[Synovectomy in rheumatoid arthritis of the knee, radiologic investigations (author's transl)].
Pathologic and radiologic investigations of rheumatoid arthritis are compared with regard to their development. Radiologic demonstration of several cases prior to and following synovectomy shows improvement as well as exacerbation of the disease. An increasing mineral content signifies an improvement of the bone lesion. The mineral content depends on reduction of inflammatory activity, increasing motility, and postoperative discontinuation of cortisone therapy. In some cases various lesions at the border line between bone and cartilage as blurring, notching and destructions are disappearing. Reduction of cartilage accompanied with narrowing of the joint spaces will subside postoperatively, too. We have to suppose a regeneration of cartilage under increasing physical strain by functional stimulation. Following synovectomy the structure of subcartilage spongiosa becomes more organized as a sign of regression of inflammatory activity, improved motility and load capacity. Following synovectomy, exacerbation of radiologic symptoms occur mainly in advanced stages of rheumatoid arthritis. We may often see progression of secondary osteoarthritis existing preoperatively in contrast to clinical recovery. The increasing load capacity may cause an identation of the articular surface in cases of extreme osteoporosis. This might result in a false position. These lesions might necessitate further surgical treatment as possibly total joint prosthesis. Following synovectomy in rheumatoid arthritis of the knee, dissolving radiologic symptoms in addition to improvement of the clinical picture may be observed. The poor results of synovectomy in advanced rheumatoid arthritis favours the of early synovectomy during the proliferative and destructive stage of the disease.
D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000503:physiopathology; D008875:Middle Aged; D011182:Postoperative Care; D011183:Postoperative Complications; D011859:Radiography; D000074402:Synovectomy; D013997:Time Factors
Die Kniegelenksynovektomie bei chronischer Polyarthritis--Röntgenologische Verlaufsuntersuchungen