Characteristic Vascular Pattern in Patients With Rheumatoid Arthritis

Naide, Meyer; Sayen, Ann; Comroe, Bernard I.

doi:10.1001/archinte.1945.00210330010002

Cited by 19 publications

(3 citation statements)

References 3 publications

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“…When observations were resumed during the summer, it was surpris- ing to note that although the pattern of the reflex was similar, the magnitude of the response was diminished ( Figure 2 and Table III). This difference seems to be related to the relative degree of vascular tone exhibited by individuals at the various seasons of the year (7,8). Painful stimuli, apprehension, alarm or smoking lowered the skin and elevated the joint temperature in all cases so studied.…”

Section: Resultsmentioning

confidence: 99%

“…The intensity of hot and cold applications was not sufficient to induce pain in most instances but apparently this phenomenon is a sympathetic reflex effect associated with the principle of counterirritation. The magnitude of this effect is apparently related to the state of vascular tone and dependent upon the season of year that observations were made (7,8).…”

Section: Discussionmentioning

confidence: 99%

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Intra-Articular Temperature as a Measure of Joint Reaction

Horvath

Hollander²

1949

J. Clin. Invest.

104

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Clinicians studying Rheumatic Diseases have long used the surface temperature over the joints as indicative of the degree of synovial reaction. Many of the terms used in rheumatology imply temperature changes in the joint tissues, viz. "the acute hot joint of gout," "the cold swelling of chronic rheumatoid arthritis," the so-called "friction effect" or "heating-up" of osteoarthritic joints following exercise, or "articular jelling" (implying excessive joint cooling and stiffening on prolonged rest). Many measurements have been made of the skin temperature over diseased joints, but no study on intra-articular temperatures in human joints has been reported. Several studies (1-4) have been made of intra-articular temperatures in dogs and one study (5) was performed on the stifle joint of a horse to determine the coefficient of friction within the joint, with and without synovial fluid. METHODIn an effort to find a method for more accurate evaluation of activity of joint disease, and for determination of the effects of rest, exercise, physical therapy, drugs, and Roentgen rays on joints, the following technique for determining intra-articular temperature has been developed.Temperature studies were performed on the joints of normal volunteers and arthritic patients. All the studies were carried out in a room having a mean temperature of 24°C. The subjects were reclining quietly for at least one half hour prior to the studies. Because of the ease of approach, the.knee joint was the usual site of study. The skin was sterilized with an antiseptic (merthiolate) solution. The skin and joint capsule at a point one half inch medial to the medial border of the patella and high enough to avoid the fat pad was infiltrated with several cubic centimeters of 1% procaine solution. A 19 gauge needle was inserted through the synovial membrane into the joint space under the patella. Even in most normal joints, a few drops of fluid could be aspirated into a dry syringe. When it was certain that the point of the needle was under the patella and in the joint space, the 1 Aided by a grant from the National Foundation for Infantile Paralysis.syringe was removed and a fine copper constantan thermocouple or a thermistor was threaded through'the needle to a depth of several inches in order to project freely into the joint space. The needle then was either left in place or, more frequently, removed leaving the temperature-sensitive element in place. The emf developed by the thermocouples was measured by a Leeds and Northrup type K potentiometer, and the change in resistance of the thermistor was measured with a Wheatstone bridge. Thermocouples or thermistors were also fixed on the skin over-lying the patella, and in most cases a thermocouple was also placed on the skin of the opposite knee. Control temperature readings were taken after the joint had been at rest, with the element in place, for at least one half hour. If a therapeutic procedure was employed to modify joint temperature which would not permit leaving the metal thermocouple in pl...

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Intra-Articular Temperature as a Measure of Joint Reaction

Horvath

Hollander²

1949

J. Clin. Invest.

104

View full text Add to dashboard Cite

show abstract

“…peripheral vessels in patients with rheumatoid arthritis are easily constricted (Naide, Sayen, and Comroe, 1945). Such focal necrosis or diminution of adrenal cortical lipoid could be detected only in the acute stages of the disease; the end-result of focal necrosis, for example, is a small area of fibrous tissue which could easily be mistaken for a fibrous-tissue septum within the cortex.…”

Section: Discussionmentioning

confidence: 99%