ObjectiveTo discuss the changes of joint fluid and blood-related indexes in patients with gouty arthritis and rheumatoid arthritis, and to analyze the clinical significance of these changes. MethodsSeventy-five patients with gouty arthritis and 68 with rheumatoid arthritis treated between January and December 2014 were included in our study. Their joint fluid-related indicators including white blood cell count (WBC), total protein (TP), albumin (ALB), glucose (GLU), and uric acid (UA), and their blood indicators including immunoglobulin G (IgG), immunoglobulin M (IgM), immunoglobulin A (IgA), C3 and C4, rheumatoid factor (RF), anti-streptolysin O (ASO), and c-reactive protein (CRP) were detected. ResultsFor joint fluid-related indicators, TP and ALB levels were not significantly different between the two groups (P > 0.05), while WBC, GLU, UA, RF and ASO between the two groups were significantly different (P < 0.05); For blood indexes, C4 was not significantly different between the two groups (P > 0.05), but IgG, IgM, IgA, CRP, C3, UA, RF and ASO were significantly different between the two groups (P < 0.05). The detection rate of ASO from the joint fluid was significantly higher than that detected from the blood in both the two groups (P < 0.05), while UA level was not significantly different between the joint fluid and the blood (P > 0.05). In patients with rheumatoid arthritis, RF detection rate was not significantly different between the joint fluid and the blood (P > 0.05), but it was significantly different for patients with gouty arthritis (P < 0.05). The positive rate of ASO in the blood and joint fluid of patients with gouty arthritis was respectively 38.7% and 44.0%, and it was 75.0% and 73.5% for patients with rheumatoid arthritis. UA positive rate in the blood and joint fluid of patients with gouty arthritis was 92.0% and 80.0% respectively, while it was 38.2% and 32.4% for patients with rheumatoid arthritis. RF positive rate was 33.3% and 40.0% in the blood and joint fluid of patients with gouty arthritis, while the rate was 86.8% and 91.2% for patients with rheumatoid arthritis. ConclusionThe joint fluid and blood indicators are in change in patients with gouty arthritis and rheumatoid arthritis, which has a certain clinical value in disease diagnosis and curative effect observation.
This study aims to investigate the diagnostic value of 18F-NaF micro PET/CT imaging in mouse models of acute gouty arthritis (AGA). Three male Balb/c mice were designated as the normal control group (Group A), and 18 male Balb/c mice were used to establish the AGA model (Group B). Group A and model groups B (B1h, B3h, B6h, B8h, B12h, B24h) underwent micro PET/CT imaging 40 minutes after injection of the radiotracer. All groups of mice underwent complete blood count, blood uric acid testing, and pathological biopsy of the ankle joint. The results showed that the counts of inflammatory cells in the blood routine of Group B were higher than those of Group A, and there were statistically significant differences between Group B6h and B8h compared to Group A (P<0.05). 18F-NaF micro PET/CT imaging revealed abnormal tracer accumulation in the right ankle joints of group B, but no bone destruction were observed on CT at the lesion sites; In group A, there was no obvious abnormal gathering of tracer in the left ankle joint. The ratios of maximum standardized uptake value (SUVmax) of the right and left ankle joints (R/LSUVmax) in Group B were higher than those in Group A, and the difference between Group B6h and Group A was statistically significant (P<0.05). The R/LSUVmax ratios were positively correlated with the counts of white blood cells and neutrophils in the blood routine and microscopic inflammatory cells (R=0.79, P<0.01; R=0.72, P<0.01; R=0.79, P<0.01, respectively). Overall, 18F-NaF micro PET/CT imaging can detect early bone metabolism changes in AGA and visually monitor its dynamic pathophysiological progression.
Objective To investigate the method and the effectiveness of a combination of the arthroscopic debridement and joint irrigation postoperatively for treating gouty arthritis of the knee. Methods Between August 2000 and November 2009, 41 patients with gouty arthritis of the knee were treated by arthroscopic debridement. All patients were males with an average age of 42 years (range, 21-71 years), including 8 incipient cases and 33 relapsed cases. The unilaterial knees wereinvolved in 36 cases, including 22 left knees and 14 right knees, and both in 5 cases. The disease duration ranged from 2 months to 20 years (median, 6 years and 2 months). The extention, flexion, and range of motion (ROM) of the knee joint were (4.88 ± 6.22), (93.95 ± 35.33), and (87.79 ± 35.19)°, respectively, and Lysholm score was 63.2 ± 11.7 preoperatively. The serum uric acid levels were higher than normal value in 32 cases. Twenty-seven cases were definitely diagnosed as gouty arthritis before operation. Arthroscopic debridement was performed in 11 cases, and the arthroscopic debridement with joint irrigation postoperatively in 30 cases. After operation, the anti-gout agents and diet control were given. Results Arthroscope and pathologic examinations confirmed diagnosis of gouty arthritis in 41 patients. Intra-articular hemorrhage occurred in 1 case and was cured after arthroscopic evacuation of hematoma. The other patients achieved heal ing of incision by first intention. All 41 patients were followed up 15-126 months (mean, 50 months) postoperatively. The Lysholm score was 96.8 ± 5.8 at 15 months after operation, showing significant difference when compared with the preoperative value (t= — 13.844, P=0.000). The postoperative extention (1.16 ± 3.91)°, flexion (125.93 ± 18.65)°, and ROM (126.86 ± 16.33)° of the knee joint were significantly improved when compared with the preoperative ones (P lt; 0.05). Thirteen cases (14 knees) recurred postoperatively; but occurrence frequency and the duration were decreased and the symptoms of joint swell ing and pain were improved. Conclusion The arthroscopicdebridement is effective in cleaning up uric acid crystals thoroughly, reducing wounds, and speeding up recovery. If antigout agents and diet control can be used postoperatively, the recurrence of gouty arthritis can be prevented effectively, and the progression can be delayed.