-
Journal of Oral and Maxillofacial... Aug 2020
Topics: Arthrocentesis; Humans; Temporomandibular Joint
PubMed: 32461063
DOI: 10.1016/j.joms.2020.04.029 -
Atlas of the Oral and Maxillofacial... Sep 2022The introduction of temporomandibular joint (TMJ) arthroscopy by Onishi in 1970 (results published in 1975 and 1980) opened a new modality for TMJ treatment. The... (Review)
Review
The introduction of temporomandibular joint (TMJ) arthroscopy by Onishi in 1970 (results published in 1975 and 1980) opened a new modality for TMJ treatment. The efficiency of arthroscopic lavage and lysis led in the 1990s to its simplification: TMJ arthrocentesis. Always associated with load control, physiotherapy, and elimination of any occlusal hazards, arthrocentesis, a simple procedure, entails less expensive and more available tools and is performed under local anesthesia. Although lacking direct visual inspection of the joint structures, it has become quite popular. Arthrocentesis is most efficient in localized joint pain and limited joint movements such as closed lock, anchored disc phenomenon, osteoarthritis, and various inflammatory diseases. In clicking joint, the results are somewhat controversial. The efficiency of arthrocentesis elicited many enquiries that led to the study and a better understanding of joint function and dysfunction and the actual role of disc location. The release of closed lock without disc repositioning was quite surprising; it improved our understanding of the pathogenesis of closed lock and led to the discovery of the anchored disc phenomenon. This was followed by the awareness of the joint-lubrication system and, in turn, alternative suggestions for the pathogenesis of TMJ disc displacement with and without reduction, open lock, and osteoarthritis, and ultimately by the development of an effective bio-lubricant. Awareness of the role of joint overloading led to the development of an interocclusal appliance that reduces intraarticular pressure; it has become a "must" support for arthrocentesis and any surgical intervention. In our view, arthrocentesis is the definitive indication of the need for surgical intervention and, therefore, should be the first in the cascade of interventions in TMJ disorders.
Topics: Arthroscopy; Humans; Lubricants; Osteoarthritis; Temporomandibular Joint; Temporomandibular Joint Disorders
PubMed: 36116872
DOI: 10.1016/j.cxom.2022.06.008 -
The Kaohsiung Journal of Medical... Apr 2018Temporomandibular joint (TMJ) is one of the most complex joints of the human body. Due to its unique movement, in terms of combination of rotation and translator... (Review)
Review
Temporomandibular joint (TMJ) is one of the most complex joints of the human body. Due to its unique movement, in terms of combination of rotation and translator movement, disc of the joint plays an important role to maintain its normal function. In order to sustain the normal function of the TMJ, disc must be kept in proper position as well as maintain normal shape in all circumstances. Once the disc is not any more in its normal position during function of the joint, disturbance of the joint can be occurred which will lead to subsequent distortion of the disc. Shape of the disc can be influenced by many factors i.e.: abnormal function or composition of the disc itself. Etiology of the internal derangement of the disc remains controversial. Multifactorial theory has been postulated in most of previous manuscripts. Disc is composed of mainly extracellular matrix. Abnormal proportion of collagen type I & III may also leads to joint hypermobility which may be also a predisposing factor of this disorder. Thus it can be recognized as local manifestation of a systemic disorder. Different treatment modalities with from conservative treatment to surgical intervention distinct success rate have been reported. Recently treatment with extracellular matrix injection becomes more and more popular to strengthen the joint itself. Since multifactorial in character, the best solution of the treatment modalities should be aimed to resolve possible etiology from different aspects. Team work may be indication to reach satisfied results.
Topics: Arthrocentesis; Arthroscopy; Collagen Type I; Collagen Type III; Extracellular Matrix; Humans; Hyaluronic Acid; Orthopedic Equipment; Physical Therapy Modalities; Synovial Fluid; Temporomandibular Joint; Temporomandibular Joint Disorders
PubMed: 29655411
DOI: 10.1016/j.kjms.2018.01.004 -
Revista Espanola de Patologia :... 2020Synovial fluid samples represent only a very small percentage of routine work in a cytology laboratory. However, its microscopic examination allows us to observe... (Review)
Review
Synovial fluid samples represent only a very small percentage of routine work in a cytology laboratory. However, its microscopic examination allows us to observe different types of cells, particles and structures that, due to their morphological characteristics, may provide relevant data for cytodiagnosis. We present certain aspects related to arthrocentesis, the relationship between the gross appearance of synovial fluid and certain pathological processes, as well as the different techniques for processing and staining the smears. Furthermore, we describe the main cytological findings in various pathological conditions of the synovial joints, such as infections (bacterial and fungal), non-infectious inflammatory type (osteoarthrosis, rheumatoid arthritis, connective tissue diseases) and tumoral, distinguishing between primary and metastatic, both solid and haematological neoplasms.
Topics: Arthrocentesis; Bacterial Infections; Crystallography; Cytodiagnosis; Humans; Joint Diseases; Mycoses; Neoplasm Metastasis; Neoplasms; Staining and Labeling; Synovial Fluid; Synovial Membrane
PubMed: 32199591
DOI: 10.1016/j.patol.2019.01.004 -
Dental Clinics of North America Apr 2023Temporomandibular disorders are a group of conditions that interfere with the daily lives of patients. Pain and limited function are primary concerns, and general... (Review)
Review
Temporomandibular disorders are a group of conditions that interfere with the daily lives of patients. Pain and limited function are primary concerns, and general dentists are usually the primary clinicians to be made aware of this issue. Evaluation and diagnosis is the key to determining a management plan. Minimally invasive surgical treatment includes arthrocentesis and arthroscopy, which can reduce inflammatory mediators, thereby reducing pain and increasing joint function. Open joint surgery for internal derangements focuses on instrumentation to remove and reshape the diseased condyle and disc as arthroplasty. Patients with severely limited function are candidates for total joint replacement.
Topics: Humans; Temporomandibular Joint Disorders; Arthrocentesis; Pain; Arthroscopy; Temporomandibular Joint; Treatment Outcome; Range of Motion, Articular; Joint Dislocations
PubMed: 36965936
DOI: 10.1016/j.cden.2022.12.002 -
Best Practice & Research. Clinical... Mar 2023Accessing a joint with a needle (arthrocentesis) to extract synovial fluid is a skill intrinsic to the rheumatologist's praxis. Joint aspirations are essential for... (Review)
Review
Accessing a joint with a needle (arthrocentesis) to extract synovial fluid is a skill intrinsic to the rheumatologist's praxis. Joint aspirations are essential for diagnosing or excluding septic joints, are the gold standard for diagnosing acute crystal arthritis, and can provide valuable information about the nature of other forms of arthritis. In appropriate settings, injecting medications into joints can provide rapid, temporary, or even prolonged relief of pain and swelling and can provide a window of relief until other treatment modalities (anti-inflammatories, immunomodulators, and physical therapy) can enforce durable responses. Soft tissue aspirations (e.g., of bursae) and soft tissue injections (of bursae, tendons, trigger points, and areas of nerve compression) can provide similar relief, earning the practitioner the gratitude of the patient. Here, we provide a primary on joint and soft tissue aspiration and injection, including indications for and against procedures, preparing for procedures, and approaches to specific musculoskeletal structures.
Topics: Humans; Arthrocentesis; Arthritis; Synovial Fluid
PubMed: 37507281
DOI: 10.1016/j.berh.2023.101853 -
The Medical Clinics of North America May 2017Monoarticular arthritis is inflammation characterized by joint pain, swelling, and sometimes periarticular erythema. Although chronic causes are seen, the onset is often... (Review)
Review
Monoarticular arthritis is inflammation characterized by joint pain, swelling, and sometimes periarticular erythema. Although chronic causes are seen, the onset is often acute. An infected joint can quickly lead to permanent damage, making it a medical emergency. However, acute gout presenting as monoarticular arthritis is often so uncomfortable it requires urgent attention. Monoarticular crystalline arthritis is common and a septic joint is a medical emergency so it is no surprise that these diagnoses come to mind with complaint of inflammation in 1 joint. However, there are many causes of monoarticular arthritis that clinicians must consider.
Topics: Adrenal Cortex Hormones; Arthritis; Arthritis, Infectious; Arthrocentesis; Chondrocalcinosis; Diagnosis, Differential; Gout; Injections, Intra-Articular; Synovitis; Uricosuric Agents; Xanthine Oxidase
PubMed: 28372716
DOI: 10.1016/j.mcna.2016.12.004