Segami Natsuki, Miyamaru Masahisa, Nishimura Masaaki, Suzuki Toshikazu, Kaneyama Keiseki, Murakami Ken-Ichiro
Department of Oral and Maxillofacial Surgery, Kanazawa Medical University, Uchinada, Japan.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002 Oct;94(4):515-21. doi: 10.1067/moe.2002.126697.
We sought to clarify the nature of joint effusion (JE) on T2-weighted magnetic resonance images of the temporomandibular joint (TMJ) by analysis of the synovial fluid in the superior compartment of patients with internal derangement and osteoarthrosis.
One hundred symptomatic TMJs (100 patients) with 65 internal derangements and 35 osteoarthroses were scanned by means of magnetic resonance imaging, and, the synovial fluid was sampled on the same day. The amount of JE was evaluated on a scale of 0 to 3. Grades 0 and 1 indicated absence of JE or a negligible amount of JE, respectively, and grades 2 and 3 indicated the presence of JE. Correlation was evaluated among the amount of JE and the concentrations of the total protein and interleukin-1beta(IL-1beta), IL-6, IL-8, and tumor necrosis factor-alpha in the synovial fluid.
Magnetic resonance imaging revealed the absence of JE in 40 joints (grade 0, 17 joints; grade 1, 23 joints) and the presence of JE in 60 joints (grade 2, 31 joints; grade 3, 29 joints). The joints with JE had, on average, significantly higher concentrations of total protein (1,675 microg vs 714 microg; P = .0001) and IL-6 (42.9 pg vs 10.6 pg; P = .009) than did the joints without JE. Furthermore, there were significant correlations between the JE grade and the concentrations of the total protein (P = .0001), IL-6 (P = .001), and IL-8 (P = .004). The detection ratio of cytokines among the presence-absence groups of JE showed a significant difference in tumor necrosis factor-alpha (68.3% vs 47.5%; P = .037) and IL-6 (86.7% vs 67.5%; P = .012). Conclusions. JE may contain the released products when there is pronounced synovitis. It is probably composed of high concentrations of total protein with inflammatory cytokines. Furthermore, IL-6 and IL-8 seem to have an important role in the pathogenesis of JE in TMJ disorders.
我们试图通过分析颞下颌关节（TMJ）内紊乱和骨关节炎患者上腔的滑液，阐明颞下颌关节在T2加权磁共振图像上关节积液（JE）的性质。
对100例有症状的颞下颌关节（100例患者）进行磁共振成像扫描，其中65例为内紊乱，35例为骨关节炎，并于同日采集滑液。根据0至3级标准评估关节积液量。0级和1级分别表示无关节积液或关节积液量可忽略不计，2级和3级表示存在关节积液。评估关节积液量与滑液中总蛋白、白细胞介素-1β（IL-1β）、IL-6、IL-8和肿瘤坏死因子-α浓度之间的相关性。
磁共振成像显示40个关节无关节积液（0级，17个关节；1级，23个关节），60个关节有关节积液（2级，31个关节；3级，29个关节）。有关节积液的关节，其总蛋白（1675微克对714微克；P = 0.0001）和IL-6（42.9皮克对10.6皮克；P = 0.009）的平均浓度显著高于无关节积液的关节。此外，关节积液分级与总蛋白浓度（P = 0.0001）、IL-6（P = 0.001）和IL-8（P = 0.004）之间存在显著相关性。关节积液有无组间细胞因子的检出率在肿瘤坏死因子-α（68.3%对47.5%；P = 0.037）和IL-6（86.7%对67.5%；P = 0.012）方面有显著差异。结论。当存在明显滑膜炎时，关节积液可能含有释放的产物。它可能由高浓度的总蛋白和炎性细胞因子组成。此外，IL-6和IL-8似乎在颞下颌关节紊乱病关节积液的发病机制中起重要作用。
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