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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Ultrason
2013 ; 13
(53
): 192-201
Nephropedia Template TP
gab.com Text
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English Wikipedia
Role of inflammatory factors and adipose tissue in pathogenesis of rheumatoid
arthritis and osteoarthritis Part I: Rheumatoid adipose tissue
#MMPMID26674614
Sudo?-Szopi?ska I
; Kontny E
; Zaniewicz-Kaniewska K
; Prohorec-Sobieszek M
; Saied F
; Ma?li?ski W
J Ultrason
2013[Jun]; 13
(53
): 192-201
PMID26674614
show ga
For many years, it was thought that synovial cells and chondrocytes are the only
sources of proinflammatory cytokines and growth factors found in the synovial
fluid in patients suffering from osteoarthritis and rheumatoid arthritis.
Currently, it is more and more frequently indicated that adipose tissue plays a
significant role in the pathogenesis of these diseases as well as that a range of
pathological processes that take place in the adipose tissue, synovial membrane
and cartilage are interconnected. The adipose tissue is considered a specialized
form of the connective tissue containing various types of cells which produce
numerous biologically active factors. The latest studies reveal that, similarly
to the synovial membrane, articular adipose tissue may take part in the local
inflammatory response and affect the metabolism of the cartilage and subchondral
osseous tissue. In in vitro conditions, the explants of this tissue obtained from
patients suffering from osteoarthritis and rheumatoid arthritis produce similar
pro- and anti-inflammatory cytokines to the explants of the synovial membrane. At
this stage already, knowledge translates into imaging diagnostics. In
radiological images, the shadowing of the periarticular soft tissues may not only
reflect synovial membrane pathologies or joint effusion, but may also suggest
inflammatory edema of the adipose tissue. On ultrasound examinations, abnormal
presentation of the adipose tissue, i.e. increased echogenicity and hyperemia,
may indicate its inflammation. Such images have frequently been obtained during
ultrasound scanning and have been interpreted as inflammation, edema, hypertrophy
or fibrosis of the adipose tissue. At present, when the knowledge concerning
pathogenic mechanisms is taken into account, abnormal echogenicity and hyperemia
of the adipose tissue may be considered as a proof of its inflammation. In the
authors' own practice, the inflammation of the adipose tissue usually accompanies
synovitis. However, we also diagnose cases in which the inflammatory process in
the joint is no longer active, but abnormal vascularity still persists in the
adipose tissue. There are also cases where abnormal adipose tissue is the only
sign of inflammation. Therefore, ultrasound examination confirms the existence of
the additional site of inflammation, i.e. the adipose tissue which should be
evaluated at the stage of initial diagnosis and during follow-up, also in terms
of remission.