“Milwaukee shoulder”—association of microspheroids containing hydroxyapatite crystals, active collagenase, and neutral protease with rotator cuff defects. ii. synovial fluid studies

Paul B. Halverson, Herman S. Cheung, Daniel J. Mccarty, John Garancis, Neil Mandel

Research output: Contribution to journalArticlepeer-review

98 Scopus citations

Abstract

Hydroxyapatite crystals in spheroid-shaped masses 1.9-15.6μ in diameter were found in 12 of 13 synovial fluids obtained from the shoulder joints of 4 patients with rotator cuff tears and glenohumeral osteoarthritis. Two of 16 control joint fluids also showed these particles. Collagen types I, II, and III were identified in the joint fluid pellets from 3 of the 4 patients, and fibers with typical collagen periodicity were also seen on transmission electronmicroscopy. Collagenase and neutral protease activities were found in fluids from 5 joints in 3 patients, whereas active collagenase was found in only 1 of 10 fluids from rheumatoid arthritis patients and in none of 3 fluids from patients with osteoarthritis. Neutral protease activities were present in several rheumatoid joint fluids. These findings are compatible with the hypothesis of an enzymatic release of hydroxyapatite crystals from the synovium and endocytosis by synovial macrophage-like cells with subsequent crystal-stimulated release of collagenase and neutral protease into the joint fluid, completing a pathogenetic cycle.

Original languageEnglish (US)
Pages (from-to)474-483
Number of pages10
JournalArthritis & Rheumatism
Volume24
Issue number3
DOIs
StatePublished - Mar 1981
Externally publishedYes

ASJC Scopus subject areas

  • Immunology and Allergy
  • Rheumatology
  • Immunology
  • Pharmacology (medical)

Fingerprint Dive into the research topics of '“Milwaukee shoulder”—association of microspheroids containing hydroxyapatite crystals, active collagenase, and neutral protease with rotator cuff defects. ii. synovial fluid studies'. Together they form a unique fingerprint.

Cite this