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European Journal of Immunology Jan 2023Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease characterized by persistent articular inflammation and joint damage. RA was first described over 200... (Review)
Review
Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease characterized by persistent articular inflammation and joint damage. RA was first described over 200 years ago; however, its etiology and pathophysiology remain insufficiently understood. The current treatment of RA is mainly empirical or based on the current understanding of etiology with limited efficacy and/or substantial side effects. Thus, the development of safer and more potent therapeutics, validated and optimized in experimental models, is urgently required. To improve the transition from bench to bedside, researchers must carefully select the appropriate experimental models as well as draw the right conclusions. Here, we summarize the establishment, pathological features, potential mechanisms, advantages, and limitations of the currently available RA models. The aim of the review is to help researchers better understand available RA models; discuss future trends in RA model development, which can help highlight new translational and human-based avenues in RA research.
Topics: Humans; Arthritis, Rheumatoid; Joints; Models, Theoretical
PubMed: 36330559
DOI: 10.1002/eji.202249962 -
Ugeskrift For Laeger May 2022Lipoma arborescens is a rare benign villous proliferation of fatty tissue in joints. It is most often affecting the knee, but it has also been reported in other joints....
Lipoma arborescens is a rare benign villous proliferation of fatty tissue in joints. It is most often affecting the knee, but it has also been reported in other joints. It may result from chronic irritation but can also be a primary condition. It is diagnosed primarily on MRI combined with the clinical presentation. The surgical treatment of choice is arthroscopic synovectomy. This case report presents a 44-year-old woman with longstanding knee pain due to lipoma arborescens. With increased awareness of this disorder, patients can benefit from proper and timely surgery.
Topics: Adipose Tissue; Adult; Female; Humans; Knee Joint; Lipoma; Magnetic Resonance Imaging
PubMed: 35656617
DOI: No ID Found -
Frontiers in Endocrinology 2023Osteoarthritis (OA) is a disabling disease with significant morbidity worldwide. OA attacks the large synovial joint, including the peripheral joints and... (Review)
Review
Osteoarthritis (OA) is a disabling disease with significant morbidity worldwide. OA attacks the large synovial joint, including the peripheral joints and temporomandibular joint (TMJ). As a representative of peripheral joint OA, knee OA shares similar symptoms with TMJ OA. However, these two joints also display differences based on their distinct development, anatomy, and physiology. Extracellular vesicles (EVs) are phospholipid bilayer nanoparticles, including exosomes, microvesicles, and apoptotic bodies. EVs contain proteins, lipids, DNA, micro-RNA, and mRNA that regulate tissue homeostasis and cell-to-cell communication, which play an essential role in the progression and treatment of OA. They are likely to partake in mechanical response, extracellular matrix degradation, and inflammatory regulation during OA. More evidence has shown that synovial fluid and synovium-derived EVs may serve as OA biomarkers. More importantly, mesenchymal stem cell-derived EV shows a therapeutic effect on OA. However, the different function of EVs in these two joints is largely unknown based on their distinct biological characteristic. Here, we reviewed the effects of EVs in OA progression and compared the difference between the knee joint and TMJ, and summarized their potential therapeutic role in the treatment of OA.
Topics: Humans; Osteoarthritis; Temporomandibular Joint; Extracellular Vesicles; Synovial Membrane; Synovial Fluid
PubMed: 36950682
DOI: 10.3389/fendo.2023.1158744 -
Annals of the Rheumatic Diseases Aug 2019The optimal duration of postsurgical antibiotic therapy for adult native joint bacterial arthritis remains unknown. (Comparative Study)
Comparative Study Randomized Controlled Trial
OBJECTIVE
The optimal duration of postsurgical antibiotic therapy for adult native joint bacterial arthritis remains unknown.
METHODS
We conducted a prospective, unblinded, randomised, non-inferiority study comparing either 2 or 4 weeks of antibiotic therapy after surgical drainage of native joint bacterial arthritis in adults. Excluded were implant-related infections, episodes without surgical lavage and episodes with a follow-up of less than 2 months.
RESULTS
We enrolled 154 cases: 77 in the 4-week arm and 77 in the 2-week arm. Median length of intravenous antibiotic treatment was 1 and 2 days, respectively. The median number of surgical lavages was 1 in both arms. Recurrence of infection was noted in three patients (2%): 1 in the 2-week arm (99% cure rate) and 2 in the 4-week arm (97% cure rate). There was no difference in the number of adverse events or sequelae between the study arms. Of the overall 154 arthritis cases, 99 concerned the hand and wrist, for which an additional subgroup analysis was performed. In this per-protocol subanalysis, we noted three recurrences: one in the 2-week arm (97 % cure); two in the 4-week arm (96 % cure) and witnessed sequelae in 50% in the 2-week arm versus 55% in the 4-week arm, of which five (13%) and six (13%) needed further interventions.
CONCLUSIONS
After initial surgical lavage for septic arthritis, 2 weeks of targeted antibiotic therapy is not inferior to 4 weeks regarding cure rate, adverse events or sequelae and leads to a significantly shorter hospital stay, at least for hand and wrist arthritis.
TRIAL REGISTRATION NUMBER
NCT03615781.
Topics: Adult; Anti-Bacterial Agents; Arthritis, Infectious; Databases, Factual; Dose-Response Relationship, Drug; Drainage; Drug Administration Schedule; Female; Hand Joints; Hospitalization; Hospitals, University; Humans; Infusions, Intravenous; Length of Stay; Male; Middle Aged; Prospective Studies; Time Factors; Treatment Outcome; Wrist Joint
PubMed: 30992295
DOI: 10.1136/annrheumdis-2019-215116 -
Ugeskrift For Laeger Oct 2020This review gives a summary of osteoarthritis (OA) of the spine involving the facet and the sacroiliac joints. Facet joint OA is widely prevalent in adults, and is... (Review)
Review
This review gives a summary of osteoarthritis (OA) of the spine involving the facet and the sacroiliac joints. Facet joint OA is widely prevalent in adults, and is thought to be a common cause of back and neck pain. The prevalence of facet and SI-joint mediated pain increases with age, suggesting that OA might have a particularly important role in older adults with spinal pain. Treatment options of symptomatic facet- and SI-joint degeneration consist of non-opioid analgesics, physiotherapy or in patients with persistent back or leg pain of either spinal decompression or fusion.
Topics: Aged; Humans; Lumbar Vertebrae; Neck Pain; Osteoarthritis; Prevalence; Sacroiliac Joint; Zygapophyseal Joint
PubMed: 33046194
DOI: No ID Found -
Nature Communications Feb 2023Massive intra-articular infiltration of proinflammatory macrophages is a prominent feature of rheumatoid arthritis (RA) lesions, which are thought to underlie articular...
Massive intra-articular infiltration of proinflammatory macrophages is a prominent feature of rheumatoid arthritis (RA) lesions, which are thought to underlie articular immune dysfunction, severe synovitis and ultimately joint erosion. Here we report an efferocytosis-informed nanoimitator (EINI) for in situ targeted reprogramming of synovial inflammatory macrophages (SIMs) that thwarts their autoimmune attack and reestablishes articular immune homeostasis, which mitigates RA. The EINI consists of a drug-based core with an oxidative stress-responsive phosphatidylserine (PtdSer) corona and a shell composed of a P-selectin-blocking motif, low molecular weight heparin (LMWH). When systemically administered, the LMWH on the EINI first binds to P-selectin overexpressed on the endothelium in subsynovial capillaries, which functions as an antagonist, disrupting neutrophil synovial trafficking. Due to the strong dysregulation of the synovial microvasculature, the EINI is subsequently enriched in the joint synovium where the shell is disassembled upon the reactive oxygen species stimulation, and PtdSer corona is then exposed. In an efferocytosis-like manner, the PtdSer-coroneted core is in turn phagocytosed by SIMs, which synergistically terminate SIM-initiated pathological cascades and serially reestablish intra-articular immune homeostasis, conferring a chondroprotective effect. These findings demonstrate that SIMs can be precisely remodeled via the efferocytosis-mimetic strategy, which holds potential for RA treatment.
Topics: Mice; Animals; P-Selectin; Heparin, Low-Molecular-Weight; Arthritis, Rheumatoid; Joints; Synovial Membrane
PubMed: 36781864
DOI: 10.1038/s41467-023-36468-2 -
Orthopadie (Heidelberg, Germany) Jun 2024The term osteoarthritis (OA) of the wrist can be used as an umbrella term for various, often independent areas of OA, as the wrist is made up of several joints.... (Review)
Review
The term osteoarthritis (OA) of the wrist can be used as an umbrella term for various, often independent areas of OA, as the wrist is made up of several joints. Radiocarpal OA often occurs after untreated ligament injuries, incorrectly healed bone fractures in the carpus or after radius fractures involving the joint. A typical sequence of propagation is known for radiocarpal OA following scapholunate (SL) insufficiency or scaphoid pseudarthrosis. Other causes include inflammation, crystal deposits or bone necrosis. Ulnocarpal arthrosis occurs posttraumatically or primarily when there are differences in levels between the ulna and radius. When treating wrist arthrosis, after conservative measures have been exhausted a surgical procedure should be chosen that enables the best possible load-bearing and residual mobility, considering the surgical risks and individual requirements. During salvage operations, the defective cartilage areas are either fused directly or eliminated using appropriate diverting partial fusions and resection arthroplasty. An accurate analysis of the affected zones is crucial for selecting an appropriate intervention.
Topics: Humans; Osteoarthritis; Wrist Joint
PubMed: 38789591
DOI: 10.1007/s00132-024-04502-w -
International Journal of Molecular... Feb 2023Osteoarthritis (OA) is a chronic, progressive, severely debilitating, and multifactorial joint disease that is recognized as the most common type of arthritis. During... (Review)
Review
Osteoarthritis (OA) is a chronic, progressive, severely debilitating, and multifactorial joint disease that is recognized as the most common type of arthritis. During the last decade, it shows an incremental global rise in prevalence and incidence. The interaction between etiologic factors that mediate joint degradation has been explored in numerous studies. However, the underlying processes that induce OA remain obscure, largely due to the variety and complexity of these mechanisms. During synovial joint dysfunction, the osteochondral unit undergoes cellular phenotypic and functional alterations. At the cellular level, the synovial membrane is influenced by cartilage and subchondral bone cleavage fragments and extracellular matrix (ECM) degradation products from apoptotic and necrotic cells. These "foreign bodies" serve as danger-associated molecular patterns (DAMPs) that trigger innate immunity, eliciting and sustaining low-grade inflammation in the synovium. In this review, we explore the cellular and molecular communication networks established between the major joint compartments-the synovial membrane, cartilage, and subchondral bone of normal and OA-affected joints.
Topics: Humans; Cartilage, Articular; Osteoarthritis; Joints; Synovial Membrane; Bone and Bones; Inflammation
PubMed: 36835530
DOI: 10.3390/ijms24044120 -
BMC Musculoskeletal Disorders Jul 2022Arthrofibrosis, or rigid contracture of major articular joints, is a significant morbidity of many neurodegenerative disorders. The pathogenesis depends on the mechanism... (Review)
Review
Arthrofibrosis, or rigid contracture of major articular joints, is a significant morbidity of many neurodegenerative disorders. The pathogenesis depends on the mechanism and severity of the precipitating neuromuscular disorder. Most neuromuscular disorders, whether spastic or hypotonic, culminate in decreased joint range of motion. Limited range of motion precipitates a cascade of pathophysiological changes in the muscle-tendon unit, the joint capsule, and the articular cartilage. Resulting joint contractures limit functional mobility, posing both physical and psychosocial burdens to patients, economic burdens on the healthcare system, and lost productivity to society. This article reviews the pathophysiology of arthrofibrosis in the setting of neuromuscular disorders. We describe current non-surgical and surgical interventions for treating arthrofibrosis of commonly affected joints. In addition, we preview several promising modalities under development to ameliorate arthrofibrosis non-surgically and discuss limitations in the field of arthrofibrosis secondary to neuromuscular disorders.
Topics: Contracture; Fibrosis; Humans; Joint Capsule; Joint Diseases; Joints; Knee Joint; Range of Motion, Articular
PubMed: 35906570
DOI: 10.1186/s12891-022-05677-z -
Skeletal Radiology May 2023Ultrasound guidance is valuable for performing precise joint interventions. Joint interventions may be requested for therapeutic and diagnostic pain injections, joint... (Review)
Review
Ultrasound guidance is valuable for performing precise joint interventions. Joint interventions may be requested for therapeutic and diagnostic pain injections, joint aspiration in the setting of suspected infection, or contrast injection for arthrography. In practice, interventions of the shoulder girdle, elbow, and hand/wrist joints may be performed without any imaging guidance. However, imaging guidance results in more accurate interventions and better patient outcomes than those performed by palpation alone. When compared to other modalities used for imaging guidance, ultrasound has many potential advantages. Radiologists should be prepared to perform ultrasound-guided upper extremity joint interventions utilizing recommended techniques to optimize clinical practice and patient outcomes. KEY POINTS: 1. Ultrasound-guided injections of the glenohumeral, acromioclavicular, sternoclavicular, elbow, and hand/wrist joints have higher accuracy than injections performed without imaging guidance. 2. Ultrasound-guided aspirations of upper extremity joints have advantages to fluoroscopic-guided aspirations because of the potential to identify effusions, soft tissue abscess, or bursitis. 3. Ultrasound-guided contrast injection prior to MR arthrography is as accurate as fluoroscopic-guided injection for upper extremity joints.
Topics: Humans; Injections, Intra-Articular; Ultrasonography, Interventional; Joints; Ultrasonography; Contrast Media; Upper Extremity
PubMed: 35962837
DOI: 10.1007/s00256-022-04148-9