Italian consensus statement for the use of allografts in ACL reconstructive surgery.

Purpose: Graft choice for primary anterior cruciate ligament reconstruction (ACL-R) is debated, with considerable controversy and variability among surgeons. Autograft tendons are actually the most used grafts for primary surgery; however, allografts have been used in greater frequency for both primary and revision ACL surgery over the past decade. Given the great debate on the use of allografts in ACL-R, the "Allografts for Anterior Cruciate Ligament Reconstruction" consensus statement was developed among orthopedic surgeons and members of SIGASCOT (Società Italiana del Ginocchio, Artroscopia, Sport, Cartilagine, Tecnologie Ortopediche), with extensive experience in ACL-R, to investigate their habits in the use of allograft in different clinical situations.

Knee joint synovitis in Behçet's disease: a sonographic study.

Objective: The aim of this study was to investigate, using ultrasound (US), knee involvement in patients with Behçet's disease (BD).

Methods: Knee US was performed in 30 unselected Italian BD patients. Signs of arthritis (joint effusion, synovial proliferation) and presence of bone erosions and Baker's cysts were recorded.

Intra-articular methotrexate in the treatment of rheumatoid arthritis and psoriatic arthritis: a clinical and sonographic study.

The aim of our study was to evaluate the effects of intra-articular methotrexate (MTX) in patients with rheumatoid arthritis (RA) and psoriatic arthritis (PsA). Twenty-three consecutive patients, 10 with RA and 13 with PsA, with prevalent or unique arthritic involvement of one knee, were treated with intra-articular injections of MTX 10 mg every 7 days for 8 weeks. Before the beginning of the treatment and after 9 and 17 weeks, the patients underwent a clinical evaluation measuring maximal knee flexion angle, visual analog scale (VAS) and erythrocyte sedimentation rate (ESR).

Successful treatment with intraarticular infliximab for resistant knee monarthritis in a patient with spondylarthropathy: a role for scintigraphy with 99mTc-infliximab.

Positive experiences with intraarticular infliximab have been reported in patients with rheumatoid arthritis, ankylosing spondylitis, and Behcet's disease. We used intraarticular infliximab to treat resistant knee monarthritis in a patient with spondylarthropathy. Clinical and laboratory improvement was associated with improvement in scintigraphic findings.

Wrist joint involvement in systemic lupus erythematosus. An ultrasonographic study.

Objective: To define joint alterations in the wrists of patients with systemic lupus erythematosus (SLE) by ultrasonography (US).

Methods: Fifty-two wrists of 26 SLE patients and 30 wrists of 15 healthy controls were evaluated using US by two different experienced operators, blinded to the clinical data. A 14 MHz linear probe was used.

Joint sonography in asymptomatic patients with HCV correlated hepatitis.

Objectives: Many different articular symptoms may appear in patients with HCV hepatitis, but in a relatively large number of patients no rheumatic symptoms are present. This sonographic study was undertaken to detect the possible presence of early articular changes in HCV patients without any rheumatic manifestations.

Methods: The knee, hip and shoulder were evaluated in a cohort of 29 consecutive HCV patients without any rheumatic symptoms.

Magnetic resonance imaging of peripheral osteoarticular tuberculosis compared with sonography and standard radiographs.

An increased incidence of osteoarticular tuberculosis (TBC) has been reported during recent years. We report a case of TBC arthritis of the knee in which magnetic resonance tomography (MRI) provided images suggestive of this finding, in contrast to plain radiographs and joint sonography. The diagnosis was confirmed with culture for tuberculous bacilli.

Sonographic study of painful shoulder.

Objective: To identify sonographically the site and entity of alterations in a high number of patients with shoulder pain.

Methods: Two different experienced operators (both rheumatologists), who were blinded to the clinical data, performed sonographic examinations on 528 shoulders of 425 consecutive patients with painful shoulder and in both shoulders of 198 control subjects. They carried out ultrasound examinations separately using a 7.

Knee joint synovitis in Sjögren's syndrome. Sonographic study.

Ultrasound detects effusion and synovial proliferation caused by synovitis. The study was undertaken to evaluate the signs of synovitis in patients with primary Sjögren's Syndrome (SS). Joint effusion was detected and synovial thickness was measured in the suprapatellar synovial bursa.

[Brucellar spinal abscess. Case report].

Brucellosis is a zoonosis commonly present in many areas of the world; in some Mediterranean countries it is endemic. The disease is usually transmitted to humans by ingestion of contaminated food; rarely it may be transmitted either by direct penetration through skin lesions or conjunctival mucosa or even by inhalation of aerosols. The disease may be asymptomatic, but in some occasions acute or chronic symptoms are present.

[Rheumatoid arthritis: frequency of hospitalization and evaluation of economic burden].

About 10% of the Italian general population is affected by rheumatic diseases (RD). Due to their chronic and disabling nature, RD are cause of an annual economic burden evaluated in about 17,000 billions italian lire. In Italy, rheumatoid arthritis (RA) affects nearly 400,000 people.

Sonography in the study of metatarsalgia.

Objective: To identify sonographically the changes of the forefoot in patients with metatarsalgia.

Methods: Sonography of the foot was performed in 112 patients with metatarsalgia and in 50 healthy controls. Metatarsophalangeal (MTP) joints, intermetatarsal web spaces, flexor and extensor tendons, and plantar aponeurosis were examined.

Power Doppler sonography in knee arthritis--a pilot study.

We compared power Doppler sonography to laboratory indices of disease activity in patients with knee arthritis to determine the clinical relevance of hypervascularity. Eight healthy volunteers and 22 patients with symptoms and signs of knee arthritis were studied. Presence or absence of hypervascularity, synovial thickening, effusion, and Baker's cysts were recorded.

Usefulness of high resolution US in the evaluation of effusion in osteoarthritic first carpometacarpal joint.

Objective: The aim of this study is to provide a reproducible and quantitative sonographic method for evaluation of effusion in the first carpometacarpal joint in osteoarthritis.

Methods: High resolution sonography of the carpometacarpal joint of the thumb was carried out in 20 normal joints and in 57 joints from patients with osteoarthritis. A 10 MHz transducer was used.

A morphological study of bone and articular cartilage in ochronosis.

An ochronotic femoral head has been studied morphologically under the light and the electron microscope. Its articular cartilage showed the alterations already reported in the literature, mainly consisting of erosions of the surface, pigment accumulation in chondrocytes and intercellular matrix, chondrocyte degeneration, the formation of pigmented, calcified and uncalcified microshards, and the presence of granulation tissue with macrophagic cells. The changes in bone were less severe than those in cartilage.

Shoulder involvement in rheumatic diseases. Sonographic findings.

Objective: To distinguish using shoulder sonography the different changes present in rheumatoid arthritis (RA), polymyalgia rheumatica (PMR), and periarticular disorders (PD) of soft tissue of the shoulder.

Methods: Ninety shoulders of patients with RA, 32 with PMR, 122 with PD, and 108 controls were studied sonographically, using a 7.5 MHz linear probe.

Sonographic findings in haemodialysis-related chronic arthropathy.

In 33 subjects receiving long-term haemodialysis sonographic examination of shoulders, hips and knees was performed. Changes of both joints and periarticular soft tissues were found in 60 shoulders, 16 hips and 42 knees. In the shoulder besides the presence of tenosynovitis and bursitis, even significant thickening of rotator cuff and increased distance between capsule and bone in transascellar scan were found.

Time course of radiologic lesions in spinal hyperostosis: an osteoradiometric study.

The purpose of this study was to evaluate changes over time in the flowing spinal ossification characteristic of spinal hyperostosis. Thirty-two patients were studied. A QR-ORM osteoradiometry apparatus was used to measure variations in the surface area of the ossification on radiographs obtained after three, ten, and 20 years.

Intra-articular somatostatin 14 reduces synovial thickness in rheumatoid arthritis: an ultrasonographic study.

Sixteen patients with RA (3 males, 13 females), diagnosed according to RA revised criteria, were selected and entered the study. They underwent six intra-articular injections of 750 mcg of SST14 at 15-day intervals. The thickness of the synovial membrane (SM) was measured with a 5-MHz linear sound with longitudinal and transversal scanning carried out on the upper patellar cavity.

[Intra-articular treatment with somatostatin 14 in rheumatoid arthritis].

19 patients with RA underwent six intraarticular injections of 750 micrograms of Somatostatin 14 in one knee at 15-day intervals. In all patients some clinical parameters were evaluated: articular function, pain on pressure, spontaneous pain, pain on movement, duration of morning stiffness. Also some laboratory parameters were examined: complete blood cell count, ESR and CRP.

Rheumatoid nodules and cyclosporin A treatment.

The authors describe the appearance of rheumatoid nodules during cyclosporin A (CsA) therapy for RA. Their course was evaluated by sonography that revealed an increase in number and size of rheumatoid nodules. The relationship between CsA treatment and the onset of nodulosis is not clear and further studies are needed to assess the role of CsA treatment in the extra-articular manifestations of rheumatoid arthritis such as rheumatoid nodules.