Das differenzialdiagnostische Spektrum der Synovialitis

Knöß, P.; Knöss, M; Otto, Mike; Kriegsmann, Jörg; Krukemeyer, Manfred Georg; Krenn, Veit

doi:10.1007/s00393-007-0247-4

Cited by 5 publications

(1 citation statement)

References 16 publications

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“…Hauptmerkmal des peripheren Gelenkbefalls ist die Synovialitis, d. h. ein entzündlicher Befall der Synovialmembran, die aufgrund der entzündlichen Reaktion die Ausschüttung proinflammatorischer Zytokine den Entzündungsprozess fördert. Dabei kann eine Differenzierung in low-grade und high-grade Synovialitis vorgenommen werden [15,16]. Zusätzlich haben Krenn und Mitarbeiter mittels histopathologischer Untersuchungen durch eine semiquantitative Bestimmung des Um-fangs der Deckzellschicht der Synovialis, der synovialen Stromazelldichte, der Leukozyten-und Residenzzellen (Fibrozyten, Fibroblasten, Makrophagen) sowie Plasmazellen und Lymphozyten einen 4-Punkte Score entwickelt.…”

Section: Introductionunclassified

Radionuklidtherapie entzündlicher Gelenkerkrankungen

Fischer

Baraliakos

2022

Angewandte Nuklearmedizin

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ZusammenfassungDie RSO stellt ein anerkanntes, wenig invasives Therapieverfahren bei entzündlichen Gelenkerkrankungen mit einer Synovialitis im Zusammenhang mit einer RA, der reaktiven Arthritis, bei der PVNS sowie einem Haemarthros dar. Auch die eine in Deutschland als Indikation nicht zugelassene Osteoarthritis kann erfolgreich behandelt werden. Dabei werden in Abhängigkeit von den physikalischen Eigenschaften 90Yttriumcitrat für Kniegelenke, 186Rheniumsulfid für mittelgroße Gelenke sowie 169Erbiumcitrat in kolloidaler Form für kleine Gelenke eingesetzt. Die Speicherung der zur RSO eingesetzten kolloidalen Radiopharmaka hängt von der Ausprägung der Synovialitis durch die aktivierten Makrophagen ab 2. So kann aus dem Synovialitis Score schon abgeleitet werden, in welchem Umfang die Akkumulation bei den unspezifischen Synovialitiden stattfindet und wie damit der zu erwartende Therapieerfolg sein wird.

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Section: Introductionunclassified

Radionuklidtherapie entzündlicher Gelenkerkrankungen

Fischer

Baraliakos

2022

Angewandte Nuklearmedizin

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Septische Arthritis des Erwachsenen

2014

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Septic arthritis is a true rheumatological emergency requiring immediate and thoughtful effort for rapid diagnosis establishment and treatment initiation. Children and elderly persons as well as immunocompromised individuals, patients with pre-existing joint damage and with inflammatory rheumatic joint diseases are preferentially affected. Bacteremia, joint surgery and intra-articular injections pose risk situations for the development of joint infections. The most frequent causative organism is Staphylococcus aureus but other relevant pathogens include coagulase-negative staphylococci, streptococci and mycobacteria. Synovial fluid analysis (e.g. appearance, cell count and microbiological examination) is the most important step to establish the diagnosis. The two main components of therapy consist of joint drainage and antibiotic treatment. The approach to periprosthetic joint infections depends on the duration of symptoms, causative organism and individual factors.

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Expression of miR-146a, miR-155, and miR-223 in formalin-fixed paraffin-embedded synovial tissues of patients with rheumatoid arthritis and osteoarthritis

et al. 2016

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Rheumatoid arthritis (RA) is a chronic autoimmune disease with a heterogeneous clinical presentation affecting about 1 % of adults in developed countries. Currently, the diagnosis is based on the revised criteria of the American College of Rheumatology (ACR) and the European League Against Rheumatism (EULAR) from 2010. These criteria include clinical and laboratory parameters. Because of the variability of the clinical picture, delayed diagnosis of RA occurs in a significant subset of patients. Therefore, the discovery of novel biomarkers that improve the diagnosis of RA is of particular interest. Recently, it became evident that miRNAs have regulatory activities in physiologic processes and human diseases. Upregulation of miR-146a, miR-155, and miR-223 has been shown in various compartments such as serum, blood, synovial fluid, and tissues in patients with RA. A total of 87 samples were analyzed (RA 50, osteoarthritis (OA) 37). RNA was isolated from formalin-fixed paraffin-embedded synovial tissue (FFPE). The relative expression of miR-146a, miR-155, and miR-223 was determined by comparison to a housekeeping RNA molecule (snRNA U6) and an RNA pool from histologically and clinically verified OA samples. miR-146a, miR-155, and miR-223 were significantly elevated in RA compared to OA synovial tissues (p < 0.001). A strong correlation between the miRNAs could be observed. The sensitivity and specificity for the detection of RA were 0.76/0.80 (miR-146a), 0.80/0.95 (miR-155), and 0.86/0.81 (miR-223). The combination of miR-155 and miR-223 resulted in the highest area under the curve (AUC 0.92) with a sensitivity and specificity of 0.84/0.91, respectively. Significantly higher expression levels of miR-146a, miR-155, and miR-223 in FFPE synovial tissue samples of patients with established RA compared to patients with OA were shown. The usefulness of these miRs for the differential diagnosis of early phases of RA against OA remains to be investigated.

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Das differenzialdiagnostische Spektrum der Synovialitis

Cited by 5 publications

References 16 publications

Radionuklidtherapie entzündlicher Gelenkerkrankungen

Radionuklidtherapie entzündlicher Gelenkerkrankungen

Septische Arthritis des Erwachsenen

Expression of miR-146a, miR-155, and miR-223 in formalin-fixed paraffin-embedded synovial tissues of patients with rheumatoid arthritis and osteoarthritis

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