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Biomedical subjects

J C Gerster

Publications and source records attributed to J C Gerster.

At least 145 records · Page 8Linked to original sources
PubMed1985

Histological study of a case of recurrent olecranon bursitis with mixed calcium pyrophosphate dihydrate and apatite crystal deposits.

This is the report of a light and transmission electron microscopic study of an olecranon bursitis and of the adjacent distal tricipital tendon in an 83 year-old man. The data are compared with those of a similar study in the same patient performed 2 years ago. Calcium pyrophosphate dihydrate crystals were observed in the bursal fluid, in the inner part of the bursal wall (extracellular localization and intracellular phagocytosis) as well as in the peripheral part of the tendon. In addition, small apatite deposits were observed in the bursa and tendon by electron microscopy. The origin of these bursal deposits is discussed; it is suggested that they may be related to an exchange from the tendon to the remodelled bursal wall.

Aged↗
PubMed1985

Ankylosing spondylitis presenting as spondylodiscitis.

Spondylopathy is a relatively common finding in advanced ankylosing spondylitis (AS). However non-infectious spondylodiscitis as an early manifestation of AS seems to be exceptional. In this article, we present such a case in an adolescent.

Adolescent↗
PubMed1985

Distribution of fluoride in calcified cartilage of a fluoride-treated osteoporotic patient.

Subchondral bone and calcified cartilage from a femoral head of a 74-year-old osteoporotic woman treated for 30 months with sodium fluoride were analyzed. The fluoride content of the calcified tissues was determined by a specific ion electrode, and the topographic distribution pattern of fluoride was determined with an electron microprobe. The fluoride content in calcified cartilage (0.39% of ash) was higher than in neighboring subchondral bone (0.28% of ash). Line scan and X-ray images indicated a high concentration of fluoride in the outer layer of calcified cartilage lining the uncalcified cartilage, as well as in the inner layer of the subcortical endosteal bone. This study shows that calcified cartilage is an important site of fluoride deposition, and suggests that the accumulation of fluoride is related to the calcification process.

Aged↗
PubMed1985

Acute synovitis with intra-articular apatite deposits in an osteoarthritic metacarpophalangeal joint.

A patient was shown to have acute arthritis in a metacarpophalangeal joint, with local calcification indicated by x-rays. Surgical and pathological examinations showed strictly intra-articular apatite crystal deposits and an erosive osteoarthritis. These crystal deposits could account for the synovial inflammation; they are thought to be related to bone fragments embedded in the synovium. The predisposing role of previous local injections of corticosteroids is debatable.

Acute Disease↗
PubMed1985

Hypothyroidism presenting as destructive arthropathy of the fingers.

A patient presenting with destructive arthropathy of the proximal interphalangeal (PIP) joints of the hands is described. She was initially believed to have rheumatoid arthritis but non-steroidal anti-inflammatory drugs were of no help. The patient was subsequently found to have hypothyroidism and erosive osteoarthritis of the fingers. Joint swelling, pain and stiffness responded dramatically to thyroid hormone substitution. The PIP joint spaces reappeared on the radiographs within 9 months. This case suggest that hypothyroidism may induce destructive arthropathy of the finger joints. As thyroxine replacement may reverse the rheumatic complaints, hypothyroidism should be considered in the differential diagnosis of a destructive arthropathy of unclear aetiology.

Female↗
PubMed1985

Enthesopathy of the heels in juvenile onset seronegative B-27 positive spondyloarthropathy.

Severe heel enthesopathy was diagnosed in 4 of 18 cases of juvenile onset seronegative spondyloarthropathy. The plantar fascia was affected in each case, whereas the insertion of the Achilles tendon was involved in only one case. All were males over the age of 8 at the onset of arthropathy; HLA-B27 was present in each patient. Mild heel pain was found in 4 other patients. The prognosis was poor in patients with severe talalgia but better in patients with mild or no talalgia. When compared with the adult onset spondyloarthropathy, the incidence of severe heel pain was almost the same. No cases of Achilles tendon thickening were found in the juvenile patients.

Adolescent↗
PubMed1984

Reflex sympathetic dystrophy syndrome and barbiturates. A study of 25 cases treated with barbiturates compared with 124 cases treated without barbiturates.

Amongst 149 cases of reflex sympathetic dystrophy syndrome (RSDS), 25 (16.8%) were being treated with barbiturates at the time the RSDS symptoms began. This group is unusual by the frequent absence of provocative events (32%), a high number of diseased joints, bilaterality (76%), involvement of upper limbs (76%) and Dupuytren's disease (52%). Swift and complete recovery depends mostly on barbiturate withdrawal. These data support the idea that barbiturates may be the principal initiating event in some RSDS. Since unfavorable progress is seen with persistent use of barbiturates, this medication should be recognised early in the course of the disease in order to prevent severe sequels.

Adult↗
PubMed1984

Prevalence of periarticular calcifications in pyrophosphate arthropathy and their relation to nodal osteoarthrosis.

X-rays of the shoulder, hand, and knee joints from 30 patients with pyrophosphate arthropathy (PA) and 30 age and sex matched control subjects were examined for periarticular, dense, homogeneous calcifications considered to be apatite deposits. They were found in 30% of the patients with PA compared with 3.3% of the controls. In addition in the PA group the incidence of Heberden's nodes was significantly increased in cases with periarticular calcifications, implying that mixed (calcium pyrophosphate dihydrate + apatite) crystal deposition disease could be related to nodal osteoarthrosis.

Adult↗
PubMed1984

Synovial fluid lactate levels in septic and non-septic arthritides.

Lactate concentration was studied in 383 synovial fluid specimens from patients with various arthritides. The highest concentrations of lactate occurred in non-gonococcal septic synovial fluids. High values were recorded in seropositive rheumatoid arthritis and crystal-induced arthritides, medium values in synovial fluids from seronegative rheumatoid arthritis, seronegative spondylarthritides, gonococcal arthritis and haemarthrosis, and the lowest values in aspirates from osteoarthrotic joints. There was a positive correlation between synovial pH and lactic acid concentration. These data suggest that determination of lactate in synovial fluid can be valuable in the rapid exclusion of septic arthritis. Its value for differentiating between other inflammatory arthritides is discussed.

Arthritis↗
PubMed1984

Meniere's disease and fibrositis syndrome (psychogenic rheumatism). Relationship in audiometric and nystagmographic results.

A prospective neuro-otological study concerning 30 cases of fibrositis syndrome (psychogenic rheumatism, PR) and 30 age-matched normal controls was made and a retrospective study concerning 33 cases of Meniere's disease (MD) diagnosed and followed-up, examined between 1965 and 1982. Results showed: sensorineural hearing loss at low frequencies in all early stages of MD and in 10/30 of PR; hyperacusis (pain threshold below 100 dBHL bilaterally for all frequencies) without other sign of recruitment in 73.3% of PR and in 3/4 cases of MD where it was measured (discomfort or vertigo due to noise was noted retrospectively in 16/33 of early stages of MD); hyperreactivity of per-rotatory nystagmus in 53.3% of PR without neurological or peripheral vestibular lesions and, with or without vestibular unilateral lesions, in 39.9% of MD. None of the controls showed hyperacusis, hyperreactivity of per-rotatory nystagmus or deafness at low frequencies.

Adult↗
PubMed1984

Hearing and vestibular abnormalities in primary fibrositis syndrome.

A prospective neurootological study of 30 cases of primary fibrositis syndrome (PFS) and 30 sex and age matched healthy volunteers was performed. Results showed that 70% of the PFS patients had decreased painful sound threshold, 40% hyperreactivity of perrotatory nystagmus without neurological or peripheral vestibular lesions, and 27% asymptomatic sensorineural hearing loss at low frequencies. Such abnormal data were not found in the matched controls. These findings suggest that otological problems may be part of the nonrheumatic features encountered in PFS.

Adult↗
PubMed1984

Recurrent episodes of arthritis in thalassemia minor.

Recurrent episodes of seronegative asymmetrical arthritis usually lasting less than a week have been observed in 4 patients with beta thalassemia minor. In one case, irreversible joint damage of a wrist joint occurred 14 years after the onset of the rheumatism. Studies of the synovial fluid and synovial membrane performed in 2 cases revealed signs of moderate inflammation. The main differential diagnosis was from microcrystalline synovitis and palindromic rheumatism which was ruled out by clinical and laboratory data.

Adult↗
PubMed1983

Bilateral fractures of femoral neck in patients with moderate renal failure receiving fluoride for spinal osteoporosis.

Two patients with moderate renal failure sustained spontaneous bilateral hip fractures during treatment with fluoride, calcium, and vitamin D for osteoporosis. They had been taking sodium fluoride (40-60 mg/day) for 11 and 21 months, respectively. Histological examination of a specimen of the bone showed severe fluorosis in the first case, and quantitative analysis of bone showed osteomalacia and skeletal fluorosis in the other case. These abnormalities were considered to be the consequence of excessive retention of fluoride due to renal insufficiency. As bilateral femoral neck fractures are very rare these data suggest a causal link between fractures and fluoride in patients with renal failure. Thus fluoride should be given at a lower dosage, if at all, to patients with even mild renal failure.

Aged↗
PubMed1983

[Malignant tumors and rheumatism. Study of their relation].

Some aspects of the relationships between malignancy and rheumatic diseases are presented. The incidence of leukaemia and lymphomas is increased in rheumatic patients previously treated by alkylating agents or x-rays; hypertrophic treated by alkylating agents or x-rays; hypertrophic osteoarthropathy is frequently associated with bronchogenic carcinoma; very exceptionally, rheumatoidlike arthritis or polymyalgia rheumatica may be paraneoplastic syndromes. As a rule there is an interval of as long as several months between the beginning of joint or bone pains and radiological appearance of metastases. Early detection is possible if there is an elevated level of alkaline phosphatase, increased excretion of hydroxyproline and a positive bone scan.

Adult↗