-
Sports Biomechanics Dec 2019Ballerinas use their ankle joints more extremely and sustain injuries on the ankle joint more frequently than non-dancers. Therefore, the ankle movement of dancers is... (Comparative Study)
Comparative Study
Ballerinas use their ankle joints more extremely and sustain injuries on the ankle joint more frequently than non-dancers. Therefore, the ankle movement of dancers is important and should be studied to prevent injuries. Measuring ankle joint range of motion (ROM) using radiographs could demonstrate the contribution to motion of each joint. The aim of this study was to analyse and compare ankle joint movements and the ratio of each joint's contribution during movement between dancers and non-dancers, using radiographic images. Dancers have lower dorsiflexion (26.7 ± 6.2°), higher plantarflexion (74.3 ± 7.1°) and higher total (101.1 ± 10.8°) ROMs than non-dancers (33.9 ± 7.0°, 57.2 ± 6.8° and 91.1 ± 9.3°, respectively) ( < 0.05). Although the ROMs were different between the two groups, the ratios of each joint movement were similar between these two groups, in all movements. Regarding total movement, the movement ratio of the talocrural joint was almost 70% and other joints accounted for almost 30% of the movement role in both dancers and non-dancers. Therefore, the differences in ROM between dancers and non-dancers were not a result of a specific joint movement but of all the relevant joints' collaborative movement.
Topics: Ankle Joint; Biomechanical Phenomena; Dancing; Female; Foot; Humans; Metatarsal Bones; Movement; Radiographic Image Interpretation, Computer-Assisted; Radiography; Range of Motion, Articular; Tarsal Bones; Young Adult
PubMed: 29768088
DOI: 10.1080/14763141.2018.1452967 -
Clinical and Experimental Rheumatology 2015In recent years the argument that enthesitis is the primary lesion in many or most patients with psoriatic arthritis and spondyloarthritis has gained further credence... (Review)
Review
In recent years the argument that enthesitis is the primary lesion in many or most patients with psoriatic arthritis and spondyloarthritis has gained further credence from animal models including IL23/IL17 axis and TNF dependent models. The role of joint biomechanics at entheses and other sites of high physical stressing as a unifying underlying basis has also been strongly supported by animal models. Mirroring the animal model data, it has been empirically shown that therapies that work for entheseal-related inflammation in man including IL23/17 axis or TNF cytokine antagonism are effective for entheseal pathology. The biological basis for the effectiveness of other therapies including PDE4 inhibitors on enthesitis is poorly understood due to the relative difficultly in procurement of entheseal tissue. This absence of a histological gold standard renders it difficult to decipher how effective various therapies are in treatment of enthesitis. Despite advances in understanding enthesitis in animal models, there is a dearth of data thus far on the immunology of human entheses that likely will be key to further refinements in therapy development.
Topics: Animals; Anti-Inflammatory Agents; Arthritis, Psoriatic; Biomechanical Phenomena; Disease Models, Animal; Humans; Inflammation Mediators; Joints; Predictive Value of Tests; Signal Transduction; Stress, Mechanical; Treatment Outcome
PubMed: 26472070
DOI: No ID Found -
Der Radiologe Mar 2020Magnetic resonance (MR) arthrography is a sensitive examination technique. In this institute the majority of MR arthrography examinations are carried out on the... (Review)
Review
Magnetic resonance (MR) arthrography is a sensitive examination technique. In this institute the majority of MR arthrography examinations are carried out on the shoulder (57 %), followed by hand (24 %) and hip joints (16 %). The use of MR arthrography is superior to native MR imaging (MRI) particularly for detection of partial thickness tendon tears of the shoulder joint. Nevertheless, this technique is invasive, time-consuming and may be uncomfortable for patients. This article summarizes the indications, risks and contraindications of MR arthrography, highlights the puncture technique and illustrates possible pitfalls.
Topics: Arthrography; Humans; Joints; Magnetic Resonance Imaging; Shoulder Joint
PubMed: 32067106
DOI: 10.1007/s00117-020-00648-8 -
Matrix Biology : Journal of the... Oct 2014Limb synovial joints are intricate structures composed of articular cartilage, synovial membranes, ligaments and an articular capsule. Together, these tissues give each... (Review)
Review
Limb synovial joints are intricate structures composed of articular cartilage, synovial membranes, ligaments and an articular capsule. Together, these tissues give each joint its unique shape, organization and biomechanical function. Articular cartilage itself is rather complex and organized in distinct zones, including the superficial zone that produces lubricants and contains stem/progenitor cells. For many years there has been great interest in deciphering the mechanisms by which the joints form and come to acquire such unique structural features and diversity. Decades ago, classic embryologists discovered that the first overt sign of joint formation at each prescribed limb site was the appearance of a dense and compact population of mesenchymal cells collectively called the interzone. Work carried out since then by several groups has provided evidence that the interzone cells actively participate in joint tissue formation over developmental time. This minireview provides a succinct but comprehensive description of the many important recent advances in this field of research. These include studies using various conditional reporter mice to genetically trace and track the origin, fate and possible function of joint progenitor cells; studies on the involvement and roles in signaling pathways and transcription factors in joint cell determination and functioning; and studies using advanced methods of gene expression analyses to uncover novel genetic determinants of joint formation and diversity. The overall advances are impressive, and the findings are not only of obvious interest and importance but also have major implications in the conception of future translational medicine tools to repair and regenerate defective, overused or aging joints.
Topics: Animals; Cartilage, Articular; Cell Differentiation; Chondrogenesis; Embryonic Stem Cells; Humans; Joint Capsule; Joints; Morphogenesis
PubMed: 25172830
DOI: 10.1016/j.matbio.2014.08.006 -
Critical Reviews in Biomedical... 2020Noncontact lower extremity injuries are commonly related to jumping and landing activities. This review presents an overview of relevant biomechanical variables that can... (Review)
Review
Noncontact lower extremity injuries are commonly related to jumping and landing activities. This review presents an overview of relevant biomechanical variables that can be modified in training to improve jumping performance, landing mechanics, and consequently, reduce injury risks. Relevant studies from the last 2 decades in the Compendex, Pubmed, and Scopus databases were considered for this review. Studies related to jumping and landing kinetics, kinematics, injuries, performance, and/or simulation were included. The use of experimental methods as the drop jump landing and jumping countermovement are widely used to measure biomechanical variables. At the same time, there has been a continuous development of simulation models that could present results without the need for testing on human subjects, with the final objective of exploring the limits of an athlete's performance without increasing the risk of any injury. The most common injuries occur in the knee and ankle ligaments and are directly related to joint angles and moments (i.e., torque or joint loading) at the hip, ankle, and knee joints. Jumping and landing biomechanics are considerably different between male and female subjects for different experimental methods and in both cases, these kinematics factors can be improved over shorter- or longer-time training to develop a better landing strategy.
Topics: Ankle; Ankle Joint; Biomechanical Phenomena; Female; Hip Joint; Humans; Knee Joint; Male; Movement
PubMed: 33463958
DOI: 10.1615/CritRevBiomedEng.2020034795 -
Rheumatology (Oxford, England) Apr 2020Increased in-depth joint temperature measured by the rapid, easy-to-perform microwave radiometry (MWR) method may reflect inflammation, even in the absence of clinical...
OBJECTIVES
Increased in-depth joint temperature measured by the rapid, easy-to-perform microwave radiometry (MWR) method may reflect inflammation, even in the absence of clinical signs. We hypothesized that MWR is useful for RA and spondyloarthritis patients' assessment.
METHODS
Clinical examination, joint ultrasound and/or MRI and MWR were performed in two independent patient-control cohorts (n = 243).
RESULTS
Among single RA joints MWR performed best in the knee using ultrasound as reference, with 75% sensitivity-73% specificity for grey-scale synovitis score ⩾2, and 80% sensitivity-82% specificity for power Doppler positivity. A stronger agreement was evident between increased knee relative temperature (Δt) and power Doppler positivity (82%) than with clinical examination (76%). In a different patient cohort with painful knees, a knee Δt ⩽0.2 predicted power Doppler positivity with 100% positive and negative predictive values. A thermo-score summing 10 Δt values of three large and seven small RA joints (elbow, knee, ankle, wrist, four hand and two foot joints of the clinically dominant arm or hand and leg or foot) correlated with ultrasound scores of synovitis/tenosynovitis (all P < 0.001) and the 28-joint Disease Activity Score (DAS28) (P = 0.004). The agreement of the thermo-score with ultrasound-defined joint inflammation (82%) was stronger than with DAS28 (64%). The thermo-score improved significantly after 90 days of treatment in patients with active RA at baseline (P = 0.004). Using MRI as reference, Δt of sacroiliac joints could discriminate between spondyloarthritis patients with or without sacroiliitis with 78% sensitivity-74% specificity.
CONCLUSION
In-depth increased MWR-derived joint temperature reflects both subclinical and clinically overt inflammation and may serve as a biomarker in arthritis.
Topics: Adult; Aged; Ankle Joint; Arthritis, Rheumatoid; Case-Control Studies; Elbow Joint; Female; Foot Joints; Hand Joints; Humans; Joints; Knee Joint; Magnetic Resonance Imaging; Male; Microwave Imaging; Middle Aged; Radiometry; Sensitivity and Specificity; Spondylarthropathies; Synovitis; Ultrasonography; Wrist Joint
PubMed: 31504966
DOI: 10.1093/rheumatology/kez373 -
Biomedical Engineering Online Aug 2017Quantitative gait analysis can provide a description of joint kinematics and dynamics, and it is recognized as a clinically useful tool for functional assessment,... (Review)
Review
Quantitative gait analysis can provide a description of joint kinematics and dynamics, and it is recognized as a clinically useful tool for functional assessment, diagnosis and intervention planning. Clinically interpretable parameters are estimated from quantitative measures (i.e. ground reaction forces, skin marker trajectories, etc.) through biomechanical modelling. In particular, the estimation of joint moments during motion is grounded on several modelling assumptions: (1) body segmental and joint kinematics is derived from the trajectories of markers and by modelling the human body as a kinematic chain; (2) joint resultant (net) loads are, usually, derived from force plate measurements through a model of segmental dynamics. Therefore, both measurement errors and modelling assumptions can affect the results, to an extent that also depends on the characteristics of the motor task analysed (i.e. gait speed). Errors affecting the trajectories of joint centres, the orientation of joint functional axes, the joint angular velocities, the accuracy of inertial parameters and force measurements (concurring to the definition of the dynamic model), can weigh differently in the estimation of clinically interpretable joint moments. Numerous studies addressed all these methodological aspects separately, but a critical analysis of how these aspects may affect the clinical interpretation of joint dynamics is still missing. This article aims at filling this gap through a systematic review of the literature, conducted on Web of Science, Scopus and PubMed. The final objective is hence to provide clear take-home messages to guide laboratories in the estimation of joint moments for the clinical practice.
Topics: Biomechanical Phenomena; Gait; Humans; Joints; Mechanical Phenomena
PubMed: 28821242
DOI: 10.1186/s12938-017-0396-x -
Orthopaedics & Traumatology, Surgery &... Oct 2016Posttraumatic carpal and carpometacarpal dislocations represent a heterogeneous group of disorders resulting from high-energy wrist trauma. Perilunate injury is the most...
Posttraumatic carpal and carpometacarpal dislocations represent a heterogeneous group of disorders resulting from high-energy wrist trauma. Perilunate injury is the most common and best-known manifestation of carpal dislocation, typically occurring after hyperextension trauma. Other forms are very rare and have different causative mechanisms. Carpometacarpal (CMC) dislocations are also uncommon and may affect isolated or multiple CMC joints. These lesions are prone to wrist instability if not treated promptly. The aim of this article is to provide a systematic radiologic approach to the evaluation of wrist injury and to present two acute cases of rare CMC dislocations.
Topics: Accidents, Traffic; Adult; Bone Nails; Carpometacarpal Joints; Female; Humans; Joint Dislocations; Male; Metacarpophalangeal Joint; Middle Aged
PubMed: 27210506
DOI: 10.1016/j.otsr.2016.04.003 -
Nature Reviews. Rheumatology May 2024In rheumatoid arthritis, juvenile idiopathic arthritis and other forms of inflammatory arthritis, the immune system targets certain joints but not others. The pattern of... (Review)
Review
In rheumatoid arthritis, juvenile idiopathic arthritis and other forms of inflammatory arthritis, the immune system targets certain joints but not others. The pattern of joints affected varies by disease and by individual, with flares most commonly involving joints that were previously inflamed. This phenomenon, termed joint-specific memory, is difficult to explain by systemic immunity alone. Mechanisms of joint-specific memory include the involvement of synovial resident memory T cells that remain in the joint during remission and initiate localized disease recurrence. In addition, arthritis-induced durable changes in synovial fibroblasts and macrophages can amplify inflammation in a site-specific manner. Together with ongoing systemic processes that promote extension of arthritis to new joints, these local factors set the stage for a stepwise progression in disease severity, a paradigm for arthritis chronicity that we term the joint accumulation model. Although durable drug-free remission through early treatment remains elusive for most forms of arthritis, the joint accumulation paradigm defines new therapeutic targets, emphasizes the importance of sustained treatment to prevent disease extension to new joints, and identifies a rolling window of opportunity for altering the natural history of arthritis that extends well beyond the initiation phase of disease.
Topics: Humans; Memory T Cells; Arthritis, Rheumatoid; Joints; Immunologic Memory; Disease Progression; Animals; Synovial Membrane; Arthritis
PubMed: 38600215
DOI: 10.1038/s41584-024-01107-7 -
Hand (New York, N.Y.) Jul 2022Small joint reconstruction of the hand poses a significant challenge, especially in children where both functional motion and preservation of the epiphysis are desired....
BACKGROUND
Small joint reconstruction of the hand poses a significant challenge, especially in children where both functional motion and preservation of the epiphysis are desired. Auto-transplantation of whole joints is the only way to reconstruct a functional joint that maintains growth potential. Historically, nonvascularized toe-to-finger joint transfer has been criticized for high rates of avascular necrosis and joint dissolution, while vascularized transfers seemingly resulted in increased durability of the joint space and epiphysis. However, certain populations remain poor candidates for microvascular reconstruction, such as those with congenital deformities or sequelae from trauma or infection. In our case series, we demonstrate that a simplified nonvascularized surgical technique and careful patient selection can produce stable, functional joints.
METHODS
Nonvascularized toe-to-finger joint transfer was performed in 3 children between the ages of 4 and 6. Reconstructed joints included 2 proximal interphalangeal (PIP) joints and 1 metacarpophalangeal (MCP) joint. Donor grafts consisted of second toe PIP joints harvested en bloc to include the epiphysis of the middle phalanx, collateral ligaments, volar plate, and a diamond-shaped island of extensor tendon with its central slip attachment.
RESULTS
Follow-up ranged from 7 to 29 months. Each patient demonstrated functional improvements in joint motion and stability. Postoperative radiographs confirmed adequate joint alignment and persistence of the joint spaces. Epiphyseal closure was observed in 1 patient as early as 25 months postoperatively.
CONCLUSIONS
Nonvascularized joint transfer should remain a practical consideration for small joint reconstruction of the hand in certain pediatric patients.
Topics: Arthroplasty, Replacement; Child; Child, Preschool; Finger Joint; Hand; Humans; Metacarpophalangeal Joint; Toe Joint
PubMed: 32779490
DOI: 10.1177/1558944720948243