Comparative histopathological analysis between tenosynovitis and joint synovitis in rheumatoid arthritis

Kaibara, N.; Yamada, Hisakata; Shuto, Toshihide; Nakashima, Yasuharu; Okazaki, Ken; Miyahara, Hisaaki; Esaki, Yu; Hirata, Gisela Carmona; Iwamoto, Yukihide

doi:10.1111/j.1365-2559.2008.03050.x

Cited by 29 publications

(21 citation statements)

References 14 publications

(24 reference statements)

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“…The histopathology of tenosynovitis is indistinguishable from joint synovitis in rheumatoid arthritis (RA). Both are characterized by synovial cell hyperplasia, infiltration by inflammatory cells including lymphocytes and plasma cells, and increased vascularity [4]. Tenosynovitis has been found in up to 71% of JIA patients with symptomatic ankle inflammation [5].…”

Section: Introductionmentioning

confidence: 99%

Ultrasound-guided steroid tendon sheath injections in juvenile idiopathic arthritis: a 10-year single-center retrospective study

et al. 2017

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BackgroundThe aims of this study were to: (a) Identify tendon sheaths most commonly treated with steroid injections in a pediatric patient population with Juvenile Idiopathic Arthritis (JIA); (b) Describe technical aspects of the procedure; (c) Characterize sonographic appearance of tenosynovitis in JIA; (d) Assess agreement between clinical request and sites injected.MethodsThis was a 10 year single-center retrospective study (May 2006-April 2016) of patients with JIA referred by Rheumatology for ultrasound-guided tendon sheath injections. Patient demographics, clinical referral information, sonographic appearance of the tendon sheaths and technical aspects of the procedure were analyzed.ResultsThere were 308 procedures of 244 patients (75% female, mean age 9.6 years) who underwent a total of 926 tendon sheath injections. Ankle tendons were most commonly injected (84.9%), specifically the tendon sheaths of tibialis posterior (22.3%), peroneus longus (20%) and brevis (19.7%). The majority of treated sites (91.9%) showed peritendinous fluid and sheath thickening on ultrasound. There were 2 minor intra-procedure complications without sequelae. A good agreement between clinical request and sites injected was observed.ConclusionsUltrasound-guided tendon sheath injections with steroids are used frequently to treat patients with JIA. It is a safe intervention with a high technical success rate. The ankle region, specifically the medial compartment, is the site most commonly injected in this group of patients. The most common sonographic finding is peritendinous fluid and sheath thickening. These findings might assist clinicians and radiologists to characterize and more effectively manage tenosynovitis in patients with JIA.

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Section: Introductionmentioning

confidence: 99%

Ultrasound-guided steroid tendon sheath injections in juvenile idiopathic arthritis: a 10-year single-center retrospective study

et al. 2017

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“…Histologically, tenosynovitis exhibits similar features as joint synovitis, including hyperplasia of the synovial lining and infiltration of particular types of leukocytes, notably CD4 T cells and CD 68+ macrophages 4. Longstanding tenosynovitis may result in tendon damage either by synovial proliferation or by bony attrition resulting in tendon rupture with consequent disability 5–7.…”

Section: Introductionmentioning

confidence: 99%

Ultrasound definition of tendon damage in patients with rheumatoid arthritis. Results of a OMERACT consensus-based ultrasound score focussing on the diagnostic reliability

Bruyn¹,

Hánová

Iagnocco

et al. 2013

Ann Rheum Dis

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Objective To develop the first ultrasound scoring system of tendon damage in rheumatoid arthritis (RA) and assess its intraobserver and interobserver reliability. Methods We conducted a Delphi study on ultrasounddefined tendon damage and ultrasound scoring system of tendon damage in RA among 35 international rheumatologists with experience in musculoskeletal ultrasound. Twelve patients with RA were included and assessed twice by 12 rheumatologists-sonographers. Ultrasound examination for tendon damage in B mode of five wrist extensor compartments (extensor carpi radialis brevis and longus; extensor pollicis longus; extensor digitorum communis; extensor digiti minimi; extensor carpi ulnaris) and one ankle tendon (tibialis posterior) was performed blindly, independently and bilaterally in each patient. Intraobserver and interobserver reliability were calculated by κ coefficients. Results A three-grade semiquantitative scoring system was agreed for scoring tendon damage in B mode. The mean intraobserver reliability for tendon damage scoring was excellent (κ value 0.91). The mean interobserver reliability assessment showed good κ values (κ value 0.75). The most reliable were the extensor digiti minimi, the extensor carpi ulnaris, and the tibialis posterior tendons. An ultrasound reference image atlas of tenosynovitis and tendon damage was also developed. Conclusions Ultrasound is a reproducible tool for evaluating tendon damage in RA. This study strongly supports a new reliable ultrasound scoring system for tendon damage.

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“…Local diffusion of inflammatory cells and molecules from the synovium is thought to be responsible for inflammatory changes seen in and around adjacent tendons RA [12, 13]. The close proximity of the patellar and achilles tendons to the synovial spaces of the knee and ankle joint facilitates their direct exposure to the local inflammatory process.…”

Section: Introductionmentioning

confidence: 99%

Patellar Tendon Properties and Lower Limb Function in Rheumatoid Arthritis and Ankylosing Spondylitis versus Healthy Controls: A Cross‐Sectional Study

Matschke

Jones

Lemmey

et al. 2013

The Scientific World Journal

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Objective. Rheumatoid arthritis (RA) and ankylosing spondylitis (AS) lead to inflammation in tendons and peritendinous tissues, but effects on biomechanical tendon function are unknown. This study investigated patellar tendon (PT) properties in stable, established RA and AS patients. Methods. We compared 18 RA patients (13 women, 59.0 ± 2.8 years, mean ± SEM) with 18 age- and sex-matched healthy controls (58.2 ± 3.2 years), and 12 AS patients (4 women, 52.9 ± 3.4 years) with 12 matched controls (54.5 ± 4.7 years). Assessments with electromyography, isokinetic dynamometry, and ultrasound included quadriceps muscle force and cross-sectional area (CSA), PT stiffness, and PT CSA. Additionally, measures of physical function and disease activity were performed. Results. PT stiffness and physical function were lower in RA and AS patients compared to healthy controls, without a significant difference in force production. PT CSA was significantly larger leading to reduction in Young's modulus (YM) in AS, but not in RA. Conclusion. The adverse changes in PT properties in RA and AS may contribute to their impaired physical function. AS, but not RA, leads to PT thickening without increasing PT stiffness, suggesting that PT thickening in AS is a disorganised repair process. Longitudinal studies need to investigate the time course of these changes and their response to exercise training.

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Comparative histopathological analysis between tenosynovitis and joint synovitis in rheumatoid arthritis

Cited by 29 publications

References 14 publications

Ultrasound-guided steroid tendon sheath injections in juvenile idiopathic arthritis: a 10-year single-center retrospective study

Ultrasound-guided steroid tendon sheath injections in juvenile idiopathic arthritis: a 10-year single-center retrospective study

Ultrasound definition of tendon damage in patients with rheumatoid arthritis. Results of a OMERACT consensus-based ultrasound score focussing on the diagnostic reliability

Patellar Tendon Properties and Lower Limb Function in Rheumatoid Arthritis and Ankylosing Spondylitis versus Healthy Controls: A Cross‐Sectional Study

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