Synovial fluid analysis by ferrography

Evans, Christopher H.; Bowen, E.Roderic; Bowen, J G; Tew, William P.; Westcott, Vernon C.

doi:10.1016/0165-022x(80)90069-x

Cited by 32 publications

(17 citation statements)

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“…This technique produced a ferrogram, along which wear particles were loosely graded according to size and chemical composition (6). The samples examined here yielded a number of different types of particle, distinguishable by their morphologies, optical properties, elemental compositions, and histologic properties.…”

Section: Resultsmentioning

confidence: 99%

“…This procedure is described in detail in a previous report (6). Briefly, the particles are harvested by centrifuging, washed in saline, treated with a magnetizing solution containing Er", deposited on a thin microscope slide (the substrate), and subjected to a strong, highly divergent magnetic field.…”

Section: Methodsmentioning

confidence: 99%

“…Previous work has led to the development of a method for magnetizing the wear particles found in synovial fluid and analyzing them ferrographically (6). Here we report our initial findings in applying this method to human synovial fluid aspirates and saline washings of diarthrodial joints.…”

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confidence: 92%

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A preliminary ferrographic survey of the wear particles in human synovial fluid

Evans

Mears

Mcknight

1981

Arthritis & Rheumatism

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The technique of ferrography has been applied to the analysis of wear particles in human synovial fluid aspirates. A number of discrete, identifiable classes of wear particles were found, including particles indicative of cutting wear and rubbing wear. The spectrum of particles varied among different groups of patients, suggesting an eventual diagnostic use for this method.No reliable method exists for the early diagnosis of degenerative arthritis. Present diagnoses rely upon radiographic or clinical data which are insufficiently sensitive to detect those early changes presignifying this condition. Osteoarthritis involves progressive erosion of the articular cartilage, eventually exposing and abrading the subchondral bone. Tissue is probably destroyed by a combination of mechanical deterioration and enzymic attack (1).Wear is a process affecting all moving surfaces, including those found in joints. Wear particles are the products of wear. In their size, shape, and composition resides the history of their production. Ferrography has proved itself to be a way of interpreting this history for wear particles that arise in machines (2). It is based on the magnetic separation of small, ferromagnetic, metal- lic wear particles which are shed from the surfaces of various components of an engine into the lubricating oil. As the machine shifts from one normal wear mode into a different normal or abnormal wear mode, the spectrum of wear particles alters accordingly. This change is detected by ferrography. As well as providing an early warning system for future, potential engine failure, ferrographic analysis of wear particles has aided basic research into the fundamentals of tribology (3).Application of ferrography to the study of wear particles in human articulating joints might, by a similar token, be expected to provide a sensitive, non-invasive diagnostic technique for the detection of early stages of degenerative joint disease. It also has the potential to shed new light on the etiology, pathogenicity, biomechanics, and tribology of osteoarthritis and other arthritides.Ferrography has already been applied to the analysis of wear in artificial joint replacements (4,5). These studies confirmed that the technique can monitor wear in arthroplastic joint implants. In these investigations, minute fragments of metal from the replacement femoral head rendered the wear particles sufficiently magnetic for ferrographic analysis without further treatment. For biological joints, with their diamagnetic constituents, the wear particles need to be artificially rendered susceptible to a magnetic field.Previous work has led to the development of a method for magnetizing the wear particles found in synovial fluid and analyzing them ferrographically (6). Here we report our initial findings in applying this method to human synovial fluid aspirates and saline washings of diarthrodial joints. In this study, we were particularly anxious to verify the premises that biological wear particles do indeed occur in synovial fluid and

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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A preliminary ferrographic survey of the wear particles in human synovial fluid

Evans

Mears

Mcknight

1981

Arthritis & Rheumatism

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“…Er a~ binds to bone, cartilage, collagen, and hydroxyapatite [6]. Its chemical properties show many similarities to Ca "+, which probably allow it to interact with HEDP in the same manner as Ca 2~ does.…”

Section: Discussionmentioning

confidence: 96%

“…As part of our biochemical studies on the particles of cartilage and bone which accumulate in human joints as they wear [6], we were seeking agents that would bind selectively to either bone or cartilage in vitro. Because of the in vivo selectivity of 99mTc-HEDP in this respect, cartilaginous and osseous particles were exposed to this agent in vitro.…”

Section: Introductionmentioning

confidence: 99%

Binding of the bone-seeking agent99mTc-1-hydroxyethylidene-1,1-diphosphonic acid to cartilage and collagen in vitro and its stimulation by Er3+ and low pH

Evans

Mears

1980

Calcif Tissue Int

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The bone-seeking agent 99mTc-labeled 1-hydroxyethylidene-1,1-diphosphonic acid (HEDP) unexpectedly binds to particles of human articular cartilage as well as cortical bone in vitro. Collagen also sequesters this compound, suggesting that collagen contributes to the uptake of 99mTc-HEDP by cartilage and bone. Particles of the bone mineral calcium hydroxyapatite also bind 99mTc-HEDP in vitro. Pretreatment of particles with Er3+ stimulates binding in each case. Lowering the pH of incubation to pH 2 has this effect for bone, cartilage, and collagen, but not for calcium hydroxyapatite. Mechanisms additional to the simple ionic attraction between the phosphonate groups of HEDP and metal cations such as Ca2+ are responsible for the uptake of 99mTc-HEDP by body tissues.

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Identification of Cartilage Wear Fragments in Synovial Fluid from Equine Joints

Tew

Hackett

1981

Arthritis & Rheumatism

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Synovial fluids from 72 equine joints were examined for the presence of cartilage debris, and these findings were compared to findings from visual inspection of the articular cartilage surfaces at necropsy. Synovial fluids from 25 joints with visual cartilage damage contained one or more large particles of articular cartilage. Cartilage fragments were not found in synovial fluids from 42 of the 47 apparently normal joints; thus, a correlation may exist between cartilage debris in the synovial fluid and lesions of the articular surfaces.Acute and chronic joint diseases present some of the more difficult diagnostic problems in both human and veterinary medicine. In particular, those pathologic conditions that involve erosion of the cartilage surface of articulating joints are especially difficult to evaluate without surgical intervention.Recently. several investigators ( I ,2) have suggested that the principles of wear particle analysis can be applied to articulate joints and may provide a means of assessing the functional integrity of articular surfaces. as well as identifying lesions or deterioration of the articular cartilage. The pathologic changes associated with many arthroses and the accompanying mechanical destruction of the articular surfaces have 1981.Arthritis and Rheumatism, Vnl. 24, So. 11 (November 1981) been shown to produce significant debris within the joint capsule. Cartilage fragments have been observed free in synovial fluid or imbedded in the synovial membrane in a number of diverse joint diseases of both humans and animals (2-4), and the presence and morphology of such fragments has been suggested as a possible indicator of the extent of articular damage (5,6).Researchers ( 1,2,6,7) have demonstrated the feasibility of recovering and identifying cartilage fragments in synovial fluid from diseased joints and have pointed out a potential diagnostic use of such analyses. In one study (6) of several hundred race horses, a positive correlation between cartilage fragments suspended in the synovial fluid and chronic joint problems was shown. The amount of cartilage debris recovered from the synovial fluids of these horses was qualitatively related to the degree of functional impairment. In another study of arthrograms of human patients (7), a similar correlation between cartilage fragments in the synovial fluid and articular lesions has been demonstrated. In principle, the presence of cartilage fragments in the synovial fluid could provide an indication of biomechanically deficient articular surfaces, and sequential evaluations over a period of time may provide an efficient way to monitor the rate and extent of progressive articular degeneration.In order to further document the relationship between lesions of the articular surfaces and wear fragments of cartilage, we examined synovial fluid samples from 72 equine joints for the presence of cartilage particles. and these findings were compared to the findings from visual examination of the articular surfaces at necropsy. These data show an excell...

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Synovial fluid analysis by ferrography

Cited by 32 publications

References 7 publications

A preliminary ferrographic survey of the wear particles in human synovial fluid

A preliminary ferrographic survey of the wear particles in human synovial fluid

Binding of the bone-seeking agent99mTc-1-hydroxyethylidene-1,1-diphosphonic acid to cartilage and collagen in vitro and its stimulation by Er3+ and low pH

Identification of Cartilage Wear Fragments in Synovial Fluid from Equine Joints

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