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Temporomandibular Joint Disorders
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Surgery can be divided into open and closed procedures. Closed procedures are arthrocentesis and arthroscopy. Arthrocentesis is the washing out of the upper joint space with 200 ml of isotonic solution, most commonly under general anaesthesia. It gives 70–80% improvement in cases of locking, restriction, and pain. Arthroscopy is similar but allows visualisation of the internal joint anatomy. Both procedures carry a 1% risk of temporary temporal branch weakness.
Applications in radiology
Published in Sam Beddar, Luc Beaulieu, Scintillation Dosimetry, 2018
Daniel E. Hyer, Ryan F. Fisher, Maxime Guillemette
Orthopedic exams: Orthopedic procedures involve the utilization of fluoroscopy for the diagnosis of disorders of bones and joints. An arthrogram procedure uses fluoroscopy to guide needle placement into joint spaces in order to inject a contrast agent for the purpose of imaging potential tears in soft connective tissues. Such tears are often difficult to visualize using standard X-ray imaging. Similarly, arthrocentesis procedures involve fluoroscopically guided needle placement for collecting synovial fluid from the joint space in order to determine the cause of joint swelling or arthritis. An image from an arthrocentesis procedure is shown in Figure 11.8.
Temporomandibular Joint Disorders
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
Arthrocentesis is the washing out of (usually) the upper joint space with isotonic solution under pressure (recommended 150 mm Hg) using around 200 ml of solution to eliminate inflammatory mediators and free radicals and to re-lubricate the joint initially with the solution, but allowing the lubricant producing cells to recover. Usually two needles are used to carry out this procedure—inlet and outlet. Whilst this procedure can be performed under local anaesthesia potentially with sedation, the preference in the UK is for general anaesthesia (GA). The advantage of carrying out the procedure under GA is that the patient can be examined with the muscles relaxed, giving a good idea of the degree of restriction due to muscle spasm. It is a day case procedure and has been shown to be successful in improving 70–80% of cases of locking, restriction and pain.1, 7, 8
IL-21 impairs pro-inflammatory activity of M1-like macrophages exerting anti-inflammatory effects on rheumatoid arthritis
Published in Autoimmunity, 2022
Leilei Jian, Changhong Li, Xinyu Wang, Lin Sun, Zhenzhen Ma, Jinxia Zhao
Synovial fluid (SF) was obtained from patients with RA who underwent arthrocentesis at Peking University Third Hospital. SF samples were collected in tubes containing heparin and centrifuged at 800 × g at 20 °C for 10 min. The cells were fractionated by centrifugation on a Histopaque density gradient at 450 × g for 20 min to isolate mononuclear cells, which were suspended in RPMI 1640 medium without FBS and allowed to adhere to cell culture dishes for 1 h. Afterward, the medium was changed to RPMI 1640 supplemented with 10% FBS (Gibco, Carlsbad, CA, USA), 100 mg/mL streptomycin, and 100 U/mL penicillin with 5% CO2 at 37 °C. This study was reviewed and approved by the Peking University Third Hospital Ethics Committee (IRB00006761-2015044) and informed consents were obtained from all patients.
Parvimonas micra causing native hip joint septic arthritis
Published in Baylor University Medical Center Proceedings, 2021
Patrick M. Ryan, Bernard F. Morrey
Diagnostic arthrocentesis was performed followed by urgent arthrotomy, irrigation, and debridement of the hip joint with abscess drainage the following morning. Culture results obtained on a blood agar plate of the synovial fluid from the arthrocentesis and the surgical specimens both grew P. micra. This organism grew on two separate days from two separate locations and was thus confirmed. Cultures from the abscesses demonstrated no growth. The patient was empirically started on vancomycin and piperacillin tazobactam. C-reactive protein levels were trended during the hospital stay (Figure 2). The patient was then switched to ampicillin/sulbactam and doxycycline following susceptibility results and remained on this treatment regimen for 6 weeks through discharge to a long-term rehabilitation facility.
Exosomes Represent an Immune Suppressive T Cell Checkpoint in Human Chronic Inflammatory Microenvironments
Published in Immunological Investigations, 2020
Gautam N Shenoy, Maulasri Bhatta, Jenni L Loyall, Raymond J Kelleher Jr, Joel M Bernstein, Richard B Bankert
Nasal polyp tissues were received from the surgical suite at DeGraff Memorial Hospital, North Tonawanda, New York, from patients under the care of Dr JM Bernstein, or from Buffalo ENT Specialists, Buffalo, New York. The polyps were from patients undergoing surgery for chronic hyperplastic rhinosinusitis with nasal polyposis. The tissue was placed and transported in RPMI-1640 medium with penicillin (20 U/mL), streptomycin (20 µg/mL) and fungizone (2 µg/mL). Synovial fluid was obtained from patients with rheumatoid arthritis by arthrocentesis. Normal donor peripheral blood was provided by the Flow and Image Cytometry Facility at Roswell Park Cancer Institute (RPCI). Normal donor peripheral blood lymphocytes (NDPBL) were obtained by monocyte depletion and Ficoll-Hypaque density separation. Cells were frozen and stored in liquid nitrogen until use, as previously reported (Broderick et al. 2006; Simpson-Abelson et al. 2013). All specimens were obtained under sterile conditions and using Institutional Review Board (IRB) approved protocols (protocol number MODCR00003458). All patient information was de-identified in accordance with the IRB protocol.