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PubMed1984

Concentrations of lonazolac in serum and synovial fluid of patients with inflammatory or degenerate joint disease.

In 15 patients with inflammatory and degenerative joint disease the concentrations of lonazolac were measured in serum and synovial fluid at steady state conditions. The mean concentration in the synovial fluid in 14 patients was 0.275 microgram/ml, which was 48% of that in the serum. For the patients with inflammatory joint disease, the synovial fluid concentration of lonazolac was 61% of that in the serum whereas in degenerative joint disease it reached only 39%.

Adult↗
PubMed1986

[Principles of joint protection in inflammatory joint disease with special reference to biomechanical status].

With respect to rehabilitation in inflammatory joint diseases, the activity of the disease, the influence of the disease on the physical ability and social and psychological situation of the patient should all be taken into consideration and treatment then planned accordingly. In the present article, special attention is paid to the biomechanical situation in the diseased joints of the upper and lower extremities, respectively. In the shoulder and elbow joints, the muscles working with long levers and the loading of joints create large intra-articular forces. In the hands the vulnerable joints are under high intra-articular stress because of loading in all situations in daily life. As the result of synovitis and destruction of cartilage, instability is often present. In the lower extremities, the hips and knees are under great strain when moving, rising from chairs, and walking on stairs. Much can be done to reduce loading on the joints. In the upper extremities splinting and the use of suitable technical aids are essential. In the lower extremities good quadriceps muscles and hip extensor muscles as well as correct loading techniques are essential. Whenever walking aids are used, they should be tried out with attention to grip function and the condition of the shoulder and elbow joints, as well as to the need of unloading the lower extremities. A walking aid should always be checked again later. A daily contracture prophylaxis program should help to prevent deformities. Strength training should be performed with attention to the intra-articular loading and stability of the joints.

Arthritis, Rheumatoid↗
PubMed1987

Osteopenia of the pelvis associated with Mseleni joint disease. Radiological aspects.

Mseleni joint disease, an endemic form of osteoarthritis (OA), is associated with osteopenia (OP). In a detailed investigation of the disorder, the degree of OP was assessed in 593 radiographs of the pelvis which were taken during surveys of four populations: rural blacks from Mseleni, rural blacks from Manguzi (a similar population to Mseleni), a black control group of rural Tswanas and a white control group from Johannesburg. Only females were included because the number of males in the rural populations was too small. The radiographic trabecular pattern was assessed at four sites: sacrum, ilium, pubis and ischium. Four grades were used: O = normal bone, 1 = minimal OP, 2 = definite OP, 3 = severe OP. The sum of the grades at the four sites made up the OP score for the individual. The OP scores increased with age in all groups, the age-specific mean OP scores did not differ in the non-OA subgroups of all four populations, and subgroups with OA had significantly higher age-specific mean OP scores than those without OA.

Adolescent↗
PubMed2003

Evaluating inflammatory joint disease: how and when can autoantibodies help?

The diagnosis of inflammatory joint disease rests on a constellation of symptoms, signs, laboratory test results and, occasionally, histological findings. Classification criteria have been developed by national learned societies, international panels of experts or, more rarely, an expert working alone. These criteria are intended to provide a common language for therapeutic trials and international publications. Yet, they are often inappropriately used as diagnostic tools for the individual patient. Identification of an early seroimmunologic marker with high sensitivity and specificity for classifying patients with recent-onset joint disease is a daunting challenge. Test performance characteristics such as sensitivity, specificity, positive and negative predictive values, and the positive or negative likelihood ratio help to assess the diagnostic usefulness of a laboratory test in a specific situation. The difference between the pretest and posttest likelihoods of obtaining a positive or negative result measures the usefulness, or performance, of a laboratory test in a specific situation according to the prevalence of the disease. A higher positive likelihood ratio indicates a more useful test. In a patient with inflammatory joint disease, the diagnosis can be sought by assaying a limited number of autoantibodies according to a decision tree. Thus, IgM rheumatoid factors (latex test or ELISA) and antibodies to filaggrin or other citrullinated proteins (antikeratin antibodies by indirect immunofluorescent assay or anticyclic citrullinated peptides by ELISA) identify more than 70% of cases of early rheumatoid arthritis with greater than 98% specificity. If these markers are negative, testing for antinuclear antibodies by indirect immunofluorescent assay on HEp-2 cells identifies 99% of cases of lupus and progressive systemic sclerosis. Confirmation of the diagnosis can be obtained by characterizing the autoantibodies: thus, presence of antidouble-stranded DNA (dsDNA, by the Farr radioimmunoassay, indirect immunofluorescent assay on Crithidia luciliae, or ELISA (IgG)) or of antinucleosome antibodies (ELISA) indicates lupus, whereas anticentromere, antitopoisomerase I (Scl 70), and antinucleolar antibodies point to progressive systemic sclerosis. A positive test for antibodies to soluble nuclear antigens of the U1 RNP type suggests mixed connective tissue disease or lupus but may indicate scleroderma. Anti-Sm antibodies are found in fewer than 10% of lupus patients but are highly specific. Anti-SSA (Ro) and anti-SSB (La) suggest lupus or primary Sjögren's syndrome. When tests are negative for ANA, several antibodies to cytoplasmic organelles are valuable diagnostic tools, such as anti-J01 for polymyositis syndromes and antiribosome antibodies for lupus, although their sensitivity is modest (20-25%). Finally antineutrophil cytoplasmic antibodies (ANCAs) ensure the diagnosis of small-vessel vasculitides, which often involve the lungs and kidneys. Thus, in diffuse Wegener's granulomatosis, ANCAs exhibiting the classic cytoplasmic pattern and corresponding by ELISA to anti-PR3 are found. In microscopic polyangiitis the ANCAs are peripheral and correspond by ELISA to antimyeloperoxidase antibodies. Tests for other antibodies are less often needed to evaluate inflammatory joint disease.

Antibodies, Antinuclear↗
PubMed2004

Direct Toll-like receptor 2 mediated co-stimulation of T cells in the mouse system as a basis for chronic inflammatory joint disease.

The pathogenesis of chronic inflammatory joint diseases such as adult and juvenile rheumatoid arthritis and Lyme arthritis is still poorly understood. Central to the various hypotheses in this respect is the notable involvement of T and B cells. Here we develop the premise that the nominal antigen-independent, polyclonal activation of preactivated T cells via Toll-like receptor (TLR)-2 has a pivotal role in the initiation and perpetuation of pathogen-induced chronic inflammatory joint disease. We support this with the following evidence. Both naive and effector T cells express TLR-2. A prototypic lipoprotein, Lip-OspA, from the etiological agent of Lyme disease, namely Borrelia burgdorferi, but not its delipidated form or lipopolysaccharide, was able to provide direct antigen-nonspecific co-stimulatory signals to both antigen-sensitized naive T cells and cytotoxic T lymphocyte (CTL) lines via TLR-2. Lip-OspA induced the proliferation and interferon (IFN)-gamma secretion of purified, anti-CD3-sensitized, naive T cells from C57BL/6 mice but not from TLR-2-deficient mice. Induction of proliferation and IFN-gamma secretion of CTL lines by Lip-OspA was independent of T cell receptor (TCR) engagement but was considerably enhanced after suboptimal TCR activation and was inhibitable by monoclonal antibodies against TLR-2.

Animals↗
PubMed1995

Assessment of glycosaminoglycan concentration in equine synovial fluid as a marker of joint disease.

A modification of a colorimetric assay was used to determine synovial fluid total and individual sulphated-glycosaminoglycan concentration in various clinical presentations of joint disease in horses. Concentrations of synovial fluid and serum sulphated-glycosaminoglycan (GAG) were measured by the 1,9-dimethylmethylene blue (DMMB) dye assay in normal horses (n = 49), horses with acute (n = 26) or chronic (n = 27) joint disease (defined by clinical, radiographic, and clinicopathological parameters), and horses with cartilaginous lesions at diagnostic arthroscopy, but with normal radiographs and synovial fluid (n = 9). Horses with acute joint disease were subdivided into moderate acute (n = 21) and severe acute (n = 5) joint disease on the basis of synovial fluid analysis and clinical examination. Horses with chronic joint disease were subdivided into mild chronic (n = 9), moderate chronic (n = 10), and severe chronic (n = 8) joint disease on the basis of synovial fluid analysis, clinical examination, and radiographic findings. The concentrations of chondroitin sulphate (CS) and keratan sulphate (KS) were analyzed in each sample following sequential enzymatic digestion of the sample with chondroitinase or keratanase. In addition, the concentration of hyaluronate (HA) in each sample was determined by a colorimetric assay following digestion of the sample with microbial hyaluronidase.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗
PubMed2001

[Radiologic imaging of degenerative and inflammatory joint diseases in women].

Pain in joints and other structures of the musculoskeletal system is a common complaint in women. It may occur as functional pain, in many cases as inflammatory episode of arthrosis or of metabolic joint disease, sometimes as early manifestation of rheumatoid disease. With conventional radiography, high-resolution sonography, and MR imaging it is possible to classify many of these clinical syndromes. A semiquantitative assessment of inflammatory activity can be made by analysing the degree of joint effusion, the thickness of the synovium and the extent of hypervascularisation.

Arthralgia↗
PubMed2004

Proteome analysis reveals disease-associated marker proteins to differentiate RA patients from other inflammatory joint diseases with the potential to monitor anti-TNFalpha therapy.

New experimental approaches of molecular medicine such as transcriptome and proteome analysis have been implemented in rheumatology research. Two-dimensional gel electrophoresis in combination with mass spectrometry was used to visualize and to identify proteins in synovial fluid (SF) and plasma samples from patients with rheumatoid arthritis (RA) and osteoarthritis (OA). The small calcium binding protein S100A9 (MRP14) was identified as a discriminatory marker protein in SF by global proteomic analysis. To confirm these results and to examine the reproducibility and the applicability as a diagnostic marker, levels of the S100A8 (MRP8)/A9 (MRP14) heterocomplex in plasma and in synovial fluid were validated from patients with RA, OA, and other inflammatory joint diseases using enzyme immunoassay techniques. It was found that plasma levels of the S100A8/A9 heterocomplex correlate well with levels in SF, and hence, determination of plasma levels can be used to distinguish RA patients from patients with other inflammatory joint diseases, as well as from OA patients and controls. Initial studies on RA patients also indicate that plasma levels of the S100A8/A9 heterocomplex are a useful marker in monitoring anti TNFalpha therapy.

ATP-Binding Cassette Transporters↗
PubMed1980

[A review of the palaeopathology of bone and joint diseases of the medieval period (author's transl)].

Diseases of joints and bones, i.e. chronic Arthritits, Ankylosing, Spondylitis, Osteoarthritis are not unusual. One of the most common in bones is Arthritis. The skeletal tuberculosis is a rare finding. A Kyphosis or a collapsed vertebral is not synonymous with spinal tuberkulosis. Femur esp. the Tibia shows often a chronic Periotitis, it is perhaps caused by Lues. Pseudopathological changes are common and have often led to erroneous diagnoses.

Bone Diseases↗
PubMed2004

Assessment of the effects of age and joint disease on hydroxyproline and glycosaminoglycan concentrations in synovial fluid from the metacarpophalangeal joint of horses.

OBJECTIVE: To assess the effects of age and joint disease on hydroxyproline and glycosaminoglycan (GAG) concentrations in synovial fluid from the metacarpophalangeal joint of horses and evaluate the association of those concentrations with severity of osteoarthritis and general matrix metalloproteinase (MMP) activity. SAMPLE POPULATION: Synovial fluid was collected from the metacarpophalangeal joints of foals at birth (n = 10), 5-month-old foals (10), 11-month-old foals (5), and adult horses (73). PROCEDURE: Hydroxyproline and GAG concentrations were determined in synovial fluid samples. The severity of osteoarthritis in adult joints was quantified by use of a cartilage degeneration index (CDI) and assessment of general MMP-activity via a fluorogenic assay. RESULTS: Hydroxyproline and GAG concentrations in synovial fluid were highest in neonates and decreased with age. Concentrations reached a plateau in adults by 4 years and remained constant in healthy joints. In synovial fluid from osteoarthritic joints, hydroxyproline and GAG concentrations were not increased, compared with unaffected joints, but hydroxyproline were significantly correlated with the CDI and general MMP activity. There was no significant correlation between GAG concentration and CDI value or MMP activity. CONCLUSIONS AND CLINICAL RELEVANCE: Changes in hydroxyproline concentration in synovial fluid appeared to indicate damage to collagen of the articular cartilage. In joints with osteoarthritis, the lack of high GAG concentration in synovial fluid and the absence of a significant correlation between GAG concentration and CDI values or MMP activity may severely limit the usefulness of this marker for monitoring equine joint disease.

Age Factors↗
PubMed2000

Incidence of chronic inflammatory joint diseases in Finland in 1995.

OBJECTIVE: To investigate trends in the incidence of chronic inflammatory joint diseases. METHODS: Subjects entitled to receive drug reimbursement for chronic inflammatory joint diseases in 5/21 central hospital districts (population base about 1 million adults) in Finland during 1995 were studied. The mean age at disease onset was compared with figures from 1975, 1980, 1985, and 1990. Incidence rates were compared with those from 1980, 1985, and 1990. RESULTS: A total of 710 subjects were entitled to drug reimbursement for chronic inflammatory joint disease that had started at the age of 16 or over. The total incidence was 65/100,000 (95% confidence interval 60.7-70.4); the figures for rheumatoid arthritis (RA), ankylosing spondylitis, psoriatic arthritis, and undifferentiated chronic poly/oligoarthritis were 34, 6, 7, and 13/100,000, respectively. In RA, the mean age at diagnosis was 59.0 years and was the same in rheumatoid factor (RF) positive and RF negative disease. The mean age at diagnosis had increased by 8.8 years from 1975 to 1995 (p<0.001). A 14% decline was evident in the incidence of RA in 1990 and 1995 compared with the earlier years (p = 0.013). In the younger age groups (35-54 years), the incidence declined by 50% compared with the year 1980. The incidence of spondyloarthropathies remained similar during 1980-95. CONCLUSION: Continuous monitoring of sickness insurance data provides information on the epidemiology of inflammatory joint diseases that will be useful in assessing demand for and supply of health services.

Adult↗
PubMed1987

Primary degenerative joint disease of the shoulder in a colony of beagles.

Shoulder joints of 149 Beagles over 8 years old at the time of death (mean age, 13.8 years +/- 3.21), were examined radiographically throughout their life-times for the frequency of degenerative joint disease (DJD). Clinical histories revealed no underlying cause for DJD. The shoulder joints of a subgroup of 18 dogs were examined at necropsy, and thin sections of the joints were evaluated radiographically and histologically. Serial clinical radiographic studies indicated that normal shoulder joint development during the first year of life was followed by the appearance of subchondral bone sclerosis and bony remodeling of normal joint contour, and by the formation of periarticular osteophytes and enthesiophytes. All changes were progressive with age and typical for DJD in dogs. Bilateral involvement was common. Evaluation of specimens obtained at necropsy revealed: articular cartilage change with roughening of the surface layer, degeneration and death of superficial chondrocytes, exposure of deeper layers of chondrocytes that had proliferated with fissuring of the damaged cartilage, total cartilage loss with polishing of the exposed subchondral bone, mixed patterns of subchondral bone sclerosis and osteoporosis, change in contour of the articular surfaces, and formation of periarticular osteophytes and enthesiophytes. Joint capsule thickening, synovitis, pannus formation, and synovial chondroma formation were observed. Because of the available clinical information, in addition to the typical changes of DJD, it was thought that the changes were primary. Instability appeared to play a role in the pathogenesis of the joint disease described; however, it was not clear whether the instability caused abnormal forces on healthy cartilage or whether the primary cartilage wear caused the instability.

Aging↗
PubMed1993

Rheumatoid cervical joint disease--a challenge to the anaesthetist.

Cervical joint disease in rheumatoid arthritis patients is common. These patients may be at risk for severe life-threatening neurological problems in the perioperative period and thus present a challenge to the anaesthetist. By understanding the various anatomical abnormalities that may occur in rheumatoid cervical joint disease, the anaesthetist can design an appropriate management plan for the patient. The destruction of normal anatomy by rheumatoid arthritis can result in atlanto-axial subluxation (AAS) or subaxial subluxation. The atlanto-axial subluxation is further divided anatomically into anterior AAS, posterior AAS, vertical AAS, and lateral/rotatory AAS. In addition to the history and physical examination of the rheumatoid arthritis patient, radiological evaluation of the cervical spine is highly recommended. With the identification of the specific anatomical lesion the anaesthetist can predict and avoid movements which may lead to, or worsen, neurological problems. In the event of an emergency where full evaluation of the cervical spine is not possible the anaesthetist must presume that the rheumatoid patient has severe cervical spine instability and use the most cautious approach.

Anesthesia↗
PubMed1976

Arthritis and heart lesions. A study of 25 cases with pericarditis or valvular lesions associated to inflammatory joint disease.

Clinical and laboratory data of 25 patients with inflammatory joint disease and pericarditis or valvular heart disease are reviewed. The patients were divided in two groups: 11 presented pericarditis and 14 valvular heart disease. The patients studied presented a spectrum of diseases ranging from classical sero-positive rheumatoid arthritis to ankylosing spondylitis. Acute rheumatic fever was in no case the actual joint disease. In contrast to the patients with valvular heart disease nearly all patients with pericarditis were rheumatoid arthritis factor positive and signs of a generalized systemic disease with vasculitis were also more frequent. In the pericarditis group there was no sex difference in contrast to the valvular group where females were more often affected. The heart lesions were usually detected late in the course of the chronic joint disease. Valvular heart disease occurs not only in ankylosing spondylitis but also in rheumatoid arthritis, usually the sero-negative type. In the light of a survey of the literature, the pertinent findings are discussed.

Adult↗
PubMed1991

Immunological aspects of markers of joint disease.

There is considerable potential for using immunological methods to detect and quantify markers of joint disease in man and animal models. These markers usually result from increased matrix turnover as the disease develops, and fall into several categories. Anabolic markers are those that specifically recognize epitopes in macromolecules that are newly synthesized in the cells' initial response to repair and remodel the tissue in the early stages of the disease. Catabolic markers are those that result from degradation of preexisting matrix as the disease progresses. At present, this laboratory has available a large panel of well characterized monoclonal antibodies directed against proteoglycan epitopes that can be used to detect both anabolic and catabolic markers of joint disease. Development of immunoassay procedures to both monitor the progression of joint disease and the effect of therapeutic intervention will occur in the near future.

Animals↗
PubMed1980

Collagenase activity in human synovial fluids from joint diseases of diverse etiology.

The content of collagenase in latent as well as in apparent active form has been determined in synovial fluids from 21 patients with rheumatoid arthritis, 16 with non-rheumatoid inflammatory joint diseases, and 15 with degenerative joint disease. Collagenase activity was measured before and after activation of the latent enzyme by NaSCN treatment. Before activation, collagenase activity was present in the synovial fluids from 1 case of rheumatoid arthritis, 3 cases of degenerative joint disease, and 1 case of Behçet's syndrome. An excess of inhibitor was present in inactive synovial fluids. The incidence of collagenolytic activity markedly increased after treatment with NaSCN. When NaSCN-dependent collagenolytic activity was present, its value was of the same order of magnitude in all patients regardless of disease type. The diagnostic value of the finding of collagenase activity in synovial fluid, and the physiological meaning of the enzyme with reference to joint diseases, are discussed.

Arthritis↗
PubMedDate not supplied

The magnitude and durability of functional improvement after total shoulder arthroplasty for degenerative joint disease.

So that patients with degenerative glenohumeral joint disease who wish to consider total shoulder arthroplasty will be better informed, we sought to document the magnitude and durability of the improvement in shoulder function after this procedure. The function of 124 shoulders with primary degenerative joint disease was documented by patient self-assessment with the Simple Shoulder Test before and sequentially after total shoulder arthroplasty performed with a standardized technique. Patients reported that they could perform 3.8 +/- 0.3 (SEM) of the 12 Simple Shoulder Test functions before surgery. The total number of performable functions was consistent at different follow-up intervals: 8.0 +/- 0.4 at 6 months, 9.5 +/- 0.4 at 1 year, 10.0 +/- 0.3 at 2 years, 9.2 +/- 0.4 at 3 years, 9.6 +/- 0.4 at 4 years, and 10.0 +/- 0.4 at 5 years. We conclude that total shoulder arthroplasty can provide substantial and durable improvement in shoulder function.

Aged↗