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Li L, Wang Y, Zhu Z, Zhou J, Li S, Qin J. Conservative tibiotalocalcaneal fusion for partial talar avascular necrosis in conjunction with ankle and subtalar joint osteoarthritis in Kashin-Beck disease: A case report. Medicine (Baltimore) 2019; 98:e16367. [PMID: 31335683 PMCID: PMC6709310 DOI: 10.1097/md.0000000000016367] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
RATIONALE Kashin-Beck disease (KBD) is known for some typical characters like finger joint enlargement, shortened fingers, and dwarfism. However, Avascular necrosis (AVN) of the talus in KBD has rarely been reported in the literature. Here, we reported on a KBD patient presented with partial AVN of the talus in conjunction with ankle and subtalar arthritis. PATIENT CONCERNS A 50-year-old woman presented with severe pain and limited range of motion in her left ankle and subtalar joint while walking for 2 years. She had been walking with the aid of crutches for many years. Conservative treatment with rigid orthosis and activity restriction could not help reduce the pain in the left foot. DIAGNOSES Radiographs demonstrated that partial AVN was developed in the body of the talus and arthritis was viewed in the left ankle and subtalar joint. Hence, we established the diagnosis of partial talar AVN in conjunction with ankle and subtalar arthritis. INTERVENTIONS A conservative tibiotalocalcaneal fusion attempting to preserve as much viable talar body as possible was performed using a humeral locking plate and 2 cannulated compression screws. OUTCOMES Bone union proved by CT scan and a good alignment of the left limb were achieved at 4-month follow-up postoperatively. LESSONS Partial AVN of the talus along with ankle and subtalar arthritis in KBD patients has rarely been reported as it is not a common characteristic of KBD in clinical practice. Conservative tibiotalocalcaneal fusion could help preserving much more viable talar body, maintaining most structural integrity of the ankle joint, and achieving a stable and plantigrade foot postoperatively.
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Affiliation(s)
| | | | | | - Jupu Zhou
- Department of Orthopaedics, the Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Shuyuan Li
- The Foot and Ankle Association, Inc. Baltimore, MD
| | - Jianzhong Qin
- Department of Orthopaedics, the Second Affiliated Hospital of Soochow University, Suzhou, China
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Zhao ZJ, Pu GL, Zhan PZ, Li Q, Wu CN, Wang LH. Detection of the Urinary Biomarkers PYD, CTX-II, and DPD in Patients with Kashin-Beck Disease in the Qinghai Province of China. Biomed Environ Sci 2017; 30:380-383. [PMID: 28549495 DOI: 10.3967/bes2017.050] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 04/25/2017] [Indexed: 06/07/2023]
Abstract
Kashin-Beck disease (KBD) is an endemic degenerative osteoarthropathy of uncertain etiology. The aim of our study was to identify changes in C-telopeptide of type II collagen (CTX-II), pyridinoline (PYD), and deoxypyridinoline (DPD) among KBD patients. 54 KBD patients and 78 healthy controls were included this study. Urinary samples were collected and measured by ELISA. The median quantities of PYD, CTX-II, and DPD of KBD patients were 1107.73 ng/μmol.cre, 695.11 ng/μmol.cre, and 1342.34 pml/μmol.cre, while the median quantities of healthy controls were 805.59 ng/μmol.cre, 546.47 ng/μmol.cre, and 718.15 pml/μmol.cre, respectively. The differences between KBD patients and healthy controls were statistically significant (Z = 4.405, 3.653, and 3.724; P < 0.001). The higher levels of PYD, CTX-II, and DPD detected in KBD patients indicate that they could be used as biomarkers of KBD.
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Affiliation(s)
- Zhi Jun Zhao
- Qinghai Institute for Endemic Disease Prevention and Control, Xining 811602, Qinghai, China
| | - Guang Lan Pu
- Qinghai Institute for Endemic Disease Prevention and Control, Xining 811602, Qinghai, China
| | - Pei Zhen Zhan
- Qinghai Institute for Endemic Disease Prevention and Control, Xining 811602, Qinghai, China
| | - Qiang Li
- Qinghai Institute for Endemic Disease Prevention and Control, Xining 811602, Qinghai, China
| | - Chun Ning Wu
- Qinghai Institute for Endemic Disease Prevention and Control, Xining 811602, Qinghai, China
| | - Li Hua Wang
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin 150087, Heilongjiang, China
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Wu W, He A, Wen Y, Xiao X, Hao J, Zhang F, Guo X. Comparison of microRNA expression profiles of Kashin-Beck disease, osteoarthritis and rheumatoid arthritis. Sci Rep 2017; 7:540. [PMID: 28373711 PMCID: PMC5428653 DOI: 10.1038/s41598-017-00522-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Accepted: 03/01/2017] [Indexed: 11/10/2022] Open
Abstract
Kashin-Beck disease (KBD) is a chronic osteochondropathy with unclear pathogeny. In this study, we compared the microRNA expression profiles of 16 KBD patients, 16 osteoarthritis (OA) patients and 16 rheumatoid arthritis (RA) patients and 16 healthy controls in their blood specimens. miRNAs expression profiling was performed using Exiqon miRCURY LNATM miRNAs Array. miRNAs target genes were predicted using miRror suite. Another independent mRNA expression profile dataset of 20 KBD patients and 15 healthy controls were integrated with the miRNA expression profiles of KBD. We identified 140 differently expressed miRNAs in KBD vs. CONTROLS GO enrichment analysis found that hypoxia, Wnt receptor signaling pathway and vitamin B6 biosynthesis related GO terms were significantly overrepresented in the target genes of differently expressed miRNAs in KBD vs. CONTROL 18 differently expressed common miRNAs were identified in KBD vs. Control, KBD vs. OA and KBD vs. RA. Integrating the lists of differently expressed miRNA target genes and mRNA differently expressed genes detected 6 common genes for KBD. Our results demonstrated the altered miRNAs expression profiles of KBD comparing to healthy controls, OA and RA, which provide novel clues for clarifying the mechanism of KBD.
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Affiliation(s)
- Wenhong Wu
- Key Laboratory of Trace Elements and Endemic Diseases of Ministry of Health, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, P.R. China
| | - Awen He
- Key Laboratory of Trace Elements and Endemic Diseases of Ministry of Health, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, P.R. China
| | - Yan Wen
- Key Laboratory of Trace Elements and Endemic Diseases of Ministry of Health, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, P.R. China
| | - Xiao Xiao
- Key Laboratory of Trace Elements and Endemic Diseases of Ministry of Health, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, P.R. China
| | - Jingcan Hao
- Key Laboratory of Trace Elements and Endemic Diseases of Ministry of Health, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, P.R. China
| | - Feng Zhang
- Key Laboratory of Trace Elements and Endemic Diseases of Ministry of Health, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, P.R. China.
| | - Xiong Guo
- Key Laboratory of Trace Elements and Endemic Diseases of Ministry of Health, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, P.R. China.
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Yu FF, Ping ZG, Yao C, Wang ZW, Wang FQ, Guo X. Evaluation of the Sensitivity and Specificity of the New Clinical Diagnostic and Classification Criteria for Kashin-Beck Disease, an Endemic Osteoarthritis, in China. Biomed Environ Sci 2017; 30:150-155. [PMID: 28292355 DOI: 10.3967/bes2017.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 12/26/2016] [Indexed: 05/19/2023]
Abstract
This study aimed to evaluate the sensitivity and specificity of the new clinical diagnostic and classification criteria for Kashin-Beck disease (KBD) using six clinical markers: flexion of the distal part of fingers, deformed fingers, enlarged finger joints, shortened fingers, squat down, and dwarfism. One-third of the total population in Linyou County was sampled by stratified random sampling. The survey included baseline characteristics and clinical diagnoses, and the sensitivity and specificity of the new criteria was evaluated. We identified 3,459 KBD patients, of which 69 had early stage KBD, 1,952 had stage I, 1,132 had stage II, and 306 had stage III. A screening test classified enlarged finger joints as stage I KBD, with a sensitivity and specificity of 0.978 and 0.045, respectively. Shortened fingers were classified as stage II KBD, with a sensitivity and specificity of 0.969 and 0.844, respectively, and dwarfism was classified as stage III KBD with a sensitivity and specificity of 0.951 and 0.992, respectively. Serial screening test revealed that the new clinical classification of KBD classified stages I, II, and III KBD with sensitivities of 0.949, 0.945, and 0.925 and specificities of 0.967, 0.970, and 0.993, respectively. The screening tests revealed that enlarged finger joints, shortened fingers, and dwarfism were appropriate markers for the clinical diagnosis and classification of KBD with high sensitivity and specificity.
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Affiliation(s)
- Fang Fang Yu
- Institute of Endemic Diseases, School of Public Health of Health Science Center, Xi'an Jiaotong University, Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, Xi'an 710061, Shaanxi, China
| | - Zhi Guang Ping
- Department of Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 45001, Henan, China
| | - Chong Yao
- Institute of Endemic Diseases, School of Public Health of Health Science Center, Xi'an Jiaotong University, Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, Xi'an 710061, Shaanxi, China
| | - Zhi Wen Wang
- The Centers for Disease Control of Linyou country, Linyou 721500, Shaanxi, China
| | - Fu Qi Wang
- The Centers for Disease Control of Linyou country, Linyou 721500, Shaanxi, China
| | - Xiong Guo
- Institute of Endemic Diseases, School of Public Health of Health Science Center, Xi'an Jiaotong University, Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, Xi'an 710061, Shaanxi, China
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Juan MW, Xiong G, Farooq U. ELEMENTS REGULATION DURING CARTILAGE AND BONE DEFORMITY - POTENTIAL CLINICAL INDEX IN EARLY DIAGNOSIS, MONITORING AND PROGNOSIS IN CHILDREN OF KASHIN-BECK DISEASE. J Ayub Med Coll Abbottabad 2015; 27:517-522. [PMID: 26720997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND Kashin-Beck Disease (KBD) is a chronic deforming osteoarthritis starting in early childhood and affecting the cartilage metabolism and endochondral ossification. Selenium (Se) deficiency has been postulated as the major environmental etiological factor for KBD by many studies. Other minerals such as the Manganese (Mn) and calcium (Ca) which don't have uniform distribution in environment are also important elements involved in bone and cartilage formation but their regulation in KBD has been rarely reported. The study was done to investigate the role of Mn and Ca in addition to Se in KBD. METHODS In this study, the Se, Mn and Calevels were investigated in children from different groups (KBD group, Healthy group from KBD endemic areas (inner control group), Healthy group (outer control group) from Non KBD areas and KBD group with selenium supplementation). The contents of Mn, S and Ca in serum and hair were analyzed by inductively coupled plasma mass spectrometry. RESULTS The increased Mn levels of. serum and hair in KBD children were observed compared with normal groups. The Mn and Ca have similar trends in different groups but Se and Mn displayed reversed trends. CONCLUSIONS The Mn and Ca contributed to KBD pathogenesis combined with se in regulation of growth and development. The relative ratio of Mn to Se can be a potential clinical index in early diagnosis, monitoring and prognosis of KBD in children.
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Shi X, Zhang F, Lv A, Wen Y, Guo X. COL9A1 gene polymorphism is associated with Kashin-Beck disease in a northwest Chinese Han population. PLoS One 2015; 10:e0120365. [PMID: 25774918 PMCID: PMC4361735 DOI: 10.1371/journal.pone.0120365] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Accepted: 01/21/2015] [Indexed: 12/12/2022] Open
Abstract
Objective We sought to determine whether genomic polymorphism in collagen IX genes (COL9A) was associated with Kashin-Beck disease (KBD). Methods Twenty seven single nucleotide polymorphisms (SNPs) in COL9AI, COL9A2 and COL9A3 were genotyped in 274 KBD cases and 248 healthy controls using the Sequenom MassARRAY system. Associations between the COL9A polymorphism and KBD risk were detected using an unconditional logistic regression model. Linkage disequilibrium (LD) and haplotypes analysis were performed with the Haploview software. Results After Bonferroni correction, the frequency distribution of genotypes in rs6910140 in COL9A1 was significantly different between the KBD and the control groups (X2 = 16.74, df = 2, P = 0.0002). Regression analysis showed that the allele “C” in SNP rs6910140 had a significant protective effect on KBD [odds ratio (OR) = 0.49, 95% confidence interval (CI) = 0.34–0.70, P = 0.0001]. The frequencies of alleles and genotypes in rs6910140 were significantly different among subjects of different KBD stages (allele: X2 = 7.82, df = 2, P = 0.02, genotype: X2 = 14.81, df = 4, P = 0.005). However, haplotype analysis did not detect any significant association between KBD and COL9A1, COL9A2 and COL9A3. Conclusions We observed a significant association between rs6910140 of COL9A1 and KBD, suggesting a role of COL9A1 in the development of KBD.
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Affiliation(s)
- Xiaowei Shi
- Center of Maternal and Child Health Care, The First Affiliated Hospital of Medical Collage of Xi’an Jiaotong University, Xi’an, Shannxi, PR of China
| | - Feng Zhang
- School of Public Health, Health Science Center, Xi’an Jiaotong University, Key Laboratory of Environment and Gene Related Diseases of Ministry of Education, Key Laboratory of Trace Elements and Endemic Diseases of Ministry of Health, Xi’an, Shannxi, PR of China
| | - Aili Lv
- School of Public Health, Health Science Center, Xi’an Jiaotong University, Key Laboratory of Environment and Gene Related Diseases of Ministry of Education, Key Laboratory of Trace Elements and Endemic Diseases of Ministry of Health, Xi’an, Shannxi, PR of China
| | - Yan Wen
- School of Public Health, Health Science Center, Xi’an Jiaotong University, Key Laboratory of Environment and Gene Related Diseases of Ministry of Education, Key Laboratory of Trace Elements and Endemic Diseases of Ministry of Health, Xi’an, Shannxi, PR of China
| | - Xiong Guo
- School of Public Health, Health Science Center, Xi’an Jiaotong University, Key Laboratory of Environment and Gene Related Diseases of Ministry of Education, Key Laboratory of Trace Elements and Endemic Diseases of Ministry of Health, Xi’an, Shannxi, PR of China
- * E-mail:
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