• 제목/요약/키워드: chronic synovitis

검색결과 22건 처리시간 0.022초

Initial experience with intra-articular 188Re-tin colloid as a "radiation synovectomy" agent in various joints

  • Shinto, Ajit S;Indira, VU;Kamaleshwaran, KK;Banka, Vinay Kumar;Aswathy, KK;Thirumalaisamy, SG;Rajamani, V;Mallia, Madhav;Banerjee, Sharmila
    • 대한방사성의약품학회지
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    • 제1권2호
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    • pp.109-117
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    • 2015
  • Radiation synovectomy has been proposed as a promising palliative therapy for recurrent joint effusions for the last two or three decades. Ionizing radiations emitted by intrarticularly administered radiolabelled colloids. The aim of this study was to assess the effectiveness of radiation synovectomy (RSV) using $^{188}Re$-tin colloid in the treatment of recurrent joint effusions and chronic synovitis of knee joints. Three phase bone scan was acquired for the concerned joint prior to radiosynovectomy. $^{188}Re$-tin colloid was prepared as per the reported protocol. 9 patients, diagnosed with rheumatoid arthritis and suffering from chronic resistant synovitis of the knee, ankle or elbow joints were administered the radiopharmaceuticals, checked for radiochemical purity >95% by intraarticular route. A whole body scan was acquired 2 h post-radiosynovectomy. In all the 9 treatments, no leakage to non-target organs was visible in the whole body scan. Static scans of the joint revealed complete retention of $^{188}Re$-tin colloid in the joints post administration of the agent. Clinically all patients exhibited a complete or partial response. RSV with $^{188}Re$-tin colloid was safe and effective in patients with chronic synovitis of rheumatoid origin.

생체분해성 Meniscus Arrow를 이용한 반월상 연골 봉합술후 발생한 비세균성 활액막염 -증례보고- (Aseptic Synovitis after Meniscal Repair using Biodegradable Meniscus Arrow - A Case Report -)

  • 송은규;이근배;이영근
    • 대한관절경학회지
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    • 제2권2호
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    • pp.181-184
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    • 1998
  • 저자들은 생체 분해성 Meniscus Arrow$^{(R)}$를 이용한 반월상 연골 봉합술후에 발생한 비세균성 활액막염을 최초로 경험하였다. 따라서 향후 Meniscus Arrow$^{(R)}$를 이용한 반월상 연골 봉합술 후에 활액막염이 발생할 수 있음을 고려하여야 하며, 이 경우에서 활액막 절제술로 좋은 결과를 얻을 수 있었기에 문헌과 함께 보고하는 바이다.

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Nested 중합효소연쇄반응을 이용하여 활막염 환자의 관절액으로부터 아데노바이러스와 대상포진바이러스의 이중감염과 지속감염의 검출 (Detection of Coinfection and Persistent Infection of Adenovirus and Varicella-Zoster Virus in Synovial Fluids from Synovitis Patients by Nested-PCR)

  • 박혜경;우소연;김현진
    • 대한바이러스학회지
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    • 제30권3호
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    • pp.179-187
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    • 2000
  • The etiology of rheumatic arthritis (RA) is associated with a number of genetic and environmental factors, but is not definitively elucidated. Recently, more attention has been paid to the possibility of microbial etiology in the pathogenesis of RA, because many different infectious agents have been reported to precede the onset or exacerbation of RA. Adenovirus (ADV) may be one cause of persistent or recurrent inflammatory arthritis. Varicella zoster virus (VZV) arthritis is detected frequently in RA patients treated with low dose methotrexate. The demonstration of simultaneous presence of both viral agents of specific viral nucleic acid in synovial fluids from synovitis patients would provide more direct evidence for arthritis etiological relationship, but there are no confirmed results. Therefore, we studied the ability of adenovirus and VZV to establish coinfection and persistent infection in synovial fluid from synovitis patients. The presence of viral agents in the synovial fluid demonstrated by isolation of cell culture, enzyme immunoassay and nested-PCR. The synovial fluids were also investgated for the presence of viral nucleic acid by nested-PCR using specific primer. ADV produced 220 bp and VZV produced 447 bp by each nested-PCR with specific primers. We detected 4/6 cases (66.7%) with persistent infection of ADV and 5/6 cases (83.3%) of VZV with 13 synovial fluids (between 7 to 52 day intervals) from synovitis patients by monoclonal ErA and nested-PCR. 21/28 cases (75%) with coinfection of adenovirus and VZV with synovial fluids from synovitis patients by nested-PCR. ADV and VZV coinfection and persistent infection of synovial fluids may provide a chronic antigenic stimuli to the immune system therefore provoking a continuing inflammatory response and caused the possibility of synovitis and arthritis.

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Tuberculous Tenosynovitis of the Elbow - A Case Report

  • Oh, Chi-Hun;Park, Jung-Ho;Kim, Jung-Wook
    • Clinics in Shoulder and Elbow
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    • 제17권2호
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    • pp.80-83
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    • 2014
  • A 29-year-old man visited our clinic owing to a persistent swelling in the anterior part of the left elbow joint that began one year ago. Through magnetic resonance imaging (MRI), we observed tenosynovitis with multiple rice bodies, and so we performed an excisional biopsy and tenosynovectomy. Through pathology and culture tests, we identified tuberculosis in the tissue biopsy that we harvested intraoperatively. Following the anti-tuberculosis medication relieved the patient's symptoms without recurrence. Since tuberculosis of the elbow occurs only rarely, and the symptoms mimic those of rheumatoid synovitis or of non-specific chronic synovitis, early diagnosis and appropriate treatment are often delayed. The authors report this rare case of tuberculous tenosynovitis of the elbow with a review of the relevant literature.

수근관절 활액막염 원인 질환 진단을 위한 다중적 접근법 (Multimodal Diagnostic Approach for Synovitis of the Wrist)

  • 배기정;김지형;윤찬;홍성화;공현식;백구현
    • 대한정형외과학회지
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    • 제53권6호
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    • pp.540-546
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    • 2018
  • 목적: 본 연구의 목적은 수근관절 활액막염 진단하에 활막 절제술을 시행한 환자들을 대상으로 원인 질환 진단을 위한 다중적 접근법을 제시하고자 한다. 대상 및 방법: 2000년 1월부터 2013년 12월까지 서울대학교병원에서 수근관절 활액막염 진단하에 활막 절제술을 시행한 환자 중 수술 전 수근관절 조영 증강 자기공명영상 검사를 시행한 29명의 환자를 대상으로 후향적으로 분석하였다. 이 중 17명의 환자는 수술 전 $Tc^{99m}$ 백혈구 스캔 검사를 시행하였다. 류마티스 관절염 진단 기준에 부합하는 환자의 경우, 수근관절 자기공명영상 및 조직 병리 검사 결과 중 하나 이상에서 류마티스 관절염을 시사하는 소견이 나왔다면 류마티스 관절염으로 최종 진단하였다. 만약 자기공명영상 검사와 조직 검사 소견이 시사하는 진단이 다르게 나타나는 경우에는 조직 검사 소견 결과를 토대로 확진하였다. 결과: 류마티스 관절염 진단 기준을 충족하는 9명의 환자 중 7명의 환자는 류마티스 관절염으로 최종 확진되었으며, 2명의 환자는 결핵성 관절염으로 최종 진단되었다. 류마티스 관절염 진단 기준을 충족시키지 못한 20명의 환자 중 12명은 자기공명영상 검사 및 조직 검사 결과 모두 동일한 질환을 시사하는 것으로 나왔으며 나머지 8명의 환자들은 임상 양상, 자기공명영상 및 조직학적 소견에 근거하여 5명은 비특이적 만성 활액막염, 1명은 류마티스 관절염, 2명은 결핵성 관절염으로 최종 진단되었다. 결론: 자기공명영상 검사 및 백혈구 스캔 검사는 수근관절 활액막염 원인 질환 진단에 많은 도움이 되는 유용한 검사이다. 진단이 어렵거나 약물 치료에 반응이 없는 경우에 활막 절제술을 통한 조직 병리 검사 결과는 매우 유용할 수 있다.

자기공명영상에서 나타난 만성 족근관절 외측 불안정성 동반 병변 (Associated Lesions of Magnetic Resonance Image in the Chronic Lateral Ankle Instability)

  • 이호진;주인탁;최광천
    • 대한족부족관절학회지
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    • 제13권1호
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    • pp.19-22
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    • 2009
  • Purpose: This retrospective study was designed to determine the type and frequency of associated lesions in patients with chronic lateral ankle instability who had modified Brostrom lateral ankle ligament reconstruction. Materials and Methods: Between 2004 and 2007, 60 cases of 60 patients were enrolled in this study. A retrospective review of the magnetic resonance images of the affected ankle was conducted by two orthopedic surgeons who did not get any information about intraoperative findings and the lesions were admitted when two doctors were coincident. Results: The overall incidence of associated lesions found in this study was about 83%. Peroneal tenosynovitis was the highest frequency (32%), followed by osteochondral lesion of talus (28%), anterolateral impingement (15%), Os subfibula (13%), Os trigonum (12%), ankle synovitis (12%), anterior tibiofibular ligament tear (15%), anterior bony spur (7%). Another findings were loose bodies (5%), flexor tendon tenosynovitis (5%), medial osteophyte (3%). Conclusion: Identifying these associated lesions will be helpful in treating chronic lateral ankle instability especially when the surgeon have a plan to operate the instability. We suggest that the better results can be obtained when the associated lesions are corrected simultaneously.

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봉합 나사를 이용한 변형 Br$\ddot{o}$strom 술식 및 관절경 검사를 이용한 족관절 외측 불안정성의 치료 (Treatment of Chronic Ankle Lateral Instability using Modified Br$\ddot{o}$strom Procedure with Anchor suture & Arthroscopy)

  • 이진영;김갑래;이은수;박현진
    • 대한족부족관절학회지
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    • 제13권2호
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    • pp.175-178
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    • 2009
  • Purpose: To evaluate the result of modified Br$\ddot{o}$strom procedure with anchor suture and explore associate lesion under arthroscopy for chronic lateral instability. Materials and Methods: From May 2005 to March 2009, Retrospective analysis of 126 patients with chronic lateral instability who underwent modified Br$\ddot{o}$strom procedure with anchor suture and arthroscopic procedure was done. Mean follow-up period was 13 months. Results: Chronic lateral instability of the ankle almost had local synovitis by arthroscopic examination. There were osteochondral lesion of talus on the anteromedial aspect in 63 cases, on the anterolateral aspect in 25 cases, osteochondral lesion of tibia side in 8 cases, fat hypertrophy of tibiofibular space in 120 cases, anterior fat impingement in 26 cases, intra-articular loose body in 13 cases. Mean Karlsson scoring scale was improve from 53 preoperatively to 91 postoperatively, There were 70 cases excellent, 27 cases good, 26 cases fair, 3 cases poor result according to the Sefton procedure. Conclusion: Modified Br$\ddot{o}$strom procedure with anchor suture and arthroscopic procedure are reliable treatment method for chronic ankle lateral instability which has intraarticular pathology.

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Chen 술식을 이용한 족근관절의 만성 외측 불안정에 대한 재건술 (Reconstruction for Chronic Lateral Instability of the Ankle by Chen Method)

  • 이기행;유종민;나기태;공윤배;주인탁
    • 대한족부족관절학회지
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    • 제14권1호
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    • pp.53-57
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    • 2010
  • Purpose: This study was designed to evaluate the clinical and radiographical results of anatomical reconstruction by Chen method for chronic lateral ankle instability. Materials and Methods: Fifteen patients with chronic lateral ankle instability who had undergone anatomical reconstruction of anterior talofibular and calcaneofibular ligaments by Chen method were evaluated retrospectively. Average age of the patients was 31.3 years, and average follow-up period was 15.5 months. Preoperative and postoperative radiographs including varus stress view and magnetic resonance imaging (MRI) were analyzed. The clinical evaluation was performed according to the American Orthopaedic Foot and Ankle Society (AOFAS) scale. Results: Radiographically average talar tilt angle was $15.3^{\circ}$ preoperatively, and the difference with contralateral normal side was $10.1^{\circ}$. At last follow up, talar tile angle and the difference with contralateral side improved to $5.9^{\circ}$ and $1.3^{\circ}$ respectively. AOFAS scale was 66.6 preoperatively and 87.3 postoperatively. In MRI findings, four patients had associated intra-articular lesion such as articular cartilage defect, synovitis and osteoarthritis. The talar tilt angle improvement and AOFAS scale of patients without intra-articular lesion was better than those of four patients with intra-articular lesions. Surgical wound pain occurred in six patients and sural neuropathy in three patients. Conclusion: The anatomical reconstruction by Chen method was an easy and effective procedure for symptomatic chronic lateral ankle instability. Careful operative technique may prevent the surgical wound pain and sural neuropathy.

아시아 지역의 닭마이코플라즈마병 상황

  • 강민수
    • 월간양계
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    • 제33권7호통권381호
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    • pp.100-105
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    • 2001
  • 마이코플라즈마 갈리셉티쿰(Mycoplasma gallisepticum, MG)및 마이코플라즈마 시노비에(M. synoviae,MS)에 의한 감염증은 아시아지역 뿐만 아니라 전세계적으로 닭에서 흔히 발생하는 질병이다. MG 감염은 흔히 닭에서 기낭염을 수반하는 만성호흡기병(chronic respiratory disease, CRD)과 칠면조의 전염성부비동염(infectious sinusitis)을 일으킨다. MS는 처음에 육계에서 전염성활막염(infectious synovitis)을 유발하는 병원체로만 알려졌으나, MG에 감염되지 않은 육계의 기낭염 병변부에서 빈번히 분리됨으로 인해 최근에는 원래의 전염성활막염보다 기낭염과 관련하여 많은 관심이 고조되고 있다. 아시아지역의 마이코플라즈마 감염상황을 대변하는 많은 문헌자료가 있으나, 대부분이 자국의 언어로 출판되어 있는 관계로 자료분석에 많은 애로가 있어 주로 해독이 가능한 영문자료를 근거로 하여 각국의 닭에서의 MG 및 MS 감염증의 발생상황과 방제현황에 대하여 언급하고자 한다. 비록 개략적이 나마 이를 토대로 국내 마이코플라즈마 방역상황을 되돌아볼 수 있는 계기가 되었으면 한다.

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