Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The knee is frequently injured and affected by a variety of diseases. A precise history of injury or onset of symptoms is essential. The joint is ideally examined as soon after injury as possible. Examination should include observation of swelling, palpation of bony prominences, determination of the presence of effusion, recording of range of motion and evaluation of joint stability. Although x-ray studies constitute an important part of overall assessment, they only augment and not supplant thorough physical examination. Aspiration of joint effusion should be performed for diagnostic purposes, or to relieve pain. Arthrocentesis is indicated when effusion of uncertain etiology is present.
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PMID:Evaluation of the knee. 379 72

Intraarticular injections of rifamycin SV were repeated weekly in patients with rheumatic disease with a chronic knee joint effusion. The clinical signs of synovitis were reduced in all, but disappeared in only one. A post injection reaction with transient local pain and effusion appeared at the third or a later injection in all the patients prompting withdrawal of 3. At these later injections local drug retention was shown by parallel determinations of rifamycin SV in synovial fluid and serum. The post treatment synovial fibrosis seen at arthroscopy could possibly explain the drug retention and the post injection inflammatory reaction. Thus, local treatment with rifamycin SV alleviated but rarely abolished synovitis.
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PMID:Rifamycin SV in local treatment of synovitis--a clinical, arthroscopic and pharmacologic evaluation. 408 69

Eight cases of sessile, intra-articular soft tissue masses originating from the cranio-dorsal attachment of the capsule of the fetlock joint of horses are presented. In 4 of these cases an osteochondral fracture of the first phalanx was also present. Clinically the condition closely resembled villonodular synovitis; however the microscopic changes did not correspond to those reported. The clinical signs included lameness after exercise, joint effusion and pain on manipulation. The offending masses were surgically resected and their histology indicated a chronic proliferative synovitis. The results of these cases indicate that the condition carries a favourable prognosis.
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PMID:Soft tissue masses in the fetlock joint of horses. 724 88

Toxic synovitis, an acute inflammatory condition of the hip, is the most common cause of limp and acute pain of the hip in children under 10 years of age. Usually, the synovitis and joint effusion are present unilaterally. The etiology of the condition is unknown, although in a few cases a recent history of an upper respiratory tract infection may be present. The child with toxic synovitis may complain of a limp and pain in the hip, the anteromedial aspect of the thigh, and the knee. The white cell count and erythrocyte sedimentation rate may be slightly elevated, as is the body temperature. Ultrasound is recommended as the primary imaging tool in the diagnosis and treatment of toxic synovitis. Septic arthritis, Perthes disease, and osteomyelitis are a few of the differential diagnoses that the practitioner should consider. Most cases can be managed with bed rest at home and administration of a nonsteroidal anti-inflammatory medication. Follow-up care should occur 2 weeks after diagnosis to ensure there is no recurrence of the joint effusion or progression to avascular necrosis. Radiographs of the hip should be repeated at 1 month and 3 months to complete the patient follow-up.
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PMID:Toxic synovitis of the hip in children. 759 30

Osteoid osteomas, relatively rare lesions in the upper extremity, can be a persistent source of hand or wrist pain. Patients under age 40 who have otherwise unexplained pain should be evaluated. Relief of pain with oral nonsteroidal anti-inflammatory drugs should suggest the possibility of osteoid osteoma. Examination may demonstrate localized swelling or joint effusion. Radiographs should be examined for sclerosis in the region of pain. If radiographs are nondiagnostic, a bone scan should be obtained. If the nidus cannot be clearly visualized by radiography and bone scan, a CT scan should be obtained. If the location of the nidus makes excision difficult without removal of a large block of bone, localization with a CT-guided needle or by radioisotope labeling will help to assure removal of the nidus.
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PMID:Osteoid osteoma of the upper extremity. 763 83

Intraarticular treatment has been considered for osteoarthritis since the first attempts at local injection of steroid derivatives. To assess the effectiveness of intraarticular drugs, in view of the variability of the disease and the remarkable placebo response, a control group of patients is necessary. The main outcome measures are pain and joint effusion when using symptomatic slow acting drugs. If a chondroprotective effect is to be demonstrated the main criterion is measurement on standardized radiography of the knee medial femorotibial joint space.
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PMID:Intraarticular treatment of osteoarthritis and guidelines to its assessment. 779 90

Septic arthritis is a synovial infection of bacterial origin. Such a diagnosis, suggested by pain and diminished resistance to infection, should be confirmed by puncture of the joint effusion. The condition calls for emergency hospitalisation and treatment in a surgical unit. Treatment should include draining and cleaning of the joint, immobilization at least in the early stages, and double parenteral antibiotic administration. Clinical, radiological and laboratory follow-up (CRP and ESR) should be pursued. Detection of the responsible germ is often difficult and requires great care in sampling and analysis. The frequency of Haemophilus in children under 4 years of age requires adaptation of antibiotic therapy. In newborns, diagnosis is often difficult and delayed, explaining the frequency of sequelae in this age group. The only important prognostic factor is the interval before beginning treatment.
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PMID:[Septic arthritis in children]. 785 26

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

The aim of this study was to determine the comparative efficacy and safety of intra-articular (i/a) triamcinolone. hexacetonide (TH) and i/a hyaluronic acid (HA) in inflammatory knee osteoarthritis. A randomized double-blind comparative trail was carried out in a rheumatology outpatient department. There were 63 patients (24 male, 39 female, mean age 70.5 years) with bilateral symptomatic knee osteoarthritis with effusion. Each was given five HA injections at weekly intervals; or 20 mg TH followed by four placebo (saline) injections. Patients were examined weekly during the treatment period and then at monthly intervals for a further 6 months. Assessment included recording of: visual analog scores (VAS) for pain; duration of stiffness; range of movement; joint effusion; local heat; synovial thickening; joint-line and periarticular tenderness. The principal outcome measure was pain on a self-selected activity assessed by Vas. The two groups were comparable at entry and no significant differences between the groups developed at any time during the treatment period. However, there was a high drop-out rate and intention to treat analysis failed to demonstrate statistically significant differences between the groups. In patients remaining in the study, significantly less pain was experienced by the HA group during the 6 month follow-up period. Other parameters showed a similar trend in favor of experienced by the HA group during the 6 month follow-up period. Other parameters showed a similar trend in favor of HA. We could not, however, demonstrate significant differences between the placebo and active treatments. HA may therefore be a useful additional therapy for symptomatic knee osteoarthritis and may have a long duration of action.
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PMID:Intra-articular hyaluronic acid compared to intra-articular triamcinolone hexacetonide in inflammatory knee osteoarthritis. 868 62

In order to investigate the relationship between various temporomandibular joint (TMJ) pain levels and the detection of high signal intensity (joint effusion) on T2 weighted magnetic resonance imaging (MRI), 19 consecutive patients who complained of unilateral painful TMJ hypomobility (closed locking) were involved in this study. All patients were clinically examined in a routine manner, and all patients rated their pain levels by a visual analogue scale and eight pain questionnaire prior MRI study. T1 and T2 weighted MRI was taken in sagittal section at unilateral affected joint side. The presence or absence of a high signal intensity spot within the TMJ compartment were judged by three examiners. The high signal intensity was detected in 10 joints, but not in 9 joints. In between these two groups, the pain ratio was calculated and compared. The data showed that there was no significant statistical correlation between pain levels and the presence of high signals. This study disclosed that the MRI detection of high signal intensity in the closed locking TMJ did not directly relate to the presence of TMJ pain nor the increased pain level. These indicate the need of further larger studies.
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PMID:MRI evidence of high signal intensity and temporomandibular arthralgia and relating pain. Does the high signal correlate to the pain? 881 54


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