Daigo Taniguchi

Low-energy laser irradiation promotes synovial fibroblast proliferation by modulating p15 subcellular localization.

Low‐energy laser irradiation (low‐level laser therapy) (LELI/LLLT/photobiomodulation) has been found to modulate various biological effects, especially those involved in promoting cell proliferation. Synovial fibroblasts are important in maintaining the homeostasis of articular joints and have strong chondrogenetic capacity. Here, we investigated the effect and molecular basis of LELI on synovial fibroblast proliferation.

Monocarboxylate Transporter 4, Associated With the Acidification of Synovial Fluid, Is a Novel Therapeutic Target for Inflammatory Arthritis

Synovial fluid pH is decreased in patients with rheumatoid arthritis (RA); however, the underlying mechanisms are unclear. We undertook this study to examine the mechanism by which synovial fluid pH is regulated and to explore the possibility of a therapeutic strategy by manipulating this mechanism.

Spontaneous flexor tendon rupture in systemic lupus erythematosus: A case report

Spontaneous flexor tendon rupture is an unusual complication of systemic lupus erythematosus (SLE) and has not previously been reported. While tendon ruptures in association with SLE have been focused on the previous studies, upper extremity tendon ruptures are infrequently reported in the literature. Here, we present an uncommon case of spontaneous flexor tendon rupture of the ring and little fingers in a patient with SLE and discuss the mechanism of injury and its surgical treatment.

Maximum intensity projection with magnetic resonance imaging for evaluating synovitis of the hand in rheumatoid arthritis: comparison with clinical and ultrasound findings

Magnetic resonance imaging (MRI) with maximum intensity projection (MIP) is used to evaluate the hand in rheumatoid arthritis (RA). MIP yields clear visualization of synovitis over the entirety of the bilateral hands with a single image. In this study, we assessed synovitis with MIP images, clinical findings, and power Doppler (PD) findings to examine the clinical usefulness of MIP images for RA in the hand. Thirty RA patients were assessed for swelling and tenderness in the joints included in the DAS28, and both contrast-enhanced MRI for bilateral hands and ultrasonography for bilateral wrist and metacarpophalangeal (MCP) joints were performed. Articular synovitis was scored in MIP images, and the scores were compared with those for PD. The agreement on synovitis between MIP and conventional MR images was excellent. Palpation showed low sensitivity and high specificity compared with both MIP and PD images. There were joints that were positive in MIP images only, but there were no joints that were positive in PD images only. A statistically significant correlation between the scores of MIP and PD images was found. Furthermore, the agreement between grade 2 on MIP images and positive on PD images was 0.87 (κ = 0.73) for the wrist and 0.92 (κ = 0.57) for MCP joints. Using MIP images together with palpation makes detailed evaluation of synovitis of the hand in RA easy. MIP images may predict further joint damage, since they allow semiquantitative estimation of the degree of thickening of the synovial membrane.

Successful Treatment of Concomitant Ipsilateral Intracapsular and Extracapsular Hip Fractures

Femoral neck fractures and intertrochanteric fractures often occur in elderly patients, but simultaneous ipsilateral intra- and extracapsular hip fractures are rare. Either osteosynthesis or femoral head prosthesis is performed, but careful rehabilitation is necessary because of the instability of the fracture, even postoperatively. This article describes a 76-year-old man who fell and sustained concomitant ipsilateral intra- and extracapsular hip fractures. The patient was treated with a femoral head prosthesis with a polished cemented stem combined with locking plate osteosynthesis. Weight-bearing gait was possible 1 day postoperatively, and bone union was achieved at postoperative week 8. The locking plate had excellent angular stability, even when the screw fixation was monocortical, leading to a reduced risk of intraoperative redislocation without disturbing stem insertion. Sufficient fixation was obtained as a result of the molding effect of the cement stem and the tension band function of the plate. These effects collectively made it possible to achieve full weight-bearing gait immediately postoperatively. Although the intramedullary blood circulation was disturbed by the cement, periosteal blood circulation was retained by the virtue of the locking plate, which facilitated early bone union.

Prediction of radiographic progression in synovitis-positive joints on maximum intensity projection of magnetic resonance imaging in rheumatoid arthritis

Contrast-enhanced magnetic resonance imaging with maximum intensity projection (MRI-MIP) is an easy, useful imaging method to evaluate synovitis in rheumatoid hands. However, the prognosis of synovitis-positive joints on MRI-MIP has not been clarified. The aim of this study was to evaluate the relationship between synovitis visualized by MRI-MIP and joint destruction on X-rays in rheumatoid hands. The wrists, metacarpophalangeal (MP) joints, and proximal interphalangeal (PIP) joints of both hands (500 joints in total) were evaluated in 25 rheumatoid arthritis (RA) patients. Synovitis was scored from grade 0 to 2 on the MRI-MIP images. The Sharp/van der Heijde score and Larsen grade were used for radiographic evaluation. The relationships between the MIP score and the progression of radiographic scores and between the MIP score and bone marrow edema on MRI were analyzed using the trend test. As the MIP score increased, the Sharp/van der Heijde score and Larsen grade progressed severely. The rate of bone marrow edema-positive joints also increased with higher MIP scores. MRI-MIP imaging of RA hands is a clinically useful method that allows semi-quantitative evaluation of synovitis with ease and can be used to predict joint destruction.

How do anti‐TNF therapies affect gait function in patients with rheumatoid arthritis?

The aim of the present study was to investigate the influence of anti‐tumor necrosis factor (anti‐TNF) agents on gait function in patients with rheumatoid arthritis (RA).

Alcohol-associated osteonecrosis of the femoral head with subsequent development in the contralateral hip: A report of two cases

Although the pathogenesis of non-traumatic osteonecrosis of the femoral head (ONFH) has not been clarified, high-dose oral corticosteroid therapy and heavy consumption of alcohol have been associated with its occurrence [1e3]. Epidemiological surveys in Japan have found that 34% of ONFH patients have a history of heavy alcohol consumption [1]. The necrotic area of ONFH is determinedwhen it occurs, and the possibility of necrotic area extension is extremely low even if the patient continues taking oral corticosteroids or consuming large quantities of alcohol. The probability of ONFH occurring in both femoral heads is 50e80% [4], with bilateral ONFH thought to occur at almost the same time. Patients with unilateral ONFH rarely develop new ONFH in the contralateral hip. To our knowledge, only two previous case reports have described the occurrence of new ONFH in the contralateral hip: one with alcohol associated ONFH [5] and the other accompanying an increased dosage of corticosteroid [6]. This report describes two patients with alcoholassociated ONFH who developed ONFH of the contralateral hip following treatment of the first side. The patients and their families were informed that data from the cases would be submitted for publication, and gave their consent.

Spontaneous flexor tendon rupture due to an insufficiency fracture of the hamate hook in a patient with systemic lupus erythematosus: A case report

Highlights • We report a case of spontaneous flexor tendon rupture in a patient with SLE.• Nonunion of the hamate hook is one of the causes of flexor tendon rupture.• SLE patients have an increased risk for osteoporosis and insufficiency fractures.• Tenosynovitis and long-term steroid use can affect tendon integrity in SLE.• SLE can lead to both tendon degeneration and insufficiency fracture of the hamate.

A new assessment tool for ulnar drift in patients with rheumatoid arthritis using pathophysiological parameters of the metacarpophalangeal joint

Abstract Objectives: To establish a new assessment tool for ulnar drift (UD) in rheumatoid arthritis (RA). Methods: We established an observational cohort of 67 patients (134 rheumatoid hands) beginning in 2004. Fifty-two patients (100 hands) had follow-up in 2009 and 37 patients (63 hands) completed follow-up in 2015. UD was evaluated with the Fearnley classification and our scoring method, which assesses four parameters of the metacarpophalangeal joint. Cluster analysis using UD parameters divided hands into groups. Changes in UD over time, correlation of the Fearnley stage and cluster with a functional assessment, and reliability of the parameters were analyzed. Results: UD increased and worsened over time according to the trend test. A dendrogram indicated five clusters would be appropriate. Both the Fearnley classification and cluster were associated with function; however, our method related to function more linearly (R-squared: 0.42). We found one type of hand in which bone destruction precedes the joint dislocation and one type in which joint dislocation progresses with little deviation during UD progression. Conclusion: Our UD evaluation appeared to be simple and related to function. Additionally, it enables dividing UD hands into five stages. Thus, our assessment should be beneficial compared to the Fearnley classification in considering treatments of UD.