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PubMed2000

Joint disease in children of Asiatic origin.

Joint disorders in Asian children are varied due to the diversity of the Asian population and show some ethnic trends. The ethnic diversity, socio-economic and geographic factors in Asia have limited the availability of data from some of the ethnic groups, many of whom live in remote and relatively underdeveloped areas, are not subjected to epidemiological surveillance and have little awareness of these diseases and their consequences. Geographic and socio-economic factors also play a significant role in some of the joint diseases peculiar to Asian children. In general, the current available data suggests that there are no large differences in the epidemiology and clinical features between the Western and Asian children. This article reviews the available literature on joint diseases in Asian children.

Adolescent↗
PubMed2003

Tobacco use and degenerative joint disease of the spine.

PURPOSE: To examine differences between tobacco users and nonusers who required surgical treatment for degenerative joint disease (DJD) of the spine. DATA SOURCES: Two hundred randomly selected medical records of patients who had undergone surgery for DJD of the spine. CONCLUSIONS: The number of tobacco users in the sample was significantly higher than the number of tobacco users in the general population, indicating greater incidence of DJD among tobacco users. The study demonstrated significant differences between tobacco users and nonusers regarding age, gender, type of occupation, number of imaging studies to diagnosis, and needs for pain management. IMPLICATIONS FOR PRACTICE: Nurse practitioners who deal with education and treatment of patients at risk for spinal degenerative joint disease must consider tobacco use as a significant factor, especially regarding diagnostic studies and pain management.

Adult↗
PubMed2006

Segment-specific association between cervical pillar hyperplasia (CPH) and degenerative joint disease (DJD).

BACKGROUND: Cervical pillar hyperplasia (CPH) is a recently described phenomenon of unknown etiology and clinical significance. Global assessment of pillar hyperplasia of the cervical spine as a unit has not shown a relationship with degenerative joint disease, but a more sensible explanation of the architectural influence of CPH on cervical spine biomechanics may be segment-specific. OBJECTIVE: The objective of this study was to determine the level of association between degenerative joint disease (DJD) and cervical pillar hyperplasia (CPH) in an age- and gender-matched sample on a [cervical spine] by-level basis. RESEARCH METHODS: Two-hundred and forty radiographs were collected from subjects ranging in age between 40 and 69 years. The two primary outcome measures used in the study were the segmental presence/absence of cervical pillar hyperplasia from C3 to C6, and segment-specific presence/absence of degenerative joint disease from C1 to C7. Contingency Coefficients, at the 5% level of significance, at each level, were used to determine the strength of the association between CPH and DJD. Odds Ratios (OR) with their 95% Confidence Intervals (95% CI) were also calculated at each level to assess the strength of the association. RESULTS: Our study suggests that an approximately two-to-one odds, or a weak-to-moderate correlation, exists at C4 and C5 CPH and adjacent level degenerative disc disease (DDD); with the strongest (overall) associations demonstrated between C4 CPH and C4-5 DDD and between C5 CPH and C5-6 DDD. Age-stratified results demonstrated a similar pattern of association, even reaching the initially hypothesized OR >or= 5.0 (95% CI > 1.0) or "moderately-strong correlation of C >or= .4 (p <or= .05)" in some age categories, including the 40-44, 50-59, and 60-64 years of age subgroups; these ORs were as follows: OR = 5.5 (95% CI 1.39-21.59); OR = 6.7 (95% CI 1.65-27.34); and OR = 5.3 (95% CI 1.35-21.14), respectively. CONCLUSION: Our results suggest that CPH has around two-to-one odds, that is, only a weak-to-moderate association with the presence of DJD (DDD component) at specific cervical spine levels; therefore, CPH may be but one of several factors that contributes (to a clinically important degree) to the development of DJD at specific levels in the cervical spine.

Journal Article↗
PubMedDate not supplied

Triple pelvic osteotomy: effect on limb function and progression of degenerative joint disease.

The objective of this study was to evaluate prospectively the outcome of 21 clinical patients treated with triple pelvic osteotomies during the year following surgery. Specific aims included documenting the time of and extent of improved limb function as measured by force plate analysis, evaluating the progression of degenerative joint disease (DJD) in the treated and untreated coxofemoral joints, and determining whether or not triple pelvic osteotomy resulted in degenerative joint changes in the ipsilateral stifle and hock. Twelve dogs were treated unilaterally and nine dogs were treated bilaterally with triple pelvic osteotomies. There were no differences in mean anteversion angles, angles of inclination, or preoperative DJD between treated hips and untreated hips. Degenerative joint disease progressed significantly in all hips regardless of treatment. Two cases developed hyperextension of their hocks after the triple pelvic osteotomies. However, no radiographic evidence of DJD was observed for any of the stifles or hocks at any observation time. A significant increase in vertical peak force (VPF) scores was noted for treated legs by two-to-three months after surgery, which continued over time. Untreated legs did not show a significant change in VPF scores over time. No differences were found in progression to higher scores when unilaterally treated legs, first-side treated legs, and second-side treated legs were compared.

Animals↗
PubMed2001

Concentration and localization of YKL-40 in hip joint diseases.

OBJECTIVE: YKL-40 is a major secretory protein from human chondrocytes and synovial fibroblasts. We evaluated the concentrations and localization of YKL-40 in hip joint diseases, and analyzed the possibility of YKL-40 as a new inflammatory joint marker. METHODS: The concentration of YKL-40 in synovial fluid (SF) was measured by a sandwich-type ELISA. SF samples were collected from 19 hips with osteoarthritis (OA) of the hip joint, 21 hips with osteonecrosis of the femoral head (ONFH), and 5 hips with failed total hip arthroplasty (failed THA). In all cases of failed THA, cartilage tissue in hip joints was removed completely during the previous THA. The localization of YKL-40 was determined through immunohistochemical analysis using a specific antibody. RESULTS: The mean SF concentration of YKL-40 was significantly higher in ONFH and failed THA than in OA. Comparison by OA grade was not significantly different. In staging of ONFH, Ficat stage III with collapsed femoral head showed significantly higher YKL-40 concentrations than the other stages. Immunohistochemical studies showed that YKL-40 was localized in chondrocytes in the superficial and middle layers of the cartilage. In the synovium, YKL-40 was localized in fibroblasts and macrophages. CONCLUSION: YKL-40 reflects the degree of inflammation rather than cartilage metabolism. YKL-40 may be a useful inflammatory marker of hip joint diseases.

Adipokines↗
PubMedDate not supplied

Results of arthroscopic subacromial decompression in patients with subacromial impingement and glenohumeral degenerative joint disease.

The purpose of this study was to determine the efficacy of shoulder arthroscopy with subacromial decompression in patients with concurrent glenohumeral arthrosis. A retrospective review of 36 patients who had arthroscopic subacromial decompression with concurrent glenohumeral degenerative joint disease was conducted. Office charts, operative notes, standard shoulder questionnaires, radiographs, and clinical examinations were used. The mean age of patients was 61 years, with 5-year follow-up. Patients with Outerbridge grade 1, 2, or 3 changes on either the glenoid or humerus had a mean final L'Insalata score of 90. Ten patients with grade 4 changes registered an ultimate score of 50. Radiographic arthrosis correlated similarly but with less reliability. Arthroscopic subacromial decompression for resistant impingement symptoms in the face of mild to moderate glenohumeral degenerative joint disease can improve shoulder function and provide durable results. Full-thickness loss of articular cartilage or radiographically severe degenerative joint disease had less predictable results.

Acromion↗
PubMed1987

Proteoglycans of articular cartilage in Mseleni joint disease.

Femoral heads were resected from patients with Mseleni joint disease, and cartilage present in 'islands' on the articulating surfaces and over marginal osteophytes was removed for study. Some specimens were grown in short-term organ culture and labelled with sulphur-35. Proteoglycans present in the tissue, and newly synthesised macromolecules were extracted, purified and assessed. The results indicated that very few of the proteoglycans present or synthesised during culture were capable of aggregation with hyaluronate and that the average size of the macromolecules was smaller than normal. In addition a large proportion of the proteoglycans were very small in size and were thought to resemble a molecule found in immature articular cartilage. The response to degenerative disease was unusual and may be peculiar to the Mseleni condition.

Cartilage, Articular↗
PubMed1983

Meclofenamate sodium, phenylbutazone, and naproxen in the treatment of degenerative joint disease. Report of a placebo-controlled double-blind clinical comparison.

40 patients with definite radiographically verified degenerative joint disease of the hip and/or the knee were treated in this double-blind study. Ten patients received 300 mg N-(2,6-dichloro-m-tolyl)anthranilic acid, sodium salt (meclofenamate sodium, Meclomen) per day for six weeks, ten patients received 500 mg phenylbutazone per day in the first week and 300 mg per day for 5 weeks. Ten patients received 500 mg naproxen per day for 6 weeks and ten patients received placebo. Measurements to assess efficacy were: intensity of pain on passive motion, intensity of starting pain, extent of painfree abduction (if the hip was involved), maximum extension and flexion (if the knee was involved) and an overall rating of the patient's condition by both the physician and the patient. Analysis of the results demonstrated that meclofenamate sodium was significantly superior to placebo in relieving pain and improving articular function as well as in improving the overall condition in patients with degenerative joint disease of the knee and/or the hip. Phenylbutazone and naproxen showed comparable statistically significant efficacy. Although the differences between the three active drug groups at the end of treatment were statistically not significant, it was, however, of interest that they favored meclofenamate sodium in each measurement, so that the 3 active agents may be ranked as follows: 1. meclofenamate sodium; 2. phenylbutazone; 3. naproxen. Meclofenamate sodium was well tolerated as were the other active drugs. Six of the 10 patients in the phenylbutazone group exhibited a marked decrease of the WBC count at the end of treatment.

Adult↗
PubMed2005

Future directions in treatment of joint disease in horses.

Osteoarthritis is one of the most economically important diseases facing equine practitioners. The loss of use associated with joint disease is a leading problem in the equine industry. Although osteoarthritis in all species is believed to be a multifactorial disease that is not well understood, significant advances are being made. This article presents areas of research that are relatively well developed but have not made it to commercialization or routine clinical practice and looks at new applications being investigated for peo-ple that may have an equine application.

Animals↗
PubMed1994

Expression of L-selectin, CD43, and CD44 in synovial fluid neutrophils from patients with inflammatory joint diseases. Evidence for a soluble form of L-selectin in synovial fluid.

OBJECTIVE: To study the expression of L-selectin, CD43, and CD44 on peripheral blood (PB) and synovial fluid (SF) neutrophils from patients with inflammatory joint diseases, and to investigate the presence of soluble L-selectin in both SF and plasma from patients with acute and chronic arthritis. METHODS: PB and SF neutrophils were isolated from 13 patients with rheumatoid arthritis (RA) and 17 patients with various inflammatory joint diseases other than RA. Expression of L-selectin, CD43, CD44, CD11a, and CD11b was determined in both unstimulated and in vitro-activated cells by immunofluorescence flow cytometry. Soluble L-selectin levels were estimated in SF and plasma by a semiquantitative radioimmunoassay. RESULTS: Neutrophils from SF showed diminished expression of L-selectin compared with PB neutrophils; CD43 expression and CD44 expression were decreased in SF neutrophils from most patients. In contrast, SF neutrophils exhibited significantly increased expression of CD11b, to an extent similar to that seen with in vitro-activated PB neutrophils. Soluble L-selectin was detected at similar levels in SF and PB. CONCLUSION: The phenotypic profile of SF neutrophils (low levels of L-selectin, CD43, and CD44, and high levels of CD11b) from most patients with RA or other inflammatory joint conditions resembles that observed in in vitro-activated neutrophils. Our results suggest that SF neutrophils are activated to a similar degree in inflammatory joint diseases with different pathogenic mechanisms.

Acute Disease↗
PubMed1993

Vibration analysis of the temporomandibular joints with degenerative joint disease.

The surface vibrations of 42 temporomandibular joints (TMJ) with degenerative joint disease (DJD) and/or perforation of the disk were evaluated using electrovibratography and compared to the surface vibrations of 83 joints with normal TMJ imagings and 61 joints with meniscal displacement without reduction. Through the frequency spectrum analysis, TMJs with DJD showed higher vibration energy above 350-450 Hz and TMJs with perforation showed higher vibration energy between 100-150 and 300-450 Hz. The presence of perforation did not seem to affect the characteristic of vibrations when TMJs were associated with DJD. A threshold was set for the total vibration energy as described in our previous report and used as a parameter in order to separate patients with internal derangement from a pool of TMJ dysfunction patients (diagnostic specificity = 75%, diagnostic sensitivity = 80.2%). Using this criteria, the following were correctly identified as internal derangement and/or DJD: a) 100% of the TMJs with meniscal displacement without reduction associated with DJD; b) 87.0% of the TMJs with meniscal displacement without reduction associated with perforation; c) 88.9% of the TMJs with meniscal displacement without reduction associated with DJD and perforation; and d) 100% of the TMJs with perforation.

Adolescent↗
PubMed1977

Degenerative joint disease in the mouse knee; histological observations.

The knee joints from males of two strains (CBA/ORT and STR/ORT) were studied histologically. The incidence of degenerative joint disease was very high in the STR/ORT strain. Degeneration of the cartilage invariably occurred first at the interface of the cruciate ligament and articular cartilage of the tibia. Lesions were only seen on the medial tibial and later the medial femoral condyles. Blocks of fibrillated, uncalcified cartilage were gradually lost across the condyle, leaving the tidemark as a secondary articulating surface. Meanwhile the subchondral bone thickened and erosion continued through the calcified cartilage into the underlying bone. A statistically significant relationship was found between the development of the lesion and (a) medial dislocation of the patella, (b) calcification and ossification of the medial collateral ligament. Patella dislocation gave rise to extensive cartilaginous and bony metaplasia of the synovial tissue. In joints with advanced degeneration there was often evidence of a slight lateral subluxation of the femur relative to the tibia.

Aging↗
PubMed1983

Meclofenamate sodium in the treatment of degenerative joint disease of the hand (Heberden nodes).

41 patients with radiographically verified degenerative joint disease of the hand who had at least one acutely inflamed Heberden node entered into the study. 22 patients were treated with 300 mg N-(2,6-dichloro-m-tolyl)anthranilic acid, sodium salt (meclofenamate sodium, Meclomen) per day for 4 weeks and 19 patients received placebo. Measures of efficacy were: the number of painful joints on both hands, an index of pain, the number of inflamed Heberden nodes and the grip strength (mmHg). Disease activity was similar in both groups at the beginning of the study. Analyses after one week of treatment and at the last observation at the conclusion of the study revealed significant differences in favor of meclofenamate sodium. This indicates that meclofenamate sodium treatment of degenerative joint disease of the hands is significantly superior to placebo. The reduction of the number of inflamed Heberden nodes demonstrates the anti-inflammatory effect of meclofenamate sodium, while the reduction of painful joints and the decreased pain index is evidence of the analgesic effect of this drug. The increase in grip strength indicates an improvement of function. The results further demonstrate the early onset of treatment effect with meclofenamate sodium. Meclofenamate sodium was well tolerated.

Adult↗
PubMed2001

[Sex differences in joint diseases: pathophysiological basis].

Gender affects the susceptibility to many joint diseases, in particular autoimmune rheumatic disorders; women have an increased risk of rheumatoid arthritis, systemic lupus erythematosus or Sjögren's syndrome. In rheumatoid arthritis alterations of sex hormone levels such as androgen deficiency or prolactin excess might, at least in part, explain the excess incidence in women. Osteoarthritis of the hand and the knee as well as generalized osteoarthritis is more frequent in women than in men. Nevertheless, until now there is no explanation for the increased incidence of osteoarthritis in women.

Age Factors↗
PubMed1976

[Diagnosis of temporomandibular joint diseases in the ambulatory practice].

The temporomandibular joints of 977 students of the Rostock University were examined clinically and radiographically. Objective findings (laterodeviation of the mandible, crackling noises of the joint, radiographic changes of the position of the condyle) were frequently obtained, whereas subjective complaints (arthralgia, crackling noises of the joint) were rare. Only the occurrence of both symptom complexes requires an exact diagnosis and therapy of the temporomandibular joint disease after optimal oral rehabilitation.

Adolescent↗
PubMed1989

An hypothesis on the etio-pathogenesis of equine inflammatory joint disease.

The role of oxygen-derived free radicals is considered critical to the etio-pathogenesis of equine inflammatory joint disease. In vivo, the superoxide radical in the joint may be derived either from activated polymorphonuclear leukocytes or from an ischemia/reperfusion cycle. In the presence of ferrous iron, it may generate the highly reactive hydroxyl radical (OH *). Predisposing factors may include synovitis, exercise-induced ischemia and minor traumatic injury to the joints. Unlike other inflammatory mediators, oxygen-derived free radicals may damage tissue directly and these reactive species could account for the tissue injury and insidious onset of equine exercise-induced degenerative joint disease.

Journal Article↗
PubMed1987

UDP-D-xylose: proteoglycan core protein beta-D-xylosyltransferase: a new marker of cartilage destruction in chronic joint diseases.

We investigated the diagnostic significance of UDP-D-xylose : proteoglycan core protein beta-D-xylosyltransferase (EC 2.4.2.26) in different chronic joint diseases. This enzyme is located almost exclusively within chondrocytes, where it initiates the formation of chondroitin sulphate during the biosynthesis of proteoglycans and from which it is easily released after damage of articular cartilage. Xylosyltransferase activity was determined in synovial fluid and serum by a radiochemical method, based on the incorporation of [14C]xylose from UDP-[14C]xylose into an exogenous acceptor protein. Serum has been shown to be the appropriate material for the determination of xylosyltransferase activity in blood, since in plasma fibrinogen causes an inhibition of enzyme activity of about 50%. The catalytic concentrations of xylosyltransferase in synovial fluids and sera of patients with chronic joint diseases (n = 131) ranged from 0.5 to 22.0 mU/l and from 0.8 to 5.6 mU/l, respectively. On most cases we found higher xylosyltransferase activities in synovial fluids than in the corresponding sera. The highest catalytic concentrations of the enzyme were observed in the synovial fluids of patients suffering from rheumatoid arthritis (median value: 5.56 mU/l, 90%-range: 3.2-22.0 mU/l). Synovial fluids of patients with arthritis urica, however, showing a comparable high degree of inflammation, contained lower enzyme catalytic concentrations (median value: 2.38 mU/l, 90%-range: 0.7-5.2 mU/l), which were in the range of those in osteoarthrosis (median value: 2.50 mU/l, 90%-range: 0.8-4.8 mU/l). The higher xylosyltransferase activities in rheumatoid synovial fluids seem to be attributed to an increased cartilage destruction during the course of this disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗