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Query: UMLS:C0018099 (gout)
 5,192 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Infectious arthritis is a commonly encountered clinical problem which may result from articular contamination by a wide variety of organisms. Involvement of an articulation may occur by one of four mechanisms: hematogenous spread, spread from a contiguous source of infection, direct implantation, or postoperative contamination. Distribution is typically monoarticular with a swollen, erythematous, and painful joint. The radiographic differential diagnosis includes limited rheumatoid arthritis, gout, synovial osteochondromatosis, and pigmented villonodular synovitis. In order to prevent complications, including growth disturbances, articular destruction with ankylosis, osteomyelitis, or soft tissue extension, early diagnostic arthrocentesis is important. Radiographic abnormalities, which include soft tissue swelling, joint space loss, periarticular osteopenia, and central or marginal osseous erosions, may be delayed following clinical onset of infection. Advanced imaging techniques such as scintigraphy, CT, or MRI may allow accurate diagnosis of the infectious process at an earlier stage.
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PMID:Septic arthritis. 305 Oct 98

174 knee joints with non-traumatic effusion have been examined by arthroscopy. In 71 cases synovial biopsy was performed. 43% of the knees had cartilaginous damage of the patella or tibiofemoral joint, 19% had an old meniscal and/or ligamentous tear and 33% a "non-specific" synovitis. The remaining 5% comprise 5 patients with pigmented villonodular synovitis, 3 patients with gout, one with synovial tuberculosis and one with a hemangioma of synovial membrane. Arthroscopy serves for early recognition of degeneration of hyalin cartilage and meniscal lesions, while synovial biopsies are also largely non-traumatic. Endoscopic evaluation of synovial membrane is more difficult. Mechanical irritation produces proliferation of synovial villi, while bacterial and rheumatoid inflammation leads to exudative and necrotic changes. The differences are obvious in marked inflammation but difficult to recognize in the beginning of any process. Arthroscopic and histological examination determines the etiology of synovitis only in pigmented villonodular synovitis and synovial tuberculosis. In the other forms of synovitis it is only possible to determine the stage and intensity of inflammation but not the etiology. The diagnosis of rheumatoid arthritis in particular is seldom secured by arthroscopy.
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PMID:[Results of arthroscope studies of knee joint effusions of unknown origin]. 714 53

By definition, monoarticular arthritis means one-joint involvement, even though, in fact, such a condition is often an oligoarthritis because as many as two or three separate joints will be involved. Arthritis is often limited and may regress, so that it is frequently misdiagnosed. Sometimes, a monoarticular condition may be a polyarthritis onset (i.e., rheumatoid arthritis). Monoarticular arthritis can be caused by many factors, such as infections (septic arthritis), nonspecific inflammatory processes (reactive arthritis), crystals deposition (gout, CPPD crystal deposition disease), trauma, neoplasm (pigmented villonodular synovitis), immunologic conditions (amyloidosis) and hormonal changes (parathyroid disease). Its onset is usually acute and sometimes dramatic, with fever, pain and joint swelling, so that a decision must be made promptly to stop rapid illness evolution and to prevent the irreversible destruction of cartilage and bone (especially in septic arthritis). Diagnostic studies are performed with mono-bilateral radiographs of the joint. Radiographic findings (i.e., soft tissue swelling, joint effusion, widening and thinning of joint spaces, bone erosions and destruction of bone surface) are typical of the disease, but some findings (e.g., type of evolution and progression), laboratory tests, synovial biopsy and arthroscopy can differentiate infectious from inflammatory forms. Scintigraphy can depict isotopic joint uptake, before articular abnormalities are demonstrated with radiography, thanks to its high sensitivity; nevertheless, because of its low specificity, scintigraphy may miss some kinds of lesions (including osteoarthritis) and cannot easily differentiate osteomyelitis from septic arthritis. CT and MRI play a secondary, though not negligible, role, especially to study such deep infections as psoas abscesses, which may mimic arthritides.
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PMID:[Monoarthritis]. 868 51

A 56-year-old woman with systemic lupus erythematosus developed septic arthritis and bursitis of the left shoulder due to an atypical mycobacterium, M. xenopi. Plain radiography, ultrasound (US), and MRI were performed. Articular disease by tuberculous and nontuberculous mycobacteria have similar presentations, clinically as well as radiologically, and have to be differentiated from other chronic bacterial or fungal infections, pigmented villonodular synovitis, rheumatoid arthritis, gout, hemophilia, and synovial chondromatosis. Although atypical mycobacterial involvement of the skeleton and soft tissues is relatively uncommon, its incidence is increasing, as is the incidence of extrapulmonary tuberculosis in western countries. The triad of Phemister is reemphasized, and the US and MRI findings are demonstrated. The definitive diagnosis has to be made by culturing biopsied synovium or synovial fluid.
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PMID:Nontuberculous mycobacterial bursitis and arthritis of the shoulder. 950 8

A comparative study of synovitis in Saudi Arabia and Malaysia was made with a view to determining any geographic variation in the incidence and pattern of the arthritides. The diagnostic spectrum in both series included pyogenic arthritis, rheumatoid arthritis, brucellar and tubercular arthritis, gout, pigmented villonodular synovitis, synovial chondromatosis and acute rheumatic fever. Date-palm thorn synovitis was observed only in the Saudi Arabian series. While brucellar and tuberculous arthritis were predominantly seen in Saudi Arabia, the incidence of rheumatoid arthritis, pigmented villonodular synovitis and acute suppurative arthritis was almost equal in both countries.
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PMID:Synovial biopsy. A comparative study from Saudi Arabia and Malaysia. 972 15

The etiology of chronic diseases of the ankle joint comprises a wide spectrum including chronic inflammatory processes and chronic degenerative, tumorous and neuropathic processes, as well as some specific syndromes based on chronic changes of the ankle joint. Of the inflammatory processes, chronic juvenile arthritis (JVC) is the most common disease. However, also Reiter disease, psoriasis or chronic monoarthritid diseases such as gout, as well as granulomatous diseases (tuberculosis, sarcoidosis) and fungal infections, may affect the ankle joint in a chronic course. Chronic degenerative changes are usually secondary due to abnormal positioning of the joint constituents or repetitive trauma. Neuropathic changes, as frequently seen in the course of diabetes, present with massive osseous destruction and malposition of the articular constituents. Chronic osseous as well as cartilaginous and synovial changes are seen in hemophilic patients. Chronic traumatic changes are represented by pigmented villonodular synovitis (PVNS), and chondromatosis, both with a predilection for the ankle joint. Due to the possibilities of magnetic resonance imaging (MRI), diagnosis of chronic ankle changes includes chronic ligamentous, tendinous and soft tissue changes. With the use of MRI, specific syndromes can be defined which particularly affect the ankle joint in a chronic way, such as the os trigonum syndrome, the anterolateral impingement syndrome and the sinus tarsi syndrome. Nevertheless, plain film radiographs are still the basic element of any investigation. MRI, however, can be potentially used as a second investigation, saving an unnecessary cascade of investigations with ultrasound and CT. The latter investigations are used only with very specific indications, for instance CT for subtle bone structures and sonography for a limited investigation of tendons or evaluation of fluid. Particularly due to the possibilities of MRI and the development of special gradient-echo imaging or high-resolution coils, the investigation of the ankle joint still offers a wide spectrum of innovation for the next years, which is particularly enforced by the increasing demand for specific diagnosis of chronic diseases in orthopedic medicine.
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PMID:[Chronic diseases of the ankle joint]. 1006 76

Diagnosis of septic arthritis requires aspiration and analysis of joint fluid. However, nonseptic articular disorders are fairly common and represent a significant diagnostic and therapeutic challenge. Such disorders include gout, Milwaukee shoulder, rapidly destructive articular disease, amyloid arthropathy, hemophilic arthropathy, primary synovial osteochondromatosis, pigmented villonodular synovitis, neuropathic arthropathy, and foreign-body synovitis. The clinical signs of articular disease, which include pain, swelling, and limitation of motion, are often nonspecific and can overlap with those of osseous or extraarticular disorders. Many articular processes have characteristic radiologic appearances that allow definitive diagnosis. Radiography is an important part of the evaluation of patients with articular disease. However, magnetic resonance (MR) imaging is the method of choice for characterizing the various disorders and assessing the full extent of osseous, chondral, and soft-tissue involvement. MR imaging can exquisitely demonstrate joint effusions, synovial proliferation, articular cartilage abnormalities, subchondral bone, ligaments, muscles, and juxtaarticular soft tissues. Although a wide spectrum of noninfectious processes may involve the joints, careful analysis of the imaging findings and correlation of these findings with the patient's clinical history can suggest a more specific diagnosis in most cases. Awareness and understanding of the underlying histopathologic findings aids in interpretation of MR images.
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PMID:Nonseptic monoarthritis: imaging features with clinical and histopathologic correlation. 1104 78

The superior soft tissue contrast and multiplanar capability of MR imaging has contributed to earlier diagnosis and implementation of effective treatment for a variety of arthropathies and infectious conditions of the elbow, wrist, and hand. Because of overlapping clinical signs and symptoms, MR imaging plays an important role in delineating the features and staging of each of these conditions. This article discusses the seropositive and seronegative inflammatory arthropathies, with emphasis on early detection and surveillance, as well as gout, synovial osteochondromatosis, pigmented villonodular synovitis, tenosynovitis, and de Quervain's tenosynovitis. Certain noninflammatory arthritides and infectious conditions are also reviewed.
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PMID:MR imaging: arthropathies and infectious conditions of the elbow, wrist, and hand. 1517 91

Intraarticular masses can be classified as noninfectious synovial proliferative processes (lipoma arborescens, synovial osteochondromatosis, pigmented villonodular synovitis, rheumatoid arthritis), infectious granulomatous diseases (tuberculous arthritis, coccidioidomycosis arthritis), deposition diseases (gout, amyloid arthropathy), vascular malformations (synovial hemangioma, arteriovenous malformations), malignancies (synovial chondrosarcoma, synovial sarcoma, synovial metastases), and miscellaneous (cyclops lesion). Knowledge of articular anatomy aids the radiologist in localizing masses to the joint space. Some joints have complex anatomy with contiguous or adjacent bursae, recesses, and tendinous connections from which masses may originate or into which masses may extend. Many of the diseases causing intraarticular masses have specific imaging characteristics, especially on magnetic resonance images, and knowledge of these characteristics will allow for a more confident diagnosis.
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PMID:Imaging of intraarticular masses. 1565 90

The superior soft tissue contrast and multiplanar capability of MR imaging has contributed to earlier diagnosis and implementation of effective treatment for a variety of arthropathies and infectious conditions of the elbow, wrist, and hand. Because of overlapping clinical signs and symptoms, MR imaging plays an important role in delineating the features and staging of each of these conditions. This article discusses the seropositive and seronegative inflammatory arthropathies, with emphasis on early detection and surveillance, as well as gout, synovial osteochondromatosis, pigmented villonodular synovitis, tenosynovitis, and de Quervain's tenosynovitis. Certain noninflammatory arthritides and infectious conditions are also reviewed.
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PMID:MR imaging: Arthropathies and infectious conditions of the elbow, wrist, and hand. 1682 53


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