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At least 613 records · Page 34Linked to original sources
PubMed1999

Biomechanical role of the intervertebral disc and costovertebral joint in stability of the thoracic spine. A canine model study.

STUDY DESIGN: Biomechanical evaluation was performed to investigate the stability of the thoracic spine. Unilateral resection of the intervertebral disc, the rib head joint, and the costotransverse joint were sequentially performed, and nondestructive cyclic loading tests were conducted at each injury stage to examine the roles of the intervertebral disc and the costovertebral joint of the thoracic spine. The effects of each resection were three-dimensionally analyzed as the main motion and the associated coupled motions. OBJECTIVE: To examine the role of the intervertebral disc and the costovertebral joint in stability of the thoracic spine. SUMMARY OF BACKGROUND DATA: The effects of unilateral resection of the intervertebral disc and the costovertebral joints in the thoracic spine with the rib cage have not been documented three-dimensionally in a biomechanical study. MATERIALS AND METHODS: Ten canine rib cage-thoracic spine complexes, consisting of the sixth to eighth ribs, the sternum and T5-T8 vertebrae, were used. Six pure moments along three axes, flexion-extension, lateral bending, and axial rotation, were applied to the specimen, and the angular deformation between T6-T7 was recorded by a stereophotogrammetric method. After the intact specimens were tested, staged resections were conducted in the following manner: partial resection of the T6-T7 intervertebral disc, performed as a resection of the anterior longitudinal ligament, the nucleus pulposus, and the annulus fibrosus on the approach side, leaving the posterior longitudinal ligament intact; resection of the right seventh rib head with the joint capsule; and resection of the right seventh costotransverse joint. At each stage, the main motion and associated coupled motions were determined three dimensionally. RESULTS: The ranges of motion (ROM) in flexion-extension, lateral bending, and axial rotation were significantly increased after partial discectomy (P < 0.01). Moreover, along with large increases in the ROM of the main motions in left axial rotation and right lateral bending, coupled motions, expressed by right lateral bending and left axial rotation, showed marked increases after resection of the rib head joint (P < 0.05). The neutral zones also increased in lateral bending, axial rotation, and flexion-extension after partial discectomy (P < 0.01). A further increase in the neutral zone was observed in lateral bending after resection of the right seventh rib head (P < 0.01). CONCLUSIONS: In this canine spine model, the intervertebral disc regulates the stability of the thoracic spine in flexion-extension, lateral bending, and axial rotation. Moreover, the articulation of the rib head with the vertebral bodies provides stability to the thoracic spine in lateral bending and axial rotation. Unilateral resection of the rib head joint after partial discectomy on the same side produces significant coupled motions in lateral bending and axial rotation, resulting in a significant decrease in thoracic spinal stability, and integrity.

Animals↗
PubMed1981

Clinical findings during the course of temporomandibular arthropathy.

During the painful phases of temporomandibular arthropathy, the mobility is restricted, pain is present in the affected joint on maximal horizontal movement, and the joint capsule and masticatory muscles are tender. As the joint pain ceases, mobility improves and crepitation may appear. Crepitation is the most frequent finding in patients with lasting symptoms. Contralaterally, the muscular reaction is less impressive and of shorter duration. TMJ clicking may appear contralaterally as the symptoms of arthropathy disappear. The man change in signs takes place as pain disappears. However, signs still change years after debut of arthropathy.

Humans↗
PubMed1978

Jaccoud's arthropathy. A case report and necropsy study.

We present a case of Jaccoud's arthropathy in a 59-year-old woman. She developed painless correctable ulnar deviation at the metacarpophalangeal joints of both hands following 4 attacks of rheumatic fever. Radiology did not show the hook lesions previously described, but we do not consider this sign essential for the diagnosis. There was no clinical evidence of rheumatoid arthritis. We were able to examine 3 complete joints from the left little finger at necropsy. Pathological examination of this kind has been possible only once before. The histological findings were fibrous thickening of the joint capsule, secondary degenerative changes, presumably due to longstanding joint deformity, and no evidence of significant synovial pathology.

Chronic Disease↗
PubMed2006

Innervation of the joint and role of neuropeptides.

Rheumatoid arthritis is considered to represent a disease of the synovial membrane, osteoarthritis of the hyaline articular cartilage, and osteoporosis of the bone. It can be questioned to what extent this is true and to what extent these diseases could be considered to be due to extra-articular, extra-skeletal pathology related to the neuroendocrine system. Pain is the main symptom in arthritis. This is related to prostaglandin-mediated sensitization of the primary afferent nociceptive nerves. Accordingly, nonsteroidal anti-inflammatory drugs are used in symptomatic treatment, occasionally together with opioids and tricyclic antidepressants. The midline symmetry and involvement of the richly innervated, small peripheral joints in rheumatoid arthritis have raised speculation about the role of neurogenic inflammation and neuropeptides in its pathogenesis. In contrast to the free nerve endings, the role of the proprioceptive sensors is to provide information of our actual motor performance (the afferent copy of our movements) compared to the efferent motor program, which is activated by our will to move. These include proprioceptors in the skin (e.g., Meissner corpuscles), muscles (annulospiral and flower-spray endings of the muscle spindles), Golgi tendon organs, and Ruffini end organs and Pacinian corpuscles in the superficial and deep layers of the joint capsule. Elderly people may have slow reflexes, lax joints, joint incongruity, and loss of muscle power; obesity, alcohol and medicinal use, and joint pain can be combined with poor/nonexisting capacity for repair and remodeling of the musculoskeletal tissues. Impaired biomechanics contributes to increased joint tenderness, accumulation of minor trauma (secondary osteoarthritis), and falls (osteoporotic fractures). More attention needs to be paid to aging of proprioception, not only to the terminal disease target.

Animals↗
PubMed2004

Radiography, computed tomography and magnetic resonance imaging at 0.5 Tesla of mechanically induced osteoarthritis in rabbit knees.

In the present experimental study we assessed induced osteoarthritis data in rabbits, compared three diagnostic methods, i.e., radiography (XR), computed tomography (CT) and magnetic resonance imaging (MRI), and correlated the imaging findings with those obtained by macroscopic evaluation. Ten young female rabbits of the Norfolk breed were used. Seven rabbits had the right knee immobilized in extension for a period of 12 weeks (immobilized group), and three others did not have a limb immobilized and were maintained under the same conditions (control group). Alterations observed by XR, CT and MRI after the period of immobilization were osteophytes, osteochondral lesions, increase and decrease of joint space, all of them present both in the immobilized and non-immobilized contralateral limbs. However, a significantly higher score was obtained for the immobilized limbs (XT: P = 0.016, CT: P = 0.031, MRI: P = 0.0156). All imaging methods were able to detect osteoarthritis changes after the 12 weeks of immobilization. Macroscopic evaluation identified increased thickening of joint capsule, proliferative and connective tissue in the femoropatellar joint, and irregularities of articular cartilage, especially in immobilized knees. The differences among XR, CT and MRI were not statistically significant for the immobilized knees. However, MRI using a 0.5 Tesla scanner was statistically different from CT and XR for the non-immobilized contralateral knees. We conclude that the three methods detected osteoarthritis lesions in rabbit knees, but MRI was less sensitive than XR and CT in detecting lesions compatible with initial osteoarthritis. Since none of the techniques revealed all the lesions, it is important to use all methods to establish an accurate diagnosis.

Animals↗
PubMed1975

[Concentration of 99mTc-tin-phosphate complexes in soft tissues].

The concentration of 99mTc-pyrophosphate was determined in the lower extremities of rabbits (normal, abacterial and bacterial affected soft tissues), in osteoarthritis of the hip joint (capsule and muscle) as well as in knee joint effusions. Compared with the 85Sr-concentration, reflecting the calcification capacity, concentrations of 99mTc-pyrophosphate in soft tissues were found to be lower 2 hours p.i., but were up to elevenfold higher 24 hours p.i. These findings should be due to a fixation of 99mTc-pyrophosphate in collagen containing tissues as in the soft tissue tumors (myosarcoma, synvialioma, breast cancer) presented. A mechanism of delayed equilibration could explain augmented uptake in lymph-edema, ascites and effusions in florid osteoarthritis of the knee joint. The possible dependence of 99mTc-pyrophosphate concentration in bone and soft tissue on collagenous contents is discussed.

Animals↗
PubMed2006

The effect of the inferior capsular shift on shoulder intra-articular pressure: a cadaveric study.

BACKGROUND: The inferior capsular shift procedure is commonly performed for multidirectional instability of the shoulder with excellent clinical results. HYPOTHESIS: The mechanism of this procedure is to increase shoulder stability by changing the responsiveness of intra-articular pressure to downward loading. STUDY DESIGN: Controlled laboratory study. METHODS: In 7 fresh-frozen cadaveric shoulders, inferior capsular shift was simulated by imbricating the anterior and posterior capsule using clamps. The position was monitored using an electromagnetic tracking device with the glenohumeral joint capsule intact, imbricated anteriorly, or imbricated anteriorly and posteriorly and with the inferior load of 0, 0.5, or 1.0 kg. Simultaneously, intra-articular pressure was monitored using a pressure transducer. Saline was injected into the glenohumeral joint to measure capsular volume. The capsule was vented, and the position was again measured. RESULTS: Intra-articular pressure was -71 +/- 19, -221 +/- 70, and -366 +/- 73 cm H(2)O with 0, 0.5, and 1.0 kg of load, respectively, with the capsule intact. With anterior imbrication, intra-articular pressure decreased to -79 +/- 10, -274 +/- 103, and -460 +/- 135 cm H(2)O, respectively, and with anterior and posterior imbrication, intra-articular pressure further decreased to -87 +/- 16, -308 +/- 74, and -548 +/- 39 cm H(2)O, respectively. The volume of the intact shoulder (36 +/- 9 mL) significantly decreased to 27 +/- 7 mL (75%) with anterior imbrication and to 15 +/- 5 mL (42%) with anterior and posterior imbrications (P = .0001). Before venting the capsule, inferior displacement was 5% of the vertical length of the glenoid, even with 1.0 kg of load with any capsular conditions. After venting, the humeral head dislocated inferiorly in all shoulders, even after imbrications. CONCLUSION: The inferior capsular shift procedure decreases joint volume and increases responsiveness of intra-articular pressure to downward loading. CLINICAL RELEVANCE: Biomechanical data provide scientific background to the commonly performed procedures of inferior capsular shift and thermal capsular shrinkage.

Adult↗
PubMed1991

Anatomy of the rat knee joint and fibre composition of a major articular nerve.

Several recent reports discuss the role of joint nerves in arthritis. Many of these are based on studies in the rat. The aim of this study is to examine the anatomy of the rat knee joint, in search for a primary articular nerve, and to analyze the fibre composition of that nerve. The results show that the structure of the joint differs in some respects from the human knee. At the upper end of the bony patella a cartilaginous patella extends proximally, forming the anterior wall of the suprapatellar bursa. Distinct collateral ligaments are integrated in the joint capsule. The extensor digitorum longus muscle bridges the knee joint, originating from the lateral femoral epicondyle. The well-developed menisci contain pyramid-shaped ossicles. The cruciate ligaments are arranged like in the human knee. A large posterior (PAN) and a small medial (MAN) articular nerve can be identified. The PAN is composed of some 400 axons, about 80% of which are unmyelinated. All myelinated fibres are sensory. They present a unimodal size spectrum with a size range of 1-8 microns, and a predominance of small fibres. Specific denervations indicate that about 1/3 of the unmyelinated axons represent afferents, and some 2/3 are sympathetic efferents. Interestingly, neonatal capsaicin treatment did not influence the number of unmyelinated PAN axons. The functional significance of the numerous unmyelinated sympathetic and sensory PAN axons in the normal knee joint remains to be elucidated.

Animals↗
PubMed1994

Consideration of anatomic and radiographic features of the caudal pouches of the femorotibial joints of horses for the purpose of arthroscopy.

Development of an arthroscopic approach to the caudal pouches of the equine stifle has been necessary because cranial approaches do not allow access to articular lesions in the caudal aspect of the joint. Therefore, the anatomy of the caudal region was examined in 52 cadaver limbs by use of gross dissection (29), x-ray-computed tomography (6), fluoroscopy (8), or arthroscopy (9). Additionally, using arthroscopic techniques developed in equine cadaver limbs, 3 stifles from 2 anesthetized horses were arthroscopically explored. Fluoroscopy was used to verify needle placement for joint injection and filling patterns of each femorotibial joint. The medial femorotibial joint sac (n = 4) held a mean +/- SD 41.67 +/- 5.77 ml of injection fluid, and the lateral femorotibial joint sac (n = 4) held a mean 61.67 +/- 2.89 ml of injection fluid. Vital structures that inadvertently could be damaged during arthroscopy of the caudal pouches of the stifle included the peroneal nerve (located approx 7 cm caudal to the lateral collateral ligament), the popliteal artery and vein (situated directly between the medial and lateral femoral condyles), and the lateral femoral condyle (most often traumatized during arthroscopy). The tendon of the popliteus muscle, which is contiguous with the joint capsule of the caudal pouch of the lateral femorotibial joint, made arthroscopic exploration of this pouch particularly difficult.

Animals↗
PubMed1997

Mechanisms of low back pain: a neurophysiologic and neuroanatomic study.

Idiopathic low back pain has confounded health care practitioners for decades. The cellular and neural mechanisms that lead to facet pain, discogenic pain, and sciatica are not well understood. To help elucidate these mechanisms, anesthetized New Zealand white rabbits were used in a series of neurophysiologic and neuroanatomic studies. These studies showed the following evidence in support of facet pain: an extensive distribution of small nerve fibers and endings in the lumbar facet joint, nerves containing substance P, high threshold mechanoreceptors in the facet joint capsule, and sensitization and excitation of nerves in facet joint and surrounding muscle when the nerves were exposed to inflammatory or algesic chemicals. Evidence for pain of disc origin included an extensive distribution of small nerve fibers and free nerve endings in the superficial annulus of the disc and small fibers and free nerve endings in adjacent longitudinal ligaments. Possible mechanisms of sciatica included vigorous and long lasting excitatory discharges when dorsal root ganglia were subjected to moderate pressure, excitation of dorsal root fibers when the ganglia were exposed to autologous nucleus pulposus, and excitation and loss of nerve function in nerve roots exposed to phospholipase A2.

Animals↗
PubMed1995

Neuropeptidergic and autonomic control of the vasculature of the rat knee joint revealed by laser Doppler perfusion imaging.

An imaging technique (laser Doppler perfusion imaging, LDI), based on measurement of backscattered Doppler-broadened laser radiation, was used to provide two-dimensional images of perfusion in the exposed rat knee joint capsule. In control animals, frequency-dependent constriction of knee joint blood vessels occurred during electrical stimulation of sympathetic nerve fibres whilst dose-dependent vasodilatation of these vessels was elicited by direct application of the sensory neuropeptide substance P (SP) to the capsule. Intra-articular injection of the neurotoxic agent capsaicin did not affect vasoconstrictor responses when tested 5-7 days later, but substantially reduced dilator responses to SP. These findings indicate that capsaicin is selectively neurotoxic for sensory unmyelinated fibres but not sympathetic postganglionic fibres and is also capable of modifying receptor-mediated effects of SP. LDI is a useful method for mapping tissue perfusion, particularly in structures such as joints where the spatial distribution of blood flow is heterogeneous.

Animals↗
PubMed1999

Magnetic resonance imaging findings in idiopathic adhesive capsulitis of the shoulder.

OBJECTIVES: To describe magnetic resonance imaging findings in idiopathic adhesive capsulitis of the shoulder. PATIENTS AND METHODS: Twenty patients with idiopathic adhesive capsulitis of the shoulder underwent magnetic resonance imaging involving two spin-echo T2-weighted sequences with fat saturation and two spin-echo T1-weighted postgadolinium sequences; for all sequences, sections were obtained in the oblique coronal and transverse axial planes. Findings were compared to those obtained using the same imaging protocol in 15 patients with clinical manifestations of rotator cuff tear. RESULTS: Postgadolinium enhancement of the joint capsule and synovial membrane was seen in the rotator interval in all 25 adhesive capsulitis patients and in the axillary recess in 22 of the 25. Only one of the 15 rotator cuff tear patients had this finding. In both groups, postgadolinium enhancement occurred in the subacromial bursa, in the rotator cuff tendons, and in the acromioclavicular joint. No significant rotator cuff tears were found in any of the adhesive capsulitis patients. CONCLUSION: In difficult cases, magnetic resonance imaging with gadolinium injection can contribute to the diagnosis of idiopathic adhesive capsulitis of the shoulder.

Adult↗
PubMed1999

Bidirectional communication of sensory afferent information in a peripheral nerve of the cat forelimb.

Kinaesthetic information is derived from both muscle and joint nerves. However, the segregation, at peripheral levels, of inputs from these sources is by no means clear cut. In the present report, we demonstrate the complexity of peripheral innervation of joint and muscle structures in the cat's forearm, in particular, with evidence for bidirectional signalling for different classes of kinaesthetic afferents within a peripheral nerve segment. Three-way simultaneous recordings were carried out in the anaesthetized cat from single kinaesthetic afferents in three nerves that were freed from nearby tissue in the distal forearm, but remained in continuity. These were the wrist-joint nerve and two components of the indicis proprius nerve, one that projects proximally from the muscle to join the deep radial nerve, the other a distal extension of this nerve that runs through and beyond its own muscle to the region of the wrist-joint capsule where it forms an anastomosis with the wrist-joint nerve. Single-unit recording from the intact nerves demonstrated that some spindle afferent fibres from the indicis proprius muscle may take an "ectopic" path to the central nervous system, conveying their signals over an initial centrifugal path via the distal extension of the indicis proprius nerve, before looping back to project centripetally via the "classic" wrist-joint nerve. As some wrist-joint afferents themselves may project "ectopically" via the distal and then proximal segment of the indicis proprius nerve (rather than via the wrist-joint nerve), the recordings demonstrate that, within the distal segment of the indicis proprius nerve, there is bidirectional traffic of kinaesthetic afferent signals, with wrist-joint impulses travelling centripetally and muscle afferent signals travelling centrifugally. The findings emphasize the complexity of signalling that may be present in sensory nerves, on account of the "ectopic" paths taken by some afferents, and the need to activate deep inputs of joint or muscle origin by natural stimulation of the appropriate receptors in order to examine selectively the central actions and processing of either source of input.

Animals↗
PubMed1980

The effect of acute abolition of knee joint afferent discharge on postural reflexes in the conscious cat.

Injection of local anaesthetic into the knee joint space in a series of 5 cats produced obvious postural abnormalities in 3 animals. However, on employing a more sensitive test, all animals exhibited abnormalities of postural reflexes on abolishing knee joint afferent discharge. Control experiments indicated that this could not be attributed to the local anaesthetic diffusing locally out of the joint capsule and affecting muscle and cutaneous afferents around the knee joint.

Afferent Pathways↗
PubMed2004

Substance P immunoreactive nerve fibres in the domestic chick ankle joint before and after acute urate arthritis.

Substance P immunoreactive (SP-IR) nerve fibres were identified using fluorescence immunohistochemistry and the length of the labelled individual nerve fibres was measured using confocal microscopy of whole mounts of the lateral wall of the ankle joint in 2-week-old domestic chicks. In the normal ankle there was an extensive network of SP-IR fibres in the synovial and subsynovial tissue of the joint capsule. Fours hours after injection of sodium urate into the joint space the joint was inflamed and there was a significant reduction in the labelled nerve fibres. These results demonstrate experimentally that painful gouty arthritis produces a neurogenic depletion of substance P from peripheral nerve fibres in the synovial and subsynovial tissue.

Animals↗
PubMed1998

Anatomical considerations on the discomalleolar ligament.

A study was carried out on the discomalleolar ligament by dissection of adult human cadavers. The ligament corresponds to the most internal portion of the superior lamina of the temporomandibular joint capsule. It extends from the posterointernal portion of the temporomandibular joint disc, penetrates the petrotympanic fissure and reaches the malleus of the middle ear. Because of its morphology and anatomical arrangement the discomalleolar ligament should be considered as an intrinsic ligament of the temporomandibular joint and distinguished from the tympanic portion of the sphenomandibular ligament (anterior ligament of the malleus).

Aged↗
PubMed1982

Electromyography of the quadriceps femoris muscles in subjects with normal knees and acutely effused knees.

The purpose of the study was to describe the electrical activity of the vastus medialis, rectus femoris, and vastus lateralis muscles in subjects with normal knees and acute, severely effused knees when contracting maximally at 30 degrees and 0 degrees of knee flexion. Two groups identified were 1) an effused group (n=8) with subjects having one effused knee and one normal knee and 2) a normal group (n = 8) with subjects having two normal knees. The results were evaluated on two occasions by an observer who has unfamiliar with the groups to which the subjects belonged. The repeated evaluation yielded a high reliability coefficient (Spearman Rho r = .91). Analysis revealed a marked decrease in electrical activity at 0 degrees knee flexion compared to 30 degrees knee flexion in all muscles monitored in the effused knees, while the electrical activity was about equal in both joint positions for the normal knees in both groups. A hypothesis was formed that suggests the decreased electrical activity at 0 degrees in the effused knees results from reflex inhibition caused by joint capsule distension and intra-articular pressures that change with joint position.

Adolescent↗
PubMed1988

MR imaging of recurrent anterior dislocation of the shoulder: comparison with CT arthrography.

Posttrauma damage due to anterior glenohumeral joint dislocation may result in recurrent dislocation. Currently CT arthrography is the method of choice to evaluate the extent of osseous and soft-tissue changes before reconstructive surgery. This study was undertaken to determine if MR was able to depict postdislocation abnormalities and if MR is a possible replacement for CT arthrography. Thirteen patients with recurrent anterior shoulder dislocation were evaluated with conventional radiography and MR; CT arthrography was performed in 10. Twelve patients underwent surgery, and the findings of MR and CT arthrography were verified. MR and CT arthrography showed the integrity of the glenoid labrum equally well. All humeral head defects, detected in nine patients with plain film radiography and CT, were easily identified with MR. Information about anterior joint capsule abnormalities is difficult to obtain with MR. However, separation of the capsule from the bony glenoid can be detected if a joint effusion is present to adequately distend the joint. Preliminary results of this study indicate that MR is useful in the assessment of postdislocation abnormalities and may possibly replace CT arthrography in the evaluation of patients with recurrent shoulder dislocation.

Humans↗