Imaging of neuropathic arthropathy

Neuropathic arthropathy is a chronic, progressive joint degeneration with bone fragmentation, ligamentous instability, and dislocation. Diabetes is the leading cause of neuropathic arthropathy. Conventional radiography is the most commonly used imaging modality for diagnosing neuropathic arthropathy. The disease is mostly the hypertrophic type and is manifested by sclerosis of the bone, fragmentation, joint destruction, swelling, large joint effusion, and large osteophyte formation. Computed tomography, magnetic resonance imaging and radionucleide scintigraphy are helpful for diagnosing the disease and may help in distinguishing neuropathic arthropathy from septic arthritis and osteomyelitis.     

Genome scan for quantity of hand osteoarthritis: the Framingham Study

OBJECTIVE: To search for markers linked to quantity of radiographic hand osteoarthritis (OA) in the Framingham Heart Study. METHODS: The sample included 684 original cohort members and 793 offspring in 296 pedigrees. Radiographic OA features evaluated included the Kellgren/Lawrence (K/L) score, osteophytes, and joint space narrowing (0-3 scale). Four quantitative phenotypes were computed from these measurements: sum of K/L scores across hand joints, sum of osteophyte scores, sum of joint space narrowing scores, and proportion of affected joints. Prior to linkage analysis, these phenotypes were adjusted for age using a linear regression analysis from which standardized residuals were computed. The regression analysis was performed separately for each sex and each generation. The variance component model (SOLAR) was then applied to the normalized scores of the residuals. RESULTS: The average age was 62 years for the original cohort and 54 years for the offspring. Fifty percent of the original cohort and 30% of their offspring had at least 1 affected joint (K/L score >or=2). Heritability ranged from 28% (proportion of joints affected with OA) to 34% (sum of K/L scores). Eight chromosomal regions indicated suggestive linkage (multipoint logarithm of odds [LOD] score >1.5) for at least 1 phenotype; LOD scores were highest for joint space narrowing, with a multipoint LOD score = 2.96 on chromosome 1p at D1S1665. Chromosomes 7, 9, 13, and 19 indicated consistent LOD score elevation for multiple OA phenotypes. CONCLUSION: There are several chromosomes that may harbor OA susceptibility genes. Further investigation of these regions using larger studies and finer maps will be important to confirm linkage.     

Comparison of the prevalence of knee osteoarthritis between the elderly Chinese population in Beijing and whites in the United States: The Beijing Osteoarthritis Study

OBJECTIVE: To estimate the prevalence of radiographic and symptomatic knee osteoarthritis (OA) in a population-based sample of elderly subjects in Beijing, China and compare it with that reported in the Framingham (Massachusetts) OA Study. METHODS: We recruited a sample of persons age > or = 60, using door-to-door enumeration in randomly selected neighborhoods in Beijing. Subjects completed a home interview including questions on knee symptoms and a hospital examination including knee radiographs obtained during weight bearing. The protocol was identical to that used in the Framingham OA Study. A reader read intermingled Beijing and Framingham Study films to ensure high reliability. We defined a subject as having radiographic knee OA when the Kellgren/Lawrence grade was > or = 2 in at least 1 knee. Symptomatic knee OA was recorded as present when knee pain was reported and the symptomatic knee had radiographic OA. We estimated the prevalence of these entities in elderly subjects in Beijing and compared it with OA prevalence in Framingham, using an age-standardized prevalence ratio. RESULTS: Of 2,180 age-eligible Beijing subjects contacted, knee radiographs were obtained in 1,787 (82.0%). The prevalence of radiographic knee OA was 42.8% in women and 21.5% in men. Symptomatic knee OA occurred in 15.0% of women and 5.6% of men. Compared with women of the same age in Framingham, women in Beijing had a higher prevalence of radiographic knee OA (prevalence ratio 1.45, 95% confidence interval 1.31-1.60) and of symptomatic knee OA (prevalence ratio 1.43, 95% confidence interval 1.16-1.75). The prevalence of knee OA in Chinese men was similar to that in their white US counterparts (for radiographic OA, prevalence ratio 0.90; for symptomatic OA, prevalence ratio 1.02). CONCLUSION: Using identical methods and definitions to evaluate the prevalence of OA across populations, we found, surprisingly, that older Chinese women have a higher prevalence of knee OA than women in Framingham, Massachusetts. The prevalence in men was comparable. Possible explanations for these differences range from genetic differences to heavy physical activity among Chinese.     

Comparison of the prevalence of radiographic osteoarthritis of the knee and hand between Japan and the United States

OBJECTIVE: There is no direct international comparison of the prevalence of osteoarthritis (OA) between Japanese and Caucasians. We compared the prevalence of radiographic knee and hand OA between women in Hizen-Oshima, Japan, and in Framingham, Massachusetts, USA. METHODS: A population based cross sectional study among 358 women in Japan and 815 women in the USA aged 63 years or older for knee joints, and 157 women in Japan and 655 women in the USA aged 71 years or older for hands. Radiographs were obtained of knees and hands, and were graded according to the Kellgren-Lawrence (K-L) criteria. Definite OA was defined as K-L grade 2 or higher, present in at least one joint of a given group. A person was defined as having OA or not in a given joint group, and we used logistic regression with the US group as referent to determine the prevalence odds ratio of OA among Japanese. RESULTS: The age adjusted prevalence of knee OA in Japanese women was higher than in Caucasians (OR 1.96, 95% CI 1.50-2.56), while the prevalence of hand OA other than distal interphalangeal joint in Japanese was lower than in Caucasians (OR for proximal interphalangeal joint 0.66, 95% CI 0.46-0.93; OR for metacarpophalangeal joint 0.62, 95% CI 0.42-0.90), especially base of thumb OA (OR 0.15, 95% CI 0.11-0.22). CONCLUSION: These findings suggest site-specific differences in the prevalence of OA that may be attributed to genetic and/or environmental factors.     

Effect of growth factors on the in vitro growth and differentiation of early and late passage C6 glioma cells

The effect of different hormones and growth factors was assayed on the in vitro growth and enzymatic activities of 2′,3′-cyclic nucleotide 3′phosphohydrolase (CNP) and glutamine synthetase (GS) of rat glioma C6 cells at two different passages in culture. Young cultures (passage 26), mainly oligodendrocytic, and older cultures (passage 134), predominantly astrocytic, were treated with 10 μM dexamethasone, 20 ng/ml transforming growth factor alpha (TGFα), 10 ng/ml insulin, 20 ng/ml platelet-derived growth factor (PDGF), and 20 ng/ml, epidermal growth factor (EGF) in serum-free chemically defined media. In vitro growth rate was measured in terms of DNA content, by a fluorometric method of diaminobenzoic acid, and rate of DNA synthesis by ³H-thymidine incorporation. CNP activity (marker for in vitro oligodendrocytes) and GS activity (marker for astrocytes) were determined spectrophotometrically. Dexamethasone reversibly and significantly inhibited growth of C6 glioma in early and late passages. PDGF and insulin promoted in vitro growth only in late passage but not in early passage cells, whereas EGF and TGFα did not significantly affect growth. An increase in CNP activity was observed in early passage cells under the effect of PDGF and insulin. The increase in GS activity induced by insulin and dexamethasone suggests a differentiating role for these factors in C6 glioma cells. These results further present the C6 glioma cell line as a useful model for studies on glial cell properties and responsiveness in culture and support its use in experimental aging in vitro.     

The fate of acetabular allografts after bipolar revision arthroplasty of the hip. A radiographic review

We reviewed the radiographs of thirty-one patients (thirty-two hips) who had had revision of the acetabular component of a total hip arthroplasty with a bipolar socket supplemented by allograft and were followed for twenty-four to forty-eight months. The grafts were categorized according to their consistency (solid or crushed bone), the location of the acetabular defect (peripheral [rim] or central), and the extent of the acetabular defect (contained--the medial part of the acetabular wall was intact, or non-contained--it was deficient). We recorded the time to incorporation of the graft, the amount of migration of the socket in the superior and medial axes, and the percentage of graft remaining at the time of the most recent follow-up. The time to healing was similar for all categories of grafts. The central, contained, solid grafts had less resorption than did the central, contained, crushed-bone grafts, as evidenced by less migration of the socket during follow-up. The non-contained grafts, in both peripheral and central locations, were associated with high rates of migration and of instability of the socket.     

Utricular papilloma

A benign prostatic utricular papilloma was found in a twenty-seven-year-old man complaining of urethral bleeding and intermittent hematuria after sexual intercourse. Local endoscopic resection was performed. Since the natural history of this lesion is not known, follow-up cystourethroscopy will be performed.