Extractable synovial fluid in inflammatory and non-inflammatory arthritis of the knee

Rolle, Noelle A.; Jan, Irum; Sibbitt, Wilmer L.; Band, Philip A.; Haseler, Luke J.; Hayward, William A.; Muruganandam, Maheswari; Emil, N. Suzanne; Fangtham, Monthida; Bankhurst, Arthur D.

doi:10.1007/s10067-019-04524-2

Cited by 10 publications

(22 citation statements)

References 29 publications

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“…Elevated WBC counts in OA have been reported by McCabe et al, since 21 of their 55 knee OA patients had WBC counts between 250 and 1000 cells/mm 3 and these counts correlated with synovitis on MRI and IA glucocorticoid responsiveness [ 28 ]. Another relevant recent publication by Rolle et al also reported a mean SF WBC count of 341 cells/mm 3 from the knees of 67 OA patients, whereas SF volumes correlated better with the severity of radiographic joint damage than SF WBC counts [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

“…This enabled us to obtain adequate SF volumes even from some patients who had very small SF volumes measuring only 1–2 mm of vertical depth on US [ 38 ]. Bhavsar and Rolle et al have also demonstrated that compression with a viscoelastic knee brace increased the volume of SF aspirated compared with aspiration without compression using landmark-based arthrocentesis [ 29 , 39 ]. While we have presented results from 16 different chemokines, cytokines, MMPs and other select proteins in this paper, we have also been able to quantitate over 50 separate proteins using multiplex bead analysis technology from SF cryopreserved samples with volumes between 0.5 and 1.0 mL.…”

Section: Discussionmentioning

confidence: 99%

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Synovial Fluid Cytokines, Chemokines and MMP Levels in Osteoarthritis Patients with Knee Pain Display a Profile Similar to Many Rheumatoid Arthritis Patients

Meehan

Regan

Hoffman

et al. 2021

JCM

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Background: There are currently no effective disease-modifying drugs to prevent cartilage loss in osteoarthritis and synovial fluid is a potentially valuable source of biomarkers to understand the pathogenesis of different types of arthritis and identify drug responsiveness. The aim of this study was to compare the differences between SF cytokines and other proteins in patients with OA (n = 21) to those with RA (n = 27) and normal knees (n = 3). Methods: SF was obtained using ultrasound (US) guidance and an external pneumatic compression device. RA patients were categorized as active (n = 20) or controlled (n = 7) based upon SF white blood cell counts (> or <300 cells/mm3). Samples were cryopreserved and analyzed by multiplex fluorescent bead assays (Luminex). Between-group differences of 16 separate biomarker proteins were identified using ANOVA on log10-transformed concentrations with p values adjusted for multiple testing. Results: Only six biomarkers were significantly higher in SF from active RA compared to OA—TNF-α, IL-1-β IL-7, MMP-1, MMP-2, and MMP-3. Only MMP-8 levels in RA patients correlated with SF WBC counts (p < 0.0001). Among OA patients, simultaneous SF IL-4, IL-6, IL-8, and IL-15 levels were higher than serum levels, whereas MMP-8, MMP-9, and IL-18 levels were higher in serum (p < 0.05). Conclusion: These results support the growing evidence that OA patients have a pro-inflammatory/catabolic SF environment. SF biomarker analysis using multiplex testing and US guidance may distinguish OA phenotypes and identify treatment options based upon targeted inflammatory pathways similar to patients with RA.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Synovial Fluid Cytokines, Chemokines and MMP Levels in Osteoarthritis Patients with Knee Pain Display a Profile Similar to Many Rheumatoid Arthritis Patients

Meehan

Regan

Hoffman

et al. 2021

JCM

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“…Historically, for the diagnosis of inflammatory arthritis, some common laboratory assays and imaging methods have been carried out. Popular laboratory tests include the detection of blood antinuclear antibodies, arthrocentesis (collection and testing of synovial fluid), complement tests, and blood cell counts (white and red blood cells, and platelets) [86,87]. For example, the sedimentation rate of erythrocytes or ESR determines how easily red blood cells deposit at the bottom of a test tube.…”

Section: Nanomaterials For the Diagnosis Of Inflammatory Arthritis 2mentioning

confidence: 99%

Nanomaterials for the Diagnosis and Treatment of Inflammatory Arthritis

Hosseinikhah

Barani

Rahdar

et al. 2021

IJMS

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Nanomaterials have received increasing attention due to their unique chemical and physical properties for the treatment of rheumatoid arthritis (RA), the most common complex multifactorial joint-associated autoimmune inflammatory disorder. RA is characterized by an inflammation of the synovium with increased production of proinflammatory cytokines (IL-1, IL-6, IL-8, and IL-10) and by the destruction of the articular cartilage and bone, and it is associated with the development of cardiovascular disorders such as heart attack and stroke. While a number of imaging tools allow for the monitoring and diagnosis of inflammatory arthritis, and despite ongoing work to enhance their sensitivity and precision, the proper assessment of RA remains difficult particularly in the early stages of the disease. Our goal here is to describe the benefits of applying various nanomaterials as next-generation RA imaging and detection tools using contrast agents and nanosensors and as improved drug delivery systems for the effective treatment of the disease.

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“…), the anatomic approach, and technique including image-guidance . However, previous studies have demonstrated a high failure rate of 38% to 68% of conventional arthrocentesis in unselected pathologic knees [1,12,[20][21][22]. This high failure rate of arthrocentesis is primarily due to large proportion of "dry" or non-effusive knees; that is, knees without conventionally extractable fluid resulting in an arthrocentesis failure rate in non-effusive knees ranging between 82 -100% [1,10,19,20].…”

Section: Introductionmentioning

confidence: 99%

“…For the diagnosis of crystal disease often only a few drops of synovial fluid are required; however, special analyses may require 0.1 ml or more and conventional analysis usually requires at least 2 ml . To obtain adequate synovial fluid yield from the non-effusive knee, ultrasound guidance, stress maneuvers, joint lavage, and external compression may be used to obtain adequate synovial fluid volumes [12,[20][21][22][23][24][25][26][27][28][29].…”

Section: Introductionmentioning

confidence: 99%

Extraction of Synovial Fluid from the Non-Effusive Pathologic Knee with Pneumatic Compression

Iqbal¹,

Brahmbhatt²,

Muruganandam³

et al. 2022

Preprint

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Objectives –Aspiration of synovial fluid from non-effusive joints is undertaken for the diagnosis of crystal-associated arthritis, biomarker analysis, and to confirm intraarticular positioning. We hypothesized that pneumatic compression of the non-effusive knee would mobilize occult synovial fluid and improve arthrocentesis success. Methods – The absence of a knee effusion was determined by physical examination, imaging, and exclusion of confounding disease. Conventional arthrocentesis was performed in 111 consecutive non-effusive knees and arthrocentesis volume (milliliters) determined. Pneumatic compression was then applied, and arthrocentesis was resumed. Results – Pneumatic compression improved fluid yield: conventional: 0.4±1.0 ml, compression: 1.8±2.5 ml (319% increase, 95% CI -1.9<-1.4<-0.9; p=0.0001). Pneumatic compression reduced arthrocentesis failure (< 0.1 ml) from 74.8% (83/111) to 41.4% (46/111) (p=0.0001) and improved successful arthrocentesis in terms of adequate synovial fluid yield: 1) ≥ 0.1 ml from 25.2% (28/111) to 58.5% (65/111) (+132%, p=0.0001), 2) ≥ 0.5 ml from 22.5% (25/111) to 57.7% (64/111) (+156%, p =0.0001), 3) ≥ 2.0 ml from 11.7% (13/111) to 47.7% (53/111) (+300%, p =0.0001), and 4) ≥ 3.0 ml from 5.4% (6/111) to 36.0% (40/111) (+319%, p =0.0001). Conclusions: Pneumatic compression of the non-effusive knee improves the extraction of synovial fluid of various requisite volumes for conventional and biomarker analysis.

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Extractable synovial fluid in inflammatory and non-inflammatory arthritis of the knee

Cited by 10 publications

References 29 publications

Synovial Fluid Cytokines, Chemokines and MMP Levels in Osteoarthritis Patients with Knee Pain Display a Profile Similar to Many Rheumatoid Arthritis Patients

Synovial Fluid Cytokines, Chemokines and MMP Levels in Osteoarthritis Patients with Knee Pain Display a Profile Similar to Many Rheumatoid Arthritis Patients

Nanomaterials for the Diagnosis and Treatment of Inflammatory Arthritis

Extraction of Synovial Fluid from the Non-Effusive Pathologic Knee with Pneumatic Compression

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