Condromalácia na articulação tíbio társica das trócleas em equino: relato de caso

Artrites traumáticas, principais causas de claudicação em equinos atletas, cursam com grande impacto econômico, em função da retirada precoce dos animais das atividades atléticas. Inúmeros fatores culminam em lesões articulares, sendo necessário o entendimento do mecanismo fisiopatológico para diagnóstico e tratamento precoce. O presente caso relata uma égua atleta com diagnóstico de osteoartrite causada por excessiva demanda biomecânica na articulação tíbio társica. O tratamento consistiu em consecutivas infiltrações de soro autólogo condicionado IRAP (Interleukin-1 Receptor Antagonist Protein). A resposta foi positiva com evidente melhora do quadro clínico. A terapia, apesar de necessitar mais estudos, já apresenta resultados promissores no tratamento das artropatias em equinos.(AU)

Traumatic arthritis, considered to be the main cause of lameness in equine athletes, have a great economic impact due to the early withdrawal of the animals from athletic activities. There are several causes that lead to joint injuries and it is necessary to know the pathophysiological mechanism, to early diagnosis and treatment. The present case reports an athlete mare with osteoarthritis caused by excessive biomechanical demand in the tibio tarsic joint. It was treated with consecutive infiltrations of conditioned autologous serum IRAP (Interleukin-1 Receptor Antagonist Protein). The response was positive with evident improvement of the clinical picture. The therapy, although more studies are needed, already presents promising results in the treatment of equine arthropathies.(au)

Condromalácia na articulação tíbio társica das trócleas em equino: relato de caso

Artrites traumáticas, principais causas de claudicação em equinos atletas, cursam com grande impacto econômico, em função da retirada precoce dos animais das atividades atléticas. Inúmeros fatores culminam em lesões articulares, sendo necessário o entendimento do mecanismo fisiopatológico para diagnóstico e tratamento precoce. O presente caso relata uma égua atleta com diagnóstico de osteoartrite causada por excessiva demanda biomecânica na articulação tíbio társica. O tratamento consistiu em consecutivas infiltrações de soro autólogo condicionado IRAP (Interleukin-1 Receptor Antagonist Protein). A resposta foi positiva com evidente melhora do quadro clínico. A terapia, apesar de necessitar mais estudos, já apresenta resultados promissores no tratamento das artropatias em equinos.

Traumatic arthritis, considered to be the main cause of lameness in equine athletes, have a great economic impact due to the early withdrawal of the animals from athletic activities. There are several causes that lead to joint injuries and it is necessary to know the pathophysiological mechanism, to early diagnosis and treatment. The present case reports an athlete mare with osteoarthritis caused by excessive biomechanical demand in the tibio tarsic joint. It was treated with consecutive infiltrations of conditioned autologous serum IRAP (Interleukin-1 Receptor Antagonist Protein). The response was positive with evident improvement of the clinical picture. The therapy, although more studies are needed, already presents promising results in the treatment of equine arthropathies.(au)

Effects of immobilization and remobilization on the ankle joint in Wistar rats

A sprained ankle is a common musculoskeletal sports injury and it is often treated by immobilization of the joint. Despite the beneficial effects of this therapeutic measure, the high prevalence of residual symptoms affects the quality of life, and remobilization of the joint can reverse this situation. The aim of this study was to analyze the effects of immobilization and remobilization on the ankle joint of Wistar rats. Eighteen male rats had their right hindlimb immobilized for 15 days, and were divided into the following groups: G1, immobilized; G2, remobilized freely for 14 days; and G3, remobilized by swimming and jumping in water for 14 days, performed on alternate days, with progression of time and a series of exercises. The contralateral limb was the control. After the experimental period, the ankle joints were processed for microscopic analysis. Histomorphometry did not show any significant differences between the control and immobilized/remobilized groups and members, in terms of number of chondrocytes and thickness of the articular cartilage of the tibia and talus. Morphological analysis of animals from G1 showed significant degenerative lesions in the talus, such as exposure of the subchondral bone, flocculation, and cracks between the anterior and mid-regions of the articular cartilage and the synovial membrane. Remobilization by therapeutic exercise in water led to recovery in the articular cartilage and synovial membrane of the ankle joint when compared with free remobilization, and it was shown to be an effective therapeutic measure in the recovery of the ankle joint.

Effects of immobilization and remobilization on the ankle joint in Wistar rats.

A sprained ankle is a common musculoskeletal sports injury and it is often treated by immobilization of the joint. Despite the beneficial effects of this therapeutic measure, the high prevalence of residual symptoms affects the quality of life, and remobilization of the joint can reverse this situation. The aim of this study was to analyze the effects of immobilization and remobilization on the ankle joint of Wistar rats. Eighteen male rats had their right hindlimb immobilized for 15 days, and were divided into the following groups: G1, immobilized; G2, remobilized freely for 14 days; and G3, remobilized by swimming and jumping in water for 14 days, performed on alternate days, with progression of time and a series of exercises. The contralateral limb was the control. After the experimental period, the ankle joints were processed for microscopic analysis. Histomorphometry did not show any significant differences between the control and immobilized/remobilized groups and members, in terms of number of chondrocytes and thickness of the articular cartilage of the tibia and talus. Morphological analysis of animals from G1 showed significant degenerative lesions in the talus, such as exposure of the subchondral bone, flocculation, and cracks between the anterior and mid-regions of the articular cartilage and the synovial membrane. Remobilization by therapeutic exercise in water led to recovery in the articular cartilage and synovial membrane of the ankle joint when compared with free remobilization, and it was shown to be an effective therapeutic measure in the recovery of the ankle joint.

Development of osteochondrosis in Lusitano foals: a radiographic study.

This study aimed to detect, by radiographic examination, the evolution of osteochondral lesions in the tarsocrural and femoropatellar joints of Lusitano foals. Within 1 month of age, 76.08% of foals had radiographic signs of osteochondrosis, but only 16.20% had lesions at 18 months. The radiographic signs resolved by 5 mo of age in most foals, but some cases that involved either joint, were not resolved until 12 mo of age. It is thought that the "age of no return" is 5 mo for the tarsocrural and 8 mo for the femoropatellar joint but this study demonstrated regression of osteochondral lesions in both joints of Lusitano foals up to 12 months of age.

Développement de l'ostéochondrose chez les poulains Lusitaniens : une étude radiographique. Cette étude visait à détecter, par examen radiographique, l'évolution des lésions ostéochondrales dans les articulations tarso-crurale et fémoro-patellaire des poulains Lusitaniens. À l'âge de 1 mois, 76,08 % des poulains présentaient des signes radiographiques d'ostéochondrose, mais seulement 16,20 % avaient des lésions à l'âge de 18 mois. Les signes radiographiques se résorbaient à l'âge de 5 mois chez la plupart des poulains, mais, dans certains cas qui touchaient l'une ou l'autre des articulations, ils n'étaient pas résolus jusqu'à l'âge de 12 mois. On croit que l'«âge de non-retour¼ est de 5 mois pour l'articulation tarso-crurale et de 8 mois pour l'articulation fémoro-patellaire, mais cette étude a démontré la régression des lésions ostéochondrales chez les poulains Lusitaniens jusqu'à l'âge de 12 mois.(Traduit par Isabelle Vallières).

Joint inflammation alters gene and protein expression and leads to atrophy in the tibialis anterior muscle in rats.

OBJECTIVE: The aim of this study was to evaluate the effect of tibiotarsal joint inflammation in rat tibialis anterior muscle through muscle fiber cross-sectional area (CSA) and gene expression (atrogin-1, muscle ring finger-1 [MuRF1], myogenic differentiation-1 [MyoD], p38 mitogen-activated protein kinase [p38MAPK], nuclear factor kappa B-dependent [NFκB], tumor necrosis factor-alpha [TNF-α]). DESIGN: Wistar rats were randomly divided into three periods (2, 7, and 15 days) and assigned into four groups within each experimental period: control, sham, inflammation, and immobilization. Real-time polymerase chain reaction, Western blot, immunofluorescence, and muscle fiber CSA analyses were performed. RESULTS: At 2 days, the inflammation group increased atrogin-1, MuRF1, and myostatin and reduced MyoD expression. At 7 days, the inflammation group increased atrogin-1, MuRF1, NFκB, p38MAPK, MyoD, myostatin, and TNF-α expression and TNF-α protein and reduced muscle fiber CSA. At 15 days, gene and protein expression in the inflammation group returned to basal levels, and CSA values were similar to those in control and sham groups. The immobilization groups have a similar pattern in all experimental periods, with increased atrogin-1, MuRF1, NFκB, and TNF-α gene expression and reduced muscle fiber CSA. The sham group had increased myostatin and atrogin-1 expression at 2 days and increased MyoD and myostatin expression at 7 days. CONCLUSIONS: Joint inflammation stimulated the expression of muscle factors related to atrophy, growth, differentiation, and mass regulation followed by muscle atrophy.

Relação entre a mobilidade da articulação talocrural e a úlcera venosa / Relationship between talocrural joint mobility and venous ulcer

CONTEXTO: O presente estudo avalia a mobilidade da articulação talocrural nos seis estágios clínicos da classificação CEAP (clínica, etiológica, anatômica e patofisiológica do International Consensus Committee Reporting Standards on Venous Disease) para doença venosa utilizando a goniometria, e detecta redução da mobilidade articular nos estágios mais avançados da doença, C5 e C6 (úlcera cicatrizada ou ativa). OBJETIVO: Investigar a existência de uma relação entre a severidade clínica da doença venosa crônica dos membros inferiores e a diminuição do grau de mobilidade da articulação talocrural. MÉTODO: Selecionaram-se aleatoriamente 120 membros pertencentes a 88 pacientes brancas, que foram separados com base em sua apresentação clínica de acordo com a categoria C da classificação CEAP, sendo distribuídos em 6 grupos pertencentes às categorias de C0-C1 (grupo controle) até C6, com 20 membros cada um e médias de idade próximas para cada grupo. O grau de mobilidade do tornozelo foi acessado por goniometria de apoio plantar em posição de decúbito supino. RESULTADOS: Os grupos C de CEAP apresentam diferença significativa em relação ao grau de mobilidade da articulação talocrural medida por goniometria (p < 0,001). C6 difere significativamente dos demais grupos (p < 0,05); C5 difere significativamente de C6, C3, C2 e C0-C1 (p < 0,05), mas não apresenta diferença significativa do grupo C4; C4 difere significativamente do grupo C6 (p < 0,05) e não difere dos demais grupos; C0-C1, C2 e C3 não apresentam diferença significativa entre si e em relação a C4, e diferem dos grupos C5 e C6 (p < 0,05). O nível de significância utilizado para os testes foi de 5 por cento. CONCLUSÃO: Existe relação entre a severidade clínica da insuficiência venosa crônica dos membros inferiores e a diminuição do grau de mobilidade da articulação talocrural, e ela se faz mais evidente na presença de úlcera venosa ativa ou cicatrizada.

BACKGROUND: This study assesses talocrural joint mobility considering the six stages of CEAP classification (clinical, etiologic, anatomic and pathophysiologic by the International Consensus Committee reporting standards on venous disease) for venous disease using goniometry, and detects reduction in joint mobility in more advanced stages of the disease, C5 and C6 (healed or active ulcer). OBJECTIVE: Investigate the existence of a relationship between clinical severity of chronic venous disease of the lower limbs and reduction in talocrural joint mobility. METHODS: A total of 120 limbs from 88 Caucasian patients were randomly selected. They were divided based on clinical presentation according to the C clinical category of CEAP, being distributed into six groups belonging to categories from C0-C1 (control group) to C6, with 20 limbs each and similar mean age for each group. Range of ankle mobility was assessed by goniometry in the supine position. RESULTS: C groups on the CEAP classification showed significant difference in relation to talocrural joint mobility measured by goniometry (p < 0.001). C6 was significantly different from the other groups (p < 0.05); C5 was significantly different from C6, C3, C2 and C0-C1 (p < 0.05), but with no significant difference from C4; C4 was significantly different from C6 (p < 0.05) and not different from the other groups; C0-C1, C2 and C3 were not significantly different between themselves and in relation to C4, but were different from C5 and C6 (p < 0.05). Significance level used for tests was 5 percent. CONCLUSION: There is a relationship between clinical severity of chronic venous insufficiency of the lower limbs and reduction in talocrural joint mobility, which is more evident in the presence of active or healed venous ulcer.

Hypernociception elicited by tibio-tarsal joint flexion in mice: a novel experimental arthritis model for pharmacological screening.

Mice have been used as animal model to study mechanisms underlying inflammatory and immune diseases. The present study describes a model of joint inflammation-induced hypernociception to discriminate pharmacological tests in mice. A polypropylene tip probe with a large area (4.15 mm2) applied on the plantar surface of the hind paw was used to produce a dorsal flexion of tibio-tarsal joint. Experiments were performed to demonstrate that the probe application did not provoke cutaneous nociception. The decrease in the withdrawal threshold of inflamed joint was used as nociceptive parameter. Administration of zymosan in the tibio-tarsal joint induced a dose and time-dependent hypernociception elicited by articular dorsal flexion movement. Maximal joint hypernociception was detected between 7 and 24 h after zymosan injection, and matched maximal inflammation score as determined by histopathology and neutrophil migration assay. In agreement with the inflammatory hypernociceptive paradigm, flexion-elicited hypernociception induced by zymosan was dose-dependently inhibited by morphine (2-8 mg/kg) and by an effective dose of indomethacin (5 mg/kg). The present study demonstrated that the tibio-tarsal flexion reflex is a behavioral nociceptive model that allows a quantitative evaluation of inflammatory joint hypernociception in mice and its pharmacological modulation.

Anti-inflammatory and analgesic effects of atorvastatin in a rat model of adjuvant-induced arthritis.

Statins exert favorable effects on lipoprotein metabolism but may also possess anti-inflammatory effects. Here, we explored the effects of atorvastatin in a model of adjuvant-induced arthritis in rat. Oral treatment with atorvastatin (1-10 mg/kg) from days 10 to 15 after arthritis induction caused inhibition of the increase in paw volume. Maximal inhibition occurred at a dose of 10 mg/kg. At this dose, atorvastatin markedly ameliorated the histopathological findings of joints obtained from day 16 of arthritic animals. This was mirrored by an effective blockade of neutrophil influx, as assessed by the tissue myeloperoxidase levels. The concentrations of the cytokines interleukin-1beta, interleukin-6 and tumor necrosis factor-alpha and the chemokines CCL5 and CCL2 were significantly decreased in arthritic rats treated with atorvastatin. In contrast, the levels of interleukin-10 were enhanced by the drug treatment. The drug also prevented the hypernociception observed in the inflamed joints. These data clearly illustrate the therapeutic potential of a statin-sensitive pathway in inflammatory arthritis.

Displasia epifisária hemimélica / Hemimelia epiphyseal dysplasia

Os autores apresentam um caso de displasia epifisária hemimélica, acometendo tíbia distal e talo, com seguimento de nove anos. A literatura é revista, sendo analisados os aspectos clínicos radiográficos a anatomopatológicos, bem como seu tratamento