Diagnosis Of Joint Disease Research Articles

Synovial fluid analysis in healthy green turtles Chelonia mydas in Taiwan.

Septic arthritis is a frustrating disease in sea turtle rehabilitation because of its unclear pathogenesis, delayed onset during rehabilitation, long-term treatment requirements, and potentially poor prognosis. Radiography, blood cultures, and arthrocentesis have been used as diagnostic tools for suspected cases. However, there is currently a lack of data on the characteristics of synovial fluid in healthy sea turtles. To establish reference data for synovial fluid in sea turtles, we enrolled 14 green turtles Chelonia mydas rescued between 2019 and 2022 from 3 facilities using the following inclusion criteria: normal attitude and appetite, normal motor functions of the 4 limbs, no joint swelling, and no ongoing use of antibiotics for at least 1 mo. Bacterial cultures of blood and synovial fluid from the shoulder joints of these turtles were obtained and a qualitative analysis of the synovial fluid was performed. The results revealed bacterial culture-negative blood and synovial fluids at 37°C. Most characteristics of normal synovial fluid in green turtles, such as being transparent, colorless, and able to create a strand of over 2.5 cm by being pulled with a needle in viscosity trials, as well as the cytology of the normal synovial fluids being dominated by histiocytes and synovial lining cells, lymphocytes, and occasionally a few heterophils or erythrocytes were similar to those in mammals. This study provides information on the normal synovial fluid characteristics of green turtles in Taiwan, which may be beneficial for the diagnosis of joint diseases in sea turtles.

Advancing joint disease diagnosis: Molecular profiling and biomarker identification in synovial fluid using Raman spectroscopy

Objectives: Synovial fluid (SF) analysis is crucial for diagnosing various joint diseases. This research delved into using Raman spectroscopy (RS) as a primary method for molecular profiling of SF and identifying significant biomarkers. The findings from this research have the potential to expand the utility of RS in diagnosing a diverse range of joint conditions. Methods: The SF samples were collected from patients undergoing knee joint surgeries and analyzed using RS coupled with a video microsampling system. Various strategies were implemented to minimize background fluorescence interference, a common challenge in biofluid RS analysis. Results: The spectral characteristics of fresh and overnight dry SF samples were compared revealing a reduction in background fluorescence in the dried samples. However, certain important signals were found to be absent due to overlap between Raman bands. The analysis showed distinct spectral features associated with hyaluronic acid, glycosaminoglycans, collagen, and proteins, highlighting their potential as biomarkers for joint diseases. Conclusion: Our study highlights the effectiveness of RS as a promising non-invasive method for analyzing SF. We have pinpointed specific biomarkers critical for joint health and disease paving the way for RS to potentially revolutionize the diagnosis and monitoring of joint pathologies. Despite the focus on osteoarthritis, the implications of this research extend to other complex joint diseases necessitating further investigation to enhance diagnostic precision and patient care.

Procalcitonin and carbonylated protein concentrations in equine synovial fluid.

Early diagnosis of joint diseases is fundamental for prompt and appropriate management, particularly in septic arthritis. Procalcitonin (PCT) and protein carbonylated content (PCC) have been investigated in both human and veterinary medicine. An increase in PCT has been shown in infectious bacterial diseases, while higher levels of PCC have been shown in inflammatory pathologies characterized by oxidative damage. This study evaluated PCT and PCC in plasma and synovial fluid (SF), in healthy and pathological equine joints, affected by different types of arthropathy. Twenty-nine joints were evaluated and underwent orthopedic, radiographic, ultrasonographic and SF evaluation. The joints were divided in three groups: healthy, septic, and non-septic arthritis. PCT and PCC were measured in horse plasma and SF. Data distribution was evaluated and results were expressed as median, quartile values. Statistical differences in SF values among groups and correlations were assessed between plasma and SF of both PCT and PCC. The groups of joint disease included: 8/29 healthy, 13/29 non-septic and 8/29 septic. Significant differences were obtained for SF PCC and plasma PCT between healthy and septic joints, while no differences were found for plasma PCC and SF PCT. A positive correlation was found between plasma and SF PCT. To the best of our knowledge, this is the first study reporting PCT in equine SF. SF PCC could be a useful biomarker to differentiate between septic and healthy joints.

The role of ultrasound diagnostics in the management of patients with juvenile psoriatic arthritis

Psoriatic arthritis (PsA) is a chronic inflammatory disease of the peripheral joints, entheses, and spine joints, affecting 10–25% of patients with psoriasis. Early diagnosis of the disease is challenging due to the possible delayed skin and joint symptoms and signs. Before the advent of ultrasound examination, the diagnosis of joint diseases was limited only to the radiological method. The ultrasound diagnosis of joint diseases in children is not established and needs a more comprehensive study.
 Materials and methods. The study included 50 PsA patients aged 3 to 17 years. We performed an ultrasound examination of 178 various joints. Knee joints were involved in 46 children, hip joints in 24, ankle joints in 34, and interphalangeal joints in 10. The mean age at onset was 7.8 years (range 1.5 to 14 years). The mean duration of the disease was 4.7 years.
 Results. Homogeneous joint effusion was the most common finding in patients with juvenile PsA (JPsA) – 83%. The effusion heterogeneity (17%) was due to hyperechoic inclusions (fibrin) in anechoic content. Diffuse synovium thickening was found in 91% of the joints. In 12.3% of joints, cartilage thinning was observed (in patients with a disease duration of 5 years or more), with fuzzy contours in some cases and normal echostructure in others.
 Conclusion. Periarticular structures, most often ligaments and tendons, are also involved in JPsA. The inflammation progresses steadily, with the rate depending on disease activity. Joint ultrasound is a reliable and highly informative method of JPsA diagnosing. It can identify a wide range of joint abnormalities; moreover, the severity of ultrasound abnormalities correlates with the disease severity, enabling using this method for monitoring disease-modifying therapy and as a screening tool for detecting the early signs of arthritis in patients with psoriasis. Joint ultrasound helps to detect early abnormalities.

Implementation of Digitization in Dentistry from the Year 2011 to 2021: A Bibliometric Analysis

Introduction: Digitalization has revolutionized dentistry in the last decade. Current application in digitization has increased which includes use of various systems such as cone-beam computed tomography for implant purpose, temporomandibular joint disease diagnosis, utilization of computer-aided design–computer-aided manufacturing system (CAD-CAM system) for prosthodontics. The usage of digital dentistry is made right from diagnosis to treatment planning which reduces the time consumption & human efforts to a great extent & increases accuracy for treatment planning. Therefore, this review focuses on analysis of implementation of digitization in dentistry from 2011 to 2021. Objectives: This study aims to analyze the scientific literature on digitization in dentistry by examining the origin of manuscripts, study types, and levels of evidence. Materials and Methods: The study retrieved data from journals indexed in Scopus. Subsequently, a descriptive analysis was conducted on bibliographic data, collaboration network, and keyword co-occurrence. The articles were then classified based on their field of interest, main research question, study type, and level of evidence. Results: The study has identified 203 original papers on digital dentistry, published in 112 journals, and co-authored by 1436 individuals affiliated with 89 institutions from 45 countries. While the majority (81.4%) of these papers were from a single country, we observed high collaboration among institutions from the United States, Britain, and Brazil. The primary focus of these papers was on the potential uses of digital technology in dentistry. Regarding study type, most articles were systematic reviews, cross-sectional studies, and original research papers. Conclusion: Integrating digital technology in dentistry has brought numerous benefits, including a more organized and streamlined approach to medical records and thorough investigation and treatment planning within a shorter timeframe. Furthermore, digital technology enables the accurate detection of even the minutest details, minimizing errors and eliminating human bias. The use of three-dimensional imaging techniques allows for the precise determination of objects’ geometrical characteristics and spatial orientation, resulting in the accurate placement of implants and prosthetics. Clinical Relevance: Digitization in dentistry has opened a whole new world for practitioners to focus on the patient satisfaction approach. Digital platforms can help optimize diagnosis and consulting and provide an excellent base for treatment planning.

Role of Cell Count of Synovial Fluid in Diagnosis of Joint Disease Compared to Gross Analysis

Joint effusion is a common clinical problem throughout the world. Synovial fluid analysis is one of the most important diagnostic tests to differentiate various inflammatory and non-inflammatory joint diseases. Gross examination and cell count of synovial fluid are two important test modalities. A comparison of performances of the tests would enable us to emphasize on the diagnostic procedures for better outcomes. A total of 105 cases were included in this study, performances of the tests such as accuracy, sensitivity, specificity, positive and negative predictive values of each test modality were calculated for comparison. Joint effusions were diagnosed as 19 rheumatoid arthritis, 12 non- inflammatory, 15 inflammatory, 14 infective, 7 tubercular, 4 traumatic, 6 osteoarthritis, 5 crystal induced arthritis, 6 non- specific arthritis and 8 normal cases. Accuracy, sensitivity, specificity, PPV and NPV of cell count were 76.19%, 72.72%, 94.11%, 98.46% and 40% respectively and accuracy, sensitivity, specificity, PPV and NPV of gross examination were 71.42%, 68.18%, 88.23%, 96.77% and 34.88% respectively. The individual parameters of synovial fluid study overlaps among each other test modalities and a combination of test procedures would yield better performances for diagnosis.

STUDY OF SYNOVIAL FLUID IN DIAGNOSIS OF JOINT DISEASES IN A TEACHING HOSPITAL

Background: Analysis of synovial uid has been recommended as a routine procedure to assist in the diagnosis of arthritis. Arthritis can be either a monoarticular or polyarticular lesion leading to morbidity, affecting all ages . Aim of the study: To study synovial uid analysis in the diagnosis of joint diseases in a teaching hospital. Materials and methods: Prospective study was done on synovial uid samples over a period of two years at the Department of Pathology. ACS medical college ,Chennai for duration of 6 months ie, from February 2021 to August 2021. Results: Majority of the cases were osteoarthritis constituting 33.3 % .Rheumatoid arthritis constituted 20%..Chronic nonspecic synovitis were noted in 30% cases .01 case of Traumatic arthritis and 02 cases of Tubercular arthritis were noted. Conclusion: Synovial uid analysis will give us an idea about the differential diagnosis of joint diseases. Synovial uid aspiration should be done for the analysis and also used as a treatment procedure of synovial inammation.

Elastic MXene Hydrogel Microfiber-Derived Electronic Skin for Joint Monitoring.

Effective and timely joint monitoring has been a significantly vital research direction in human healthcare. As an emerging technology, flexible electronics provides more possibilities and applicabilities for practical sensing and signal transmission. Here, we provide novel elastic MXene microfibers of controllable morphologies at a microscale through microfluidic technology for actual joint motion monitoring. Double-network hydrogels including covalently cross-linking polyacrylamide and ionically cross-linking alginate were chosen for superelasticity. For the improvement of the electrical conductivity of superelastic hydrogel microfibers, MXene was selected to mix with them. By introducing the cross-linker to the outer channel, microfibers with controllable diameters along with high electrical conductivities and tensile properties could be fabricated successfully. The practical value of the synthesized microfibers in joint movement sensing has been demonstrated by acting as the element of new motion sensors. Based on these features, it is believed that these elastic MXene hydrogel microfibers have high potential for rapid sensing and diagnosis of joint diseases.

Statistically based algorithm for differential diagnosis of arthropathies based on quantitative osteoscintigraphy

Background. EULAR experts include osteoscintigraphy of joints in the list of promising methods for the diagnosis of joint diseases. However, the method remains little used in rheumatology in our country.Aim of the study – to develop an algorithm for differential diagnosis for the most common arthropathies based on quantitative osteoscintigraphy.Materials and methods. 3 hours after the injection of pyrophosphate labeled with Tc-99m, scintigraphy of skeletal bones was performed according to the “whole body” program. The joint/adjacent bone uptake ratio was calculated. The CHAID algorithm was used for classification tree constructing.Results. The study included 266 patients aged 46.6±14.3 years, 134 men (50.4%). Axial spondyloarthritis (including ankylosing spondylitis) was diagnosed in 40 patients, peripheral spondyloarthritis (including reactive arthritis) – in 87, rheumatoid arthritis– in 45, osteoarthritis – in 68, psoriatic arthritis – in 26 people. A total of 2279 joints were included in the analysis. A classification tree algorithm for differential diagnosis of arthropathies was constructed. Key indicators for identifying subgroups in the algorithm were the intensity of radiopharmaceutical uptake in the wrist, knee and hip joints. The significance level of differences between the resulting groups at all points of the algorithm branching, taking into account the Bonferroni adjustment, was p=0.001 or less. In the training sample, 51.5% of the observations were correctly classified. According to results of the cross-validation, the expected rate of correct classifications in the actual application of the algorithm is 38.0%.Conclusions. An algorithm for differential diagnosis of the most common inflammatory diseases of the joints has been developed. It allows the use of quantitative osteoscintigraphy data in the diagnosis of arthritis.

Synovial Fluid Analysis and Biopsy in Diagnosis of Joint Diseases

Worldwide, Arthritis is a communal clinical incidence of joints, and very predominant chronic disease in India. To evaluate to affect 1% of world’s adult population. Biopsies of Synovial fluid are being done as an adjuvant technique to assist in the diagnosis of arthritis. It offers a non-invasive method to diagnose any condition of the joint like traumatic, non-inflammatory/ inflammatory. Cytomorphological examination of Synovial fluids received in the Department of Pathology, Sree Balaji Medical College and Hospital, Chennai. To examine the gross, microscopic, biochemical and microbiologic variations in the synovial fluid in percutaneous synovial biopsy along with synovial fluid analysis was studied in 102 enrolled cases of arthritis. The liquefied was subjected to physical, biochemical and cytological analysis. To correlate synovial fluid cytology with biopsies whenever possible to increase the accuracy of diagnosis. Synovial fluid analysis plays an important role in categorizing various arthritis and thereby helps in arriving at a diagnosis early.

Application Value and Progress of Musculoskeletal Ultrasound in the Diagnosis of Joint Diseases

Application Value and Progress of Musculoskeletal Ultrasound in the Diagnosis of Joint Diseases

Designing of an inflammatory knee joint thermogram dataset for arthritis classification using deep convolution neural network.

ABSTRACT Limited application of thermography for inflammatory joint disease diagnosis is due to unavailability of joint thermogram dataset and formulated protocol of data acquisition. Focusing on the limitations, we aimed on creation and analysis of knee thermogram dataset by introducing standardized protocols of acquisition. The dataset named as “Infrared Knee Joint Dataset”, and includes healthy, and three different types of arthritis affected knee thermograms. Dataset validation and inflammation oriented ground truth generation procedures are also mentioned in this study. After data acquisition, thermograms are preprocessed and segmented. Finally, the system separates healthy and abnormal knee thermograms, and classifies those abnormal thermograms into three classes. For the classification, conventional feature-based techniques combined with shallow learning as well as deep learning have been used. The experimental results show the following: 1) classification of healthy and arthritis affected knee thermogram achieved 92% accuracy with SVM and 96% using VGG19; 2) In inter-arthritis classification VGG16 has shown the highest accuracy of 86% through ROI-based classification. Creation of standardized knee thermogram dataset and application of deep learning methodology diagnosis arthritis-oriented knee abnormality non-invasively. The described database acquisition protocol and classification strategies could contribute to the designing of accurate and robust image-based arthritis diagnosis systems.

Descripción imagenológica de un caballo criollo colombiano con enfermedad articular degenerativa del tarso

En este artículo se reporta un caso clínico de una yegua criolla de 4 años, que llega a consulta por cojera y aumento de tamaño de la articulación del tarso en el miembro posterior derecho producto de un traumatismo. Se realiza examen clínico de la paciente en el cual se evidencia una claudicación de apoyo 5/5 con notables movimientos compensatorios; a la palpación refiere dolor y se evidencia tumefacción, aumento de temperatura y del tamaño. Se realizó hemograma, química sanguínea, evaluación del líquido articular por medio de citología y cultivo; a su vez, se realiza diagnóstico imagenológico mediante radiografía convencional y ecografía articular, el mismo se hace durante varios períodos de la evolución del caso, se realiza radiografía convencional en la cual se encuentran hallazgos como reacción proliferativa, presencia de osteofitos, anquilosis, entre otros; la evaluación ecográfica presentó hallazgos como disminución del líquido sinovial, aumento de tamaño y de ecogenicidad de la membrana sinovial y presencia de bandas de fibrina presentes en el líquido articular. El abordaje terapéutico se realiza mediante fármacos analgésico, lavado articular e infiltración con corticoides, e infusión intraarticular con DMSO al 10%. El presente caso describe el seguimiento imagenológico mediante ecografía y radiografía, hecho en un paciente equino con enfermedad articular degenerativa del tarso, lo cual entrega herramientas útiles a la comunidad veterinaria en el conocimiento y la interpretación de los cambios radiográficos y ultrasonográficos en un equino con enfermedad articular degenerativa durante el tiempo de evolución patológica.

Epidemiology and clinical management of elbow joint disease in dogs under primary veterinary care in the UK

BackgroundConditions affecting the elbow joint are a common cause of lameness in dogs. Primary-care veterinary clinical data are now recognised as a valuable research resource. Using data from the VetCompass Programme, this study aimed to report the frequency and risk factors for elbow joint disease in dogs under primary veterinary care in the UK and describe clinical management. ResultsFrom 455,069 dogs under veterinary care, the one-year period prevalence for elbow joint disease diagnosis was 0.56% (95% CI: 0.53–0.60). Of 616 incident cases, the most common specific variants of elbow joint disease were osteoarthritis (n = 468, 75.97%), elbow dysplasia (190, 30.84%) and traumatic (41, 6.66%). The most common signs described by the owners were lameness (n = 466, 75.65%), difficulty exercising (123, 19.97%) and pain (86, 13.96%). The most common findings recorded on veterinary examination were pain (n = 283, 45.94%), lameness (278, 45.13%) and reduced range of movement (243, 39.45%). Common medications used included non-steroidal anti-inflammatory drugs (n = 544, 88.31%), tramadol (121, 19.64%) and disease modifying agents (118, 19.16%). Of 109 deaths involving euthanasia with information available from the 616 incident cases, elbow joint disease contributed to the decision to euthanase in 45 (41.28%) dogs.Five breeds showed increased odds of elbow joint disease compared with crossbred dogs: Rottweiler (OR: 6.16, 95% CI 3.89–9.75), Labrador Retriever (OR: 5.94, 95% CI 4.65–7.60), German Shepherd Dog (OR: 4.13, 95% CI 2.88–5.93), Golden Retriever (OR: 3.11, 95% CI 1.93–5.00) and English Springer Spaniel (OR: 2.00, 95% CI 1.26–3.18). Additional risk factors included having an adult bodyweight that was equal or higher than their breed/sex mean, advancing age, being male, being neutered, being insured and larger bodyweight.ConclusionsElbow joint disease is a relatively common diagnosis in dogs and has a high welfare impact as evidenced by the high proportion of cases recorded with pain, lameness and analgesic therapy. There are strong breed predispositions, in particular for large breed dogs. These findings present a clear case for improved breeding programmes to reduce the burden of elbow joint disease.

Role of Synovial Fluid Examination in Diagnosis of Joint Diseases

Role of Synovial Fluid Examination in Diagnosis of Joint Diseases

Understanding the human knee and its relationship to total knee replacement.

The knee is the intermediate joint of the lower limb and it allows the movement between the femur, tibia and patella. Under normal conditions there is a normal distribution of the load forces on these three articular components in both the static load and during ambulation. The understanding of anatomy and knee biomechanics is important for the gait analysis, the diagnosis of joint diseases and the design and development of prosthetic implants. In the last decades comprehension of knee physiology and kinematics has led to the introduction of a wide range of enhanced prosthetic implant designs for a variety of indications. There are a number of types of total knee arthroplasty implant designs, which are intended to offer the surgeon options for individual patients. The various choices imply that each specific problem has a corresponding implant that provides a reliable solution. However, until the current date, it has not been possible to produce a prosthetic design fully restoring the complex kinematics of the normal knee joint.

Spectrum of synovial lesions with a rare case report of lipoma arborescens

Context: Synovium is the site for a series of pathologic processes that are characteristic and in some cases specific, to a particular disease. Examination of the synovial biopsies plays a key role in the diagnosis of joint diseases as the disease affecting the joints can have varied clinical presentations. Materials and Methods: We present here the different spectrum of synovial lesions that was diagnosed on synovial biopsy. Results: There were ten cases of synovium and related diseases which includes two cases of Chronic nonspecific synovitis, one case of Septic arthritis, two cases of Tuberculous synovitis, one case of Rheumatoid arthritis, one case of Tenosynovial giant cell tumor of tendon sheath, one case of Synovial lipomatosis, and two cases of Secondary chondromatosis. Conclusion: This series highlights the various spectrums of joint diseases. Synovial biopsy is an important and final tool for definitive diagnosis of joint disorders. Correlation with clinical, radiological, and serological findings helps to arrive at an accurate diagnosis.

Estimation of Systematic and Spatially Correlated Components of Random Signals from Repeated Measurements: Application to Contrast Enhanced Computer Tomography Measurements

Observational errors can be categorized into two groups: random noise, which is altered every time when measurement is repeated, and a systematic temporally invariant error. In this paper, we propose a method to estimate the covariance structure for systematic error and random noise using a small number of repeated measurements of the signal. We model the systematic and random components as stationary Gaussian random fields and use the Bayesian approach to estimate the spatial covariance functions of these components simultaneously. The study is motivated by an application related to the diagnosis of joint diseases using contrast enhanced computer tomography (CT) measurements. The noise in the measured contrast agent concentration profiles within cartilage tissue is strongly spatially correlated and includes a systematic component. Since the estimates are significantly sensitive to all errors in modeling, the systematic error and random noise components should be characterized for reliable estimation. The method proposed in this paper can be used to construct approximative covariance matrices for the observational noise using a small number of CT measurements. The capabilities of the proposed method are demonstrated using numerical simulations and also real CT data corresponding to measurements of contrast agent diffusion profile in cartilage.

Integrated photoacoustic and diffuse optical tomography system for imaging of human finger joints in vivo.

In this study, we developed a dual-modality tomographic system that integrated photoacoustic imaging (PAI) and diffuse optical tomography (DOT) into a single platform for imaging human finger joints with fine structures and associated optical properties. In PAI, spherical focused transducers were utilized to collect acoustic signals, and the concept of virtual detector was applied in a conventional back-projection algorithm to improve the image quality. A finite-element based reconstruction algorithm was employed to quantitatively recover optical property distribution in the objects for DOT. The phantom results indicate that PAI has a maximum lateral resolution of 70µm in resolving structures of targets. DOT was able to recover both optical absorption and reduced scattering coefficients of targets accurately. To validate the potential of this system in clinical diagnosis of joint diseases, the distal interphalangeal (DIP) joints of 4 healthy female volunteers were imaged. We successfully obtained high-resolution images of the phalanx and the surrounding soft tissue via PAI, and recovered both optical absorption and reduced scattering coefficients of phalanx using DOT. The in vivo results suggest that this dual-modality system has the potential for the early diagnosis of joint diseases such as osteoarthritis (OA) and rheumatoid arthritis (RA). Integrated PAI/DOT imaging interface (top) and typical reconstruction of structures and associated optical properties of a female finger joint via PAI and DOT (bottom).

Diagnosis of Knee Osteochondral Lesions With Ultrasound Imaging

Evaluation of articular cartilage and subchondral bone is essential in the diagnosis of joint diseases and injuries. Interobserver and intraobserver reproducibilities of arthroscopic grading are only poor to moderate. Thus, for quantitative and objective evaluation of cartilage and subchondral bone, ultrasound arthroscopy (UA) has been introduced to clarify this dilemma. Assessment of the clinical feasibility of high-frequency ultrasonography (US) during 6 knee arthroscopies was conducted, and the surgical technique is presented. US imaging was conducted with a flexible 9-MHz US catheter inserted into the joint through conventional portals. US and arthroscopy videos were synchronously recorded, and US parameters for cartilage and subchondral bone characteristics were measured. Arthroscopy and US imaging were combined to perform cartilage grading. UA produced quantitative data on lesion size, as well as cartilage quality, and showed subchondral bone changes. Visualization of an osteochondritis dissecans lesion not detected by conventional arthroscopy and US-guided retrograde drilling were possible with UA. To conclude, UA proved to be clinically feasible and aided in the diagnosis when assessing knee osteochondral lesions.