Experimentally induced corticosteroid arthropathy
TL;DR: The correlation between certain pre-existing patterns of cartilage histology and susceptibility to degenerative change may provide a clue to the localization of degenerative joint disease in humans.
Abstract: Intraarticular injections of triamcinolone acetonide resulted in deleterious changes in living rabbit articular knee cartilage. These changes were characterized by an increased frequency of chondrocyte nuclear degeneration and prominent cyst formation as compared with control animals. Degenerative changes were localized to the cartilage of the medial tibial plateau. This localization may be related to the different histologic pattern seen in this cartilage surface as compared to other areas of the knee. The correlation between certain pre-existing patterns of cartilage histology and susceptibility to degenerative change may provide a clue to the localization of degenerative joint disease in humans.
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TL;DR: 2 years of intra-articular triamcinolone, compared with intra-artsicular saline, resulted in significantly greater cartilage volume loss and no significant difference in knee pain, and these findings do not support this treatment for patients with symptomatic knee osteoarthritis.
Abstract: Importance Synovitis is common and is associated with progression of structural characteristics of knee osteoarthritis Intra-articular corticosteroids could reduce cartilage damage associated with synovitis but might have adverse effects on cartilage and periarticular bone Objective To determine the effects of intra-articular injection of 40 mg of triamcinolone acetonide every 3 months on progression of cartilage loss and knee pain Design, setting, and participants Two-year, randomized, placebo-controlled, double-blind trial of intra-articular triamcinolone vs saline for symptomatic knee osteoarthritis with ultrasonic features of synovitis in 140 patients Mixed-effects regression models with a random intercept were used to analyze the longitudinal repeated outcome measures Patients fulfilling the American College of Rheumatology criteria for symptomatic knee osteoarthritis, Kellgren-Lawrence grades 2 or 3, were enrolled at Tufts Medical Center beginning February 11, 2013; all patients completed the study by January 1, 2015 Interventions Intra-articular triamcinolone (n = 70) or saline (n = 70) every 12 weeks for 2 years Main outcomes and measures Annual knee magnetic resonance imaging for quantitative evaluation of cartilage volume (minimal clinically important difference not yet defined), and Western Ontario and McMaster Universities Osteoarthritis index collected every 3 months (Likert pain subscale range, 0 [no pain] to 20 [extreme pain]; minimal clinically important improvement, 394) Results Among 140 randomized patients (mean age, 58 [SD, 8] years, 75 women [54%]), 119 (85%) completed the study Intra-articular triamcinolone resulted in significantly greater cartilage volume loss than did saline for a mean change in index compartment cartilage thickness of -021 mm vs -010 mm (between-group difference, -011 mm; 95% CI, -020 to -003 mm); and no significant difference in pain (-12 vs -19; between-group difference, -06; 95% CI, -16 to 03) The saline group had 3 treatment-related adverse events compared with 5 in the triamcinolone group and had a small increase in hemoglobin A1c levels (between-group difference, -02%; 95% CI, -05% to -0007%) Conclusions and relevance Among patients with symptomatic knee osteoarthritis, 2 years of intra-articular triamcinolone, compared with intra-articular saline, resulted in significantly greater cartilage volume loss and no significant difference in knee pain These findings do not support this treatment for patients with symptomatic knee osteoarthritis Trial registration ClinicalTrialsgov Identifier: NCT01230424
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TL;DR: Alterations in Cartilage in Osteoarthritis The morphologic changes in joints affected by osteoarth arthritis were identified in writings of the Hunter brothers over 200 years ago.
Abstract: Alterations in Cartilage in Osteoarthritis The morphologic changes in joints affected by osteoarthritis were identified in writings of the Hunter brothers over 200 years ago.88 Over the intervening...
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TL;DR: Degenerative lesions characterized by osteochondrophyte spur formation and cartilage degeneration were induced by partial meniscectomy in the rabbit knee and may be useful in studies of osteoarthritis pathogenesis, pathology and treatment.
Abstract: Degenerative lesions characterized by osteochondrophyte spur formation and cartilage degeneration were induced by partial meniscectomy in the rabbit knee. Cartilage degenerative lesions included ulceration, fissure and cyst formation, and diminished concentration of matrix proteinpolysaccharide. Proliferation of chondrocytes represented efforts at repair. Osteophytes increased in size with time. Changes resembled certain components of degenerative joint disease. The partial meniscectorny animal may be useful in studies of osteoarthritis pathogenesis, pathology and treatment.
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TL;DR: THA provided short term pain relief in knee OA and increased benefit was associated with both clinical evidence of joint effusion and successful aspiration of synovial fluid at the time of injection.
Abstract: OBJECTIVE--To assess the efficacy of a single intra-articular injection of triamcinolone hexacetonide (THA) in knee osteoarthritis (OA) and examine factors which may relate to treatment efficacy. METHODS--Eighty four patients with clinical and radiographic evidence of knee OA were recruited and randomly allocated to receive either THA (20 mg in 1 ml) or placebo (0.9% normal saline, 1 ml). Follow up assessments evaluated the following outcome variables: patient opinion of overall change in the treated knee, visual analogue pain score (VAS), distance walked in one minute (WD), and Health Assessment Questionnaire modified for lower limb function (HAQ). RESULTS--Seventy eight percent of THA and 49% of placebo treated patients reported overall improvement at week 1 (p
234 citations
References
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TL;DR: The effect of intra-articularly administered hydrocortisone acetate in doses of 0.16 and 1.6 milligrams per kilogram on the incorporation of glycine-H3 into articular cartilage of rabbits is demonstrated.
Abstract: This study demonstrates the effect of intra-articularly administered hydrocortisone acetate in doses of 0.16 and 1.6 milligrams per kilogram on the incorporation of glycine-H3 into articular cartilage of rabbits. The steroid was injected into one knee joint and, at intervals up to twety-four days, t
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TL;DR: Changes have been observed in the venous clotting time and the heparin-retarded venous clots time which indicate that ACTH and cortisone frequently produce a hypercoagulable state of blood coagulation.
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TL;DR: Injection of commercially available microcrystalline adrenocorticosteroid esters into normal canine joints was ac-companied by a leukocyte-rich exudative response, roughly proportional to the dose injected, and no tenderness or evidence of pain was noted.
Abstract: Injection of commercially available microcrystalline adrenocorticosteroid esters into normal canine joints was ac-companied by a leukocyte-rich exudative response, roughly proportional to the dose injected. No tenderness or evidence of pain was noted. Injection of these preparations into normal human joints often induced similar reactions which were sometimes painful. The response varied with the preparation employed and in the case of hydrocortisone acetate, with the manufacturer of the drug. The possible injurious effects of this relatively painless inflammatory response are discussed.
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TL;DR: The clinical manifestations and pathology of diffuse vascular lesions, occurring in three patients with rheumatoid arthritis, are described and the possible significance of such lesions including their apparent relationship to corticosteroid therapy is discussed in detail.
Abstract: The clinical manifestations and pathology of diffuse vascular lesions, occurring in three patients with rheumatoid arthritis, are described. The possible significance of such lesions including their apparent relationship to corticosteroid therapy is discussed in detail.
Es describite le manifestationes clinic e le pathologia de diffuse lesiones vascular, occurrente in tres patientes con arthritis rheumatoide. Es discutite in detalio le signification possibile de tal lesiones, incluse lor apparente relation con therapia corticosteroide.
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TL;DR: This paper aims to provide a history of the field of comparative medicine in India and some of the techniques used, as well as some new ideas, that have been developed since the publication of this work in 2012.
Abstract: Alain, M., Saint-Etienne, J., and Reynes, V. (1949). Med. trop., 9, 119. Blanc, G., and Baltazard, M. (1941). Presse mdd., 49, 1293. Couture E. (1935). Rev. Hyg. Mid. pr&v., 57, 190. Grant, A., and Barwell, C. (1943). Lancet, 1, 199. Gutner, L. B., and Fisher, M. W. (1948). Ann. intern. Med., 28, 1157. de Moor, C. E., Soekarnen, and van der Walle, N. (1932). Geneesk. T. Ned.-Ind., 72, 1618. Olds, R. J., and Lewis, F. A. (1954). Aust. vet. J., 30, 253. Stanton, A. T., and Fletcher, W. (1932). Studies from the In.stitute for Medical Research, F.M.S., No. 21. Bale, Sons and Danielsson, London. Sudibyo, R. M. S. (1938). Geneesk. T. Ned.-Ind., 78, 1424. Whitmore, A (1913). J. Hyg. (Camb.), 13, 1. and Krishnaswami, C. S. (1912). Indian med. Gaz., 47, 262.
87 citations