Diagnostic usefulness of synovial vascular morphology in chronic arthritis. A systematic survey of 100 cases*,*,**,***
Section snippets
Patients
The first consecutive 100 patients from the database of the Rheumatological Arthroscopy Unit were selected: 81 patients with active inflammatory arthritis (39 with early arthritis), 8 patients with OA, and 11 patients with CPPD disease. CPPD disease was diagnosed by radiologic chondrocalcinosis and episodic monarthritis with CPPD crystals in synovial fluid.
In the inflammatory group, 35 patients had RA according to American College of Rhuematology (formerly, American Rheumatology Association)
Results
Thirty-nine of 81 patients with inflammatory arthritis had ≤12 months duration. Eighty-five knees, 11 wrists, 3 elbows, and 1 MCP joint were studied. The distribution of patients according to diagnosis showed no significant differences in disease duration, and no differences were found in the distribution of the vascular patterns (straight, tortuous, and mixed) between patients with less or more than 12 months of disease (Table 1).
Discussion
This study systematically analyzed the vascular changes that occur in the synovial membrane in early and longstanding inflammatory arthritis, as well as noninflammatory arthropathies. Our results suggest that vascular changes in inflammatory arthritis do not depend on disease duration or DMARD therapy. Rather, the synovial vessel morphology seems to be more related to the type of arthritis. This also seems to be true in joints other than the knee, but the number of cases is too low to for
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2011, Academic RadiologyCitation Excerpt :A possible explanation could be that the early signal curve characteristics are more strongly influenced by synovial vascularity and capillary permeability, whereas the late enhancement is more dependent on contrast diffusion processes (29). Histological studies have shown that, in PsA, the vessel wall is markedly thickened (30,31) which restricts diffusion of contrast media into the synovium. Histopathology revealed proliferative synovial change in acute EOA similar to that of rheumatoid arthritis with lymphocytic and neutrophilic infiltration, synovial hypertrophy, and pannus formation explaining also the similarities of the present data acquired in patients with EOA with those of Schwenzer et al (13) acquired in patients with rheumatoid arthritis.
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Juan D. Cañete, MD PhD: José R. Rodríguez, MD: Georgina Salvador, MD: Antonio Gómez-Centeno, MD: J. Muñoz-Gómez, MD FRCP(Ed): Raimón Sanmartí, MD: Arthritis Unit, Rheumatology Department, Institut Clínic de l'Aparell Locomotor (ICAL), Hospital Clínic de Barcelona, and Institut d'Investigacions Biomédiques Agustí Pí i Suñer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.
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Supported by a grant from Fondo de Investigaciones Sanitarias (Ministerio de Sanidad, Spain), Proyecto FIS 1548/01.
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Address reprint requests to Juan D. Cañete, MD PhD, Arthritis Unit, Rheumatology Department, Hospital Clínic, Villarroel, 170, 08036 Barcelona, Spain.
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