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

In patients with rheumatoid arthritis, the presence of acute synovial inflammation is an indication of the activity of the disease. It is an important finding because it often influences therapeutic decisions. However, acute synovitis may be difficult to detect by clinical examination, especially if a joint effusion also is present. As gadolinium tetra-azacyclododecane tetraacetic acid (Gd-DOTA) can be expected to accumulate in areas of acute inflammation, we studied the value of Gd-DOTA-enhanced MR to determine the presence of acute synovitis. Nine patients with current knee symptoms underwent MR examination of the knee. Short and long TR/TE MR images were obtained with a 0.3-T magnet before and immediately after IV administration of Gd-DOTA. A 15-min delayed short TR/TE image also was obtained. Of eight patients with moderate to severe clinical evidence of acute synovitis, six had marked increase and two had moderate increase in signal intensity from synovial tissue on the short TR/TE image obtained immediately after administration of contrast material. In the ninth patient, who had minimal synovitis clinically, the signal from the synovium did not change after administration of contrast material. No difference was seen between the enhancement pattern on the immediate and the 15-min delayed images. These results suggest that Gd-DOTA is taken up by inflamed synovium and that Gd-DOTA-enhanced MR scans may be useful in detecting acute synovitis in patients with rheumatoid arthritis.
 ...
PMID:MR imaging of the knee in acute rheumatoid arthritis: synovial uptake of gadolinium-DOTA. 192 4

To evaluate the ability of magnetic resonance imaging (MRI) to detect shoulder abnormalities 18 patients (36 shoulders) with rheumatoid arthritis (RA) and shoulder complaints were studied. Osseous abnormalities of the glenoid and humeral head were readily detected with MRI. The imaging planes used were not suitable for the evaluation of acromioclavicular joint involvement. Magnetic resonance imaging depicted soft tissue abnormalities that were not clearly visualised by plain film radiography, such as involvement of rotator cuff tendons and subacromial bursae, joint effusion, and muscular atrophy. Magnetic resonance imaging appears to be a sensitive method for evaluation of glenohumeral joint changes in patients with RA.
 ...
PMID:Magnetic resonance imaging of the shoulder in patients with rheumatoid arthritis. 202 31

Magnetic resonance imaging (MRI) permits visualization of anatomic structures not appreciated by conventional radiographic imaging and may quantify inflammatory disease and its progression with greater sensitivity than available techniques. We therefore compared MRI with clinical evaluation and with radiographic examination of 17 patients with inflammatory arthritis of the knee. We sought to determine anatomic integrity of bone, cartilage, menisci, and ligaments, and to quantify joint effusion and synovial proliferation. Patients studied had rheumatoid arthritis (10 patients), juvenile rheumatoid arthritis (4 patients), ankylosing spondylitis (1 patient), and monoarticular arthritis (2 patients). In all patients MRI revealed clinically important abnormalities not detected by physical or conventional radiographic exams. These included proliferative synovitis (13 patients), cartilage thinning (2 patients), cartilage erosion (8 patients), bone infarction (1 patient), meniscal injury (1 patient), and synovial invagination into bone (1 patient). Also MRI indicated inflammatory disease to be quantitatively greater than had been appreciated on clinical examination or routine X-ray studies--proliferative synovitis (12 patients), erosion (7 patients), effusion (8 patients), cartilage thinning (11 patients), and ligamentous/meniscal damage (1 patient). These findings led to reassessment of anatomic staging and influenced therapeutic decision for these patients. Thus MRI provides clinically important information about joint integrity and inflammatory disease, with a sensitivity and resolution considerably beyond conventional techniques.
 ...
PMID:Magnetic resonance imaging in patients with inflammatory arthritis of the knee. 233 54

The knees of 20 patients with rheumatoid arthritis and two healthy volunteers were evaluated with magnetic resonance (MR) imaging. Spin-echo sequences were performed, and the signal-intensity patterns of normal and pathologic articular soft-tissue structures were quantitatively evaluated with a dynamic FLASH (fast low-angle shot) sequence after bolus intravenous injection of gadolinium diethylenetriaminepentaacetic acid. In contrast to the spin-echo images obtained before injection of contrast material, it appears possible with this technique to distinguish joint effusion from hypervascular pannus formations and to grade the vascularity of proliferative synovitis. Flat pannus deposits on the articular surface and subchondral pannus masses were identified only by their marked enhancement of signal intensity after injection of contrast material. Dynamic MR imaging appears to yield decisive information for diagnosing rheumatoid arthritis.
 ...
PMID:Rheumatoid arthritis: evaluation of hypervascular and fibrous pannus with dynamic MR imaging enhanced with Gd-DTPA. 236 63

Physical examination is often insufficient in distinguishing between joint effusion and inflamed synovium in the knee joints of patients with rheumatoid arthritis. The authors prospectively evaluated the role of intravenously administered gadopentetate dimeglumine in distinguishing between these two conditions. Fourteen patients with classic rheumatoid arthritis were examined first by a rheumatologist and then by means of magnetic resonance (MR) imaging with T1- and T2-weighted sequences. T1-weighted images were also obtained following the intravenous administration of gadopentetate dimeglumine. T1-weighted images obtained prior to contrast material administration demonstrated an identical low-intensity signal from both effusion and inflamed synovium, and T2-weighted images demonstrated increased signal intensity in both cases. Intravenous administration of gadopentetate dimeglumine allowed distinction between effusion and abnormal synovium, with the effusion remaining of low signal intensity and the synovium demonstrating enhancement and increased signal intensity. The authors conclude that the use of gadopentetate allows distinction between synovial thickening and joint effusion in the knee, which may affect treatment decisions.
 ...
PMID:Rheumatoid knee: role of gadopentetate-enhanced MR imaging. 238 44

Prostaglandin (PG)E2, cyclic adenosine monophosphate (cAMP), white blood cells (WBC), total protein (TP), total complement activity (CH50) and beta-2-microglobulin (beta-2-m) were measured at baseline and after eight days in the synovial fluid (SF) of 16 patients affected with knee-joint effusion due to various arthropathies. The volume of SF was also calculated. Eight patients--4 with rheumatoid arthritis (RA), 2 with recurrent monoarthritis (RM) and 2 with osteoarthritis (OA) were randomly allocated to the treatment with intra-articular injection of Hyalgan (HA, Na-hyaluronate, 20 mg/2 ml), while eight patients having similar arthropathies--4 RA, 2 RM and 2 OA--were not treated (control group). In the patients treated with HA a significant reduction of SF volume (from 28.5 +/- 5.1 ml to 20.5 +/- 4.0 ml; p less than 0.02) and PGE2 (from 96.1 +/- 22.7 pg/ml to 66.2 +/- 14.5 pg/ml; p less than 0.05) was found, whereas cAMP concentration was significantly increased (from 4.5 +/- 0.7 pmol/ml to 7.2 +/- 1.2 pmol/ml; p less than 0.05). No significant variations were observed in the control group. Moreover, no differences in WBC count, TP and beta-2-m and CH50 were found in either group. These data could suggest an anti-inflammatory effect of HA that appears to be mediated by PG-inhibition as well as cAMP stimulation.
 ...
PMID:The influence of intra-articular hyaluronic acid on PGE2 and cAMP of synovial fluid. 254 40

We examined the activities of peptidases in synovial fluid from patients with rheumatoid arthritis (RA) and osteoarthritis (OA). Dipeptidyl peptidase IV (DPP IV) activity was lower in synovial fluid from patients with RA, in contrast to the increase of DPP II activity in synovial fluid, as compared with OA. The DPP II/DPP IV ratio for synovial fluid was significantly higher in patients with RA than in patients with OA. A significant correlation was observed between the DPP II/DPP IV ratio for synovial fluid from patients with RA and the amount of C-reactive protein reaction. These results may be useful in the diagnosis of joint effusion of unknown origin.
 ...
PMID:Activities of dipeptidyl peptidase II and dipeptidyl peptidase IV in synovial fluid from patients with rheumatoid arthritis and osteoarthritis. 256 14

Thirty-four joints (19 knees, 15 wrists) of 31 patients suffering from rheumatoid arthritis and related disorders were examined prior to and following intravenous administration of Gadolinium-DTPA (0.1 mmol/kg body weight). T1-weighted spin-echo sequences and the gradient-echo technique FLASH were applied. FLASH scanning was used for the registration of the time-dependent changes of signal intensity following Gd-DTPA. Synovial proliferations exhibited a rapid and marked increase of signal intensity whereas fatty tissue, bone marrow, muscle and synovial effusion demonstrated only minor changes, causing enhanced contrast between synovial pannus and joint effusion or other neighbouring structures. Within the synovial pannus, ratios (absolute signal increase) of 131.3 +/- 53.4% and 122.9 +/- 51.1% were found in T1-weighted spin-echo and in FLASH sequences respectively. The average signal increase gradient of pannus (108.2 +/- 70.6%/min) was significantly (p less than 0.001) different from muscle (13.4 +/- 7.8%/min), fatty tissue (10.2 +/- 8.4%/min), bone marrow (5.5 +/- 7.1%/min), and joint effusion (14.7 +/- 7.8%/min).
 ...
PMID:Gadolinium-DTPA in rheumatoid arthritis and related diseases: first results with dynamic magnetic resonance imaging. 260 93

In this study, the immunoregulation of IgG and IgM synthesis by synovial fluid lymphocytes (SFL) in rheumatoid arthritis (RA) was investigated. A group of 15 sero-positive rheumatoids with a level of lymphocytes in the joint effusion fluids greater than 40% were selected. In 20 experiments, Con A stimulated peripheral blood lymphocytes (PBL) suppressed Ig synthesis by autologous SFL, tested in the presence and absence of pokeweed mitogen. Mean inhibition value for IgG production was 70.5% +/- 7.1 and for IgM 64.8% +/- 7.5. There were significant differences in the numbers of IgG and IgM producing cells compared to that of controls (p less than 0.001). In contrast, SFLs preactivated with Con A had little suppressive effect; but when SFL's suppressor cells were co-cultured with PBL in a diffusion chamber (used as model for the human joint), they were able to decrease Ig synthesis. The highest inhibition was induced when SFL were pre-incubated with allogeneic PBL from healthy donors. Mean decreases were 514 counts per minute (CPM) for IgG and 486 CPM for IgM compared to control values, almost 50% of the total spontaneous production. These results indicate that the impairment of the suppressor function is restricted to the site of inflammation and can be corrected by PBL. The data hints that intra-articular immunotherapy may have potential therapeutic value.
 ...
PMID:Immunotherapy in rheumatoid arthritis by T-suppressor lymphocytes: experimental model in vitro. 294 11

Five normal knees and 20 knees with suspected abnormalities involving the menisci or articular surfaces were examined with high-resolution surface-coil MRI. Surgical correlation was available in 15 cases. Signal-to-noise ratios were optimized using a field strength of 1.5 T and a round 7.6-cm surface coil. Spatial resolution was maximized by using fields of view reduced to as small as 8 cm. Separate examinations of the medial and lateral joint compartments were performed with the surface coil positioned vertically adjacent to the meniscus of interest. Ten meniscal tears were identified using sagittal and coronal images. T1-weighted images were adequate to detect most meniscal tears, and T2-weighted images were useful for providing an "arthrogram effect" in the presence of a joint effusion. Extrameniscal lesions that were examined included osteonecrosis of the femoral condyle, subchondral cysts, rheumatoid arthritis, degenerative arthritis, and anterior cruciate ligament tears. MRI was useful in determining the integrity of articular cartilage overlying defects in the subchondral bone and in detecting gross cartilage lesions in arthritis, but was less sensitive than arthroscopy in evaluating moderate changes in the hyaline cartilage.
 ...
PMID:1.5-T surface-coil MRI of the knee. 348 47


<< Previous 1 2 3 4 5 6 7 8 9 Next >>