Spondylolisthesis and related conditions.
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Biomedical subjects
Publications and source records attributed to A Soren.
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Light microscopic examination of histological sections of synovial membrane from patients with rheumatoid arthritis revealed that prolonged administration of corticosteroids had an inhibiting effect on the participation of lymphocytes and histiocytes in inflammatory infiltrates, as well as on the hypertrophy of synoviocytes, the proliferation of fibroblasts, the accumulation of fibrocytes, the deposition of fibrous tissue, and the formation of villi. Short-term (i.e., 12- to 24-h) steroid administration inhibited proliferation of fibroblasts only.
Histopathological examinations were carried out on synovial tissues obtained in 74 cases of primary osteoarthritis. The changes observed in the synovial membrane were quantified, and their percentile incidence was compared with that in rheumatoid arthritis. Survey revealed that all histopathological features, considered as manifestations of inflammation, were observed in osteoarthritis too; some features occurred with equal frequency, others with lesser frequency, and others with substantially lesser frequency. In view of the unequivocally pathogenetic start of this joint disease with degeneration of the articular cartilage the prefix of chondrosis is indicated for characterization of this disease, and in view of the undeniably inflammatory changes of the synovial membrane followed by involvement of all articular components the suffix of arthritis is indicated. Thus the designation of chondrosarthritis for "osteoarthritis" or "arthrosis" appears more descriptive and appropriate.
Ulcerative colitis and regional ileitis may be accompanied by articular involvement as extraintestinal complications, and were observed in 11 and 4 patients respectively. The temporal connection between the intestinal diseases and the appearance of subsidence of these complications in the majority of the cases suggest an etiologic relationship, regardless of the fact that the etiology of the intestinal diseases has not yet been elucidated. The clinical picture and course as well as the laboratory findings indicate that the joint involvement in question differs from rheumatoid arthritis.
As a practical and unequivocally pathognomonic sign for RA could serve a histopathologic change which both displays a conspicuous morphologic distinctiveness and occurs with an overwhelming frequency in RA versus an insignificant or absent frequency in other categories of synovitis. Such postulates were not fulfilled by any of the herein described histopathologic changes. Therefore, no absolutely or indisputably pathognomonic feature may be asserted for RA, although it must be recognized that highly suggestive or indicative significance has to be acknowledged for some of the herein listed histopathologic changes of the synovial membrane.
Whereas the histopathologic picture of the synovial membrane in rheumatoid arthritis varies widely and that in osteoarthritis displays a small range of changes, light- and transmission electron microscopic studies of synovial sections from both disease entities complement each other and assist reciprocally to corroborate the observed changes. Beyond that comparative survey of the ascertained histopathologic features and their correlation with clinical observations disclose that a study of a larger material of specimens permits with some limitations to infer the nature of the joint disease.
The similarity of the histopathologic changes in posttraumatic synovitis and osteoarthritis suggests that similar etiologic agents, possibly macro- and microtraumata, were pathogenetic factors in common.