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2.
Zhen Ci Yan Jiu ; 46(3): 194-200, 2021 Mar 25.
Artigo em Chinês | MEDLINE | ID: mdl-33798291

RESUMO

OBJECTIVE: To explore the effect of moxibustion at "Zusanli"(ST36) and "Shenshu"(BL23) on synovitis, and expressions of miR-155, Toll-like receptor 4 (TLR4), myeloid differentiation factor 88 (MyD88), interlukine(IL-1) receptor-associated kinase (IRAK1), tumor necrosis factor receptor-associated factor 6 (TRAF6), nuclear factor κB (NF-κB), IL-1ß, tumor necrosis factor receptor (TNF)-α and IL-6 mRNA and protein of synovial membrane in rheumatoid arthritis (RA) rats, so as to explore its mechanism underlying improvement of RA. METHODS: A total of 48 male Wistar rats were randomly divided into normal control, model, moxibustion and antagonist groups (n=12 rats in each group). The RA model was replicated by placing the rats in a wind, cold and wet environment and injection of Freund's complete adjuvant (CFA, 0.5 mL) into the right hindlimb foot plantar. Moxibustion was applied to bilateral ST36 and BL23 for 30 min, once daily for 21 consecutive days. Rats of the antagonist group was treated by injection of TLR4 antagonist (TAK-242, 1 mg/mL, 0.1 mg/kg) via tail vein, once per day for consecutive 21 d. The joint swelling degree (JSD) and arthritis index (AI, red swelling scale) were determined, and the expression levels of various indicators of miR-155, and TLR4, myeloid MyD88, IRAK1, TRAF6, NF-κB, IL-1ß, TNF-α and IL-6 mRNA and protein were assayed by quantitative real time-PCR and Western blot, separately. RESULTS: Compared with the normal control group, the JSD and AI, and the expression levels of synovial miR-155, TLR4, MyD88, IRAK1, TRAF6, NF-κB, IL-1ß, TNF-α and IL-6 mRNA and protein were significantly increased in the model group (P<0.01). Compared with the model group, the increased levels of JSD and AI, and the expression levels of synovial miR-155, TLR4, MyD88, IRAK1, TRAF6, NF-κB, IL-1ß, TNF-α and IL-6 mRNA and protein were notably down-regulated in both moxibustion and antagonist groups (P<0.01). The effects of moxibustion were evidently superior to the antagonist in down-regulating the abovementioned indexes (P<0.01), except TLR4 mRNA and protein. CONCLUSION: Moxibustion at ST36 and BL23 can reduce the synovitis of RA rats, which is related to its effects in suppressing the expressions of miR-155, TLR4, MyD88, IRAK1, TRAF6, NF-κB, IL-1ß, TNF-α and IL-6 mRNA and protein (i.e., inhibition of miR-155/TLR4/NF-κB signaling).


Assuntos
Artrite Reumatoide , MicroRNAs , Moxibustão , Sinovite , Animais , Artrite Reumatoide/genética , Artrite Reumatoide/terapia , Masculino , MicroRNAs/genética , NF-kappa B/genética , Ratos , Ratos Wistar , Receptor 4 Toll-Like/genética
3.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 43(1): 149-152, 2021 Feb 28.
Artigo em Chinês | MEDLINE | ID: mdl-33663677

RESUMO

Remitting seronegative symmetrical synovitis with pitting edema(RS3PE),the inflammatory arthritis attacking mainly elderly males,is characterized by symmetrical synovitis with pitting edema of the dorsum of hands and feet and the absence of rheumatoid factor.RS3PE commonly accompanies malignant tumor,infections and other diseases.Here we report a case of RS3PE associated with lung malignancy and review other six cases to summarize the clinical features,treatment and prognosis.


Assuntos
Neoplasias Pulmonares , Sinovite , Idoso , Edema/etiologia , Humanos , Neoplasias Pulmonares/complicações , Masculino , Síndrome , Sinovite/complicações , Sinovite/tratamento farmacológico
4.
Radiologe ; 61(4): 351-361, 2021 Apr.
Artigo em Alemão | MEDLINE | ID: mdl-33728481

RESUMO

BACKGROUND: All rheumatic autoimmune diseases are associated with arthritis of the hands, whereby it is possible to differentiate between typical and atypical arthritis patterns, which are key for diagnosis. Rheumatoid arthritis is commonly associated with synovitis of the hands. While patients with disease duration of less than 2 years were previously considered to have early disease, unfavorable prognosis with delayed initiation of therapy has reduced this time frame to 3 months after symptom onset. OBJECTIVE: The aim is to provide radiologists with a systematic description of the clinical aspects of rheumatoid arthritis in order to better understand this entity so that they can confidently recognize arthritis patterns in the hands at an early stage. MATERIALS AND METHODS: Narrative review based on the current literature on the subject from radiological and rheumatological point of view. RESULTS: Synovitis of the hands is a common manifestation in rheumatoid arthritis. Knowledge of the epidemiology, prevalence, incidence, pathogenesis, genetics, etiology, biology and immunology, serology, histology, clinical presentation, the classification and diagnostic criteria, and therapy is essential for the radiologist to better understand the image-based morphologic changes associated with this complex disease and thereby gain greater confidence in the diagnosis of early stages. CONCLUSIONS: For the diagnosis of rheumatoid arthritis, the radiologist must be familiar with basic clinical knowledge to confidently analyze the patterns present in arthritis of the hands at initial diagnosis and during the course of the disease, which are essential for therapy decisions.


Assuntos
Artrite Reumatoide , Sinovite , Artrite Reumatoide/diagnóstico por imagem , Mãos/diagnóstico por imagem , Humanos , Prognóstico , Radiografia , Sinovite/diagnóstico por imagem
5.
Radiologe ; 61(4): 362-374, 2021 Apr.
Artigo em Alemão | MEDLINE | ID: mdl-33728480

RESUMO

BACKGROUND: Rheumatoid arthritis can cause joint destruction, especially joints of the hands. Diagnosed at an early stage, which often includes imaging methods, can minimize structural joint damage and resulting disabilities as well as avoid systemic manifestations such as cardiovascular damage through rapid and continuous so-called targeted treatment approaches. OBJECTIVE: The aim of this work is the systematic description and report of imaging findings in rheumatoid arthritis as the most common autoimmunologic rheumatologic disease, which is characterized by a typical pattern of synovitis of the hands. MATERIALS AND METHODS: Narrative review based on the current literature on the subject from the radiological and rheumatological point of view. RESULTS: Inflammation of the hands represents the most frequently affected area of the body in rheumatoid arthritis. Taking into consideration the topology and typical synovitis patterns of the hands, differences between early and late stages are described. Knowledge regarding image-based morphological changes associated with this complex disease, especially in the hands, is important in the differential diagnosis, especially in early stages of the disease. CONCLUSIONS: For the diagnosis of rheumatoid arthritis of the hands, the radiologist must be familiar with basic knowledge of arthritis in the hands to confidently analyze the typical patterns present in the diagnostic imaging at initial diagnosis and during the course of the disease, which serve as a guide for therapy decisions.


Assuntos
Artrite Reumatoide , Sinovite , Artrite Reumatoide/diagnóstico por imagem , Humanos , Inflamação , Imagem por Ressonância Magnética , Radiografia , Sinovite/diagnóstico por imagem
6.
Praxis (Bern 1994) ; 110(2): 77-78, 2021 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-33530785

RESUMO

CME Rheumatology 22/Answers: Rheumatological Cases Abstract. With the help of various cases, frequent and less frequent causes of painful or swollen joints are illustrated. Usually, the medical history and precise clinical examination already leads us in the right diagnostic direction. The further clarifications such as laboratory analyses or imaging procedures are used in a targeted manner, taking into account the clinic.


Assuntos
Doenças Reumáticas , Reumatologia , Sinovite , Edema , Humanos , Exame Físico , Doenças Reumáticas/diagnóstico
7.
Autoimmun Rev ; 20(3): 102758, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33476818

RESUMO

Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease affecting joints and causing progressive damage and disability. Macrophages are of critical importance in the initiation and perpetuation of synovitis in RA, they can function as antigen presenting cells leading to T-cell dependent B-cell activation, assume a variety of inflammatory cell states with the production of destructive cytokines, but also contribute to tissue homeostasis/repair. The recent development of high-throughput technologies, including bulk and single cells RNA-sequencing, has broadened our understanding of synovial cell diversity, and opened novel perspectives to the discovery of new potential therapeutic targets in RA. In this review, we will focus on the relationship between the synovial macrophage infiltration and clinical disease severity and response to treatment. We will then provide a state-of-the-art picture of the biological roles of synovial macrophages and distinct macrophage subsets described in RA. Finally, we will review the effects of approved conventional and biologic drugs on the synovial macrophage component and highlight the therapeutic potential of future strategies to re-program macrophage phenotypes in RA.


Assuntos
Artrite Reumatoide , Sinovite , Humanos , Macrófagos , Membrana Sinovial , Linfócitos T
8.
Praxis (Bern 1994) ; 110(1): 9-15, 2021 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-33406928

RESUMO

CME Rheumatology 22: Rheumatological Cases Abstract. With the help of various cases, frequent and less frequent causes of painful or swollen joints are illustrated. Usually, the medical history and precise clinical examination already leads us in the right diagnostic direction. The further clarifications such as laboratory analyses or imaging procedures are used in a targeted manner, taking into account the clinic.


Assuntos
Doenças Reumáticas , Reumatologia , Sinovite , Edema , Humanos , Exame Físico , Doenças Reumáticas/diagnóstico por imagem
9.
Autoimmun Rev ; 20(2): 102731, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33326852

RESUMO

Axial spondyloarthritis (axSpA), psoriatic arthritis (PsA), psoriasis, inflammatory bowel disease (IBD), and noninfectious uveitis form a distinct group among the immune mediated inflammatory diseases. Thus, many patients suffer from more than one of these disease manifestations. Here, we will use the term spondylitis-psoriasis-enthesitis-enterocolitis-dactylitis-uveitis-peripheral synovitis (SPEED-UP) spectrum disease. The aim is to review the new targeted pharmacological treatment options for all these diseases. All biological or targeted synthetic drugs with U.S. Food and Drug Administration (FDA) or European Medicines Agency (EMA) approval for any of the diagnoses axSpA, PsA, psoriasis, IBD, or non-infectious uveitis were included. Some of the drugs have documented efficacy in more than one of the diseases, e.g. tumor necrosis factor (TNF) inhibitors. However, other drugs are particularly effective for a specific inflamed tissue and approved in only one or two of the disease entities, e.g. abatacept for peripheral arthritis and vedolizumab for inflammatory bowel disease. This contributes with bedside to bench understanding of the immunology underlying this disease spectrum and provides clinicians with an overview that can assist stratified treatment decisions. We hope that this review will help guide clinicians to speed up treatment of patients with this disease spectrum.


Assuntos
Artrite Psoriásica , Enterocolite , Psoríase , Sinovite , Uveíte , Artrite Psoriásica/complicações , Artrite Psoriásica/tratamento farmacológico , Humanos , Sinovite/diagnóstico , Sinovite/tratamento farmacológico , Uveíte/diagnóstico , Uveíte/tratamento farmacológico , Uveíte/etiologia
10.
Clin Nucl Med ; 46(1): 21-24, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33234919

RESUMO

INTRODUCTION: After knee replacement, therapy resistant, persistent synovitis is a common issue, which causes effusion and pain, and leads to loosing. It has been hypothesized that radiosynovectomy (RSO) is useful in these patients. MATERIALS AND METHODS: A cohort of 55 patients with 57 knee replacements and persistent synovitis underwent RSO using 4.9 ± 0.24 mCi (182 ± 9 MBq) of Y-citrate. The number of RSOs ranged from 1 to 4. Bone scans before and 3 months after every RSO were performed. Long-term follow-up ranged from 0.8 to 7.6 years with a mean of 23.2 months. For qualitative analysis, an established 4 steps scoring was used. For quantification, the uptake was determined within the Tc-MDP scintigraphy blood pool phase before and after therapy. RESULTS: Long-term response was in 27% with excellent, 24% good, 30% weak, and 20% no response. The duration of response was 12.0 ± 12.0 months (maximum, 54 months). In patients with repeated treatment, the effect after the first therapy was lesser than in patients who received a single treatment in total. However, 3 months after the last RSO, patients with repeated treatment showed a similar effectiveness than single treated patients. At the end of long-term follow-up, patients with repeated RSOs had a higher effectiveness at similar duration response. In bone scan, 65% of patients showed a reduction of uptake. When comparing subjective and objective response, 78% of patients showed a concordance in both symptoms and scintigraphy. Pilot histological analysis revealed that the synovitis is triggered by small plastic particles. CONCLUSIONS: We concluded that RSO is an effective therapy in patients with knee replacement and persistent synovitis with high long-term response. Repeated treatment leads to a stronger long-time response.


Assuntos
Artroplastia do Joelho/efeitos adversos , Sinovectomia , Sinovite/etiologia , Sinovite/cirurgia , Radioisótopos de Ítrio/uso terapêutico , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sinovite/diagnóstico por imagem , Resultado do Tratamento
11.
BMJ Case Rep ; 13(12)2020 Dec 22.
Artigo em Inglês | MEDLINE | ID: mdl-33370985

RESUMO

Osteochondroma of the talus is a rare entity that can cause pain, swelling, restriction of movements, synovitis and tarsal tunnel syndrome (TTS). We present three such cases with varying presentation. Case 1 presented with synovitis of the ankle along with a bifocal origin of the talar osteochondroma. Case 2 presented with TTS as a result of compression of the posterior tibial nerve. Case 3 presented with deformity of the foot. In all the three cases, the mass was excised en bloc and histologically proven to be osteochondroma. In case 3, the ankle joint was reconstructed with plate, bone graft and arthrodesis of the inferior tibiofibular joint. All the three cases had good clinical outcomes.


Assuntos
Neoplasias Ósseas/diagnóstico , Deformidades Adquiridas do Pé/etiologia , Osteocondroma/diagnóstico , Sinovite/etiologia , Tálus/patologia , Síndrome do Túnel do Tarso/etiologia , Adolescente , Adulto , Articulação do Tornozelo/diagnóstico por imagem , Articulação do Tornozelo/patologia , Articulação do Tornozelo/cirurgia , Artrodese/instrumentação , Neoplasias Ósseas/complicações , Neoplasias Ósseas/patologia , Neoplasias Ósseas/cirurgia , Placas Ósseas , Transplante Ósseo , Criança , Feminino , Deformidades Adquiridas do Pé/cirurgia , Humanos , Masculino , Osteocondroma/complicações , Osteocondroma/patologia , Osteocondroma/cirurgia , Osteotomia , Sinovite/patologia , Sinovite/cirurgia , Tálus/diagnóstico por imagem , Tálus/cirurgia , Síndrome do Túnel do Tarso/cirurgia , Tomografia Computadorizada por Raios X , Resultado do Tratamento
13.
Curr Opin Ophthalmol ; 31(6): 532-537, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33009086

RESUMO

PURPOSE OF REVIEW: This article summarizes the systemic and ocular manifestations of Blau syndrome, its genetic basis, and reviews recently published literature. RECENT FINDINGS: A large multicenter prospective case series is underway, with 3-year preliminary results indicating the prevalence of uveitis, clinical characteristics and early data on its visual prognosis. Case reports have demonstrated the successful use of newer biologic agents. SUMMARY: Blau syndrome is an exceedingly rare autoinflammatory disorder with skin, joint and eye manifestations. It is caused by autosomal dominant mutations of the NOD2 protein. Eye involvement is typically a chronic bilateral granulomatous iridocyclitis, often with multifocal choroiditis in the posterior segment. Treatment starts with topical and systemic steroids and often requires antimetabolites or biologic agents.


Assuntos
Artrite , Sinovite , Uveíte , Artrite/genética , Humanos , Coroidite Multifocal , Mutação , Proteína Adaptadora de Sinalização NOD2/genética , Sarcoidose , Sinovite/genética , Uveíte/genética
14.
Nat Commun ; 11(1): 5406, 2020 10 26.
Artigo em Inglês | MEDLINE | ID: mdl-33106495

RESUMO

Mutations in nucleotide-binding oligomerization domain-containing protein 2 (NOD2) cause Blau syndrome, an inflammatory disorder characterized by uveitis. The antimicrobial functions of Nod2 are well-established, yet the cellular mechanisms by which dysregulated Nod2 causes uveitis remain unknown. Here, we report a non-conventional, T cell-intrinsic function for Nod2 in suppression of Th17 immunity and experimental uveitis. Reconstitution of lymphopenic hosts with Nod2-/- CD4+ T cells or retina-specific autoreactive CD4+ T cells lacking Nod2 reveals a T cell-autonomous, Rip2-independent mechanism for Nod2 in uveitis. In naive animals, Nod2 operates downstream of TCR ligation to suppress activation of memory CD4+ T cells that associate with an autoreactive-like profile involving IL-17 and Ccr7. Interestingly, CD4+ T cells from two Blau syndrome patients show elevated IL-17 and increased CCR7. Our data define Nod2 as a T cell-intrinsic rheostat of Th17 immunity, and open new avenues for T cell-based therapies for Nod2-associated disorders such as Blau syndrome.


Assuntos
Proteína Adaptadora de Sinalização NOD2/imunologia , Células Th17/imunologia , Uveíte/imunologia , Uveíte/prevenção & controle , Animais , Artrite/genética , Artrite/imunologia , Linfócitos T CD4-Positivos/imunologia , Feminino , Humanos , Interleucina-17/genética , Interleucina-17/imunologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Proteína Adaptadora de Sinalização NOD2/genética , Receptores CCR7/genética , Receptores CCR7/imunologia , Sarcoidose , Sinovite/genética , Sinovite/imunologia , Uveíte/genética
15.
Reumatol. clín. (Barc.) ; 16(5,pt.2): 419-422, sept.-oct. 2020. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-199738

RESUMO

A 52-year-old male patient developed RA in March 2009 at the age of 43, with symmetric polyarthritis and active synovitis affecting hands, knees, ankles and both feet without symptoms or signs suggestive of extra-articular features. Laboratory investigations showed negative RF and positive anti-CCP antibodies, negative ANA, negative anti-dsDNA antibodies; the X-rays of both hands showed typical erosive changes in RA and fulfilled the new ACR/EULAR (2010) criteria of RA. The patient achieved remission on a combination of DMARDs. He did well until January 2017 when he developed acute onset of progressive chest pain, dyspnea, and acute respiratory failure. High-resolution CT of the lung showed extensive areas of ground glass veiling, and interstitial subpleural infiltrates were found consistent with aggressive interstitial lung disease (ILD). Autoantibodies against extractable nuclear antigens were screened and showed positive results for anti-RO and anti-Jo1 autoantibodies. The positive anti-Jo1was an expression of anti-synthetase syndrome complicating the RA course and explained the rapidly aggressive course of ILD


Un paciente de 52 años de edad desarrolló artritis reumatoide (AR) en marzo de 2009 a la edad de 43 años, con poliartritis simétrica y sinovitis activa que afecta manos, rodillas, tobillos y ambos pies, sin síntomas o signos sugestivos de características extraarticulares. Las investigaciones de laboratorio mostraron anticuerpos anti-CCP positivos, RF negativo, ANA negativo, anticuerpos anti-dsDNA negativos; los rayos X de ambas manos mostraron cambios erosivos típicos de la AR y cumplieron los nuevos criterios ACR/EULAR (2010) de AR. El paciente logró la remisión con una combinación de DMARD. Le fue bien hasta enero de 2017, cuando desarrolló una aparición aguda de dolor de pecho progresivo y disnea, e insuficiencia respiratoria aguda. La TC de pulmón de alta resolución mostró áreas extensas de velado de vidrio esmerilado y se encontraron infiltrados subpleurales intersticiales consistentes con enfermedad pulmonar intersticial (EPI) agresiva. Los autoanticuerpos contra antígenos nucleares extraíbles se cribaron y mostraron resultados positivos para autoanticuerpos anti-RO y anti-Jo1. El anti-Jo1 positivo fue una expresión del síndrome anti-sintetasa que complica el curso de la AR y explicó el curso rápidamente agresivo de EPI


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Artrite Reumatoide/complicações , Sinovite/complicações , Antirreumáticos/uso terapêutico , Anticorpos Anti-Proteína Citrulinada/isolamento & purificação , Dermatomiosite/diagnóstico , Diagnóstico Diferencial
17.
Medicine (Baltimore) ; 99(37): e22185, 2020 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-32925790

RESUMO

BACKGROUND: To compare superb microvascular imaging with power Doppler imaging for evaluating joint lesion scores in rheumatoid arthritis based on high quality clinical cohort or case control studies. METHODS: We searched Medline (via PubMed), Web of Science, Cochrane Library, Embase, and Chinese Biomedical Literature Database without restrictions of language and publication status. Two investigators will identify relevant trials, extract data, and appraise risk of bias in each eligible trial. Data will be pooled by either a fixed-effects model or a random-effects model according to the results of heterogeneity identification. The primary outcomes include a semi-quantitative scoring system, through which synovial vascularity intensity was evaluated by means of both power Doppler imaging (PDI) and superb microvascular imaging (SMI). This study will only include high quality clinical cohort or case control studies. Statistical analyses were conducted by STATA version 15.1 software. RESULTS: This meta-analysis included 11 studies. A total of 4342 joints were assessed through both SMI and PDI. The pooled summary odds ratio was 2.12 (95% confidence interval = 1.80-2.51) with statistical significance (z = 8.82, P < .01). In subgroup analyses, the results revealed also that SMI exhibited more sensitive performance in different subgroups. We found no evidence for publication bias (t = 0.55, P = .598). CONCLUSION: Our meta-analysis indicates that SMI ultrasound is more sensitive than conventional PDI in detecting synovitis in RA patients. INPLASY REGISTRATION NUMBER: INPLASY202060089.


Assuntos
Artrite Reumatoide/diagnóstico por imagem , Sinovite/diagnóstico por imagem , Ultrassonografia Doppler/métodos , Humanos , Microvasos/diagnóstico por imagem , Membrana Sinovial/irrigação sanguínea , Ultrassonografia/métodos
18.
Rev. patol. respir ; 23(3): 120-l122, jul.-sept. 2020. ilus
Artigo em Espanhol | IBECS | ID: ibc-194924

RESUMO

La dermatomiositis amiopática, o sine miositis, se ha asociado a una muy alta prevalencia de anticuerpos anti-MDA5, unos anticuerpos descritos en 2005. Esta entidad a su vez se encuentra fuertemente asociada al desarrollo de enfermedad pulmonar intersticial rápidamente progresiva de mal pronóstico. Presentamos las imágenes radiológicas pulmonares más frecuentemente descritas de esta enfermedad en un caso en el que se descartó la sospecha inicial de neumonia vírica por SARS-2


Amyopathic dermatomyositis, or syne myositis, has been associated with a very high prevalence of anti-MDA5 antibodies, antibodies described in 2005. This entity, in turn, is strongly associated with the development of rapidly progressive interstitial lung disease with a poor prognosis. We present the most frequently described pulmonary radiological images of this disease in a case in which the initial suspicion of SARS-2 viral pneumonia was ruled out


Assuntos
Humanos , Masculino , Adolescente , Dermatomiosite/complicações , Doenças Pulmonares Intersticiais/diagnóstico por imagem , Infecções por Coronavirus/diagnóstico por imagem , Pneumonia Viral/diagnóstico por imagem , Autoanticorpos/imunologia , Síndrome Respiratória Aguda Grave , Imunossupressores/uso terapêutico , Sinovite/diagnóstico , Broncoscopia , Radiografia Torácica , Tomografia Computadorizada por Raios X , Dermatomiosite/imunologia , Pneumonia Viral/tratamento farmacológico , Infecções por Coronavirus/tratamento farmacológico
19.
Praxis (Bern 1994) ; 109(9): 687-692, 2020 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-32635850

RESUMO

CME-Rheuma 21: Precision Medicine - Synovial Biopsy in Rheumatology Abstract. Synovial biopsy is increasingly performed in the medicine of the musculoskeletal system. On the one hand it allows the in-depth diagnosis of unclear arthritides. On the other hand, there is an increasing body of publications showing that histology, immunohistochemistry and RNA analysis of synovial tissue may lead to subclassifications within rheumatoid arthritis. This in turn may have predictive value for the treatment response. We herein give a short overview of the joint biopsy technique, the basic evaluation of biopsy samples and the prospects of synovial biopsy.


Assuntos
Reumatologia , Sinovite , Biópsia , Humanos , Medicina de Precisão , Membrana Sinovial , Sinovite/diagnóstico
20.
Clin J Sport Med ; 30(4): 341-347, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32639441

RESUMO

OBJECTIVE: To compare hip joint effusion-synovitis prevalence in professional ballet dancers with nondancing athletes and to evaluate the relationship between effusion-synovitis and clinical measures and cartilage defects. DESIGN: Case-control study. SETTING: Elite ballet and sport. PARTICIPANTS: Forty-nine professional ballet dancers and 49 age-matched and sex-matched athletes. INDEPENDENT VARIABLES: Group (dancers/athletes), sex, age, years of training, Copenhagen Hip and Groin Outcome Scores (HAGOSs), hip rotation range of motion (ROM), generalized joint hypermobility (GJH), and hip cartilage defect scores. MAIN OUTCOME MEASURES: Hip joint effusion-synovitis (absent, grade 1 = 2-4 mm, grade 2 = >4 mm) scored with 3-Tesla magnetic resonance imaging. RESULTS: Hip joint effusion-synovitis was found in 22 (45%) dancers and 13 (26.5%) athletes (P = 0.06). Grade 2 effusion-synovitis was only found in dancers (n = 8, r = 0.31, P = 0.009). The prevalence of effusion-synovitis was similar in men (n = 11, 26%) and women (n = 24, 43%, P = 0.09). Female dancers with effusion-synovitis had lower HAGOS pain (r = 0.63, P = 0.001) and sports/recreation scores (r = 0.66, P = 0.001) compared with those without effusion-synovitis. The HAGOS scores were not related to effusion-synovitis in male dancers or female and male athletes (P > 0.01 for all). Effusion-synovitis was not related to hip ROM, GJH, or cartilage defect scores (P > 0.05 for all). CONCLUSIONS: Hip joint effusion-synovitis was related to higher levels of pain and lower sports/recreation function in female ballet dancers. Effusion-synovitis was not related to hip rotation ROM, GJH or cartilage defects. Larger sized joint effusion-synovitis was exclusively found in dancers.


Assuntos
Artralgia/fisiopatologia , Dança/lesões , Articulação do Quadril/fisiopatologia , Sinovite/fisiopatologia , Adulto , Artralgia/diagnóstico por imagem , Artralgia/epidemiologia , Líquidos Corporais/fisiologia , Cartilagem Articular/diagnóstico por imagem , Cartilagem Articular/fisiopatologia , Estudos de Casos e Controles , Feminino , Articulação do Quadril/diagnóstico por imagem , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Prevalência , Amplitude de Movimento Articular , Rotação , Sinovite/diagnóstico por imagem , Sinovite/epidemiologia
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