, such as other diseases, social factors, or a work-related injury, for each patient. The number of functions on the Simple Shoulder Test that the patient could perform had a significant negative correlation with the number of comorbidities (r = -0.32, intercept = 4.6 per cent, slope = -0.6, and p = 0.0031). Each parameter on the Short Form-36 (except for physical role function) had a significant negative correlation with the number of comorbidities (p < 0.05). This negative relationship was strongest for general health perception (r = -0.42) and vitality (r = -0.35). We concluded that the number of comorbidities has a quantitative effect on function of the shoulder. In the evaluation of the functional status of patients and the effectiveness of treatment, the effects of comorbidity must be controlled. The results of the present study demonstrate that the scores on the Short Form-36 are quantitatively related to the number of comorbidities. The six parameters that are unrelated to function of the shoulder (physical function, social function, emotional role function, mental health, vitality, and general health perception) may provide a practical way to integrate the effects of all potential comorbidities on individual patients. Future clinical research will be strengthened by efforts to measure the impact of comorbidities and by strategies to control for their effects.

Adult↗
PubMedDate not supplied

Correlation between occult bone lesions and meniscoligamentous injuries in patients with traumatic knee joint disease.

To identify any correlation between the distribution of occult bone lesions and meniscoligamentous injuries, magnetic resonance images of 333 patients with traumatic knee joint disease were reviewed. Bone lesions of the knee were commonly associated with medial meniscal injuries and/or anterior cruciate ligament injuries. While knees with bone lesions showed a higher incidence (P < 0.05) of anterior cruciate ligament injury than knees without bone lesions, the presence of a lateral femoral condylar lesion resulted in a significantly higher incidence of anterior cruciate ligament injuries (P < 0.01). However, no significant positive correlation was found between other occult bone lesions and meniscoligamentous injuries.

Anterior Cruciate Ligament↗
PubMed1983

C1 inactivator-C1s complexes in inflammatory joint disease.

A newly developed enzyme linked immunosorbent assay for the quantitation of C1 inhibitor (C1In)-C1s complexes was used to study activation of the classical pathway of complement in inflammatory joint diseases. Synovial fluid (SF) specimens were obtained from patients with rheumatoid arthritis (RA), other arthritides and non-inflammatory joint effusions. Paired serum (S) samples were obtained in 17 cases. Immune complexes (IC) were measured by the staphylococcal binding assay. C1In-C1s were higher in RA SF samples than in paired RAS samples (P less than 0.01). IC were higher in RA SF than non-RA SF. There was a significant inverse correlation between SF C1In-C1s complexes and SF total haemolytic complement. For all SF samples there was a correlation between IC and C1In-C1s complexes, but for RA SF alone there was no significant correlation between these parameters. There was no correlation between titre of rheumatoid factor and C1In-C1s complexes. These results demonstrate that activation of the classical pathway of complement is the hallmark of rheumatoid synovitis, yet also suggest functional heterogeneity of both circulating and intra-articular IC.

Antigen-Antibody Complex↗
PubMed1995

Systemic lupus erythematosus: emerging concepts. Part 2: Dermatologic and joint disease, the antiphospholipid antibody syndrome, pregnancy and hormonal therapy, morbidity and mortality, and pathogenesis.

PURPOSE: To review 1) advances in the pathogenesis, diagnosis, and management of dermatologic and joint disease and the antiphospholipid antibody syndrome in patients with systemic lupus erythematosus; 2) controversies related to pregnancy and hormonal therapy and to morbidity and mortality in these patients; and 3) current views on the pathogenesis of systemic lupus erythematosus. DATA SOURCES AND STUDY SELECTION: Review of the English-language medical literature with emphasis on articles published within the last 5 years. More than 400 articles were reviewed. DATA SYNTHESIS: Despite considerable overlap, cutaneous lesions specific to lupus erythematosus may be divided into subsets with distinct clinical, histologic, and immunofluorescent features. A recent short-term, prospective, uncontrolled trial found hydroxychloroquine and retinoids to be of similar efficacy in the treatment of cutaneous lupus erythematosus. Optimal treatment for patients with lupus and the anticardiolipin antibody syndrome remains to be defined; uncontrolled, retrospective, and treatment-withdrawal studies suggest that warfarin may be more protective than aspirin. Whether pregnancy induces lupus flares has not yet been established; existing data suggest both that it does and that it does not. Oral contraceptive use and postmenopausal estrogen replacement therapy appear not to cause clinical deterioration in patients with lupus. Recent studies have documented a substantial improvement in the survival of patients with systemic lupus erythematosus; they found 5-year survival rates of 90% or more and 10-year survival rates of more than 80%. Most data suggest that systemic lupus erythematosus results from the activation of self-reactive T cells and B cells by genetic or environmental factors. CONCLUSIONS: The optimal treatment for dermatologic disease and the antiphospholipid antibody syndrome in patients with systemic lupus erythematosus remains unknown. Although mortality has decreased substantially, the morbidity related to the disease itself and to complications of therapy is still considerable. More studies are needed to further elucidate the effects of pregnancy on this condition and the pathogenetic mechanisms responsible for the development of this disease.

Antiphospholipid Syndrome↗
PubMed2006

Pathophysiology and treatment of pain in joint disease.

Deep somatic pain originating in joints and tendons is a major therapeutic challenge. Spontaneous pain and mechanical hypersensitivity can develop as a consequence of sensitization of primary afferents directly involved in the inflammatory process, but also following sensitization of neuronal processing in the spinal cord (central sensitization) or higher centres. Inflammatory pain is linked to sensitization of sensory proteins at the nociceptive endings whereas pain originating from nerve damage (neuropathic pain) has been linked to changes in axonal ion channels producing ectopic discharge in nociceptors as a source of pain. New targets for analgesic therapy include sensory proteins at the nociceptive nerve endings such as the activating TRPV and ASIC channels, but also inhibitory opioid and cannabinoid receptors. Therapeutic targets are also found among the axonal channels that set membrane potential and modulate discharge frequency such as voltage sensitive sodium channels and various potassium channels.

Animals↗
PubMed1979

Temporomandibular joint disease: results of a ten-year study.

Ninety patients with clinically documented temporomandibular joint disease were followed for ten years. Sixty-four of these patients were treated by conservative means alone, and over 90% responded with complete relief of symptoms. Conservative therapy consisted primarily of jaw rest, with adjunctive use of heat, analgesics, and antiinflammatory agents.

Acute Disease↗
PubMed1998

Chondroitin sulfate and joint disease.

Chondroitin sulfate is an important and major component of articular cartilage, where it occurs as part of the large proteoglycan, aggrecan. In the early stages of joint disease, both in animal models and in man, there are changes in chondroitin sulfate that affect the chain length and the pattern of sulfation. These changes can be detected by monoclonal antibodies and appear to reflect part of the cellular response by the chondrocytes to damage to the articular cartilage matrix. The specificity of the changes show that the biosynthesis of chondroitin sulfate is under tight cellular control in chondrocytes and suggests that selected patterns of sulphation within chains are expressed to suit different biological functions.

Aggrecans↗
PubMed1995

Expression of basic fibroblast growth factor in synovial tissue from patients with rheumatoid arthritis and degenerative joint disease.

BACKGROUND: Recent studies have implicated polypeptide growth factors in the development of rheumatoid arthritis (RA), which is characterized by synoviocyte hyperplasia and neovascularization. One such polypeptide, basic fibroblast growth factor (bFGF), is of particular interest because of its potent mitogenic and angiogenic activities. We have previously reported that cultured human synoviocytes synthesize and bind bFGF and also proliferate in response to it (1). Recently, we found a close association between increased bFGF expression and destructive changes in arthritic joints from rats (2). Now we extend our study by detecting in vivo expression of bFGF in human synovial tissues obtained from patients with RA. EXPERIMENTAL DESIGN: Human synovial tissues from patients with RA, degenerative joint disease (DJD), and trauma were collected during joint surgery. The expression of bFGF protein and mRNA by the synovia was examined by immunolocalization, Western blot, Northern blot, and RNase protection assays. Synovium from patients with DJD and trauma was used to compare with rheumatoid synovium. Double immunostaining with cell type-specific antibodies was carried out to identify cellular sources of bFGF. RESULTS: Both polypeptide and mRNA for bFGF were detected in the synovial samples examined. Increased bFGF staining was found in synovium-cartilage interface where joint destruction occurred and in hyperplastic synoviocytes of a subset of rheumatoid synovium. Strong cytoplasmic bFGF staining was localized in the majority of mast cells and vascular cells. CONCLUSIONS: Synovial tissue from patients with RA, DJD, and trauma express bFGF. Increased bFGF staining in the hyperplastic lining synoviocytes and at the pannus-cartilage interface suggests that bFGF may play a role in synovial hyperplasia and joint destruction. Strong cytoplasmic bFGF staining found in mast cells and vascular cells indicates that these cells are the major sources of tissue bFGF.

Adult↗
PubMed2003

Comparison of skeletal and dental morphology in asymptomatic volunteers and symptomatic patients with bilateral degenerative joint disease.

The purpose of this study was to evaluate the effect of bilateral degenerative joint disease (BDJD) on the skeletal and dental patterns of affected individuals. There were 29 symptomatic female patients and 46 asymptomatic normal female volunteers. All study participants had bilateral high-resolution magnetic resonance scans in the sagittal (closed and open) and coronal (closed) planes to evaluate the temporomandibular joints. Linear and angular cephalometric measurements were taken to evaluate the skeletal, denture base and dental characteristics of the two groups. Analysis of variance was used to compare symptomatic subjects with control subjects. There was an overall retrusion of the maxilla and mandible with a clockwise mandibular rotation. The upper and lower denture bases were retruded. The upper incisor was more protruded, whereas the lower incisor was more retroclined in the symptomatic group. The overjet was also increased. This study suggests that subjects with BDJD may manifest altered craniofacial morphology. Clinicians should be aware of this possibility, especially for patients who are growing children and orthognathic surgery candidates.

Adult↗
PubMedDate not supplied

[The effect of yttrium-90 radio synovectomy on the intra-articular xenon-133 clearance in rheumatic joint diseases].

Nine inflamed knee joints out of eight patients were examined before and after intraarticular injection of yttrium-90 silicate colloid, in order to find out the effect of radiation synovectomy on the perfusion of the joints. These joints and the untreated contralateral knee joints were examined as to the clinical status and the fast component Tf of the xenon-133 clearance was determined as a means of the perfusion of the synovium. A linear correlation exists between the clinical status of the knee joint and the perfusion as determined by Tf measured three months before and after injection of yttrium-90. Also the joints without any radiation synovectomy showed this correlation. Three months after radiation synovectomy with yttrium-90 there was still no therapeutic effect apparent in the majority of the inflamed knee joints (seven out of nine). At this stage there still existed a hyperaemia. Therefore, it seems that on the whole three months are too short a period to judge the therapeutic effect.

Adult↗
PubMed2005

Hip joint disease in psoriatic arthritis: risk factors and natural history.

OBJECTIVE: To determine the natural history of hip joint disease in psoriatic arthritis (PsA) and identify clinical risk factors for its early identification. PATIENTS AND METHODS: 504 patients with PsA according to ESSG criteria were studied. Mean follow up was 5.7 years (range <1-45). Mean age at onset of psoriasis was 32 years and of PsA, 39 years. The most common pattern of PsA at onset was oligoarticular (49%) and at the latest examination, polyarticular (65%). Sacroiliitis or spondylitis was diagnosed in 94 (18.7%) patients. RESULTS: 32 (6.3%) patients developed psoriatic hip arthropathy, and of these, 26 (81%) also had sacroiliitis or spondylitis. In 7/17 (41%) patients the hip became affected within 1 year after the onset of PsA. Hip disease occurred more often in younger patients. Sex, pattern of peripheral arthritis, duration of psoriasis before arthritis affected the distal interphalangeal joints, dactylitis, or enthesitis were not associated with the risk of hip disease. Seventeen patients were followed up and nine required hip arthroplasty. Sixteen (50%) first had arthroplasty within 5 years after the onset of hip pain. CONCLUSIONS: Psoriatic hip arthropathy occurs infrequently in PsA and is associated with earlier onset of arthritis and psoriatic spondylitis. Bilateral hip involvement and rapid progression to hip arthroplasty are common.

Adult↗