PURPOSE: To confirm the pathophysiology and proper treatment of synovial chondromatosis according to preoperative radiographs, intraoperative findings, and postoperative histology. MATERIALS AND METHODS: Twenty one patients with synovial chondromatosis who underwent the removal of loose bodies and synovectomy since 1995 were investigated. Patients were analyzed in terms of various radiologic and histologic findings of osteochondromas and synovium. RESULTS: The joints involved were the shoulder joint in 9, the knee in 7, the hip in 3, and the elbow in 2 patients. Removals of osteochondromas were performed in all patients, and four who had intrasynovial proliferating nodules were treated by partial synovectomy. Histologically, the synovia were hypertrophied, and osteochondromas classifiable as three distinct types: premature, maturing, and matured. Osteochondromas in the synovium were of the premature type. There were no recurrences at an average 39 months of follow-up. CONCLUSIONS: Based on a study of 21 cases of synovial chondromatosis, there appear to be three separate types of this disease: premature, maturing, and matured. Partial synovectomy may be necessary in premature and maturing types with intrasynovial proliferating nodules.
Chondromatosis, Synovial* ; Elbow ; Follow-Up Studies ; Hip ; Humans ; Joints ; Knee ; Osteochondroma ; Recurrence ; Shoulder Joint ; Synovial Fluid ; Synovial Membrane

Unlike other soluble receptors, the soluble interleukin-6 receptor (sIL-6R) cooperates with IL-6 to activate gp130 of effector cell. As the IL-6 and sIL-6R are important in the rheumatoid disease, this study was designed to measure concentration of IL-6 and sIL-6R in synovium and synovial fluid of the degenerative arthritis. The synovium and synovial fluid were obtained during total knee replacement arthroplasty. The synovium was taken from eleven patients, and synovial fluid taken from sixteen patients. Same patients between two groups were seven. Tissue cultures of the synovial tissues were done with 10% FBS for 72 hours. After irrigation, thery were incubated for 48 hours without FBS, and the culture media and the synovial fluid were collected after centrifuged at 2500rpm for 10 minutes. The level of IL-6 and sIL-6R were measured by quantitative sandwich enzyme immunoassay technique. RESULTS: In the synovium, the IL-6 level was 5.1+/-0.12ng/ml, and the sIL-6R level was 0.41+/-0.25ng/ml. In the synovial fluid, the IL-6 level was 0.09+/- 0.15ng/ml, and the sIL-6R level was 10.37+/-3.28ng/ml. These results show that IL-6 concentration was measured highly in two groups, especially in synovium (sixty times), and the sIL-6R concentration was measured significantly high in synovial fluid (twenty-five times). CONCLUSION: The IL-6 and sIL-6R were elevated in degenerative arthrits. We confirmed the source of IL-6 was synovium (very high in synovial tissue culture media), but we need further study for the source of sIL-6R as it was remarkably elevated as IL-6 and its level was lower than serum.
Arthroplasty ; Arthroplasty, Replacement, Knee ; Culture Media ; Humans ; Immunoenzyme Techniques ; Interleukin-6* ; Osteoarthritis ; Synovial Fluid ; Synovial Membrane

Pigmented villonodular synovitis is a kind of benigh inflammatory lesion involving synovial membrane, characterized by yellowish or yellow-grayish colored villous nodules of synovial membrane, formed by accumulation of cholesterol and hemosiderin with numerous cleftings of synovial membrane. The lesion was first described by Chassaignac (1852) as the nodular form arising in relation to the flexor tendon sheath of the middle and index fingers. After that Simon (1865) described it as a xanthoma of the synovia, and there after various names were given by many authors, according to the characteristics of the pathologic fetures. In 1941 Jaffe named this lesion pigmented villonodular synovitis, which is now generally accepted. Still the direct cause of this lesion is not clearly known, but chronic stimulation of synovia is generally accepted as an etiologic factor. In this paper we report four cases of pigmented villonodular synovitis, which were diagnosed and treated in our department. One of the four cases occurred at the proximal tibiofibula joint which is a very rare site.
Cholesterol ; Fingers ; Hemosiderin ; Joints ; Synovial Fluid ; Synovial Membrane ; Synovitis, Pigmented Villonodular ; Tendons ; Xanthomatosis

Humans ; Synovial Fluid ; MicroRNAs/genetics* ; Exosomes/genetics* ; Osteoarthritis/genetics* ; Synovial Membrane

This study was designed to observe the expression of perlecan in the normal and degenerative arthritic synovial membrane. By using the immunohistochemical staining and immuno -electron microscopical gold labeling techniques, we observed five materials of normal and degenerative arthritic synovia each. The results were as follows. 1. By the immunohistochemical methods, perlecan -positive staining was seen on the 1 ~2 cell layers of the normal synovial membrane. But, a weaker staining compared to that seen in the normal synovial membrane was found in the degenerative arthritic synovial membrane. 2. Under the electron microscopic observation, perlecan was largely distributed in the rough endoplasmic reticulum of the secretory synovial cell, and in the vacuoles of the phagocytic synovial cell on the normal synovium of the human knee joint. It was also found in the extracellular matrix of the synovial membrane. 3. Perlecan -positive cells were also identified on the degenerative arthritic synovium of the human knee joint. However, fewer perlecan was observed here than that found in the normal synovium. In conclusion, perlecan is synthesized by the secretory synovial cells and degraded by the phagocytic synovial cells. And it, known as a major component of the basement membrane, also proven to exist in the extracellular matrix of the synovial membrane having no basement membrane. From the fact that less perlecan was observed in the degenerative arthritis, perlecan is might to play a major role in the degenerative process.
Basement Membrane ; Endoplasmic Reticulum, Rough ; Extracellular Matrix ; Humans ; Knee Joint ; Knee* ; Osteoarthritis* ; Synovial Fluid ; Synovial Membrane* ; Vacuoles

PURPOSE: To evaluate correlations between vascular endothelial growth factor (VEGF) which is associated with tissue remodeling and bone repair and systemic and tissue inflammation in osteoarthritis. MATERIALS AND METHODS: Sixty patients who were above grade 2 in Kellgren-Lawrence radiologic classification of osteoarthritis were classified into group 1 (grade 2, 16 patients), group 2 (grade 3, 18 patients) and group 3 (grade 4, 26 patients). All patients were checked C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and total WBC count in the blood and VEGF and total WBC count in the synovial fluid by ELISA. RESULTS: The severe in osteoarthritic change in radiographs, the more VEGF in the synovial fluid (mean value; group 1 82.7 pg/ml, group 2 111.6 pg/ml, group 3 152.6 pg/ml). VEGF in the synovial fluid were related with total WBC count in the blood and in the synovial fluid (p=0.012, p=0.028 respectively), but not related with CRP and ESR in the blood. CONCLUSION: The severe in osteoarthritic change in radiographs, the more VEGF in the synovial fluid. This facts suggested that there were much neovascularization and bone repair in the synovium of advanced osteoarthritis. Therefore further study elucidating mechanisms of tissue remodeling and its associated factors will be needed.
Acute-Phase Proteins ; Blood Sedimentation ; C-Reactive Protein ; Humans ; Inflammation ; Osteoarthritis ; Synovial Fluid ; Synovial Membrane ; Vascular Endothelial Growth Factor A

synovial inflammation is developed and pain mediators such as prostaglandin E2 or leukortiene B4 are released from the synovial membrane. This can be a cause of TMJ disorder. I present a variety of experimental study about the condylar fracture and menisical injury and enzyme-immunoassay of synovial fluid after mandibular trauma that have been studied since 1992 and establish the treatment criteria of traumatic TMJ injury. I think that the treatment option of condylar fracture depends upon the surgeon's criteria exclusively. There are no significant differences between conservative and surgical treatment. If the aggressive functional physical therapy and long-term followup be performed, the favorable functional recovery of TMJ is unnecessary in condylar fracture. And also arthrocentesis can be available to release the patient's subjective symptoms and improve the healing of injured TMJ.]]>
Accidents, Traffic ; Ankylosis ; Arthritis ; Dinoprostone ; Follow-Up Studies ; Inflammation ; Synovial Fluid ; Synovial Membrane ; Synovitis ; Temporomandibular Joint Disorders ; Temporomandibular Joint

The suprapatellar plica is a synovial membrane that lies between the suprapatellar pouch and the true knee joint, but pathologic suprapatellar plica has been reported not frequently. We experienced one case of arch type of pathologic suprapatellar plica which was excised by arthroscopic technique, and report it with review of literature.
Knee Joint ; Synovial Membrane

BACKGROUND: CD4+Fop3+ regulatory T cells (Tregs) are needed to maintain peripheral tolerance, but their role in the development of autoimmune arthritis is still debated. The present study was undertaken to investigate the mechanism by which Tregs influence autoimmune arthritis, using a mouse model entitled K/BxN. METHODS: We generated Treg-deficient K/BxNsf mice by congenically crossing K/BxN mice with Foxp3 mutant scurfy mice. The arthritic symptoms of the mice were clinically and histopathologically examined. The proportions and activation of CD4+ T cells and/or dendritic cells were assessed in the spleens, draining lymph nodes and synovial tissue of these mice. RESULTS: K/BxNsf mice exhibited earlier onset and more aggressive progression of arthritis than their K/BxN littermates. In particular, bone destruction associated with the influx of numerous RANKL+ cells into synovia was very prominent. They also contained more memory phenotype CD4+ T cells, more Th1 and Th2 cells, and fewer Th17 cells than their control counterparts. Plasmacytoid dendritic cells expressing high levels of CD86 and CD40 were elevated in the K/BxNsf synovia. CONCLUSION: We conclude that Tregs oppose the progression of arthritis by inhibiting the development of RANKL+ cells, homeostatically proliferating CD4+ T cells, Th1, Th2 and mature plasmacytoid dendritic cells, and by inhibiting their influx into joints.
Animals ; Arthritis ; Dendritic Cells ; Joints ; Lymph Nodes ; Memory ; Mice ; Peripheral Tolerance ; Phenotype ; Spleen ; Synovial Fluid ; Synovial Membrane ; T-Lymphocytes ; T-Lymphocytes, Regulatory ; Th17 Cells ; Th2 Cells

BACKGROUND: CD4+Fop3+ regulatory T cells (Tregs) are needed to maintain peripheral tolerance, but their role in the development of autoimmune arthritis is still debated. The present study was undertaken to investigate the mechanism by which Tregs influence autoimmune arthritis, using a mouse model entitled K/BxN. METHODS: We generated Treg-deficient K/BxNsf mice by congenically crossing K/BxN mice with Foxp3 mutant scurfy mice. The arthritic symptoms of the mice were clinically and histopathologically examined. The proportions and activation of CD4+ T cells and/or dendritic cells were assessed in the spleens, draining lymph nodes and synovial tissue of these mice. RESULTS: K/BxNsf mice exhibited earlier onset and more aggressive progression of arthritis than their K/BxN littermates. In particular, bone destruction associated with the influx of numerous RANKL+ cells into synovia was very prominent. They also contained more memory phenotype CD4+ T cells, more Th1 and Th2 cells, and fewer Th17 cells than their control counterparts. Plasmacytoid dendritic cells expressing high levels of CD86 and CD40 were elevated in the K/BxNsf synovia. CONCLUSION: We conclude that Tregs oppose the progression of arthritis by inhibiting the development of RANKL+ cells, homeostatically proliferating CD4+ T cells, Th1, Th2 and mature plasmacytoid dendritic cells, and by inhibiting their influx into joints.
Animals ; Arthritis ; Dendritic Cells ; Joints ; Lymph Nodes ; Memory ; Mice ; Peripheral Tolerance ; Phenotype ; Spleen ; Synovial Fluid ; Synovial Membrane ; T-Lymphocytes ; T-Lymphocytes, Regulatory ; Th17 Cells ; Th2 Cells