Synovial xanthomatosis: are there clues to mechanisms for this rare disease?

We report a 64-year-old man with arthritis and nodules to describe that this picture can be caused by normo-lipidemic xanthomas. Light and electron microscopy (EM) plus polymerase chain reaction (PCR) studies were performed for diagnosis and investigation. These showed features typical of xanthomas plus PCR and EM evidence of possible infection with Chlamydia pneumoniae as a pathogenetic mechanism deserving consideration.

Clinical diagnostic criteria for gout: comparison with the gold standard of synovial fluid crystal analysis.

Background: Several classification or diagnostic criteria sets for gout have been proposed but none validated.

Objective: This small pilot study considered urate crystal identification as the gold standard for diagnosis and compared the clinical aspects of 3 proposed criteria sets with that standard.

Methods: Eighty-two subjects who had synovial fluid analyses in a VA medical center were studied.

Elimination of rheumatoid synovium in situ using a Fas ligand 'gene scalpel'.

Surgical synovectomy to remove the inflammatory synovium can temporarily ameliorate rheumatoid inflammation and delay the progress of joint destruction. An efficient medically induced programmed cell death (apoptosis) in the rheumatoid synovium might play a role similar to synovectomy but without surgical tissue damage. Gene transfer of Fas ligand (FasL) has increased the frequency of apoptotic cells in mouse and rabbit arthritic synovium.

Prophylactic effect of highly selective COX-2 inhibition in acute monosodium urate crystal induced inflammation in the rat subcutaneous air pouch.

Objective: To examine the ability of rofecoxib prophylaxis to blunt the effect of monosodium urate (MSU) crystal inflammation induced in the rat subcutaneous air pouch.

Methods: Eight rats were used in each of 4 groups. On day one, air was injected subcutaneously to create the pouches and gavage feedings were started with placebo or 2 different doses of rofecoxib.

Update on identification of pathogenic crystals in joint fluid.

Crystal identification in joint fluid has been an essential part of diagnosis of joint disease. Recent advances have included progress in crystal identification on stained slides, attention to aspiration techniques, and arthrocenteses of asymptomatic joints. Challenges remain to increase use and optimize techniques.

Are there distinctive inflammatory flares after hylan g-f 20 intraarticular injections?

Objective: This survey was designed to examine features of a group of patients with acute painful joint effusions following hylan G-F 20 (Synvisc) knee injections.

Methods: Eight patients with painful local reactions after intraarticular hylan G-F 20 injections for knee osteoarthritis were evaluated clinically, with detailed synovial fluid analysis, and followed for outcome.

Results: Leukocyte counts ranged from 3150 to 103,000/mm3.