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Results for “SYNOVITIS”

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At least 19 recordsLinked to original sources

PubMed2006

Synovitis score: discrimination between chronic low-grade and high-grade synovitis.

AIMS: To standardize the histopathological assessment of synovial membrane specimens in order to contribute to the diagnostics of rheumatic and non-rheumatic joint diseases. METHODS AND RESULTS: Three features of chronic synovitis (enlargement of lining cell layer, cellular density of synovial stroma, leukocytic infiltrate) were semiquantitatively evaluated (from 0, absent to 3, strong) and each feature was graded separately. The sum provided the synovitis score, which was interpreted as follows: 0-1, no synovitis; 2-4, low-grade synovitis; 5-9, high-grade synovitis. Five hundred and fifty-nine synovectomy specimens were graded by two independent observers. Clinical diagnoses were osteoarthrosis (n=212), post-traumatic arthritis (n=21), rheumatoid arthritis (n=246), psoriatic arthritis (n=22), reactive arthritis (n=9), as well as controls (n=49) from autopsies of patients without joint damage. Median synovitis scores when correlated with clinical diagnoses were: controls 1.0, osteoarthritis 2.0, post-traumatic arthritis 2.0, psoriatic arthritis 3.5, reactive arthritis 5.0 and rheumatoid arthritis 5.0. The scores differed significantly between most disease groups, especially between degenerative and rheumatic diseases. A high-grade synovitis was strongly associated with rheumatic joint diseases (P<0.001, sensitivity 61.7%, specificity 96.1%). The correlation between the two observers was high (r=0.941). CONCLUSION: The proposed synovitis score is based on well-defined, reproducible histopathological criteria and may contribute to diagnosis in rheumatic and non-rheumatic joint diseases.

Adolescent↗

PubMed1981

[Histological classification of rheumatoid synovitis compared with cell-kinetics and morphology of experimental immune synovitis (author's transl)].

During the course of the experimental immune arthritis of the guinea pig four phases can be distinguished: I=fibrinopurulent, partly ulcerative synovitis, II=granulocytic activee granulomatous synovitis, III=lymphocytic activ granulomatous synovitis, IV=synovitic sequelae with subintimal fibrosis. On the basis of cell-kinetic studies with initial and systemic labelling with 3H-thymidine of the synovial membrane and of the bone marrow it could be demonstrated that in this model the infiltrating cells as well as the structural cells belong to the monocyte-macrophage system. The typical multilayer of the lining cells of this immune synovitis therefore seems to be mainly as a type A cell hyperplasia of bone marrow derived cells instead of a local proliferation of the lining cells. Clinical cases of various joint diseases are described including symptoms, X-ray findings and histopathological studies. Depending on the stage of the clinical course and the number, localization and activity of the macrophages within the synovial membrane the reaction pattern can be classified in a new way using the categories mentioned above in the experimental model. Thus the classical picture of rheumatoid arthritis corresponds to the synovitis of the subintimal type. The polyarthritic syndrome which mostly is pathogenetically unclear in contrast is designated as synovitis of the intimal type. The same holds true for the activated arthrosis.

Aged↗

PubMed1988

Concentric joint space narrowing of the hip associated with hemosiderotic synovitis (HS) including pigmented villonodular synovitis (PVNS).

Concentric joint space narrowing of the hip is an expected radiographic finding in cases of inflammatory arthritis such as rheumatoid arthritis or sepsis. However, similar joint space narrowing is associated with chronic hemorrhagic conditions that produce hemosiderotic synovitis. Hemosiderotic synovitis results from chronic intra-articular bleeding such as occurs in pigmented villonodular synovitis, generalized bleeding diathesis, synovial hemangioma, and chronic trauma. Five hips in five patients with concentric joint space narrowing not associated with inflammatory arthritis or with hemophilia were reviewed clinically, radiographically, and pathologically. All patients had a hemosiderotic synovitis. The definitive diagnosis of pigmented villonodular synovitis was made pathologically in two cases that demonstrated nodular areas of giant cell proliferation, collagen production, and lipid-laden histiocytes on histologic samples.

Adult↗

PubMedDate not supplied

Low-field MRI for assessing synovitis in patients with rheumatoid arthritis. Impact of Gd-DTPA dose on synovitis scoring.

OBJECTIVE: To investigate the impact of a double dose compared to a single dose of contrast material in low-field magnetic resonance imaging (MRI) on semi-quantitative scoring of synovitis in patients with rheumatoid arthritis (RA). METHODS: This prospective study included 38 RA patients (23 women and 15 men, mean age 51 years). All patients underwent low-field MRI of the hand before administration of contrast medium, after intravenous injection of 0.1 mmol/kg gadolinium diethylenetriaminepentaacetic acid (Gd-DTPA), and after another dose of 0.1 mmol/kg Gd-DTPA. Two readers (A and B) blinded to dosage independently scored the single dose and double dose image sets for synovitis according to outcome measures in rheumatology (OMERACT) recommendations. Contrast-to-noise ratio (CNR) and signal-to-noise ratio (SNR) were also calculated for each set. RESULTS: 149 metacarpophalangeal (MCP) joints were evaluated. There was good inter-reader agreement for each of the two sets (intra-class correlation coefficient of 0.75 for the single dose set and 0.83 for the double dose). Median CNR and SNR values were 5.4 and 15.9, respectively, for the single dose set and 8.5 and 16.6, respectively, for the double dose set (p<0.0001). Single dose set mean synovitis scores were 1.7 and 1.6 for readers A and B, respectively. Double dose set scores were 1.9 and 2.0, respectively. Thus, higher synovitis scores were recorded for the double dose sets than the single dose sets (p<0.005). CONCLUSION: In low-field MRI, when evaluating RA, the dose of the contrast material influences synovitis scoring. Therefore, dosage of contrast material should be taken into consideration when using extremity dedicated low-field MRI.

Adolescent↗

PubMed1981

[Ultrastructure of detritus synovitis ("hydroxylapatite synovitis?") (author's transl)].

Detritus synovitis is a sequel of cartilage and osseous destruction in diarthrosis. Cartilage and bone fragments are enclosed by granulation tissue. Remnants of the destroyed bone and calcified cartilage appear as defined accumulations of hydroxylapatite crystals in the granulation tissue. These hydroxylapatite tissues resemble those considered by other authors as being responsible for a "third crystal synovitis, namely, hydroxylapatite synovitis". However, the findings communicated here allow us to conclude that these crystals are the sequel of a destruction of diarthrosis, so that it is not justified to consider hydroxylapatite synovitis as a separate disease entity.

Aged↗

PubMed1996

Bilateral synovitis in symptomatic unilateral transient synovitis of the hip: an ultrasonographic study in 56 children.

56 children with a clinical diagnosis of unilateral transient synovitis of the hip underwent bilateral sonographic assessment. On the anterior scan, the distance between the femoral neck and the fibrous joint capsule was measured. This distance, which we call the synovial capsular complex distance, was compared with age-dependent normal values. An increased distance was found in all 56 symptomatic hips (mean 10 mm, SD 1.8). This distance was also increased in 14 hips on the contralateral side (mean 8 mm, SD 1.6). An effusion was demonstrated in 53 symptomatic hips and in 8 hips on the contralateral side. These findings indicate that in one quarter of children with symptoms of unilateral transient synovitis the contralateral hip may have an increased synovial capsular complex distance due to synovial swelling or joint effusion, suggesting an asymptomatic synovitis. We therefore recommend a comparison of the synovial capsular complex distance on the symptomatic side with age-related normal values, in addition to a comparison with the asymptomatic hip.

Adolescent↗

PubMedDate not supplied

Implant failure with particulate silicone synovitis (detritic synovitis).

The authors present a case of particulate synovitis due to a silicone hemi-implant. Other names for this condition are silastic detritic synovitis and silastic foreign body synovitis. Small, free pieces of silastic cause inflammation of the synovial tissues. A literature review also is presented.

Arthritis↗

PubMed1991

Prosthesis-induced synovitis simulating villonodular synovitis.

Prosthetic arthroplasties are performed frequently in arthritic patients. The usual causes of prosthetic failures are loosening, infection, subluxation, or fracture. A 65-year-old man with total knee arthroplasty illustrates the complication of prosthetic synovitis developing 5 years after metal-polyethylene arthroplasty. Double contrast arthrography revealed nodular synovial filling defects. Arthrotomy and hematoxylin-and-eosin-stained histological sections of the synovium showed nonpigmented villonodular synovitis (VS). Giant cells and polyethylene particles were observed by polarized light within the synovium.

Aged↗

PubMed1983

[Hemopigmented villonodular synovitis: ultrastructural study and a comparison with hemophiliac synovitis].

In a study of the ultrastructure of two cases of villonodular synovitis and two cases of haemophiliac synovitis, the authors observed very similar lesions. In both diseases, the lesions of the superficial layer of the synovium consisted of intermediate type (type C) synoviocytes loaded with iron pigments or lipid vacuoles. In the deep layer, the authors observed numerous macrophages loaded with siderosomes, lipid inclusions or phagocytosed red blood cells, giant cells and capillaries with a thickened basement membrane with a layered appearance. The cytoplasmic membranes of the synoviocytes were joined by desmosomes or filopodal digitations. The similarity of the lesions in the two diseases suggests a common histogenetic mechanism for the synovial lesions: chronic haemarthrosis.

Cytoplasm↗

PubMed2006

Histological changes in murine haemophilic synovitis: a quantitative grading system to assess blood-induced synovitis.

Haemophilia is a congenital disorder that results in frequent bleeding into joints, in which a chronic and debilitating arthritis develops. The presence of blood evokes an inflammatory and proliferative synovial reaction. Although the molecular mechanisms and biochemical pathways which underlie this disorder are not known, significant advances have been made by studying a murine model of human haemophilic synovitis. In order to better understand and correlate the pathological, molecular and biochemical changes, it has become necessary to grade the histological changes observed. Despite a search of the literature and review of relevant publications, none of the currently utilized schemes were appropriate, and therefore a novel grading scheme was developed. After review of over 1000 histological sections, six characteristic changes were identified: (i) synovial hyperplasia; (ii) vascularity; (iii) discolouration by haemosiderin; (iv) the presence of blood (erythrocytes); (v) villus formation; and (vi) cartilage erosion. Synovial hyperplasia and vascularity were present in variable amounts and were quantitatively scored (0-3), while the other changes were qualitatively scored as absent or present (0 or 1). Application of the grading scheme was tested and a high interobserver correlation (greater than 80%) was found. The scheme was easy to learn even by novices, with no prior experience. The availability of the histological grading scheme for murine synovitis will allow for precise evaluation of the pathological changes following joint bleeding, and facilitate correlations with molecular and biochemical changes that lead to these changes.

Adolescent↗

PubMed1994

Experimentally-induced synovitis as a model for acute synovitis in the horse.

The use of extremely small dosages of intra-articular E. coli lipopolysaccharide (LPS) endotoxin can create a model of synovitis that mimics acute synovitis in horses. Dosages of 5000 ng, 25 ng, 0.5 ng, 0.25 ng, 0.17 ng and 0.125 ng per joint were injected into various joints of a total of 6 horses. The dose response of LPS on clinical signs and synovial fluid parameters was evaluated at baseline and 12, 24, 36 and 48 h after LPS injection. Peripheral venous blood analysis was performed at baseline and at 0, 4, and 12 h after LPS injection. Dosages greater than 0.5 ng/joint resulted in clinical signs of endotoxaemia including fever, depression, inappetence and non-weightbearing lameness. Although the total peripheral venous leucocyte count was not decreased at any dosage, the 5000 ng/joint dosage of LPS altered venous leucocyte differential resulting in an increase in the number of segmented and band neutrophils with a concomitant decrease in lymphocytes. Synovial fluid total nucleated cell count (TNC) and total protein (TP) was linearly responsive to increases in intra-articular LPS dosages up to the 0.5 ng/joint dose. At dosages of LPS > 0.5 ng, synovial fluid mean +/- s.e.m. TNC and TP were 122.0 +/- 27 x 10(9) cells/l and 59.3 +/- 1.7 milligrams respectively, at 12 h after injection. This may represent the maximal response of the joint to increased concentrations of LPS endotoxin over 0.5 ng/joint.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗

PubMed1965