Inflammatory Fluid Research Articles

Clinical and radiographic outcomes after subduro-peritoneal shunt insertion in adults

BackgroundSubdural collections consist amongst others of cerebrospinal, inflammatory, haemorrhagic or infective fluid. While these accumulations can be treated with conservative or surgical measures, such as burr hole evacuation or craniotomy, clinicians may resort to implantation of a subduro-peritoneal shunt, due to their high recurrence rates. While this treatment option is widely used in the pediatric population, its efficacy and safety in adults is scarcely reported. MethodsThis project is a retrospective case series of 25 adult patients, who underwent subduro-peritoneal shunt (SDPS) implantation between December 2008 and June 2021. The indications included symptomatic subdural collections following trauma, tumor resection or bone flap reimplantation. In general, adjustable valves were used. All patients received a pre- and postoperative computed tomography (CT) scan. We evaluated patients’ postoperative clinical outcomes as well as radiographic criteria, including midline shift, frontal horn width and collection volume. Additionally, we analyzed shunt-related complications. ResultsImpaired consciousness was the commonest presenting symptom. We report a significant reduction in volume and width of the subdural collection after SDP shunt implantation. Furthermore, the midline shift decreased significantly. While 60% (N=15) of the patients improved clinically, only 12% (N=3) deteriorated. Complications comprised infection in 12% (N=3) of patients and valve dysfunction in 1 patient. ConclusionsOur study shows that SDPS in adults is an effective treatment to eliminate or reduce subdural collections, that improves clinical outcomes in the majority of patients. Hence, it should be utilised more widely in this patient population. However, further studies are necessary to validate the treatment and identify eligible patients.

Triple Trouble: Acute Appendicitis with Right Testicular Torsion and Concurrent Right Inguinoscrotal Hernia- A Case Report

Acute appendicitis commonly presents with right iliac fossa pain. However, it may present with right scrotal pain and swelling, which may be confused with other scrotal pathologies such as orchitis, scrotal abscess, and testicular torsion. Acute appendicitis in children and adolescents may present with scrotal pain due to inflammatory intraperitoneal fluid tracking down into the scrotal sac via a patent processus vaginalis. In rare cases, acute appendicitis may present concurrently with testicular torsion, making the diagnosis much more challenging. Herein, we present an even rarer case of acute appendicitis with right testicular torsion and concurrent right inguinoscrotal hernia.

Effects of Far-Infrared Rays Emitted from Loess Bio-Balls on Lymphatic Circulation and Reduction of Inflammatory Fluids.

Background: FIR therapy is used in various medical settings to treat diseases associated with inflammation and edema. Unlike conventional FIR lamp therapy, this study investigated how body fluids change depending on the intensity and duration of FIR irradiation to the whole body. Method: Subjects in group A (n = 27) were exposed to FIR emitted from a loess bio-ball mat set at 40 °C for 30 min, and subjects in group B (n = 27) were exposed to FIR emitted from a loess bio-ball mat set at 30 °C for 7 h during sleep. Changes in bioimpedance parameters and fluid-related values were measured using a body fluid analyzer before and after exposure to FIR. Results: Changes in bioimpedance parameters associated with inflammatory fluids were quantitatively confirmed. In group A, there was a minimal change in fluid-related measurements. However, significant changes in bioimpedance parameters associated with inflammatory fluids were observed in group B exposure to FIR for 7 h during sleep. Conclusions: FIR emitted from loess bio-balls activates biological tissues and lymphatic circulation, gradually reducing the levels of inflammatory fluids over time.

Material Composition and Implantation Site Affect in vivo Device Degradation Rate.

Successful tissue engineering requires biomedical devices that initially stabilize wounds, then degrade as tissue is regenerated. However, the material degradation rates reported in literature are often conflicting. Incorporation of in situ monitoring functionality into implanted devices would allow real time assessment of degradation and potential failure. This necessitates introduction of contrast agent as most biomedical devices are composed of polymeric materials with no inherent contrast in medical imaging modalities. In the present study, computed tomography (CT)-visible radiopaque composites were created by adding 5-20wt% tantalum oxide (TaO x ) nanoparticles into polymers with distinct degradation profiles: polycaprolactone (PCL), poly(lactide-co-glycolide) (PLGA) 85:15 and PLGA 50:50, representing slow, medium and fast degrading materials respectively. Radiopaque phantoms, mimicking porous tissue engineering devices, were implanted into mice intramuscularly or intraperitoneally, and monitored via CT over 20 weeks. Changes in phantom volume, including collapse and swelling, were visualized over time. Phantom degradation profile was determined by polymer matrix, regardless of nanoparticle addition and foreign body response was dictated by the implant site. In addition, degradation kinetics were significantly affected in mid-degrading materials, transitioning from linear degradation intramuscularly to exponential degradation intraperitoneally, due to differences in inflammatory responses and fluid flow. Nanoparticle excretion from degraded phantoms lagged behind polymer, and future studies will modulate nanoparticle clearance. Utilizing in situ monitoring, this study seeks to unify literature and facilitate better tissue engineering devices, by highlighting the relative effect of composition and implant site on important materials properties.

KVX-053, a Protein Tyrosine Phosphatase 4A3 inhibitor, ameliorates SARS-CoV-2 Spike protein subunit 1 - induced acute lung injury in mice.

The Acute Respiratory Distress Syndrome (ARDS), often preceded by acute lung injury (ALI), is characterized by the accumulation of inflammatory fluid in the lung alveoli, leaky alveolar epithelium and endothelium, and overexpression of pro-inflammatory cytokines. This progression from ALI to ARDS is a major contributor to the high mortality observed in COVID-19 patients. The Spike protein of SARS-CoV-2 binds to lung ACE2 and, in addition to facilitating viral cell entry, it plays an important role in the development of ALI and ARDS, especially in the later phases of COVID-19 as well as long COVID. Protein tyrosine phosphatase (PTP) 4A3 is a key mediator of ARDS pathology. This study tested the hypothesis that targeting PTP4A3 would prevent COVID-19 associated ALI. Intratracheal administration of SARS-CoV-2 Spike protein Subunit 1 to K18-hACE2 transgenic mice expressing human ACE2 elicited pulmonary and systemic inflammation, leaky alveoli, overexpression of cytokines, structural lung injury and lung dysfunction; all these symptoms were ameliorated by the selective, allosteric inhibitor of PTP4A3, KVX-053. These findings provide the first evidence supporting a role for PTP4A3 in the development of SARS-CoV-2- mediated ALI. Significance Statement This study tested the hypothesis that targeting PTP4A3 would prevent COVID-19 associated ALI/ARDS. Intratracheal administration of SARS-CoV-2 Spike protein Subunit 1 to K18-hACE2 transgenic mice expressing human ACE2 elicited pulmonary and systemic inflammation, leaky alveoli, overexpression of cytokines and chemokines, structural lung injury and lung dysfunction; all these symptoms were ameliorated by the selective, allosteric inhibitor of PTP4A3, KVX-053. These findings suggest that this novel PTP4A3 inhibitor may be useful against COVID-19 and potentially other viral-induced ARDS.

Clinical, Radiological, and Etiological Aspects of Pachymeningitis: A Study of 24 Cases.

Introduction and importance Hypertrophic pachymeningitis (HP) is an uncommon disorder with varied etiological origins and heterogeneous clinical presentation. Establishing the etiological diagnosis poses a challenge, but prompt identification provides a treatment window, potentially leading to a reversal of symptoms.MRI is the reference examination, allowingnot onlythe early diagnosis of pachymeningitisbut alsothe assessment of its extent and importance, detection of possible complications, and suggestion of etiology. Case presentation We conducted a retrospective study involving 24 patients recruited over 5 years for who brain imaginghad revealed the presence ofpachymeningitis.The average age of the patients was 40 years, with a male-to-female ratio of 0.6. Clinical discussion Headache was present in 54.17% of patients. All the patients underwent MRI examinations utilizing different sequences, with subsequent Gadolinium injection showing localized and asymmetrical meningeal thickening in 13cases,and diffuse in the rest. The cerebrospinal fluid study unveiled an inflammatory fluid characterized by a lymphocytic predominance and hyperproteinorrhea, noted in 50% of the patients. The histopathological analysis of a stereotactic biopsyconductedon an individual patient revealed non-diagnostic results. The etiological investigationwas dominatedby tuberculosis, which was detectedin 33.3% of cases.Idiopathic origin was identifiedin 16.7% of patients. Conclusion Meningeal thickening is rare, and the multitude of potential causes makes the etiological investigation challenging unless they fall within the scope of secondary meningeal disorders; otherwise, a dural biopsy becomes necessary, and the prompt initiation of treatment, along with determining the etiology influences the prognosis.

Antifungal drug penetration in soft tissue abscesses: a comparative analysis.

Invasive fungal infections (IFIs) are severe and difficult-to-treat infections affecting immunocompromised patients. Antifungal drug penetration at the site of infection is critical for outcome and may be difficult to achieve. Data about antifungal drug distribution in infected human tissues under real circumstances of IFI are scarce. Multiple samples were obtained from soft tissue abscesses of a lung transplant patient with Candida albicans invasive candidiasis who underwent recurrent procedures of drainage, while receiving different consecutive courses of antifungal therapy [itraconazole (ITC), fluconazole, caspofungin]. Antifungal drug concentrations were measured simultaneously at the site of infection (surrounding inflammatory tissue and fluid content of the abscess) and in plasma for calculation of the tissue/plasma ratio (R). The concentration within the infected tissue was interpreted as appropriate if it was equal or superior to the MIC of the causal pathogen. A total of 30 tissue samples were collected for measurements of ITC (n = 12), fluconazole (n = 17) and caspofungin (n = 1). Variable concentrations were observed in the surrounding tissue of the lesions with median R of 2.79 (range 0.51-15.9) for ITC and 0.94 (0.21-1.37) for fluconazole. Concentrations ranges within the fluid content of the abscesses were 0.39-1.83 for ITC, 0.66-1.02 for fluconazole and 0.23 (single value) for caspofungin. The pharmacodynamic target (tissue concentration ≥ MIC) was achieved in all samples for all three antifungal drugs. This unique dataset of antifungal drug penetration in infected human soft tissue abscesses suggests that ITC, fluconazole and caspofungin could achieve appropriate concentrations in soft tissue abscesses.

Clinical and serological insights into paraneoplastic brachial amyotrophic diplegia.

Brachial amyotrophic diplegia (BAD) is typically linked to a neurodegenerative etiology such as amyotrophic lateral sclerosis (ALS). Clinical and serological characterizations of paraneoplastic neurologic syndromes resembling BAD are limited. A retrospective chart review of patients with BAD-like presentations was conducted. Clinical/paraclinical features of paraneoplastic BAD and neurodegenerative BAD cases were compared. Between 2017 and 2023, 13 cases of BAD were identified, of these 10 were neurodegenerative BAD (ALS variant), and 3 cases associated with paraneoplastic autoimmunity. An additional paraneoplastic BAD case diagnosed in 2005 was included. LUZP4-IgG was detected in all four paraneoplastic cases, with coexisting KLHL11-IgG in three cases and ANNA1 (anti-Hu)-IgG in one case. Out of the four paraneoplastic cases, two patients had seminoma, while the remaining two had limited cancer investigation. Three patients exhibited bi-brachial weakness as the initial symptom before the onset of brainstem symptoms or seizures. Compared to BAD patients with a neurodegenerative etiology, a higher proportion of paraneoplastic cases had ataxia (75% vs 0%, p = 0.011). Other clinical features only detected in the paraneoplastic BAD group were vertigo (n = 2), hearing loss (n = 2) and ophthalmoplegia (n = 2). Electrodiagnostic studies in these patients revealed cervical myotome involvement, supportive of motor neuronopathy. All paraneoplastic cases but none of the neurodegenerative BAD cases exhibited inflammatory cerebrospinal fluid (CSF) findings (lymphocytic pleocytosis and/or supernumerary oligoclonal bands; p = 0.067). Despite the administration of immunotherapy and/or cancer treatment, none of the paraneoplastic patients reported clinical improvement. BAD or bi-brachial neurogenic weakness is a rare phenotypic presentation associated with paraneoplastic autoimmunity. Co-existing features of brainstem dysfunction or cerebellar ataxia should prompt further paraneoplastic evaluation. Common serological and cancer associations among these cases include LUZP4-IgG and KLHL11-IgG, along with testicular germ cell tumors, respectively.

Acute Intestinal Obstruction by Intussusception at the Communal Medical Center of Ratoma About A Case

Acute intestinal obstruction by intussusception is defined by a cessation of materials and gases due to the penetration of an intestinal segment into the segment immediately adjacent to it . We report a case of intussusception concerning a 26 year old lady, admitted to the General Surgery department of the Ratoma Communal Hospital for acute intestinal obstruction, in whom an unprepared abdominal X-ray was performed which revealed central hydroaeric levels multiple steps and a biological assessment before being taken to the operating room. Intraoperatively, inflammatory fluid leaked and exploration revealed catarrhal appendicitis and an ileo-ileal intussusception located 6 cm from the ileocecal angle, the disinvagination of which revealed a thickening of the wall of the invaginated loop and a mass of approximately 1 cm. We performed a resection of the invaginated loop followed by reestablishment of end to end ileo-ileal digestive continuity and an appendectomy. The postoperative course was simple.

Tubercular Meningitis Mimicking Acute Disseminated Encephalomyelitis (ADEM)- A Case Report

Tuberculosis remains endemic in India, and its manifestation in the central nervous system (CNS) poses significant challenges in diagnosis and management. We present a rare case of a 65-year-old male with tubercular meningitis exhibiting atypical features of acute disseminated encephalomyelitis (ADEM). The patient presented with a month-long history of fever, severe headache, altered sensorium, and neurological signs including brisk reflexes, neck rigidity, and bilateral motor weakness. Initial investigations revealed elevated inflammatory markers and abnormal cerebrospinal fluid (CSF) findings consistent with tubercular meningitis. Despite negative CSF culture and nucleic acid amplification tests (NAATs) for Mycobacterium tuberculosis, the patient displayed characteristic asymmetrical bilateral cerebral lesions on MRI suggestive of ADEM. Given the diagnostic ambiguity and a high suspicion of CNS tuberculosis with concurrent ADEM, the patient was treated with anti-tubercular therapy (ATT) and a course of intravenous methylprednisolone followed by oral prednisolone. Subsequent clinical improvement prompted gradual tapering of prednisolone, leading to a full recovery at discharge. This case highlights the complexity of diagnosing CNS tuberculosis coexisting with ADEM, emphasizing the importance of a comprehensive clinical assessment and tailored therapeutic interventions in managing such intricate neurological presentations.

Efficient pulmonary lymphatic drainage is necessary for inflammation resolution in ARDS.

The lymphatic vasculature is the natural pathway for the resolution of inflammation, yet the role of pulmonary lymphatic drainage function in sepsis-induced acute respiratory distress syndrome (ARDS) remains poorly characterized. In this study, indocyanine green-near infrared lymphatic living imaging was performed to examine pulmonary lymphatic drainage function in septic mouse models. We found that the pulmonary lymphatic drainage was impaired owing to the damaged lymphatic structure in sepsis-induced ARDS. Moreover, prior lymphatic defects by blocking vascular endothelial growth factor receptor-3 (VEGFR-3) worsened sepsis-induced lymphatic dysfunction and inflammation. Posttreatment with vascular endothelial growth factor-C (Cys156Ser) (VEGF-C156S), a ligand of VEGFR-3, ameliorated lymphatic drainage by rejuvenating lymphatics to reduce the pulmonary edema and promote draining of pulmonary macrophages and neutrophils to pretracheal lymph nodes. Meanwhile, VEGF-C156S posttreatment reversed sepsis-inhibited CC chemokine ligand 21 (CCL21), which colocalizes with pulmonary lymphatic vessels. Furthermore, the advantages of VEGF-C156S on the drainage of inflammatory cells and edema fluid were abolished by blocking VEGFR-3 or CCL21. These results suggest that efficient pulmonary lymphatic drainage is necessary for inflammation resolution in ARDS. Our findings offer a therapeutic approach to sepsis-induced ARDS by promoting lymphatic drainage function.

Blood-brain barrier disruption measured by albumin index correlates with inflammatory fluid biomarkers

Blood-brain barrier disruption measured by albumin index correlates with inflammatory fluid biomarkers

From a rat otorrhagia to a febrile rash

A 19-year-old patient, without medical history, presented a first episode of continuous fever (about 39°C) for 14 days, with rash and arthromyalgia and functional impotence of the ankles for 7 days. Clinically, the patient had asthenia with ankle biarthritis with a predominantly palm-plant rash (Figure 1). Right ankle joint puncture finding inflammatory fluid (5300 nucleated elements/mm3 including 91% neutrophils), without microcrystals. Immunological test (rheumatoid factor and citrullinated anti-peptide antibodies) was negative. The skin biopsy performed in an area of pathological skin is in favor of an infectious origin, with microabscesses.

Diagnosis of periprosthetic joint infections in patients who have rheumatoid arthritis.

To investigate the optimal thresholds and diagnostic efficacy of commonly used serological and synovial fluid detection indexes for diagnosing periprosthetic joint infection (PJI) in patients who have rheumatoid arthritis (RA). The data from 348 patients who had RA or osteoarthritis (OA) and had previously undergone a total knee (TKA) and/or a total hip arthroplasty (THA) (including RA-PJI: 60 cases, RA-non-PJI: 80 cases; OA-PJI: 104 cases, OA-non-PJI: 104 cases) were retrospectively analyzed. A receiver operating characteristic curve was used to determine the optimal thresholds of the CRP, ESR, synovial fluid white blood cell count (WBC), and polymorphonuclear neutrophil percentage (PMN%) for diagnosing RA-PJI and OA-PJI. The diagnostic efficacy was evaluated by comparing the area under the curve (AUC) of each index and applying the results of the combined index diagnostic test. For PJI prediction, the results of serological and synovial fluid indexes were different between the RA-PJI and OA-PJI groups. The optimal cutoff value of CRP for diagnosing RA-PJI was 12.5 mg/l, ESR was 39 mm/hour, synovial fluid WBC was 3,654/μl, and PMN% was 65.9%; and those of OA-PJI were 8.2 mg/l, 31 mm/hour, 2,673/μl, and 62.0%, respectively. In the RA-PJI group, the specificity (94.4%), positive predictive value (97.1%), and AUC (0.916) of synovial fluid WBC were higher than those of the other indexes. The optimal cutoff values of synovial fluid WBC and PMN% for diagnosing RA-PJI after THA were significantly higher than those of TKA. The specificity and positive predictive value of the combined index were 100%. Serum inflammatory and synovial fluid indexes can be used for diagnosing RA-PJI, for which synovial fluid WBC is the best detection index. Combining multiple detection indexes can provide a reference basis for the early and accurate diagnosis of RA-PJI.

Platelet Rich Plasma (PRP) Augmentation: A Novel Approach in Management of Radicular Cyst Present at Different Locations within Jaw: A Case Series

Periapical cysts are inflammatory cysts that developed due to caries and trauma of the involved tooth. Usually, the tooth becomes nonvital with pain, swelling, and sinus formation. On radiographic examination these cyst shows radiolucency around the apex of the involved tooth. On aspiration straw colored inflammatory fluid with or without pus comes out suggestive of a radicular cyst. Surgical removal with curettage of the lesion, apicoectomy, and root canal treatment should be performed to treat the lesion. Excised cavity can be augmented with PRP (Platelet rich plasma) or PRF (Platelet rich fibrin) for better healing of the lesion. This case series reported 3 such cases and their treatment with follow-up.

Investigation of pyometra in dogs in Ho Chi Minh City, Vietnam

The objectives of this study were to evaluate the status of pyometra in dogs and effects of treatment, and to isolate bacteria from the inflammatory fluid of pyometra in dogs. The study was carried out from September 2022 to February 2023 at the Animal Health Laboratory and Treatment Division, Sub-Department of Animal Health and Husbandry of Ho Chi Minh City. Out of total 1,715 bitches, there were 81 cases of pyometra (4.43%). The results showed that dogs aged 5 - 7 years (35.80%) had the highest rate of pyometra, followed by dogs aged 2 - 4 years (20.99%), and the lowest rate with dogs < 2 years old (3.70%). Local breeds had a lower pyometra rate (19.75%) compared to foreign breeds (80.25%) (P < 0.05). Dogs kept in cages accounted for 58.02% of the pyometra rate, which was higher than the rate of free-roaming dogs at 41.98% (P < 0.05). Non-reproductive dogs had the highest rate of this disease (64.20%), followed by primiparous dogs (25.93%) and the lowest rate was recorded in dogs with parity 5 (1.23%) (P < 0.05). Common clinical symptoms included moodiness/proneness, vaginal discharge, abdominal distension/pain to touch, excessive drinking/thirst, loss of appetite, dehydration, fever, weight loss, polyuria and vomiting, which were important for the diagnosis of pyometra. Streptococcus was a bacterial group found in uterine fluid samples of pyometra by isolation and culture method. The treatment method chosen by the owners for pyometra in dogs in Ho Chi Minh City was surgical intervention and the effect of successful treatment was very high (90.12%).

Tumefactive demyelinating disorders as stroke mimics: Description of cases and systematic review of the literature.

tumefactive multiple sclerosis (TmMS) is a rare subtype of a demyelinating disease that develops over time. Cases of hyperacute presentations mimicking cerebrovascular disorders have been reported; however, detailed clinical and demographic data are lacking. this study aimed to systematically review the literature on tumefactive demyelinating disorders presenting as strokes. After screening the PubMed, PubMed Central, and Web of Science databases, 39 articles describing 41 patients were identified, including 2 historical patients from our center. 23 (53.4%) patients were diagnosed with multiple sclerosis variants (vMS), 17 (39.5%) with inflammatory demyelinating variants (vInf), and 3 with tumors; however, only 43.5% of cases were verified histologically. In subgroup analysis, vMS differed from vInf in several aspects. Inflammatory cerebral spinal fluid parameters, including pleocytosis, proteinorachia was more commonly observed in vInf [11 (64.7%) vs. 1 (5.2%), P=0.001 and 13/17 (76.4%) vs. 6/23 (31.5%), P=0.02] than that in vMS. Neurological deterioration and fatal outcomes were more commonly observed in vInf [13/17 (76.4%) vs. 7/23 (30.4%), P=0.003, and 11/17 (64.7%) vs. 0/23 (0%), P=0.0001] than that in vMS. Clinicodemographic data might aid in recognizing different subtypes of TmMS and warrant consideration of unconventional therapies because outcomes may be poor in the vInf of TmMS.

Poster 121: Association Between MRI Findings in ACL Injury and Subacute Synovial Fluid Inflammatory Biomarker Levels at the Time Of Surgery

Objectives: To Investigate the association between MRI findings following anterior cruciate ligament (ACL) injury and synovial fluid biomarker profile at the time of surgery Methods: Patients undergoing surgery for ACL injury from October 2011 to December 2021 were included in a database of subjects who had synovial fluid samples collected at the time of surgery. From this cohort, 82 subjects with acute ACL injury were retrospectively selected who met the following inclusion criteria: no history of prior knee trauma to suggest chronic ACL injury, history of acute non- contact knee injury, MRI examination of the knee performed within 3 weeks of knee injury, subsequent knee surgery performed between 4 and 12 weeks of knee injury, and no additional ligament tear requiring surgical treatment. All subjects underwent a preoperative MRI examination of the knee using multi-planar, multi-contrast fast spin-echo sequences. Synovial fluid was aspirated from the operative knee prior to surgical incision. Concentrations of inflammatory biomarkers including regulation on activation normal T cell expressed and secreted (RANTES), interleukin 6 (IL-6), vascular endothelial growth factor (VEGF), tissue inhibitor matrix metalloproteinase 1 (TIMP1), interleukin 1 receptor agonist (IL1-RA) and matrix metalloproteinase 3 (MMP-3) were measured. The MRI examinations of all subjects were reviewed by a fellowship trained musculoskeletal radiologist to assess the presence and severity of various MRI features of acute and chronic knee injury using the validated Anterior Cruciate Ligament Osteoarthritis Score (ACLOAS) system. Nonparametric Wilcoxon tests and Fisher’s exact test were used to compare demographic factors, MRI findings, clinical symptoms, and synovial fluid inflammatory biomarkers between clusters. K-means cluster analysis was used to identify 2 distinct clusters of subjects with acute ACL injury based on biomarkers concentrations in synovial fluid. Results: The mean age of the cohort was 31.6 ± 8 years, average body mass index (BMI) was 25.5 ± 4.4 kg/m2. There 42.7% (n=35) of the cohort was female and 85.4% (n=70) were non-smokers. Two distinct clusters were identified: cluster 1 included 45 subjects and was marked by older subjects (33.2 ± 9.1 years, p=.038) with lower levels of all inflammatory synovial fluid biomarkers. Cluster 2 included 37 subjects and was marked by younger patients (29.7 ± 6.1 years, p=.038) with a more pro-inflammatory synovial fluid biomarker profile, higher ACLOAS Hoffa’s synovitis score (p=.001), and a higher incidence of subchondral bone fractures (54%, p=.002). There were no differences between clusters in time from injury to surgery (p=), BMI (p=.141), or ACLOAS meniscus (p=.086), cartilage (p=.730), or effusion scores (p=.202) Conclusions: Given the variable outcomes seen following ACL reconstruction (ACLR) surgery, a better understanding of the pathophysiology following ACL injury is needed. This study found distinct cluster of patients who exhibited a higher inflammatory reaction at the time of surgery as well as more severe findings on preoperative MRI. These findings could be used to identified clinical parameters associated with more inflammation at the time of surgery and their effect on clinical outcomes of ACLR.

The joint ultrasound markers in the early diagnosis of psoriatic arthritis

Objectives. Early establishment of arthritis in PsA based on clinical data and ultrasound examination. Material and methods. The study was conducted between 2019-2023, in the rheumatology and arthrology departments of the Timofei Moşneaga Republican Clinical Hospital, or treated in outpatient. In order to meet the requirements of the study, 100 people were examined, including 70 patients with PsA. Results. In patients with PsA the most common changes were an increase in the amount of intra-articular fluid and the proliferation of the synovial membrane. In total, fluid was detected in 293 out of 3,232 joints (9.1%). Conclusions. Ultrasound is a highly informative method in detecting a wide range of morphological changes in the joints of patients with PsA. The highest index of sensitivity appeared when inflammatory fluid, cartilage changes, osteophytes and tenosynovitis were detected.

Examen cytologique du liquide synovial

AbstractSynovial fluid, present in the joint cavity, ensures among other things lubrication of the diarthrodial joints. It reflects various pathological processes affecting the joints (arthropathies), which gives its cytological study a major interest for the diagnosis of arthropathies, in particular by separating inflammatory arthropathies (arthritides) and «mechanical» arthropathies. The steps of the technical management and cytological examination of a synovial fluid are explained, then the different types of fluids are described, according to two main categories : non-inflammatory fluids (osteoarthritis, mechanical pathology) and inflammatory fluids (infection, microcrystalline arthropathies, inflammatory rheumatism); in the second case, the identification of micro-crystals in the fluid, which is quite simple, allows a rapid diagnosis and management of the pathology.