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Delayed endochondral ossification in early medial coronoid disease (MCD): a morphological and immunohistochemical evaluation in growing Labrador retrievers

Lau SF, Hazewinkel HA, Grinwis GC, Wolschrijn CF, Siebelt M, Vernooij JC, et al.

Vet J, 2013 Sep;197(3):731-8.
PMID: 23746870 DOI: 10.1016/j.tvjl.2013.04.021

Medial coronoid disease (MCD) is a common joint disease of dogs. It has a multifactorial aetiology, but the relationship between known causal factors and the disease has yet to be elucidated. As most of the published literature is clinical and it reports changes associated with advanced disease, it is not known whether the changes reflect the cause or consequences of the condition. The aim of this study was to investigate early micromorphological changes occurring in articular cartilage and to describe the postnatal development of the medial coronoid process (MCP) before MCD develops. Three litters of MCD-prone young Labrador retrievers were purpose-bred from a dam and two sires with MCD. Comparisons of the micromorphological appearance of the MCP in MCD-negative and MCD-positive joints demonstrated that MCD was initially associated with a disturbance of endochondral ossification, namely a delay in the calcification of the calcifying zone, without concurrent abnormalities in the superficial layers of the joint cartilage. Cartilage canals containing patent blood vessels were only detected in dogs <12 weeks old, but the role of these channels in impaired ossification requires further investigation. Retained hyaline cartilage might ossify as the disease progresses, but weak areas can develop into cracks between the retained cartilage and the subchondral bone, leading to cleft formation and fragmentation of the MCP.

Matched MeSH terms: Joints/pathology*
The early development of medial coronoid disease in growing Labrador retrievers: radiographic, computed tomographic, necropsy and micro-computed tomographic findings

Lau SF, Wolschrijn CF, Hazewinkel HA, Siebelt M, Voorhout G

Vet J, 2013 Sep;197(3):724-30.
PMID: 23702281 DOI: 10.1016/j.tvjl.2013.04.002

Medial coronoid disease (MCD) encompasses lesions of the entire medial coronoid process (MCP), both of the articular cartilage and the subchondral bone. To detect the earliest signs of MCD, radiography and computed tomography were used to monitor the development of MCD in 14 Labrador retrievers, from 6 to 7 weeks of age until euthanasia. The definitive diagnosis of MCD was based on necropsy and micro-computed tomography findings. The frequency of MCD in the dogs studied was 50%. Radiographic findings did not provide evidence of MCD, ulnar subtrochlear sclerosis or blunting of the cranial edge of the MCP. Computed tomography was more sensitive (30.8%) than radiography (0%) in detecting early MCD, with the earliest signs detectable at 14 weeks of age. A combination of the necropsy and micro-computed tomography findings of the MCP showed that MCD was manifested as a lesion of only the subchondral bone in dogs <18 weeks of age. In all dogs (affected and unaffected), there was close contact between the base of the MCP and the proximal radial head in the congruent joints. Computed tomography and micro-computed tomography findings indicated that the lesions of MCD probably originated at the base of the MCP.

Matched MeSH terms: Joints/pathology*
Fulltext Functional Outcome after Treatment of Aggressive Tumours in the Distal Radius: Comparison between Reconstruction using Proximal Fibular Graft and Wrist Fusion

Choo CY, Mat-Saad AM, Wan-Azman WS, Wan Z, Nor-Azman MZ, Yahaya S, et al.

Malays Orthop J, 2018 Nov;12(3):19-23.
PMID: 30555642 MyJurnal DOI: 10.5704/MOJ.1811.004

Introduction: Restoration of a functional hand is the ultimate goal following a distal radius tumour resection. The early outcomes of mobile wrist reconstruction are satisfactory; however, long-term results are unpredictable due to late wrist instability and degenerative arthritis. Our aim is to compare mobile wrist reconstruction with wrist fusion (pan-carpal fusion) in our cohort of patients. Materials and Methods: A retrospective cohort study was performed for functional outcomes of all patients who underwent resection for distal radius tumour and treated with either fusion or reconstruction of the wrist in a single institution from years 2000-2013 with a minimum of three years follow-up. Results: Eleven patients were included in the study, six of whom had wrist reconstruction with proximal fibula graft and the remaining five wrist fusion, with a mean follow-up of 6.3 years. The mean Musculoskeletal Tumour Society (MSTS) score was 82.78%, ranging from 70% to 93.3%. Average grip strength compared to the normal contralateral hand was 60.0% for total wrist fusion, which was better than wrist reconstruction with 58.07%. There was no difference in the functional outcome between fusion and mobile reconstruction in our study. Osteoarthritis changes and subluxation of the wrist joint were the most common findings in the long-term follow-up for this group. Conclusion: There was no difference in the functional outcome of the long-term follow-up between the two groups.

Matched MeSH terms: Hand Joints
Evaluation of antiarthritic activity of nimbolide against Freund's adjuvant induced arthritis in rats

Cui X, Wang R, Bian P, Wu Q, Seshadri VDD, Liu L

Artif Cells Nanomed Biotechnol, 2019 Dec;47(1):3391-3398.
PMID: 31394949 DOI: 10.1080/21691401.2019.1649269

Nimbolide, a triterpenoid isolated from flower of neem tree possess various therapeutic properties. The objective of the study was to assess the anti-arthritic activity of nimbolide in arthritis induced rats. Nimbolide (20 mg/kg per day) was given orally to arthritic rats induced with Complete Freund's Adjuvant and changes in paw volume, body weight, organ indices (thymus and spleen), arthritic score, biochemical parameters and proinflammatory cytokines levels were determined. Histopathological analysis was also performed. Western blot analysis was also performed. Rats treated with nimbolide displayed marked reduction in arthritic score, organ indices, volume of paw, edema formation, along with substantial enhancement in body weight. Histopathological findings showed significant reduction in destruction of joints and inflammation following nimbolide treatment. The protective action of arthritic rats treated with nimbolide was also substantiated by molecular and biochemical studies. The results of the study show that nimbolide treatment has markedly enhanced health and reduced inflammation via lessening the proinflammatory cytokines expression in arthritic rats. Hence, nimbolide may be used as a potent therapeutic drug in treating rheumatoid arthritis.

Matched MeSH terms: Joints/drug effects; Joints/metabolism; Joints/pathology
Fulltext Infected Non-union of Tibia Treated with Ilizarov External Fixator: Our Experience

Fahad S, Habib AA, Awais MB, Umer M, Rashid HU

Malays Orthop J, 2019 Mar;13(1):36-41.
PMID: 31001382 DOI: 10.5704/MOJ.1903.006

Introduction: Tibia is the most common long bone fractured due its vulnerable subcutaneous location and most often associated with acquired complications of delayed union or non-union due to infection. Amongst the various treatment options to treat them, the Ilizarov external fixator application is considered superior due to its multiple advantages. The objective of this study was to analyse the role of Ilizarov fixation in infected tibial non-union, as well as to assess bony union and associated functional outcomes. Materials and Methods: A retrospective review was conducted for the duration between 1st January 2005 to 31st December 2016. Total of fifty-one patients with tibial non-union associated with infection who treated with the Ilizarov fixator were included in the study. Patient records were reviewed for union of bone, bone and functional outcomes and complications. Results: The most common organism for infection was identified to be Staphylococcus Aureus. At the time of final follow-up all patients had achieved union except two, one of whom had to undergo amputation due to non-union and sepsis. Majority of the patients had an excellent score as per ASAMI grading system for bone and function results. The most common complication noted was pin track infections. Conclusion: In our experience, Ilizarov external fixator is better suited for infected non-union of tibia because it can provide a stable mechanical environment, bone transport, correct deformities, and enable weight bearing and hence we recommend its use for the same.

Matched MeSH terms: Joints
Fulltext Pathogenic role of immune cells in rheumatoid arthritis: implications in clinical treatment and biomarker development

Yap HY, Tee SZ, Wong MM, Chow SK, Peh SC, Teow SY

Cells, 2018 Oct 09;7(10).
PMID: 30304822 DOI: 10.3390/cells7100161

Rheumatoid arthritis (RA) is a chronic, autoimmune, systemic, inflammatory disorder that affects synovial joints, both small and large joints, in a symmetric pattern. This disorder usually does not directly cause death but significantly reduces the quality of life and life expectancy of patients if left untreated. There is no cure for RA but, patients are usually on long-term disease modifying anti-rheumatic drugs (DMARDs) to suppress the joint inflammation, to minimize joint damage, to preserve joint function, and to keep the disease in remission. RA is strongly associated with various immune cells and each of the cell type contributes differently to the disease pathogenesis. Several types of immunomodulatory molecules mainly cytokines secreted from immune cells mediate pathogenesis of RA, hence complicating the disease treatment and management. There are various treatments for RA depending on the severity of the disease and more importantly, the patient's response towards the given drugs. Early diagnosis of RA and treatment with (DMARDs) are known to significantly improve the treatment outcome of patients. Sensitive biomarkers are crucial in early detection of disease as well as to monitor the disease activity and progress. This review aims to discuss the pathogenic role of various immune cells and immunological molecules in RA. This review also highlights the importance of understanding the immune cells in treating RA and in exploring novel biomarkers.

Matched MeSH terms: Joints
Fulltext Proposal for a Radiological Classification System for Carpo-Metacarpal Joint Dislocations with or without Fractures

Pundkare GT, Deshpande SS

Malays Orthop J, 2018 Jul;12(2):42-46.
PMID: 30112128 DOI: 10.5704/MOJ.1807.008

Introduction: Though complex injuries like CarpoMetacarpal (CMC) Joint dislocations represent only 1% of all hand injuries, they have disabling impact on the functional status of patient. There are no reports in the literature classifying disabling complex injuries like CMC joint dislocations presumably because of low incidence. We propose a new classification through retrospective analysis of patients, along with literature search. Materials and Methods: A new classification system has been proposed and designed at our clinical unit and applied to eight patients with CMC joint dislocations. All patients were treated with open reduction with Kirschner wire fixation. At follow-up all these patients were analysed for radiographic assessments and functional scores. Results: The proposed classification identifies three types of dislocations and an additional complex category to supplement any basic type. The direction of dislocation describes the types as Type A: Dorsal, Type B: Volar and Type C: Divergent. Among the eight patients in our study, we had two of Type A, two Type B, three Type B.1, one Type C. 1. These patients had average follow-up of 18 months. The quick DASH score improved from 75.76 at 6 weeks to 1.9 at 18 months. We also did intra-observer and inter-observer reliability which scored 1. Conclusion: Our proposal is a reproducible, simple, comprehensive and practical classification, easily remembered and communicated among colleagues. It is clinically relevant as it helps us in planning surgical management and prognostic evaluation.

Matched MeSH terms: Carpometacarpal Joints
Fulltext Therapeutic Effects of Olive and Its Derivatives on Osteoarthritis: From Bench to Bedside

Chin KY, Pang KL

Nutrients, 2017 Sep 26;9(10).
PMID: 28954409 DOI: 10.3390/nu9101060

Osteoarthritis is a major cause of morbidity among the elderly worldwide. It is a disease characterized by localized inflammation of the joint and destruction of cartilage, leading to loss of function. Impaired chondrocyte repair mechanisms, due to inflammation, oxidative stress and autophagy, play important roles in the pathogenesis of osteoarthritis. Olive and its derivatives, which possess anti-inflammatory, antioxidant and autophagy-enhancing activities, are suitable candidates for therapeutic interventions for osteoarthritis. This review aimed to summarize the current evidence on the effects of olive and its derivatives, on osteoarthritis and chondrocytes. The literature on animal and human studies has demonstrated a beneficial effect of olive and its derivatives on the progression of osteoarthritis. In vitro studies have suggested that the augmentation of autophagy (though sirtuin-1) and suppression of inflammation by olive polyphenols could contribute to the chondroprotective effects of olive polyphenols. More research and well-planned clinical trials are required to justify the use of olive-based treatment in osteoarthritis.

Matched MeSH terms: Joints/drug effects*; Joints/metabolism; Joints/pathology
High incidence and treatment of flexor carpi radialis tendinitis after trapeziectomy and abductor pollicis longus suspensionplasty for basal joint arthritis

Low TH, Hales PF

J Hand Surg Eur Vol, 2014 Oct;39(8):838-44.
PMID: 24051478 DOI: 10.1177/1753193413506150

We reviewed the incidence and treatment of flexor carpi radialis tendinitis in 77 patients (81 thumbs) who had trapeziectomy and abductor pollicis longus suspensionplasty for thumb carpometacarpal joint arthritis. Eighteen patients, 20 wrists (25%) had flexor carpi radialis tendinitis. The onset was 2-10 months (mean 4.7) after surgery. Two cases had preceding trauma. Eight cases (40%) responded to splinting and steroid injection. Ten patients, 12 wrists (60%) underwent surgery after failing non-operative treatment. Eleven wrists had frayed or partially torn flexor carpi radialis tendon and one had a complete tendon rupture with pseudotendon formation. Flexor carpi radialis tenotomy and pseudotendon excision were performed. All operated patients obtained good pain relief initially post-operatively. However, the pain recurred in two patients after 8 months. One required a local steroid injection for localized tenderness at the site of the proximal tendon stump. The other patient required a revision operation for scaphotrapezoid impingement. Both obtained complete pain relief. Our study has shown a high incidence of flexor carpi radialis tendinitis following trapeziectomy and abductor pollicis longus suspensionplasty. Patients should be warned about this potential complication.

Study a collaboration between Malaysia and Australia

Matched MeSH terms: Carpometacarpal Joints/surgery*
The effect of control and self-medication of chronic gout in a developing country. Outcome after 10 years

Darmawan J, Rasker JJ, Nuralim H

J Rheumatol, 2003 Nov;30(11):2437-43.
PMID: 14677190

OBJECTIVE: We describe a 10 year observation of the effect of control of hyperuricemia compared with self-medication alone in patients with chronic gout.
METHODS: We studied 299 consecutively self-referred Malayo-Polynesian men with chronic gout, mean age 35 +/- 14.3 SD years. Subjects comprised 228 cases with chronic gout without tophi or urolithiasis (Group 1) and 71 with those complications (Group 2). Attacks of acute gouty arthritis were treated with nonsteroidal antiinflammatory drugs (NSAID) and/or corticosteroids. After acute arthritis had settled, urate-lowering drugs were instituted in both groups combined with low dose colchicine and/or low dose NSAID for at least 0.5-2 years. Urate levels were maintained longterm at a mean of < 5 mg/dl. After 10 years, the dropouts were traced and evaluated for comparison with baseline and those who remained in the study. In Group 2 the urate-lowering drugs were continued.
RESULTS: Control of gout and hyperuricemia was achieved in all patients who remained under control: 91.6% of the 299 patients for at least 2 years (short-term), up to 5 years in 87.5% (medium term), and up to 10 years in 79.6% (longterm). In Group 1 (chronic gout without complication) only 36.8% had no attacks during 8 years, after they had tapered urate-lowering drug after the first 2 years of the study. In the 61 dropouts the intermittent symptomatic treatment and/or self-medication without longterm control of hyperuricemia resulted after 1 decade in chronic gout with more complications and associated conditions leading to increased morbidity, disability, and comorbidity, and 3 early mortalities.
CONCLUSION: By controlling hyperuricemia, improvement of the prognosis of chronic gout, comorbidity, and early death was achieved compared with self-medication alone. Self-medication in a developing country if continued unchecked may become a public health problem in a population with a high prevalence rate of gout.

Matched MeSH terms: Joints/metabolism*
Fulltext Brief Report: A Randomized, Double-Blind, Parallel-Group, Placebo-Controlled, Multiple-Dose Study to Evaluate AMG 557 in Patients With Systemic Lupus Erythematosus and Active Lupus Arthritis

Cheng LE, Amoura Z, Cheah B, Hiepe F, Sullivan BA, Zhou L, et al.

Arthritis Rheumatol, 2018 07;70(7):1071-1076.
PMID: 29513931 DOI: 10.1002/art.40479

OBJECTIVE: To evaluate the safety and potential efficacy of AMG 557, a fully human antibody directed against the inducible T cell costimulator ligand (ICOSL) in patients with systemic lupus erythematosus (SLE) with arthritis.
METHODS: In this phase Ib, randomized, double-blind, placebo-controlled study, patients received AMG 557 210 mg (n = 10) or placebo (n = 10) weekly for 3 weeks, then every other week for 10 additional doses. The corticosteroid dosage was tapered to ≤7.5 mg/day by day 85, and immunosuppressants were discontinued by day 29. Primary end points on day 169 were safety, immunogenicity, the Lupus Arthritis Response Index (LARI; defined by a reduction in the tender and swollen joint counts), ≥1-letter improvement in the musculoskeletal domain of the British Isles Lupus Assessment Group (BILAG) index, and medication discontinuation. The secondary/exploratory end points were changes in the tender and swollen joint counts, BILAG index scores (musculoskeletal, global), and the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI).
RESULTS: The incidence of adverse events, most of which were mild, was similar between groups. LARI responses occurred in 3 of 10 patients receiving AMG 557 and 1 of 10 patients receiving placebo (P = 0.58). More patients in the AMG 557 group achieved a ≥4-point improvement in the SLEDAI score on day 169 (7 of 10 patients) compared with the placebo group (2 of 10 patients) (P = 0.07). Patients treated with AMG 557 (versus placebo) had greater improvements from baseline in the global BILAG index scores (-36.3% versus -24.7%) and the SLEDAI score (-47.8% versus -10.7%) and in tender (-22.8% versus -13.5%) and swollen (-62.1% versus -7.8%) joint counts on day 169.
CONCLUSION: AMG 557 showed safety and potential efficacy, supporting further evaluation of the clinical efficacy of ICOSL blockade in patients with SLE.

Matched MeSH terms: Joints/drug effects; Joints/pathology
Fulltext Outcome of surgically treated Lisfranc injury: a review of 34 cases

Miswan MF, Singh VA, Yasin NF

Ulus Travma Acil Cerrahi Derg, 2011 Nov;17(6):504-8.
PMID: 22290002 DOI: 10.5505/tjtes.2011.04809

We reviewed cases with Lisfranc injuries who presented to our center in order to study the adequacy of the treatment method and their final functional outcome.

Matched MeSH terms: Tarsal Joints/injuries*
Radiographic and computed tomographic assessment of the development of the antebrachia and elbow joints in Labrador Retrievers with and without medial coronoid disease

Lau SF, Hazewinkel HA, Voorhout G

Vet Comp Orthop Traumatol, 2015;28(3):186-92.
PMID: 25804656 DOI: 10.3415/VCOT-14-09-0144

To compare the development, monitored by radiography and computed tomography, of the antebrachia and elbow joints in seven Labrador Retrievers with healthy elbow joints and in seven Labrador Retrievers that developed medial coronoid disease (MCD), in order to determine whether disturbances in the development of the antebrachia and elbow joints, between the age of six and 17 weeks may lead to medial coronoid disease.

Matched MeSH terms: Joints/pathology
A study of joint mobility in a normal population

Seow CC, Chow PK, Khong KS

Ann Acad Med Singap, 1999 Mar;28(2):231-6.
PMID: 10497673

Joint hypermobility is a clinical entity that has been little studied in Southeast Asia in contrast to the many studies that have been conducted in the West. A pioneer study was conducted in Singapore involving 306 subjects from the three major races i.e. Chinese, Malays and Indians. Their ages ranged from 15 to 39 years. The objective was to ascertain the joint mobility profile in a study sample representative of the Singapore population and the prevalence of joint hypermobility amongst normal individuals. Joint mobility was assessed using criteria according to Carter and Wilkinson modified by Beighton et al. The distribution of the three major races in the study sample was based on the 1990 census of the Singapore population. The prevalence of joint hypermobility was found to be 17%. The results showed that joint mobility decreases with age and that females had consistently higher degree of joint mobility compared to males throughout the age group. Among the racial groups, Malays had the highest degree of joint mobility followed by Indians and Chinese.

Matched MeSH terms: Joints/physiology*
The role of the kallikrein-kinin system in joint inflammatory disease

Sharma JN

Pharmacol Res, 1991 Feb;23(2):105-12.
PMID: 1648214

Components of kallikrein-kininogen-kinin are activated in response to noxious stimuli (chemical, physical or bacterial), which may lead to excessive release of kinins in the synovial joints that may produce inflammatory joint disease. The inflammatory changes observed in synovial tissue may be due to activation of B2 receptors. Kinins also stimulate the synthesis of other pro-inflammatory agents (PGs, LTs, histamine, EDRF, PGI2 and PAF) in the inflamed joint. B2 receptor antagonists may provide valuable new analgesic drugs. The mode of excessive kinin release in inflamed synovial joints leads to stimulation of pro-inflammatory actions of B2 kinin receptors. These properties could be antagonized by novel B2 receptor antagonists (see Fig. 4). Further, it is suggested that substances directed to reduce the activation of KKS may provide a pharmacological basis for the synthesis of novel antirheumatic or anti-inflammatory drugs.

Matched MeSH terms: Joints/metabolism
Fulltext Domains of quality of life affecting elderly patients with hand osteoarthritis: a qualitative study in the Asian perspective

Thumboo J, Wu L, Leung YY

Int J Rheum Dis, 2017 Sep;20(9):1105-1119.
PMID: 26990791 DOI: 10.1111/1756-185X.12843

OBJECTIVES: Hand osteoarthritis (HOA) is common but little is known about how HOA has impact on disability and quality of life (QoL).We aim to identify important domains of concern among participants suffering from symptomatic HOA in Singapore, representing an Asian socio-cultural context.
METHODS: A qualitative study using a focus group technique was performed. We ran focus groups stratified by gender, ethnicity and language. Two independent, trained analysts identified relevant categories and assigned codes to text segments through open coding, with discrepancies resolved through consensus. The final lists of domains and subthemes descriptive of QoL were then compared to the following commonly used HOA specific instruments: Functional Index for Hand Osteoarthritis (FIHOA), Score for Assessment and quantification of Chronic Rheumatic Affections of the Hand (SACRAH), Australian/Canadian Hand Osteoarthritis Index (AUSCAN); and Health Assessment Questionnaire (HAQ).
RESULTS: Twenty-six patients (23 women, three men; 24 Chinese and two Malay; mean ± SD age 62.9 ± 7.5 years) with symptomatic HOA according to the American College of Rheumatology Classification Criteria participated in seven focus groups. Two and five focus groups were conducted in Chinese and English, respectively. The qualitative analysis revealed pain, stiffness and functional disability as the main domains. However, psychological consequences, aesthetic concerns, participation in leisure activities, participation in family roles were important concepts from the focus groups which were not covered by existing instruments. Impact on work productivity by HOA and the unmet health care need is revealed.
CONCLUSION: The domains of concepts important to people with HOA in an Asian socio-cultural context are not fully represented in the most commonly used instruments. Further studies on the selection of main domains relevant to HOA patients are necessary.
Study site: Rheumatology outpatient clinic, Singapore General Hospital

Matched MeSH terms: Hand Joints/physiopathology*

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