1/25. Do B cells influence disease progression in chronic synovitis? Lessons from primary hypogammaglobulinaemia.We describe a 62-yr-old male patient with primary hypogammaglobulinaemia (PH) who fulfilled the 1987 American Rheumatism association/American College of rheumatology revised diagnostic criteria for rheumatoid arthritis (RA) but, despite persistent symmetrical synovitis, did not develop erosions. virology studies and blood and synovial fluid (SF) cultures were consistently negative; a search for crystals in the SF was unrevealing. Peripheral blood (PB) B cells were absent, whilst the PB CD3( ) cell count was normal. The ratio of naive (CD45RA( )) to memory (CD45R0( )) cells was also normal (1:1) but the CD4:CD8 ratio was reversed. To our knowledge, this is the first report which combines the immunophenotypic analysis of the PB with that of the SF and synovial membrane (SM). This confirmed the absence of B cells and the reversed CD4:CD8 ratio. However, as in other chronic arthropathies, the SF and SM cellular infiltrate consisted almost exclusively of memory T cells, consistent with the preferential localization of this subset to inflamed tissues. This case indicates that synovitis can proceed persistently in the absence of B cells and that the migratory mechanisms of T cells are not altered. However, the case suggests that the absence of B cells and negativity for rheumatoid factor, combined with an increased presence of CD8( ) (suppresser/cytotoxic) T cells in the joint, might contribute to the non-erosive nature of the synovitis.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
2/25. Septic arthritis following anterior cruciate ligament reconstruction using tendon allografts--florida and louisiana, 2000.In the united states, approximately 50,000 knee surgeries are performed each year for repairing anterior cruciate ligament (ACL) injuries. Tissue allografts frequently are used for ACL reconstruction, and septic arthritis is a rare complication of such procedures. This report describes four patients who acquired postsurgical septic arthritis probably associated with contaminated bone-tendon-bone allografts used for ACL reconstruction. Effective sterilization methods that do not functionally alter musculoskeletal tissue are needed to prevent allograft-related infections.- - - - - - - - - - ranking = 595.21391061633keywords = ligament (Clic here for more details about this article) |
3/25. Septic arthritis caused by erysipelothrix rhusiopathiae infection after arthroscopically assisted anterior cruciate ligament reconstruction.A case of septic arthritis caused by erysipelothrix rhusiopathiae, after an arthroscopically assisted anterior cruciate ligament (ACL) substitution in a non-immunosuppressed patient is described. An 18-year-old man underwent an ACL reconstruction with a quadruple hamstring graft. Eight days postoperatively, the patient developed fever, knee pain, and effusion without erythema or suppuration. He was readmitted to the hospital with the diagnosis of septic arthritis. The patient's erythrocyte sedimentation rate, c-reactive protein level, and white blood cell count were high. The joint was aspirated and the fluid was sent for cultures that revealed the presence of E rhusiopathiae. E rhusiopathiae is widespread in nature, it is transmitted by direct cutaneous laceration, and it causes septic arthritis, meningitis, endocarditis, and renal failure in immunosuppressed people with poor prognosis. In our case, the infection was treated with arthroscopic lavage and debridement, retention of the graft and hardware, and intravenous antibiotic administration for 6 weeks, followed by oral administration for 16 weeks.- - - - - - - - - - ranking = 595.21391061633keywords = ligament (Clic here for more details about this article) |
4/25. Posterior dislocation of a cruciate-retaining total knee arthroplasty following an acute bacterial infection.BACKGROUND: We report a rare complication of posterior dislocation of a cruciate-retaining total knee arthroplasty following an acute bacterial infection. The mechanism of dislocation proved to be septic loosening of the femoral component and a tear of the posterior cruciate ligament near to the femoral insertion site. The tear arose during the treatment of acute septic arthritis following total knee arthroplasty when the patient attempted full weight-bearing with the affected limb in a semiflexion position and twisted the knee. methods AND RESULTS: Successful treatment was provided with subsequent surgical debridement, removal of the loosened prosthesis, the application of systemic antibiotics, and a revision total knee arthroplasty utilizing a posteriorly stabilized prosthesis after adequate control of the infection. CONCLUSION: Soft-tissue protection from full weight-bearing of the knee during the treatment of an acute infection following total knee arthroplasty and timely removal of the loosened total knee prosthesis are recommended in order to prevent such a complication.- - - - - - - - - - ranking = 119.04278212327keywords = ligament (Clic here for more details about this article) |
5/25. Onset of Berger disease after staphylococcus aureus infection: septic arthritis after anterior cruciate ligament reconstruction.Septic arthritis is rare in patients undergoing knee arthroscopic surgery. If the infection is due to staphylococcus aureus, patients might experience fever, severe clinical syndromes, and extra-articular manifestations, including vasculitis and glomerulonephritis. We describe a case of onset of immunoglobulin A nephropathy (Berger disease) after S aureus septic arthritis complicating an anterior cruciate ligament surgical reconstruction. The patient had no previous history of renal disease, and renal function returned to normal after resolution of the knee infection. S aureus infection has been associated with several glomerular diseases, but this is the first report of the infection causing immunoglobulin a nephropathy. In addition, this is the first description of Berger disease after arthroscopic treatment, providing evidence that this disease might complicate the clinical course of orthopedic surgery.- - - - - - - - - - ranking = 595.21391061633keywords = ligament (Clic here for more details about this article) |
6/25. Chicken pox infection (varicella zoster virus) and acute monoarthritis: evidence against a direct viral mechanism.A 9 year old boy developed acute monoarthritis of the left knee concurrent with the appearance of a varicella zoster virus (VZV) rash. Repeated VZV dna hybridisation of the cells within the synovial fluid and synovial membrane failed to show any evidence of intracellular virus. Virus was isolated from synovial fluid 24 hours after the start of clinical infection but not later. These findings suggest that the mechanism of the arthritis is not due to viral replication inside the swollen joint.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
7/25. Septic arthritis due to arcanobacterium haemolyticum.Diphtheroids or "coryneform" bacilli are usually considered to be nonpathogenic "normal flora" of human skin and mucous membranes. Because bacterial cultures are frequently contaminated with these organisms the correct diagnosis and treatment may be delayed by the failure to recognize serious infections caused by them. Few confirmed cases of orthopaedic infections due to arcanobacterium haemolyticum infection have been reported, partly because of inadequate identification of this bacterium. We report a case of septic arthritis due to A. haemolyticum.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
8/25. A case of persistent parvovirus B19 infection with bilateral cartilaginous and ligamentous damage to the wrists.We describe a case of persistent parvovirus B19 infection in a 48-year-old female physician that was complicated by prolonged fatigue and arthritis associated with cartilaginous and ligamentous damage in both wrists. Nineteen months after presentation, intravenous immunoglobulin therapy resulted in clearance of parvovirus B19 viremia and a significant improvement in the symptoms of fatigue and arthritis.- - - - - - - - - - ranking = 595.21391061633keywords = ligament (Clic here for more details about this article) |
9/25. Isolation of yersinia-specific T cell clones from the synovial membrane and synovial fluid of a patient with reactive arthritis.synovial fluid (SF) mononuclear cells from patients with reactive arthritis (ReA) proliferate in vitro when challenged with ReA-associated bacteria, the maximal response being for the organism causing the triggering infection. We report the results of a study of the antigenic specificity of synovial T lymphocytes from an HLA-B27 positive ReA patient whose SF mononuclear cells responded preferentially to yersinia antigens. This is the first report of the isolation of yersinia-specific T cell clones from synovial membrane (obtained by closed-needle synovial biopsy). We present a detailed analysis of these clones, together with others obtained from the SF.- - - - - - - - - - ranking = 5keywords = membrane (Clic here for more details about this article) |
10/25. haemophilus influenzae polyarthritis in an adult: an analysis of serotype b strains.A 61-year-old man who presented with clinical features suggestive of septic arthritis was found to have acute septic polyarthritis due to haemophilus influenzae (type b). The clinical and laboratory diagnoses of the case are presented, and the isolates of H. influenzae are characterized. Four isolates recovered from different sites had identical minimal inhibitory drug concentrations, outer membrane protein patterns, and genomic dna restriction digests. These observations indicate that the disseminated infection arose from a single source. The patient developed antibody to several outer membrane proteins, particularly the P6 protein.- - - - - - - - - - ranking = 2keywords = membrane (Clic here for more details about this article) |
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