Monomeric C reactive protein (mCRP) presents important proinflammatory effects in endothelial cells, leukocytes, or chondrocytes. However, CRP in its pentameric form exhibits weak anti-inflammatory activity. It is used as a biomarker to follow severity and progression in infectious or inflammatory diseases, such as intervertebral disc degeneration (IVDD). This work assesses for the first time the mCRP effects in human intervertebral disc cells, trying to verify the pathophysiological relevance and mechanism of action of mCRP in the etiology and progression of IVD degeneration.

We demonstrated that mCRP induces the expression of multiple proinflammatory and catabolic factors, like nitric oxide synthase 2 (NOS2), cyclooxygenase 2 (COX2), matrix metalloproteinase 13 (MMP13), vascular cell adhesion molecule 1 (VCAM1), interleukin (IL)-6, IL-8, and lipocalin 2 (LCN2), in human annulus fibrosus (AF) and nucleus pulposus (NP) cells. We also showed that nuclear factor-κβ (NF-κβ), extracellular signal-regulated kinase 1/2 (ERK1/2), and phosphoinositide 3-kinase (PI3K) are at play in the intracellular signaling of mCRP.

Our results indicate that the effect of mCRP is persistent and sustained, regardless of the proinflammatory environment, as it was similar in healthy and degenerative human primary AF cells. This is the first article that demonstrates the localization of mCRP in intravertebral disc cells of the AF and NP and that provides evidence for the functional activity of mCRP in healthy and degenerative human AF and NP disc cells.

Aims

CRP is an acute-phase protein that is used as a biomarker to follow severity and progression in infectious and inflammatory diseases. Its pathophysiological mechanisms of action are still poorly defined. CRP in its pentameric form exhibits weak anti-inflammatory activity. The monomeric isoform (mCRP) exerts potent proinflammatory properties in chondrocytes, endothelial cells, and leucocytes. No data exist regarding mCRP effects in human intervertebral disc (IVD) cells. This work aimed to verify the pathophysiological relevance of mCRP in the aetiology and/or progression of IVD degeneration.

Introduction and purpose: The ulnar carpal impaction syndrome (UCIS) is a common cause of pain in the ulnar aspect of the wrist. It has numerous causes, although most cases are due to rupture of the triangular fibrocartilaginous complex (TFC), either traumatic or degenerative.

Materials and methods: We carried out a prospective study of the results of ulnar shortening osteotomy in 41 wrists. The osteotomy (transverse) was performed in the middle third of the ulnar and the shortening ranged from 3 to 10 mm. For stabilisation we used a 3.5-mm AO LC-DCP and LCP plate. Minimum follow-up was 6 months and maxim was 8 years.

Results: The mean age was 37; there were 28 women and 12 men. The ulnar variance ranged from 5 mm positive to 2 mm negative. All the wrists had Tolat type I or II distal radioulnar morphology. Pain and pain frequency were reduced to levels below surgical indication in 89% of cases within 2 and 4 months after the operation. All the ulnae consolidated satisfactorily between 12 and 14 weeks, except for one case of pseudoarthrosis, which was treated with an iliac crest graft and further bone synthesis.

Conclusions: The results obtained in this series reveal adequate progression of wrist pain and function in patients treated for UCIS by ulnar shortening. There were very few complications and revisions.

A case of duplication of the patella in the coronal plane is reported. Previously reported cases of double patella have shown sagittal or vertical duplication, and some have been associated with multiple epiphyseal dysplasia. In our case, excision of one patella and realignment of the extensor mechanism relieved symptoms of giving-way.