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Diagnostics
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Inflammatory and Infectious Bone and Joint Diseases: Diagnosis and Management
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Inflammatory and Infectious Bone and Joint Diseases: Diagnosis and Management

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (28 February 2022) | Viewed by 17880

Special Issue Editor

Dr. Thomas M. Randau

E-Mail Website
Guest Editor
Universitäts-Klinikum Bonn, Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Bonn, Germany
Interests: revision arthroplasty; orthopedic rheumatology; infection; bone marrow edema; arthritis; periprosthetic joint infection

Special Issue Information

Inflammation is the key mechanism in the pathophysiology of many bone diseases. While it is obvious in diseases such as septic arthritis, periprosthetic infections, spondylodiscitis and rheumatoid arthritis, bone tumors and fracture healing are also closely linked to inflammation, which cannot happen without them. New technologies in the lab have created numerous diagnostic possibilities in the last few years, some already in routine use and others still far away from clinical application. With this, our understanding of the highly complex regulation of inflammation in the musculoskeletal system has grown steadily. This Special Issue shall focus on novel aspects of diagnostics and the management of inflammatory bone and joint diseases and welcomes both original research articles as well as reviews and meta-analyses. Work with a clinical link is preferred, but we also encourage authors to submit basic research papers concerned with immunology and inflammation, as long as it is related to bone, cartilage and synovia, or their precursor cells. Translational research papers concerning novel diagnostic methods, such as biomarkers, PCR, MALDI, proteomics, sequencing and cell differentiation are highly welcome, both with data from preclinical trials or confirmatory results of approved diagnostic products. After a fast peer-review process, accepted articles will be published open-access in the Journal Diagnostics (ISSN 2075-4418) by swiss-based publisher, MDPI. The current impact factor of the Journal in the Science Citation Index is 3.11 (2019), up from 2.49 in 2018. Article processing charges of 1400 CHF will apply only upon acceptance of your article.

Dr. Thomas M. Randau
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • muskuloskeletal diseases
  • arthritis
  • osteitis
  • inflammation
  • infection
  • osteoarhritis
  • arthroplasty
  • biomarkers
  • molecular biology
  • spine
  • rheumatology
  • periprosthetic joint infection
  • spondylodiscitis
  • diagnostic methods

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Published Papers (5 papers)

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9 pages, 35538 KiB  
Article
Development and Proof of Concept of a Low-Cost Ultrasound Training Model for Diagnosis of Giant Cell Arteritis Using 3D Printing
by Florian Recker, Lei Jin, Patrick Veith, Mark Lauterbach, Pantelis Karakostas and Valentin Sebastian Schäfer
Diagnostics 2021, 11(6), 1106; https://doi.org/10.3390/diagnostics11061106 - 17 Jun 2021
Cited by 6 | Viewed by 2297
Abstract
Objectives: Currently, ultrasound (US) is widely used for the diagnosis of giant cell arteritis (GCA). Our aim was to develop a low-cost US training model for diagnosis of GCA of the temporal and axillary artery using a modern 3D printing system. Methods: We [...] Read more.
Objectives: Currently, ultrasound (US) is widely used for the diagnosis of giant cell arteritis (GCA). Our aim was to develop a low-cost US training model for diagnosis of GCA of the temporal and axillary artery using a modern 3D printing system. Methods: We designed an US training model, which enables measurement of the intima-media thickness (IMT) of temporal and axillary arteries using Autodesk Fusion360. This model was printed using a modern 3D printer (Formlabs Form3) and embedded in ballistic gelatine. The ultrasound images including measurement of the IMT by ultrasound specialists in GCA were compared to ultrasound images in acute GCA and healthy subjects. Results: Our ultrasound training model of the axillary and temporal artery displayed a very similar ultrasound morphology compared to real US images and fulfilled the OMERACT ultrasound definitions of normal and pathological temporal and axillary arteries in GCA. The IMT measurements were in line with published cut-off values for normal and pathological IMT values in GCA and healthy individuals. When testing the models on blinded US specialists in GCA, they were identified correctly in all test rounds with an intra-class coefficient of 0.99. Conclusion: The production of low-cost ultrasound training models of normal and pathological temporal and axillary arteries in GCA, which fulfil the OMERACT ultrasound definitions and adhere to the published IMT cut-off values in GCA, is feasible. Ultrasound specialists identified each respective model correctly in every case. Full article
(This article belongs to the Special Issue Inflammatory and Infectious Bone and Joint Diseases: Diagnosis and Management)
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13 pages, 911 KiB  
Article
How to Differentiate Gout, Calcium Pyrophosphate Deposition Disease, and Osteoarthritis Using Just Four Clinical Parameters
by Dmitrij Kravchenko, Charlotte Behning, Raoul Bergner and Valentin Sebastian Schäfer
Diagnostics 2021, 11(6), 924; https://doi.org/10.3390/diagnostics11060924 - 21 May 2021
Cited by 3 | Viewed by 6274
Abstract
Clinical differentiation between gout, osteoarthritis (OA), and calcium pyrophosphate deposition disease (CPPD) remains a hurdle in daily practice without imaging or arthrocentesis. We performed a retrospective analysis of consecutive patients with gout, CPPD, and OA at a tertiary rheumatology center. A total of [...] Read more.
Clinical differentiation between gout, osteoarthritis (OA), and calcium pyrophosphate deposition disease (CPPD) remains a hurdle in daily practice without imaging or arthrocentesis. We performed a retrospective analysis of consecutive patients with gout, CPPD, and OA at a tertiary rheumatology center. A total of 277 patients were enrolled, with 164 suffering from gout, 76 from CPPD, and 37 from OA. We used ANOVA and conditional inference tree analysis (Ctrees) to find associations between clinical, laboratory, and imaging data and gout, OA, and CPPD. The sonographic double contour sign was unable to differentiate gout from CPPD. Ctrees were able to exclude OA and CPPD as possible differentials based on elevated uric acid, C-reactive protein (CRP), presence of arterial hypertension, and sex, diagnosing gout with a sensitivity and specificity of 95.1% and 41.6%, respectively. Elevated CRP was observed using simple linear regressions in patients with type II diabetes, higher cumulative joint scores, increased number of affected joints, as well as elevated uric acid, erythrocyte sedimentation rate, and leukocyte count. Ctrees were able to differentiate gout, OA, and CPPD based on just four characteristics. Inflammatory response correlated with type II diabetes, more or larger joint involvement, and elevated uric acid levels. Full article
(This article belongs to the Special Issue Inflammatory and Infectious Bone and Joint Diseases: Diagnosis and Management)
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10 pages, 1876 KiB  
Article
Synovial Complement Factors in Patients with Periprosthetic Joint Infection after Undergoing Revision Arthroplasty of the Hip or Knee Joint
by Frank Sebastian Fröschen, Sophia Schell, Matthias Dominik Wimmer, Gunnar Thorben Rembert Hischebeth, Hendrik Kohlhof, Sascha Gravius and Thomas Martin Randau
Diagnostics 2021, 11(3), 434; https://doi.org/10.3390/diagnostics11030434 - 4 Mar 2021
Cited by 5 | Viewed by 1860
Abstract
The role and diagnostic value of the synovial complement system in patients with low-grade periprosthetic joint infection (PJI) are unclear. We sought to evaluate, for the first time, the usefulness of synovial complement factors in these patients by measuring the individual synovial fluid [...] Read more.
The role and diagnostic value of the synovial complement system in patients with low-grade periprosthetic joint infection (PJI) are unclear. We sought to evaluate, for the first time, the usefulness of synovial complement factors in these patients by measuring the individual synovial fluid levels of complement factors (C1q, C3b/iC3b, C4b, C5, C5a, C9, factor B, factor D, factor H, factor I, properdin, and mannose-binding lectin [MBL]). The patients (n = 74) were classified into septic (n = 28) and aseptic (n = 46). Receiver-operator characteristic curves and a multiple regression model to determine the feasibility of a combination of the tested cytokines to determine the infection status were calculated. The synovial fluid levels of C1q, C3b/C3i, C4b, C5, C5a, MBL, and properdin were significantly elevated in the PJI group. The best sensitivity and specificity was found for C1q. The multiple regression models revealed that the combination of C1q, C3b/C3i, C4b, C5, C5a, and MBL was associated with the best sensitivity (83.3%) and specificity (79.2%) for a cutoff value of 0.62 (likelihood ratio: 4.0; area under the curve: 0.853). Nevertheless, only a combined model showed acceptable results. The expression patterns of the complement factors suggested that PJI activates all three pathways of the complement system. Full article
(This article belongs to the Special Issue Inflammatory and Infectious Bone and Joint Diseases: Diagnosis and Management)
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11 pages, 2457 KiB  
Article
Introduction of a Simplified Psoriatic Arthritis Magnetic Resonance Imaging Score (sPsAMRIS): A Potential Tool for Treatment Monitoring in Peripheral Psoriatic Arthritis
by Daniel B. Abrar, Christoph Schleich, Ralph Brinks, Christine Goertz, Miriam Frenken, Matthias Schneider, Sven Nebelung and Philipp Sewerin
Diagnostics 2020, 10(12), 1093; https://doi.org/10.3390/diagnostics10121093 - 15 Dec 2020
Cited by 1 | Viewed by 4009
Abstract
Background: To evaluate whether a simplified (s) version of the psoriatic arthritis magnetic resonance imaging score (PsAMRIS), sPsAMRIS, is a potential tool for therapy monitoring in psoriatic arthritis (PsA). Methods: Seventeen patients with active psoriatic arthritis (PsA) underwent magnetic resonance imaging (MRI) at [...] Read more.
Background: To evaluate whether a simplified (s) version of the psoriatic arthritis magnetic resonance imaging score (PsAMRIS), sPsAMRIS, is a potential tool for therapy monitoring in psoriatic arthritis (PsA). Methods: Seventeen patients with active psoriatic arthritis (PsA) underwent magnetic resonance imaging (MRI) at 3 T of the clinically dominant hand at baseline and after 6 months. Scoring was performed by two musculoskeletal radiologists in terms of the PsAMRIS and sPsAMRIS, which is a simplified version with reduced item numbers based on prior evaluation of responsiveness to change by standardized response means (SRMs). Both scores were compared by calculation of overall and each sub-score’s SRMs and relative efficacy (RE) after bootstrapping. Results: PsAMRIS sub-scores of MCP joints 3 and 4, and proximal interphalangeal (PIP) joint 4 had the highest SRM (−0.07 each), indicating highest responsiveness to change, and were, therefore, included in sPsAMRIS. Compared to PsAMRIS, sPsAMRIS was characterized by higher SRMs (sPsAMRIS: −0.13 vs. PsAMRIS: −0.02) and higher RE (29.46). sPsAMRIS and PsAMRIS were highly correlated at baseline (r = 0.75, p < 0.01 (Pearson’s correlation)) and at 6-month follow-up (r = 0.64, p = 0.01). Mean time burden for completion of scoring per MRI study was significantly reduced when using PsAMRIS (469 ± 87.03 s) as compared to sPsAMRIS (140.1 ± 21.25 s) (p < 0.001). Conclusion: Due to its similar responsiveness to change compared to standard PsAMRIS, and time efficiency, sPsAMRIS might be a potential diagnostic tool to quantitatively assess and monitor therapy in PsA. Full article
(This article belongs to the Special Issue Inflammatory and Infectious Bone and Joint Diseases: Diagnosis and Management)
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17 pages, 5020 KiB  
Case Report
Primary Bone Lesions in Rosai–Dorfman Disease, a Rare Case and Diagnostic Challenge—Case Report and Literature Review
by Razvan Adam, Tudor Harsovescu, Sorin Tudorache, Cosmin Moldovan, Mark Pogarasteanu, Adrian Dumitru and Carmen Orban
Diagnostics 2022, 12(4), 783; https://doi.org/10.3390/diagnostics12040783 - 23 Mar 2022
Cited by 3 | Viewed by 2396
Abstract
Rosai–Dorfman Disease (RDD), also known as sinus histiocytosis, is included in the group of rare diseases, characterized by proliferation and accumulation of histiocytes in the lymph nodes (lymphadenopathy), most often involving the cervical ganglion chains (nodal form). RDD bone involvement is rare, estimated [...] Read more.
Rosai–Dorfman Disease (RDD), also known as sinus histiocytosis, is included in the group of rare diseases, characterized by proliferation and accumulation of histiocytes in the lymph nodes (lymphadenopathy), most often involving the cervical ganglion chains (nodal form). RDD bone involvement is rare, estimated at 10% of cases, but primary bone involvement (extranodal form), is very rare—2–8%. Usually they are solitary lesions, with multifocal primary bone manifestations being extremely rare. Histopathological analysis is of high value for a correct diagnosis. We present the case of a Caucasian woman, 42 years old, initially treated in another clinic, for an osteolytic tumor formation in the right tibial shaft. An excisional biopsy with bone trepanation was performed, the histopathological diagnosis being the chronic inflammatory tissue. The evolution was atypical, with tumor growth, extraosseous, subcutaneous. A needle biopsy was repeated in our clinic, the result being similar to the original one. Evolution of the tumor, and the radiological and imaging aspect (periosteal reaction, eroded and thin bone cortex) suggested a more aggressive disease, these being in inconsistency with the result obtained. The biopsy was repeated, as an excision type this time. The histopathological result and immunohistochemistry indicated an RDD primary bone lesion. Based on this result, and corroborated with the data from the literature, we initiated the surgical treatment, curettage and grafting with bone substitute plus safety osteosynthesis with locked plaque, the patient registering a favorable evolution. RDD primary bone lesions are in fact an atypical manifestation of a rare disease. The correct diagnosis is very difficult due to the non-specific imaging aspect. Histopathological examination errors, especially in the case of needle biopsies can lead to errors in diagnosis and treatment with negative results for the patient. Full article
(This article belongs to the Special Issue Inflammatory and Infectious Bone and Joint Diseases: Diagnosis and Management)
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