Iron in the synovial membrane in rheumatoid arthritis and other joint diseases.
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Joint degeneration and dystrophy observed in some subjects exposed to low-dose radiation after the Chernobyl accident is accompanied with more active production of lipid peroxidation products. This overproduction is corrected by combined sulfurated hydrogen balneotherapy and magnetophoresis of vitamin E on the affected joints.
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An alternative technique for temporomandibular joint arthroplasty is described, in which the mandibular condyle is replaced by a soft compressible silicone rubber prosthesis. A modified Nicolle-Calnan metacarpo-phalangeal joint prosthesis was used to reconstruct 31 joints in 24 patients. Results suggest that in those patients where there has been no loss of the prosthesis, function continues to be markedly improved when compared with the pre-operative condition. Painful symptoms were relieved in cases of specific joint pathology but the technique was of little value in the management of dysfunctional pain when radiographic evidence of joint pathology was absent. A specifically designed TMJ prosthesis of this type may be a useful addition to the surgeon's armamentarium.
Inflammatory changes of the shoulder joint could be detected at a very early stage, when the clinical and radiological examinations were unremarkable. In 50% of the cases a rupture of the rotator cuff could be demonstrated. Only 10% of the shoulder joints had normal sonographic findings, whereas 50% were normal on clinical or radiological examination. Synovitis and effusion of the hand can be diagnosed very well by clinical examination, and can be documented in ultrasound. The sonographic diagnostic accuracy in tendon ruptures of the hand is lower than accuracy of the clinical examination. New technical developments may yield better results. Inflammatory changes of the hip joint are very difficult to diagnose by clinical examination. Synovitis, effusion and changes of the capsule can be better detected by ultrasound. Sonography of the hip joint has become part of our routine diagnostic programme, especially because early changes of the joint do not present clear symptoms.
It has been speculated that joint instability resulting from anterior cruciate ligament (ACL) rupture could be exacerbated by changes in vasomotor activity in the remaining supporting structures. In this study, the effect of ACL transection on medial collateral ligament (MCL) basal perfusion and its responsiveness to calcitonin gene-related peptide (CGRP) and sympathetic adrenergic influences was examined. Using urethan-anesthetized rabbits, we tested the effects of CGRP and its antagonist CGRP-(8-37) by topical application of these agents to the exposed knee while sympathetic influences were tested by electrically stimulating the saphenous nerve. It was found that MCL basal perfusion was elevated in ACL-sectioned joints; however, this effect was abrogated by prior resection of the articular nerve supply. At the doses tested, the normal vasodilator response to CGRP was abolished in ACL-sectioned joints, whereas the response to CGRP-(8-37) was attenuated. Even under the influence of increased constrictor tone, MCL and capsule blood vessels still showed substantially reduced responses to exogenous CGRP administration. By contrast, nerve-mediated constrictor responses were mostly unaffected by joint instability. This study suggests that posttraumatic knee joint hyperemia is neurogenically mediated, possibly by increased secretion of CGRP.
The histories of 36 Charcot joints (including four fractures) in 22 patients were investigated and a new stage classification system (Stage I-III) was introduced. Scintiscanning showed the uptake magnitude of radioactive substance in the Charcot lesions ranged from 6-22 times that of normal areas.
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Deep fungi exhibit different degrees of aggressiveness toward joints and bone, most likely depending on the individual make-up of the respective organism. Immunodepressed patients have a propensity to bone and joint involvement by sporotrichosis, cryptococcosis and candidiasis. African histoplasmosis, blastomycosis and coccidioidomycosis are the main mycoses to produce osteoarthritic complications. Arthralgias as part of primary mycotic infection are seen in histoplasmosis capsulati and in coccidioidomycosis. The recognition of the specific agent by morphologic, cultural and serologic methods changes potentially the prognosis and treatment of patients.
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