[Studies on the blood circulation at the proximal site of the tibia in rheumatoid arthritis]

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.