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Physical and Engineering Sciences in... Mar 2023The knee is one of the most stressed joints of the human body, being susceptible to ligament injuries and degenerative diseases. Due to the rising incidence of knee... (Review)
Review
The knee is one of the most stressed joints of the human body, being susceptible to ligament injuries and degenerative diseases. Due to the rising incidence of knee pathologies, the number of knee X-rays acquired is also increasing. Such X-rays are obtained for the diagnosis of knee injuries, the evaluation of the knee before and after surgery, and the monitoring of the knee joint's stability. These types of diagnosis and monitoring of the knee usually involve radiography under physical stress. This widely used medical tool provides a more objective analysis of the measurement of the knee laxity than a physical examination does, involving knee stress tests, such as valgus, varus, and Lachman. Despite being an improvement to physical examination regarding the physician's bias, stress radiography is still performed manually in a lot of healthcare facilities. To avoid exposing the physician to radiation and to decrease the number of X-ray images rejected due to inadequate positioning of the patient or the presence of artefacts, positioning systems for stress radiography of the knee have been developed. This review analyses knee positioning systems for X-ray environment, concluding that they have improved the objectivity and reproducibility during stress radiographs, but have failed to either be radiolucent or versatile with a simple ergonomic set-up.
Topics: Humans; X-Rays; Reproducibility of Results; Knee Joint; Knee; Radiography
PubMed: 36692683
DOI: 10.1007/s13246-023-01221-y -
Cells, Tissues, Organs 2024The impact of mild synovitis on the chondrogenic environment in the joint pertaining to cartilage repair is often neglected. In this study, 21 synovial samples were...
The impact of mild synovitis on the chondrogenic environment in the joint pertaining to cartilage repair is often neglected. In this study, 21 synovial samples were collected from foot surgeries for histology and isolation of fibroblast-like synoviocytes (FLSs). Of the 21 samples, 13 were normal and eight were mild synovitis, according to their synovitis scores. In mild synovitis, CD3+ lymphocytes were increased in the sublining layer. When chondrocytes were cultured and treated with the conditioned medium produced by FLSs, their glycosaminoglycan production was negatively correlated with the synovitis scores of the synovium, from which FLSs were isolated. In conclusion, mild synovitis in common joint conditions compromises the process of chondrogenesis, via inhibiting chondrocyte matrix production by FLSs. The results suggest that the concomitant synovitis, even being mild, could significantly alter the joint environment for chondrogenesis and impair the outcome of cartilage repair.
Topics: Humans; Synovitis; Chondrogenesis; Chondrocytes; Middle Aged; Male; Female; Synoviocytes; Adult; Aged; Glycosaminoglycans; Cells, Cultured; Joints; Culture Media, Conditioned; Synovial Membrane
PubMed: 37524055
DOI: 10.1159/000532008 -
Frontiers in Immunology 2022Inflammatory arthritis is an inflammatory disease that involves the joints and surrounding tissues. Synovial hyperplasia often presents when joints become inflamed due...
Inflammatory arthritis is an inflammatory disease that involves the joints and surrounding tissues. Synovial hyperplasia often presents when joints become inflamed due to immune cell infiltration. Synovial membrane is an important as well as a highly specific component of the joint, and its lesions can lead to degeneration of the joint surface, causing pain and joint disability or affecting the patients' quality of life in severe cases. Synovial macrophages (SMs) are one of the cellular components of the synovial membrane, which not only retain the function of macrophages to engulf foreign bodies in the joint cavity, but also interact with synovial fibroblasts (SFs), T cells, B cells, and other inflammatory cells to promote the production of a variety of pro-inflammatory cytokines and chemokines, such as TNF-α, IL-1β, IL-8, and IL-6, which are involved in the pathogenic process of inflammatory arthritis. SMs from different tissue sources have differently differentiated potentials and functional expressions. This article provides a summary on studies pertaining to SMs in inflammatory arthritis, and explores their role in its treatment, in order to highlight novel treatment modalities for the disease.
Topics: Arthritis, Rheumatoid; Humans; Joints; Macrophages; Quality of Life; Synovial Membrane
PubMed: 35958604
DOI: 10.3389/fimmu.2022.905356 -
Journal of Magnetic Resonance Imaging :... Apr 2011Due to its high spatial resolution and excellent tissue contrast, magnetic resonance imaging (MRI) has become the most commonly used imaging method to evaluate joints.... (Review)
Review
Due to its high spatial resolution and excellent tissue contrast, magnetic resonance imaging (MRI) has become the most commonly used imaging method to evaluate joints. Most musculoskeletal MRI is performed using 2D fast spin-echo sequences. However, 3D sequences have also been used for joint imaging and have the advantage of acquiring thin continuous slices through joints, which reduces the effects of partial volume averaging. With recent advances in MR technology, 3D sequences with isotropic resolution have been developed. These sequences allow high-quality multiplanar reformat images to be obtained following a single acquisition, thereby eliminating the need to repeat sequences with identical tissue contrast in different planes. Preliminary results on the diagnostic performance of 3D isotropic resolution sequences are encouraging. However, additional studies are needed to determine whether these sequences can replace currently used 2D fast spin-echo sequences for providing comprehensive joint assessment in clinical practice.
Topics: Adult; Ankle Joint; Cartilage; Diagnostic Imaging; Elbow Joint; Female; Hip Joint; Humans; Image Processing, Computer-Assisted; Imaging, Three-Dimensional; Joints; Magnetic Resonance Imaging; Male; Middle Aged; Sensitivity and Specificity; Shoulder Joint
PubMed: 21448939
DOI: 10.1002/jmri.22342 -
Journal of Athletic Training Oct 2015Unilateral body-weight exercises are commonly used to strengthen the lower limbs during rehabilitation after injury, but data comparing the loading of the limbs during...
CONTEXT
Unilateral body-weight exercises are commonly used to strengthen the lower limbs during rehabilitation after injury, but data comparing the loading of the limbs during these tasks are limited.
OBJECTIVE
To compare joint kinetics and kinematics during 3 commonly used rehabilitation exercises.
DESIGN
Descriptive laboratory study.
SETTING
Laboratory.
PATIENTS OR OTHER PARTICIPANTS
A total of 9 men (age = 22.1 ± 1.3 years, height = 1.76 ± 0.08 m, mass = 80.1 ± 12.2 kg) participated.
INTERVENTION(S)
Participants performed the single-legged squat, forward lunge, and reverse lunge with kinetic data captured via 2 force plates and 3-dimensional kinematic data collected using a motion-capture system.
MAIN OUTCOME MEASURE(S)
Peak ground reaction forces, maximum joint angles, and peak sagittal-joint moments.
RESULTS
We observed greater eccentric and concentric peak vertical ground reaction forces during the single-legged squat than during both lunge variations (P ≤ .001). Both lunge variations demonstrated greater knee and hip angles than did the single-legged squat (P < .001), but we observed no differences between lunges (P > .05). Greater dorsiflexion occurred during the single-legged squat than during both lunge variations (P < .05), but we noted no differences between lunge variations (P = .70). Hip-joint moments were greater during the forward lunge than during the reverse lunge (P = .003) and the single-legged squat (P = .011). Knee-joint moments were greater in the single-legged squat than in the reverse lunge (P < .001) but not greater in the single-legged squat than in the forward lunge (P = .41). Ankle-joint moments were greater during the single-legged squat than during the forward lunge (P = .002) and reverse lunge (P < .001).
CONCLUSIONS
Appropriate loading progressions for the hip should begin with the single-legged squat and progress to the reverse lunge and then the forward lunge. In contrast, loading progressions for the knee and ankle should begin with the reverse lunge and progress to the forward lunge and then the single-legged squat.
Topics: Biomechanical Phenomena; Exercise; Humans; Joints; Kinetics; Male; Muscle Stretching Exercises; Wounds and Injuries; Young Adult
PubMed: 26418958
DOI: 10.4085/1062-6050-50.9.05 -
Chinese Medical Journal Nov 2018To propose a new definition of the pericollapse stage of osteonecrosis of the femoral head (ONFH) and review its significance in disease diagnosis and treatment... (Review)
Review
OBJECTIVE
To propose a new definition of the pericollapse stage of osteonecrosis of the femoral head (ONFH) and review its significance in disease diagnosis and treatment selection.
DATA SOURCES
A search for eligible studies was conducted in three electronic databases including PubMed, Cochrane Library, and Embase up to August 10, 2018, using the following keywords: "osteonecrosis", "prognosis", and "treatment".
STUDY SELECTION
Investigations appraising the clinical signs, symptoms, and imaging manifestations in different stages of ONFH were included. Articles evaluating the prognosis of various joint-preserving procedures were also reviewed.
RESULTS
The pericollapse stage refers to a continuous period in the development of ONFH from the occurrence of subchondral fracture to early collapse (<2 mm), possessing specific imaging features that mainly consist of bone marrow edema and joint effusion on magnetic resonance imaging (MRI), crescent signs on X-ray films, and clinical manifestations such as the sudden worsening of hip pain. Accumulating evidence has indicated that these findings may be secondary to the changes after subchondral fractures. Of note, computed tomography provides more information for identifying possible subchondral fractures than does MRI and serves as the most sensitive tool for grading the pericollapse lesion stage. The pericollapse stage may indicate a high possibility of progressive disease but also demonstrates satisfactory long- and medium-term outcomes for joint-preserving techniques. In fact, if the articular surface subsides more than 2 mm, total hip arthroplasty is preferable.
CONCLUSIONS
The pericollapse stage with distinct clinical and imaging characteristics provides a last good opportunity for the use of joint-preserving techniques. It is necessary to separate the pericollapse stage as an independent state in evaluating the natural progression of ONFH and selecting an appropriate treatment regimen.
Topics: Femur Head; Femur Head Necrosis; Humans; Joints; Magnetic Resonance Imaging
PubMed: 30381593
DOI: 10.4103/0366-6999.244111 -
Seminars in Arthritis and Rheumatism Jun 2019To update definitions of multiple joint osteoarthritis (MJOA), and to determine the frequency and impact of MJOA in a community-based cohort.
BACKGROUND/PURPOSE
To update definitions of multiple joint osteoarthritis (MJOA), and to determine the frequency and impact of MJOA in a community-based cohort.
METHODS
Following PRISMA guidelines and with the help of a professional research librarian, we performed a systematic review in Medline using the terms osteoarthritis, generalized, polyarticular, multiple joint, and multi-joint among others, to obtain articles related to MJOA. A total of 42 articles were included for data extraction based on multiple criteria including the requirement for a clearly stated definition of OA assessed at more than one body site. We assessed frequency of these definitions in the Johnston County OA Project (JoCo OA) cohort as well as outcomes related to general health and physical function.
RESULTS
A total of 6 clearly stated definitions for MJOA were identified. These definitions were integrated with a list of 24 definitions from our previous systematic review and distilled down to produce 10 literature-derived, operationalized MJOA definitions. Based on these definitions, high frequencies of radiographic (4-74%) and symptomatic (2-52%) MJOA were found in the JoCo OA. Significant detrimental effects were seen on general health and physical function for most definitions.
CONCLUSIONS
We constructed a list of 10 summary MJOA definitions based in the literature that are frequent and associated with important clinical outcomes. These definitions capture some of the variability of MJOA phenotypes and provide a starting point for future analyses of both existing and newly initiated studies.
Topics: Hand Joints; Health Status; Hip Joint; Humans; Knee Joint; Osteoarthritis; Prevalence; Radiography
PubMed: 30390991
DOI: 10.1016/j.semarthrit.2018.10.001 -
Sensors (Basel, Switzerland) Dec 2022Current research concerning the repeatability of the joint's sounds examination in the temporomandibular joints (TMJ) is inconclusive; thus, the aim of this study was to...
Current research concerning the repeatability of the joint's sounds examination in the temporomandibular joints (TMJ) is inconclusive; thus, the aim of this study was to investigate the repeatability of the specific features of the vibroarthrogram (VAG) in the TMJ using accelerometers. The joint sounds of both TMJs were measured with VAG accelerometers in two groups, study and control, each consisting of 47 participants ( = 94). Two VAG recording sessions consisted of 10 jaw open/close cycles guided by a metronome. The intraclass correlation coefficient (ICC) was calculated for seven VAG signal features. Additionally, a k-nearest-neighbors (KNN) classifier was defined and compared with a state-of-the-art method (joint vibration analysis (JVA) decision tree). ICC indicated excellent (for the integral below 300 Hz feature), good (total integral, integral above 300 Hz, and median frequency features), moderate (integral below to integral above 300 Hz ratio feature) and poor (peak amplitude feature) reliability. The accuracy scores for the KNN classifier (up to 0.81) were higher than those for the JVA decision tree (up to 0.60). The results of this study could open up a new field of research focused on the features of the vibroarthrogram in the context of the TMJ, further improving the diagnosing process.
Topics: Humans; Reproducibility of Results; Temporomandibular Joint; Vibration; Sound
PubMed: 36502244
DOI: 10.3390/s22239542 -
Clinical Rheumatology Jan 2012Gouty arthritis is an inflammatory condition associated with debilitating clinical symptoms, functional impairments, and a substantial impact on quality of life. This... (Review)
Review
Gouty arthritis is an inflammatory condition associated with debilitating clinical symptoms, functional impairments, and a substantial impact on quality of life. This condition is initially triggered by the deposition of monosodium urate crystals into the joint space. This causes an inflammatory cascade resulting in the secretion of several proinflammatory cytokines and neutrophil recruitment into the joint. While generally effective, currently available agents are associated with a number of adverse events and contraindications that complicate their use. Based on our increased understanding of the inflammatory pathogenesis of gouty arthritis, several new agents are under development that may provide increased efficacy and reduced toxicity.
Topics: Aged; Arthritis, Gouty; Female; Gout Suppressants; Humans; Joints; Male; Middle Aged; Rheumatology; Uric Acid
PubMed: 22069122
DOI: 10.1007/s10067-011-1877-0 -
Journal of Orthopaedic Research :... Aug 2020The objectives of this study were to evaluate temporal changes in lubricin, hyaluronan (HA), and HA molecular weight (MW) distributions in three distinct models of... (Comparative Study)
Comparative Study
The objectives of this study were to evaluate temporal changes in lubricin, hyaluronan (HA), and HA molecular weight (MW) distributions in three distinct models of equine joint injury affecting the carpal (wrist), tarsal (ankle), and femoropatellar (knee) joints. To establish ranges for lubricin, HA, and HA MW distributions across multiple joints, we first evaluated clinically healthy, high-motion equine joints. Synovial fluid was collected from high-motion joints in horses without clinical signs of joint disease (n = 11 horses, 102 joints) and from research horses undergoing carpal osteochondral fragmentation (n = 8), talar cartilage impact injury (n = 7), and femoral trochlear ridge full-thickness cartilage injury (n = 22) prior to and following arthroscopically induced joint injury. Lubricin and HA concentrations were measured via enzyme-linked immunosorbent assays, and gel electrophoresis was performed to evaluate HA MW distributions. Synovial fluid parameters were analyzed via linear regression models, revealing that lubricin and HA concentrations were conserved across healthy, high-motion joints. Lubricin concentrations increased post-injury in all osteoarthritis models (carpal fragmentation P = .001; talar impact P < .001; femoral trochlear ridge cartilage defect P = .03). Sustained loss of HA was noted post-arthroscopy following carpal osteochondral fragmentation (P < .0001) and talar impact injury (P < .001). Lubricin may be elevated to compensate for the loss of HA and to protect cartilage post-injury. Further investigation into the mechanisms regulating lubricin and HA following joint injury and their effects on joint homeostasis is warranted, including whether lubricin has value as a biomarker for post-traumatic osteoarthritis.
Topics: Animals; Female; Glycoproteins; Horses; Hyaluronic Acid; Joint Diseases; Joints; Male; Synovial Fluid
PubMed: 31965593
DOI: 10.1002/jor.24597