Search Results (4)

Genicular artery embolization (GAE) has emerged as a minimally invasive interventional radiology technique for the management of symptomatic knee osteoarthritis (OA), a highly prevalent condition associated with substantial functional impairment and socioeconomic burden. The rationale of GAE is based on superselective embolization of pathological periarticular neovascularization, aiming to modulate synovial inflammation, angiogenesis, and nociceptive signaling while preserving physiological joint perfusion. This narrative review provides an interventional radiology–oriented framework integrating pathophysiological mechanisms, imaging-based patient selection, and procedural strategy. Particular emphasis is placed on the vascular–inflammatory phenotype of OA, MRI-derived biomarkers of synovitis and hypervascularity, and technical aspects of embolization, including embolic agent selection and angiographic endpoints. A structured literature search was performed to identify relevant studies, including prospective trials and randomized controlled studies. Available evidence is critically discussed, with attention to clinical outcomes, safety profile, and current limitations. In addition, practical technical considerations and procedural pitfalls are summarized to provide a clinically applicable perspective. GAE represents a promising therapeutic option for selected patients with knee OA refractory to conservative management. However, further high-quality studies are required to define long-term durability, optimal patient selection, and standardized procedural strategies. Full article

Background: Chronic pain after unicompartmental knee arthroplasty (UKA) represents a significant clinical issue, often unrelated to mechanical causes and resistant to standard therapies. This work combines a narrative review and a case report to explore the pathophysiological mechanisms underlying persistent post-UKA pain and to propose genicular artery embolization (GAE) with Imipenem/Cilastatin (IPM/CS) as a novel minimally invasive treatment option. Methods: A comprehensive literature review was conducted to analyze current diagnostic and therapeutic approaches to chronic post-UKA pain, with emphasis on vascular and inflammatory mechanisms. Additionally, a patient with chronic lateral knee pain refractory to conservative management underwent selective GAE targeting hypervascularized genicular branches. Results: Following the procedure, the patient experienced substantial and sustained pain reduction, functional improvement, and no complications. The literature supports synovial neovascularization as a potential pain generator and confirms the safety of IPM/CS due to its transient embolic effect and preservation of normal perfusion. Conclusions: The combination of literature review and clinical evidence suggests that GAE may represent a promising therapeutic alternative for chronic post-UKA pain. Further studies are needed to confirm its efficacy, long-term outcomes, and appropriate indications within this challenging clinical setting. Full article

Rheumatoid arthritis (RA) is a typical autoimmune-mediated rheumatic disease presenting as a chronic synovitis in the joint. The chronic synovial inflammation is characterized by hyper-vascularity and extravasation of various immune-related cells to form lymphoid aggregates where an intimate cross-talk among innate and adaptive immune cells takes place. These interactions facilitate production of abundant proinflammatory cytokines, chemokines and growth factors for the proliferation/maturation/differentiation of B lymphocytes to become plasma cells. Finally, the autoantibodies against denatured immunoglobulin G (rheumatoid factors), EB virus nuclear antigens (EBNAs) and citrullinated protein (ACPAs) are produced to trigger the development of RA. Furthermore, it is documented that gene mutations, abnormal epigenetic regulation of peptidylarginine deiminase genes 2 and 4 (PADI2 and PADI4), and thereby the induced autoantibodies against PAD2 and PAD4 are implicated in ACPA production in RA patients. The aberrant expressions of non-coding RNAs (ncRNAs) including microRNAs (miRs) and long non-coding RNAs (lncRNAs) in the immune system undoubtedly derange the mRNA expressions of cytokines/chemokines/growth factors. In the present review, we will discuss in detail the expression of these ncRNAs and their target molecules participating in developing RA, and the potential biomarkers for the disease, its diagnosis, cardiovascular complications and therapeutic response. Finally, we propose some prospective investigations for unraveling the conundrums of rheumatoid pathogenesis. Full article

Objectives: The prevalence of elbow joint arthritis in rheumatoid arthritis (RA) assessed by ultrasound has not yet been investigated. Methods: We investigated 102 patients with RA and 50 patients without rheumatological disease. Both elbow joints were examined by ultrasound for effusion, hypervascularization, and enthesitis. A clinical examination was performed, and Disease Activity Score in 28 joints (DAS28), and visual analog scale for pain (VASp) were recorded. Arthritis was defined as joint effusion (≥grade II) and synovial hyperperfusion. Results: The RA cohort versus the control group displayed a joint effusion in 54.9% vs. 6.9%, a hypervascularization in 6.8% vs. 0%. Arthritis was detected in 36 RA patients (35.29%) and no one in the control group. Four (3.8%) RA patients and one (1%) control displayed enthesitis. The RA cohort showed a significant correlation between movement restriction and joint effusion (p-value = 0.001) as well as DAS28 (p-value = 0.02) and between DAS28 and ultrasound detected arthritis (p-value = 0.022). In an overall analysis, a highly significant correlation of VASp with movement restriction (MR) (p-value ≤ 0.001), the presence of joint effusion (p-value ≤ 0.001), and the diagnosis of RA (p-value ≤ 0.001) were observed. Interrater analysis of ultrasound imaging showed good agreement with Cohen’s kappa of 0.896. Conclusion: The prevalence of elbow arthritis in RA seems to be high, with 35.29%. Movement restriction is a good indicator, but not in all RA patients (32 vs. 70 patients without MR) compared to the control group (5 vs. 45 patients without MR). Reported pain correlates with joint effusion and MR (p-value ≤ 0.001). Full article