[ ISSN : 2576-5442 ]
Synovial and ganglion cysts are fluid-filled lesions within joints, most often occurring in the periarticular areas of the wrist, knees, and feet.
Juvenile Idiopathic Arthritis (JIA) is an autoimmune disease that may lead to inflammation of multiple joints at a young age, often complicated by destruction and growth disturbances, including the craniofacial region. The annual incidence is reported as 0.008–0.226 per 1000 children [1]. Temporomandibular Joint (TMJ) arthritis in children with chronic arthritis was first reported by Still in 1897 [2].
The TMJ is frequently affected (17-88%) in JIA patients and it has a high risk for inflammation and destruction among them [3]. The often undetected arthritis in the TMJ might cause significant destruction and craniofacial developmental abnormalities [1]. The TMJ is particularly susceptible to damage from arthritis due to its unique anatomy and biochemical composition [2].
Unlike other diarthrodial joints, the mandibular growth plate is located just beneath the fibrocartilage of the condylar head, making it particularly vulnerable to inflammatory damage. Damage to the mandibular growth center due to inflammation or trauma during prenatal period until just after puberty frequently results in alterations in mandibular growth. Untreated, TMJ arthritis leads to micrognathia, poor mouth opening, facial dysmorphism and lifetime disability [4-6].
The frequency of JIA is comparable to that of other diseases with high craniofacial impact, such as cleft lip/palate where a multidisciplinary treatment approach has been established successfully. In the case of JIA, such an approach is still lacking. The possible therapeutic measures for JIA patients with TMJ involvement are currently still at a clinical level of evidence [1]. Despite the effectiveness of currently available treatments, the optimal treatment for a child with TMJ arthritis is yet to be established.
Intraarticular corticosteroid injections for TMJ arthritis in JIA have been shown to improve TMJ range of motion and improvement of TMJ inflammation measures; possible drawbacks are lipoatrophy at the injection site, TMJ avascular necrosis and infections [5,7-9]. TMJ arthritis does not appear to respond fully to aggressive systemic therapy for arthritis, including anti-TNF agents [4,5,10]. Several studies have demonstrated improvement with local TNF antagonist therapy [4,11-13].
Future studies are needed in order to compare intra-articular infliximab to intra-articular corticosteroid injections for the treatment of TMJ arthritis. Dexamethasone Iontophoresis (DIP) is a noninvasive physiotherapy modality that allows transdermal delivery of dexamethasone. Low-grade electric currents lead to the dissociation of hydrophilic medications into ions that penetrate anatomic structures. However, further research is required to determine the optimal number of DIP sessions based on sensitive imaging approaches, durability of treatment response, and performance of DIP in direct comparison to intraarticular corticosteroid injection to the TMJ [7,14-16].
Renkema RW, Resnick CM and Padwa BL. Temporomandibular Joint Cyst Causing Malocclusion. SM Musculoskelet Disord. 2017; 2(3): 1018.
Occlusion is biologically defined as the coordinated functional interaction between the various cell populations forming the masticatory system as they differentiate, model, remodel, fail and repair
Talia Becker*
Achilles tendon is a common site of foot and ankle discomfort but its rupture is not frequent. It’s a superficial tendon and this lends it to excellent evaluation by sonography instead of magnetic resonance imaging. Recently ultrasonography has been widely used in musculoskeletal practice. We present a case of Achilles tendon ruptures diagnosed based on fundamental sonographic findings.
Arash Babaei-Ghazani¹,², Safoora Ebadi¹,², Bijan Forogh¹,³, and Bina Eftekharsadat⁴*
Osteoarthritis (OA), one of the most common skeletal disorders characterized by cartilage degradation and osteophyte formation in joints, is induced by accumulated mechanical stress; however, little is known about the underlying molecular mechanism. Several experimental OA models in mice by producing instability in the knee joints have been developed to apply approaches from mouse genetics. Although proteinases like matrix metalloproteases and aggrecanases have now been proven to be the principal initiators of OA progression, clinical trials of proteinase inhibitors have not been successful for the treatment, turning the interest of researchers to the upstream signals of proteinase induction. These signals include under graded and fragmented matrix proteins like type II collagen or fibronection that affects chondrocytes through distinct receptors. Another signal is pro inflammatory factors that are produced by chondrocytes and synovial cells; however, recent studies that used mouse OA models in knockout mice did not support that these factors have a role in the central contribution to OA development. Our mouse genetic approaches found that the induction of a transcriptional activator Runx2 in chondrocytes under mechanical stress contributes to the pathogenesis of OA through chondrocyte hypertrophy. In addition, chondrocyte apoptosis has recently been identified as being involved in OA progression. We hereby propose that these endochondral ossification signals may be important for the OA progression, suggesting that the related molecules can clinically be therapeutic targets of this disease.
Hiroshi Kawaguchi
Estimating the Knee Functional Axis (KFA) is crucial to both correctly implanting the prosthesis and accessing the joint kinematics. Researchers have mainly reported KFA by manual management of flexion extension movements, which are passively performed without any voluntary movements. Active touch and movement refers to what is ordinarily called as touching, which is defined as variations in skin stimulation caused by variations in a person’s motor activity.
The difference is very important for the individual. However, it has not been emphasized in the biomechanical literatures. This study aims to confirm the distinction between touching and being touched. We are particularly interested in measuring the Instantaneous Axes of the Knee (IAK) during locomotion. This geometrical “pattern” of the IAK is altered along with the touch pattern by the mechanical necessities of terrestrial movement.
Wangdo Kim¹, Young Choi², and Hong-Gi Lee³*
Although fractures of the epiphyseal cartilage injuries are common in childhood, epiphyseal fractures involving the proximal tibia entities are very rare and are usually caused by high-energy trauma, with an incidence ranging between 0.5 and 3.1% of patients; peak incidence between the ages 12-14 years in male patients. The aim of this report is describe a case of fracture of the epiphyseal cartilage of a 13 year old boy, a victim of sports trauma showing lateral tibial plateau fracture and epiphyseal cartilage fracture at the same side, not compatible with the classifications of fractures in children.
Omar Ferreira Miguel
In the last few years, clinical applications of regenerative medicine have been increasing their way in medical practice.
Valerio Di Nicola¹,² and Mauro Di Pietrantonio³*
The twentieth century epidemic of low back pain has continued unabated into the 21st century. Up to 20% of the Australian population will experience low back pain at some stage of their lives
J Saunders¹, M Cusi¹,³ and H Van der Wall¹,²*
Music is the most essential ingredient of any entertainment. In order to create successful entertaining event musicians plays an imperative role. Musicians are wizards who spread the fragrance of joy by absorbing woes, in the form of Playing Related Musculoskeletal Disorders (PRMDs), for themselves. Like other occupations, musicians also suffer from work related musculoskeletal disorders which are often disabling
Wricha Mishra
Dupuytren’s Contracture (DC) is a fibro-proliferative tumor according to ICD 10 - fascial fibromatosis of unknown etiology (M 720), accompanied by a stable bending contracture of fingers. In CD in the postoperative period extremely high rate of surgical complications is observed: intraoperative (injury of blood vessels, nerves, tendons), general postoperative (hematoma, necrosis, odema, stiffness, etc.), late postoperative (recurrence, spread, progression). In the last case according to the data of different authors, complications frequency is depend upon the degree (from partial up to the total) and the accuracy of excision of the affected aponeurosis ?almaris. One of the problems in choosing the type of operation and technology is the complexity of the cutoff determination boundaries of the affected CD. Up to now there is no suitable for use in the practical CD surgery algorithm of the affected aponeurosis ?almaris spread non invasive visualization in a particular patient. The most appropriate method for the solution of this problem is a method of MRI. The technology of identifying the boundaries of surgery of the affected aponeurosis palmaris in Dupuytren’s contracture by means of MRI has been elaborated. It has been shown that MRI is a highly informative method in the assessment of topographic anatomy of aponeurosis palmaris in normal and CD states. PD, T1, T2 - weighed images allow objectively to visualize the border areas of the affected aponeurosis in I - III stages of CD. PD fsat (fat tissues signal saturation) MRI mode is not recommended for use.
Baikeev RF¹, Mikusev GI², Osmonaliyev IZh², Zakirov RH² and Afletonov EN²*
Metallosis is an aseptic fibrosis, local necrosis, inflammation, or loosening of an implant device secondary to metallic corrosion and release of wear debris. The condition has been highlighted recent years due to the clinical complications caused by metal-on-metal (MoM) hip replacement. Although some major types of MoM hip prostheses have been recalled from the market, metallosis is far from over as not only there are still a million implanted MoM hip prosthetic cases worldwide, but also it has been found in non-MoM hip prostheses and other metal implants. This mini review aims to provide recent findings of implants related metallosisin skeletal tissue.
Zhidao Xia