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Query: UMLS:C0003864 (arthritis)
 69,039 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Sympathetic arthritis is a sterile, non-pyogenic complication due to adjacent bone disease, particularly chronic inflammatory osteomyelitis. Radiologically it is manifested as an arthrosis or serous arthritis (painful effusion), or as a chronic destructive arthitis. In the latter case, there is a lymphatic and plasma cell synovitis which may persist, clinically and radiologically, for a period of months or years before definite radiological signs of a chronic osteomyelitis become apparent. Observations of patients with plasma cell osteomyelitis and chronic destructive sympathetic arthritis indicate a special set of findings due to plasma cell osteomyelitis: metadiaphyseal ossifying periostitis, extreme demineralisation of the adjacent epiphysis with spotty focal sclerosis of the spongiosa and a chronic arthritis.
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PMID:[Sympathetic arthritis. A contribution to plasma cell osteomyelitis (author's transl)]. 14 34

Radiographs of 20 patients with acute chondrolysis complicating a slipped capital femoral epiphysis were reviewed with emphasis on the radiographic features and differential diagnosis. There was bilateral disease in five instances; radiographic follow-up ranged from 6 months to 5 years. The onset of chondrolysis occurred after surgery in 18 of the 25 abnormal hips. Acute necrosis of the articular cartilage is characterized radiographically by (1) persistent juxtaarticular osteoporosis; (2) progressive narrowing of all or a portion of the cartilage space; and (3) erosion of the subchondral cortices of the femoral head and acetabulum. The radiographic differential diagnosis varies with the stage of disease. The initial osteoporosis is indistinguishable from disuse. The rapid loss of the joint space, accompanied by destruction of the central portions of the subchondral bone, makes differentiation from postoperative infection a common problem. Late changes may resemble either degenerative joint disease or a chronic inflammatory arthritis. The accurate diagnosis of acute chondrolysis depends on correlation of the clinical history and radiographic findings.
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PMID:Acute chondrolysis complicating slipped capital femoral epiphysis. 41 97

A case suggesting sequential infection of bone, synovial membranes, and finally synovial fluid is presented. Hematogenous osteomyelitis manifests itself differently in children than in adults. In children, the avascular epiphyseal cartilage in the growing long bone is an effective barrier to the spread of bone infection to the joint. After obliteration of the growth plate, vascular anastomoses form between metaphysis and epiphysis, and at maturity the entire bone shares a common blood supply with the capsule and synovium of the adjacent joint. In the adult with acute osteomyelitis, contiguous joint infection should be anticipated. In septic arthritis, unless caused by penetrating trauma, the synovium must be infected before the joint fluid. Even when bacterial joint infection is present, repeated arthrocenteses may be required over several days to confirm the diagnosis.
Arthritis Rheum
PMID:Acute hematogenous osteomyelitis progressing to septic synovitis and eventual pyarthrosis. The vascular pathway. 73 20

Coxa magna is probably due to a period of relative hyperemia of the capial femur epiphysis between 2 and 8 years of age. The peripheral cartilage of the metaphysis and epiphysis proliferate as a response to reactive hyperemia secondary to synovitis. We have observed 11 patients with coxa magna and have followed five in detail. Good function is expected in childhood and adolescence, but traumatic arthritis will probably occur as these patients get older.
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PMID:Coxa magna. 91 96

Recent reports of and our own experience with biochemical alterations of liver function secondary to salicylate therapy stimulated this prospective study. Thirty-four children with juvenile rheumatoid arthritis, 6 children with acute cartilagenous necrosis of the hipfollowing slipped capital femoral epiphysis, and 2 children with ulcerative colitis and hip disease who were on salicylates were followed over a period of 1-27 months with serial determinations of serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT), lactic dehydrogenase (LDH), alkaline phosphatase (AP), bilirubin, and serum salicylate. Prothrombin time was measured in 14 children. Twenty-two of 34 children with rheumatoid arthritis and none of the 8 controls demonstrated abnormalities of various liver functions at serum salicylate levels between 7.0 and mg%. Three children demonstrated severe abnormalities characterized by marked elevation of SGOT, SGPT, LDH, and AP, prolongation of prothrombin time, and epistaxis. This type of reaction occurred within 5-14 days of initiation of aspirin therapy and occurred at serum salicylate levels between 18 and 43 mg%. Moderate changes in various liver function tests were observed in 19 other children. None of those children who were tested showed prolongation of prothrombin time. The serum salicylate level in this group varied between 7.0 and 38.2 mg%. The abnormal liver function tests returned to normal in 6 children upon withdrawal of aspirin and in 12 others even when salicylates were continued. Therefore, despite the occurrence of biochemical abnormalities following chronic salicylate therapy, it does not appear to be necessary to discontinue their use except in those children who develop bleeding.
Arthritis Rheum
PMID:Aspirin-induced hepatotoxicity in juvenile rheumatoid arthritis. A prospective study. 115 54

Mechanical stress causes remodelling of bone, a transformation of bone structure by physical forces through an unknown mechanism. Inflammation also affects bone structure, through altered use and the production of various inflammatory mediators. The peripheral nervous system may play both a sensory and an efferent role in the mechanical and inflammatory influences on bone structure. We studied the occurrence of substance P and calcitonin gene related peptide (CGRP) containing nerves in periosteal tissue, bone marrow, diaphysis and epiphysis of the ankle and knee joints of healthy and adjuvant arthritic rats. In arthritic animals, only ankle joints were affected by the inflammation. The periosteum was richly innervated both in healthy and arthritic animals. In arthritic rats few nerve fibers penetrated the woven, callous bone underlying the periosteum. Also bone marrow contained substance P and CGRP immunoreactive nerves in normal bone, whereas the hypercellular bone marrow of arthritic rats showed a decrease in the density of substance P and CGRP containing fibers. Epiphysis had a dense innervation compared to diaphysis. In contrast to large erosions, small peripheral erosions contained some CGRP immunoreactive fibers, perhaps as a sign of attempts of reactive repair. Our results suggest a local delivery system of potent peptide regulatory factors in bone, a system also affected by the pathophysiology of arthritis.
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PMID:Innervation of bone from healthy and arthritic rats by substance P and calcitonin gene related peptide containing sensory fibers. 138 42

A significant association between slipped upper femoral epiphysis (SCFE) and subtalar arthritis causes peroneal spastic flatfoot. Three patients with this association were observed in 136 cases of SCFE, an incidence of 2.3%; the anticipated incidence would be 0.4%. We postulate that both conditions reflect an underlying immunologic disorder.
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PMID:Association of slipped upper femoral epiphysis and peroneal spastic flatfoot. 201 May 24

A consensus view has been obtained from 108 colleagues about four major questions relating to post-traumatic osteoarthritis (OA) posed by a retired judge. In determining the likelihood of OA developing after a fracture, several factors must be taken into account. These include whether the fracture goes through the joint, the resulting angular deformity, the degree of soft tissue damage, the ensuing laxity of the joint, the presence of generalized OA, the involvement of nearby blood vessels supplying the bones of the joint and possibly the degree of immobilization. Lower limb joints are more likely to develop arthritis after injury than arm joints as they carry more load (although it would be wrong to think that arm joints were not load bearing). Occupation is a further factor. Age is thought to be important, with the elderly more at risk immediately, but the younger having longer in which to develop the disease. Younger people are less likely to develop post-traumatic OA, unless there is involvement of the epiphysis or residual angular deformity. Whilst in animals and in some fractures, degenerative changes begin immediately after damage to the joint, in most adults they take at least 2 years. The span is 2-5 years in more severe cases, including fractures of the joint line with a step in the surface, and associated dislocation. Otherwise it may take 10 years. Most of these data are anecdotal or obtained from retrospective surveys. There is great need for prospective work in this field.
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PMID:Post-traumatic osteoarthritis--a medico-legal minefield. 225 60

Evidence of deleterious effects following intraarticular injection of triamcinolone hexacetonide was sought through a review of radiographs of 145 joints of 55 children with chronic arthritis. Possible deleterious effects were noted in 16 joints of 11 patients. These effects included: small patella (2 joints), patellar osteochondritis dissecans (1 joint), periarticular calcification (9 joints), intraarticular tibial bony spur (1 joint), avascular necrosis of the distal radial epiphysis (2 joints), and avascular necrosis of the proximal femoral epiphysis (1 joint). Only the latter possible complication was symptomatic. Serial radiographs of 76 joints of 30 children showed mild progressive changes compatible with the underlying disease, except in the hip joint, where changes were more severe. The intraarticular injection of triamcinolone hexacetonide is a procedure that appears to be associated with an acceptably low frequency of radiologic abnormalities for many joints in children with chronic arthritis, but its effects on the hip joint remain uncertain.
Arthritis Rheum 1990 Jun
PMID:Radiographic followup of joints injected with triamcinolone hexacetonide for the management of childhood arthritis. 236 37

Radiographic signs of ischemic necrosis of the femoral head in terms of abnormal epiphysis and caput indices were found in 30/72 hips in 36 children with hip pain or limitation of motion among 206 children, consecutively admitted during 15 months because of juvenile chronic arthritis. Nine out of 10 hips with obvious signs of femoral head necrosis showed a sclerotic rim at the base of the femoral neck, confirming an earlier episode of ischemic damage to the epiphysis and growth plate. Femoral head necrosis in children with juvenile chronic arthritis seems to be more common than previously reported, and may be caused by circulatory disturbance secondary to increased intraarticular pressure due to synovitis and/or effusion, or to treatment with passive extension of the hip. This should be considered in the treatment and the follow-up of these children.
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PMID:Femoral head necrosis in juvenile chronic arthritis. 272 75


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