rifampin and Synovitis

Topics: Adrenal Cortex Hormones; Adult; Animals; Antirheumatic Agents; Antiviral Agents; Arthritis, Juvenile; Arthritis, Rheumatoid; Child; Enzyme Inhibitors; Ganciclovir; Genetic Therapy; Haplorhini; Hormones; Humans; Injections, Intra-Articular; Methotrexate; Mice; Osmium Tetroxide; Osteoarthritis; Photochemotherapy; Rats; Rifampin; Somatostatin; Synovectomy; Synovitis; Time Factors

The indication for a synoviorthesis (medical synovectomy) is chronic haemophilic synovitis causing recurrent haemarthroses, unresponsive to haematological treatment. Synoviorthesis is the intra-articular injection of a certain material to diminish the degree of synovial hypertrophy, decreasing the number and frequency of haemarthroses. There are two basic types of synoviorthesis: chemical synoviorthesis and radiation synoviorthesis. On average, the efficacy of the procedure ranges from 76 to 80%, and can be performed at any age. The procedure slows the cartilaginous damage which intra-articular blood tends to produce in the long term. Synoviorthesis can be repeated up to three times with 3-month intervals if radioactive materials are used (Yttrium-90 and Phosphorus-32), or weekly up to 10-15 times if rifampicin (chemical synovectomy) is used. After 30 years of using radiation synovectomy worldwide, no damage has been reported in relation to the radioactive materials. Radiation synovectomy is currently the preferred procedure when radioactive materials are available, however, rifampicin is an effective alternative method if radioactive materials are not available. Several joints can be injected in a single session, although no more than two joints at the same time is probably the best protocol to follow.

Topics: Hemarthrosis; Hemophilia A; Humans; Injections, Intra-Articular; Radioisotopes; Radiopharmaceuticals; Rifampin; Synovitis

Rifampicin is an antibiotic that has been currently used for the treatment of noninfectious articular lesions with satisfactory results. The first experience was performed with patients who presented rheumatoid arthritis, and later with haemophilic patients. The clinical experience of three haemophilia centres which used rifampicin for the treatment of chronic haemophilic synovitis is presented here. The protocols were different. It was observed that rifampicin is more effective when it is used in small joints (elbows and ankles), than when used in bigger ones (knees), and that a high number of injections predicts failure. Mention is also made of experimental studies in animals where it was shown that the healing pattern of rifampicin is similar to that of NSAIDs.

Topics: Animals; Clinical Trials as Topic; Hemarthrosis; Hemophilia A; Humans; Rifampin; Synovitis

Rifampicin synoviorthesis has been empirically used for the treatment of haemophilic synovitis for some time. This paper reports on the experience of three Latin American centers with this treatment and compares it with radioactive synoviorthesis results. Chemical synoviorthesis with rifampicin is best indicated in younger patients (< 15 years) and small joint (ankles and elbows).

Topics: Hemophilia A; Humans; Nucleic Acid Synthesis Inhibitors; Rifampin; Synovitis

This paper reviews personal experience in the treatment of recurrent haemarthrosis and chronic synovitis by non-surgical means. Experience with synoviorthesis with rifampicine and radioactive colloids is analyzed, and a multiple chromosomal study to demonstrate safety of radioactive injections is described. The results obtained are so very satisfactory as to recommend non-aggressive synoviorthesis as the treatment of choice to prevent recurrence of bleeding. Long experience in the treatment of chronic arthropathy with intrarticular corticosteroids and hyaluronic acid has shown very promising results.

Topics: Colloids; Hemophilia A; Humans; Osmium Tetroxide; Rifampin; Synovitis

Brucellosis is a systemic infectious disease frequently associated with osteoarticular involvement. While sacroiliitis is a common manifestation of brucellosis, septic osteoarthritis is less frequent. Here, we report two cases of septic osteoarthritis caused by Brucella melitensis.. Both patients had a history of contact with goats before admission. Upon clinical examination, they showed marked pain and limited movement in the hip. Imaging findings revealed obvious osteonecrosis of the right femoral head. Inflammatory markers, including erythrocyte sedimentation rate and C-reactive protein level, were elevated. The tube agglutination test results of both patients were positive (1:160 and 1:200). Real-time polymerase chain reaction analysis of synovial fluid revealed the presence of B. melitensis. We deduced that septic osteoarthritis could explain these clinical and radiological findings. Both patients were followed-up for 12 months. They returned to their normal routine after completing a standard antibiotic regimen, including doxycycline (100 mg, daily) and rifampicin (600 mg), for 6 weeks.. Brucellar hip arthritis is a serious clinical manifestation of brucellosis, presenting mainly as marked joint pain and limited mobility. It is characterized by joint effusion, synovitis, and soft-tissue swelling on magnetic resonance images. Physicians should consider brucellosis as one of the differential diagnoses of arthritis.

Topics: Adult; Animals; Anti-Bacterial Agents; Blood Sedimentation; Brucella melitensis; Brucellosis; Diagnosis, Differential; DNA, Bacterial; Doxycycline; Goats; Hip; Humans; Magnetic Resonance Imaging; Male; Osteoarthritis, Hip; Polymerase Chain Reaction; Rifampin; Synovitis

Remitting seronegative symmetrical synovitis with pitting oedema (RS3PE syndrome) is a very rare condition incorporating a tenosynovitis of the hands and wrists, as well as the feet, ankles and shoulders. The aetiology of RS3PE syndrome is unknown, although it has been linked with infectious agents (including mycobacteria), other rheumatological conditions, HLA serotypes and malignancies.. This report examines the case of a 72-year-old man with a heart transplant and infected knee prosthesis, who developed RS3PE syndrome after introducing antibiotic treatment with rifampicin. His symptoms resolved with cessation of this agent.. This case demonstrates a possible direct aetiological link between rifampicin and RS3PE.

Topics: Aged; Antibiotics, Antitubercular; Edema; Humans; Knee Prosthesis; Male; Prosthesis-Related Infections; Rifampin; Syndrome; Synovitis; Tenosynovitis

Osteoarticular pathology in leprosy is common and described at all stages, but rarely as the most evident clinical manifestation. We report a case of borderline lepromatous leprosy with initial and disabling hands edema. The swollen hands syndrome is probably due to chronic Mycobacterium leprae tenosynovitis.

Topics: Adult; Anti-Bacterial Agents; Dapsone; Edema; Hand Injuries; Humans; Leprosy, Lepromatous; Male; Mycobacterium leprae; Rifampin; Syndrome; Synovitis

Recurrent bleeding into joints represents the clinical hallmark of haemophilia and, if not adequately treated, it may cause chronic synovitis and degenerative arthropathy. In haemophilia patients with inhibitors, a more severe degree of synovitis is often observed owing to the fact that treatment is more problematic in this setting. The first treatment option of recurrent haemarthroses and/or chronic synovitis is represented by synoviorthesis, both chemical and radioisotopic, with a success rate of approximately 80% for both. However, radioisotopic synoviorthesis should be preferred in inhibitor patients because it makes it possible to obtain complete synovial fibrosis usually in one session, without the need for repeated injections, thus reducing the risk of bleeding complications and concentrate consumption. For all these reasons this procedure should be implemented and supported, particularly in developing countries.

Topics: Adolescent; Adult; Antibiotics, Antitubercular; Blood Coagulation Factor Inhibitors; Child; Child, Preschool; Hemarthrosis; Hemophilia A; Humans; Injections, Intra-Articular; Radioisotopes; Radiopharmaceuticals; Rifampin; Synovitis; Treatment Outcome; Young Adult

The article presents ultrasonic characterization of hemophilic synovitis in 73 hemophilia patients. The technology of performing rifampicin synoviortesis under ultrasonic control has been developed, ensuring the exact fulfilling intraarticular punctures taking into account the alterations in the intraarticular structures and optimization of filling the articular cavity with sclerosant. The effectiveness of the developed method was 93.7% in the 3 years of follow-up observations.

Topics: Adolescent; Adult; Child; Female; Hemophilia A; Humans; Injections, Intra-Articular; Male; Middle Aged; Nucleic Acid Synthesis Inhibitors; Rifampin; Synovitis; Treatment Outcome; Ultrasonography; Young Adult

A 67-year-old man, who had widespread and well-defined erythematous violaceous hyperkeratotic plaques on his skin, was diagnosed with borderline tuberculoid leprosy. The patient began treatment with clofazimine, rifampicin, and dapsone, but 15 days afterwards he complained of acral edema with godet sign. Magnetic resonance imaging was done, and the case was interpreted as remitting seronegative symmetrical synovitis with pitting edema. About 8 mg/day of methylprednisolone were started with excellent response.

Topics: Aged; Clofazimine; Dapsone; Drug Therapy, Combination; Edema; Foot; Humans; Leprostatic Agents; Leprosy; Magnetic Resonance Imaging; Male; Methylprednisolone; Rifampin; Synovitis; Treatment Outcome

Topics: Adolescent; Child; Follow-Up Studies; Hemarthrosis; Hemophilia A; Humans; Hyaluronic Acid; Injections, Intra-Articular; Male; Rifampin; Synovitis

Chemical synovectomy has been used for the last three decades as an alternative for surgical synovectomy in the treatment of chronic haemophilic synovitis. Comparable results have been obtained with the many different radionuclides used: decreased bleeding, decreased pain and stable range of motion, in more than 50% of treated patients. Yttrium 90Y and Phosphorus 32P seem to be the isotopes of choice. Osmic acid and rifampicine have been used in a relatively small number of subjects. Global result of treatment with these two pro-ducts seems to be less favourable than with radionuclides. Late effects of chemical synovectomy are not known.

Topics: Hemarthrosis; Hemophilia A; Humans; Osmium Tetroxide; Practice Guidelines as Topic; Radioisotopes; Radiopharmaceuticals; Rifampin; Synovial Membrane; Synovitis

We report on the first case of documented Helicobacter cinaedi septic arthritis in an immunocompetent heterosexual young man. The patient presented no identified risk factor except for contact with animals that have been incriminated as a possible source of infection, particularly for these patients. Despite prolonged bacteremia, the response to long-term therapy with ciprofloxacin and rifampin was excellent.

Topics: Adult; Anti-Infective Agents; Arthritis, Infectious; Bacteremia; Ciprofloxacin; Helicobacter; Helicobacter Infections; Humans; Immunocompetence; Male; Rifampin; Synovitis

For many years, Rifampicin has been used empirically for the treatment of hemophilic chronic synovitis with encouraging results. A study was performed in which Rifampicin was shown to reduce the inflammation of joints affected by hemophilic synovitis. A clinical study was performed on 48 hemophilic patients (48 joints). Seventeen elbows, eight knees, and 23 ankles were treated. The mean age of the patients was 6 years (range, 4-23 years) and the mean followup was 29 months (range, 24-53 months). Overall, 40 excellent results and eight good results were obtained. The average number of weekly injections of Rifampicin was 3.06 (range, 1-10 injections). Eight patients experienced pain on the first injection, which subsided gradually with the subsequent procedures. Synoviorthesis with Rifampicin seems to be a good method for the treatment of hemophilic synovitis, especially in small joints (elbows and ankles) and in younger children.

Topics: Adolescent; Adult; Age Factors; Animals; Ankle Joint; Anti-Bacterial Agents; Arthralgia; Child; Child, Preschool; Chronic Disease; Disease Models, Animal; Elbow Joint; Follow-Up Studies; Forecasting; Hemarthrosis; Hemophilia A; Hemophilia B; Humans; Injections, Intra-Articular; Knee Joint; Logistic Models; Male; Rabbits; Rifampin; Synovitis; Treatment Outcome

Evaluation of the clinical and epidemiological features of Mycobacterium marinum infection in Queensland.. Laboratory identification and in-vitro susceptibility tests of 29 isolates from the Queensland Health Department Tuberculosis Reference Laboratory were retrospectively gathered and followed up by contacting referring practitioners and obtaining clinical details of patients involved.. 29 patients from whom M. marinum was isolated, with a male:female ratio of 3.1:1, and a mean age of 47.4 years.. Of 26 patients for whom adequate information was available, 12 had evidence of involvement of deep tissues (including two cases of arthritis) and five suffered sporotrichoid spread of infection. The delay between onset of symptoms and consultation with a medical practitioner was five months (range, two weeks to two years), with a further mean delay to definitive diagnosis of 4.4 weeks. Cure was apparent in 22 of 23 cases. Chemotherapy alone was adequate in 11 cases, as was surgical intervention in three, while a combination approach was successful in eight cases. Trimethoprim/sulfamethoxazole was successful in seven of nine cases and combination rifampicin and ethambutol in six of seven. Tetracyclines were employed as single-agent therapy in nine patients and were effective in seven.. Synovitis was a common presenting feature of M. marinum infection in Queensland patients. Occupational and recreational exposure to salt or fresh water was common, and although this history was available to practitioners a mean delay to definitive diagnosis of 4.4 weeks still occurred. The data suggest that chemotherapy alone is often adequate, even with deep tissue involvement. Combinations of conventional antimycobacterial drugs may be the therapy of choice, especially for serious infections, although success was recorded with trimethoprim/sulfamethoxazole alone.

Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Combined Modality Therapy; Drug Therapy, Combination; Environmental Exposure; Ethambutol; Female; Humans; Male; Middle Aged; Mycobacterium Infections, Nontuberculous; Occupational Exposure; Queensland; Recreation; Rifampin; Synovitis; Tetracyclines; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Adolescent; Adult; Amputation, Surgical; Debridement; Diagnosis, Differential; Ethambutol; Female; Fingers; Hand; Humans; Male; Middle Aged; Mycobacterium; Mycobacterium Infections; Osteomyelitis; Rifampin; Skin Diseases, Infectious; Skin Ulcer; Synovitis; Tuberculosis