1/424. Failure of the hinge mechanism of a trispherical total wrist arthroplasty: a case report and review of the literature. We report a patient with rheumatoid arthritis who developed late catastrophic failure of the hinge mechanism of her trispherical total wrist arthroplasty. This was associated with synovitis secondary to wear debris from titanium, cement, and polyethylene which produced exuberant flexor and extensor tendon synovitis and median nerve compression. ( info) |
2/424. Pigmented villonodular synovitis of the knee: a description of two cases treated in arthroscopy. The authors present two cases of pigmented villonodular synovitis of the knee. After a discussion of the aspecificity of clinical findings and difficulties in diagnosis based on radiographic evaluation, they conclude that diagnosis may be possible preoperatively by MRI, and that arthroscopic surgery allows for suitable treatment of localized forms of the disease. ( info) |
3/424. Synovial non-Hodgkin's lymphoma in a human immunodeficiency virus infected patient. We describe a case of articular non-Hodgkin's lymphoma (NHL) with malignant lymphoma cells observed in synovial fluid. Bone involvement in NHL is common, but an English language medline search revealed only 14 reported cases of synovial NHL. Although NHL is a well recognized complication of human immunodeficiency virus (hiv) infection, this is the first report of synovial NHL in an hiv infected patient. ( info) |
4/424. Stress-induced SAPHO syndrome. We describe the case of a woman with the classic combination of features of synovitis-acne-pustulosis-hyperostosis-osteitis (SAPHO) syndrome, including pustulosis palmo-plantaris and anterior chest wall involvement. The varying symptomology, etiology and pathogenesis of this syndrome and the contribution of stress are discussed. The authors ascribe the dearth of reported cases to lack of awareness and recognition of SAPHO, and not to the real incidence of the syndrome. ( info) |
5/424. Gastric carcinoma in association with remitting seronegative symmetrical synovitis with pitting edema. We describe an elderly woman who developed remitting seronegative symmetrical synovitis with pitting edema (RS3PE). In addition to typical findings, she had increased alkaline phosphatase; and investigations revealed metastatic gastric carcinoma. The literature relating to RS3PE in association with neoplasia is reviewed. ( info) |
6/424. Cutaneous mucinous nodules associated with proliferating synovitis of rheumatoid arthritis. Rheumatoid arthritis (RA) is occasionally associated with specific or non-specific cutaneous conditions. In this report, we describe unusual cutaneous nodules arising on the skin overlying the inflamed joints of two patients with RA. The nodules were histopathologically characterized by mucinous granulation tissue associated with neutrophilic infiltration and proliferation of starry-shaped mesenchymal cells. The affected joints of both cases showed synovitis with synovial tissue hyperplasia due to RA. Because hyaluronic mucin, which is the major component of synovial fluids, was deposited in the nodules, intradermal inoculation of synovial cells seemed to be responsible for the nodular development. The nodules of one patient spontaneously resolved in several months. We are unaware of any report describing similar cases. Such nodules should be included as a cutaneous complication of RA, distinct from neoplasias. ( info) |
7/424. Posterior interosseous nerve palsy in a patient with rheumatoid synovitis of the elbow: a case report and review of the literature. A 54-year-old woman with rheumatoid arthritis developed loss of finger extension in the left hand. history, physical examination, and electromyography led to the diagnosis of posterior interosseous nerve palsy secondary to synovitis of the elbow. Anterior decompression and synovectomy resulted in a complete recovery. A literature review describes similar cases and compares outcomes. ( info) |
8/424. Remitting seronegative symmetrical synovitis with pitting edema (RS3PE syndrome). A 63-year-old man presented with acute symmetrical polysynovitis associated with pitting edema of both the hands and feet. He was seronegative for rheumatoid factor and no radiologically evident erosion was noted in the joints of his hands and feet. Evaluation excluded congestive heart failure, nephrotic syndrome, and hypothyroidism as the cause of edema. Treatment with nonsteroidal anti-inflammatory drugs and low-dose steroids induced complete remission. The clinical manifestations of this patients were consistent with those of a distinctive, although rare, form of arthritis called remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome. This syndrome has a good prognosis in elderly patients. ( info) |
9/424. safety and efficacy of three arthroscopic procedures using holmium: Yag laser in two high-responder haemophiliacs. We report here on the efficacy and safety of three arthroscopic procedures using a holmium: Yag laser in two high-responder haemophiliacs. The two patients were treated with an activated prothrombin complex concentrate (FEIBA; Immuno, Vienna, austria). Treatment was started just before surgery and continued for 4-8 days. On one occasion antifibrinolytics were concomitantly used without thromboembolic complication. Post-operative blood loss was slight, joint mobility was rapidly acceptable and full weight bearing without pain was possible on day 4. Such a procedure would appear to be superior to conventional arthroscopic synovectomy utilizing mechanical devices in haemophiliacs, because it might improve the quality of local haemostasis and the rapidity of post-operative recovery. In addition, it is also the technical procedure of choice in haemophilic patients with inhibitors who need synovectomy. ( info) |
10/424. synovitis of small joints: sonographic guided diagnostic and therapeutic approach. OBJECTIVE: The aim of this pictorial essay is to describe the sonographic guided approach to investigation and local injection therapy of a small joint in a patient with psoriatic arthritis (PA). methods: Sonographic pictures are obtained using a high frequency ultrasonography apparatus equipped with a 13-MHz transducer. RESULTS: ultrasonography allows a careful morphostructural assessment of soft tissue involvement in PA patients. Sonographic findings include joint cavity widening, capsular thickening, synovial proliferation, synovial fluid changes, tendon sheath widening. Ultrasound guided placement of the needle within the joint and injection of corticosteroid under sonographic control can be easily performed. CONCLUSIONS: High frequency ultrasonography is a quick and safe procedure that allows a useful diagnostic and therapeutic approach in patients with arthritis of small joints. ( info) |