• Title/Summary/Keyword: Synovitis

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Assessment of the Synovial Inflammation in Rheumatoid Arthritis with $^{99m}Tc$-labelled Polyclonal Human IgG(HIG): Prospective Comparison with Gadolinium Enhanced MRI ($^{99m}Tc$-labelled HIG 스캔을 이용한 류마티스 관절염 환자에서 활막염증의 평가 : 조영증강 자기공명영상과의 전향적인 비교)

  • Ryu, Young-Hoon;Lee, Jong-Doo;Suh, Jin-Suck;Park, Chang-Yun;Jeon, Pyoung;Na, Jae-Beom;Lee, Soo-Kon
    • The Korean Journal of Nuclear Medicine
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    • v.29 no.1
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    • pp.84-91
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    • 1995
  • Many clinical and laboratory tests have been employed to evaluate disease activity in rheumatioid arthritis. $^{99m}Tc$-labelled polyclonal IgG(HIG) has been demonstrated to accumulate in focal sites of infection or inflammation in both animals and human subjects. The purpose of this study was to distinguish arthritis with active inflammation from those without active inflammation and to correlate relative intensities of $^{99m}Tc$-labelled HIG uptake of the rheumatoid arthritis with clinical and MR indices of the joint inflammation. This study included twelve patients with active rheumatoid arthritis, two with ankylosing spondylitis and one with degenerative osteoarthritis without active inflammation. A Whole-body and spot images were obtained 4 hours after intravenous injection of 20mCi of $^{99m}Tc$-labelled HIG. Scintigrams were assessed visually by 3 experienced radiologists, and graded as normal or mildly and markedly increased uptake within the joints, and the degree of uptake was compared with clinical and radiologic severity of synovial inflammation. MRI studies were done on the involved joints consisted of wrist(n = 11), knee(n = 2) and hip joint(n= 2). Active synovitis was defined when marked elevation of ESR and gadolinium enhancement of synovium on MRI were demonstrated. Markedly increased radiotracer uptake was seen in 10 of 11 rheumatoid arthritic patients with active synovitis whereas normal or mildly increased uptakes were noted in others, including rheumatoid arthritic patient(n=1) and non-rheumatoid patients(n = 3) without active synovitis. This study showed that the localization of involved joints in rheumatoid arthritis could be detected with $^{99m}Tc$-labelled HIG and that the degree of uptake correlated well with the degree and activity of inflammation. In conclusion, $^{99m}Tc$-labelled HIG scan is a useful method in the evaluation of active inflammation in rheumatoid arthritis.

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Foreign Body Synovitis of a Child's Knee - A Case Report - (소아에서의 이물질에 의한 슬관절 활액막염 - 증례보고 -)

  • Kim, Sung-Jae;Lee, Su-Chan;Lee, Young-Soo;Lee, Yun-Tae
    • Journal of the Korean Arthroscopy Society
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    • v.3 no.1
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    • pp.51-53
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    • 1999
  • A four-year-old boy with knee pain who had an obscure history showed radiopaque material in the radiograph of the medial side of the knee joint. We successfully treated removal of a piece of glass by arthroscope followed by debridement of erosive cartilage and torn meniscus.

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아시아 지역의 닭마이코플라즈마병 상황

  • 강민수
    • KOREAN POULTRY JOURNAL
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    • v.33 no.7 s.381
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    • pp.100-105
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    • 2001
  • 마이코플라즈마 갈리셉티쿰(Mycoplasma gallisepticum, MG)및 마이코플라즈마 시노비에(M. synoviae,MS)에 의한 감염증은 아시아지역 뿐만 아니라 전세계적으로 닭에서 흔히 발생하는 질병이다. MG 감염은 흔히 닭에서 기낭염을 수반하는 만성호흡기병(chronic respiratory disease, CRD)과 칠면조의 전염성부비동염(infectious sinusitis)을 일으킨다. MS는 처음에 육계에서 전염성활막염(infectious synovitis)을 유발하는 병원체로만 알려졌으나, MG에 감염되지 않은 육계의 기낭염 병변부에서 빈번히 분리됨으로 인해 최근에는 원래의 전염성활막염보다 기낭염과 관련하여 많은 관심이 고조되고 있다. 아시아지역의 마이코플라즈마 감염상황을 대변하는 많은 문헌자료가 있으나, 대부분이 자국의 언어로 출판되어 있는 관계로 자료분석에 많은 애로가 있어 주로 해독이 가능한 영문자료를 근거로 하여 각국의 닭에서의 MG 및 MS 감염증의 발생상황과 방제현황에 대하여 언급하고자 한다. 비록 개략적이 나마 이를 토대로 국내 마이코플라즈마 방역상황을 되돌아볼 수 있는 계기가 되었으면 한다.

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Subtalar Arthroscopy (거골하 관절경술)

  • Suh, Jin-Soo
    • Journal of Korean Foot and Ankle Society
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    • v.16 no.1
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    • pp.26-30
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    • 2012
  • The subtalar joint is a complex joint that is functionally responsible for inversion and eversion of the hindfoot. Advances in optical technology and surgical instrumentation have allowed the arthorscocpic surgeon to investiagate the small joints including the subtalar joint. Indications for subtalar arthroscopy include pain, swelling, stiffness and locking. Therapeutic indications include treatment of chondromalacia, osteophytes, arthrofibrosis, synovitis, loose bodies, osteochondral lesions, excision of a painful os trigonum, arthrodesis, and FHL tendinopathy. Contraindications to subtalar arthroscopy include infection, advanced osteoarthritis with deformity, severe edema, poor vascularity and poor skin quality. Subtalar arthroscopy is a technically demanding and difficult procedure that should only be performed by experienced surgeons. With proper instrumentation and careful operative techniques, satisfactory results may be obtained with minimal morbidity.

Diagnostic efficacy of specialized MRI & clinical results of arthroscopic treatment in ankle soft tissue impingement syndrome (족근 관절 연부조직 충돌 증후군에서 MRI의 진단적 의의 및 관절경적 치료 결과)

  • Lee, Jin-Woo;Moon, Eun-Su;Kim, Sung-Jae;Hahn, Soo-Bong;Kang, Eung-Shick
    • Journal of Korean Foot and Ankle Society
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    • v.7 no.2
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    • pp.208-217
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    • 2003
  • Introduction: Soft-tissue impingement syndrome is now increasingly recognized as a significant cause of the chronic ankle pain. As a method to detect soft-tissue ankle impingement, a characteristic history and physical examination, routine MR imaging, and direct MR arthrography were used. The efficacy of routine MR imaging has been controversial for usefulness because of low sensitivity and specificity. Direct MR artrhography was recommaned for diagnosis because of the highest sensitivity, specificity and accuracy, but it requires an invasive procedure. The purpose of this study is to investigate the diagnostic accuracy of Fat suppressed, contrast enhanced, three-dimensional fast gradient recalled acquisition in the steady state with rediofrequency spoiling magnetic resonance imaging(CE 3D-FSPGR MRI) and to evaluate the clinical outcome of the arthroscopic treatment in assessing soft-tissue impingement associated with trauma of the ankle. Materials and Methods: We reviewed 38 patients who had arthroscopic evaluations and preoperative magnetic resonance imaging studies(3D-FSPGR MRI) for post-traumatic chronic ankle pain between January 2000 and August 2002. Among them, 24 patients had osteochondral lesion, lateral instability, loose body, malunion of lateral malleoli, and peroneal tendon dislocation. The patient group consisted of 23 men and 15 women with the average age of 34 years(16-81 years). The mean time interval from the initial trauma to the operation was 15.5 months(3 to 40 months), The mean follow-up duration of the assessment was 15.6months(12-48 months). MRI was simultaneously reviewed by two radiologists blinded to the clinical diagnosis. The sensitivity, specificity and accuracy of MRI was obtained from radiologic and arthroscopic finding. Arthroscopic debridement and additional operation for associated disease were performed. We used a standard protocol to evaluate patients before the operation and at follow-up which includes American Orthopedic Foot and Ankle Society Ankle-Hindfoot Score. Results: For the assessment of the synovitis and soft tissue impingement, fat suppressed CE 3D-FSPGR MR imaging had the sensitivity of 91.9%, the specificity of 84.4 and the accuracy of 87.5%. AOFAS Ankle-Hindfoot Score of preoperative state was 69.2, and the mean score of the last follow-up was 89.1. These were assessed as having 50% excellent(90-100) and 50% good(75-89). The presence of other associated disease didn't show the statistically significant difference(>0.05). Conclusion: Fat suppressed CE 3D-FSPGR MR imaging is useful method comparable to MR arthrography for diagnosis of synovitis or soft-tissue impingement, and arthroscopic debridement results in good clinical outcome.

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Pathophysiology and MRI Findings of Infectious Spondylitis and the Differential Diagnosis (감염성 척추염과 감별질환의 병태생리와 MRI 소견)

  • Sunjin Ryu;Yeo Ju Kim;Seunghun Lee;Jeongah Ryu;Sunghoon Park;Jung Ui Hong
    • Journal of the Korean Society of Radiology
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    • v.82 no.6
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    • pp.1413-1440
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    • 2021
  • On MRI, abnormal signals of the intervertebral disc, destruction of the upper and lower vertebral body endplate around the disc, and bone marrow edema around the endplate are considered typical findings of infectious spondylitis. These findings can also appear in various non-infectious spinal diseases, such as degenerative changes, acute Schmorl's node, spondyloarthropathy, synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO), chronic recurrent multifocal osteomyelitis, and calcium pyrophosphate dihydrate crystal deposition disease. The imaging findings of infectious spondylitis that can be differentiated from these non-infectious spinal diseases on MRI are high signal intensity and abscess of the disc space, an abscess in the paraspinal soft tissue, and the loss of the linear low signal intensity on T1-weighted images of the bony endplate. However, these differentiation points do not always apply since there are many similarities in the imaging findings of infectious and non-infectious diseases. Therefore, for an accurate diagnosis, it is important to know the imaging characteristics related to the pathophysiology of not only infectious spondylitis but also non-infectious spinal diseases, which requires differentiation from infection.

TRAUMATIC TMJ INJURY (외상성 악관절 손상)

  • Kim, Young-Kyun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.19 no.2
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    • pp.191-199
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    • 1997
  • Mandibular trauma is developed due to traffic accident, fall down, industrial injury, and others. TMJ disorder is usually also developed after facial traumatic injury. Many authors suggested that disc displacement or tearing, acute synovitis, TMJ ankylosis, traumatic arthritis, or effusion are developed after facial trauma. It is still very controversible what is the best treatment of TMJ injury such as condylar fracture and meniscal injury. In TMJ injury, synovial inflammation is developed and pain mediators such as prostaglandin E2 or leukotriene B4 are released from the synovial membrane. This can be a cause of TMJ disorder. I present a variety of experimental study about the condylar fracture and meniscal injury and enzyme-immunoassay of synovial fluid after mandibular trauma that have been studied since 1992 and establish the treatment criteria of traumatic TMJ injury. I think that the treatment option of condylar fracture depends upon the surgeon's criteria exclusively. There are no significant differences between conservative and surgical treatment. If the aggressive functional physical therapy and long-term followup be performed, the favorable functional recovery of TMJ can be obtained. And I think that the initial surgical management of meniscus of TMJ is unnecessary in condylar fracture. And also arthrocentesis can be available to release the patient's subjective symptoms and improve the healing of injured TMJ.

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The Effect of Intra-articular Bee Venom Injection on Meniscal Injury : Four Cases Report (반월상 연골 손상에 대한 관절강내 봉약침 치료 증례보고 4례)

  • Kim, Dong-Eun;Yu, Deok-Seon;Yeom, Seung-Ryong;Kwon, Young-Dal;Song, Yung-Sun
    • Journal of Korean Medicine Rehabilitation
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    • v.20 no.1
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    • pp.219-230
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    • 2010
  • According to previous reports, intra-articular bee venom injection is very effective for synovitis, intra-articular lesions. In this article, we report 4 cases of well-treated meniscal tear with intra-articular bee venom injection. We used intra-articular bee venom injection on meniscal tear diagnosed by MR imaging and prescribed herbal medication, physiotherapy if necessary. Outcomes were measured by Visual Analogue Scale(VAS) and Lysholm Knee Scoring Scale. Patients who are treated by intra-articular bee venom injection had a significant effect on the pain reduction, improved range of motion and knee function. Further well-designed, controlled studies and more cases are needed to define the effect of intra-articular bee venom injection on knee.

Cytologic Findings of Rheumatoid Pleuritis in Pleural Effusion - A Case Report - (흉막강액에서 진단된 류마티스성 흉막염 - 세포학적 소견 1예 보고 -)

  • Cha, Hee-Jeung;Min, Soo-Kee;Kim, Joon-Mee;Chu, Young-Chae
    • The Korean Journal of Cytopathology
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    • v.8 no.1
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    • pp.47-51
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    • 1997
  • Patients with rheumatoid arthritis of any degree of severity or duration may develop necrotizing granulomatous pleuritis, a morphologic replica of the inflammatory reaction characteristic of rheumatoid synovitis and rheumatoid nodules. The principal feature is the background composed of granular, amorphous, particulate material or debris of various hues. The material is sometimes eosinophilic sometimes more cyanophilic, or even green in the Papanicolaou stain. Within this background are elongated, fibroblast-like epithelioid cells, numerous multinucleated giant cells and degenerating leukocytes. The combination of the debris, spindle epithelioid ceils, and multinucleated giant cells in fluid is pathognomonic for rheumatoid pleuritis. We experienced a hcase of rheumatoid pleuritis showing these characteristic cytologic findings. The patient was a 63 year-old man with positive rheumatoid factor. The pleual fluid specimen revealed elongated epithelioid cells and multinucleated giant cells on a background of amorphous granular material.

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The Relationship between Dental Treatment and Temporomandibular Disorder (치과치료와 턱관절장애의 연관성에 관한 연구)

  • Kim, Yeong-Gyun;Lee, Yong-In
    • The Journal of the Korean dental association
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    • v.46 no.5
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    • pp.308-314
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    • 2008
  • The risk of temporomandibular joint disorder (TMD) can be increased during dental treatment due to excessive mouth opening and change of occlusion. The aim of this study is to find the relationship between dental treatment and TMD in the patients who developed TMD after dental treatment. The subjects of this study were 21 patients, who developed TMD after dental treatment and were treated with active TMD therapy in Seoul National University Bundang Hospital from June 2003 to February 2007. The subjects were examined with preceding dental treatment, symptom, diagnosis, treatment method of TMD and prognosis of TMD. The obtained results were as follows. 1. Preceding dental treatments were : Implant treatment, 14 cases ; Tooth extraction, 3 cases and others. 2. TMD symptoms were : pain on TMJ, 12cases : Sound on TMJ, 3cases ; Mouth opening limitation, Headache and others. 3. Diagnoses of TMD were : Synovitis and/or capsulitis, 10 cases ; 8 cases of Internal derangement and others. 4. Most TMD were treated by stabilization splint. 5. Prognoses of TMD were : Improvement, 6cases ; sustained 11 cases. In conclusion, the risk of TMD is increased during implant treatment. Prognoses of TMD after dental treatment were bad. It might be that these patients were non-cooperative and have distrust of dental treatment. Because the overloading on TMJ is possible in dental treatment of patients with underlying TMD, prior explanation and knowledge TMJ treatment are very important in these cases.

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