Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0003873 (rheumatoid arthritis)
 53,068 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Eighteen cases of long-standing rheumatoid arthritis and superimposed pyarthrosis were reviewed to determine the most distinguishing radiographic features. Soft-tissue changes allowed earlier diagnosis in the knee and ankle joints and consisted of large asymmetrical joint effusion and fat-pad edema. Bony articular changes were more helpful than soft-tissue changes in the wrist and hip because of the paucity of adjacent extracapsular fat and were associated with delayed radiographic recognition of superimposed pyarthrosis. These changes are presumptive evidence of complicating septic arthritis and their presence necessitates needle aspiration and culture of the joint for proper definitive treatment.
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PMID:Septic arthritis: a complication of rheumatoid arthritis. 83 Mar 30

We have examined the nature of some mononuclear cells from inflamed synovial membranes of patients with rheumatoid arthritis. It was found that cells which remained in the supernatant medium after overnight culture of trypsinized tissue contained a variable number of lymphocytes which were shown to be T cells by rosetting and mitogen response. This suggests a source of T cell lymphokines with an effect on macrophages and thus a role in the maintenance of inflammation. Another role for mononuclear cells is suggest by the cytotoxicity of blood mononuclear cells directed against cultured synovial cells. This was found to occur in an autologous system using fibroblasts from rheumatoid synovium, but was not specific for rheumatoid arthritis. Stimulatory factors from rheumatoid joint effusion macrophages for blood lymphocytes were sought, but although blast transformation occurred, the results were equivocal. In this communication we set out to examine the nature of lymphoid cells in the synovial membrane and the role which they may play in the pathogenesis of chronic inflammation. We also briefly consider cell-mediated mechanisms of tissue injury. Since an active role of lymphoid cells pre-supposes the presence of an agent or agents which serve to stimulate them, we also report some recent attempts to find evidence for this. One of the striking histological features of the inflamed synovial tissue in rheumatoid arthritis, but also in some other forms of chronic arthritis, is the presence of lymphocytes and plasma cells. Immunofluorescent studies and organ culture studies have shown the presence and synthesis of immunoglobulins, predominantly the domain of plasma cells. The production of immunoglobulins, formation of complexes and activation of complement is a major factor in pathogenesis, but lymphocytes may also have a direct role through the production of lymphokines. Until recently these substances have been attributed to T lymphocytes, but Rocklin et al. (1) have recently shown that B cells may also be involved in certain experimental circumstances. The availability of synovectomy specimens from patients with rheumatoid arthritis has enabled us to examine the nature of lymphoid cells from synovial membranes. (This part of the work is reported fully elsewhere.
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PMID:Some cellular aspects of chronic inflammation in joint disease. 108 94

Five patients with pyarthrosis complicating rheumatoid arthritis are described. Only minimal clinical signs may be seen in such patients, making accurate diagnosis of this occasional complication difficult. Roentgenographic abnormalities include a rapidly enlarging joint effusion and progressive cartilage and bone destruction. Fistulas may develop. The principal differential diagnoses include exacerbtion of rheumatoid arthritis and alterations in the rheumatoid joint following trauma.
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PMID:Pyarthrosis complicating rheumatoid arthritis. Roentgenographic evaluation of 5 patients and review of the literature. 111 60

The authors describe 5 patients with rheumatoid arthritis; in 3 patients rupture of the synovial membrane and in 2 patients a calf cyst caused symptoms resembling a deep vein thrombosis. Contrast arthrography is of great help in differential diagnosis in conjunction with thorough anamnesis and clinical examination. The joint effusion plays a dominating role in the disease process, and treatment of the effusion is of the greatest importance for both prophylaxis and therapy of membrane rupture and calf cysts.
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PMID:[Deep vein thrombosis in the differential diagnosis of knee-joint capsule changes in rheumatoid arthritis]. 126 23

The mechanisms involved in juxta-articular bone destruction are poorly understood. Osteocalcin or gamma-carboxyglutamic acid (GLA) protein is a small non-collagenous bone protein. It is a sensitive marker of osteoblastic bone formation. Its seric variations in the serum in such rheumatisms as rheumatoid arthritis remain unclear. Further information on local osteoblastic activity may be obtained by assaying the level of osteocalcin in the synovium. Its serum level can be evaluated by radioimmunoassay. The same method can be used in the synovial fluid. Paired serum and synovial fluid samples have been assayed from 63 patients, 33 patients with inflammatory arthritis (rheumatoid arthritis, psoriasis, chondrocalcinosis, pyogenic arthritis) and 30 patients with mechanical joint effusion (osteoarthritis, meniscal lesions). Serum levels of osteocalcin were the same in the inflammatory group (m: 8.69 +/- 0.68 ng/ml) and in the mechanical group (m: 10.2 +/- 0.67 ng/ml). In the synovial fluid, the levels of osteocalcin were significantly lower in the inflammatory group (m: 3.27 +/- 0.40 ng/ml) than in the mechanical group (m: 6.91 +/- 0.47 ng/ml). The same results were obtained with the ratio of synovial fluid osteocalcin on serum osteocalcin. There was a significant correlation between serum and synovial fluid osteocalcin and an inverse correlation between synovial fluid osteocalcin and the number of synovial fluid cells. The present study suggests that periarticular osteoblastic depression, among patients with inflammatory arthritis, is likely.
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PMID:Serum and synovial fluid osteocalcin in rheumatic diseases. 147 75

Using the enzyme-linked immunosorbent assay (ELISA), the immune complex (IC) level was estimated in sera of 100 individuals grouped as follows; Group 1: 40 cases with bilharzial arthropathy. Group II: 20 cases with bilharziasis. Group III: 20 cases with rheumatoid arthritis. Group IV: 20 apparently healthy individuals. IC level was also estimated in synovial fluid of 4 cases with knee joint effusion. A significant increase in IC level in cases with bilharzial infection (with or without arthropathy) was noticed. This was higher in intestinal than in urinary bilharziasis. Further more IC level was significantly higher in cases of bilharzial arthropathy than in cases with bilharziasis alone. The IC level in synovial fluid was higher than in serum with a positive correlation. The role of IC as a causative agent in the pathogenesis of bilharzial arthropathy is clearly discussed.
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PMID:Circulating immune complex in bilharzial arthropathy. 157 79

The authors examined 487 synovial fluid specimens in patients affected with spontaneous effusion in the knee. In 202 of the cases the features indicating the nature of the effusion were observed (rheumatoid arthritis: 27; active S.L.E.: 2; microcrystals: 77; infections: 38; doubts as to rheumatoid arthritis or other connectivitis: 58). In 84 cases no features were determined despite the presence of specific clinical signs (psoriasis, arthrosis, previous trauma). In 201 cases where there were no clinical signs in the synovial fluid, the authors were able to differentiate moderate phlogosis in 27 specimens, and intense phlogosis in 104. Based on the results obtained, an attempt was made to define which tests are best to measure the amount of inflammation and which may be correlated with the etiology of the joint effusion.
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PMID:Synovial fluid in arthropathy. 181 85

T cell receptor (TCR) gamma/delta bearing lymphocytes in peripheral blood and synovial fluid from rheumatoid arthritis (RA) and seronegative spondyloarthritides (SSA) were evaluated by means of double label immunofluorescence and cytofluorographic analysis. Three monoclonal antibodies (MAb) were used. TCR delta-1 against a common delta chain epitope, BB3 directed against the T cell subset whose TCR is encoded by the V delta 2 gene, and A13 directed against the V delta 1 subset. Peripheral blood T gamma delta cells were significantly reduced compared to normal control blood in RA patients who had joint effusion but not in other RA patients. The decrease of T gamma delta in the RA PB was mainly confined to the A13+ subset. In RA synovial fluid (RA SF) T gamma delta cells were significantly increased compared to paired but not normal peripheral blood, the most significant being the increase of A13+ cells. In contrast, in patients with SSA, no change in T gamma delta cells was observed on PB or SF. These data suggest that in RA, but not SSA, T gamma delta cells migrate from PB to inflamed synovium and thus may be involved in the pathogenesis of RA.
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PMID:Gamma/delta T cells and their subpopulations in blood and synovial fluid from rheumatoid arthritis and spondyloarthritis. 182 66

In an attempt to differentiate among joint effusion, synovitis, pannus, and subchondral sclerosis in patients with clinically proved chronic rheumatoid arthritis, we used gadopentetate dimeglumine-enhanced MR imaging to examine 23 patients with acute knee symptoms. All patients had had rheumatoid arthritis for more than 6 months and satisfied four or more of the criteria of the American Rheumatism Association for rheumatoid arthritis. MR imaging was performed on a 1.5-T machine by using unenhanced T1-weighted spin-echo imaging, unenhanced T2*-weighted gradient-echo imaging, and unenhanced and enhanced T1-weighted gradient-echo imaging. Signal intensities of the synovium and bone marrow were measured with the region-of-interest technique on unenhanced and enhanced T1-weighted gradient-echo scans. Conventional radiographs were available for each patient. Joint effusion, synovitis, intraarticular pannus, subchondral sclerosis, and subchondral pannus had the same signal intensities on unenhanced T1-weighted spin-echo, unenhanced T1-weighted gradient-echo, and unenhanced T2*-weighted gradient-echo MR images, and could not be differentiated from one another. On enhanced T1-weighted gradient-echo sequences, pannus and synovitis showed marked enhancement in 15 patients, whereas joint effusion and sclerosis did not. Synovitis was diagnosed if the synovial membrane showed high enhancement; pannus was diagnosed if enhancing masses were seen within the joint space or in the subchondral area. In eight of the 23 joints, there was no enhancement of the synovium or intraarticular or subchondral tissue. We conclude that gadopentetate dimeglumine-enhanced MR imaging allows differentiation between synovitis and joint effusion and between subchondral pannus and subchondral sclerosis. Enhancement of the synovium and pannus indicates acute inflammation of the joint.
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PMID:Rheumatoid arthritis of the knee: value of gadopentetate dimeglumine-enhanced MR imaging. 189 45

We performed MR (magnetic resonance) imaging of 25 knee joints in 20 patients with rheumatoid arthritis (RA) before synovectomy and the findings were compared with the pathological specimens. When based on the findings on T2-weighted images of the examined joints, the degree of joint involvement by RA could be divided into four stages: stage 1 in which only joint effusion was present; stage 2 in which synovial thickening, lower in signal intensity than joint effusion, was present; stage 3 in which cartilage destruction was present; stage 4 in which apparent bone destruction was present. There were eleven joints which appeared unremarkable on conventional X-ray films but three of them were at stage 2 and six at stage 3. In conclusion, MR imaging is of help in diagnosis of early involvement of the knee joints by RA.
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PMID:[A study of MRI diagnosis for rheumatoid arthritis in the knee joint--imaging and pathologic correlation]. 208 96


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