Our data form the basis for revised radiographic criteria to evaluate the distal tibiofibular syndesmosis which may influence clinical management of these patients.
Much of the work aimed at elucidating the pathogenesis of osteonecrosis (ON) of the femoral head has focused on bone blood supply, with little attention to the surrounding synovial tissue (ST). We hypothesized that patients with ON exhibit synovial infl ammation. Using immunohistological techniques, we found that a large population of patients with ON had synovial infl ammation. Moreover, a population of ON patients had infl amed ST without having an infl ammatory disease co-morbidity. The infl ammatory infi ltrate in these patients comprised primarily CD4 + T cells and CD68 + macrophages, the latter of which expressed increased levels of cellular adhesion molecules. Our results suggest the presence of a previously unrecognized population of ON patients without a diagnosed infl ammatory co-morbidity and a highly infl ammed synovium consisting primarily of a macrophage and CD4 + T-cell infi ltrate.
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