Joint Disease (joint + disease)

Distribution by Scientific Domains
Distribution within Medical Sciences

Kinds of Joint Disease

  • degenerative joint disease
  • inflammatory joint disease

  • Selected Abstracts

    Hereditary Bone and Joint Disease in the Dog

    Neil Burton
    Hereditary Bone and Joint Disease in the Dog Joe Morgan, Alinda Wind & Autumn Davidson Published by Manson Publishing, 2003. Hardback, 328 pages Price Ł61.00. ISBN 3-87706-548-1 [source]

    Effect of transcranial magnetic stimulation on voluntary activation in patients with quadriceps weakness

    MUSCLE AND NERVE, Issue 2 2005
    Dietmar Urbach MD
    Abstract Joint disease causes weakness and wasting of adjacent muscles, in part because of inability to fully activate these muscles voluntarily. Previous findings suggest that transcranial magnetic stimulation (TMS) paired with muscle contractions enhances maximal voluntary contraction force (MVC) in healthy subjects by improving voluntary activation (VA). The aim of the present study was to evaluate whether such an effect is also present in subjects suffering from diminished muscle force due to decreased VA. Three single TMS over resting motor threshold were applied in 10 patients with a mean age of 62 years after total-knee arthroplasty either during MVC or during muscle relaxation (control experiment) in a blinded randomized crossover study. MVC and VA were determined using a twitch-interpolation technique at 1, 15, 30, and 60 min after stimulation. There was a significant effect of TMS on MVC if applied in synchrony with muscle contraction, and this persisted for at least 60 min beyond stimulation. In patients suffering from joint disease, TMS might make physiotherapy more effective. Muscle Nerve, 2005 [source]

    Aberrant hypertrophy in Smad3-deficient murine chondrocytes is rescued by restoring transforming growth factor ,,activated kinase 1/activating transcription factor 2 signaling: A potential clinical implication for osteoarthritis

    ARTHRITIS & RHEUMATISM, Issue 8 2010
    Tian-Fang Li
    Objective To investigate the biologic significance of Smad3 in the progression of osteoarthritis (OA), the crosstalk between Smad3 and activating transcription factor 2 (ATF-2) in the transforming growth factor , (TGF,) signaling pathway, and the effects of ATF-2 overexpression and p38 activation in chondrocyte differentiation. Methods Joint disease in Smad3-knockout (Smad3,/,) mice was examined by microfocal computed tomography and histologic analysis. Numerous in vitro methods including immunostaining, real-time polymerase chain reaction, Western blotting, an ATF-2 DNA-binding assay, and a p38 kinase activity assay were used to study the various signaling responses and protein interactions underlying the altered chondrocyte phenotype in Smad3,/, mice. Results In Smad3,/, mice, an end-stage OA phenotype gradually developed. TGF,-activated kinase 1 (TAK1)/ATF-2 signaling was disrupted in Smad3,/, mouse chondrocytes at the level of p38 MAP kinase (MAPK) activation, resulting in reduced ATF-2 phosphorylation and transcriptional activity. Reintroduction of Smad3 into Smad3,/, cells restored the normal p38 response to TGF,. Phosphorylated p38 formed a complex with Smad3 by binding to a portion of Smad3 containing both the MAD homology 1 and linker domains. Additionally, Smad3 inhibited the dephosphorylation of p38 by MAPK phosphatase 1 (MKP-1). Both ATF-2 overexpression and p38 activation repressed type X collagen expression in wild-type and Smad3,/, chondrocytes. P38 was detected in articular cartilage and perichondrium; articular and sternal chondrocytes expressed p38 isoforms ,, ,, and ,, but not ,. Conclusion Smad3 is involved in both the onset and progression of OA. Loss of Smad3 abrogates TAK1/ATF-2 signaling, most likely by disrupting the Smad3,phosphorylated p38 complex, thereby promoting p38 dephosphorylation and inactivation by MKP-1. ATF-2 and p38 activation inhibit chondrocyte hypertrophy. Modulation of p38 isoform activity may provide a new therapeutic approach for OA. [source]

    Joint diseases of the elderly

    Yasufumi Hayashi
    First page of article [source]

    Risk factors associated with hindlimb lameness and degenerative joint disease in the distal tarsus of Icelandic horses

    Summary The aim of this study was to evaluate potential risk factors associated with hindlimb lameness and radiographic signs of degenerative joint disease (DJD) in the distal tarsus in Icelandic horses. The material consisted of riding horses (n = 420) age 6,12 years sired by 17 selected sires representing all major breeding lines, and of riding horses (n = 194) in the same age range sired by other sires. The examination protocol included the following: interview with owners/trainers, assessment of conformation, motion evaluation and radiographic examination. At the interview, data related to factors outside the horse (environmental variables) and data associated directly with the horse (intrinsic variables) were obtained. Data analysis was performed in 2 steps: screening using bivariate analysis, followed by testing with a multivariate logistic regression model. In the multivariate analysis, the factors of sire, age when broken to saddle and stud show participation were strongly associated with the prevalence of lameness. Height at the croup and ability to perform different gaits were also associated with the prevalence of lameness, but to a lesser degree. The risk factors of age, tarsal angle and birthplace were significantly associated with radiographic signs of DJD in the distal tarsus. Neither the variation in applied training intensity, the use of a professional oramateurtrainernorthe temperament or front limb action of the individual horse was significantly associated with the prevalence of hindlimb lameness and/or radiographic signs of DJD in the distal tarsus in the Icelandic horse. [source]

    Evidence supporting an increased presence of reactive oxygen species in the diseased equine joint

    A. N. Dimock
    Summary Reactive oxygen species (ROS) are capable of degrading many components of the joint in the presence of insufficient antioxidant defences, and as a result have been implicated in the pathogenesis of joint disease in horses. However, to our knowledge, evidence of ROS occurring in diseased joints of horses has not been reported. The objective of this experiment was to compare differences in synovial fluid protein carbonyl content (as a marker of oxidative modification of synovial fluid proteins by ROS) and the antioxidant status of synovial fluid between clinically normal and diseased equine joints. Synovial fluid was collected from the metacarpophalangeal, metatarsophalangeal, carpal and tarsal joints of 4 horses, age 2,5 years, as controls, and from diseased joints (metacarpophalangeal, metatarsophalangeal, carpal, tarsal and/or femoropatellar) of 61 horses, age 2,5 years. Synovial fluid protein carbonyl content was higher (P<0.01) in diseased joints as compared to controls. Antioxidant status of synovial fluid from diseased joints was higher, but not significantly, than that of controls (P = 0.0595). These findings require further study to determine their contribution to the overall disease process. [source]

    Radiographic and clinical survey of degenerative joint disease in the distal tarsal joints in Icelandic horses

    S. Björnsdóttir
    Summary The prevalence of degenerative joint disease (DJD) in the distal tarsal joints and the relation between radiographic and clinical signs compatible with the disease were estimated in a population of Icelandic horses used for riding. The material consisted of 614 horses age 6,12 years (mean age = 7.9 years). Radiographs with 3 projections of each tarsus were made and a clinical examination, including palpation of the medial aspect of the distal tarsus and motion evaluation of the hindlimbs before and after a flexion test of the tarsus, was performed. Radiographic signs of DJD in the distal tarsal joints were found in 30.3% of the horses and the prevalence was strongly correlated with age. Hindlimb lameness before and after flexion test and palpation abnormalities were significantly associated with the radiographic findings. The lameness was usually mild and, in most cases, detectable only after the flexion test. The prevalence of lameness was not significantly correlated with age. Lameness could not be predicted by details of the radiographic findings. [source]

    Emerging clinical concerns in the ageing haemophilia patient

    HAEMOPHILIA, Issue 6 2009
    B. A. KONKLE
    Summary., The availability of safe replacement clotting factor concentrates together with effective antiviral drugs to treat human immunodeficiency and hepatitis C viruses and the provision of care at designated haemophilia treatment centres have resulted in a new phenomenon in haemophilia management , the ageing patient. Today, increasing numbers of persons with haemophilia (PWH) are middle-aged and older, and they face the same age-related health issues as the general population. The impact of these risks on PWH is unclear, however, and there is a paucity of information about how to manage comorbidities in this patient population. This review focuses on five comorbidities that uniquely affect older PWH: cardiovascular disease, liver disease, cancer, renal disease and joint disease. Available research is summarized and potential management approaches are suggested. [source]

    Pathogenesis of haemophilic synovitis: experimental studies on blood-induced joint damage

    HAEMOPHILIA, Issue 2007
    Summary., Hemarthrosis is a common manifestation of haemophilia, and joint arthropathy remains a frequent complication. Even though the exact mechanisms related to blood-induced joint disease have not yet been fully elucidated, it is likely that iron deposition in the synovium induces an inflammatory response that causes not only immune system activation but also stimulates angiogenesis. This process ultimately results in cartilage and bone destruction. Investigating the processes that occur in the early stages of blood-induced joint disease in humans has been very limited. Therefore, the use of haemophilic animal models is critical to augment the understanding of this phenomenon. This article discusses three cellular regulators (p53, p21 and TRAIL) induced in synovial tissue that are important for iron metabolism. A cartilage remodelling programme induced by the release of cytokines and growth factors that result in articular damage is also discussed. Full elucidation of the pathogenesis of haemophilic joint disease is required to identify new avenues for prevention and therapy. [source]

    Prophylactic recombinant factor VIIa in haemophilia patients with inhibitors

    HAEMOPHILIA, Issue 3 2005
    G. Young
    Summary., Prevention of bleeding, especially into joints, with prophylactic factor infusions is the most effective treatment for severe haemophilia patients. Approximately 15,30% of patients with factor VIII deficiency and 3,5% of patients with factor IX deficiency develop neutralizing antibodies (inhibitors) to factor precluding their use. Such patients often have significant bleeding complications including life- and limb-threatening bleeds and severe joint disease. Prophylaxis for such patients is not generally considered because of the fact that the standard (bypassing) agents for such patients are not as effective as natural factor replacement, because of concerns for thrombotic complications and also because of the very high cost of bypassing agents. We treated two patients with high titre inhibitors with prophylactic recombinant factor VIIa (rFVIIa). The first patient was treated as a result of development of a target joint and to reduce the use of agents that can lead to anamnesis of his inhibitor. The second patient had multiple severe bleeds and was hospitalized 20% of the time over a 2-year period. He had a very poor quality of life. Both patients had shown good responses previously to rFVIIa for treatment of bleeds. Both patients had an outstanding response to prophylaxis albeit at a very high cost. Prophylaxis with rFVIIa can be an effective approach in select inhibitor patients with severe complications related to bleeding. [source]

    Schmorl's nodes in a post-medieval skeletal sample from Klostermarienberg, Austria

    Article first published online: 11 NOV 200, H. Üstünda
    Abstract The prevalence and distribution pattern of Schmorl's nodes (SNs) were studied in a post-medieval skeletal sample (n,=,473) from the 16th,18th century cemetery of Klostermarienberg, Austria. The reasons for the prevalence and distribution pattern of SNs in this sample are discussed with regard to their aetiology. SNs were correlated with age and sex as well as with degenerative spinal joint disease such as vertebral osteophytosis (VO) and apophyseal osteoarthritis (OA). SNs were most commonly found in the lower thoracic region, in agreement with other studies. Males were more affected than females by SNs, especially in the lower thoracic region. SNs show a completely different distribution pattern to VO and OA. Additionally, there was no relationship found between SNs and ageing. Observed differences in the prevalence of SNs in the vertebral column and between the sexes suggest that mechanical factors may be responsible. Copyright © 2008 John Wiley & Sons, Ltd. [source]

    Morphological changes in the shape of the non-pathological bony knee joint with age: a morphometric analysis of the distal femur and proximal tibia in three populations of known age at death

    S. D. Stevens
    Abstract This study examines possible morphological variation in the knee joint of Homo sapiens with increasing age in ostensively healthy and non-pathological distal femora and proximal tibiae. Throughout the lifetime of each individual, the hard tissue of the knee undergoes considerable remodelling as a response to biomechanical stresses, changes in bone microarchitecture and reduction of bone mineral content as a concomitant of ageing. The knee is also subject to greater levels of degenerative joint disease than any other joint. If death occurs whilst such diseases are in the earliest stages, initial bone changes may not be visually obvious in museum specimens. If such specimens are used for comparative analyses, it is hypothesised that changes might render it problematic if all ages are conglomerated into discrete samples. This study therefore investigates the degree to which the distal femur and proximal tibia change shape during ageing and, if changes are present, whether they are expressed similarly in males and females. It also examines whether changes are of greater magnitude than those morphological differences which might exist between populations. In an example population of African-Americans, results indicate that there is a statistically significant difference in shape between age groups and those differences become progressively greater between the youngest and oldest adults. Results also show that although morphological variation caused by ageing is apparent, those shape differences attributable to sexual dimorphism are more powerful. When two additional populations are analysed jointly with the African-Americans (Caucasian Americans and the European Spitalfields sample), results indicate that inter-population shape differences are considerably greater than differences caused by increasing age. Results imply that it is justifiable to combine specimens of all ages into discrete samples for comparative purposes. Copyright © 2007 John Wiley & Sons, Ltd. [source]

    A case of bilateral scapholunate advanced collapse in a Romano-British skeleton from Ancaster

    A. M. Roberts
    Abstract Degenerative joint disease (DJD) of the wrist (radiocarpal joint) is relatively uncommon in modern Western populations, usually occurring as a result of trauma. Clinically, scapholunate advanced collapse (SLAC) is the most common pattern of DJD seen in the wrist, involving a progressive destruction of the radioscaphoid and then the capitolunate joint. There is only one report of SLAC wrist in the palaeopathological literature. In this paper, we report on another ancient case of bilateral SLAC wrists, found in a Roman skeleton from Ancaster, Lincolnshire. The osteological analysis of ANC 01 217 skeleton determined that this was an elderly but robust adult (50+ years) male, about 165,cm tall. The bones were sufficiently well preserved to allow inspection of joint surfaces. The bones were also radiographed. Osteoarthritis (OA) was diagnosed according to accepted palaeopathological criteria: principally the presence of eburnation on a joint surface. Eburnation was found at the articular surfaces of the wrist joint and numerous intercarpal joints bilaterally. The pattern of joints affected matched modern clinical descriptions of SLAC wrist. Radiographic changes characteristic of OA were identifiable at the wrist joint, but not at the intercarpal joints. This case proves that SLAC wrist is identifiable in dry bones, but the discrepancy between the observational and radiographic findings highlights the problems encountered when attempting to compare disease in archaeological versus modern populations. Copyright © 2006 John Wiley & Sons, Ltd. [source]

    State of the art: Juvenile idiopathic arthritis

    Prudence J. Manners
    Abstract Juvenile idiopathic arthritis (JIA) is the most common of the autoimmune musculoskeletal conditions in children. As awareness of this condition increases, so too does the apparent prevalence reported from countries around the world, suggesting that significant numbers of children with JIA have previously gone undiagnosed. Prevalence varies with race and possibly geography. However, JIA should no longer be considered as a rare condition. In the past decade, there have been definite advances in understanding the pathogenesis of JIA, and there have been parallel advances in therapies. There have been fairly modest advances in the classification of JIA, but there is at least heightened international debate on the issue, which will lead to progress. It is estimated that nearly one-third of children with this condition continue into adult life with inflammatory joint disease, and therefore the burden of disease remains significant. [source]

    Classifying degenerative joint disease by the RDC/TMD and by panoramic imaging: a retrospective analysis

    Summary, The purposes of the study were to evaluate the utility of diagnosing degenerative joint disease (DJD) by the clinical finding of coarse crepitus alone, without supporting imaging studies, as defined by the RDC/TMD, and to evaluate the contribution of panoramic radiography as an aid in the diagnosis of DJD. A retrospective analysis of 372 consecutive patients with TMD was conducted. Their panoramic radiographs were evaluated for the extent of their contribution to the final diagnosis. Panoramic radiography was of no diagnostic value in 94·4% of the cases when the group was considered as a whole. When patients diagnosed with DJD were considered separately, panoramic radiography was completely sufficient for reaching the final diagnosis in 20·0% of the cases. In almost 90% of these patients, however, the clinical examination did not support the diagnosis of DJD (no coarse crepitus was found). This raises some doubts about the effectiveness of the clinical examination according to the RDC/TMD and about the utility of panoramic radiography in the definitive diagnosis of DJD, because both techniques have low accuracy (11·1% and 20%, respectively). The present study supports the current recommendations that panoramic radiography should not be ordered routinely to assess DJD, but still it is first choice when any dental problem is suspected. Further additional imaging (computerized tomography, magnetic resonance imaging) should be considered only if there is reason to expect that the findings might affect diagnosis and management. This study adds to recent criticisms of the clinical validity of the RDC/TMD, with regard to DJD. [source]

    MMP-mediated collagen breakdown induced by activated protein C in equine cartilage is reduced by corticosteroids

    Elaine R. Garvican
    Abstract The plasma serine protease activated protein C (APC) is synthesized by human chondrocytes at sites of pathological cartilage fibrillation. APC levels are increased in osteoarthritis (OA) synovial fluid, and in vitro APC has been shown to synergize with interleukin-1, (IL-1) to promote degradation from ovine cartilage. A model of equine cartilage degradation was established and used to explore corticosteroid activities. Intraarticular corticosteroids are a commonly prescribed treatment for joint disease, however their role in disease modification remains unclear. APC synergized with IL-1 or tumor necrosis factor-, (TNF,), promoting significant collagen degradation from equine cartilage explants within 4 days, but did not augment glycoaminoglycan (GAG) release. APC activated pro-matrix metalloproteinases (MMP)-2 but not pro-MMP-9, as assessed by gelatin zymography. APC did not directly activate pro-MMP-13. Dexamethasone, triamcinolone, and methylprednisolone acetate (MPA) were evaluated at concentrations between 10, 5M and 10,10M. High concentrations significantly increased GAG release from IL-1+APC,treated explants. With the exception of MPA at 10,10M, all concentrations of corticosteroids caused significant decreases in IL-1+APC-driven hydroxyproline loss. Treatment with corticosteroids suppressed expression of MMP-1, -3, and -13 mRNA. The collagenolysis associated with IL-1+APC synergy, and the inhibition of this effect by corticosteroids may involve gelatinase activation and downregulation of MMP expression, respectively. © 2009 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 28:370,378, 2010 [source]

    Periarticular ligament changes following ACL/MCL transection in an ovine stifle joint model of osteoarthritis

    Yusei Funakoshi
    Abstract Anterior cruciate ligament (ACL) injuries often lead to significant functional impairment, and are associated with increased risk for induction of degenerative joint disease. However, few studies have described the effect of ligament transection on the remaining intact knee ligaments. This study sought to determine specifically what impact combined ACL/medial collateral ligament (MCL) transection had on the remaining intact knee ligaments, particularly from the histological, biochemical, and molecular perspectives. Twenty weeks post-ACL/MCL transection, the cut ends of sheep MCLs were bridged by scar, while the posterior cruciate ligaments (PCLs) and lateral collateral ligaments (LCLs) seemed gross morphologically normal. Water content and cell density increased significantly in the MCL scars and the intact PCLs but were unchanged in the LCLs. Collagen fibril diameter distribution was significantly altered in both MCL scar tissue and uninjured PCLs from transected joints. MMP-13 mRNA levels in MCL scars and PCLs from ligament transected joints were increased, while TIMP-1 mRNA levels were significantly decreased in the PCLs only. This study has shown that some intact ligaments in injured joints are impacted by the injury. The joint appears to behave like an integrated organ system, with injury to one component affecting the other components as the "organ" attempts to adapt to the loss of integrity. © 2007 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 25:997,1006, 2007 [source]

    Proposed model of botulinum toxin-induced muscle weakness in the rabbit

    D. Longino
    Abstract Osteoarthritic patients show only a weak association between radiographic signs of joint disease and joint pain and disability. Conversely, muscle weakness is one of the earliest and most common symptoms of patients with osteoarthritis (OA). However, while many experimental models of osteoarthritis include a component of muscular weakness, no model has isolated this factor satisfactorily. Therefore, the purpose of this study was to develop and validate an experimental animal model of muscle weakness for future use in the study of OA. Botulinum Type-A toxin (BTX-A) was uni-laterally injected into the quadriceps musculature of New Zealand white rabbits (3.5 unit/kg). Isometric knee extensor torque at a range of knee angles and stimulation frequencies, and quadriceps muscle mass, were quantified for control animals, and at one- and six-months post-repeated injections, in both, the experimental and the contralateral hindlimb. Ground reaction forces were measured in all animals while hopping across two force platforms. Isometric knee extension torque and quadriceps muscle mass was systematically decreased in the experimental hindlimb. Vertical ground reaction forces in the push off phase of hopping were also decreased in the experimental compared to control hindlimbs. We conclude that BTX-A injection into the rabbit musculature creates functional and absolute muscle weakness in a reproducible manner. Therefore, this model may be used to systematically study the possible effects of muscle weakness on joint degeneration, either as an isolated intervention, or in combination with other interventions (anterior cruciate ligament transection, meniscectomy) known to create knee joint degeneration. © 2005 Orthopaedic Research Society. Published by Elsevier Ltd. All rights reserved. [source]

    Repeated intraarticular injections of triamcinolone acetonide alter cartilage matrix metabolism measured by biomarkers in synovial fluid

    Christophe Céleste
    Abstract Although intraarticular (IA) corticosteroids are frequently used to treat joint disease, the effects of their repeated use on articular cartilage remains controversial. The aim of our study was to determine the effects of a clinically recommended dose of IA triamcinolone acetonide (TA), on synovial fluid (SF) biomarkers of cartilage metabolism. Ten adult horses, free of osteoarthritis (OA) in their radiocarpal joints, were studied. One radiocarpal joint of each horse was randomly chosen for treatment and the contralateral anatomically paired joint acted as the control. Aseptic arthrocentesis was performed weekly on both joints for 13 weeks. The initial results from the first 3 weeks of the experimental period established baseline untreated control marker levels for each joint, each being its own control. On weeks 3, 5, and 7, a sterile suspension of 12mg of TA was injected into the treated joint and an equivalent volume of sterile saline solution (0.9%) was injected into the control joint. SF was immunoassayed for biomarkers of aggrecan turnover (CS 846 & KS), types I and II collagen cleavage (C1,2C) and type II collagen synthesis (CPII). In treated joints, there was a significant increase in CS 846, KS, C1,2C and CPII epitope concentrations following IA TA injections when compared to baseline levels. There was also a significant increase in C1,2C and CPII epitope concentrations in the contralateral control joints following IA TA injections in the treated joint. Significant differences were observed between treated and control joints for all markers except CPII. These findings indicate that TA alters articular cartilage and collagen metabolism in treated and, interestingly, also in control joints, suggesting a systemic effect of the drug. Though intuitively the observed findings would favor the hypothesis that long-term IA TA treatment changes joint metabolism and this may have detrimental effects; further studies would be necessary to confirm this. © 2004 Orthopaedic Research Society. Published by Elsevier Ltd. All rights reserved. [source]

    Quantitative cartilage imaging of the human hind foot: Precision and inter-subject variability

    Dina Al-Ali
    Alterations of ankle cartilage are observed in degenerative and inflammatory joint disease, but cartilage cannot be directly visualized by radiography. The purpose of this study was therefore to analyze the feasibility and precision of quantitative cartilage imaging in the human hind foot (talocrural, talotarsal, and intertarsal joints), and to report the inter-subject variability for cartilage volume, thickness and surface areas. The feet of 16 healthy volunteers were imaged using a 3D gradient-echo magnetic resonance imaging sequence with water-excitation. After interpolation to a resolution of 1 ± 0.125 ± 0.125 mm3 the cartilage plates were segmented, and the cartilage volume, thickness, and surface areas determined. The precision (four repeated measurements) was examined in eight volunteers, the RMS average CV% being 2.1% to 10.9% in single joint surfaces, and , 3% for the cumulative values of all joints. The mean cartilage thickness ranged from 0.57 ± 0.08 (navicular surface) to 0.89 ± 0.19 mm (trochlear surface for tibia). In conclusion this study shows that it is feasible to quantify thin cartilage layers in the hind foot under in vivo imaging conditions, and that the precision errors are substantially smaller than the inter-subject variability in healthy subjects. © 2002 Orthopaedic Research Society. Published by Elsevier Science Ltd. All rights reserved. [source]

    Power Doppler sonography in the diagnosis of hemophilic synovitis , a promising tool

    Summary.,Background:,Recurrent hemarthroses in hemophilia results in synovitis and joint arthropathy. Primary prophylaxis when universally instituted at current doses can prevent joint deterioration but is expensive. Alternatively, the selective implementation of prophylaxis would require a more sensitive tool for detecting synovitis than possible with clinical surveillance or plain radiographs. Magnetic resonance imaging (MRI) is such a tool and is utilized for the evaluation of hemophilic joint disease (HJD). However, it is expensive, and requires sedation in younger children precluding its utility for monitoring of synovitis. Ultrasonography (USG) with power Doppler (USG-PDS) has been utilized to detect and quantitate synovial vascularity in other arthritides and could provide an equally effective but less costly tool for HJD, particularly in children who would not require sedation. Objectives:,To determine whether USG-PDS is comparable to MRI in the evaluation of hemophilic synovitis. Patients:,A prospective cohort of 31 subjects including 33 joints (knees, elbows, ankles) underwent dynamic contrast enhanced (DCE)-MRI and USG-PDS. Results:,USG-PDS measurements of synovial thickness(r = 0.70, P < 0.0001) and synovial vascularity (r = 0.73, P < 0.0001) correlated strongly with those obtained with DCE-MRI. A cutoff of PDS intensity of 1.3 decibels (dB) per mm2 was found to yield a sensitivity of 100% and a specificity of 94.1% in 17 joints with/without a history of hemarthroses. Pettersson radiographic scores correlated significantly with synovial thickness in adults but not children. Conclusions:,Our data suggest that USG-PDS may be an inexpensive and easily implemented imaging tool for detecting hemophilic synovitis and could be useful in tailoring effective prophylaxis. [source]

    Pharmacokinetics of amoxycillin in normal horses and horses with experimental arthritis

    J. O. Errecalde
    The serum and synovial pharmacokinetics of amoxycillin (AMX) were studied after i.v. administration at a dosage of 40 mg/kg to normal horses and horses with induced aseptic carpal arthritis. The best estimates of serum and synovial pharmacokinetic parameters were calculated by mono or bivariable non-linear regression analysis. A biexponential equation was used to describe the concentration vs. time profiles in both normal and arthritic horses. There were no serum kinetic differences between normal and arthritic horses. There were, however, major synovial kinetic changes between these groups. The rate of penetration from serum to synovial fluid was larger in arthritic animals, indicating better penetration in this case. On the other hand, the rate of disappearance from synovial fluid was larger in normal horses, indicating more persistence of the drug in the diseased joint. Synovial AMX availability increased from 21% in normal horses to 79% in arthritic horses. These findings support the use of AMX for the treatment of infectious synovial joint disease produced by susceptible organisms in horses. [source]

    Effect of transcranial magnetic stimulation on voluntary activation in patients with quadriceps weakness

    MUSCLE AND NERVE, Issue 2 2005
    Dietmar Urbach MD
    Abstract Joint disease causes weakness and wasting of adjacent muscles, in part because of inability to fully activate these muscles voluntarily. Previous findings suggest that transcranial magnetic stimulation (TMS) paired with muscle contractions enhances maximal voluntary contraction force (MVC) in healthy subjects by improving voluntary activation (VA). The aim of the present study was to evaluate whether such an effect is also present in subjects suffering from diminished muscle force due to decreased VA. Three single TMS over resting motor threshold were applied in 10 patients with a mean age of 62 years after total-knee arthroplasty either during MVC or during muscle relaxation (control experiment) in a blinded randomized crossover study. MVC and VA were determined using a twitch-interpolation technique at 1, 15, 30, and 60 min after stimulation. There was a significant effect of TMS on MVC if applied in synchrony with muscle contraction, and this persisted for at least 60 min beyond stimulation. In patients suffering from joint disease, TMS might make physiotherapy more effective. Muscle Nerve, 2005 [source]

    Very low dose warfarin as prophylaxis against ultrasound detected deep vein thrombosis following primary hip replacement

    Murray M. Bern
    Abstract One mg daily warfarin was compared to variable dose warfarin (PT 1.3,1.5 times the normal PT), as prophylaxis against deep vein thrombosis (DVT) following unilateral hip replacement for degenerative joint disease (DJD). Ninety-eight patients entered onto study after having had negative color Doppler ultrasounds of the legs. Patients receiving 1 mg began therapy 7 days preoperatively and continued daily until discharge. Patients receiving the variable dose took 5 mg the night preoperatively, and thereafter daily based upon the daily PT. Seventy-eight patients completed the study protocol. No patient completing the protocol had DVT or pulmonary embolus (PE). Based upon intent to treat for all registered patients, one from each group had DVT after withdrawal from study. For patients receiving 1 mg warfarin daily, PTs extended none or slightly. Therefore, 1 mg warfarin can be used to prevent postoperative DVT following elective hip surgery. Am. J. Hematol. 71:69,74, 2002. © 2002 Wiley-Liss, Inc. [source]

    Paleopathology and the origin of agriculture in the Levant

    Vered Eshed
    Abstract This study addresses changes in health which were consequential to the Neolithic transition in the southern Levant, judged on the basis of the study of specific and nonspecific stress indicators, trauma, and degenerative joint disease in 200 Natufian (hunter-gatherer) skeletons (10,500,8300 BC) and 205 Neolithic (agricultural) skeletons (8300,5500 BC) from the southern Levant. The comparison of the health profiles of pre-Neolithic (Natufian) and Neolithic populations reveals a higher prevalence of lesions indicative of infectious diseases among the Neolithic population, and an overall reduction in the prevalence of skull trauma among males. No change over time was observed in the prevalence of degenerative joint disease. These results indicate that in the southern Levant the Neolithic transition did not simply lead to an overall deterioration in health but rather resulted in a complex health profile which was shaped by 1) an increase exposure to disease agents, 2) changes in diet, 3) population aggregation in larger and denser settlements, 4) changes in activity patterns and the division of labor, and possibly 5) a higher resistant immunological system and response capacity to environmental aggressions (mainly infections). Am J Phys Anthropol 143:121,133, 2010. © 2010 Wiley-Liss, Inc. [source]

    Economic intensification and degenerative joint disease: Life and labor on the postcontact north coast of Peru

    Haagen D. Klaus
    Abstract This study tests the hypothesis that the colonial economy of the Lambayeque region of northern coastal Peru was associated with a mechanically strenuous lifestyle among the indigenous Mochica population. To test the hypothesis, we documented the changes in the prevalence of degenerative joint disease (or DJD) in human remains from the late pre-Hispanic and colonial Lambayeque Valley Complex. Comparisons were made using multivariate odds ratios calculated across four age classes and 11 principle joint systems corresponding to 113 late pre-Hispanic and 139 postcontact adult Mochica individuals. Statistically significant patterns of elevated postcontact DJD prevalence are observed in the joint systems of the shoulder, elbow, wrist, and knee. More finely grained comparison between temporal phases indicates that increases in prevalence were focused immediately following contact in the Early/Middle Colonial period. Analysis of DJD by sex indicates postcontact males experienced greater DJD prevalence than females. Also, trends between pre- and postcontact females indicate nearly universally elevated DJD prevalence among native colonial women. Inferred altered behavioral uses of the upper body and knee are contextualized within ecological, ethnohistoric, and ethnoarchaeological frameworks and appear highly consistent with descriptions of the local postcontact economy. These patterns of DJD appear to stem from a synergism of broad, hemispheric level sociopolitical alterations, specific changes to Mochica activity and behavior, regional economic intensification, and local microenvironmental characteristics, which were all focused into these biological outcomes by the operation of a colonial Spanish political economy on the north coast of Peru from A.D. 1536 to 1751. Am J Phys Anthropol, 2009. © 2009 Wiley-Liss, Inc. [source]

    Measuring and interpreting age-related loss of vertebral bone mineral density in a medieval population

    Sabrina C. Agarwal
    Abstract This study investigates the age- and sex-related patterns in vertebral bone mineral density (BMD) and the relationship between BMD and vertebral osteophytosis (VO), using a specialized peripheral densitometer in a skeletal sample excavated from the British medieval village Wharram Percy. A total of 58 individuals were divided by sex into three broad age categories (18,29, 30,49, 50+ years.). Each fourth intact vertebral centra was scored for VO and 5-mm thick coronal sections scanned in a specialized peripheral densitometer (GE Lunar Piximus DXA). Changes in BMD associated with age, sex, and VO severity were examined in the whole vertebral section, a strictly trabecular region, and a primarily cortical region of bone separately. Significant change in vertebral BMD was found to occur by middle age with little or no statistical change in BMD between middle and old age. Females appear to suffer greater bone loss at an earlier age with no change in BMD between middle and old age, whereas males show a more steady loss of BMD across the age groups. The bone mineral content and BMD of the cortical region is higher in individuals with pronounced/severe osteophytosis. The unusual age- and sex-related patterns of change in vertebral BMD at Wharram Percy are compared with the patterns of age-related change from recent longitudinal population-based studies. The results emphasize the different pattern of bone loss in young adulthood seen in trabecular regions of the skeleton and highlight the importance of consideration of degenerative joint disease in BMD studies. The influence of lifestyle factors on vertebral BMD in this medieval population is also discussed. Am J Phys Anthropol 2009. © 2009 Wiley-Liss, Inc. [source]

    Ligament and bone pathologic abnormalities more frequent in neuropathic joint disease in comparison with degenerative arthritis of the foot and ankle: Implications for understanding rapidly progressive joint degeneration,

    ARTHRITIS & RHEUMATISM, Issue 8 2010
    Jill Halstead
    Objective The variable disease progression of osteoarthritis (OA) and the basis for rapid joint deterioration in some subgroups of patients are poorly understood. To explore an anatomic basis for rapidly progressive OA, this observational study compared the magnetic resonance imaging (MRI) patterns of disease between patients with neuropathic joint disease (NJD) and patients with degenerative arthritis of the ankle and foot. Methods MR images of the foot and ankle of patients with early NJD (n = 7) and patients with OA (n = 15) were assessed. The anonomized MR images were dichotomously scored by a musculoskeletal radiologist for the presence of the following abnormalities per bone (of a total of 14 bones): cartilage defects, bone cysts, bone marrow edema, fractures, joint debris, joint effusions, tendinopathy, tendinitis, and ligament tears. Results Although the degree of cartilage damage and joint cyst formation was comparable between the groups, the degree of ligament tears, or change in MRI signal intensity in the ligaments, was significantly greater in patients with NJD compared with patients with OA (median of 3 tears versus 0, of 14 total bones; P < 0.01). Moreover, in patients with early NJD compared with patients with OA, there was a significantly greater degree of diffuse bone marrow edema (median of 6.5 tarsal bones versus 2 adjacent bones, of 14 total bones; P < 0.01), a greater number of bone fractures (median 4 versus 0; P < 0.01), and more frequent bone debris (median 4.5 versus 0; P = 0.013). Conclusion This analysis of NJD in the foot and ankle shows the predominance of bone and ligament abnormalities in NJD compared with the pattern of involvement in OA. These findings highlight the importance of structures other than articular cartilage in OA of the ankle and foot, and suggest that rapid joint degeneration in NJD may be more ligamentogenic or osteogenic in nature. [source]

    Premature arthritis is a distinct type II collagen phenotype

    ARTHRITIS & RHEUMATISM, Issue 5 2010
    Peter Kannu
    Mutations in the gene encoding type II collagen (COL2A1) give rise to a spectrum of phenotypes predominantly affecting cartilage and bone. These chondrodysplasias are typically characterized by disproportionately short stature, eye abnormalities, cleft palate, and hearing loss. It is less recognized that mutations in COL2A1 can also present as degenerative joint disease in the absence of any other phenotypic clues. We report 2 Australian families presenting with an isolated arthritis phenotype, segregating as a dominant trait affecting both large and small joints, prior to age 30 years. Sequencing of COL2A1 in the propositi revealed 2 sequence changes resulting in glycine substitutions in the triple-helical domain of type II collagen. We review the increasing evidence implicating COL2A1 mutations in individuals presenting with isolated degenerative joint disease, aiming to alert physicians who assess these patients to this possibility. The importance of finding a COL2A1 mutation in such patients lies in the subsequent ability to accurately assess recurrence risks, offer early (including prenatal) diagnosis, and provide information regarding the natural history of the condition. Most importantly, it enables at-risk individuals to be identified for implementation of preventative strategies (i.e., weight loss, joint-friendly exercise programs) and early ameliorative management of their condition. [source]

    Trefoil factor 3 is induced during degenerative and inflammatory joint disease, activates matrix metalloproteinases, and enhances apoptosis of articular cartilage chondrocytes

    ARTHRITIS & RHEUMATISM, Issue 3 2010
    Sophie Rösler
    Objective Trefoil factor 3 (TFF3, also known as intestinal trefoil factor) is a member of a family of protease-resistant peptides containing a highly conserved motif with 6 cysteine residues. Recent studies have shown that TFF3 is expressed in injured cornea, where it plays a role in corneal wound healing, but not in healthy cornea. Since cartilage and cornea have similar matrix properties, we undertook the present study to investigate whether TFF3 could induce anabolic functions in diseased articular cartilage. Methods We used reverse transcriptase,polymerase chain reaction, Western blot analysis, and immunohistochemistry to measure the expression of TFF3 in healthy articular cartilage, osteoarthritis (OA),affected articular cartilage, and septic arthritis,affected articular cartilage and to assess the effects of cytokines, bacterial products, and bacterial supernatants on TFF3 production. The effects of TFF3 on matrix metalloproteinase (MMP) production were measured by enzyme-linked immunosorbent assay, and effects on chondrocyte apoptosis were studied by caspase assay and annexin V assay. Results Trefoil factors were not expressed in healthy human articular cartilage, but expression of TFF3 was highly up-regulated in the cartilage of patients with OA. These findings were confirmed in animal models of OA and septic arthritis, as well as in tumor necrosis factor ,, and interleukin-1,,treated primary human articular chondrocytes, revealing induction of Tff3/TFF3 under inflammatory conditions. Application of the recombinant TFF3 protein to cultured chondrocytes resulted in increased production of cartilage-degrading MMPs and increased chondrocyte apoptosis. Conclusion In this study using articular cartilage as a model, we demonstrated that TFF3 supports catabolic functions in diseased articular cartilage. These findings widen our knowledge of the functional spectrum of TFF peptides and demonstrate that TFF3 is a multifunctional trefoil factor with the ability to link inflammation with tissue remodeling processes in articular cartilage. Moreover, our data suggest that TFF3 is a factor in the pathogenesis of OA and septic arthritis. [source]