Takahashi S
Department of Orthopaedic Surgery, Tohoku University School of Medicine, Sendai, Japan.
Nihon Seikeigeka Gakkai Zasshi. 1989 Sep;63(9):1029-39.
It has not been well studied the blood flow of the bone of patients with rheumatoid arthritis. For this reason, the author of this report studied the circulatory state of the venous system at the proximal portion of 28 tibiae from 22 patients with rheumatoid arthritis and one from a healthy male as a control. In this study, we tried to correlate the clinical symptoms with local destruction of the joint and the bone atrophy. We injected 1 ml of saline into the medullary cavity through the cortical bone, then measured the time required for the back-flow of 5 drops-leakage of bone marrow blood. In addition oxygen pressure and carbon dioxide gas pressure of the marrow blood were evaluated, phlebography was also taken. Delayed venous circulation shown on the phlebogram tended to coincide with high rates of back-flow. When the venous circulation surrounding and within the bone marrow was fair, many of our patients were found to have mild pain associated with gradual degeneration and moderate atrophy of the bone. On the other hand, when the venous circulation of the above area showed stasis, most of our patients were found to have progressive destruction and atrophy of the bone. This study has concluded that inflammation and swelling of the synovial membrane produces circulatory disturbances in and out of the joint. These disturbances result in bone atrophy and the aggravation of clinical symptoms including intensified pain.
类风湿性关节炎患者骨骼的血流情况尚未得到充分研究。因此，本报告的作者研究了22例类风湿性关节炎患者的28根胫骨近端以及1名健康男性（作为对照）的静脉系统循环状态。在本研究中，我们试图将临床症状与关节局部破坏和骨质萎缩联系起来。我们通过皮质骨向骨髓腔内注入1毫升生理盐水，然后测量5滴骨髓血回流所需的时间。此外，还评估了骨髓血的氧分压和二氧化碳气体分压，并进行了静脉造影。静脉造影显示的静脉循环延迟往往与高回流率一致。当骨髓周围和内部的静脉循环良好时，我们发现许多患者的疼痛较轻，伴有骨质逐渐退变和中度萎缩。另一方面，当上述区域的静脉循环出现淤滞时，我们发现大多数患者出现骨质进行性破坏和萎缩。本研究得出结论，滑膜的炎症和肿胀会导致关节内外的循环紊乱。这些紊乱会导致骨质萎缩和临床症状加重，包括疼痛加剧。
