pyrophosphate and Synovitis

Topics: Adult; Aged; Arthritis; Calcinosis; Diphosphates; Female; Gout; Humans; Joint Diseases; Male; Middle Aged; Phagocytosis; Synovial Fluid; Synovitis; Terminology as Topic; Uric Acid

It is now well recognized that osteoarthritis (OA) synovial membrane presents inflammatory components. The aim of this work is to provide evidence that similar inflammatory mechanisms exist in synovial membrane (n = 24) obtained from three pathologies presenting altogether an inflammatory gradient: OA, chronic pyrophosphate arthropathy (CPPA) and rheumatoid arthritis (RA). Synovial biopsies were first characterized by a histological score based on synovial hyperplasia and infiltration of lymphocytes, plasma cells, polymorphonuclear and macrophages. All biopsies were also analyzed by 2D-nano-UPLC-ESI-Q-Orbitrap for protein identification and quantification. Protein levels were correlated with the histological score. Histological score was in the range of 3 to 8 for OA, 5 to 13 for CPPA and 12 to 17 for RA. Of the 4,336 proteins identified by mass spectrometry, 51 proteins were selected for their strong correlation (p < 0.001) with the histological score of which 11 proteins (DNAJB11, CALR, ERP29, GANAB, HSP90B1, HSPA1A, HSPA5, HYOU1, LMAN1, PDIA4, and TXNDC5) were involved in the endoplasmic reticulum (ER) stress. Protein levels of S100A8 and S100A9 were significantly higher in RA compared to OA (for both) or to CPPA (for S100A8 only) and also significantly correlated with the histological score. Eighteen complement component proteins were identified, but only C1QB and C1QBP were weakly correlated with the histological score. This study highlights the inflammatory gradient existing between OA, CPPA and RA synovitis either at the protein level or at the histological level. Inflamed synovitis was characterized by the overexpression of ER stress proteins.

Topics: Adult; Aged; Aged, 80 and over; Arthritis, Rheumatoid; Biomarkers; Chondrocalcinosis; Diphosphates; Endoplasmic Reticulum Chaperone BiP; Endoplasmic Reticulum Stress; Female; Humans; Inflammation; Inflammation Mediators; Male; Middle Aged; Osteoarthritis; Proteins; Proteome; Retrospective Studies; Synovitis

We report a case of rupture of the extensor tendons at the wrist shown histologically to be related to calcium pyrophosphate crystal deposition disease. This cause for extensor tendon rupture has not previously been described.

Topics: Aged; Calcinosis; Calcium Pyrophosphate; Carpal Tunnel Syndrome; Crystallization; Diphosphates; Female; Fingers; Humans; Radiography; Rupture; Synovial Membrane; Synovitis; Tendon Injuries; Wrist Joint

Topics: Calcium Pyrophosphate; Diphosphates; Humans; Synovitis

We measured levels of cartilage proteoglycan (PG) fragments in knee joint synovial fluid obtained from patients with previous trauma of the knee, early gonarthrosis, or pyrophosphate synovitis, and in age-matched control subjects. During the initial 3-4 weeks after rupture of the anterior cruciate ligament or the meniscus (confirmed by arthroscopy), markedly increased PG fragment levels were found. At later times after trauma (up to 4 years), many of these patients still had significantly elevated levels of cartilage PG fragments in the joint fluid. In a group of older patients with gonarthrosis, these levels were only moderately elevated, while in patients with acute pseudogout, greatly increased levels were observed. Although longitudinal studies are needed to validate the significance, PG fragments in joint fluid may be a marker for early posttraumatic arthrosis.

Topics: Adolescent; Adult; Cartilage; Chondrocalcinosis; Diphosphates; Female; Humans; Knee Injuries; Male; Middle Aged; Osteoarthritis; Peptide Fragments; Proteoglycans; Synovial Fluid; Synovitis; Time Factors

We examined the time course of the development of hemorrhagic synovitis in response to repeated autologous blood injections into knee joints in mature dogs and the possible usefulness of joint imaging with technetium-99m pyrophosphate (Tc99m-PYP) in monitoring the early response of synovium to blood. Experimental hemarthrosis was induced in dogs by twice weekly injection of autologous blood into the knee joints. Sequential examination of the synovium at monthly intervals over a period of 12 weeks revealed early inflammatory cell infiltration and capillary neovascularization with eventual replacement of the normal fatty synovium by dense fibrous tissue. Serial Tc99m-PYP joint images demonstrated a progressive increase in isotope accumulation in the knees during the course of the study. Further isotope accumulation was observed after CO2 laser synovectomy. During the 24-week course of the entire study, no changes in joint cartilage or bone were observed by gross inspection or radiologic and light-microscopic examination. The findings indicate that the progressive proliferative, inflammatory, fibrotic changes in joint synovium associated with experimental hemarthrosis in dogs may be noninvasively and semiquantitatively assessed with the use of Tc99m-PYP scintigraphy. Evidence is also presented that the intensity of Tc99m-PYP joint accumulation (immediate static images) may not readily reflect synovial vascularity or synovial tissue mass.

Topics: Animals; Diphosphates; Dogs; Hemarthrosis; Knee Joint; Radionuclide Imaging; Synovitis; Technetium; Technetium Tc 99m Pyrophosphate

Topics: Aged; Calcium Pyrophosphate; Chondrocalcinosis; Diphosphates; Female; Humans; Ligaments, Articular; Radiography; Synovitis; Wrist Joint

Naturally occurring deposition of calcium pyrophosphate has been identified in six rhesus monkeys following acute episodes of trauma and various septicemias. Scanning electron microscopy with energy-dispersive X-ray analytical system and single crystal electron diffraction studies were used to identify the crystals within the articular cartilage. The osteoarthritis grading system was used to determine the degree of cartilage degenerative changes.

Topics: Animals; Calcium Pyrophosphate; Cartilage Diseases; Cartilage, Articular; Diphosphates; Female; Knee Joint; Macaca mulatta; Male; Microscopy, Electron, Scanning; Monkey Diseases; Osteoarthritis; Synovitis; X-Ray Diffraction

Radionuclide joint imaging with the technetium-99m-labeled phosphates is a sensitive technique for the detection of inflammatory articular disease, although it is nonspecific as to the cause of the increased uptake and offers poor resolution in comparison to conventional radiography. There does not appear to be any place for the routine use of joint imaging of the peripheral joints, as there is little evidence that it benefits patient management. Scintigraphy is of benefit in the detection of osteomyelitis, Legg-Perthes' disease, and osteonecrosis, where changes may antedate roentgenologic abnormalities. Technetium-99m-phosphates may have an increasing role in the evaluation of knee and hip prosthetic joint loosening and infection, especially regarding the femoral components. Scintigraphy may be useful in excluding synovitis and allaying concern in selected patients with chronic articular pain in whom a conventional diagnostic evaluation is unrewarding. Attempts have been made to use radionuclide joint imaging to quantitate the degree of synovitis present in individual joints, particularly the sacroiliac joints. To date, reliable methods that distinguish normal from abnormal joints have not been established, although this remains an area of potential usefulness and active research. Scintigraphy with 99mTc-phosphates is useful in the detection of spinal fracture and pseudoarthrosis in individuals with ankylosing spondylitis.

Topics: Adult; Arthritis; Bone Neoplasms; Child; Diphosphates; Diphosphonates; Female; Gallium Radioisotopes; Humans; Joint Diseases; Legg-Calve-Perthes Disease; Male; Middle Aged; Osteoarthritis; Osteomyelitis; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Spondylitis, Ankylosing; Synovitis; Technetium; Technetium Compounds; Technetium Tc 99m Medronate; Technetium Tc 99m Pyrophosphate

Topics: Adult; Aged; Cartilage, Articular; Diagnosis, Differential; Diphosphates; Female; Humans; Joint Diseases; Male; Radiography; Synovial Fluid; Synovitis

Pyrophosphate arthropathy has a wide spectrum of clinical symptoms and is a common cause of synovitis in the elderly. The acute "pseudogout" attack is the most commonly recognized, but chronic synovitis might be just as prevalent. Familial pyrophosphate arthropathy with a dominant autosomal heredity is a rare form, with an earlier debut and a more severe prognosis. Another rare expression of pyrophosphate arthropathy is severe joint destruction. The cause of pyrophosphate arthropathy is still unknown. Both individual reactivity and crystal properties determine the intensity of the inflammatory response to crystals.

Topics: Acute Disease; Adult; Aged; Anti-Inflammatory Agents; Calcium Pyrophosphate; Cartilage, Articular; Chondrocalcinosis; Chronic Disease; Diphosphates; Female; Humans; Intervertebral Disc; Knee Joint; Male; Middle Aged; Radiography; Synovial Fluid; Synovitis

Topics: Acute Disease; Age Factors; Aged; Calcium Pyrophosphate; Cartilage, Articular; Chronic Disease; Diphosphates; Humans; Middle Aged; Synovial Membrane; Synovitis

Topics: Arthritis; Calcium Pyrophosphate; Diagnosis, Differential; Diphosphates; Humans; Synovitis

A scanning electron microscopic study of six cases of pyrophosphate arthropathy has been conducted. In the majority of cases the crystals were rectangular. In some cases giant crystals were present. In one case, the crystals were pyramidal. It is concluded that many geometrically different forms of calcium pyrophosphate crystal exist and that the scanning electron microscope is a useful tool in the differentiation of pyrophosphate arthropathy from other forms of crystal synovitis.

Topics: Cartilage, Articular; Diphosphates; Humans; Joint Diseases; Microscopy, Electron, Scanning; Surface Properties; Synovitis

Topics: Adolescent; Adult; Aged; Calcium; Diphosphates; Female; Humans; Male; Middle Aged; Synovial Fluid; Synovitis

Topics: Adult; Aged; Arthritis; Calcium; Chondrocalcinosis; Crystallization; Diabetes Complications; Diet Therapy; Diphosphates; Female; Gout; Humans; Hyperparathyroidism; Knee Joint; Leukocytes; Male; Middle Aged; Physical Therapy Modalities; Radiography; Synovial Fluid; Synovitis; Uric Acid

Topics: Age Factors; Aged; Arthritis; Arthrography; Calcium; Calcium Phosphates; Chondrocalcinosis; Crystallization; Diphosphates; Drainage; Exercise Therapy; Humans; Leukocytes; Middle Aged; Phenylbutazone; Synovial Fluid; Synovitis

Topics: Acute Disease; Age Factors; Aged; Calcium; Chondrocalcinosis; Diagnosis, Differential; Diphosphates; Female; Hospitals; Humans; Knee Joint; Male; Middle Aged; Postoperative Care; Postoperative Complications; Sex Factors; Syndrome; Synovitis

Topics: Aged; Chondrocalcinosis; Crystallization; Diagnosis, Differential; Diphosphates; Female; Gout; Humans; Indomethacin; Middle Aged; Synovitis; Uric Acid

Topics: Arthritis; Diphosphates; Humans; Synovitis

Topics: Aged; Calcinosis; Calcium Phosphates; Diagnosis, Differential; Diphosphates; Female; Gout; Humans; Joint Diseases; Knee Joint; Male; Middle Aged; Synovial Fluid; Synovitis

Topics: Calcinosis; Diphosphates; Humans; Osteoarthritis; Synovial Fluid; Synovitis

Topics: Arthritis; Calculi; Cartilage Diseases; Colchicine; Crystallization; Diphosphates; Female; Humans; Joint Diseases; Kidney Failure, Chronic; Knee; Male; Periarthritis; Radiography; Shoulder; Synovial Fluid; Synovitis; Wrist

Topics: Arthritis; Crystallization; Diphosphates; Drainage; Gout; Humans; Synovial Fluid; Synovitis

Topics: Calcium; Diphosphates; Histocytochemistry; Humans; Leukocytes; Lysosomes; Synovial Fluid; Synovial Membrane; Synovitis

Topics: Calcium Phosphates; Crystallization; Diphosphates; Humans; Synovial Fluid; Synovitis; Uric Acid

Injection of sodium urate or calcium pyrophosphate crystals into the stifle joints of anesthetized dogs almost invariably induced an acute exudative response. This response was quantified by serial measurements of intra-articular pressure, pH and leukocyte concentration. Pressure rose progressively and reflected intra-articular volume increase. The hydrogen ion concentration increased as the reaction progressed and correlated in a given exudate with the leukocyte concentration. Analysis of sequential physiologic and biochemical changes occurring in this model of crystal-induced inflammation may provide insight into the mechanisms of acute gouty arthritis in man.

Topics: Animals; Arthritis; Calcium Phosphates; Diphosphates; Dogs; Injections, Intra-Articular; Synovitis; Uric Acid

Topics: Arthritis; Calcinosis; Chondrocalcinosis; Diphosphates; Humans; Rheumatic Diseases; Synovitis

Topics: Adrenal Cortex Hormones; Calcification, Physiologic; Cartilage; Chondrocalcinosis; Crystallography; Diphosphates; Gout; Humans; Joint Diseases; Phenylbutazone; Synovitis