[Importance of cytologic synovial findings for the early diagnosis, differential diagnosis and activity assessment of joint diseases].
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Chronic inflammatory arthritis causes progressive destruction of the joints. Non-specific parameters of inflammation are used in controls, because specific tests are not yet available. In this study, we determined parameters of connective tissue metabolism in 215 sera of patients with chronic inflammatory arthritis, since morphological changes in synovial tissue in these diseases are characterized by proliferation of mesenchymal cells and extracellular matrix. Serum concentration of procollagen-III-peptide (P-III-P) was increased in patients with a markedly progressive disease. Fragment P1 of the basement membrane component laminin was found to be enhanced in the serum of all groups of patients - even in the early stages of diseases. In addition, follow-up over 2 years showed a good correlation between the progression of the diseases and the serum concentration of the two parameters. Our results indicate that P-III-P and laminin P1 serum content specifically reflect the proliferation of mesenchymal tissue in rheumatic diseases of the joints. Determination of both parameters may therefore be useful in estimating the progression of the disease and the benefit of treatment.
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This self-directed learning module highlights assessment and therapeutic options in the rehabilitation of patients with osteoarthritis. It is part of the chapter on rehabilitation of orthopedic and rheumatologic disorders in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. New advances covered in this article include updates on conservative and operative treatment of lumbar spinal stenosis and pediatric hip diseases, prophylactic therapy for thromboembolic disease after lower limb joint replacement, new therapies for osteoarthritis, and the impact of exercise on outcome following hip replacement in active persons.
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The spectro-fluorescent characteristics of synovial exudate in different diseases of the knee joint were studied. It was established that in pigmented villonodular synovitis the position of the maximum of fluorescence spectrum of synovial exudate was in the range of 510-530 nm and in synovitis of other etiology 430-440 nm. The authors propose a method of differential diagnosis of pigmented villonodular synovitis by fluorescent parameters of synovial exudate.