WorldWideScience

Sample records for acute gouty arthritis

  1. MR imaging findings of acute gouty arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Gyung Kyu [Hallym University College of Medicine, Chuncheon (Korea, Republic of); Lee, Jee Young [Dankook University College of Medicine, Cheonan (Korea, Republic of); Suh, Jin Suck [Yonsei University College of Medicine, Seoul (Korea, Republic of)] (and others)

    2006-08-15

    The purpose of this study was to describe the clinical and MR imaging features of acute gouty arthritis and to define the characteristic findings that would be helpful for differentiating acute gouty arthritis from septic arthritis. The authors retrospectively studied seven patients who suffered from acute gouty arthritis. The MR imaging findings were analyzed by two musculoskeletal radiologists who focused on joint effusion, subchondral bone erosion, bone marrow edema, synovial thickening (regular and even, or irregular and nodular), and the soft tissue changes (edema or abscess). The clinical records of the patients were reviewed with regard to age and gender, the clinical presentation and the laboratory findings (serum uric acid, WBC, erythrocyte sedimentation rate, C-reactive protein and synovial fluid culture). The patients consisted of six men and one woman whose mean age was 41 years (age range:24-65 years). The joints involved were the knee (n=6), and ankle (n=1). Two patients had medical histories of gouty attacks that involved the first metatarsophalangeal joint. In six cases, the serum uric acid level during acute attacks was elevated. In all the patients, the affected joint became swollen, hot, erythematous and extremely tender, and this was accompanied by a high ESR and a high C-reactive protein level at the time of presentation. The results of Gram stain and culture of the synovial fluid were negative. In all patients, the MR images showed large amounts of joint effusion, thick irregular and nodular synovial thickening and soft tissue edema without subchondral bone erosions and soft tissue abscess. In one case, subchondral bone marrow edema of the medial femoral condyle was present. In five cases, there were multiple low signal foci in the joint on the spin-echo T2-weighted MR image. Even though the MR imaging findings of acute gouty arthritis are nonspecific, it should be considered as a possible diagnosis when a large amount of joint effusion

  2. Gouty Arthritis: A Review of Acute Management and Prevention.

    Science.gov (United States)

    Wilson, Liza; Saseen, Joseph J

    2016-08-01

    Gouty arthritis is one of the most common rheumatic diseases. The clinical burden of gouty arthritis has historically been well recognized; however, gout is often misdiagnosed and mismanaged. The prevalence of gout is rising and is likely attributed to several factors including increased incidence of comorbidities, lifestyle factors, and increased use of causative medications. With the increasing prevalence, there have been several innovations and evidence-based updates related to the diagnosis and management of gout. Acute gouty arthritis should be treated with nonsteroidal antiinflammatory drugs (NSAIDs), colchicine, or corticosteroids, or a combination of two agents. Xanthine oxidase inhibitor therapy remains the consensus first-line treatment option for the prevention of recurrent gout. Add-on therapies that reduce serum urate concentration include traditional uricosuric agents and a novel uric acid reabsorption inhibitor. Prophylaxis of acute gout with NSAIDs, colchicine, or corticosteroids is universally recommended when initiating any urate-lowering therapy in order to prevent acute gouty arthritis for a period of at least 6 months. In this review, we discuss the epidemiology and risk factors for gouty arthritis and evaluate diagnostic strategies and therapeutic regimens for the management of gout, including a new drug approval.

  3. Gouty arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Barthelemy, C.R.; Nakayama, D.A.; Lightfoot, R.W. Jr.; Wortmann, R.L.; Carrera, G.F.

    1984-01-01

    A prospective analysis of 60 patients with gout was undertaken to evaluate the radiographic spectrum of gouty arthritis in patients treated in the era of hypouricemic therapy. Twenty-two of these patients were clinically tophaceous; 36 were considered to have radiographic findings diagnostic of gouty arthritis by strict radiographic criteria. Up to 24% of the patients denied symptoms in joints with radiographic changes of gout; 42% with no evidence of tophi on clinical examination had radiographic changes characteristic of gout. Radiographic assessment can be extremely helpful in the management of gout by documenting the degree and extent of bony involvement, particularly in patients with limited symptoms or without clinical tophi.

  4. Post-streptococcal acute glomerulonephritis complicated by gouty arthritis: a case report.

    Science.gov (United States)

    Kuniyoshi, Yasutaka; Kamura, Azusa; Yasuda, Sumie; Tashiro, Makoto

    2015-06-17

    Gouty arthritis is uncommon in childhood and adolescence. On the other hand, there has been no report of cases with development of gouty arthritis with post-streptococcal acute glomerulonephritis (PSAGN) in pediatric patients. Here we report the case of a mildly obese 12-year-old boy with PSAGN complicated by gouty arthritis of the left first metatarsophalangeal joint. On follow-up, it was confirmed that as serum C3 level returned to normal, urinary excretion of uric acid increased and serum uric acid level decreased, thereby resolving the burning pain of the left big toe. In this case, not only did renal insufficiency associate with PSAGN but also mild obesity may have led to hyperuricemia and gouty arthritis. In conclusion, clinicians should be aware that PSAGN may be complicated by gouty arthritis in obese pediatric patients.

  5. Gadolinium-enhanced MRI features of acute gouty arthritis on top of chronic gouty involvement in different joints

    NARCIS (Netherlands)

    Emad, Yasser; Ragab, Yasser; El-Naggar, Ahmed; El-Shaarawy, Nashwa; Abd-Allah, Mayada A.; Gamal, Rania M.; Fathy, Ahmed; Hawass, Mona; Rasker, Hans

    2015-01-01

    The aims of the current study are to describe gadolinium-enhanced MRI features of an acute flare of established gouty arthritis in different joints and to examine a possible association between serum uric acid and MRI signs indicative of ongoing inflammation and/or structural joint damage as well as

  6. Hypothermia induced by adenosine 5'-monophosphate attenuates early stage injury in an acute gouty arthritis rat model.

    Science.gov (United States)

    Miao, Zhimin; Guo, Weiting; Lu, Shulai; Lv, Wenshan; Li, Changgui; Wang, Yangang; Zhao, Shihua; Yan, Shengli; Tao, Zhenyin; Wang, Yunlong

    2013-08-01

    To investigate whether the hypothermia induced by Adenosine 5'-Monophosphate (5'-AMP) could attenuate early stage injury in a rat acute gouty arthritis model. Ankle joint injection with monosodium urate monohydrate crystals (MSU crystals) in hypothermia rat model which was induced by 5'-AMP and then observe whether hypothermia induced by 5'-AMP could be effectively inhibit the inflammation on acute gouty arthritis in rats. AMP-induced hypothermia has protective effects on our acute gouty arthritis, which was demonstrated by the following criteria: (1) a significant reduction in the ankle swelling (p gouty arthritis model.

  7. Appearance of acute gouty arthritis on indium-111-labeled leukocyte scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Palestro, C.J.; Vega, A.; Kim, C.K.; Swyer, A.J.; Goldsmith, S.J. (Mt. Sinai Medical Center, New York, NY (USA))

    1990-05-01

    Indium-111-labeled leukocyte scintigraphy was performed on a 66-yr-old male with polyarticular acute gouty arthritis. Images revealed intense labeled leukocyte accumulation in a pattern indistinguishable from septic arthritis, in both knees and ankles, and the metatarsophalangeal joint of both great toes, all of which were involved in the acute gouty attack. Joint aspirate as well as blood cultures were reported as no growth; the patient was treated with intravenous colchicine and ACTH for 10 days with dramatic improvement noted. Labeled leukocyte imaging, repeated 12 days after the initial study, revealed near total resolution of joint abnormalities, concordant with the patient's clinical improvement. This case demonstrates that while acute gouty arthritis is a potential pitfall in labeled leukocyte imaging, in the presence of known gout, it may provide a simple, objective, noninvasive method of evaluating patient response to therapy.

  8. A diagnostic rule for acute gouty arthritis in primary care without joint fluid analysis.

    NARCIS (Netherlands)

    Janssens, H.J.E.M.; Fransen, J.; Lisdonk, E.H. van de; Riel, P.L.C.M. van; Weel, C. van; Janssen, M.

    2010-01-01

    BACKGROUND: Most cases of acute gouty arthritis are diagnosed in primary care and without joint fluid analysis in many instances. Our objectives were to estimate the validity of this diagnosis by family physicians and to develop a diagnostic rule. METHODS: Patients with monoarthritis recruited in an

  9. The application of dual-energy computed tomography in the diagnosis of acute gouty arthritis.

    Science.gov (United States)

    Wu, Huaxiang; Xue, Jing; Ye, Lu; Zhou, Qijing; Shi, Dan; Xu, Rongzhen

    2014-07-01

    The aim of the study was to investigate the sensitivity and specificity of dual-energy computed tomography in the diagnosis of acute gouty arthritis, and the related risk factors for urate crystal deposition. One hundred ninety-one patients (143 with acute gouty arthritis and 48 with other arthritic conditions) were studied. All patients had acute arthritic attack in the recent 15 days and underwent dual-energy computed tomography (DECT) scan with the affected joints. The urate volume was calculated by DECT and the basic information of these patients was recorded at the same time. Uric acid crystals were identified with DECT in 140 of 143 (97.9 %) gout patients and 6 of 48 (12.5 %) of nongout patients, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of DECT in the diagnosis of acute gouty arthritis were 97.9, 87.5, 95.9, and 93.3 %, respectively. The urate volumes were ranged from 0.57 to 54,543.27 mm(3) with a mean volume of 1,787.81 ± 7,181.54 mm(3). Interestingly, urate volume was correlated with the disease duration, serum uric acid levels, the presence of tophi, and bone erosion. Two-year follow-up data was available in one patient with recurrent gouty arthritis, whose urate volume was gradually reduced in size by DECT detection after urate-lowering therapies. DECT showed high sensitivity and specificity for the identification of urate crystals and diagnosis of acute gout. The risk factors for uric acid deposition include the disease duration, serum uric acid levels, the presence of tophi, and bone erosion. DECT has an important role in the differential diagnosis of arthritis, and also could be served as a follow-up tool.

  10. Canakinumab: a guide to its use in acute gouty arthritis flares.

    Science.gov (United States)

    Lyseng-Williamson, Katherine A

    2013-08-01

    Canakinumab (Ilaris®), an anti-interleukin-1β monoclonal antibody, is a novel approach to treat acute gouty arthritis flares in a targeted population of patients in whom treatment options are limited. Relative to on-demand treatment with intramuscular triamcinolone acetonide 40 mg, on-demand treatment with subcutaneous canakinumab 150 mg significantly relieved the pain and inflammation of a new gout flare, and reduced the risk of new flares in patients with acute gouty arthritis flares in whom standard treatment with non-steroidal anti-inflammatories and/or colchicine was inappropriate. Canakinumab has an acceptable tolerability profile in this difficult-to-treat population. The increased risk of infections and neutropenia associated with canakinumab treatment can be minimized by following the recommended precautions.

  11. Acute gouty arthritis as a manifestation of immune reconstitution inflammatory syndrome after initiation of antiretroviral therapy

    Directory of Open Access Journals (Sweden)

    Walter de Araujo Eyer-Silva

    2012-08-01

    Full Text Available Immune reconstitution inflammatory syndrome (IRIS in HIV-infected subjects initiating antiretroviral therapy most commonly involves new or worsening manifestations of previously subclinical or overt infectious diseases. Reports of non-infectious IRIS are much less common but represent important diagnostic and treatment challenges. We report on a 34-year-old HIV-infected male patient with no history of gout who developed acute gouty arthritis in a single joint one month after initiating highly active antiretroviral therapy.

  12. Effect of sodium alginate addition to resveratrol on acute gouty arthritis.

    Science.gov (United States)

    Wang, Peng; Ren, Dunlin; Chen, Ying; Jiang, Meiju; Wang, Robin; Wang, Yan-Gang

    2015-01-01

    Resveratrol has been shown to exert anti-inflammatory and antioxidant effects, while sodium alginate is a common pharmaceutic adjuvant with antioxidative and immunomodulatory properties. We performed an animal study to investigate the effect of sodium alginate addition to resveratrol on acute gouty arthritis. Twenty-four SPF Wistar mice were randomized to four groups receiving the combination of sodium alginate and resveratrol, resveratrol alone, colchicine, and placebo, respectively. Acute gouty arthritis was induced by injection of 0.05 ml monosodium urate (MSU) solution (25g/mL) into ankle joint cavity. IL-1β, CCR5, and CXCL10 levels in both serum and synovial fluid were measured using ELISA. NLRP3 expression in the synovial tissues was measured using western plot. The combination of sodium alginate and resveratrol significantly reduced synovial levels of IL-1β, CCR5, and CXCL10 when compared with colchicines, and all P values were less than 0.0001. The combination of sodium alginate and resveratrol was also superior to resveratrol in terms of both serum levels and synovial levels of IL-1β, CCR5, and CXCL10. In addition, resveratrol, with or without sodium alginate, could reduce NLRP3 expression obviously in the synovial tissues. The combination of sodium alginate and resveratrol has better effect over colchicines in treating MSU-induced acute gouty arthritis.

  13. Effect of Sodium Alginate Addition to Resveratrol on Acute Gouty Arthritis

    Directory of Open Access Journals (Sweden)

    Peng Wang

    2015-04-01

    Full Text Available Objective: Resveratrol has been shown to exert anti-inflammatory and antioxidant effects, while sodium alginate is a common pharmaceutic adjuvant with antioxidative and immunomodulatory properties. We performed an animal study to investigate the effect of sodium alginate addition to resveratrol on acute gouty arthritis. Methods: Twenty-four SPF Wistar mice were randomized to four groups receiving the combination of sodium alginate and resveratrol, resveratrol alone, colchicine, and placebo, respectively. Acute gouty arthritis was induced by injection of 0.05 ml monosodium urate (MSU solution (25g/mL into ankle joint cavity. IL-1β, CCR5, and CXCL10 levels in both serum and synovial fluid were measured using ELISA. NLRP3 expression in the synovial tissues was measured using western plot. Results: The combination of sodium alginate and resveratrol significantly reduced synovial levels of IL-1β, CCR5, and CXCL10 when compared with colchicines, and all P values were less than 0.0001. The combination of sodium alginate and resveratrol was also superior to resveratrol in terms of both serum levels and synovial levels of IL-1β, CCR5, and CXCL10. In addition, resveratrol, with or without sodium alginate, could reduce NLRP3 expression obviously in the synovial tissues. Conclusion: The combination of sodium alginate and resveratrol has better effect over colchicines in treating MSU-induced acute gouty arthritis.

  14. Mechanistic aspects of inflammation and clinical management of inflammation in acute gouty arthritis.

    Science.gov (United States)

    Cronstein, Bruce N; Sunkureddi, Prashanth

    2013-01-01

    It has been recently demonstrated that interleukin 1β (IL-1β) plays a central role in monosodium urate crystal-induced inflammation and that the NALP3 inflammasome plays a major role in IL-1β production. These discoveries have offered new insights into the pathogenesis of acute gouty arthritis. In this review, we discuss the molecular mechanisms by which monosodium urate crystals induce acute inflammation and examine the mechanisms of action (MOAs) of traditional anti-inflammatory drugs (e.g., nonsteroidal anti-inflammatory drugs, colchicine, and glucocorticoids) and biologic agents (e.g., the IL-1β antagonists anakinra, rilonacept, and canakinumab) to understand how their MOAs contribute to their safety profiles. Traditional anti-inflammatory agents may act on the IL-1β pathway at some level; however, their MOAs are broad-ranging, unspecific, and biologically complex. This lack of specificity may explain the range of systemic adverse effects associated with them. The therapeutic margins of nonsteroidal anti-inflammatory drugs, colchicine, and glucocorticoids are particularly low in elderly patients and in patients with cardiovascular, metabolic, or renal comorbidities that are frequently associated with gouty arthritis. In contrast, the IL-1β antagonists act on very specific targets of inflammation, which may decrease the potential for systemic adverse effects, although infrequent but serious adverse events (including infection and administration reactions) have been reported. Because these IL-1β antagonists target an early event immediately downstream from NALP3 inflammasome activation, they may provide effective alternatives to traditional agents with minimal systemic adverse effects. Results of ongoing trials of IL-1β antagonists will likely provide clarification of their potential role in the management of acute gouty arthritis.

  15. Therapeutic efficacy of small doses of colchicine combined with glucocorticoid for acute gouty arthritis

    Directory of Open Access Journals (Sweden)

    Ying LIU

    2015-10-01

    Full Text Available Objective To observe the clinical effect of small dose of colchicine combined with glucocorticoid for acute gouty arthritis. Methods Ninety-two patients with acute gouty arthritis were equally and randomly divided into small doses of colchicine combined with dexamethasone treatment group (treatment group and conventional large dose colchicine treatment group (control group between January 2009 and December 2013. The articular lesion scoring and clinical efficacy evaluation were performed at 3, 6, 12, 24, 48, and 72h after treatment. Erythrocyte sedimentation rate (ESR, white blood cells, hepatorenal function and glomerular filtration rate (GFR were determined before and 72h after treatment respectively. The gastrointestinal adverse events and recurrence rate were observed within one month after treatment. Results The articular lesion scores were significantly decreased at 6, 12, 48, and 72h after treatment in treatment group compared with control group (P0.05. Serum uric acid, glutamic-pyruvic transaminase in serum (SGPT, and GFR did not show any change before and 72h after the treatment, and there was also no significant difference between groups (P>0.05. The incidence of gastrointestinal adverse events were obviously higher in control group (76.1% compared with that of the treatment group (P<0.05, and the differences was statistically significant. There was no statistical difference in recurrence rate between the control group and treatment group after a follow-up of one month. Conclusions Compared with conventional large dose colchicine, small dose of colchicine combined with dexamethasone can more rapidly and effectively control acute gouty arthritis, with good tolerability and safety, thus being worthy of popularization clinically. DOI: 10.11855/j.issn.0577-7402.2015.08.10

  16. Application of a Novel Diagnostic Rule in the Differential Diagnosis between Acute Gouty Arthritis and Septic Arthritis.

    Science.gov (United States)

    Lee, Kwang-Hoon; Choi, Sang-Tae; Lee, Soo-Kyung; Lee, Joo-Hyun; Yoon, Bo-Young

    2015-06-01

    Septic arthritis and gout are major diseases that should be suspected in patients with acute monoarthritis. These two diseases are clinically similar and often indistinguishable without the help of synovial fluid analysis. Recently, a novel diagnostic rule for gout without synovial fluid analysis was developed and showed relevant performances. This study aimed to determine whether this diagnostic rule could perform well in distinguishing gout from septic arthritis. The diagnostic rule comprises 7 clinical and laboratory variables, each of which is given a specified score. The probability of gout is classified into 3 groups according to the sum of the scores: high (≥ 8), intermediate (> 4 to arthritis (n = 54) based on synovial fluid analysis. The mean sum of scores of acute gout patients was significantly higher than that of those with septic arthritis (8.6 ± 0.2 vs. 3.6 ± 0.32, P arthritis (Eta[η]: 0.776). The prevalence of acute gouty arthritis, as confirmed by the presence of monosodium crystal, was 95.5% (61/64), 57.5% (19/33), and 5.1% (2/39) in high, intermediate and low probability group, respectively. The recently introduced diagnostic rule properly discriminates acute gout from septic arthritis. It may help physicians diagnose gout in cases difficult to be differentiated from septic arthritis.

  17. Colchicine-responsive protracted gouty arthritis with systemic inflammatory reactions.

    Science.gov (United States)

    Nonaka, Fumiaki; Migita, Kiyoshi; Haramura, Tomoko; Sumiyoshi, Remi; Kawakami, Atsushi; Eguchi, Katsumi

    2014-05-01

    Acute gouty arthritis is a severe but self-limiting arthritis caused by inflammatory responses to urate crystals. Oral colchicines are effective for initial stages or prophylaxis, but generally, colchicines are ineffective for established gouty arthritis. We describe an unusual case of gouty arthritis with systemic inflammatory reactions, including high fever and polymyalgia. Refractory polyarthritis and high fever were eradicated by colchicine treatment. Genetic analysis revealed a heterozygous mutation in exon 2 of the MEFV gene (E148Q). This case underscores the possibility that MEFV gene mutations may modify the phenotype of gouty arthritis.

  18. Acute gouty arthritis and rapidly progressive renal failure as manifestation of multiple myeloma: clinical case description

    Directory of Open Access Journals (Sweden)

    O.V. Gudym

    2017-09-01

    Full Text Available The article describes a clinical case of multiple myeloma in 78-year-old man, its clinical onset was as an acute attack of gout. The patient was admitted to hospital due to the development of the first acute attack of gout. The attack was characterized by polyarthricular joint lesion of the upper and lower extremities, pronounced inflammatory reaction, insufficient response to the use of non-steroidal anti-inflammatory drugs, and a high level of hyperuricemia. The serum uric acid concentration ranged from 636 to 712 μmol/l. The study of the synovial fluid of the inflamed knee joint made it possible to reveal uric acid crystals and to confirm the diagnosis of acute gouty arthritis. Simultaneously, the patient had significant renal impairment: creatinine was 574 μmol/l, urea — 39.9 mmol/l, glomerular filtration rate according to CKD-EPI — 8 ml/min. The daily proteinuria was 1.8 g. A retrospective assessment of laboratory parameters allowed to reveal completely normal indicators of renal function 6 months ago. Considering the development of acute gouty arthritis, its polyarticular nature, persistent course, rapid involvement of new joints, high uric acid levels during an acute attack exceeding 600 μmol/l (10 mg/dL, rapid development of renal failure within 6 months until the terminal stage, it was suggested the secondary nature of gout on the background of kidney damage by another pathological process. Further clinical, laboratory and instrumental studies allowed verifying multiple myeloma with renal damage. Bence Jones protein in the urine was not detected, there was also no evidence of hyperproteinemia. However, pain in the spine, ribs and chest was the basis for carrying out an X-ray study of the bones of the skeleton. Changes in the skeleton typical for multiple myeloma have been identified. Myelogram showed a high content of plasma cells (21.1 %, electrophoresis of blood proteins showed a high M-gradient (30.42 %, and a cytochemical

  19. Factors modulating the inflammatory response in acute gouty arthritis

    NARCIS (Netherlands)

    Cleophas, M.C.P.; Crisan, T.O.; Joosten, L.A.B.

    2017-01-01

    PURPOSE OF REVIEW: Gout is a common debilitating form of arthritis and despite our extensive knowledge on the pathogenesis its prevalence is still rising quickly. In the current review, we provide a concise overview of recent discoveries in factors tuning the inflammatory response to soluble uric

  20. An improved acute gouty arthritis rat model and therapeutic effect of rhizoma Dioscoreae nipponicae on acute gouty arthritis based on the protein-chip methods.

    Science.gov (United States)

    Yao, Li; Dong, Wanru; Lu, Fang; Liu, Shumin

    2012-01-01

    Rhizoma Dioscoreae nipponicae (RDN) is an herbal medicine. In the theories of Traditional Chinese Medicine (TCM), the function of RDN is to expel wind and remove dampness. Inflammatory mechanisms play an important role in the pathological process and prognosis of acute gouty arthritis (AGA). The aim of this study was to determine the specially expressed proteins through testing the proteins of the synovium in rats with AGA. The animal model of AGA was set up by Monosodium urate crystal (MSU) combined with hypoxanthine (HX), which was ameliorated in our previous experiment. Blood samples for measurement of serum uric acid were collected prior to sacrifice. Outcomes were assessed (two days after injection) by histological stain and protein quantitation. Three chips of RayBio® Human Label-based Antibody Array I were applied to detect 90 proteins in the synovium tissue of AGA rats. 14 differently expressed proteins were found in the synovium of AGA rats, and nine of them were first found in this model. There were seven up-regulated and seven down-regulated proteins, both TRAIL and Neuropilin-2 could be identified as key contributors to the pathomechanism of AGA.

  1. Gadolinium-enhanced MRI features of acute gouty arthritis on top of chronic gouty involvement in different joints.

    Science.gov (United States)

    Emad, Yasser; Ragab, Yasser; El-Naggar, Ahmed; El-Shaarawy, Nashwa; Abd-Allah, Mayada A; Gamal, Rania M; Fathy, Ahmed; Hawass, Mona; Rasker, Johannes J

    2015-11-01

    The aims of the current study are to describe gadolinium-enhanced MRI features of an acute flare of established gouty arthritis in different joints and to examine a possible association between serum uric acid and MRI signs indicative of ongoing inflammation and/or structural joint damage as well as association with disease characteristics and laboratory findings. Twenty-seven male patients with established chronic gout agreed to participate, mean age 47.6 years, and mean disease duration in months 43.2 (±31.8). For all patients, detailed demographic, disease characteristics, and laboratory findings were obtained and correlated with MRI findings. In 27 patients with established gout, a total of 50 MRI studies were performed of the following joints: feet joints (n = 23), ankles (n = 18), knees (n = 5), and hand and wrist joints (n = 4). MRI revealed capsular thickening in 19 patients, bone marrow edema (BME) in 15, soft tissue edema (STE) in 20, joint effusion in 21, bone erosions in 17, cartilaginous erosions in 4, and tenosynovitis in 9 cases. In 17 cases, tophaceous lesions were found. Post contrast MRI showed synovial thickening in seven cases. Positive correlations were observed between serum uric acid levels and the following MRI findings: capsular thickening (r = 0.552, p = 0.003), BME (r = 0.668, p ≤ 0.0001), STE (r = 0.559, p = 0.002), and tenosynovitis (r = 0.513, p = 0.006). Using MRI in chronic gout, important features can be detected like BME, minute cartilaginous erosions, and hypertrophic synovial inflammation in post contrast MR images. Serum uric acid (SUA) was positively correlated with capsular thickening, BME, STE, and tenosynovitis.

  2. Effect of acupuncture on rats with acute gouty arthritis inflammation: a metabonomic method for profiling of both urine and plasma metabolic perturbation.

    Science.gov (United States)

    Wen, Si-Lan; Liu, Yu-Jie; Yin, Hai-Lin; Zhang, Liu; Xiao, Jin; Zhu, Hong-Yuan; Xue, Jin-Tao; Ye, Li-Ming

    2011-01-01

    Acute gouty arthritis is a common inflammation model with multiple pathogenic mechanisms seen in clinical practice, for which acupuncture may potentially be an alternative therapy. To investigate the effect of acupuncture on acute gouty arthritis and search for its mechanism, a metabonomic method was developed in this investigation. Acute gouty arthritis model rats were induced by monosodium urate (MSU) crystals. The urine and plasma samples were collected at several time points and the endogenous metabolites were analyzed by an ultra-performance liquid chromatography coupled with a mass spectrometry (UPLC-MS). Data were analyzed using principal components analysis (PCA) and partial least squares (PLS) analysis to compare metabolic profiles of MSU crystal-induced acute gouty arthritis rats with MSU crystal-induced acute gouty arthritis, treated with acupuncture rats. The results showed that acupuncture could restore the metabolite network that disturbed by MSU administration. Our study indicates that UPLC-MS-based metabonomics can be used as a potential tool for the investigation of biological effect of acupuncture on acute gouty arthritis.

  3. Protein adsorption to monosodium urate crystals: differential responses of human peripheral blood neutrophils. [Etiology of acute gouty arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Skosey, J.L.; Kozin, F.; Ginsberg, M.

    1976-01-01

    In order for acute gouty arthritis to occur, neutrophils must interact with monosodium urate (MSU) crystals. As a result of this interaction, enzymes, chemotactic factors, and other mediators of the inflammatory response are released from neutrophil lysosomes. It was observed that MSU crystals adsorb gamma globulin, albumin, and other proteins found in serum and joint fluid. Results are reported from a study designed to demonstrate the effects of coating of MSU crystals with proteins on the phlogistic responses of neutrophils to crystals.

  4. Clinical Observation on Treatment of Acute Gouty Arthritis with Acupuncture: A Report of 60 Cases

    Institute of Scientific and Technical Information of China (English)

    ZHANG Qin-chun; HUANG Qing-lin; LIANG Xue-fang; HAN chou-ping

    2004-01-01

    Bilateral Quchi (LI 11), Zusanli (ST 36), Shenshu (BL 23), Pangguangshu (BL 28),Yinlingquan (SP 9), Dazhui (GV 14) and Ashi points have been selected to treat 60 cases of acute gouty arthritis with the combination of moxa-stick moxibustion, and indomethacin and colchicines have been selected to treat another 60 cases as the control group. Two weeks after the treatment, the therapeutic effect of the two groups had significant difference with the effective rate of 93.3% in the former and 70.0% in the latter respectively (P<0.01).%针刺双侧曲池、足三里、肾俞、膀胱俞、阴陵泉,大椎和阿是穴,并用艾条熏灸疼痛部位,治疗60例痛风性关节炎患者,同时用消炎痛和秋水仙碱治疗60例为对照.治疗2个星期后,两组有效率分别为93.3%和70.0%,两组疗效差异有显著统计学意义(P<0.01).

  5. Comparative Study on Treatment of Acute Gouty Arthritis by Electroacupuncture with Different Frequency

    Institute of Scientific and Technical Information of China (English)

    ZOU Ran; ZHANG Hong-xing; ZHANG Tang-fa

    2006-01-01

    Objective: To study the therapeutic effect of treatment of acute gouty arthritis (AGA) respectively by electroacupuncture (EA) with different frequency and oral intake of Western medicine. Methods: Seventy-two patients of AGA were randomly assigned into three groups, 24 in each group. Group A was treated with EA 100 Hz; Group B with EA 2 Hz; and Group C with Western medicine. The analgesic effect,initiating time and sustaining time of analgesia were observed and the level of serum uric acid was measured before and after treatment. Results; The initiating time of analgesia was shorter while the sustaining time of analgesia was longer in Group A and B than those in Group C (all P<0.01 ). The efficacy of analgesia was higher in Group B than that in Group A , and a better effect was shown in Group B in reducing serum uric acid level than that in Group A (P<0.01), which was near that in Group C (P>0.05). Conclusion: EA is an effective treatment for AGA, and low frequency (2 Hz) EA showed a better efficacy.

  6. Gemcitabine-induced gouty arthritis attacks.

    Science.gov (United States)

    Bottiglieri, Sal; Tierson, Neil; Patel, Raina; Mo, Jae-Hyun; Mehdi, Syed

    2013-09-01

    In this case report, we review the experience of a patient who presented with early stage pancreatic cancer (Stage IIb) who underwent a Whipple procedure and adjuvant chemoradiation. The patient's past medical history included early stage colon cancer in remission, post-traumatic-stress-disorder, hypertension, hyperlipidemia, osteoarthritis, gout, and pre-diabetes. Chemotherapy initially consisted of weekly gemcitabine. The patient developed acute gouty attacks after his second dose of gemcitabine, which brought him to the emergency room for emergent treatment on several occasions. Gemcitabine was held and treatment began with fluorouracil and concurrent radiation. After completion of his chemoradiation with fluorouracil, he was again treated with weekly gemcitabine alone. As soon as the patient started gemcitabine chemotherapy the patient developed gouty arthritis again, requiring discontinuation of chemotherapy. The patient received no additional treatment until his recent recurrence 8 months later where gemcitabine chemotherapy was again introduced with prophylactic medications consisting of allopurinol 100 mg by mouth daily and colchicine 0.6 mg by mouth daily throughout gemcitabine chemotherapy, and no signs of gouty arthritis occurred. To our knowledge, this is the first case report describing gout attacks associated with gemcitabine therapy. There is limited data available describing the mechanism that gouty arthritis may be precipitated from gemcitabine chemotherapy. Further monitoring and management may be required in patients receiving gemcitabine chemotherapy with underlying gout.

  7. Current concepts in the treatment of gouty arthritis.

    Science.gov (United States)

    Fang, Zhen-hua; Waizy, Hazibullah

    2013-02-01

    Gouty arthritis is an extremely painful condition that causes functional impairment. Gouty arthritis has become increasingly complex because of multiple comorbidities, iatrogenic factors and hyperuricemia that is refractory to treatment. In this review, we present a general overview of gouty arthritis including its pathophysiology, clinical presentations, diagnosis, predisposing factors and prophylactic therapy for preventing gouty arthritis flares.

  8. Acute gouty arthritis complicated with acute ST elevation myocardial infarction is independently associated with short- and long-term adverse non-fatal cardiac events.

    Science.gov (United States)

    Liu, Kuan-Liang; Lee, Hsin-Fu; Chou, Shing-Hsien; Lin, Yen-Chen; Lin, Chia-Pin; Wang, Chun-Li; Chang, Chi-Jen; Hsu, Lung-An

    2014-01-01

    Large epidemiologic studies have associated gouty arthritis with the risk of coronary heart disease. However, there has been a lack of information regarding the outcomes for patients who have gout attacks during hospitalization for acute myocardial infarction. We reviewed the data of 444 consecutive patients who were admitted to our hospital between 2005 and 2008 due to acute ST elevation myocardial infarction (STEMI). The clinical outcomes were compared between patients with gout attack and those without. Of the 444, 48 patients with acute STEMI developed acute gouty arthritis during hospitalization. The multivariate analysis identified prior history of gout and estimated glomerular filtration rate as independent risk factors of gout attack for patients with acute STEMI (odds ratio (OR) 21.02, 95 % CI 2.96-149.26, p = 0.002; OR 0.92, 95 % CI 0.86-0.99, p = 0.035, respectively). The in-hospital mortality and duration of hospital stay did not differ significantly between the gouty group and the non-gouty group (controls). During a mean follow-up of 49 ± 28 months, all-cause mortality and stroke were similar for both groups. Multivariate Cox regression showed that gout attack was independently associated with short- and long-term adverse non-fatal cardiac events (hazard ratio (HR) 1.88, 95 % CI 1.09-3.24, p = 0.024; HR 1.82, 95 % CI 1.09-3.03, p = 0.022, respectively). Gout attack among patients hospitalized due to acute STEMI was independently associated with short-term and long-term rates of adverse non-fatal cardiac events.

  9. Attenuation of gouty arthritis by emodinol in monosodium urate crystal-treated mice.

    Science.gov (United States)

    Chen, Lvyi; Lan, Zhou; Ma, Shuwei; Zhao, Ling; Yang, Xinzhou

    2013-05-01

    A series of studies have recently demonstrated that the release of interleukin 1β induced by monosodium urate crystals is central to the experimental gouty arthritis. Elaeagnus pungens has been traditionally used for the treatment of gouty arthritis in China for more than thousands years. However, there is still little known about the active ingredients and mechanisms of E. pungens against gouty arthritis. Emodinol, as a major triterpene compound in E. pungens, has been seldom reported to have an effect on gouty arthritis. Therefore, the potential beneficial effects and mechanisms of emodinol on gouty arthritis were investigated in this study. Results showed that it significantly ameliorated the hyperalgesia, inflammation, and levels of multiple proinflammatory cytokines in monosodium urate crystals-treated mice. These findings elucidate that emodinol exhibits a prominent effect on improving symptoms of acute gouty arthritis induced by monosodium urate crystals through inhibiting the generation of proinflammatory cytokines.

  10. Etoricoxib versus indometacin in the treatment of Chinese patients with acute gouty arthritis: a randomized double-blind trial

    Institute of Scientific and Technical Information of China (English)

    LI Ting; CHEN Shun-le; DAI Qing; HAN Xing-hai; LI Zhan-guo; WU Dong-hai; ZHANG Xiao

    2013-01-01

    Background Acute gout is an intensely painful,inflammatory arthritis.Although the non-steroidal anti-inflammatory drugs (NSAIDs) are widely used for this condition,the efficacy is based on only a few studies,particularly in China.We tried to assess the safety and efficacy of etoricoxib in the treatment of acute gouty arthritis in China.Methods A randomized,double-blind,active comparator study was conducted at 10 sites in China.Patients (n=178; ≥18 years of age) with acute gouty attack (<48 hours) were treated for 5 days with etoricoxib (120 mg/d; n=89) or indometacin (75 mg twice daily; n=89).The primary efficacy end point was self-assessed pain in the affected joint (0-4 point Likert scale) from days 2-5.Secondary end points included investigator assessments of tenderness and swelling,patient/ investigator global assessments of response to therapy,and patients discontinuing treatment.Safety was assessed by adverse events (AEs).Results Etoricoxib and indometacin had comparable primary and secondary end points.Mean change difference from baseline from days 2-5 was 0.03 (95% confidence interval (Cl)-0.19 to 0.25; P=0.6364),which fell within the prespecified comparative bounds of-0.5 to 0.5.No severe AEs were associated with etoricoxib use.Non-severe AEs were mainly digestive and general,and most (73.7%) were mild,although they caused withdrawal of two subjects in the etoricoxib group,due to bilateral renal calculi and uronephrosis of the left kidney (unrelated to etoricoxib) and fever and chills (potentially etoricoxib-related).Overall,AEs were similar,although the absolute number of AEs in the etoricoxib group (n=31) was less than the indometacin group (n=34).Conclusions Etoricoxib (120 mg once daily) is effective in treating acute gout,is generally safe and well-tolerated,and is comparable in efficacy to indometacin (75 mg twice daily).

  11. Management of gouty arthritis in patients with chronic kidney disease.

    Science.gov (United States)

    Abdellatif, Abdul A; Elkhalili, Naser

    2014-01-01

    Chronic kidney disease (CKD) is a comorbid condition that affects, based on recent estimates, between 47% and 54% of patients with gouty arthritis. However, data from randomized controlled trials in patients with gouty arthritis and CKD are limited, and current gouty arthritis treatment guidelines do not address the challenges associated with managing this patient population. Nonsteroidal anti-inflammatory drugs and colchicine are recommended first-line treatments for acute gouty arthritis attacks. However, in patients with CKD, nonsteroidal anti-inflammatory drugs are not recommended because their use can exacerbate or cause acute kidney injury. Also, colchicine toxicity is increased in patients with CKD, and dosage reduction is required based on level of kidney function. Allopurinol, febuxostat, and pegloticase are all effective treatments for controlling elevated uric acid levels after the treatment of an acute attack. However, in patients with CKD, required allopurinol dosage reductions may limit efficacy; pegloticase requires further investigation in this population, and febuxostat has not been studied in patients with creatinine clearancegouty arthritis including urate-lowering therapy in patients with CKD. Challenges specific to primary care providers are addressed, including guidance to help them decide when to collaborate with, or refer patients to, rheumatology and nephrology specialists based on the severity of gout and CKD.

  12. Coexistence of Sarcoidosis and Gouty Arthritis.

    Science.gov (United States)

    Semiz, Hüseyin; Kobak, Senol

    2017-08-21

    Sarcoidosis is an inflammatory disease with unknown cause characterized by non-caseating granuloma formations. It may present with bilateral hilar lymphadenopathy, skin lesions, the involvement of eye and symptoms on the locomotor system. Gouty arthritis is an autoinflammatory disease characterized by hyperuricemia, recurrent arthritis attacks and the deposition of monosodium urate crystals in the joints and the surrounding tissues. We reported the coexistence of sarcoidosis and gouty arthritis in this paper. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  13. The Unique Macroscopic Appearance of Gouty Arthritis of the Knee.

    Science.gov (United States)

    Mittl, Gregory S; Zuckerman, Joseph D

    2015-07-01

    Patients with significant gouty arthritis can develop disabling joint pain secondary to monosodium urate (MSU) articular deposition. We report a case of white, chalky MSU crystal deposition covering the articular surfaces of the knee as discovered by total knee arthroplasty. A 65-year-old male with a history of gout presented with bilateral knee pain. His radiographic imaging was negative for gouty tophi, and he elected to undergo left total knee arthroplasty. Intraoperatively a distinct chalky, white paste consistent with MSU deposition was observed covering the articular surfaces of the knee consistent with the diagnosis of gouty arthritis. Gout is the most common inflammatory arthritis affecting more than 3 million people in the USA. The inflammation results from the phagocytosis of monosodium urate crystals (MSU) and the release of inflammatory cytokines within the joint. Gout progresses from acute to chronic over many years and frequently causes chronic arthropathy. When significant knee pain and disability is associated with gouty arthropathy, total knee arthroplasty is certainly an option. The pathological appearance of gouty joints is characteristic. Macroscopic examination of joints affected by gout reveals a nodular, white, chalky appearance. Polarized microscopy of gout demonstrates negative birefringent needle-shaped MSU crystals. In this case report, we describe the characteristic chalky, white MSU deposit that covers the articular surfaces of a knee joint in a patient with a history of gout undergoing total knee arthroplasty. The investigators have obtained the patient's informed written consent for print and electronic publication of the case report.

  14. The effect of resveratrol on the recurrent attacks of gouty arthritis.

    Science.gov (United States)

    Chen, Haiyan; Zheng, Shucong; Wang, Yuankai; Zhu, Huiqing; Liu, Qiong; Xue, Yu; Qiu, Jianhua; Zou, Hejian; Zhu, Xiaoxia

    2016-05-01

    Gouty arthritis is characterized by inflammation induced by monosodium urate (MSU) crystal deposition, which is resulted by an increase of serum urate concentration. The management of gout, especially the recurrent acute attacks of chronic gouty arthritis, is still a problem to be resolved. In this study, we aimed to develop the preventive and therapeutic effect of resveratrol on gouty arthritis. MSU was used to induce gouty arthritis in the foot pad of C57BL/6 mice. Yeast polysaccharide and potassium oxonate were used to induce hyperuricemia in Kunming mice. Resveratrol was intraperitoneal injected to the mice in the treatment group. The pad inflammation and the level of serum uric acid were investigated to estimate the effect of resveratrol in gouty arthritis. Hyperuricemia was significantly detected in the mice treated with yeast polysaccharide and potassium oxonate, and gouty arthritis was successfully induced with MSU in mice. We further identified that resveratrol inhibited pad swelling and pad 99mTc uptake in gouty mice. Moreover, serum uric acid level was also decreased by resveratrol in hyperuricemia mice. This study highlighted that resveratrol might be applied to prevent the recurrent acute attack of gouty arthritis because of its inhibition of articular inflammation and down-regulation of serum uric acid.

  15. Gouty arthritis: understanding the disease state and management options in primary care.

    Science.gov (United States)

    Sunkureddi, Prashanth

    2011-09-01

    Acute gouty arthritis is an inflammatory response triggered by the release of monosodium urate crystal deposits into the joint space. The disease is associated with debilitating clinical symptoms and functional impairments as well as adverse economic and quality-of-life burdens. Because gouty arthritis is typically diagnosed and managed in the primary care setting, clinicians require a thorough knowledge of the presenting clinical features, risk factors, differential diagnoses, and treatment options for appropriate management. Although generally effective, the use of currently available therapies to control gouty arthritis is challenging because many medications used to treat comorbidities can exacerbate gouty arthritis and because current agents are associated with a number of adverse events, contraindications, or both. Based on an understanding of the underlying inflammatory pathogenesis of gouty arthritis, several new agents are being developed that may provide improved efficacy.

  16. Treatment of acute gouty arthritis with medicine and closure%药物结合封闭治疗痛风性关节炎

    Institute of Scientific and Technical Information of China (English)

    贾考田; 贾占田; 贾佳

    2013-01-01

      Objective To explore the treatment of acute gouty arthritis.Methods 157 patients with acute gouty arthritis,were randomly divided into two groups.Curative groups:including 78 patients,were treated with closure and medicine treatment. Control groups including 79 patients,were treated with medicine. Results The difference between both groups is significant. A shorter duration of therapy,a good outcome,are obtained by the curative groups. Conclusion The treatment with closure and medicine are adopted to cure acute gouty arthritis,can we achieve an ideal goal,fewer side effects,the curative effect is satisfied.%  目的探讨急性痛风性关节炎的治疗方法。方法将157例急性痛风性关节炎患者随机分为2组,治疗组78例采用封闭加药物治疗,对照组79例采用单纯药物治疗。观察2组疗效及治愈所需疗程。结果与对照组相比治疗组治疗时间短,疗效显著。结论急性痛风性关节炎采用封闭加口服药物治疗疗效好,见效快,副作用小,值得推广。

  17. Effects of Rebixiao Granules(热痹消颗粒剂) on Blood Uric Acid in Patients with Repeatedly Attacking Acute Gouty Arthritis

    Institute of Scientific and Technical Information of China (English)

    JI Wei; ZHU Xuan-xuan; TAN Wen-feng; LU Yan

    2005-01-01

    Objective:To observe the clinical effect of Rebixiao granule (热痹消颗粒剂, RBXG) in treating repeatedly attacking acute gouty arthritis and through experimental study on blood uric acid to explore RBXG's therapeutic mechanism. Methods: Ninety repeatedly attacking acute gouty arthritis patients were divided into the treated group (n= 60) and control group (n = 30). The treated group was treated with RBXG, and the control group was treated with Futalin tablets (diclofenac sodium). The baseline treatment including good rest, Iow purine diet, sufficient water drinking and urine alkalization, etc. was then given to both groups. Hypoxanthine 600 mg/kg and niacin 100 mg/kg was applied to hyperuricemic mice by gastrogavage to establish the animal models. Results: The clinical effective rate of the treated group was 95.0% and that of the control 90.0 %. Good therapeutic effects were won, insignificant difference (P>0.05)was shown between the two groups. However, the cure rate of the treated group was 26.7% while that of the control group was 10.0%, with significant difference (P<0.01) shown between them. The treated group had its blood uric acid lowered, which was significantly different (P<0.05) from that of the control group. The animal experiment indicated that all the three groups treated with different dosages of RBXG, as well as the Ash bark and Smilax glabra rhizome groups had their blood uric acid content reduced in the hyperuricemic mice. Conclusion: RBXG has a quicker initiation and better treatment effects than sole anti-inflammatory and analgesic agents on the treatment of repeatedly attacking acute gouty arthritis, showing no obvious toxic or adverse reactions and therefore good for long-term administration and likely to be a safe TCM preparation to control the symptoms and reduce the onsets of repeatedly attacking of acute gouty arthritis. The animal experiment shows that both the compound preparation and part of the single ingredients in the

  18. Gouty arthritis in the human aging process

    Directory of Open Access Journals (Sweden)

    Juliana Secchi Batista

    2012-09-01

    Full Text Available The aging process has gained universal recognition and is occurring at an accelerated pace. Gout is a metabolic disorder in which an overproduction and / or decreased excretion of uric acid, leading to the deposition of crystals of sodium monourato joints and soft tissue. The present study was based on a literature review that aimed to analyze the incidence of gouty arthritis in the human aging process. To this end, we searched for articles indexed journals, books, among others, published in English and Portuguese, using the keywords "Human Aging", "Rheumatic Diseases", "Drop" and "Gouty Arthritis". The data obtained suggest that the prevalence of gout is higher in men, affecting oligo / polyarticular inflammatory symptoms with smaller and often with involvement of small joints of the hands also may be the coexistence of gout with other autoimmune diseases such as ankylosing spondylitis and rheumatoid arthritis, should be performed nutritional treatment and medication.

  19. Different duration of Colchicine for preventing recurrence of Gouty arthritis

    Directory of Open Access Journals (Sweden)

    H Karimzadeh

    2006-05-01

    Full Text Available Background: Gout is a Common recurrent clinical syndrome characterized by increased serum uric acid and recurrent attacks of acute arthritis. Colchicine is used for Prophylaxis against recurrence of arthritis, but the duration of its administration has mentioned variable. In this study, optimal duration of prophylactic colchicine for prevention of gouty arthritis was assessed. Methods : In a clinical trial 190 patients with gouty arthritis divided randomly to group 1,2and 3 and received colchicine for 3 to 6, 7 to 9 and 10 to 12 months then colchicine discontinued and the patients followed one year for recurrence of arthritis. Result assessed by survival analysis with Kaplan –Meier method. Results: The probability of recurrence of arthritis (in order of duration of colchicine prophylaxis was 54%, 27.5% and 23%, respectively. The difference between group one and others was statistically significant, but between group 2 and 3 was not statistically significant. Conclusion: The most suitable duration of colchicine prophylaxis that accompanied with lower recurrence rate was 7-9 months, which seems more cost -effective than 10-12 months regimen. Key words: Gout, Colchicine, Arthritis, Recurrence

  20. The pathogenesis of bone erosions in gouty arthritis.

    Science.gov (United States)

    Schlesinger, Naomi; Thiele, Ralf G

    2010-11-01

    The characteristic radiographic hallmarks of chronic gouty arthritis are the presence of macroscopic tophi and erosions with overhanging edges and relative preservation of the joint space. In recent years there has been more insight into the processes underlying the development of bone erosions in gouty arthritis. This review discusses the mechanical, pathological, cellular and immunological factors that may have a role in the pathogenesis of bone erosions in gouty arthritis. It highlights the evidence suggesting that monosodium urate crystal deposition is associated with the presence of underlying osteoarthritis and the important role of osteoclasts and the receptor for activation of nuclear factor κ B (RANK) and RANK ligand (RANK-RANKL) pathway in the pathogenesis of gouty erosions. Gouty arthritis is primarily driven by interleukin 1β (IL-1β). IL-1β has been implicated in bone destruction and erosions in other inflammatory arthridities. Thus, future IL-1 inhibitors may prevent and treat erosion formation due to tophaceous gouty arthritis. This review discusses imaging modalities and highlights ultrasongraphic evidence suggesting a significant relationship between the presence of the gouty tophus and bone erosions as well as the frequent presence of persistent low-grade inflammation in asymptomatic chronic tophaceous gouty arthritis on high-resolution ultrasonography. It is the tophus eroding the underlying bone that is pivotal for the development of bone erosions in gouty arthritis.

  1. The Human and Economic Burden of Difficult-to-Treat Gouty Arthritis

    NARCIS (Netherlands)

    Oude Voshaar, Martijn A.H.; Bardin, Thomas; Laar, van de Martinus A.F.J.

    2015-01-01

    Gouty arthritis, one of the most painful and common forms of adult arthritis, is caused by monosodium urate crystal deposits in joints, most often in the lower extremities. Crystals trigger an inflammatory response leading to acute flares characterized by a rapid onset of pain, warmth, swelling, and

  2. Overview ofTCM External Treatment on Acute Gouty Arthritis%中医外治法治疗急性痛风性关节炎综述

    Institute of Scientific and Technical Information of China (English)

    田雪梅; 张丽君

    2011-01-01

    系统回顾并总结了近5年来有关中医外治法治疗急性痛风性关节炎的方法,并对其作用机理进行了初步探讨,以期为进一步进行科学的临床总结和机理探讨提供思路和途径.%Through systematic review and summarizing the external treatment method of traditional Chinese medicinal on acute gouty arthritis for the past five years, and to explore its mechanism of action,in order to provide ideas and approaches for further scientific clinical summary and mechanism study.

  3. 40 Cases of Acute Gouty Arthritis Treated by Warming Needle Moxibustion%温针灸治疗急性痛风性关节炎20例

    Institute of Scientific and Technical Information of China (English)

    宗静杰; 高宇; 王淑颖; 荷花女

    2011-01-01

    目的:观察温针灸治疗急性痛风性关节炎的临床疗效及对血尿酸的影响,寻求治疗急性痛风性关节炎的有效方法.方法:将40例急性痛风性关节炎患者随机分为温针灸组(治疗组)和西药组(对照组),每组20例,分别采用温针灸及口服西药2种方法治疗,并于治疗前、后分别测定两组患者血尿酸的变化,然后进行两组临床疗效的对比研究.结果:两组疗效比较差异有显著性意义(P<0.01),治疗组、西药组的有效率分别为95.0%、75.0%;治疗组能显著降低血尿酸值、症状积分指标(各项指标其自身前后对比及与西药组的组间比较有显著性差异,P<0.01).结论:温针灸是治疗急性痛风性关节炎的有效方法,且对血尿酸有调节作用.%Objective: To study the clinical curative effect on acute gouty arthritis and the influence of blood serum uric acid treated by warming needle moxibustion, to follow up the effective method of treating acute gouty arthritis. Methods: 40 cases of acute gouty arthritis patients were randomly divided into warming needle moxibustion group (treatment group) and western group (control group), and 20 cases in each group, acupuncture and oral medicine treatment of two methods by used respectively, and the changes of their blood uric acid levels before and after treatment were detected and their therapeutic effects were compared.Results: There was a significant difference between the two groups in clinical therapeutic effect (P<0. 01 ), and the effective rate was respectively 95.0%, 75.0% in the treatment group and oral medicine group. Uric acid of acupuncture group significantly decreased, symptom score index ( there is significantly difference not only in the patients of their own but also between the two groups, P<0.01 ). Conclusion: The warming needle moxibustion is effective on treating of acute gouty arthritis, and has regulatory effects on the blood uric acid.

  4. TCM Sequential Enema Treat Acute Gouty Arthritis%中药序贯灌肠治疗急性痛风性关节炎临床观察

    Institute of Scientific and Technical Information of China (English)

    李晓霞; 赵威

    2013-01-01

    [Objective] To observe the clinical effect of sequential enema treatment on acute gouty arthritis. [Method]60 patients were divided randomly in two groups named traditional Chinese medicine enema in the treatment of group sequential and the control group of Western Medicine. Observation of the two groups before and after treatment syndrome of traditional Chinese Medicine, the clinical curative effect is related to the changes of parameters. [Result] The treatment group in syndrome of traditional Chinese Medicine, the overall clinical efficacy, blood uric acid ( BUA ) ,erythrocyte sedimentation rate(ESR),Creaction protein(CRP),white blood cell(WBC),liver and kidney function are superior to that of control group. [Conclusion] Chinese medicine sequential enema in the treatment of acute gouty arthritis is an effective method in treating this disease.%[目的]观察序贯灌肠治疗急性痛风性关节炎的临床疗效.[方法]采用随机对照的方法,将60例患者分为中药序贯灌肠治疗组与西药对照组,观察两组治疗前后中医证候、临床疗效及各项相关指标的变化.[结果]治疗组在中医证候、临床总体疗效、血尿酸(Blood uric acid,BUA)、血沉(Erythrocyte sedimentation rate,ESR)、C反应蛋白(C reaction protein,CRP)、血白细胞(White blood cell,WBC)、肝肾功能等方面优于对照组.[结论]中药序贯灌肠治疗急性痛风性关节炎疗效满意,是治疗本病的有效方法之一.

  5. Effect of Shuijing Pill in External Application on Acute Gouty Arthritis%水晶丹外敷对痛风性关节炎急发的干预

    Institute of Scientific and Technical Information of China (English)

    黄琼芳

    2014-01-01

    Objective Crystal Dan topical ef icacy of acute gouty arthritis hair.Methods Crystal Dan topical to the af ected area. Results Crystal Dan patients after topical treatment significantly reduced the symptoms and shorten the course of treatment, and the ef ect is good.Conclusion Crystal Dan topical treatment of acute gouty arthritis is a worthy send drugs.%目的:观察水晶丹外敷对痛风性关节炎急发的疗效。方法将水晶丹外敷于患处。结果患者外敷水晶丹治疗后,症状明显减轻,缩短了疗程,且效果好。结论水晶丹外敷治疗痛风性关节炎急发是一种值得推广的药物。

  6. The Human and Economic Burden of Difficult-to-Treat Gouty Arthritis.

    Science.gov (United States)

    Bardin, Thomas; Voshaar, Martijn A H Oude; van de Laar, Martinus A F J

    2015-10-01

    Gouty arthritis, one of the most painful and common forms of adult arthritis, is caused by monosodium urate crystal deposits in joints, most often in the lower extremities. Crystals trigger an inflammatory response leading to acute flares characterized by a rapid onset of pain, warmth, swelling, and redness in involved joints. Over time, continued monosodium urate crystal deposits and inflammation can lead to chronic tophaceous gout that result in bone erosion, progressing to joint destruction and significant disability. The goal of therapy in an acute gout flare is prompt and safe termination of pain and inflammation. Acute gouty arthritis is usually treated with nonsteroidal anti-inflammatory drugs, colchicine, or corticosteroids. However, for a growing number of patients, current standard treatments are ineffective or are contraindicated, largely due to the presence of comorbidities. Gouty arthritis can have a major negative impact of health-related quality of life, especially in patients with difficult-to-treat disease, as revealed by recent studies comparing health-related quality of life with that of the general population. Additionally, gouty arthritis also constitutes an important economic burden through absence from work and medical costs. This burden is even greater in patients with difficult-to-treat disease.

  7. 痛风消停汤治疗急性痛风性关节炎60例%Sixty Cases of Acute Gouty Arthritis Treated with Tongfeng Xiaoting Decoction

    Institute of Scientific and Technical Information of China (English)

    王志虹; 邓福忠; 艾显江; 王忠志; 周天寒

    2016-01-01

    Objective:To observe the clinical curative effect of Tongfeng Xiaoting Decoction (TFXTD) on acute gouty arthritis.Methods:Sixty cases of gouty arthritis were treated with TFXTD,one dose each day and 7 days continuously.Results:Among the 60 cases,18 (accounting for 30%) were cured;39 (65%) were improved;3 (5%) was not cured;The effective rate was 95.0%.Conclusion:TFXTD has remarkable clinical curative effect on acute gouty arthritis.%目的:观察痛风消停汤治疗急性痛风性关节炎的临床疗效.方法:对60例痛风性关节炎患者进行痛风消停汤治疗,日1剂,连续治疗7d.结果:60例患者中治愈18例,占30%;好转39例,占65%;未愈3例,占5%,有效率为95.0%.结论:痛风消停汤治疗急性痛风性关节炎疗效显著.

  8. Difficult-to-treat gouty arthritis: a disease warranting better management.

    Science.gov (United States)

    Schlesinger, Naomi

    2011-07-30

    Gouty arthritis is the most common inflammatory arthritis in adults and is characterized by very painful flares. Gouty arthritis results from an elevated body uric acid pool, which leads to deposition of monosodium urate crystals, mainly in the joints. These crystals trigger the release of proinflammatory cytokines, in particular interleukin (IL)-1β, which stimulates inflammation. Gouty arthritis can progress to a chronic, deforming and physically disabling disease through the development of disfiguring tophi, joint destruction and persistent pain. Standard treatments are effective in most patients. Acutely, anti-inflammatory therapies provide rapid pain relief and resolution of flares. Chronically, urate-lowering therapies reduce serum urate levels and, in combination with anti-inflammatory prophylaxis, reduce the risk of flares. However, for a growing number of patients, current standard treatments are ineffective or are contraindicated, largely due to the presence of co-morbidities. Indeed, metabolic syndrome, hypertension, dyslipidaemia, cardiovascular disease, diabetes mellitus and renal impairment are all highly prevalent in individuals with gouty arthritis, and may lead to standard treatments being ineffective or inappropriate. Such patients with difficult-to-treat disease require alternative therapies. Gouty arthritis can have a major impact on health-related quality of life (HR-QOL), especially in patients with difficult-to-treat disease, as revealed by recent studies comparing HR-QOL for patients with gouty arthritis with that of the general population. All studies revealed clinically significant reductions in physical functioning for individuals with gouty arthritis compared with the general population. The difference was particularly marked for patients with difficult-to-treat disease. Gouty arthritis also constitutes an important economic burden through absence from work and medical costs. Again, the burden is greater in patients with difficult

  9. Randomized and Controlled Clinical Study of Modified Prescriptions of Simiao Pill(四妙丸) in the Treatment of Acute Gouty Arthritis

    Institute of Scientific and Technical Information of China (English)

    SHI Xin-de; LI Guo-chun; QIAN Zu-xi; JIN Ze-qiu; SONG Yan

    2008-01-01

    Objective: To investigate the compatibility of a modified prescription of Simiao Pill (四妙丸) in the treatment of acute gouty arthritis and to verify the clinical efficacy and safety of the drug through a clinical trial. Methods: A randomized and controlled clinical trial was designed based on clinical epidemiological principles, A total of 107 patients with acute gouty arthritis were enrolled and randomly assigned to four groups. The first group (Group Ⅰ) included 27 patients taking gout prescription Ⅰ ; the second group (Group Ⅱ) included 27 patients taking gout prescription Ⅱ ; the third group (Group Ⅲ) included 28 patients taking gout prescription Ⅲ; and the fourth group (control group) included 25 patients taking indomethacin and Benzobromarone as a control group. The duration of the treatment in all 4 groups was two weeks. After the treatment, the index of blood uric acid, blood leukocyte count, score of clinical symptoms, etc. were observed and measured. Results: The total clinical effective rate of the three different modified prescriptions of the Simiao Pill was above 96%,significantly superior to that of the control group (68%, P<0.05). In terms of the improvement of main symptoms, the scores of four symptoms in all TCM treatment and control groups decreased after treatment, with statistically significant differences (P<0.05). Moreover, the scores markedly fell more so in the three Chinese herb groups than in the control group, and especially in Group Ⅲ (P<0.05). There was a statistically significant difference in blood uric acid values before and after the treatment in the same group but no significant inter-group difference was seen. Conclusion: The modified prescriptions, based on the clinical research, clinical experience and traditional Chinese medicine theory, did show a better effect than Western medicine in this clinical study. Moreover, the prescriptions were precise, with the herbs inexpensive and readily available. The

  10. Trikatu, a herbal compound that suppresses monosodium urate crystal-induced inflammation in rats, an experimental model for acute gouty arthritis.

    Science.gov (United States)

    Murunikkara, Vachana; Rasool, Mahaboobkhan

    2014-01-01

    Gout is an inflammatory joint disorder characterized by hyperuricaemia and precipitation of monosodium urate crystals in the joints. In the present study, we aimed to investigate the anti-inflammatory effect of trikatu, a herbal compound in monosodium urate crystal-induced inflammation in rats, an experimental model for acute gouty arthritis. Paw volume and levels/activities of lysosomal enzymes, lipid peroxidation, anti-oxidant status and histopathological examination of ankle joints were determined in control and monosodium urate crystal-induced rats. In addition, analgesic (acetic acid-induced writhing response), anti-pyretic (yeast-induced pyrexia) and gastric ulceration effects were tested. The levels of lysosomal enzymes, lipid peroxidation and paw volume were significantly increased, and anti-oxidant status was found to be reduced in monosodium urate crystal-induced rats, whereas the biochemical changes were reverted to near normal levels upon trikatu (1000 mg/kg b.wt) administration. The trikatu has also been found to exhibit significant analgesic and anti-pyretic effects with the absence of gastric damage. In conclusion, the present results clearly indicated that trikatu exert a potent anti-inflammatory effect against monosodium urate crystal-induced inflammation in rats in association with analgesic and anti-pyretic effects in the absence of gastrointestinal damage.

  11. Acute gouty bursitis: report of 15 cases.

    Science.gov (United States)

    Canoso, J J; Yood, R A

    1979-01-01

    Fifteen cases of acute gouty bursitis were seen among 136 crystal-proved cases of gout. Bursal aspirate yielded yellow or pink fluid in 10, chalky white fluid in 1, and a small amount of bloody fluid in 4. Monosodium urate crystals were present in all. Bursal fluid leucocyte counts averaged 2.9 X 10(9)/1 compared with synovial fluid leucocyte counts that averaged 25.5 X 10(9)/1 in cases of articular gout (P less than 0.05). Gouty, septic, and idiopathic (traumatic) bursitis share clinical features, and detailed bursal fluid analysis is crucial for diagnosis. PMID:496446

  12. Electroacupuncture plus Blood -letting Puncture in the Treatment of Acute Gouty Arthritis%电针配合刺络放血治疗急性痛风性关节炎疗效观察

    Institute of Scientific and Technical Information of China (English)

    金泽; 张滨滨

    2012-01-01

    目的:观察电针配合刺络放血治疗急性痛风性关节炎的临床疗效.方法:将60例急性痛风性关节炎患者随机分为治疗组和西药组,各30例,治疗组采用电针配合刺络放血法,西药组口服秋水仙碱和消炎痛,观察比较两组临床疗效、即刻止痛效果、长期止痛效果.结果:两组临床疗效、即刻及长期止痛效果比较差异有统计学意义(P<0.01).结论:电针配合刺络放血治疗急性痛风性关节炎具有良好疗效.%Objective:To investigate the efficacy of electroacupuncture plus blood -letting puncture for treating acute gouty arthritis. Methods: Sixty patients with acute gouty arthritis were randomly allocated into treatment and control groups, 30 cases in each group. The treatment group received electroacupuncture plus blood - letting puncture and the control group received oralmedicine. The efficacy , immediate pain relief effect and long - term pain relief effect were compared. Results; There was a statistically significant difference between the two groups (P<0.01). Conclusion;The electroacupuncture plus blood -letting puncture is effective for treating acute gouty arthritis.

  13. Can ultrasonography make identification of asymptomatic hyperuricemic individuals at risk for developing gouty arthritis more crystal clear?

    Science.gov (United States)

    Schlesinger, Naomi

    2011-04-19

    Hyperuricemia is the most important risk factor for gouty arthritis. The quandary is how to predict which patient with asymptomatic hyperuricemia will develop gouty arthritis. Can ultrasonography help identify hyperuricemic individuals at risk for developing gouty arthritis? In the previous issue of Arthritis Research & Therapy, Pineda and colleagues found ultrasonography changes suggestive of gouty arthritis in 25% of hyperuricemic individuals. These were found exclusively in hyperuricemic individuals but not in normouricemic patients. Ultrasonography may serve as a noninvasive means to diagnose gouty arthritis in hyperuricemic individuals who have yet to develop symptomatic gouty arthritis.

  14. Subclinical atherosclerosis in gouty arthritis patients: a comparative study.

    Science.gov (United States)

    Çukurova, Selçuk; Pamuk, Ömer Nuri; Ünlü, Ercüment; Pamuk, Gülsüm Emel; Çakir, Necati

    2012-06-01

    We evaluated the incidence of subclinical atherosclerosis and associated factors in our gouty arthritis patients. We included 55 gouty arthritis patients diagnosed at our center within the last 4 years. The control group included 41 patients with rheumatoid arthritis (RA) and 34 patients with asymptomatic hyperuricemia (AHU). Atherosclerotic risk factors were determined in all subjects. Carotid intima-media thickness (IMT) and the presence of plaques were evaluated by B-mode ultrasonography. The carotid IMT in gouty arthritis patients (0.730 ± 0.19) was significantly higher than in AHU subjects (0.616 ± 0.12) (P = 0.004) and tended to be higher than the RA group (0.669 ± 0.17) (P = 0.1). Atheromatous plaques were significantly more frequent in gouty arthritis patients (16 cases, 29.1%) than in RA patients (5 cases, 12.2%) and AHU subjects (3 cases, 8.8%) (P values, 0.05 and 0.023). Gout patients with plaques were older (P = 0.006) and tended to have tophi more frequently (P = 0.06). Logistic regression analysis showed that age (OR: 1.3, 95% CI: 1.02-1.54) and the presence of tophi (OR: 12.5, 95% CI: 1.2-140) were independent risk factors for the presence of plaques. Gouty arthritis bears a higher risk of atherosclerosis than both RA and AHU.

  15. [The effects of electro-acupuncture on the signaling pathway of TLR/MYD88 in ankle joint synovial tissue of acute gouty arthritis rats].

    Science.gov (United States)

    Zhang, Chao-nan; Huang, Xue-kuan; Luo, Yan; Jiang, Juan; Wan, Lei; Wang, Ling

    2014-11-01

    To investigate the effects of electro-acupuncture ( EA) on the related protein expression of the signaling pathway of the toll-like receptor2 (TLR2)/myeloid differentiation factor (MYD) 88 in ankle joint synovial tissue of acute gouty arthritis (AGA) rats. Fifty male SD rats were randomly divided into 5 groups: normal group, SMD group, AGA model group, medication group and EA group, 10 rats in each group. SMD group established model by inducing SMD, other groups established AGA model by inducing monosodium urate, except the normal group. Two days before model was established, normal and SMD and AGA model groups were lavaged with normal saline (20 mL/kg), medication group was lavaged with colchicine solution (1 mg/kg), EA (1. 5-2 Hz, D.-D. wave, 9 V, 1-3 mA) was applied to"Sanyinjiao" (SP6),"Jiexi"(ST41) and "kunlun" (BL60) for 20 min, once daily, continuously for 9 days. Then the join sewlling index was observed periodically, the protein expression of TLR2 and MYD88 was determined by immunohistochemistry. Compared to the normal group, the join sewlling of the SMD group in test join increased significantly (P0.05), the oin sewlling and protein expression of TLR2 and MYD88 in synovial tissue of model group increased significantly P0.05). EA can alleviate the symptoms of AGA, which may be related to regulation of the protein expression Y TRI and MYD88 in the TLR/MYD88 signaling pathway.

  16. Gout lotion in treatment of acute gouty arthritis clinical observation%痛风洗剂治疗急性痛风性关节炎

    Institute of Scientific and Technical Information of China (English)

    姬艳波; 李聪; 廖立宏

    2016-01-01

    Objective To study the gout lotion the clinical curative effect of treatment of acute gouty arthritis. Methods From July 2013 to July 2015,98 cases of patients with acute gouty arthritis,and according to the age, course and severity of disease were randomly divided into three groups,namely the 33 cases of gout lotion 33 cases,hot water group and control group 32 cases. All patients in clinic that night taking relying on exam yesterday 60 mg,gout gout lotion for external use lotion group applications soak the affected 3 times/ day,30 minutes;Hot water group used hot water soak the affected 3 times/ day,30 minutes;The control group taking only relying on the test yesterday,and not for external use only. Results Soaking the affected area 1 time,gout lotion VAS score decreased from 7. 11 ± 1. 47 to 4. 18 ± 1. 14,hot water groups VAS score decreased from 6. 97 ± 1. 54 to 5. 71 ± 1. 55,control group VAS score decreased from 6. 95 ± 1. 55 to 6. 28 ± 1. 88,gout lotion and hot water group,the control group had significant difference,but the difference between hot water and control groups was not significant;topical soak the affected area after 6 times,namely 48 hours,VAS score there was no significant difference between groups. Conclusion Gout lotion can quickly relieve acute gouty arthritis pain,have the effect of rapid pain relief.%目的:探讨痛风洗剂治疗急性痛风性关节炎的临床疗效。方法选取我院2013年7月—2015年7月急性痛风性关节炎患者98例,并按年龄、病程及疾病严重程度随机分为3组,即痛风洗剂组33例、热水组33例及对照组32例。所有患者均于就诊当晚服用依托考昔60 mg,痛风洗剂组应用痛风洗剂外用浸泡患处,3次/ d,30 min /次;热水组应用热水浸泡患处,3次/ d,30 min /次;对照组仅服用依托考昔,而不外用。结果浸泡患处1次后,痛风洗剂组 VAS 分值由(7.11±1.47)下降至(4.18±1.14),热水组 VAS

  17. Can ultrasonography make identification of asymptomatic hyperuricemic individuals at risk for developing gouty arthritis more crystal clear?

    OpenAIRE

    Schlesinger, Naomi

    2011-01-01

    Hyperuricemia is the most important risk factor for gouty arthritis. The quandary is how to predict which patient with asymptomatic hyperuricemia will develop gouty arthritis. Can ultrasonography help identify hyperuricemic individuals at risk for developing gouty arthritis? In the previous issue of Arthritis Research & Therapy, Pineda and colleagues found ultrasonography changes suggestive of gouty arthritis in 25% of hyperuricemic individuals. These were found exclusively in hyperuricemic i...

  18. Treatment of gouty arthritis in different phases by a series of Tongfeng granule: an efficacy observation

    Institute of Scientific and Technical Information of China (English)

    周蜜

    2014-01-01

    Objective To evaluate the clinical efficacy of a series of Tongfeng Granule(TG)in treating gouty arthritis patients in different stages.Methods Ninety primary gout patients were randomly assigned to two groups,the TCM treatment group(60 cases)and the Western medicine control group(30 cases).Huzhang Tongfeng Granule in combination with external application of Jinhuang Ointment was given to those in the TCM treatment group in the acute phase,and Yinlian Tongfeng Granule in the

  19. PPAR-γ agonist pioglitazone affects rat gouty arthritis by regulating cytokines.

    Science.gov (United States)

    Wang, R-C; Jiang, D-M

    2014-08-28

    The objective was to study peroxisome proliferator-activated receptor gamma (PPARγ) agonist pioglitazone regulation effect and its mechanism of expression of cytokines on acute gouty arthritis synovial in rats. Rats with unilateral ankle were injected with artificial monosodium urate (MSU) crystals to make the acute gouty arthritis model. Taking the synovium 48 h after the injection of MSU and using RT-PCR, we assessed the effect of pioglitazone (20 mg·kg(-1)·day(-1), oral administration) on synovial expression, by detecting tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and interferon-γ (IFN-γ). The pioglitazone treatment group showed synovial expression of TNF-α, and IFN-γ was significantly lower than in the control group; the inhibition rates were 78.5 and 60.4%. The IL-1 expression difference was not statistically significant between the two groups. Pioglitazone has anti-inflammatory effects on acute gouty arthritis by inhibiting the expression of TNF-α and IFN-γ.

  20. The effect of montelukast in a model of gouty arthritis induced by sodium monourate crystals.

    Science.gov (United States)

    Ponce, Loida; Arjona, Marjorie; Blanco, Gustavo; Alvarez, Stuart; Arcila, Eduardo; Ortega, Arnaldo; Nuñez, Dubelis; Verzura, Julie; Tovar, Robert; Bethencourt, Sarah; Riera, Ricardo; Mora-Orta, Sioly; Corado, José

    2011-03-01

    Non-steroidal anti-inflammatory drugs (NSAIDS) are the first line of therapy in acute gouty arthritis. NSAIDs inhibit the cyclooxygenase pathway, but not the lipooxygenase activity and can have many adverse effects and thus have a limited effect on the control of inflammation in this disease. In this work we studied the effect of montelukast on the cellular inflammatory infiltrate in a model of murine arthritis induced by sodium monourate crystals (SMU), using a subcutaneous air cavity (air pouch) in BALB/c mice. Seven groups of BALB/c mice (n = 4) were distributed into five experimental groups and two inflammatory control groups, a positive and a negative one. Previous to SMU exposure, the experimental groups received montelukast (1 and 0.01 mg/Kg/w) and/or indomethacine (2.5 mg/Kg/w), followed by administration of SMU in the air pouch. The total and differential counts of inflammatory cells were analyzed after 2, 6, 12 and 24 hours. Montelukast, significantly reduced the total number of cells (p gouty arthritis. Consequently, anti-leukotrienes could represent a new and effective therapy, either isolated or combined with conventional therapy of gouty arthritis.

  1. Observation of the curative effect of self-made traditional Chinese medicine prescription for treatment of acute gouty arthritis%自拟中药组方治疗急性痛风性关节炎疗效观察

    Institute of Scientific and Technical Information of China (English)

    孔丽萍

    2015-01-01

    Objective:To explore the curative effect of self-made traditional Chinese medicine prescription for treatment of acute gouty arthritis.Methods:86 patients with acute gout arthritis were selected.They were randomly divided into the control group and the observation group with 43 case in each.The control group was given conventional treatment,and the observation group was treated with self-made traditional Chinese medicine prescription,then we compared the therapeutic effect of the two groups. Results:In the observation group,the total effective rate was significantly higher than that of the control group(P<0.05).Conclusion:The curative effect of self-made traditional Chinese medicine prescription for treatment of acute gouty arthritis was significant.It can effectively alleviate the symptoms of patients and reduce the pain of patients.%目的:探讨自拟中药组方治疗急性痛风性关节炎的效果。方法:收治急性痛风性关节炎患者86例,随机分为对照组和观察组各43例。对照组采用常规治疗,观察组采用自拟中药治疗,比较两组的治疗效果。结果:观察组的总体有效率明显高于对照组(P<0.05)。结论:自拟中药组方治疗急性痛风性关节炎效果显著,能有效缓解患者症状,减轻患者痛苦。

  2. Overinfection by Paracoccidioides brasiliensis in Gouty Crystal Arthritis

    Directory of Open Access Journals (Sweden)

    F. Bonilla-Abadía

    2012-01-01

    Full Text Available Paracoccidioidomycosis is an endemic South American systemic mycosis caused by the dimorphic fungus Paracoccidioides brasiliensis (P. brasiliensis. The main clinical form of disease is pulmonary, but all organs may be involved. We report a case of overinfection by P. brasiliensis in chronic gouty arthritis affecting the proximal phalanx of the right hallux. The patient required proximal amputation and long-term antifungal therapy.

  3. Efficacy Study of Etoricoxib in the Treatment of Acute Severe Gouty Arthritis%依托考昔治疗急性重度痛风性关节炎的疗效研究

    Institute of Scientific and Technical Information of China (English)

    潘奇; 陈黔

    2016-01-01

    Objective To analyze the effect of etoricoxib in the treatment of acute severe gouty arthritis. Methods 136 cases of acute severe gouty arthritis were selected and randomly divided into control group and observation group with 68 cases each. Control group received diclofenac treatment, while observation group received etoricoxib treatment. Results Compared with control group, the clinical symptoms in observation group had significantly improved, the difference was significant (P<0.05). The total effective rate of control group (79.4%) was significantly lower than that of observation group (95.6%);and the number of adverse reactions in observation group was 3 cases, and that in control group was 9 cases, the differences was statistically significant (P<0.05). Conclusion Applying etoricoxib for acute gouty arthritis has a good clinical effect, and improves symptoms significantly, with fewer adverse reactions, which is worth in clinical use.%目的:分析研究依托考昔对急性重度痛风性关节炎患者的临床治疗效果。方法选取136例急性重度痛风性关节炎患者,随机将其分为对照组和观察组,每组68例。对照组给予双氯芬酸钠进行治疗,观察组给予依托考昔进行治疗。结果与对照组相比,观察组患者的临床症状具有明显的改善,对比差异具有显著性意义(P<0.05)。对照组患者的治疗总有效率(79.4%)显著低于观察组患者(95.6%);且观察组不良反应发生数为3例,对照组为9例,差异均具有统计学意义(P<0.05)。结论采用依托考昔进行急性痛风性关节炎的治疗具有良好的临床疗效,且病症改善明显,不良反应少,值得在临床推广使用。

  4. 活血止痛消痹汤治疗痰瘀痹阻型痹证70例%Effect of Huoxue Zhitong Xiaobi decoction in the treatment of 70 cases of acute gouty arthritis

    Institute of Scientific and Technical Information of China (English)

    余维东

    2012-01-01

    目的 观察活血止痛消痹汤在治疗痰瘀痹阻型痹证方面的临床疗效.方法 选择2009年2月至2011年2月在我院风湿科门诊就诊并确诊的140例痰瘀痹阻型痹证患者,随机平均分为两组,研究组(70例)给予活血止痛消痹汤治疗,水煎早晚温服,日一剂,对照组(70例)给予正清风痛宁片口服治疗,3片/次,3次/d.两组均治疗1个月,观察统计两组的临床疗效.结果 研究组治疗的总有效率为91.4%,显著高于对照组的77.1%,差异有统计学意义(P<0.05).结论 活血止痛消痹汤在治疗痰瘀痹阻型痹证方面疗效确切,值得临床推广和普及.%Objective To explore the clinical effect of Huoxue Zhitong Xiaobi decoction in the treatment of acute gouty arthritis. Methods One hundred and forty patients of acute gouty arthritis were randomly divided into two groups. The study group (n=70) were treated with Huoxue Zhitong Xiaobi decoction, one bag per day, and the control group (n=70) were treated with Zhengqing Fengtongning tablets, 3 pieces per time, 3 times per day. The curative effects of two groups were observed and compared. Results The total effective rate of the study group after treatment was 91.4%, significantly higher than that of the control group (77.1%), P<0.05. Conclusion Huoxue Zhitong Xiaobi decoction has good clinical curative effect in the treatment of acute gouty arthritis.

  5. 解毒散治疗急性痛风性关节炎临床疗效观察%Clinical Observation to Acute Gouty Arthritis Treated with Toxin-resolving Powder

    Institute of Scientific and Technical Information of China (English)

    林松青; 彭力平; 姚志城

    2011-01-01

    Objective:To investigate the clinical effect of acute gouty arthritis treated by toxin-resolving powder for external application. Methods; 120 patients with acute gouty arthritis were randomly divided into the toxin-resolving powder group and the Shuang bai powder group, 60 patients in each group. Results .-Clinical symptoms were impoved in both groups. The total effective rate was 98. 2% ,92. 5% in the toxin-resolving powder group and in the Shuang bai powder group separately. There was significant difference in the two groups,according to the ridit analysis. The clinical effect of toxin-resolving powder was better than those of Shuang bai powder. Conclusion; Toxin-resolving powder for external application is effective in treating acute gouty arthritis and the clinical effects of toxin-resolving powder is significant. Toxin-resolving powder was worth popularizing and using.%目的:探讨解毒散外敷治疗急性痛风性关节炎的临床疗效。方法:将2008年~2010年,急性痛风性关节炎患者120例,随机分为2组,每组60例。治疗组给予解毒散外敷,对照组给予双柏散外敷。结果:治疗组和对照组的临床症状均有明显改善,治疗组总有效率98.2%,对照组总有效率92.5%;2组比较差异有统计学意义,解毒散临床疗效优于双柏散。结论:中药解毒散外敷是治疗急性痛风性关节炎的一种有效方法,疗效显著,值得在临床上推广使用。

  6. A clinical analysis of treating acute gouty arthritis with Tongfeng decoction%痛风汤治疗急性痛风性关节炎的临床疗效分析

    Institute of Scientific and Technical Information of China (English)

    贾友均

    2014-01-01

    Objective:To investigate the Tongfeng decoction and its clinical curative effect of treatment on acute gouty arthritis, sum up experience in order to improve the treatment level. Methods:From November 2010 to November 2013 our department treated 84 cases of acute gouty arthritis, Tongfeng decoction was given and recorded data were retrospectively analyzed. Results:84 patients were cured of 46 cases, 26 cases were markedly effective, effective 9 cases, 3 had no effect, the total effective rate was 96.43%;before and after treatment the blood uric acid are respectively (578.42±63.84) μmol/L、 (298.68±40.95) μmol/L, blood sedimentation are respectively (29.51±6.29) mm/h、 (10.12±3.04) mm/h, the differences were statistically significant (P<0.05). Conclusion:Tongfeng decoction of the clinical curative effect in treatment on acute gouty arthritis, can quickly relieve symptoms, reduce the blood level of uric acid and blood sedimentation, is worth promoting.%目的:探讨痛风汤治疗急性痛风性关节炎的方法及其临床疗效,总结经验以提高治疗水平。方法:对2010年11月-2013年11月我科收治的84例急性痛风性关节炎患者给予痛风汤治疗,记录资料并进行回顾性分析。结果:84例患者中临床治愈46例,显效26例,有效9例,无效3例,总有效率为96.43%;治疗前后血尿酸分别是(578.42±63.84)μmol/L、(298.68±40.95)μmol/L,血沉分别是(29.51±6.29)mm/h、(10.12±3.04)mm/h,差异均具有统计学意义(P<0.05)。结论:痛风汤治疗急性痛风性关节炎的临床疗效肯定,能够迅速缓解症状,降低血尿酸及血沉水平,值得推广。

  7. On 30 Cases of Acute Gouty Arthritis Treated with Zhuye Xiaotong Granule%竹叶消痛颗粒治疗急性痛风性关节炎30例

    Institute of Scientific and Technical Information of China (English)

    杨瑞宇; 彭江云; 吴晶金

    2014-01-01

    Objective:To observe the clinical efficacy and safety of Zhuye Xiaotong Granule in the treatment of acute gouty arthritis to provide the theoretical basis for the further treatment.Methods:60 cases of acute gouty arthritis were randomly and equally divided into the treatment group and the control group.The treatment group was given Zhuye Xiaotong granule,15 g each time,3 times daily;the control group was given orally Celecoxib Capsules,200 g each time,1 time a day.Their treatment course was 7 days,observing,before and after the treatment,their symptoms,signs,erythrocyte sedimentation rate,C-reactive protein,blood routine,urine routine,ALT,AST,BUN,CR and other parameters.Results:Symptoms,signs,serum erythrocyte sedimentation rate,C-reactive protein and other indicators of the acute gouty arthritis in the treatment group were improved (P0.05).Conclusion:Zhuye Xiaotong Granule has a signiifcant effect and high safety in the treatment of acute gouty arthritis.%目的:观察竹叶消痛颗粒治疗急性痛风性关节炎的临床疗效和安全性,为其治疗急性痛风性关节炎提供理论依据。方法:将60例急性痛风性关节炎患者按随机数字表法分为治疗组和对照组,每组30例。治疗组给予竹叶消痛颗粒每次15 g,每日3次,冲服;对照组给予塞来昔布胶囊每次200 g,每日1次,口服。两组均以7d为1个疗程,疗程结束后观察两组给药前后的症状、体征及红细胞沉降率、C-反应蛋白、血常规、尿常规、ALT、AST、BUN、CR等参数的变化。结果:治疗组能改善急性痛风性关节炎的症状、体征及血清红细胞沉降率、C-反应蛋白等指标(P0.05)。结论:竹叶消痛颗粒治疗急性痛风性关节炎疗效显著,安全性高。

  8. Predisposing Factors Analysis for 105 Patients With Acute Gouty Arthritis in the Coastal Area%沿海地区105例急性痛风性关节炎患病诱因分析

    Institute of Scientific and Technical Information of China (English)

    国建文; 张涌泉; 贾忠林; 盖永乐

    2015-01-01

    Objective To describe predisposing factors of acute gouty arthritis in Shandong coastal area,and to investigate the relationship between gout and activities induced energy metabolism level. Methods In this clinical investigation,105 patients with acute gouty arthritis were observed and predisposing factors were described. Activities induced energy metabolism levels of the patients were determined by the intensity of labor and physical exercise activities. The body mass index(BMI)and serum uric acid were determined. Data were analyzed statistical y using simple correlation. Results The main predisposing factors of acute gouty arthritis were drinking(29.5%)and careless diet(25.7%). The patients were in the low level of activities induced energy metabolism. Meanwhile,BMI(25.9)of gout patients was positive correlation with serum uric acid(533 μmol/L).Conclusion There were many inducements of acute gouty arthritis and the main precipitating factors were drinking and careless diet. The low level of activities induced energy metabolism could be one of the long-term predisposing factors of gout.%目的:描述山东沿海地区急性痛风性关节炎诱发因素的分布情况,并探讨活动能量代谢水平与痛风的关系。方法收集了105例急性痛风性关节炎患者资料,调查其发病诱因;通过劳动强度和体育锻炼情况确定患者的活动能量代谢水平,同时测定体重指数和血尿酸水平。对数据进行描述性统计分析和简单相关性分析。结果导致痛风性关节炎急性发作最主要的诱发因素是大量饮酒(29.5%)和饮食不慎(25.7%);痛风人群的日常活动能量代谢水平较低;体重指数平均值为(25.9±2.23),血尿酸平均值为(533±69.2)μmol/L,二者呈正相关。结论众多因素可引起痛风性关节炎的急性发作,其中大量饮酒和饮食不慎是最主要的诱发因素;较低的活动能量代谢水平是痛风的长期发病诱因之一。

  9. 四妙散加减治疗急性痛风性关节炎89例疗效观察%Clinical observation on treating89 cases of acute gouty arthritis with Simiao San

    Institute of Scientific and Technical Information of China (English)

    曾宪勇; 王振伟

    2016-01-01

    Acute gouty arthritis was a common rheumatology; the main pathogenesis was improper diet, could cause hypertension, hyperlipidemia, diabetes, atherosclerosis and other diseases. Simiao San was applied in treating this disease by the author, showed satisfactory results.%急性痛风性关节炎是常见的风湿病之一,主要病机是饮食不节,引起高血压、高脂血症、糖尿病、动脉硬化等多种疾病。笔者运用四妙散加减治疗该病,取得了令人满意的效果。

  10. The effect of xitong powder on acute gouty arthritis in rats%息痛散对大鼠急性痛风性关节炎的作用

    Institute of Scientific and Technical Information of China (English)

    雷鹏; 李娟娥; 李静; 衣蕾; 姜小帆; 吉海旺

    2016-01-01

    Objective :To study the effects and mechanisms of Xitong Powder on Acute Gouty Arthritis in rats . Methods :The rats of Acute Gouty Arthritis stimulated by monosodium urate crystals were divided randomly according to body weight into Models ,Allopurinol group ,Xitong Powder Ⅰgroup(18g/kg/d) ,Xitong PowderⅡgroup(36g/kg/d) ,Xi‐tong Powder Ⅲ group(72g/kg/d) ,and 8 normal SD rats as normal control group .All rats were treated by corresponding drugs or physiological saline for 5 days .The ankle jionts’ swelling degree and gait profile score were tested at different time ,and plasma IL‐1β、TNF‐αlevels were tested by Radioimmuno assay at the end of the experiment .Results :Xitong Powder dose‐dependently decreased ankle jionts’ swelling degree and improved gait profile score ,and induced the levels of serum IL‐1β,TNF‐αin Acute Gouty Arthritis rats stimulated by monosodium urate crystals .There was no difference be‐tween Allopurinol group and Xitong PowderⅢ group .Conclusion Xitong Powder decreased ankle jionts’ swelling degree in Acute Gouty Arthritis rats stimulated by monosodium urate crystals .The mechanism is possibly mainly related to in‐flammatory parameters .%目的:观察息痛散对尿酸钠晶体诱导的大鼠急性痛风性关节炎的作用。方法:通过关节局部注射尿酸钠晶体建立急性痛风性关节炎大鼠模型,将模型成功的大鼠随机分为模型组、别嘌醇组、息痛散高、中、低剂量组(18g/kg/d、36g/kg/d、72g/kg/d),并灌胃治疗5d ,观察各组大鼠的足跖肿胀度、步态学评分,并检测大鼠血清炎性因子白介素1‐lβ(I L‐lβ)、肿瘤坏死因子(Tumor necrosis factor‐α,TNF‐α)水平。结果:息痛散呈剂量依赖性抑制急性痛风性关节炎模型大鼠关节足跖肿胀度,改善大鼠步态学评分,降低血清炎性因子IL‐1β、T N F‐α水平,息痛散高剂量组与别嘌醇组比较无统计

  11. Clinical observation on treating acute gouty arthritis by Biling gout recipe%萆苓痛风方治疗急性痛风性关节炎的临床观察

    Institute of Scientific and Technical Information of China (English)

    欧艳娟; 李景良

    2014-01-01

    目的:观察萆苓痛风方治疗急性痛风性关节炎的临床效果。方法:患者随机分为治疗组和对照组各16例,对照组使用常规西医治疗,治疗组在对照组的基础上加单纯服用中药汤剂萆苓痛风方。结果:治疗组临床痊愈1例,显效13例,有效2例,无效0例;对照组临床痊愈1例,显效10例,有效4例,无效1例。结论:萆苓痛风方治疗急性痛风性关节炎效果显著。%Objective:To observe the effect on treating acute gouty arthritis by Biling gout recipe. Methods:Patients were randomly divided into the treated group and the control group, each of 16 cases, the control group using routine modern medicine treatment, the treated group using Biling gout recipe based on control group treatment. Results:In treated group 1 cases were cured, 13 cases markedly effective, effective 2 cases, invalid in 0 case;the control group clinical cure in 1 case, effective in 10 cases, effective 4 cases, invalid in 1 cases. Conclusion:Treating acute gouty arthritis by Biling gout recipe has significant effect.

  12. Comprehensive review on therapeutic strategies of gouty arthritis.

    Science.gov (United States)

    Akram, Muhammad; Usmanghani, Khan; Ahmed, Iqbal; Azhar, Iqbal; Hamid, Abdul

    2014-09-01

    Traditional medicines are practiced worldwide for treatment of gouty arthritis since ancient times. Herbs and plants always have been used in the treatment of different diseases such as gout. The present article deals with the therapeutic strategies and options for the cure of gouty arthritis. Bibliographic investigation was carried out by analyzing classical textbooks and peer reviewed papers, consulting worldwide accepted scientific databases. In this article a detailed introduction, classification, epidemiology, risk factors, symptoms, diagnosis and treatment of gout with reference to modern and Unani system of medicines have been discussed. It is also tried to provide a list of plants used in the treatment of gout along with their formulations used in Unani system of medicine. The herbs and formulations have been used in different systems of medicine particularly Unani system of medicines exhibit their powerful role in the management and cure of gout and arthritis. Most of herbs and plants have been chemically evaluated and some of them are in clinical trials. Their results are magnificent and considerable. However their mechanisms of actions are still on the way.

  13. Update on the Clinical Effect of Acupuncture Therapy in Patients with Gouty Arthritis: Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Lu, Wei-Wei; Zhang, Jin-Ming; Lv, Zheng-Tao; Chen, An-Min

    2016-01-01

    Objective. The aim of this study is to evaluate the clinical efficacy and safety of acupuncture therapy in the treatment of acute gouty arthritis. Methods. A literature search of PubMed, EMBASE, ISI Web of Science, CENTRAL, and CNKI was conducted from the inception date of each database up to October 2015. Two investigators screened each article independently and were blinded to the findings of the other reviewer. Data was extracted according to the predetermined collection form. Meta-analysis was performed. Results. We analyzed data from 28 RCTs involving 2237 patients with gouty arthritis. Compared with conventional pharmacological treatments acupuncture was more effective in rendering patients free from symptoms after 24 hours, lowering serum urate, alleviating pain associated with gouty arthritis, and decreasing the ESR; regarding CRP, no statistically significant difference was found. In addition, the frequency of adverse events in acupuncture treatment was lower than that in control group. Conclusion. Based on the findings of our study, we cautiously suggest that acupuncture is an effective and safe therapy for patients with gouty arthritis. However, the potential beneficial effect of acupuncture might be overstated due to the methodological deficiency of included studies. High quality RCTs with larger scale are encouraged.

  14. Update on the Clinical Effect of Acupuncture Therapy in Patients with Gouty Arthritis: Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Wei-wei Lu

    2016-01-01

    Full Text Available Objective. The aim of this study is to evaluate the clinical efficacy and safety of acupuncture therapy in the treatment of acute gouty arthritis. Methods. A literature search of PubMed, EMBASE, ISI Web of Science, CENTRAL, and CNKI was conducted from the inception date of each database up to October 2015. Two investigators screened each article independently and were blinded to the findings of the other reviewer. Data was extracted according to the predetermined collection form. Meta-analysis was performed. Results. We analyzed data from 28 RCTs involving 2237 patients with gouty arthritis. Compared with conventional pharmacological treatments acupuncture was more effective in rendering patients free from symptoms after 24 hours, lowering serum urate, alleviating pain associated with gouty arthritis, and decreasing the ESR; regarding CRP, no statistically significant difference was found. In addition, the frequency of adverse events in acupuncture treatment was lower than that in control group. Conclusion. Based on the findings of our study, we cautiously suggest that acupuncture is an effective and safe therapy for patients with gouty arthritis. However, the potential beneficial effect of acupuncture might be overstated due to the methodological deficiency of included studies. High quality RCTs with larger scale are encouraged.

  15. A case of gouty arthritis following percutaneous radiofrequency ablation for hepatocellular carcinoma

    Institute of Scientific and Technical Information of China (English)

    Dae; Hee; Choi; Hyo-Suk; Lee

    2010-01-01

    Percutaneous radiofrequency thermal ablation(RFA) is considered an effective technique for providing local control in the majority of Hepatocellular carcinoma(HCC) patients.Although RFA is generally well tolerated,recent studies have reported complications associated with RFA.We describe a case of acute gouty arthritis in a 71-year-old man with chronic renal failure who was treated with RFA for a HCC lesion and who had hepatitis B-associated cirrhosis and mild renal insufficiency.Regular surveillance of the...

  16. Impact of sonography in gouty arthritis: Comparison with conventional radiography, clinical examination, and laboratory findings

    Energy Technology Data Exchange (ETDEWEB)

    Schueller-Weidekamm, Claudia [Department of Diagnostic Radiology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria)]. E-mail: claudia.schueller-weidekamm@meduniwien.ac.at; Schueller, Gerd [Department of Diagnostic Radiology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Aringer, Martin [Department of Rheumatology, Internal Medicine III, Medical University of Vienna (Austria); Weber, Michael [Department of Diagnostic Radiology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Kainberger, Franz [Department of Diagnostic Radiology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria)

    2007-06-15

    Objective: To explore the typical sonographic features of gray-scale and Power Doppler of acute and chronic gouty arthritis in conjunction with radiographic, clinical, and laboratory findings. Materials and methods: All hand, finger, and toe joints of 19 patients with acute and chronic gout were examined with gray-scale and Power Doppler sonography. The number and size of bone changes detected with sonography was compared to radiographic findings. Vascularization of the synovial tissue was scored on Power Doppler (grades 0-3), and was compared with clinical appearance, including swelling, tenderness, and redness (grades 0-3). Results: In acute gout, mild to moderate echogenic periarticular nodules with sonotransmission and hypervascularization of the edematous surrounding soft tissue were found. In chronic gout, tophaceous nodules completely blocked transmission of US wave, leading to strong reflexion and dorsal shadowing in a minority of cases. No significant difference in the detection of large bone changes (>2 mm) was found between sonography and radiography. However, gray-scale sonography was significantly more sensitive in the detection of small bone changes (p < 0.001). Power Doppler scores were statistically significantly higher than clinical examination scores (p < 0.001). Discussion: Sonography is superior to radiographs in evaluating small bone changes. The inflammatory process in joints can be better detected with Power Doppler sonography than with clinical examination. Typical sonographic appearance of acute and in particular of chronic gout might provide clues on gouty arthritis that adds to the information available from conventional radiography, clinical, and laboratory findings.

  17. 丹溪痛风方对小鼠急性痛风性关节炎的实验研究%Experimental study of Danxi Gout Party on Mice with Acute Gouty Arthritis

    Institute of Scientific and Technical Information of China (English)

    周忠光; 白云; 李宝龙; 仲丽丽; 孟鑫雨; 丑小月; 费洪新; 韩玉生; 廖婷; 张英博; 王金库; 杜徽; 朴成玉

    2015-01-01

    Objective:To study the mice effects on mice acute gouty arthritis from Danxi gout party.Methods:The mice a-cute gouty arthritis model induced by sodium uric acid was observed and anti joint swelling effect observed in Danxi gout party,detect changes in blood levels of uric acid.Results:The joint swelling degrees of acute gouty arthritis mice the modeling were 0.113 3 ±0.047 2mL、0.346 7 ±0.116 9mL、0.106 7 ±0.057 9mL、0.175 0 ±0.093 5mL、0.160 0 ± 0.065 4mL for Control group、model group,treatment group 1、treatment group 2 and Danxi gout party group.Danxi gout party reactive arthritis in mice to improve the role, Danxi gout party no significant effect on body weight of mice.after treatment,uric acid were significantly decreased.Conclusion:The effect of Danxi gout party on mice acute gout joint swelling induced significant,Improved significantly reduce inflammation,Danxi gout party has no side effects on mice.%目的:研究丹溪痛风方对小鼠急性痛风性关节炎的作用。方法:采用尿酸钠诱导,建立小鼠急性痛风性关节炎模型,观察丹溪痛风方抗关节肿胀的作用。结果:小鼠急性痛风性关节炎对照组、模型组、治疗1组、治疗2组、丹溪痛风方组关节肿胀度分别为(0.1133±0.0472) mL、(0.3467±0.1169) mL、(0.1067±0.0579)mL、(0.1750±0.0935)mL、(0.1600±0.0654)mL。丹溪痛风方改善小鼠关节炎症反应,对小鼠体质量无显著影响。结论:丹溪痛风方对小鼠急性痛风性关节肿胀的作用效果改善明显,显著减轻炎症反应,并且副作用较小。

  18. A case of gouty arthritis to tophi on 18F-FDG PET/CT imaging.

    Science.gov (United States)

    Ito, Kimiteru; Minamimoto, Ryogo; Morooka, Miyako; Kubota, Kazuo

    2012-06-01

    We report a case of gouty arthritis with tophi that was evaluated using 18F-fluorodeoxyglucose (FDG) positron emission tomography. A 77-year-old man with a history of gouty attacks was admitted with severe polyarticular pain and fever. 18F-FDG positron emission tomography/CT demonstrated focal uptake at multiple joints, including the juxta-articular soft-tissue-density masses of the elbows, and the bases of bilateral large toes. Gouty arthritis should be considered with focal 18F-FDG uptake in juxta-articular soft-tissue-density masses (tophi) with or without associated erosions.

  19. Canakinumab for the Patient With Difficult-to-Treat Gouty Arthritis: Review of the Clinical Evidence.

    Science.gov (United States)

    Bardin, Thomas

    2015-10-01

    Many patients with gouty arthritis experience frequent flares and have comorbidities that may limit their anti-inflammatory treatment options for acute flare management. For patients with contraindications to both NSAIDs and/or colchicine, treatment options are particularly limited, and there is an unmet medical need in this subgroup of patients. Two phase 3 studies and their extensions have demonstrated that a single dose of canakinumab during an acute flare provided rapid and effective pain relief and prolonged suppression of flares and inflammation in patients with a history of frequent flares and contraindicated for, intolerant of, or unresponsive to NSAIDs and/or colchicine. Canakinumab was consistently superior to the active comparator triamcinolone acetonide and was generally well tolerated in this patient population with a high prevalence of multiple medical comorbidities. Canakinumab should therefore be considered as a treatment option in a target population of patients with frequent gouty arthritis attacks who are unable to use NSAIDs and colchicine and in whom frequent use of corticosteroids is not considered appropriate.

  20. 穿虎痛风合剂治疗急性痛风性关节炎的临床研究%A clinical study of Chuanhu anti-gout mixture in the treatment of acute gouty arthritis

    Institute of Scientific and Technical Information of China (English)

    余霄龙; 李杨; 李恩泽; 李长贵; 王颜刚

    2014-01-01

    In this double-blind,double-dummy,non-inferiority study,144 cases of newly diagnosed acute gouty arthritis were reassigned to Chuanhu anti-gout mixture group (CH,n =72) and colchicine group (Col,n =72).After treatment for 10 days,the total efficiency rates of CH and Col groups were 93.02% and 95.35%,respectively,showing no difference between two groups.Three months later,the overall recurrence rates in CH and Col groups were 12.50% and 13.89% respectively (P<0.05).The incidence of adverse reactions in colchicine group was significantly higher than CH group (34.72% vs 2.78%,P < 0.01).Blood uric acid,alanine aminotransferase,aspartate aminotransferase,and creatinine in CH group were decreased significantly compared with Col group (P<0.05 or P<0.01).The results suggest that the clinical efficacy of Chuanhu anti-gout mixture in the treatment of acute gouty arthritis was not inferior to colchicine,but with higher safety.%采用随机、双盲双模拟、平行对照的非劣效试验设计方法,选取急性痛风性关节炎患者144例分为中药组(72例,穿虎痛风合剂)和秋水仙碱组(72例),治疗10d.结果显示,中药组和秋水仙碱组总有效率分别为93.02%和95.35%,差异无统计学意义,3个月后总复发率分别为12.50%和13.89%(P<0.05).不良反应发生率秋水仙碱组明显高于中药组(34.72%对2.78%,P<0.01).血尿酸、谷丙转氨酶、谷草转氨酶、肌酐治疗前后差值中药组均高于秋水仙碱组(P<0.05或P<0.01).穿虎痛风合剂治疗急性痛风性关节炎的临床疗效与秋水仙碱相当,且安全性高.

  1. Clinical Observation on Modified SiMiao YongAnTang in Treating 140 Cases of Acute Gouty Arthritis%四妙永安汤加味治疗急性痛风性关节炎140例

    Institute of Scientific and Technical Information of China (English)

    张勇

    2012-01-01

    目的:观察四妙永安汤加减治疗急性痛风性关节炎的临床疗效.方法:将140 例急性痛风性关节炎患者随机分为2 组.治疗组70 例,予四妙永安汤加减;对照组70 例,予秋水仙碱、苯溴马隆治疗,2 组疗程均为2 周.观察治疗前后病变关节肿胀、疼痛、活动等情况及血尿酸、血沉和C 反应蛋白的变化情况.结果:治疗组与对照组总有效率分别为88.57%、74.29%,不良反应发生率分别为21.43%、58.57%,2组比较有显著性差异(P<0.05).结论:四妙永安汤加减治疗急性痛风性关节炎疗效显著,不良反应发生率较低.%Objective: To observe clinical effects of modified SiMiao YongAnTang in treating acute gouty arthritis. Method: All 140 cases were randomly assigned into treatment group administered with modified SiMiao YongAnTang and control group treated with colchicines and benzbromarone. The session was two weeks for both groups. The conditions of joint swelling, pain, movement and the changes of blood uric acid, erythrocyte sedimentation rate and C reactive protein were observed before and after the treatment. Result: Total effective rate of treatment group was 88.57%, higher than 74.29% of control group with significant difference (P<0.05). Incidence of adverse reaction of treatment group was 21.43%,lower than 58.57% of control group with statistical meaning (P<0.05).Conclusion: Modified SiMiao YongA nTang is effective in treating acute gouty arthritis with low incidence of adverse reaction.

  2. Clinical analysis of treating acute gouty arthritis with the gout decoction%痛风汤治疗急性痛风性关节炎的临床疗效分析

    Institute of Scientific and Technical Information of China (English)

    丁平

    2012-01-01

      Objective: To observe the clinical effects of the gout decoction in treating acute gouty arthritis. Methods: The patients were randomly divided into two groups, the treated group was given the gout decoction, and the control group was treated with colchicine, for 7 days with colchicine. changes in clinical symptoms before and after treatment, and uric acid and ESR values change were observed. Results: The total effective rate of the treated group was significantly higher than that of the control group, improvement of serum uric acid was better than that of the control group. Clinical effects of the gout decoction for acute gouty arthritis showed that, the gout decoction could lower blood uric acid, lower ESR, no significant side effects and adverse reactions. Conclusion: The gout decoction could significantly improve symptoms of gout, reduce the level of uric acid and erythrocyte sedimentation rate, clinical results were satisfactory.%  目的:观察痛风汤治疗急性痛风性关节炎的临床效果.方法:将患者随机分为两组,治疗组用予以痛风汤,对照组用秋水仙碱,两组疗程均为7d.观察两组治疗前后临床症状的变化和血尿酸值及血沉值的改变.结果:治疗组总有效率明显高于对照组,血尿酸改善优于对照组.痛风汤对急性痛风性关节炎的临床疗效观察表明,痛风汤可以降血尿酸,降低血沉、无明显毒副作用与不良反应,总体疗效优于秋水仙碱.结论:痛风汤能明显改善痛风急性期症状,降低血尿酸及血沉水平,临床疗效满意.

  3. Value of Shear Wave Elastography in the Diagnosis of Gouty and Non-gouty Arthritis.

    Science.gov (United States)

    Tang, Yuanjiao; Yan, Feng; Yang, Yujia; Xiang, Xi; Wang, Liyun; Zhang, Lingyan; Qiu, Li

    2017-02-07

    Our aim was to analyze the diagnostic performance of shear wave elastography (SWE) in the diagnosis of gouty arthritis (GA) and non-gouty arthritis (non-GA). Thirty-nine patients in the GA group and 55 patients in the non-GA group were included in the study. Based on the echo intensity of the joint lesions, the GA group was subdivided into hypo-echoic GA, slightly hyper-echoic GA and hyper-echoic GA subgroups. Quantitative SWE features were evaluated and receiver operating characteristic analysis was performed. On the basis of the study, the elastic modulus (Emax), mean elastic modulus (Emean), minimum elastic modulus (Emin) and elastic modulus standard deviation (ESD) were significantly higher in the GA group than in the non-GA group and were highest in the hyper-echoic GA subgroup (p < 0.01 for all). Emin, Emean and Emax were significantly higher in the hyper-echoic GA subgroup than in the hypo-echoic GA subgroup and non-GA group (p < 0.001 for all), and ESD was significantly higher in the hyper-echoic GA subgroup than in the non-GA group (p = 0.001). Emin, Emean, Emax and ESD were higher in the hypo-echoic GA subgroup than in the non-GA group, and the differences were significant (p < 0.001 for all). Based on the hypo-echoic GA subgroup and non-GA group, areas under the receiver operating characteristic curves for the prediction of GA were 0.749 for Emin, 0.877 for Emean, 0.896 for Emax and 0.886 for ESD, with optimal cutoff values of 29.40 kPa for Emin, 45.35 kPa for Emean, 67.54 kPa for Emax and 7.85 kPa for ESD. Our results indicate that SWE can differentially diagnose GA and non-GA, especially when the ultrasound manifestations are not typical.

  4. Prevalence and significance of MEFV gene mutations in patients with gouty arthritis.

    Science.gov (United States)

    Karaarslan, Ahmet; Kobak, Senol; Kaya, Işın; Intepe, Nazım; Orman, Mehmet; Berdelı, Afig

    2016-11-01

    Gouty arthritis is a chronic erosive autoinflammatory disease. Pyrin has anti-inflammatory effects in the regulation of inflammasome and is encoded by the MEFV gene. The relationship between different rheumatic diseases and the MEFV gene mutations was demonstrated. The aim of this study was to determine the frequency of MEFV gene mutations in patients with gouty arthritis and identify a possible correlation with disease phenotype. Ninety-three patients with gouty arthritis and 102 healthy controls, compatible with age, gender and ethnicity, were included in the study. MEFV gene mutations were investigated by PCR method. Out of 93 patients with gouty arthritis, 36 (38.7 %) showed MEFV gene mutations carriage, whereas 20.6 % in healthy control group. Distribution of mutations identified in patients with gouty arthritis was as; R202Q in 18 (19.3 %), E148Q in 5 (5.4 %), K695R in 4 (4.3 %), M680I in 2 (2.1 %), V726A in 2 (2.1 %), P369S in 2 (2.1 %), R408Q in 2 (2.1 %), M694 V in 1 (1.1 %), respectively. Three patients were identified with compound heterozygosity. Distribution of MEFV gene mutations carriage in healthy controls was; E148Q in 11 (10.7 %), M694 V in 2 (1.9 %), M694I in 1 (0.9 %), M680I in 2 (1.9 %), V726A in 1 (0.9 %), A744S in 1 (0.9 %), K695R in 2 (1.9 %), and P369S in 1 (0.9 %) patients, respectively. Higher MEFV gene mutations carrier frequency was observed in patients with gouty arthritis, compared with the control group (p = 0.009). Heterozygous R202Q was the most common mutation detected in patients with gouty arthritis, while heterozygous E148Q in healthy control group. Statistically significant difference was not detected between clinical findings of gouty arthritis and the MEFV gene mutations (p > 0.05). We determined higher prevalence of MEFV gene mutations in patients with gouty arthritis compared with the healthy control group. The most frequently detected mutation was heterozygous R202Q, whereas E148Q in healthy

  5. Rare coexistence of gouty and septic arthritis after arthroscopic rotator cuff repair: a case report.

    Science.gov (United States)

    Ichiseki, Toru; Ueda, Shusuke; Matsumoto, Tadami

    2015-01-01

    Coexistence of septic arthritis and gouty arthritis is rare. In particular, no reports have described the development of both gouty and septic arthritis after arthroscopic shoulder surgery. The patient was an 83-year-old man who underwent arthroscopic rotator cuff repair. He had a history of diabetes mellitus (HbA1c: 7.4%), but not of gout, and the GFR was decreased (GFR=46). During the postoperative course fever suddenly developed and joint fluid retention was found. Uric acid crystals were detected when the joint fluid was aspirated, after which when the culture results became available sepsis due to methicillin sensitive Staphylococcus aureus (MSSA) was diagnosed. On the 2(nd) day after fever onset, lavage and debridement were performed under arthroscopy, with the subsequent course uneventful with no recurrence of the infection or gouty arthritis and no joint destruction. When uric acid crystals are found in aspirated joint fluid, gouty arthritis tends to be diagnosed, but like in the present case if infection also supervenes, joint destruction and a poor general state may result if appropriate intervention is not initiated swiftly. Accordingly, even if uric acid crystals are found, the possibility of coexistence of septic arthritis and gouty arthritis should be kept in mind.

  6. 电针合艾条温和灸综合治疗急性痛风性关节炎48例%FORTY-EIGHT CASES OF ACUTE GOUTY ARTHRITIS TREATED COMPREHENSIVELY WITH ELECTROACUPUNCTURE AND WARMING MOXIBUSTION

    Institute of Scientific and Technical Information of China (English)

    陈英; 曹晶晶

    2008-01-01

    Objective To probe into the effects on acute gouty arthritis treated comprehensively with electroacupuncture (EA) and warming moxibustion. Methods 70 cases were randomized into treatment group (48 cases), in which the EA+warming moxibustion was applied; and controlled group (22 cases), in which, colchicine was prescribed for oral administration. Results The statistical outcomes after 1 course treatment in treatment group: 28 cases were cured (58.33%), 18 cases improved (37.50%) and the total effective rate was 95.83%. In controlled group: 12 cases (54.55%) were cured, 8 cases improved (36.36%) and the total effective rate was 90.91%. The therapeutic effects of two groups were basically consistent, without significant different (P>0.05). But, concerning to side effect, there was no any toxic side effects in the group treated with EA+warming moxibustion, and the occurrence rate in the group treated with colchicine was 40.91%. Conclusion Electroacupuncture+warming moxibustion achieves good therapeutic effects without any side effects.

  7. A case-control study of determinants for the occurrence of gouty arthritis in heart failure patients

    NARCIS (Netherlands)

    Hueskes, B.A.; Willems, F.F.; Leen, A.C.; Ninaber, P.A.; Westra, R.; Mantel-Teeuwisse, A.K.; Janssens, H.; Lisdonk, E.H. van de; Roovers, E.A.; Janssen, M.

    2012-01-01

    AIMS: Gouty arthritis is a frequent and disabling complication in heart failure patients. This study aimed to investigate which factors are associated with the occurrence of gouty arthritis in these patients. METHODS AND RESULTS: A case-control study was performed in heart failure patients (February

  8. [Historical study on traditional Chinese formulations and crude drugs used for gouty arthritis].

    Science.gov (United States)

    Nakao, Kikuyo; Moriyama, Kenzo; Murata, Kazuya; Matsuda, Hideaki; Tani, Tadato

    2011-01-01

    Rates of gouty arthritis with hyperuricemia have increased recently as it has become a lifestyle-related disease. We reviewed historical treatments for pain due to gouty arthritis in traditional Chinese medical books, with special interest in pathological causes, including dietary and drinking habits, as well as the frequency of crude drugs used in historical prescriptions. From the present historical survey, we showed that six traditional terms may be equivalent to modern gouty arthritis and that the "Manbyokaishun," a formulary edited in the 16th century in China, included medical information for gouty arthritis. Furthermore, the 46 prescriptions, including Sokeikakketsuto, mentioned in the "Manbyokaishun," were selected as likely treatments for gouty arthritis. The most common crude drugs in the 46 prescriptions were aconite root, angelica root, cinnamon bark, peony root and saposhnikovia root. The inhibitory activity of these crude drugs extracts against xanthine oxidase was investigated. Angelica root and saposhnikovia root showed more potent inhibitory activity (20% at 250 microg/mL) than aconite root (16%), notopterygium rhizome (15%) and cinnamon bark (12%).

  9. Polymorphisms in the NLRP3 gene and risk of primary gouty arthritis.

    Science.gov (United States)

    Meng, Dong-Mei; Zhou, Yu-Jiao; Wang, Luan; Ren, Wei; Cui, Ling-Ling; Han, Lin; Qu, Zheng-Hai; Li, Chang-Gui; Zhao, Jia-Jun

    2013-06-01

    The aim of the present study was to investigate the association between genetic variants in 17 tagSNPs of the NLRP3 gene and the susceptibility to primary gouty arthritis. A genotype-phenotype analysis of 480 primary gout and 480 control patients was performed. Samples from all the patients were collected from The Affiliated Hospital of Medical College (Qingdao, China). Seventeen tagSNPs of the NLRP3 gene were amplified using polymerase chain reaction (PCR) and MassARRAY technology was used for single nucleotide polymorphism (SNP) genotyping. The genetic frequency of rs7512998 was significantly different between the gout and control patients (P0.05). The haplotype association among the 17 SNPs of the NLRP3 gene indicated that no individual SNP was significantly associated with primary gouty arthritis. CTATCAGCGCCCAGTGC was the most common haplotype in the case and control groups, with a frequency of 0.224 and 0.243, respectively. However, the odds ratios (ORs) of the 8 haplotypes were not identified to be significantly associated with gouty arthritis (P>0.05 for all the 8 haplotypes). To the best of our knowledge, this is the first study to investigate the association between SNPs of the NLRP3 gene and the risk of primary gouty arthritis, although no significant association was identified. Further clinical studies and functional analysis are required to explore the potential associations between NLRP3 gene polymorphisms and the risk of primary gouty arthritis.

  10. Risk Factors in the Incidence of Gouty Arthritis in Masohi Town, Central Maluku Regency in 2010.

    Directory of Open Access Journals (Sweden)

    Bellytra Talarima

    2012-12-01

    Full Text Available The gouty arthritis incidence rate in Masohi Town of Central Maluku Regency is 54 people based on the data from the general hospital in Masohi. The aim of study was to find out the risk factor in the incidence of gouty arthritis in Masohi Town of Central Maluku Regency. The study was analytic observation using a control case study. The number of respondents was 196 people consisting of 98 cases and 98 controls. The data were analyzed by using odds ratio (OR and multiple logistic regression. The results of the study indicate that the risk factors in the incidence of gouty arthritis arehypertension (OR = 2.20 CI 95%; 1.24-3.90, central obesity (OR = 3.04 CI 95%; 1.66-5.55, alcoholic comsumption (OR = 2.28 CI 95%; 1.29-4.05, purine food consumption (OR = 5.14 CI 95% 2.80-9.44, gout history in family (OR = 3.10 CI 95%; 1.73-5.55, and soft drink consumption (OR = 1.33 CI 95%; 0.72-2.45. The multivariate analysisindicates that the most dominant factor affecting the incidence of gouty arthritis is purine food consumption (p = 0.000. Since the consumption of purine food is the most dominant factor affecting the incidence of gouty arthritis, diet pattern is necessary for the patients

  11. Curative Analysis of Using Xuanbi Decoction Addition and Subtraction Combined with Needle Pricking Blood Therapy to Treat Acute Gouty Arthritis%宣痹汤加减联合火针放血疗法治疗急性痛风性关节炎疗效分析

    Institute of Scientific and Technical Information of China (English)

    王福育

    2014-01-01

    目的:观察宣痹汤加减联合火针放血疗法治疗急性痛风性关节炎的疗效,并探讨其作用机理.方法:选择84例我院确诊为急性痛风性关节炎的患者,随机分为A、B、C组,分别采用西药对照、口服宣痹汤加减及口服中药联合火针放血的疗法进行治疗.结果:C组有效率最高,疗效优于其它两组;与B组相比,差异具有显著性意义(P<0.05),与A组相比,差异具非常显著性意义(P<0.01).结论:以针药合用,内外并施的方法治疗急性痛风性关节炎疗效显著,可靠.%Objective:To observe the curative effect of Xuanbi Decoction combined with needle pricking blood therapy in the treatment of acute gouty arthritis,and to explore its mechanism.Methods:84patients in our hospital diagnosed as acute gouty arthritis,randomly divided into A,B,C groups respectively,by western medicine group,Xuanbi Decoction group and traditional Chinese medicine combined with acupuncture blood letting therapy group.Results:the C group had the highest efficiency,curative effect was better than the other two groups; compared with B group,the difference was significant (P< 0.05),compared with the A group,with a very significant difference (P<0.01).Conclusion:The combined use of acupuncture and medicine are more effective and reliable in the treatment of acute gouty arthritis.

  12. 中西医并治急性期痛风性关节炎关节红肿痛120例%Chinese medicine combined with Western medicine on 120 cases of gouty arthritis with joint swelling and pain in their acute stages

    Institute of Scientific and Technical Information of China (English)

    余克强; 熊学华; 李义凯

    2002-01-01

    @@ Background:The acute gouty arthritis causes painful joints and obvious swelling. Sometimes it also causes liquid in joints. The joints are so painful that touch is resisted, it has trouble to curve and extend and the function is greatly hampered. Also fever, palpitation and fatigue are caused. Most cases are in fat people with good diet. The incidence is greatly increased with the development of living condition in recent years and male cases are more than female cases (about 20:1). Purine and colchinine cause slow effect and serious side effects. We began to treat it with Chinese medicine combined with western medicine from 1998 and gained some experience

  13. An update on the pathology and clinical management of gouty arthritis.

    Science.gov (United States)

    Gonzalez, Emilio B

    2012-01-01

    Gouty arthritis is an inflammatory condition associated with debilitating clinical symptoms, functional impairments, and a substantial impact on quality of life. This condition is initially triggered by the deposition of monosodium urate crystals into the joint space. This causes an inflammatory cascade resulting in the secretion of several proinflammatory cytokines and neutrophil recruitment into the joint. While generally effective, currently available agents are associated with a number of adverse events and contraindications that complicate their use. Based on our increased understanding of the inflammatory pathogenesis of gouty arthritis, several new agents are under development that may provide increased efficacy and reduced toxicity.

  14. Gouty arthritis in a 15-year-old girl with Bartter′s syndrome

    Directory of Open Access Journals (Sweden)

    Derakhshan Nima

    2010-01-01

    Full Text Available A 15-year-old girl, a known case of Bartter′s syndrome (BS for 7 years, developed severe pain in her right knee and right and left ankle. Her older sister had BS and developed end-stage renal disease (ESRD at the age of 14 years. Her serum uric acid was 12.6 mg/dL, 6 months ago, and 15.4 mg/dL in her recent lab data. Hyperuricemia and gouty arthritis are commonly seen in adults with BS, but to our knowledge there is no report of gouty arthritis in pediatric literature.

  15. High Level Serum Procalcitonin Associated Gouty Arthritis Susceptibility: From a Southern Chinese Han Population.

    Directory of Open Access Journals (Sweden)

    Wen Liu

    Full Text Available To study the serum Procalcitonin (PCT level in inflammatory arthritis including gouty arthritis (GA, Rheumatoid arthritis (RA, and ankylosing spondylitis (AS without any evidence of infection were evaluated the possible discriminative role of PCT in gouty arthritis susceptibility in southern Chinese Han Population.From Feb, 2012 to Feb, 2015, 51 patients with GA, 37 patients with RA, 41 patients with AS and 33 healthy control were enrolled in this study with no evidence of infections. The serum level of PCT (normal range < 0.05 ng/ml was measured by electrochemiluminescence immunoassay (ECLIA. Disease activity was determined by scores of VAS (4.07 ± 1.15, DAS28 (4.97 ± 1.12, and ASDAS (2.97 ± 0.81 in GA, RA and AS groups respectively. Other laboratory parameters such as, serum creatinine (CRE, erythrocyte sedimentation rate (ESR, C-reactive protein (CRP, uric acid (UA and white blood cells (WBC were extracted from medical record system.Serum PCT level was predominantly higher in gouty arthritis than in RA and AS patients, especially in the GA patients with tophi. PCT was significantly positively correlated with VAS, CRP and ESR in gouty arthritis and CRP in AS. PCT also had positive correlation-ship with ESR, DAS28 and ASDAS in RA and AS patients respectively, but significant differences were not observed.These data suggested that PCT is not solely a biomarker for infection, but also an indicator in inflammatory arthritis, especially in gouty arthritis.

  16. Clinical Observation on the Treatment of Acute Gouty Arthritis with Gout Powder Combined with Acupuncture%自拟痛风散加针刺治疗急性痛风性关节炎临床观察

    Institute of Scientific and Technical Information of China (English)

    关凤媛; 纪维峰; 赵福义; 马蕊; 王文文

    2014-01-01

    Objective:To observe the curative effect of taking traditional Chinese medicine orally combined with acupuncture on acute gouty arthritis and its effects on blood uric acid.Methods:60 cases of gout were randomly divided into a treatment group and a control group,30 cases in each group.The treatment group were treated with Gout Powder No.1 and needled Yinbai(SP1),Taichong(LR3),Gongsun(SP4),Sanyinjiao (SP6) and Zusanli(ST36) combined with local and distal point locating.The control group were given orally Meloxicam Tablets,15mg each time,once a day;and Sodium Bicarbonate Tablets,1 g each time,3 times a day.1 weeks for 1 courses.The patients were evaluated on the aspects of clinical symptoms and signs before and after treatment(joint pain,swelling degree,range of the joint motion,function) and uric acid changes.Results:In the treatment group,5 cases were cured,19 cases were markedly effective,5 cases were effective,1 case was not healed,the effective rate being 96.67%;while in the control group,3 cases were cured,4 cases were markedly effective,15 cases were effective,8 cases were ineffective,efficiency being 73.33%.The difference between the two groups was statistically significant(P 0.05).Conclusion:Taking traditional Chinese medicine orally combined with acupuncture has a better therapeutic effect in the treatment of acute gouty arthritis.%目的:观察中药口服配合针灸治疗急性痛风性关节炎的临床疗效及对血尿酸的影响。方法:将60例痛风患者随机分为治疗组和对照组,每组30例。治疗组口服自拟痛风散1号方并配合针刺隐白、太冲、公孙、三阴交、足三里,结合局部取穴及远端取穴;对照组给予美洛昔康片每次15 mg,每日1次,口服;碳酸氢钠片每次1.0 g,每日3次,口服。对两组患者用药前后临床症状及体征(关节疼痛、红肿程度、关节活动度、功能评估)以及尿酸变化情况进行评估。结果:治疗组临床治愈5

  17. Morin, a dietary bioflavonol suppresses monosodium urate crystal-induced inflammation in an animal model of acute gouty arthritis with reference to NLRP3 inflammasome, hypo-xanthine phospho-ribosyl transferase, and inflammatory mediators.

    Science.gov (United States)

    Dhanasekar, Chitra; Rasool, Mahaboobkhan

    2016-09-05

    The anti-inflammatory effect of morin, a dietary bioflavanol was explored on monosodium urate (MSU) crystal-induced inflammation in rats, an experimental model for acute gouty arthritis. Morin treatment (30mg/kg b.wt) significantly attenuated the ankle swelling and the levels of lipid peroxidation, nitric oxide, serum pro-inflammatory cytokines (tumor necrosis factor (TNF) -α, interleukin (IL)-1β, and IL-6), monocyte chemoattractant protein (MCP)-1, vascular endothelial growth factor (VEGF), prostaglandin E2 (PGE2), and articular elastase along with an increased anti-oxidant status (catalase (CAT) and superoxide dismutase (SOD)) in the joint homogenate of MSU crystal-induced rats. Histological assessment revealed that morin limited the diffusion of joint space, synovial hyperplasia, and inflammatory cell infiltrations. The mRNA expression of NLRP3 (nucleotide oligomerization domain (NOD)-like receptor family, pyrin domain containing 3) inflammasome, caspase-1, pro-inflammatory cytokines, MCP-1, inflammatory enzymes (inducible nitric oxide synthase (iNOS), and cyclooxygenase-2 (COX-2)), and nuclear factor-kappa B (NF-κB) p65 was found downregulated and HPRT (hypo-xanthine phospho-ribosyl transferase) mRNA expression was upregulated in morin treated MSU crystal-induced rats. In addition, morin treatment reduced the protein expression of NF-κB p65, p-NF-κB p65, iNOS, COX-2, and TNF-α. The results clearly demonstrated that morin exert a potent anti-inflammatory effect on MSU crystal-induced inflammation in rats.

  18. 痛风一号对实验性痛风性关节炎及尿酸代谢的影响%Effect of Chinese traditional medicine-gout 1 on the hyperuricemia and acute gouty arthritis

    Institute of Scientific and Technical Information of China (English)

    马文聪; 梅峥嵘; 严鹏科

    2014-01-01

    目的:观察中药组方痛风一号对痛风性关节炎及尿酸代谢的影响。方法将尿酸钠溶液注射大鼠右后肢踝关节腔内制备急性痛风性关节炎模型,观察痛风一号对痛风性关节炎的影响。容积法检测足踝关节肿胀程度;ELISA法检测血清中肿瘤坏死因子-α( TNF-α)和白介素-1β( IL-1β)含量, HE染色观察大鼠踝关节滑膜组织的病理变化。用黄嘌呤灌胃以及腹腔注射黄嘌呤混悬剂的方法制备高血尿酸模型小鼠,观察痛风一号对小鼠血尿酸、尿尿酸以及肝脏黄嘌呤氧化酶活性的影响。结果与正常组相比,急性痛风性关节炎血清模型大鼠48 h后关节肿胀指数显著增加。与模型组相比,痛风一号组关节肿胀度明显减轻( P<0.05),血清中TNF-α和IL-1β的水平显著降低( P<0.05),HE染色显示模型大鼠关节滑膜炎症明显,伴炎性细胞浸润,经痛风一号治疗后,上述病理改变减轻。在高尿酸血症小鼠试验中,与模型组相比,痛风一号组血尿酸水平及黄嘌呤氧化酶活性显著降低( P<0.05)。结论痛风一号对痛风性关节炎有良好的防治作用,其机制与降低血清中TNF-α和IL-1β的含量有关,痛风一号能有效抑制尿酸生成、促进尿酸代谢,其机制与抑制黄嘌呤氧化酶活性有关。%Objective To study the therapeutic effect of Chinese traditional medicine-gout 1 on the hyperuricemia and acute gouty arthritis. Methods Inflammatory model was established by injection of uric acid sodium crystal suspension into the ankle joint of the right hind limb in rats. The joint swelling degree was measured by volume method. The level of serum IL-1β was detected by ELISA. The pathological changes of the ankle joint synovial tissue were observed by HE staining. The hyperuricemic mice were induced by treatment with xanthine and uricase inhibitor. The effect of Chinese traditional medicine-gout 1 on the levels of serum uric acid and urine acid

  19. EVALUATION OF GUDUCHI YOGA IN THE MANAGEMENT OF VATARAKTA (GOUTY ARTHRITIS: A CLINICAL STUDY

    Directory of Open Access Journals (Sweden)

    Shivaprasad Huded

    2013-10-01

    Full Text Available Vatarakta is one of the main articular diseases, which is characterized by severe pain, tenderness, inflammation and burning sensation in the affected joints. It is a tridoshaja vyadhi, with vata pradhanyata and rakta as main dushya. Sedentary lifestyle is one of the etiological factors of Vatarakta. The etiology and symptomatology of Gout is very much similar to that of Vatarakta. Gout is a pathological reaction of joint or periarticular tissues which results from deposition of monosodium urate monohydrate crystals in joints and tissues. In Ayurvedic classics, although we find plenty of dravyas for joint disorders, the area of joint diseases management still remains to be elusive. Hence the present clinical study aims to evaluate the efficacy of combined effect of 'Guduchi extract and cucumber juice extract' in the management of Vatarakta (Gouty arthritis. In the present study, 20 patients fulfilling the diagnostic criteria of Vatarakta and who met the American College of Rheumatology (ACR criteria for acute Gouty arthritis were selected. Detailed profile which incorporated relevant data like symptomatology, physical signs and investigation reports were considered for assessment criteria. The ‘Guduchi Yoga’ (Aqueous extract of Guduchi and Trapusha was administered to patients of either sex in the dosage of 1 g BID with lukewarm water after food for 12 weeks (3 months. After the course of therapy for 12 weeks, symptomatic improvement was observed with statistically significant results (P < 0.001 along with attainment of normal serum uric acid levels followed by feeling of general wellbeing. From the present study it can be concluded that the combined effect of Guduchi and Trapusha extracts showed promising results in the management of vatarakta.

  20. 补肾利湿法对急性痛风性关节炎大鼠血清IL-17表达水平的影响%The Effect of Bushen Lishi Method on the Expression of Serum IL-17 Of Rats with Acute Gouty Arthritis

    Institute of Scientific and Technical Information of China (English)

    姜德友; 李文昊; 解颖; 隋方宇; 孙许涛; 韩洁茹; 刘彤彤; 常佳怡

    2015-01-01

    目的:研究并观察补肾利湿法对痛风性关节炎大鼠白介素17(IL-17)表达水平的影响,探讨补肾利湿法防治急性痛风性关节炎(Gouty Arthritis,GA)的作用机制。方法:将84只 Wistar 大鼠随机分为7组:空白组(BG)、模型组(MG)、中药对照组(CMCG)、西药对照组(WMCG)及中药复方低、中、高浓度组(CMLG、CMMG、CMHG),每组12只。采用 MSU 联合草酰钾诱导大鼠急性痛风性关节炎模型,应用 ELISA 法,分别检测各组大鼠血清 IL-17的含量。结果:与空白组比较,造模各组大鼠血清 IL-17的水平明显升高,差异有显著统计学意义(P <0.01);与模型组比较,西药对照组、中药对照组、中药复方低、中、高浓度各组 IL-17水平明显降低,差异有显著统计学意义(P <0.01);西药对照组与中药复方中浓度组比较, IL-17含量差异不大(P >0.01)。结论:补肾利湿法处方可明显抑制急性痛风性关节炎大鼠 IL-17的表达,对防治痛风性关节炎具有一定作用。%Objective:To observe the effect of Bushen Lishi Method on gouty arthritis on rat interleukin 17 (IL-17)expression level and to study the mechanism of Bushen Lishi Method in the prevention and treatment of acute gouty arthritis (GA).Meth-ods:A total of 84 Wistar rats were randomly divided into 7 groups:blank group,model group,Chinese medicine control group, western medicine control group and Chinese medicine with low,medium and high dose groups,with 12 rats in each group.Using the model of uric acid sodium combined with potassium oxonate to induce acute gouty arthritis,and then use ELISA method to de-tect the content of serum IL-17 of rats.Results:Compared with the blank group,the levels of the serum IL-17 of model group rats were significantly increased,and there was a significant difference (P 0.01).Conclusion:The pre-scription of Bushen Lishi Method can reduce the

  1. Treatment of 60 Cases of Gouty Arthritis with Modified Simiao Tang

    Institute of Scientific and Technical Information of China (English)

    Qiu Renbin; Shen Ruizi; Lin Dejiu; Chen Yuanlin; Ye Hongping; Zhu Hanting

    2008-01-01

    Objective:To observe the clinical effect of a modified Simiao Tang(加味四妙汤 Modified Decoction of Four Wonderful Drugs)for gouty arthritis and its influence on uric acid in blood.Methods:120 cases of gouty arthritis were randomly divided into the treatment group and control group with 60 cases in each group.Modified Simiao Tang(MST)was orally administered to the patients in the treatment group and allopurinol tablet was orally administered to the patients in the control group.The clinical effects of two groups were evaluated after one-week treatment and uric acid(UA)and C-reactive protein(CRP)levels in blood were determined after 1-month treatment.Results:The total effective rate in the treatment group was significantly higher than in the control group,86.7%vs.68.3%(P<0.01).And the treatment group was also significantly better than the control group in decreasing UA and CRP(P<0.05 or P<0.01).Conclusions:MST can significantly improve the symptoms and signs of gouty arthritis and decrease the levels of UA and CRP It is good for gouty arthritis.

  2. Use of diuretics and the risk of gouty arthritis: a systematic review

    NARCIS (Netherlands)

    Hueskes, B.A.; Roovers, E.A.; Mantel-Teeuwisse, A.K.; Janssens, H.; Lisdonk, E.H. van de; Janssen, M.

    2012-01-01

    OBJECTIVE: To systematically review the literature investigating the relationship between use of diuretics and the risk of gouty arthritis. METHODS: PubMed (1950-October 2009), Embase (1974-October 2009), and the Cochrane Library (up to October 2009) were searched using keywords and MeSH terms diure

  3. The progress of musculoskeletal ultrasound in gouty arthritis%痛风性关节炎的超声研究进展

    Institute of Scientific and Technical Information of China (English)

    王益茹; 陈九如

    2014-01-01

    Gouty arthritis is a common disease. The musculoskeletal manifestations of gout are triggered by the deposition of monosodium urate (MSU) crystals in cartilage, joints, and surrounding soft tissues. Ultrasonography is not only helpful in diagnosing gouty arthritis but also in evaluating the curative effects. It can also be used for needle guidance to obtain tissue samples for diagnosis. This paper introduces the most feasible ultrasound examination for gouty arthritis (Six-Minutes Examination), and the application in diagnosis different phases of gouty arthritis (asymptomatic hyperuricemia, acute, intercritical, chronic gout). Compared with comparison with X-ray, CT, and MRI, US is considered as a more effective, non-radiating, and least expensive imaging technique in diagnosis and management of gouty arthritis.%痛风性关节炎是临床常见疾病,由单钠尿酸盐结晶沉积在软骨、关节和周围软组织引发。超声不仅能用于痛风性关节炎的诊断和疗效评估,还可以引导细针穿刺获得诊断所需的组织样本。介绍痛风性关节炎的实用超声检查方法(六分钟检查法),以及超声在痛风性关节炎不同时期(无症状高尿酸血症期、急性期、发作间期和慢性期)中的诊断应用。在痛风性关节炎的诊治上,超声比X线、CT和MRI更有效,而且无辐射、检查费用低。

  4. 电针的不同波形对实验性大鼠急性痛风性关节炎滑膜组织中HSP70表达的影响%The Effect of Electro Acupuncture in Different Waveforms to HSP70 Expression in Rats of Acute Gouty Arthritis

    Institute of Scientific and Technical Information of China (English)

    金弘; 刘婷婷; 陈英华; 刘勇; 孙晓伟

    2012-01-01

    目的:明确不同波形电针治疗急性痛风性关节炎的疗效,探讨电针对实验性急性痛风性关节炎大鼠关节局部保护作用及其机制.方法:采用Coderre等经典造模方法建立急性痛风性关节炎大鼠模型.随机分成5组:空白组、模型组、电针疏波组、电针密波组、电针疏密波组.各组分成1天、3天、5天共3个时间点,选取“足三里”、“三阴交”穴进行电针治疗.以免疫组织化学技术观察病变关节滑膜组织中HSP70的表达变化,并进行统计学分析.结果:电针疏密波组能使急性痛风性关节炎大鼠滑膜内HSP-70蛋白表达显著增加(P<0.05或P<0.01),从而抑止滑膜组织炎症发生.结论:电针不同波形均能有效上调急性痛风性关节炎大鼠足踝关节滑膜内HSP70蛋白表达,从而减轻踝关节局部炎症反应,减轻关节损伤,且以电针疏密波为最佳.%Objective: To clear up the therapeutic effects of electroacupuncture in different waveforms to acute gouty arthritis, and reveal its mechanisms of partial protection for acute gouty arthritis. Methods: Coderre's Classical methods was used to establish the acute gouty arthritis model for rats. Wistar rats were divided ran- domly into five groups: blank group, model group, group of electroacupuncture in Shu - wave, group of elec-troacupuncture in dense -wave, group of electroacupuncture in Shu and dense wave. Each group was separated into 1 day ,3 day,and 5 day as subgroup for investigation. Select "Zusanli" , "Sanyinjiao" to be electroacupuncture points. To observe the changes of the expression of HSP70 in the diseased synovial tissue by using immuno-histochemical techniques and statistically analyzed the data. Results: Group of electroacupuncture in Shu and dense wave can significantly promote the expression of HSP - 70 protein in synovial tissues of acute gouty arthritis rats (P <0. 05 or P <0. 01 ) , thus restrains the occurrence of synovial tissue inflammation

  5. The Way Forward: Practical Clinical Considerations for the Use of Canakinumab in Patients With Difficult-to-Treat Gouty Arthritis.

    Science.gov (United States)

    Bardin, Thomas; van de Laar, Martinus A F J

    2015-10-01

    Canakinumab is indicated for patients with frequent gouty arthritis attacks who cannot be managed with standard-of-care medication, and should be used according to the labeled indication. Given its mechanism of action, physicians need to be aware of the potential contraindications and precautions with its use. When deciding as to whether a patient with gouty arthritis is an appropriate candidate for canakinumab treatment, several key clinical considerations should be kept in mind, which are discussed herein.

  6. Study on wine combined with onion in the treatment of acute gouty arthritis%葡萄酒协同洋葱对大鼠痛风症作用的研究

    Institute of Scientific and Technical Information of China (English)

    华菲; 曹宇; 宋凡; 张环; 王四旺; 孙纪元

    2016-01-01

    目的:通过尿酸钠(monosodium urate monohydrate ,MSU)晶体诱导炎症动物模型,探讨红酒泡洋葱对急性痛风性关节炎(acute gouty arthritis ,GA)的治疗作用。方法选用48只健康雄性SD大鼠,随机分为6组:空白组,模型组,阳性组,葡萄酒协同洋葱低剂量组,葡萄酒协同洋葱中剂量组和葡萄酒协同洋葱高剂量组。采用MSU晶体制备大鼠GA模型。空白组和模型组给予生理盐水,阳性组给予雷公藤多苷片,低、中、高剂量组分别给予不同剂量的葡萄酒+洋葱,检测血清中UA、IL‐1β和CAT活性水平。取踝关节滑膜,观测其病理变化。结果低剂量(3 mg · kg -1)能够显著降低GA模型大鼠的踝关节肿胀度及白细胞介素浓度(P<0.01),提高CAT 活性(P<0.01);低、中(6 mg · kg-1)剂量能够显著降低血清中尿酸的含量(P<0.01);尿酸钠所致痛风症大鼠的关节滑膜病变显著,经给药后各组大鼠的关节滑膜病理情况均有所缓解。结论葡萄酒泡洋葱可降低MSU晶体诱导的GA大鼠血清中尿酸及白细胞介素的水平,增强过氧化氢酶活性,对关节滑膜有保护和修复作用,其机制可能与抗氧化作用有关。%Objective To study the therapeutic effect of wine combined with onion on acute gouty arthritis (GA) in the animal model of sodium urate (monosodium urate monohydrate ,MSU) crystal‐induced inflammations .Methods 48 healthy male SD rats were randomly divided into six groups :control group ,model group ,positive group ,low dose group ,middle dose group and high dose group .GA models were made by using MSU .Control group and model group were given normal saline ,positive group were given Tripterygiumwilfordii Glycosides Tablets ,and low dose group ,middle dose group and high dose group were given different doses of wine (onion) .Wine (onion) ,Tripterygiumwilfordii Glycosides Tablets or normal saline

  7. Clinical Study of Acute Gouty Arthritis of Damp-Heat Accumulation Type Treated with Sanhuang Zhongtong Ointment and Xinhuang Tablet%三黄肿痛膏合新癀片治疗湿热蕴结型急性痛风性关节炎的临床观察

    Institute of Scientific and Technical Information of China (English)

    杨金颖

    2015-01-01

    Objective To observe the effect of Sanhuang Zhongtong ointment and Xinhuang tablet in the treatment of Damp-Heat accumulation type of acute gouty arthritis. Methods Chose 60 cases of patients with Damp-Heat accumulation type of acute gouty arthritis and divided into treatment group and control group, 30 cases in the control group were treated with ibuprofen. 30 cases in the control group were treated with Sanhuang Zhongtong ointment and Xinhuang tablet. Observed the clinical symptoms, signs and the change of blood uric acid in two groups. Results The total effective rate in treatment group was 90%, in control group was 66.67%. Comparing the two groups, the difference was statistically significant (P<0.05). After treatment, blood uric acid values in treatment group were signiifcantly lower than the control group, the difference was statistically significant (P<0.05). Conclusion The effect of Sanhuang Zhongtong ointment and Xinhuang tablet in treatment of acute gouty arthritis curative has good effect and less side effect.%目的:观察三黄肿痛膏合新癀片治疗湿热蕴结型急性痛风性关节炎的临床疗效。方法共选取60例患者,随机分为治疗组和对照组。对照组30例采用布洛芬治疗;治疗组30例采用三黄肿痛膏外敷合新癀片内服治疗。主要观察临床症状、体征及血尿酸的变化。结果治疗组总有效率为90%,对照组总有效率为66.67%。两组比较,差异有统计学意义(P<0.05)。治疗后治疗组的血尿酸值低于对照组,差异有统计学意义(P<0.05)。结论三黄肿痛膏联合新癀片治疗急性痛风性关节炎疗效好,副作用小。

  8. 中西医结合治疗急性痛风性关节炎40例疗效观察%Clinical observation of combination of traditional Chinese and western medicine in the treatment of acute gouty arthritis in 40 cases

    Institute of Scientific and Technical Information of China (English)

    喻忠; 李建岗

    2016-01-01

    目的:探讨中西医结合治疗急性痛风性关节炎的临床疗效。方法:收治急性痛风性关节炎患者80例,随机分为治疗组和对照组各40例,对照组采用双氯芬酸钠缓释片和秋水仙碱片治疗,观察组在对照组基础上加用竹叶石膏汤加减治疗,比较两组的治疗效果。结果:在治疗组,显效率62.5%,明显高于对照组的40%,总有效率90%,明显高于对照组的72.5%(P<0.05)。结论:竹叶石膏汤加减联合西药治疗急性痛风性关节炎临床疗效确切。%Objective:To explore the clinical effect of combination of traditional Chinese and western medicine in the treatment of acute gouty arthritis.Methods:80 patients with acute gouty arthritis were selected.They were randomly divided into the treatment group and the control group with 40 cases in each.Patients in the control group were treated with diclofenac sodium sustained release tablets and colchicine tablets,while patients in the observation group were treated with modified Zhu Ye Shi Gao Decoction on the basis of the control group.We compared the therapeutic effect of two groups.Results:In the treatment group,the marked effective rate of 62.5% was significantly higher than 40% of the control group,and the total efficiency of 90% was significantly higher than 72.5% of the control group(P<0.05).Conclusion:The clinical effect of modified Zhu Ye Shi Gao Decoction combined with western medicine in the treatment of acute gouty arthritis was exact.

  9. The dynamic changes of the serum levels of interleukin-1β, tumor necrosis factor-α, cyclooxygenase-2 in acute gouty arthritis patients%痛风性关节炎患者血清白细胞介素-1β肿瘤坏死因子-α环氧化酶-2水平的动态变化研究

    Institute of Scientific and Technical Information of China (English)

    袁艳平; 李长贵

    2013-01-01

    目的 观察严重程度不同的急性痛风患者血清白细胞介素(IL)-1β、肿瘤坏死因子(TNF)-α、环氧化酶-2的动态变化,为确定痛风急性期镇痛药物的使用疗程提供依据.方法 选择痛风性关节炎患者90例,其中急性发作期60例,缓解期30例(观察组3),健康体检者(对照组)30名.参照主诉疼痛程度评分法(VRS-4法),将急性痛风性关节炎分为重度(观察组1)和轻度(观察组2)2个亚组.痛风急性发作期的患者均给予相同剂量和疗程的依托考昔和秋水仙碱治疗14 d,应用酶联免疫吸附法(ELISA)分别检测发病后第1、3、7、10、14天血清IL-1β、TNF-α、环氧化酶-2水平.组间比较采用t检验,多组间均数比较采用单因素方差分析.结果 ①与对照组相比,观察组1、2在急性痛风性关节炎发病的第1~7天IL-1β、TNF-α水平明显升高(P<0.01),第10~14天恢复正常水平;环氧化酶-2水平在第1~3天明显升高(P<0.01),第7~10天恢复正常水平;而上述指标观察组3与对照组比较差异无统计学意义(t=-0.880,-1.201,-0.548; P=0.383,0.235,0.586).②与观察组2相比,在急性痛风发病的第10天观察组1 IL-1β、TNF-α水平明显升高[(24±5) pg/ml和(19±3) pg/ml,(323±84)ng/ml和(234±29) ng/ml;P=0.001,0.002],而观察组2与对照组之间比较差异无统计学意义(P=0.357);环氧化酶-2水平在急性痛风发病的第7天观察组1明显升高[(12.9±2.0) pg/ml和(9.1±1.6) pg/ml],而观察组2与对照组之间比较差异无统计学意义(P=0.941).结论 急性痛风性关节炎镇痛治疗10~14 d炎性因子才能完全恢复正常.本研究为急性痛风性关节炎镇痛药物使用疗程提供了依据.%Objective To investigate the dynamic changes of serum interleukin (IL)-1β,tumor necrosis factor (TNF)-α,cyclooxygenase (COX)-2 levels in patients with acute gouty arthritis with various severityes and to provide evidence for the course of anti-inflammatory drug used

  10. First metatarsophalangeal joint arthrodesis for the treatment of tophaceous gouty arthritis.

    Science.gov (United States)

    Kim, Yong Sang; Park, Eui Hyun; Lee, Ho Jin; Koh, Yong Gon

    2014-02-01

    In tophaceous gouty arthritis, surgeons face the choice between preservation of the involved joint and arthrodesis after tophi excision. Magnetic resonance imaging (MRI) can allow evaluation of the distribution of tophaceous deposits, which can be difficult to visualize on radiography. The goal of this study was to evaluate the characteristic MRI features of tophaceous lesions and to compare the clinical outcomes of arthrodesis after tophi excision with those of simple tophi excision. The authors reviewed 16 feet in 15 consecutive patients diagnosed with tophaceous gouty arthritis of the first metatarsophalangeal (MTP) joint who underwent surgery. Nine feet (group A) were treated with simple tophi excision, whereas the other 7 (group B) underwent first MTP joint arthrodesis after tophi excision. For clinical evaluation, the visual analog scale (VAS) for pain, American Orthopaedic Foot and Ankle Society (AOFAS) score, Tegner activity scale, and patient satisfaction assessments were used. Magnetic resonance imaging was performed to evaluate the characteristics of tophaceous deposits in the first MTP joint. Mean VAS and AOFAS scores and patient satisfaction significantly differed between the 2 groups at final follow-up (P=.007, .005, and .002, respectively). In group A, progression of arthritis of the first MTP joint was observed in 6 of 9 cases at final follow-up. The tophaceous lesions of these 6 cases were found to be located intra-articularly on MRI. Arthrodesis after tophi excision should be considered for treating tophaceous gouty arthritis of the first MTP joint when tophi are located intra-articularly and loss of cartilage involved is greater than 50% of the entire joint.

  11. Sonographic Findings in Gouty Arthritis: Diagnostic Value and Association with Disease Duration.

    Science.gov (United States)

    Elsaman, Ahmed M; Muhammad, Eman M S; Pessler, Frank

    2016-06-01

    The objective of this work was to evaluate the sonographic features of gouty arthritis and correlate findings with disease duration. The study was conducted on 100 patients in ambulatory care aged ≥40 y. Inclusion criteria included mono- or oligo-arthritis with effusion of the knee or the first metatarsophalangeal (MTP) joint and no known history of gout. A complete medical history was obtained with emphasis on the known risk factors or causes of gouty arthritis. A 12-MHz Medison linear probe was used for ultrasonography (US). Synovial fluid analysis with polarizing light microscopy was performed on all patients. Ninety-eight knee joints and 33 first MTP joints were examined. Gouty arthritis was found by US in four forms: (i) floating echogenic foci in effusion fluid or Baker cysts, (ii) deposits on the cartilage surface (double contour sign), (iii) erosions and (iv) mature tophus/tophi. These were found in 78.9%, 42.3%, 39.4% and 28.2% of patients, respectively. The overall sensitivity and specificity of US in detecting gout (as defined by the clinical gold standard, i.e., detection of urate crystals by polarizing light microscopy) were 85.9% and 86.7%, respectively. Detection of echogenic foci in effusion fluid was associated with the shortest duration of symptoms (median duration 2 y) followed by double contour sign (3.5 y), erosions (4 y) and tophus (12.5 y). Sonographic findings in gout can be assigned a temporal pattern, with echogenic foci being associated with the shortest and full tophus formation with the longest disease duration.

  12. 双源双能量 CT在痛风性关节炎的诊断应用%Application of dual energy CT in diagnosis of gouty arthritis

    Institute of Scientific and Technical Information of China (English)

    戴春雷

    2014-01-01

    Objective To evaluate the effect of dual energy CT in gouty arthritis urate crystal detection . Methods We selected 26 cases of patients with gouty arthritis , for dual energy CT check .Results 26 cases of acute gouty arthritis were found 36 urate crystal, the first metatarsophalangeal joint was the most common site of deposition.Conclusions Dual energy CT can clearly show the urate crystal , on gouty arthritis diagnosis with specificity .%目的:评价双源双能量CT在痛风性关节炎尿酸盐结晶检出中的作用。方法选出26例痛风性关节炎患者,行双源双能量CT检查。结果26例痛风性关节炎患者发现36处尿酸盐结晶,第一跖趾关节为最常见沉积部位。结论双源双能量CT能清楚显示尿酸盐结晶,对痛风性关节炎诊断具有特异性。

  13. THE COURSE OF GOUTY ARTHRITIS ACCORDING TO THE KHABAROVSK CITY RHEUMATOLOGY ROOMAND THE EFFECTIVENESS OF GOUT SCHOOL

    Directory of Open Access Journals (Sweden)

    Faina Sergeyevna Zharskaya

    2010-01-01

    Full Text Available The past decade is marked by a rise in the detection rates of gout. The paper gives data on its incidence, risk factors, the frequency of diagnostic errors, the specific features of the course of male gouty arthritis, and the effectiveness of Gout school activities

  14. Observations on the Efficacy of Acupuncture plus Ashi Point Pricking Bloodletting in Treating Acute Gouty Arthritis%针刺配合阿是穴刺络放血治疗急性痛风性关节炎疗效观察

    Institute of Scientific and Technical Information of China (English)

    徐颖; 黄微珍; 李斌

    2016-01-01

    目的:针刺配合阿是穴放血治疗急性痛风性关节炎的临床疗效。方法将70例急性痛风性关节炎患者随机分为治疗组38例和对照组32例。治疗组采用针刺配合阿是穴刺络放血治疗,对照组采用常规药物治疗。观察两组治疗前后血尿酸及C反应蛋白含量变化情况,比较两组临床疗效。结果两组治疗1、2个疗程后血尿酸及C反应蛋白含量与同组治疗前比较,差异均具有统计学意义(P<0.01)。治疗组治疗2个疗程后C反应蛋白含量与对照组比较,差异具有统计学意义(P<0.05)。治疗组总有效率为84.2%,对照组为81.3%,两组比较差异具有统计学意义(P<0.05)。结论针刺配合阿是穴刺络放血是一种治疗急性痛风性关节炎的有效方法。%Objective To investigate the clinical efficacy of acupuncture plus ashi point pricking bloodletting in treating acute gouty arthritis.Methods Seventy patients with acute gouty arthritis were randomly allocated to a treatment group of 38 cases and a control group of 32 cases. The treatment group received acupuncture plus ashi point pricking bloodletting and the control group, routine medication. Blood uric acid and C reaction protein contents were measured in the two groups before and after treatment. The clinical therapeutic effects were compared between the two groups.Results There were statistically significant differences in blood uric acid and C reaction protein contents after one and two courses of treatment compared with before treatment in the two groups (P<0.01). After two courses of treatment, there was a statistically significant difference in comparing C reaction protein contents between the two groups (P<0.05). The total efficacy rate was 84.2% in the treatment group and 81.3% in the control group; there was a statistically significant difference between the two groups (P<0.05).Conclusion Acupuncture plus ashi point pricking bloodletting is an effective way to

  15. Pharmacokinetic and pharmacodynamic properties of canakinumab in patients with gouty arthritis.

    Science.gov (United States)

    Chakraborty, Abhijit; Van, Linh M; Skerjanec, Andrej; Floch, David; Klein, Ulf R; Krammer, Gerhard; Sunkara, Gangadhar; Howard, Dan

    2013-12-01

    Pharmacokinetics and pharmacodynamics of the anti-interleukin (IL)-1β monoclonal antibody, canakinumab, in gouty arthritis patients from three studies are reported. Canakinumab has low serum clearance (0.214 L/day), low steady-state volume of distribution (7.44 L), a 25.8-day half-life, and approximately 60% subcutaneous absolute bioavailability in a typical 93-kg patient. Creatinine clearance had a small positive impact on serum canakinumab clearance that is not likely to be clinically relevant. Binding to circulating IL-1β was demonstrated by increases in total serum IL-1β following canakinumab dosing. Total IL-1β kinetics and canakinumab pharmacokinetics were characterized by a population-based pharmacokinetic-binding model, where the estimated apparent in vivo dissociation constant (signifying binding affinity of canakinumab to circulating IL-1β) was 0.99 nmol/L in gouty arthritis patients. Canakinumab treatment provided rapid, sustained decreases in C-reactive protein and serum amyloid A, provided superior pain relief to triamcinolone acetonide, and increased time to first recurrent attack (P ≤ 0.01 favoring all canakinumab doses vs. triamcinolone acetonide).

  16. NOD2/CARD15 gene mutations in patients with gouty arthritis.

    Science.gov (United States)

    Karaarslan, Ahmet; Kobak, Senol; Berdeli, Afig

    2016-11-10

    Nucleotide binding and oligomerization domains/caspase recruitment domain-containing protein 15 (NOD2/CARD15) is a cytoplasmic molecule controlling apoptosis and inflammatory processes by recognizing some microbial components. We aimed to identify the frequencies of NOD2/CARD15 gene mutations in patients with gouty arthritis and to determine their possible correlation with the disease phenotype. The study included 93 patients with gouty arthritis and 51 healthy controls matched for age, gender, and ethnicity. The NOD2/CARD15 R702W and G908R gene mutations were explored by the polymerase chain reaction restriction fragment length polymorphism method while the 3020insC mutation was analyzed by DNA sequencing. The mean patient age was 54.2 ± 14.2 years and mean duration of the disease was 3.1 ± 2.9 years. The first metatarsophalangeal and finger joint involvements were detected in 72 (77.4%) and 18 (19.5%) patients, respectively. Ankle arthritis and knee arthritis were detected in 43 (46.2%) and 20 (21.5%) patients, respectively. In total, 4 (9%) heterozygous mutations were detected in the G908R and R702W genes, while no mutation was detected in the 3020insC gene. Compared to the control group, there were no significant differences in all three DNA regions (G908R, R702W, and 3020insC; p = 0.452, p = 0.583, and p = 0.350, respectively). No correlation between the NOD2/CARD15 variants and clinical or laboratory findings (p > 0.05) was found. The frequencies of the NOD2/CARD15 gene mutations in the patients were similar to healthy control group. No association between clinical or laboratory findings and the NOD2/CARD15 gene mutations was observed.

  17. NOD2/CARD15 gene mutations in patients with gouty arthritis

    Directory of Open Access Journals (Sweden)

    Ahmet Karaarslan

    2016-11-01

    Full Text Available Nucleotide binding and oligomerization domains/caspase recruitment domain-containing protein 15 (NOD2/CARD15 is a cytoplasmic molecule controlling apoptosis and inflammatory processes by recognizing some microbial components. We aimed to identify the frequencies of NOD2/CARD15 gene mutations in patients with gouty arthritis and to determine their possible correlation with the disease phenotype. The study included 93 patients with gouty arthritis and 51 healthy controls matched for age, gender, and ethnicity. The NOD2/CARD15 R702W and G908R gene mutations were explored by the polymerase chain reaction restriction fragment length polymorphism method while the 3020insC mutation was analyzed by DNA sequencing. The mean patient age was 54.2 ± 14.2 years and mean duration of the disease was 3.1 ± 2.9 years. The first metatarsophalangeal and finger joint involvements were detected in 72 (77.4% and 18 (19.5% patients, respectively. Ankle arthritis and knee arthritis were detected in 43 (46.2% and 20 (21.5% patients, respectively. In total, 4 (9% heterozygous mutations were detected in the G908R and R702W genes, while no mutation was detected in the 3020insC gene. Compared to the control group, there were no significant differences in all three DNA regions (G908R, R702W, and 3020insC; p = 0.452, p = 0.583, and p = 0.350, respectively. No correlation between the NOD2/CARD15 variants and clinical or laboratory findings (p > 0.05 was found. The frequencies of the NOD2/CARD15 gene mutations in the patients were similar to healthy control group. No association between clinical or laboratory findings and the NOD2/CARD15 gene mutations was observed.

  18. hURAT1基因多态性与急性痛风性关节炎湿热证型的相关性研究%Correlation study on HURAT1 Gene Polymophism and Acute Gouty Arthritis of Damp Heat Type

    Institute of Scientific and Technical Information of China (English)

    王晓跃; 邓运明; 王力; 陈浩; 王明森; 李华南; 褚小刚

    2014-01-01

    目的:研究人尿酸盐阴离子蛋白1(hURAT1)基因启动子区单核苷酸多态性(SNP)与急性痛风性关节炎湿热证型的相关性。方法:临床筛选痛风性关节炎急性期发作患者110例,对照组115例。取研究对象外周抗凝血标本,通过Axygene96血基因组DNA小量制备试剂盒提取DNA,设计特异性引物,运用聚合酶链反应( PCR)进行扩增,运用基因序列测定技术,寻找SNP及突变位点。结果:hURAT1启动子区基因rs3825018基因型及等位基因频率研究显示,rs3825018杂合突变基因型( CT)、野生基因型( CC)、纯和突变基因( TT)在对照组和痛风组中的分布,分别为43.5%对27.3%,53.9%对70.0%,2.6%对2.7%,与野生基因相比,杂合突变基因型在两组中分布差异具有统计学意义( P=0.012)。其突变等位基因T基因频率为16.4%,低于对照组的24.3%( P=0.048),具有统计学差异。杂合突变基因型者患急性痛风性关节炎的风险较野生基因者降低( OR=0.493)。结论:人尿酸盐阴离子蛋白1(hURAT1)基因启动子区SNPs位点rs3825018与急性痛风性关节炎湿热证型密切相关。其突变性等位基因T为急性痛风性关节炎湿热证型的保护性等位基因。%Purpose:This research studies the correlation between SNP in hURAT 1 gene promoter region and damp -heat syndrome of acute gouty arthritis .Methods:Clinical screening 110 patients had acute phase of gouty arthritis attack , 115 cases of control group .Tak-ing peripheral anticoagulant samples of research subject , extracting DNA through Axygene 96 blood genomic DNA mini-prep kit, de-signing specific primers for amplification by PCR , is to find a SNP and mutation point by the use of gene sequencing technology .Re-sults:The study of four SNPs genotype and allele frequencies shows that ,the distribution frequency of rs 3825018 heterozygous mutant genotype CT, wild

  19. Role of IL-8 rs4073 and rs2227306 polymorphisms in the development of primary gouty arthritis in a Chinese population.

    Science.gov (United States)

    Cui, Y X; Zhao, H; Guo, H Q

    2016-10-17

    In this study, we investigated the role of two single nucleotide polymorphisms in the promoter region of the interleukin-8 gene (IL-8; rs4073 and rs2227306) in the susceptibility to primary gouty arthritis in a Chinese population. Three hundred and twelve patients with primary gouty arthritis and 340 healthy controls were recruited from the Yan'an University Affiliated Hospital between January 2014 and March 2015. The IL-8 rs4073 and rs2227306 polymorphisms were genotyped by polymerase chain reaction combined with restriction fragment length polymorphism. Unconditional multiple-logistic regression analysis revealed that the TT genotype of rs4073 was correlated with primary gouty arthritis risk, compared to the AA genotype [adjusted odds ratio (OR) = 1.65, 95% confidence interval (CI) = 1.08-2.54; P = 0.02]. In addition, the IL-8 rs4073 T allele was associated with a significant elevated risk of primary gouty arthritis, in comparison to the A allele (OR = 1.34, 95%CI = 1.07-1.67; P = 0.01). However, we observed no significant relationship between the IL-8 rs2227306 polymorphism and primary gouty arthritis risk. The results of this study suggest that the IL-8 rs4073 polymorphism could be a marker for primary gouty arthritis development.

  20. OBSERVATION ON THE THERAPEUTIC EFFECT OF ACUPOINT-INJECTION FOR TREATMENT OF GOUTY ARTHRITIS

    Institute of Scientific and Technical Information of China (English)

    曾振秀; 林文清

    2001-01-01

    In the present paper, 60 cases of gouty arthritis patients were randomly divided into acupuncture group (n=30) and acupoint-injection group (n=30). In these two groups, the tender-point was used as the main acupoint, combined with Taichong (LR 3), Yinbai (SP 1), Sanyinjiao (SP 6), Juegu (GB 39), Xuehai (SP 10), etc. 10 % Chishao (Radix Paeoniae Rubra) Injection and dexamethasone were used for acupoint-injection. Results indicated that in acupoint-injeution and acupuncture groups, 15 (50.0%) and 9 (30.0%) cases had marked improvement, 12 (40.0%) and 10 (33.3%) were effective, and 3 (10.0%) and 11(36.7%) failed in treatment, with the total effective rats being 90.0 % and 63.3 % respectively. Statistical analysis shows that acupoint-injection is significantly superior to simple acupuncture in the therapeutic effect ( P<0.05)

  1. Effects of Extract from Mangifera indica Leaf on Monosodium Urate Crystal-Induced Gouty Arthritis in Rats

    Directory of Open Access Journals (Sweden)

    Yan Jiang

    2012-01-01

    Full Text Available The leaves of Mangifera indica L. (Anacardiaceae is used as a medicinal material in traditional herb medicine for a long time in India, China, and other Eastern Asian countries. Our present study investigated the therapeutic effects of the ethanol extract from Mangifera indica (EMI in rat with monosodium urate (MSU crystals-induced gouty arthritis. Effects of EMI (50, 100, and 200 mg/kg, p.o. administrated for 9 days on the ankle swelling, synovial tumor necrosis factor-alpha (TNF-α, and interleukin-1beta (IL-1β levels were assessed in MSU crystal rat. Data from our study showed that rat with gouty arthritis induced by MSU crystal demonstrated an elevation in ankle swelling, synovial TNF-α, IL-1β mRNA, and protein levels. Oral administration of 100 and 200 mg/kg EMI for 9 days reversed the abnormalities in ankle swelling, synovial TNF-α, IL-1β mRNA, and protein levels. The results indicated that the beneficial antigouty arthritis effect of EMI may be mediated, at least in part, by inhibiting TNF-α and IL-1β expression in the synovial tissues. Our study suggests that Mangifera indica and its extract may have a considerable potential for development as an anti-gouty arthritis agent for clinical application.

  2. The proinflammatory role and clinical significance of IL-1 beta in gouty arthritis%IL-1β在痛风性关节炎中的致炎作用及临床意义

    Institute of Scientific and Technical Information of China (English)

    曹建梅; 王晓霞; 郭景煜; 丁旭东

    2016-01-01

    Recently, researches about the relation between gouty arthritis and inflammatory factors have drawn common concern of experts and scholars in home and abroad. Most experts believe that acute gouty arthritis is due to the deposition of urate crystals in joints that prompted the inflammatory infiltrating and swallowing of mononuclear macrophages, thus resulting in the secretion of inflammatory factors and lead to immune response. IL-1beta is an important pro-inflammatory cytokine, which takes a great part in the genesis of immune diseases, and also plays a key role in the process of joint damage in gouty arthritis. With the deeper research of the role of IL-1beta in the pathogenesis of gouty arthritis, IL-1 inhibitors, as the biological products against gouty arthritis, are becoming the hot spots in the medical community, which will open up new expectation on gout treatment and further help to improve the management and outcome in patients with gouty arthritis.%近年来国内外许多学者对痛风性关节炎与炎性因子的关系进行了探讨,大多数观点认为急性痛风性关节炎是由于体内沉积的尿酸盐结晶促使单核巨噬细胞黏附渗出,并吞噬尿酸盐微晶体后分泌炎症因子,从而诱发的免疫反应。IL-1β作为体内重要的致炎因子,在许多自身免疫性疾病中发挥着重要作用,也在尿酸盐晶体沉积引起的痛风性关节炎的关节损害过程中扮演了关键角色。随着对 IL-1β在痛风性关节炎发病机制中作用的深入研究,应用抗 IL-1类生物制剂治疗痛风已受到医学界高度关注,为治疗痛风带来了新希望,有助于进一步改善痛风的结局。

  3. Treating gouty arthritis inTCM%痛风性关节炎的中药治疗

    Institute of Scientific and Technical Information of China (English)

    何静; 朱电波

    2015-01-01

    中医各家对于痛风性关节炎均有不同程度的认识,且都通过临床取得了良好的疗效。现将治疗痛风性关节炎的药方以及其他治疗方法进行阐述,以期为今后治疗痛风性关节炎提供更多的借鉴思路。%Pathogeny of gouty arthritis was understood of varying degrees by different parties of TCM doctors. In clinical, according to theory of different parties of TCM doctors, signiifcant efifcacy was received. In the paper, prescription and other treatment methods for treating gouty arthritis were described, in order to provide ideas for the future.

  4. Analysis of Efficacy and Safety of a Small Dose of Colchicine Combined With Meloxicam Capsules for the Treatment of Acute Gouty Arthritis%小剂量秋水仙碱联合美洛昔康胶囊治疗痛风性关节炎急性发作期的疗效与安全性分析

    Institute of Scientific and Technical Information of China (English)

    张利; 戴小良; 郑聪; 宋利梅; 高旭; 刘柳; 卢杰

    2016-01-01

    Objective A small dose of colchicine combined with Meloxicam Capsules to explore the effcacy and safety of the treatment of acute attack of gouty arthritis.Methods 80 cases of gout arthritis patients treated in our hospital from March 2015 to March 2016 were selected as the research object and divided into control group and experimental group according to the principle of random. Control group were treated with colchicines, experimental group, on the basis of the control group, was given small dose of colchicine combined with meloxicam capsules, evaluation of efficacy and safety after 2 weeks of treatment, the clinical effcacy of the two groups were compared and the adverse conditions were compared.Results The total effective rate of the control group (62.50%) was lower than that of experimental group (95%), the incidence of adverse reactions (25.00%) was higher than that of the experimental group (5.00%), and the difference was statistically signiifcant (P < 0.05). Conclusion A small dose of colchicine combined with meloxicam capsules in the treatment of acute exacerbation of the effects of gouty arthritis.%目的:探究小剂量秋水仙碱联合美洛昔康胶囊治疗痛风性关节炎急性发作期的疗效与安全性。方法选取我院2015年3月~2016年3月收治的符合标准的80例痛风性关节炎患者为研究对象,并按随机原则将其分为对照组与实验组,对照组采用秋水仙碱治疗,实验组在对照组的基础上予以小剂量秋水仙碱联合美洛昔康胶囊。治疗2周后,评价疗效及安全性,比较两组患者的临床疗效及产生的不良症状情况。结果对照组的总有效率为62.50%,低于实验组(95.00%),不良反应发生率(25.00%)高于实验组(5.00%),且比较结果,差异具有统计学意义(P<0.05)。结论小剂量秋水仙碱联合美洛昔康胶囊治疗痛风性关节炎急性发作期的疗效显著。

  5. Determination of gouty arthritis' biomarkers in human urine using reversed-phase high-performance liquid chromatography

    Institute of Scientific and Technical Information of China (English)

    Lei-Wen Xiang; Jing Li; Jin-Ming Lin; Hai-Fang Li

    2014-01-01

    Creatinine, uric acid, hypoxanthine and xanthine are important diagnostic biomarkers in human urine for gouty arthritis or renal disease diacrisis. A simple method for simultaneous determination of these biomarkers in urine based on reversed-phase high-performance liquid chromatography (RP-HPLC) with ultraviolet (UV) detector was proposed. After pretreatment by dilution, centrifugation and filtration, the biomarkers in urine samples were separated by ODS-BP column by elution with methanol/50 mM NaH2PO4 buffer solution at pH 5.26 (5:95). Good linearity between peak areas and concentrations of standards was obtained for the biomarkers with correlation coefficients in the range of 0.9957-0.9993. The proposed analytical method has satisfactory repeatability (the recovery of data in a range of creatinine, uric acid, hypoxanthine and xanthine was 93.49-97.90%, 95.38-96.45%, 112.46-115.78%and 90.82-97.13%with standard deviation of o5%, respectively) and the limits of detection (LODs, S/N Z 3) for creatinine, uric acid, hypoxanthine, and xanthine were 0.010, 0.025, 0.050 and 0.025 mg/L, respectively. The established method was proved to be simple, accurate, sensitive and reliable for the quantitation of gouty arthritis' biomarkers in human urine samples. The ratio of creatinine to uric acid was found to be a possible factor for assessment of gouty arthritis.

  6. Pharmacological Basis for Use of Selaginella moellendorffii in Gouty Arthritis: Antihyperuricemic, Anti-Inflammatory, and Xanthine Oxidase Inhibition

    Science.gov (United States)

    Zhao, Ping; Chen, Ke-li; Zhang, Guo-li

    2017-01-01

    This study was aimed at evaluating the effects of Selaginella moellendorffii Hieron. (SM) on gouty arthritis and getting an insight of the possible mechanisms. HPLC method was developed for chemical analysis. The paw oedema, the neutrophil accumulation, inflammatory mediators, lipid peroxidation, and histopathological changes of the joints were analyzed in gouty arthritis rat model, and the kidney injury and serum urate were detected in hyperuricemic mice. Pharmacokinetic result demonstrated that the main apigenin glycosides might be quantitatively transformed into apigenin in the mammalian body. Among these compounds, the apigenin exhibited the strongest effect on xanthine oxidase (XOD). SM aqueous extract has proved to be active in reducing hyperuricemia in dose-dependent manner, and the levels of blood urea nitrogen (BUN) and creatinine (Cr) in high dose group were decreased significantly as compared with hyperuricemic control group (P < 0.01). The high dose of SM extract could significantly prevent the paw swelling, reduce gouty joint inflammatory features, reduce the release of IL-1β and TNF-α, lower malondialdehyde (MDA) and myeloperoxidase (MPO) levels, and increase superoxide dismutase (SOD) level (P < 0.01). For the first time, this study provides a rational basis for the traditional use of SM aqueous extract against gout in folk medicine. PMID:28250791

  7. Pharmacological Basis for Use of Selaginella moellendorffii in Gouty Arthritis: Antihyperuricemic, Anti-Inflammatory, and Xanthine Oxidase Inhibition

    Directory of Open Access Journals (Sweden)

    Ping Zhao

    2017-01-01

    Full Text Available This study was aimed at evaluating the effects of Selaginella moellendorffii Hieron. (SM on gouty arthritis and getting an insight of the possible mechanisms. HPLC method was developed for chemical analysis. The paw oedema, the neutrophil accumulation, inflammatory mediators, lipid peroxidation, and histopathological changes of the joints were analyzed in gouty arthritis rat model, and the kidney injury and serum urate were detected in hyperuricemic mice. Pharmacokinetic result demonstrated that the main apigenin glycosides were almost quantitatively transformed into apigenin in the mammalian body. Among these compounds, the apigenin exhibited the strongest effect on xanthine oxidase (XOD. SM aqueous extract has proved to be active in reducing hyperuricemia in dose-dependent manner, and the levels of blood urea nitrogen (BUN and creatinine (Cr in high dose group were decreased significantly as compared with hyperuricemic control group (P<0.01. The high dose of SM extract could significantly prevent the paw swelling, reduce gouty joint inflammatory features, reduce the release of IL-1β and TNF-α, lower malondialdehyde (MDA and myeloperoxidase (MPO levels, and increase superoxide dismutase (SOD level (P<0.01. For the first time, this study provides a rational basis for the traditional use of SM aqueous extract against gout in folk medicine.

  8. The Role of miRNAs in Common Inflammatory Arthropathies: Osteoarthritis and Gouty Arthritis

    Science.gov (United States)

    Papanagnou, Panagiota; Stivarou, Theodora; Tsironi, Maria

    2016-01-01

    MicroRNAs (miRNAs) are small, non-coding RNA species that are highly evolutionarily conserved, from higher invertebrates to man. Up to 1000 miRNAs have been identified in human cells thus far, where they are key regulators of the expression of numerous targets at the post-transcriptional level. They are implicated in various processes, including cell differentiation, metabolism, and inflammation. An expanding list of miRNAs is known to be involved in the pathogenesis of common, non-autoimmune inflammatory diseases. Interestingly, osteoarthritis (OA) is now being conceptualized as a metabolic disease, as there is a correlation among hyperuricemia and metabolic syndrome (MetS). Experimental evidence suggests that metabolic deregulation is a commonality between these different pathological entities, and that miRNAs are key players in the modulation of metabolic routes. In light of these findings, this review discusses the role of miRNAs in OA and gouty arthritis, as well as the possible therapeutic targetability of miRNAs in these diseases. PMID:27845712

  9. Gouty arthritis: the diagnostic and therapeutic impact of dual-energy CT

    Energy Technology Data Exchange (ETDEWEB)

    Finkenstaedt, Tim; Manoliou, Andrei; Higashigaito, Kai; Andreisek, Gustav; Guggenberger, Roman; Alkadhi, Hatem [University Hospital Zurich and University of Zurich, Institute of Diagnostic and Interventional Radiology, Zurich (Switzerland); Toniolo, Martin; Michel, Beat [University Hospital Zurich and University of Zurich, Department of Rheumatology, Zurich (Switzerland)

    2016-11-15

    To determine the diagnostic and therapeutic impact of dual-energy computed tomography (DECT) in gout. Forty-three patients with (n = 20) and without a history of gout (n = 23) showing non-specific soft tissue deposits underwent DECT after unrewarding arthrocentesis. Two blinded, independent readers evaluated DECT for the presence of urate crystals. Clinical diagnosis, clinically suspected urate crystal locations, diagnostic thinking and therapeutic decisions were noted before and after DECT. Clinical 1-month follow-up was obtained. DECT showed urate in 26/43 patients (60 %). After DECT, clinical diagnosis of gout was withdrawn in 17/43 (40 %) and was maintained in 16/43 patients (37 %). In 10/43 patients (23 %) the diagnosis was maintained, but DECT revealed urate in clinically unsuspected locations. In 23/43 patients (53 %), a treatment-change based on DECT occurred. Changes in diagnostic thinking occurred more frequently in patients without a history of gout (p < 0.001), changes in therapeutic decisions more frequently in patients with a history of gout (p = 0.014). Clinical follow-up indicated beneficial effects of DECT-based diagnoses in 83 % of patients. In patients with or without a history of gout and a recent suspicion for gouty arthritis with an unrewarding arthrocentesis, DECT has a marked diagnostic and therapeutic impact when hyperdense soft-tissue deposits are present. (orig.)

  10. Association of DNA methyltransferase polymorphisms with susceptibility to primary gouty arthritis

    Science.gov (United States)

    Zhong, Xiaowu; Peng, Yuanhong; Yao, Chengjiao; Qing, Yufeng; Yang, Qibin; Guo, Xiaolan; Xie, Wenguang; Zhao, Mingcai; Cai, Xiaoming; Zhou, Jing-Guo

    2016-01-01

    Gouty arthritis is the most common type of inflammatory and immune disease, and the prevalence and incidence of gout increases annually. Genetic variations in the DNA methyltransferases (DNMTs) gene have not, to the best of our knowledge, been reported to influence gene expression and to participate in the pathogenesis of gout. The aim of the present study was to investigate whether the DNMT1, DNMT3A and DNMT3B polymorphisms contribute to gout susceptibility. These polymorphisms were screened for in 336 gout patients and 306 healthy control subjects (from a South China population) for association with gout. The distribution frequencies of DNMT1 rs2228611 AA genotype (P=0.007) and A allele (P=0.002; odds ratio=1.508, 95% confidence interval=1.158–1.964) were found to be significantly increased in the gout patients when compared with those in the healthy control subjects. The rs1550117 in DNMT3A and rs2424913 in DNMT3B exhibited no significant associations with gout susceptibility between the patients and control subjects. These results demonstrated that the DNMT1 rs2228611 polymorphism may be involved in the pathogenesis of gout, while DNMT3A rs1550117 and DNMT3B rs2424913 did not show any obvious significance in the current study; thus, may not be used as risk factors to predict the susceptibility to gout. However, further studies are required to investigate the functions and regulatory mechanism of the polymorphisms of DNMTs in gout. PMID:27699015

  11. Association of DNA methyltransferase polymorphisms with susceptibility to primary gouty arthritis.

    Science.gov (United States)

    Zhong, Xiaowu; Peng, Yuanhong; Yao, Chengjiao; Qing, Yufeng; Yang, Qibin; Guo, Xiaolan; Xie, Wenguang; Zhao, Mingcai; Cai, Xiaoming; Zhou, Jing-Guo

    2016-10-01

    Gouty arthritis is the most common type of inflammatory and immune disease, and the prevalence and incidence of gout increases annually. Genetic variations in the DNA methyltransferases (DNMTs) gene have not, to the best of our knowledge, been reported to influence gene expression and to participate in the pathogenesis of gout. The aim of the present study was to investigate whether the DNMT1, DNMT3A and DNMT3B polymorphisms contribute to gout susceptibility. These polymorphisms were screened for in 336 gout patients and 306 healthy control subjects (from a South China population) for association with gout. The distribution frequencies of DNMT1 rs2228611 AA genotype (P=0.007) and A allele (P=0.002; odds ratio=1.508, 95% confidence interval=1.158-1.964) were found to be significantly increased in the gout patients when compared with those in the healthy control subjects. The rs1550117 in DNMT3A and rs2424913 in DNMT3B exhibited no significant associations with gout susceptibility between the patients and control subjects. These results demonstrated that the DNMT1 rs2228611 polymorphism may be involved in the pathogenesis of gout, while DNMT3A rs1550117 and DNMT3B rs2424913 did not show any obvious significance in the current study; thus, may not be used as risk factors to predict the susceptibility to gout. However, further studies are required to investigate the functions and regulatory mechanism of the polymorphisms of DNMTs in gout.

  12. The Role of miRNAs in Common Inflammatory Arthropathies: Osteoarthritis and Gouty Arthritis

    Directory of Open Access Journals (Sweden)

    Panagiota Papanagnou

    2016-11-01

    Full Text Available MicroRNAs (miRNAs are small, non-coding RNA species that are highly evolutionarily conserved, from higher invertebrates to man. Up to 1000 miRNAs have been identified in human cells thus far, where they are key regulators of the expression of numerous targets at the post-transcriptional level. They are implicated in various processes, including cell differentiation, metabolism, and inflammation. An expanding list of miRNAs is known to be involved in the pathogenesis of common, non-autoimmune inflammatory diseases. Interestingly, osteoarthritis (OA is now being conceptualized as a metabolic disease, as there is a correlation among hyperuricemia and metabolic syndrome (MetS. Experimental evidence suggests that metabolic deregulation is a commonality between these different pathological entities, and that miRNAs are key players in the modulation of metabolic routes. In light of these findings, this review discusses the role of miRNAs in OA and gouty arthritis, as well as the possible therapeutic targetability of miRNAs in these diseases.

  13. 中医药治疗痛风性关节炎的研究进展%Research Progress of Chinese Medicine Treatment on Gouty Arthritis

    Institute of Scientific and Technical Information of China (English)

    李鑫浩; 赵树森

    2014-01-01

    通过对近年来应用中医疗法(包括中药外敷、推拿、针灸治疗等)治疗痛风性关节炎的文献及研究,探讨目前中医药研究治疗痛风性关节炎的使用方法及建议。%Through the recent application of Chinese medicine ( including Chinese medicine, acupuncture and moxibustion therapy ) literature research on treatment of gouty arthritis, suggestions on traditional Chinese medicine on the treatment of gouty arthritis are proposed.

  14. Association of TLR4 Gene rs2149356 polymorphism with primary gouty arthritis in a case-control study.

    Directory of Open Access Journals (Sweden)

    Yu-Feng Qing

    Full Text Available BACKGROUND: The toll-like receptor (TLR4-interleukin1β (IL1β signaling pathway is involved in the monosodium urate (MSU-mediated inflammation. The aim of this present study was to determine whether the TLR4 gene rs2149356 SNP is associated with gouty arthritis (GA susceptibility and whether rs2149356 SNP impacts the TLR4-IL1β signaling pathway molecules expression. METHODS AND FINDINGS: The rs2149356 SNP was detected in 459 GA patients and 669 control subjects (containing 459 healthy and 210 hyperuricemic subjects. Peripheral blood mononuclear cells (PBMCs TLR4 mRNA and serum IL1β were measured in different genotype carriers, and correlations between TLR4 gene SNP and TLR4 mRNA, IL1β were investigated. The frequencies of the genotype and allele were significantly different between the GA and control groups (P<0.01, respectively. The TT genotype was associated with a significantly increased risk of GA (OR = 1.88; this finding was not influenced by making adjustments for the components of possible confounders (adjusted OR = 1.96. TLR4 mRNA and IL1β were significantly increased in the TT genotype from acute GA patients (P<0.05, respectively, and lipids were significantly different among three genotypes in the GA patients (P<0.05, respectively. CONCLUSIONS: The TLR4 gene rs2149356 SNP might be associated with GA susceptibility, and might participate in regulating immune, inflammation and lipid metabolism. Further studies are required to confirm these findings.

  15. Determination of gouty arthritis' biomarkers in human urine using reversed-phase high-performance liquid chromatography

    Directory of Open Access Journals (Sweden)

    Lei-Wen Xiang

    2014-04-01

    Full Text Available Creatinine, uric acid, hypoxanthine and xanthine are important diagnostic biomarkers in human urine for gouty arthritis or renal disease diacrisis. A simple method for simultaneous determination of these biomarkers in urine based on reversed-phase high-performance liquid chromatography (RP-HPLC with ultraviolet (UV detector was proposed. After pretreatment by dilution, centrifugation and filtration, the biomarkers in urine samples were separated by ODS-BP column by elution with methanol/50 mM NaH2PO4 buffer solution at pH 5.26 (5:95. Good linearity between peak areas and concentrations of standards was obtained for the biomarkers with correlation coefficients in the range of 0.9957–0.9993. The proposed analytical method has satisfactory repeatability (the recovery of data in a range of creatinine, uric acid, hypoxanthine and xanthine was 93.49–97.90%, 95.38–96.45%, 112.46–115.78% and 90.82–97.13% with standard deviation of <5%, respectively and the limits of detection (LODs, S/N≥3 for creatinine, uric acid, hypoxanthine, and xanthine were 0.010, 0.025, 0.050 and 0.025 mg/L, respectively. The established method was proved to be simple, accurate, sensitive and reliable for the quantitation of gouty arthritis' biomarkers in human urine samples. The ratio of creatinine to uric acid was found to be a possible factor for assessment of gouty arthritis.

  16. X - ray diagnosis of the gouty arthritis%痛风性关节炎的X线诊断

    Institute of Scientific and Technical Information of China (English)

    李志晓

    2009-01-01

    Objective To enhance the recognition of gouty arthritis through analyzing the X -ray findings in 30 cases. Methods The data of thirty eases of gouty arthritis proved by clinic, laberatory ex-amination and X -ray findings were retrospectively analysed, and discussed with review of literature. Re-stilts The first metatarso -phalangeal joint was a common location of pathological changes(83.3%) ,and be diagnosied correctly in the early stage if the doctor is quite familiar with early radiologicmanifestations and features of the gouty arthritis, and also considered with clinical features and laboratory examination.%目的 总结30例痛风性关节炎的X线表现,旨在加强对本病的再认识.方法 收集1990年以来经临床证实的痛风性关节炎30例.就其X线表现、临床症状及实验室检查并结合文献进行回顾性分析.结果 病变以第一跖趾关节为最好发和首发部位,占83.3%(25/30),其他关节亦可受累.X线表现为:①软组织肿胀;②骨质破坏24例(80%);③关节改变20例(66.7%);④其他改变有少数病例受累关节邻近骨质疏松等.结论 只有熟悉痛风性关节炎的旱期X线表现及其特点,结合临床症状及实验室检查,才能及早对本病作出正确诊断.

  17. Procalcitonin levels in fresh serum and fresh synovial fluid for the differential diagnosis of knee septic arthritis from rheumatoid arthritis, osteoarthritis and gouty arthritis.

    Science.gov (United States)

    Wang, Chenggong; Zhong, DA; Liao, Qiande; Kong, Lingyu; Liu, Ansong; Xiao, Han

    2014-10-01

    Whether the levels of procalcitonin (PCT) in the serum and synovial fluid are effective indicators for distinguishing septic arthritis (SA) from non-infectious arthritis remains controversial. The present study aimed to evaluate whether PCT levels in fresh serum or fresh joint fluid may be used in the differential diagnosis of SA from rheumatoid arthritis (RA), osteoarthritis (OA) and gouty arthritis (GA). From January 2012 to June 2013, 23 patients with knee SA, 21 patients with RA, 40 patients with OA and 11 patients with GA were enrolled in the current study. The levels of PCT were measured within 24 h after specimen collection at room temperature. An enzyme-linked fluorescence assay (ELFA) was used to detect the levels of PCT in the serum and synovial fluid. The correlations between the levels of PCT in the serum and synovial fluid and the arthritic patient groups were determined by the Nemenyi test. Areas under the receiver operating characteristic (ROC) curve were calculated to evaluate the accuracy of the correlations. The levels of PCT in the serum and joint fluid of the patients in the SA group were higher compared with those of the other groups (Parthritis; however, the PCT levels in fresh synovial fluid are more sensitive and accurate indicators than PCT levels in fresh serum.

  18. X-ray diagnosis of gouty arthritis%痛风性关节炎的X线诊断

    Institute of Scientific and Technical Information of China (English)

    杜天会; 张富军; 郑雷

    2011-01-01

    Objective : To discuss the X-ray features of gouty arthristis. Methods: To analyze the dinic and X-ray findings of 28 cases retrospectively which have been diagnose as gouty arthristis. Results: The gouty arthristis is mainly invade the small joint in hands and feet of adult man, especially the first metatarsophalageal joint. There is no positive X-ray findings in the prophase of the disease, but in the middle or advanced stage there is typical X-ray findings as follows : ① the chiselliked bone destruction at epiphysis neighbouring joint ; ②secondum degenerative osteoarthropathy;③ eccentricity soft tissue swelling and the tuberculum arthriticum formation. Conclusion : The gouty arthritis has a certain special X-ray findings ,and its early diagnosis must link to the clinic closely.%目的:探讨痛风性关节炎的X线特征.方法:回顾性分析28例确诊为痛风性关节炎患者的临床和X线资料.结果:痛风性关节炎多见于成年男性.常侵犯手、足小关节,其中以第1跖趾关节最为好发.早期X线常无阳性表现,中晚期可见典型X线表现:①位于关节边缘骨端的穿凿样骨质破坏;②)继发性退行性骨关节病;③软组织偏心性肿胀和痛风结节的形成.结论:痛风性关节炎的X线表现有一定的特征性,早期诊断须密切结合临床.

  19. 痛风性关节炎的高频超声表现%High-frequency ultrasonographic findings of gouty arthritis

    Institute of Scientific and Technical Information of China (English)

    王磊; 邱逦; 张凌燕

    2011-01-01

    目的 探讨痛风性关节炎的超声表现特征.方法分析22例临床确诊的痛风性关节炎且曾有急性痛风发作的32个受累关节的超声表现.结果受累关节共32个:第一跖趾关节28个(28/32,87.50%),膝关节2个(2/32,6.25%),踝关节1个(1/32,3.13%),肘关节1个(1/32,3.13%).所有受累关节均有超声阳性表现.超声表现:关节积液30个(30/32,93.75%),滑膜增生16个(16/32,50.00%),骨侵蚀10个(10/32,31.25%),关节软骨"双边征"25个(25/32,78.13%),关节液内"暴雪样"回声10个(10/32,31.25%),关节内点状强回声8个(8/32,25.00%),关节内片状强回声团伴声影15个(15/32,46.88%),关节旁肌腱周围强回声8个(8/32,25.00%),关节周围滑囊积液4个(4/32,12.50%).结论痛风性关节炎在高频超声下有多种表现,且部分超声表现具有特异性.高频超声可作为诊断痛风性关节炎的重要影像学方法.%Objective To explore the ultrasonographic features of gouty arthritis.Methods Sonographic manifestations of 32 joints with acute gout attack in 22 gouty arthritis patients were analyzed.Results Thirty-two involved joints included 28 first metatarsophalangeal joints (28/32, 87.50%), 2 knee joints (2/32, 6.25%), 1 ankle joint (1/32, 3.13%) and 1 elbow joint (1/32, 3.13%).Sonographic positive performance were found in all the involved joints, including effusion in 30 joints (30/32, 93.75%), synovial hypertrophy in 16 joints (16/32, 50.00%), bony erosion in 10 joints (10/32,31.25%), double contour sign of articular cartilage in 25 joints (25/32, 78.13%), snowstorm appearance of the joint fluid in 10 joints (10/32, 31.25 %), hyperechoic spots in 8 joints (8/32, 25.00 % ), intraarticular patchy hyperechogenicity with posterior acoustic shadow in 15 joints (15/32, 46.88%), hyperechogenicity around the periarticular tendon in 8 joints (8/32, 25.00%) and effusion in periarticular synovial bursa in 4 joints (4/32, 12.50%).Conclusion Gouty arthritis has multiple

  20. Engagement of fatty acids with Toll-like receptor 2 drives interleukin-1beta production via the ASC/caspase 1 pathway in monosodium urate monohydrate crystal-induced gouty arthritis.

    NARCIS (Netherlands)

    Joosten, L.A.B.; Netea, M.G.; Mylona, E.; Koenders, M.I.; Malireddi, R.K.; Oosting, M.; Stienstra, R.; Veerdonk, F.L. van de; Stalenhoef, A.F.H.; Giamarellos-Bourboulis, E.J.; Kanneganti, T.D.; Meer, J.W.M. van der

    2010-01-01

    OBJECTIVE: The concept that intraarticular crystals of uric acid by themselves trigger episodes of painful gouty arthritis is inconsistent with the clinical reality. Patients with large deposits of monosodium urate monohydrate (MSU) crystals (tophi) do not necessarily experience gouty attacks. In fa

  1. Zisheng Shenqi decoction ameliorates monosodium urate crystal-induced gouty arthritis in rats through anti-inflammatory and anti-oxidative effects.

    Science.gov (United States)

    Han, Jieru; Xie, Ying; Sui, Fangyu; Liu, Chunhong; Du, Xiaowei; Liu, Chenggang; Feng, Xiaoling; Jiang, Deyou

    2016-09-01

    Based on traditional Chinese medicinal theories on gouty arthritis, Zisheng Shenqi decoction (ZSD), a novel Chinese medicinal formula, was developed due to its multiple functions, including reinforcing renal function, promoting blood circulation and relieving pain. In the present study, the effect of ZSD on monosodium urate (MSU) crystal-induced gouty arthritis in rats was investigated and the underlying mechanisms were examined. The data from these investigations showed that the injection of MSU crystals into the ankle joint cavity caused significant elevations in ankle swelling and inflammatory cell infiltration into the synovium, whereas these abnormal changes were markedly suppressed by oral administration of ZSD (40 mg/kg) for 7 days. Mechanically, ZSD treatment prevented MSU crystal‑induced inflammatory responses, as evidenced by downregulation in the expression levels of NACHT domain, leucine‑rich repeat and pyrin domain containing protein (NALP) 1 and NALP6 inflammasomes, decreased serum levels of tumor necrosis factor‑α and interleukin‑1β, and inhibited activation of nuclear factor‑κB. In addition, ZSD administration markedly enhanced the anti-oxidant status in MSU crystal‑induced rats by the increase in the activities of superoxide dismutase and glutathione peroxidase, and the levels of reduced glutathione. These results indicated that ZSD effectively prevented MSU crystal-induced gouty arthritis via modulating multiple anti‑oxidative and anti‑inflammatory pathways, suggesting a promising herbal formula for the prevention and treatment of gouty arthritis.

  2. 痛风性关节炎动物模型研究进展%Research Process of Animal Model of Gouty Arthritis

    Institute of Scientific and Technical Information of China (English)

    杨玲玲; 黄丽贞; 邓家刚

    2015-01-01

    痛风性关节炎是一种代谢障碍性疾病,近年来随着人们生活方式的改变,其发病率逐升高,对该病的研究也逐渐增多。为进一步研究痛风性关节炎的形成机制及防治方法,提供一个近于人类发病机理的痛风性关节炎动物模型,兹就国内外痛风性关节炎模型做一综述。%Gouty arthritis is a metabolic disorder.In recent years,with changing lifestyles,the incidence rate of gouty arthritis gradually increased and studies relate to the disease gradually increased.To further study the formation mechanism and control methods of gouty arthritis,this paper did a review on studies of animal model of gouty arthritis.

  3. Effects of RuPeng15 Powder (RPP15 on Monosodium Urate Crystal-Induced Gouty Arthritis in Rats

    Directory of Open Access Journals (Sweden)

    Y.-Y. Kou

    2015-01-01

    Full Text Available RuPeng15 Powder (RPP15 is a herbal multicompound remedy that originates from traditional Tibetan medicine and possesses antigout, anti-inflammatory, and antihyperuricemic properties based on the traditional conceptions. The present study was undertaken to evaluate the therapeutic effect of PRP15 in rat gouty arthritis induced by monosodium urate (MSU crystals. In the present study, we found that treatment with RPP15 (0.4, 0.8, and 1.2 g/kg in rats with gouty arthritis induced by MSU crystals significantly attenuated the knee swelling. Histomorphometric and immunohistochemistry analyses revealed that MSU-induced inflammatory cell infiltration and the elevated expressions of nuclear transcription factor-κB p65 (NF-κB p65 in synovial tissues were significantly inhibited, and enzyme-linked immunosorbent assay (ELISA result showed that MSU-induced high levels of tumor necrosis factor-alpha (TNF-α, interleukin-1 beta (IL-1β, and interleukin-8 (IL-8 in synovial fluid were reduced by treatment with RPP15 (0.4, 0.8, and 1.2 g/kg. We conclude that RPP15 may be a promising candidate for the development of a new treatment for gout and its activity of antigout may be partially related to inhibiting TNF-α, IL-1β, IL-8, and NF-κB p65 expression in the synovial tissues.

  4. Anti-Gouty Arthritis and Antihyperuricemia Effects of Sunflower (Helianthus annuus Head Extract in Gouty and Hyperuricemia Animal Models

    Directory of Open Access Journals (Sweden)

    Lanzhou Li

    2017-01-01

    Full Text Available This study was performed to investigate the therapeutic effects and possible mechanisms of sunflower (Helianthus annuus head extract (SHE on gout. First, the components of sunflower head powder and SHE were analyzed systematically. SHE, especially SHEB (extracted with 20% ethanol and 80% double-distilled water, strongly suppressed the swelling of the ankles in rats with acute gout induced by monosodium urate (MSU crystals and reduced the levels of uric acid and xanthine oxidase (XO in mice with hyperuricemia induced by oteracil potassium and yeast extract powder. Hematoxylin and eosin staining indicated that SHEB reduced inflammation cells and increased the joint space in the ankle compared with the control rats with MSU-induced gout. In the rats with acute gout, among 13 detected inflammatory cytokines, SHEB significantly enhanced the serum levels of interleukin-10 and the monocyte chemoattractant protein 1α. In the mice with hyperuricemia, SHEB reduced the levels of glutathione peroxidase, superoxide dismutase, malondialdehyde, and nitrogen monoxide in liver tissues. The potential therapeutic effects of SHE on gout are probably due to the production of anti-inflammatory cytokines and the suppression of XO activity via the modulation of oxidative stress status.

  5. The Efficacy of the Combined Acupuncture and China Ixeris treatment of the patients presenting acute gouty arthritis%针灸配合中药苦蝶子治疗急性痛风性关节炎

    Institute of Scientific and Technical Information of China (English)

    马蕊

    2013-01-01

    目的观察中医治疗痛风的有效治疗方法。方法中医认为痛风是痰湿内聚,瘀久化热,闭阻经脉,气血运行不畅而发病。临床上经过抽血化验尿酸增高,结合症状表现进行诊断。本文将46例痛风患者随机分为两组,中药治疗组(针刺和静点苦蝶子)和西药对照组(急性期给醋氯芬酸片,缓解期给别嘌呤醇口服)。结果 治疗组总有效率95.65%,对照组总有效率82.60%,两组疗效有显著差异,治疗组疗效优于对照组。结论 针药并举安全有效,是治疗痛风的一个比较理想的方法。%Objective:To observe the effective treatment method of Chinese medicine treatment in gout therapy. Methods: The Chinese medicine consider the onset of gout is cohesive phlegm stasis long time of heat, closed block meridians, blood runs sluggish.Uric acid increased in blood tests,combined clinical manifestations to diagnose. In this paper, 46 cases of gout patients were randomly divided into two groups,Chinese medicine treatment group(Acupuncture and China Ixeris Intravenous drop ) and The control group of Western Medicine(Aceclofenac tablets for the acute phase,Remission to oral allopurinol).Results: total effective rate was 95.65%intreatment group,82.60% in control group ,there are significant differences in the two groups, the treatment group is better than the control group.Conclusion:The Acupuncture combinedherbs are both safe and effective, and is an ideal way to treat gout.

  6. Zhou Fuming's Gouty Arthritis Treatment Tips%周富明痛风性关节炎辨治要诀

    Institute of Scientific and Technical Information of China (English)

    沈佳红; 周富明

    2016-01-01

    [目的]总结周富明名老中医发挥中医药优势治疗痛风性关节炎的学术观点和临床经验。[方法]通过临证侍诊、跟师抄方、收集分析老师临床资料,研究探讨周老治疗痛风性关节炎的学术观点和临床经验,对其中医药治疗痛风性关节炎的辨证特色予以总结,并附验案举隅。[结果]痛风性关节炎中医称之为痹证,正虚外感、邪气痹阻经脉为基本病因病机,周老提出先辨主证、后辨兼证,明确缓急、虚实、病位的辨证要诀,据此遣方用药,最终达到扶正驱邪、标本兼治的目的。所举医案,贯彻周师的临床经验,疗效满意。[结论]周富明老中医中医辨证论治治疗痛风性关节炎效果显著,具有推广应用价值。其临床辨证思路及遣方用药原则值得深入学习与探究。%Objective] To sum up the academic ideas and clinical experience of Zhou Fuming's old Chinese medicine in treating gout arthritis. [Method] From the clinical treatment,coping the teacher's prescription drugs, collecting the clinical information of the teacher, research and discuss Zhou Fuming old doctor of traditional Chinese medicine academic ideas and clinical experience in gouty arthritis treatment, to summarize the traditional Chinese medicine of gouty arthritis in dialectical characteristic, and for proven cases. [Result] Gouty arthritis in TCM is called arthromyodynia, physical weakness and disease blocking main and collateral channels are the basic pathogenesis. Zhou Fuming old Chinese medicine puts forward first identifing the main symptoms, then identifing secondary symptoms, to make clear major and minor, virtual and real, the site of disease treatment tips, with objective to reach strengthening the physique and driving away the disease and clinical cure. The listed medical case carried out teacher Zhou's academic experience, whose curative effect was satisying. [Conclusion] Zhou Fuming old Chinese

  7. 痛风性关节炎46例X线诊断分析%Analysis of X-ray diagnosis in 46 cases with gouty arthritis

    Institute of Scientific and Technical Information of China (English)

    翟丕力; 朱丽丽; 吴敬涛; 刘源

    2011-01-01

    Objective To study the X-ray imaging characteristics of gouty arthritis. Methods The X-ray plates from gouty arthritis were analyzed. Results The gouty arthritis usually occurred in the first metatarsophalangeal joint. The X-ray findings were dissymmetric swellings of soft tissue,bony erosion defect with sharp and hard edge,narrowed joint space and irregular articular surface,emergence of fiber stiffness,even joint malformations and sublimation or dislocation, associated with hyperosteogeny and nearby osteoporosis. Conclusion Diversification was presented in X-ray findings of gouty arthritis, which could be easily confused with other single or multiple bone joint diseases. As a result, accurate diagnosis should be based on careful analysis about X-ray findings.%目的 研究痛风性关节炎的X线影像学特征.方法 回顾性分析46例被确诊为痛风性关节炎患者的X线影像学资料.结果 痛风性关节炎多发生于第一跖趾关节,占80.4%.X线表现主要是软组织偏侧性肿胀,骨质侵蚀性破坏,关节间隙狭窄,关节面不规整,可发生纤维强直,关节畸形,半脱位或脱位,可伴有骨质增生,骨质疏松.结论 痛风性关节炎的X线表现呈多样化,易与其他骨关节病混淆,必须认真分析其X线征象才能作出正确诊断.

  8. A Randomized, Controlled Trial to Assess the Efficacy of Arthroscopic Debridement in Combination with Oral Medication Versus Oral Medication in Patients with Gouty Knee Arthritis.

    Science.gov (United States)

    Wang, Xin; Wanyan, Pingping; Wang, Jian Min; Tian, Jin Hui; Hu, Long; Shen, Xi Ping; Yang, Ke Hu

    2015-12-01

    Gouty knee arthritis refers to a form of inflammatory diseases caused by deposits of needle-like crystals of uric acid in knee joint. The aim of this study was to assess the efficacy and safety of arthroscopic debridement in combination with oral medication versus oral medication alone for the treatment of gouty knee arthritis. A total of 60 patients with gouty knee arthritis were randomized to receive either arthroscopic surgery in combination with oral medication or oral medication alone. Efficacy was assessed with the angle of motion, functions, and visual analog scale (VAS). These indices were measured prior to treatment and at 2, 4, 12, 24, and 48 weeks posttreatment. Surgery- and medication-related complications were observed. Significant differences in flexion and extension of the knee joint, lymphoma scores, and VAS were detected between the two groups at 2, 4, and 12 weeks posttreatment (P  0.05) . Significant differences in these indices were detected at different time points in each group (P  0.05). Arthroscopic surgery in combination with oral medication is superior to single oral medication in the flexion and extension of the knee joint, lymphoma scores, and pain relief (VAS) before 24 weeks, although no statistical differences were detected in the efficacy after 24 weeks, and in medication-related safety between the two groups. Although arthroscopic debridement cannot replace systemic uric acid-lowering treatments such as medication and dietary control, it is still an effective approach.

  9. Kinsenoside screening with a microfluidic chip attenuates gouty arthritis through inactivating NF-κB signaling in macrophages and protecting endothelial cells

    Science.gov (United States)

    Han, Qiao; Bing, Wang; Di, Yin; Hua, Li; Shi-he, Li; Yu-hua, Zheng; Xiu-guo, Han; Yu-gang, Wang; Qi-ming, Fan; Shih-mo, Yang; Ting-ting, Tang

    2016-01-01

    Gouty arthritis is a rheumatic disease that is characterized by the deposition of monosodium urate (MSU) in synovial joints cause by the increased serum hyperuricemia. This study used a three-dimensional (3D) flowing microfluidic chip to screen the effective candidate against MSU-stimulated human umbilical vein endothelial cell (HUVEC) damage, and found kinsenoside (Kin) to be the leading active component of Anoectochilus roxburghi, one of the Chinese medicinal plant widely used in the treatment of gouty arthritis clinically. Cell viability and apoptosis of HUVECs were evaluated, indicating that direct Kin stimulation and conditioned medium (CM) from Kin-treated macrophages both negatively modulated with MSU crystals. Additionally, Kin was capable of attenuating MSU-induced activation of nuclear factor-κB/mitogen-activated protein kinase (NF-κB/MAPK) signaling, targeting IκB kinase-α (IKKα) and IKKβ kinases of macrophages and influencing the expressions of NF-κB downstream cytokines and subsequent HUVEC bioactivity. Inflammasome NLR pyrin domain-containing 3 (NALP3) and toll-like receptor 2 (TLR2) were also inhibited after Kin treatment. Also, Kin downregulated CD14-mediated MSU crystals uptake in macrophages. In vivo study with MSU-injected ankle joints further revealed the significant suppression of inflammatory infiltration and endothelia impairment coupled with alleviation of ankle swelling and nociceptive response via Kin treatments. Taken together, these data implicated that Kin was the most effective candidate from Anoectochilus roxburghi to treat gouty arthritis clinically. PMID:27584788

  10. Suppressive effect of Sanmiao formula on experimental gouty arthritis by inhibiting cartilage matrix degradation: An in vivo and in vitro study.

    Science.gov (United States)

    Zhu, Fangfang; Yin, Lian; Ji, Leilei; Yang, Fan; Zhang, Guangji; Shi, Le; Xu, Li

    2016-01-01

    Sanmiao formula (SM) is a compound prescription, which has been used in traditional Chinese medicine since the Ming Dynasty for gouty and rheumatoid arthritis treatments. However, no evidence has been unfolded to show the relationship between SM and gouty arthritis (GA), particularly inhibiting cartilage matrix degradation. In the present study, we undertook a characterization of anti-GA activity of SM using an in vivo rat model induced by potassium oxonate and cold bath together with in vitro studies with chondrocytes for further molecular characterization. Potassium oxonate and cold bath rats were treated with SM at doses of 7.2g/kg per day for 5days. SM treatments significantly suppressed the swelling rate and the severe pathologic changes in the joints of the animals in gout model. Inflammatory factors count by ELISA analysis, SM exhibited inhibition on IL-1β and TNF-α. Moreover, histological analysis of the joints and SM-serum substantially interfered with the MSU-induced expression of glycosaminoglycans (GAG), up-regulated the content of proteoglycan. Importantly, SM interfered with GA-augmented expression of matrix metalloproteinases (MMPs) -3 and aggrecanases (ADAMTS)-4, which are considered to be key enzymes in cartilage matrix degradation, and simultaneously augmented GA-reduced tissue inhibitors of metalloproteinases (TIMPs) -1 and -3 expression in the joints and chondrocytes. Therefore, SM is looking forward to be a potential novel agent that could prevent cartilage matrix degradation effectively in gouty arthritis, and this provides a new target for development of new medicines.

  11. Therapeutic Effects of Chinese Medicine Herb Pair, Huzhang and Guizhi, on Monosodium Urate Crystal-Induced Gouty Arthritis in Rats Revealed by Anti-Inflammatory Assessments and NMR-Based Metabonomics.

    Science.gov (United States)

    Han, Bin; Huang, Huizhu; Li, Zhong; Gong, Mengjuan; Shi, Wan; Zhu, Chunxia; Gu, Zulian; Zou, Zhongjie

    2016-01-01

    The present study was undertaken to evaluate the therapeutic effects of Huzhang-Guizhi herb pair (HG), firstly included in Hu-Zhang Power documented in Taiping Shenghui Fang, on monosodium urate (MSU) crystals-induced gouty arthritis in rats. We found that pretreatment with HG in rats with gouty arthritis could significantly attenuate the ankle joint swelling, and this beneficial antigout effect might be mediated, at least in part, by inhibiting tumor necrosis factor-alpha (TNF-α) and interleukin-1 beta (IL-1β) production in synovial fluid as well as nuclear transcription factor-κB p65 (NF-κB p65) protein expression in synovial tissue. Moreover, metabonomic analysis demonstrated that 5 and 6 potential biomarkers associated with gouty arthritis in plasma and urine, respectively, which were mainly involved in energy metabolism, amino acid metabolism, and gut microbe metabolism, were identified. HG could reverse the pathological process of MSU-induced gouty arthritis through regulating the disturbed metabolic pathways. These results provided important mechanistic insights into the protective effects of HG against MSU-induced gouty arthritis in rats.

  12. Therapeutic Effects of Chinese Medicine Herb Pair, Huzhang and Guizhi, on Monosodium Urate Crystal-Induced Gouty Arthritis in Rats Revealed by Anti-Inflammatory Assessments and NMR-Based Metabonomics

    Directory of Open Access Journals (Sweden)

    Bin Han

    2016-01-01

    Full Text Available The present study was undertaken to evaluate the therapeutic effects of Huzhang-Guizhi herb pair (HG, firstly included in Hu-Zhang Power documented in Taiping Shenghui Fang, on monosodium urate (MSU crystals-induced gouty arthritis in rats. We found that pretreatment with HG in rats with gouty arthritis could significantly attenuate the ankle joint swelling, and this beneficial antigout effect might be mediated, at least in part, by inhibiting tumor necrosis factor-alpha (TNF-α and interleukin-1 beta (IL-1β production in synovial fluid as well as nuclear transcription factor-κB p65 (NF-κB p65 protein expression in synovial tissue. Moreover, metabonomic analysis demonstrated that 5 and 6 potential biomarkers associated with gouty arthritis in plasma and urine, respectively, which were mainly involved in energy metabolism, amino acid metabolism, and gut microbe metabolism, were identified. HG could reverse the pathological process of MSU-induced gouty arthritis through regulating the disturbed metabolic pathways. These results provided important mechanistic insights into the protective effects of HG against MSU-induced gouty arthritis in rats.

  13. 痛风性关节炎的高频超声表现%Ultrasonographic Findings in Gouty Arthritis

    Institute of Scientific and Technical Information of China (English)

    钟岩; 石亚妹; 武丽君

    2015-01-01

    目的:探讨痛风性关节炎高频超声的特异性与非特异性表现。方法对确诊的19例痛风性关节炎患者76个病变关节的超声表现进行回顾性分析,总结痛风性关节炎的声像图特点。结果(1)受累关节中,第一跖趾关节19个(19/76,25%),腕关节12个(12/76,15.8%),肘关节11个(11/76,14.5%),双手关节11个(包括掌指、近指关节,11/76,14.5%),膝关节9个(9/76,11.8%),踝关节9个(9/76,11.8%),足背5个(5/76,6.6%)。(2)病变关节的超声表现:1)痛风性关节炎的特异性超声表现:痛风石形成13个(13/76,17.1%),“双轨征”24个(24/76,31.6%),关节积液“暴风雪”样回声2个(2/76,2.6%);2)非特异性表现:关节积液58个(58/76,76.3%),滑膜增厚及血流34个(34/76,44.7%),腱鞘炎14个(14/76,18.4%),骨侵蚀6个(6/76,7.9%)。结论根据室壁瘤的大小和病变程度合理的选择手术方式、有效的心肌保护是手术成功的关键。%Objective To explore the specific and non-specific appearance of gouty arthritis by high-frequency ultrasound. Methods The sonographic features of gouty arthritis were summarized by retrospectively studying the sonogram of 76 disease joints of 19 patients.Results The involved joints included 19 first metatarsophalangeal joints (19/76,25%),12 wrists (12/76,15.8%),11 elbows (11/76,11.8%),9 ankles, 11 double hands (include metacarpophalangeal joints,proximal interphalangeal joints, 11/76,14.5%),9 knees (9/76,11.8%),9 ankle joints (9/76,11.8%),5 acrotarsium (5/76,6.6%).Sonographic performance of disease joints: including specific performance:tophus in 13 joints(17.1%),double contour sign in 24 joints (31.6%),snowstorm appearance of the joint fluid in 2 joints (2.6%);non-specific performance:effusion in 58 joints (76.3%),synovial thickening and blood flowing in 34 joints (44.7%),tenosynovitis in 14 joints (18.4%),bone

  14. 血清Dickkopf-1与原发性痛风性关节炎骨破坏的相关性%Relation of serum Dickkopf-1 with bone destruction in patients with gouty arthritis

    Institute of Scientific and Technical Information of China (English)

    赵卫; 高辉; 朱佳鑫; 张学武; 栗占国

    2012-01-01

    -resis-tant acid phosphatase 5b (TRAP5b) in gouty arthritis. Methods; Blood serum DKK-1 and TRAP5b were assessed by ELJSA method. The serum samples were collected from 150 patients with gouty arthritis, 100 with hyperuricemia and 100 healthy controls. Of the 150 gouty arthritis patients, 40 were diagnosed as acute gout (joint rash and pain), and the other 110 as chronic gout. At the time of serum sampling, variousclinical and laboratory parameters were assessed. The correlations of DKK-1 or TRAP5b and clinical/laboratory parameters were analyzed. Results: ( 1) The serum levels of DKK-1 were elevated in the patients with gouty arthritis [ (2 574.8 ±997.9) ng/L] and with hyperuricemia [ (2 009.4 ±756.9) ng/L] compared with the healthy controls [ (981. 8 ±770. 7 ) ng/L], F = 49. 59, P < 0. 001. (2) The serum levels of TRAP5b in the three groups were (3. 2 ±1. 4) U/L, (2. 5 ±1. 4) U/L and (0.2±0.2)U/L, respectively. F = 103.039, P<0.001. (3) A significant difference of DKK-1 was observed between the patients with gouty arthritis and with hyperuricemia (t = 3.998, P <0.001). Similarly, a significant difference of TRAP5b was observed between the patients with gouty arthritis and with hyperuricemia (t =3.391, P =0.004). (4) In the patients with gouty arthritis, there was a positive correlation between DKK-1 and TRAP5b(r =0. 47, P <0. 001 ) , while the levels of DKK-1 were not related with age, disease duration, body mass index or serum uric acid(r = -0. 153, -0. 123, 0. 158, 0.00,P=0. 126, 0.509, 0. 381, 0.926). (5) In the patients with gouty arthritis, the serum levels of TRAP5b were elevated in the patients with tophi compared with the patients without tophi [ (8.4 ?.4) U/L vs. (4. 0 ?1. 6) U/L, t = - 2. 938, P - 0. 007 ]. The level of TRAP5b was associated with the disease duration (r =0.455 ,P =0.01) , while there was no correlation between TRAP5b and age, body mass index or serum uric acid(r =0.135, 0.278, 0. 144,P =0.595, 0. 117,0. 132). Conclusion; In the patients with gouty

  15. Clinical observation on red light irradiation combined with three yellow powder in the treatment of acute gouty arthritis%红光照射联合三黄散外敷治疗痛风性关节炎急性发作的临床观察

    Institute of Scientific and Technical Information of China (English)

    江成林

    2014-01-01

    目的:观察红光照射联合三黄散外敷治疗痛风性关节炎的临床疗效。方法选取痛风性关节炎急性发作的患者60例,随机分为两组,治疗组(30例)给予红光照射,2次/d,20 min/次,三黄散外敷,1次/d;对照组(30例)给予秋水仙碱片口服,3次/d,0.5 mg/次,治疗时间7d ,分别于治疗前及治疗后观察血尿酸、血沉、CRP 水平。以及治疗前后关节疼痛(视觉模拟评分法visual analogue scale,简称VAS评分标准,0~10分)。结果患者治疗后VAS积分、UA、CRP、ESR均较前明显下降,差异有统计学意义(P0.05),治疗后两组比较, CRP、ESR差异有统计学意义(P0.05), compared the two groups after treatment, there are significant difference of CRP, ESR (P<0.05), two groups of patients efficient comparison, the treatment group is better than that of control group, with significant difference (P<0.05). Conclusion The combination of red glow of three yellow powder topical treatment of gouty arthritis.

  16. 孙维峰治疗痛风性关节炎经验%Sun Wei-feng's Experience of Treating Gouty Arthritis

    Institute of Scientific and Technical Information of China (English)

    劳贝妮

    2016-01-01

    Professor Sun Wei-feng thinks that gouty arthritis during the intermittent period and chronic phase are mainly due to yin deficiency of the liver and kidney leading to the spleen failing to activate,internal phlegmatic dampness,intermingled phlegm and blood stasis blocking in meridians,joints and the viscera.He emphasizes that "deficiency of the liver,spleen and kidney,intermingled phlegm and blood stasis" are the root of gouty arthritis during the intermittent period and chronic phase,so the treatment should focus on "purging turbidity and removing pathogenesis,dissolving the dampness and clearing away heat,activating blood circulation to remove blood stasis." He uses self-made (XZCBD) to treat it.He especially pays attention to prevention and regulation of patients with gouty arthritis.%孙维峰教授认为痛风性关节炎间歇期及慢性期的病因多为肝肾阴虚,脾失健运,痰湿内生,久则痰瘀互结,留滞经脉、关节、脏腑,强调“肝脾肾虚、痰瘀互结”为痛风的发病根源.孙教授认为痛风性关节炎间歇期及慢性期的治疗原则为“泄浊祛邪、化湿清热、活血化瘀”,自拟“泄浊除痹汤”治疗痛风间歇期及慢性期.孙维峰教授特别注重对痛风性关节炎患者生活上的预防调摄.

  17. 痛风性关节炎中医药治疗研究进展%Research Progress of Treating Gouty Arthritis with Chinese Medicine

    Institute of Scientific and Technical Information of China (English)

    张程悦

    2012-01-01

    目的:探讨痛风性关节炎中医药治疗研究进展.方法:归纳、总结、分析近年来的文献资料.结果:从辨证论治、分期治疗、专方专药内治方法和中药外敷、针灸等外治方法以及内外合治等方面综述了近些年痛风性关节炎中医药治疗的研究进展,并指出了中医药在治疗该病方面的优势及不足.结论:中医药治疗痛风性关节炎疗效显著,不良反应小.%Objective:To explore the research progress of treating gouty arthritis with Chinese medicine. Methods:The relative literature was summarized,concluded and analyzed in recent years. Results:This paper summarized the research progress of treating gouty arthritis with Chinese medicine in recent years, from the aspects of applying internal treatment methods such as syndrome differentiation and treatment,treatment by stages,special prescription with special medicine and external treatment such as external application of Chinese medicine, acupuncture and moxibustion and integrating internal and external treatment. It also pointed out the advantages and disadvantages of Chinese medicine in treating this disease. Conclusion: Chinese medicine has remarkable effects in treating gouty arthritis, and has little adverse effects.

  18. 银莲花胶囊治疗痛风性关节炎临床观察%Clinical Observation of Anemone Capsules in Treatment of Gouty Arthritis

    Institute of Scientific and Technical Information of China (English)

    黄建华; 张国斌; 赵艳荣; 邴飞虹

    2015-01-01

    s:Objective To observe the effect of Anemone capsules in treatment of gouty arthritis .Methods 84 cases of gouty arthritis were randomly divided into two groups ,the treatment group received Anemone capsules ,and the control group received Colchicine tablets , af-ter treating for 1 month, the effect wes observe.Results The total effective rate of treatment group was better than control group (P <0.05);the uric acid had statistically significant difference between two groups (P <0.01).Conclusion Anemone capsule is quite effective for gouty arthritis in reducing uric acid levels and improving the symptoms.%目的:观察银莲花胶囊治疗痛风性关节炎的疗效。方法84例痛风患者随机分为两组,治疗组服用银莲花胶囊,对照组服用秋水仙碱片,两组均连续服药1个月后进行疗效观察。结果治疗组总有效率优于对照组(P <0.05);两组治疗后的尿酸水平比较有显著性差异(P <0.01)。结论银莲花胶囊治疗痛风性关节炎疗效确切,可显著降低尿酸水平,改善关节症状。

  19. 口服中药治疗痛风性关节炎疗效观察%Efficacy Observation on Treating Gouty Arthritis by Orally Taking Chinese Herbs

    Institute of Scientific and Technical Information of China (English)

    于长志; 罗懿明; 林玉洁

    2014-01-01

    Objective:To investigate the efficacy of treating gouty arthritis by orally taking Chinese herbs. Methods:83 cases of patients with gouty arthritis were randomly divided into treatment group (43 cases) and control group (40 cases), the treatment group treated by orally taking self-made Chinese herbas, while control group by orally taking etoricoxib and benzbromarone, and observed the efficacy of two groups. Results:There was no significant difference on total effecitve rate between two groups (P>0.05). Conclusion:Orally taking Chinese herbs has significant curative effect on gouty arthritis, which also can avoid adverse reactions that brings by chemical drugs, deserves clinical promotion and application.%目的:探讨口服中药治疗痛风性关节炎的疗效。方法:将83例痛风性关节炎患者随机分为治疗组(43例)和对照组(40例),治疗组给予自拟中药内服,对照组则服用依托考昔及苯溴马隆治疗,观察两组临床疗效。结果:两组总有效率差异无统计学意义(P>0.05)。结论:口服中药治疗痛风性关节炎疗效显著,且可避免化学药物带来的不良反应,值得临床推广应用。

  20. Analysis on the magnetic resonance imaging features of gouty arthritis of the knee%膝关节痛风性关节炎MRI表现分析

    Institute of Scientific and Technical Information of China (English)

    张园园; 赵建农; 陈君辉; 贾颖; 梁娜

    2016-01-01

    Objective: To analyse the MRI features of gouty arthritis of the knee and discuss its diagnosis value. Materials and Methods: Twenty-one cases with gouty arthritis of the knee underwent knee MRI plain scan. MRI findings were retrospectively reviewed. Results: All of the 21 cases showed synovial thickness, hydrarthrosis, and soft tissue swelling. Twelve patients had the bone erosion which located at the femoral condyle, tibial plateau, patella, fibular head and showed hypointensity on T1WI and hyperintensity on T2WI. Bone edema was seen in 3. Eleven cases had the gouty tophus which located at the patella bursa, patellar fat pad, joint cavity, intercondylar fossa, femoral condyle or surrounding, patella or before, and tibial platform or before. The gouty tophus displayed as acicular, strip, nodosity or mass. Magnetic resonance signals had no specificity. Gouty tophus showed hypointensity (n=4), iso-/hypo- intensity (n=7) on T1WI, hypointensity (n=2), slight hyperintensity (n=5), and hypo-/slight hyper-intensity (n=4) on T2WI. Conclusions:To the early stage of gout arthritis of the knee, MRI can sensitively observe synovial thickeness, hydrarthrosis and soft tissue swelling, but no specificity. However, diagnostic specificity of MRI for the knee arthritis associated with the bone erosion and the gouty tophi is high.%目的:分析膝关节痛风性关节炎的MRI表现,探讨其诊断价值。材料与方法21例膝关节痛风性关节炎均行MRI检查,并对影像资料进行分析。结果21例均表现为膝关节滑膜增厚、关节腔积液及膝关节周围软组织肿胀。12例可见膝关节骨质侵蚀破坏,位于股骨髁内或边缘,胫骨平台、髌骨、腓骨头等,表现为长T1、长T2信号影。3例伴有不同程度骨髓水肿。11例可见痛风石形成,多位于髌上囊、髌下脂肪垫、关节腔、髁间窝、股骨髁内或旁、髌骨内或髌骨前、胫骨平台内或胫骨前方等;呈针状、条状、结节状

  1. Treating gouty arthritis inTCM%中医综合治疗痛风性关节炎的治疗效果观察

    Institute of Scientific and Technical Information of China (English)

    刘广荣

    2015-01-01

    Objective: To treat gouty arthritis patients in TCM. Methods: 86 cases of gouty arthritis were divided into the observed group and the control group. Observed group recieved oral comprehensive treatment of TCM plus colchicine treatment. Results: In observation efficacy and adverse reactions rates were 93.02% (40/43), 4.65% (2/43), better than control group 86.05% (37/43), 13.95% (6/43) (P < 0.05). Conclusion: The TCM treatment for gouty arthritis can effectively improve the clinical symptoms and fewer adverse reactions, and should be promoted.%目的:对痛风性关节炎患者采用中医综合治疗,观察分析其临床治疗效果.方法:将我院于 2012 年 1 月-2014年3月期间收治的86例痛风性关节炎患者按照随机数字表法分为观察组和对照组.对照组采用秋水仙碱治疗;观察组采用中医内服综合治疗联合秋水仙碱治疗.观察两组患者治疗期间的临床疗效及所发生的不良反应情况.结果:观察组治疗有效率与不良反应率分别为 93.02%(40/43)、4.65%(2/43);与对照组的86.05%(37/43)、13.95%(6/43)比较,P<0.05.结论:临床采用中医综合治疗痛风性关节炎,可有效改善患者的临床症状,提高治疗效果,且不良反应少,值得推广与应用.

  2. 误诊为痛风性关节炎的布鲁菌病一例并文献复习%Brucellosis Misdiagnosed as Gouty Arthritis:A Case Report and Literature Review

    Institute of Scientific and Technical Information of China (English)

    晏益民; 黄淑玉; 刘峰; 邹毅; 吴敏; 朱钊; 李玲; 廖世波

    2015-01-01

    Objective To explore the clinical features of brucellosis and reduce the misdiagnosis and mistreatment rates. Methods A retrospective analysis of clinical data was made for 1 case of brucellosis misdiagnosed as gouty arthritis, and the literature was reviewed. Results The patient with right ankle joint pain and fever as the main symptoms was suspec-ted as having acute gouty arthritis upon admission. Anti-infection and pain relief measures were taken with no obvious effect. The patient was found having a history of animal contact recently and detection of brucellosis tube agglutination titer was more than 1∶ 400, the rose Bengal plate agglutination test was positive, and therefore brucellosis was confirmed and then rifampicin and doxycycline antibiotic therapy were given. The patient recovered well. Conclusion We should consider to rule out the possibility of brucellosis for patients with intermittent fever and peripheral arthritis, and should ask if the patient has a history of contact with diseased animals such as cattle and sheep. Suspected patients should be given brucellosis serological tests quickly to confirm the diagnosis.%目的:探讨布鲁菌病的临床特点,减少误诊误治。方法回顾分析1例误诊为痛风性关节炎的布鲁菌病的临床资料,并复习相关文献。结果本例以右踝关节疼痛、发热为主要临床表现,初诊考虑痛风性关节炎急性发作,经抗感染、镇痛治疗效果不明显,追溯病史了解患者近期有病畜接触史,布鲁杆菌试管凝集试验效价>1∶400,虎红平板凝集试验阳性,明确诊断为布鲁菌病,予利福平、多西环素治疗,痊愈。结论对间断低热、外周单关节炎患者需注意排除布鲁菌病的可能,注意详细询问牛、羊等病畜接触史,疑诊者应及时行布鲁杆菌血清学检查以确诊。

  3. Soft coral-derived lemnalol alleviates monosodium urate-induced gouty arthritis in rats by inhibiting leukocyte infiltration and iNOS, COX-2 and c-Fos protein expression.

    Science.gov (United States)

    Lee, Hsin-Pai; Huang, Shi-Ying; Lin, Yen-You; Wang, Hui-Min; Jean, Yen-Hsuan; Wu, Shu-Fen; Duh, Chang-Yih; Wen, Zhi-Hong

    2013-01-10

    An acute gout attack manifests in the joint as dramatic inflammation. To date, the clinical use of medicinal agents has typically led to undesirable side effects. Numerous efforts have failed to create an effective and safe agent for the treatment of gout. Lemnalol-an extract from Formosan soft coral-has documented anti-inflammatory and anti-nociceptive properties. In the present study, we attempt to examine the therapeutic effects of lemnalol on intra-articular monosodium urate (MSU)-induced gouty arthritis in rats. In the present study, we found that treatment with lemnalol (intramuscular [im]), but not colchicine (oral [po]), significantly attenuated MUS-induced mechanical allodynia, paw edema and knee swelling. Histomorphometric and immunohistochemistry analysis revealed that MSU-induced inflammatory cell infiltration, as well as the elevated expression of c-Fos and pro-inflammatory proteins (inducible nitric oxide synthase and cyclooxygenase-2) observed in synovial tissue, were significantly inhibited by treatment with lemnalol. We conclude that lemnalol may be a promising candidate for the development of a new treatment for gout and other acute neutrophil-driven inflammatory diseases.

  4. Soft Coral-Derived Lemnalol Alleviates Monosodium Urate-Induced Gouty Arthritis in Rats by Inhibiting Leukocyte Infiltration and iNOS, COX-2 and c-Fos Protein Expression

    Directory of Open Access Journals (Sweden)

    Hsin-Pai Lee

    2013-01-01

    Full Text Available An acute gout attack manifests in the joint as dramatic inflammation. To date, the clinical use of medicinal agents has typically led to undesirable side effects. Numerous efforts have failed to create an effective and safe agent for the treatment of gout. Lemnalol — an extract from Formosan soft coral — has documented anti-inflammatory and anti-nociceptive properties. In the present study, we attempt to examine the therapeutic effects of lemnalol on intra-articular monosodium urate (MSU-induced gouty arthritis in rats. In the present study, we found that treatment with lemnalol (intramuscular [im], but not colchicine (oral [po], significantly attenuated MUS-induced mechanical allodynia, paw edema and knee swelling. Histomorphometric and immunohistochemistry analysis revealed that MSU-induced inflammatory cell infiltration, as well as the elevated expression of c-Fos and pro-inflammatory proteins (inducible nitric oxide synthase and cyclooxygenase-2 observed in synovial tissue, were significantly inhibited by treatment with lemnalol. We conclude that lemnalol may be a promising candidate for the development of a new treatment for gout and other acute neutrophil-driven inflammatory diseases.

  5. 抗痛风性关节炎的天然药物研究进展%Research progress in natural drugs used for treating gouty arthritis

    Institute of Scientific and Technical Information of China (English)

    桂璇; 黄宝康

    2013-01-01

    痛风性关节炎(gouty arthritis,GA)是嘌呤代谢障碍引起的血尿酸浓度过高导致尿酸盐结晶沉积于关节所致的一种代谢性关节疾病.目前临床上大多使用西药控制其急性发作,但都有不良反应,应用天然药物治疗GA已逐步成为研究热点,并取得了一定的成果.对植物药、单体成分以及动物药抗GA及其作用机制进行综述,为开发抗GA的天然药物提供参考.

  6. Research of Qingganjiangzhuo Method on Gouty Arthritis%清肝降浊法治疗痛风性关节炎临床研究

    Institute of Scientific and Technical Information of China (English)

    赵恒立; 郝亮; 张文学; 迟荣香

    2012-01-01

    目的 观察清肝降浊法对痛风性关节炎的临床治疗作用.方法 将62例痛风性关节炎患者随机分为两组,在饮食控制的基础上,对照组予醋氯芬酸口服,治疗组予醋氯芬酸加中药二秦降酸饮;以10d为1疗程,治疗2个疗程;对两组痛风主症积分、临床疗效、血尿酸值进行评测.结果 治疗组临床疗效及各项指标均优于对照组.结论 二秦降酸饮疗效可靠,具有控制症状、提高患者生活质量的作用.%Objective:To observe the effect of Qingganjiangzhuo Method on gouty arthritis. Methods:62 cases of gouty arthritis were divided randomly into the control group and the treatment group. On the basis of diet control, the control group was used aceclofenac and the treatment group was given the Erqinjiungsuan Decoction. After 2 therapy periods for 20 days,the gout main symptom score,the clinical effect and the blood uric acid were compared in 2 groups. Results:The clinical effects and these indices in the treatment group were superior to those in the control group. Conclusion:Erqinjiangsuan Decoction has a certain effect in the controlling symptoms and improving life quality.

  7. Treatment of acute septic arthritis.

    Science.gov (United States)

    Pääkkönen, Markus; Peltola, Heikki

    2013-06-01

    Acute septic arthritis is a rare, but potentially devastating disease. The treatment is initiated intravenously, but can be safely switched to oral after 2-4 days providing large doses of a well-absorbing antibiotic and, for time-dependent antibiotics, 4 times-a-day administration are used. Empiric treatment should always cover Staphylococcus aureus and common respiratory pathogens, whereas Kingella kingae and Salmonella are important only regionally. Studies conducted by our group have shown that a total course of 10 days may suffice for previously healthy children in a Western setting. Treatment of neonates, patients with immunodeficiency or cases caused by methicillin-resistant S. aureus, may deserve a different approach.

  8. Clinical observation on treating 46 cases of gouty arthritis with Xiaotong Yin%秦建黎运用消痛饮治疗痛风性关节炎46例疗效观察

    Institute of Scientific and Technical Information of China (English)

    王丽华; 秦建黎; 董新寨

    2014-01-01

    With the development of living standards, due to the increase of uric acid production from irregular diet and excess drink, gouty arthritis comes into being. Professor QIN Jian-li treat 46 cases of gouty arthritis with Xiaotong Yin, effects were obvious.%随着生活水平的不断提高,宴席不断,饮食不节,偏食富含嘌呤、蛋白质的食物,嗜酒无度,嘌呤代谢异常致使尿酸合成增加,从而导致痛风性关节炎。秦建黎教授自2010年1月-2013年12月采用消痛饮为主治疗痛风性关节炎46例,疗效确切。

  9. Research Progress on the Treatment of Gouty Arthritis by Blood-letting Puncture%刺络放血治疗痛风性关节炎的研究进展

    Institute of Scientific and Technical Information of China (English)

    张雪; 徐天舒

    2014-01-01

    本研究总结近10年刺络放血治疗痛风性关节炎的研究进展,并提出科研中应该注意的问题及发展方向。从治法联合的多样性、放血量的控制、刺血手法的选取、实验研究等方面,对近10年刺络放血治疗痛风性关节炎的文献进行综述。结果发现刺络放血治疗痛风性关节炎有一定疗效,起效快、疗效好、不良反应少、复发率低、方法各异,但机制研究缺乏,还存在问题有待于进一步的研究解决。%The paper summarizes advances of studies on blood-letting puncture for the treatment of gouty ar-thritis in the recent decade and puts forward the problems that should be paid attention to and the developmental direction in scientific research.Review the literature about the treatment for gouty arthritis by blood -letting puncture in the recent decade from diversity of combined treatments, control of the bleeding amount,selection of the pricking blood technique and the experimental research.Blood-letting puncture for treating gouty arthritis has a certain effect,but it lacks the mechanism research.Blood-letting puncture for treating gouty arthritis is effective and rapid action with few side-effects and low recurring rates,but there are some problems that should be solved in the further study.

  10. Clinical Study on Treatment of Gouty Arthritis with Plasma Exchange%血浆置换疗法在痛风性关节炎治疗中的应用

    Institute of Scientific and Technical Information of China (English)

    应美爱; 陈家萍; 叶书来

    2009-01-01

    目的 观察治疗性血浆置换治疗痛风性关节炎的临床疗效.方法 采用血浆置换法治疗17例痛风性关节炎患者,比较置换前后患者血尿酸(UA)、C-反应性蛋白(CRP)、血沉(ESR)的变化及临床症状的改善.结果 17例患者经血浆置换后血尿酸、C-反应蛋白、血沉明显降低(P<0.01);临床症状明显好转,关节红、肿、热、痛症状消失.结论 血浆置换结合药物治疗痛风性关节炎的疗效显著.%Objective To study the clinical effect of plasma exchange in the treatment of gouty arthritis. Methods Seventeen patients with gouty arthritis were treated with plasma exchange.Results In 17 patients,the clinical symptoms were significantly ameliorated after treatment with plasma exchange. The contents of uric acid(UA),C-reactive protein(CRP) and erythrocyte sedimentation rate (ESR) descended after the treatment. Conclusion The plasma exchange is a reliable therapy or gouty arthritis.

  11. Therapeutic effect of Rhizoma Dioscoreae Nipponicae on gouty arthritis based on the SDF-1/CXCR 4 and p38 MAPK pathway: an in vivo and in vitro study.

    Science.gov (United States)

    Lu, Fang; Liu, Lei; Yu, Dong-hua; Li, Xu-zhao; Zhou, Qi; Liu, Shu-min

    2014-02-01

    Rhizoma Dioscoreae Nipponicae (RDN) is a widely used traditional Chinese herb, which is used to treat arthroncus, arthrodynia and arthritis. As is known to us, inflammatory mechanisms have played an important role in the occurrence, course and prognosis of gouty arthritis (GA). The aim of this study was to determine the characteristic expressed proteins of synovium in GA rat and synovial cell. The rat model of GA was induced by monosodium urate (MSU) crystal. Tissue samples were assayed by immunohistochemical method. The effects of RDN on Stromal cell-derived factor 1 (SDF-1), CXCR 4 and p38 mitogen-activated protein kinase (MAPK) were investigated in MSU crystal-induced rat. The levels of SDF-1 and mitogen-activated kinase kinase (MKK) 3/6 were measured by Western Blot in interleukin-1β (IL-1β) incubated fibroblast-like synoviocytes (FLS). A significant increase in the levels of SDF-1, CXCR 4 and p38 MAPK were observed in MSU crystal-induced rat. The increased SDF-1 and MKK 3/6 levels were observed in IL-1β incubated FLS. With the treatment of RDN, the above changes were reverted back to near normal levels. RDN might have some therapeutic effects on GA through SDF-1/CXCR 4 and p38 MAPK pathway, and dioscin may be the active compound in RDN to exert therapeutic effect on GA.

  12. 针刀治疗痛风性关节炎疗效观察%Efficacy observation on treating gouty arthritis by acupuncture

    Institute of Scientific and Technical Information of China (English)

    杨戈

    2012-01-01

      Objective: To investigate the clinical efficacy of acupuncture on treating gout arthritis. Methods: Retrospective analysis of the medical records that patients with gout were treated by acupuncture plus TCM and medicinal liquor oral topicalnearly a decade. Results: The clinical cure rate was more than 90%, the recurrence rate is very low. Conclusion: The acupuncture have a breakthrough in principle and the cure rate, that explains the effect of acupuncture is simple and convenient on treating gouty arthritis, and worthy of clinical promoted application.%  目的:探讨针刀治疗痛风的临床疗效。方法:回顾分析近十年间所有痛风患者给予小针刀配合中药、药酒内服外用之病案。结果:临床治愈率达90%以上,复发率极低。结论:小针刀治疗痛风在原理上和治愈率方面均有突破,说明小针刀治疗痛风性关节炎具有简便验廉的效果,值得临床大力推广运用。

  13. THE CURATIVE EFFECT OF MINIMALLY INVASIVE TREATMENT OF 27 CASE OF GOUTY ARTHRI-TIS OF KNEE JOINT%微创治疗膝关节痛风性关节炎27例疗效观察

    Institute of Scientific and Technical Information of China (English)

    陶建峰; 王爱军; 陈德生; 赵立彦

    2014-01-01

    目的:探讨关节镜手术治疗膝关节痛风性关节炎的方法及疗效。方法应用关节镜微创技术对27例膝关节痛风性关节炎患者行关节清理、滑膜切除、半月板修整或切除及关节软骨修整,术后辅助药物治疗及功能康复练习。结果27例痛风性关节炎患者术中均可见不同程度的尿酸盐结晶沉积,术后肿痛症状均得到明显缓解,关节功能得到改善,随访6~36个月均得到满意疗效。结论对于内科治疗无效,反复发作或痛风石形成的膝关节痛风性关节炎,关节镜手术治疗具有诊断明确、创伤小、方法简单、效果显著等优点,可作为膝关节痛风性关节炎的外科治疗首选方法。%Objective To investigate the methods and efficacy of arthroscopic surgical treatment of knee gouty arthritis .Methods Arthroscopic minimally invasive techniques which included joint clean -up ,sy-novectomy ,trimming or removal of the meniscus and articular cartilage dressing were used in 27 patients with knee gouty arthritis ,postoperative assisted drug treatment and functional rehabilitation exercises .Re-sults Twenty -seven patients with gouty arthritis were seen in different levels of urate crystal deposition , postoperative swelling and pain symptoms were eased significantly improved joint function ,the outcome of followed up for 6~36 months were satisfied .Conclusions Arthroscopic surgery in the treatment of gouty arthritis of the knee has a clear diagnosis ,less invasive ,simple method ,significant effect .It can be used as the preferred method of surgical treatment of knee gouty arthritis .

  14. Changes in toll-like receptor (TLR)4-NFκB-IL1β signaling in male gout patients might be involved in the pathogenesis of primary gouty arthritis.

    Science.gov (United States)

    Qing, Yu-Feng; Zhang, Quan-Bo; Zhou, Jing-Guo; Jiang, Li

    2014-02-01

    We undertook this study to determine whether the altered toll-like receptor (TLR)4-nuclear factor κB (NFκB)-interleukin1β (IL1β) signaling in peripheral blood of gout patients could provide insights into the pathogenesis of primary gouty arthritis (GA). TLR4 mRNA, TLR4 and NFκBp65 proteins expression and IL1β production were measured in 52 acute GA (AGA) and 34 non-acute GA (NAGA) male patients and 78 male healthy subjects (HC). NFκBp65 transcriptional activity and IL1β production were measured after TLR4 inhibition with anti-TLR4 antibody in peripheral whole blood from 13 AGA patients. The TLR4, NFκBp65 and IL1β expression was significantly increased in the AGA group than those in the NAGA or HC group (P < 0.05, respectively), also the levels were higher in the NAGA group comparing with those in the HC group (P < 0.05, respectively). Furthermore, moderate positive correlations were observed between concentration of uric acid and the TLR4 mRNA level, serum IL1β production (r = 0.649, 0.616), and strong positive correlation was observed between TLR4 mRNA level and serum IL1β (r = 0.848) in 52 AGA patients. On the other hand, NFκBp65 level and IL1β production were dramatically reduced after TLR4 blockade with anti-TLR4 antibody in peripheral blood from the AGA patients (P < 0.05, respectively). TLR4-NFκB-IL1β signaling might play a crucial role in the development of acute inflammation in primary gout patients.

  15. Pandigital and subcutaneous chronic tophaceous gout with acute renal failure

    Directory of Open Access Journals (Sweden)

    J Shashibhushan

    2015-01-01

    Full Text Available Gout (Podagra is a disorder of purine metabolism characterized by the deposition of monosodium urate crystals in joints and connective tissue and risk of deposition in kidney interstitium. Although acute gouty arthritis is familiar for most physicians, chronic gouty arthritis, which affects small joints of the hands can be difficult to distinguish from other common interphalangeal arthropathies such as rheumatoid arthritis (RA, psoriatic arthritis, and erosive osteoarthritis because of very similar presentations. Here we describe a 60-year-old male diabetic patient with pandigital, extensive subcutaneous tophaceous gout presented with uremic encephalopathy and joint deformities. He had been treated mistakenly as RA for 10 years.

  16. Calcium pyrophosphate arthritis

    Science.gov (United States)

    ... are similar, CPPD arthritis can be confused with: Gouty arthritis (gout) Osteoarthritis Rheumatoid arthritis Exams and Tests Most arthritic ... A.M. Editorial team. Related MedlinePlus Health Topics Gout Browse the Encyclopedia A.D.A.M., Inc. ...

  17. Total knee replacement for severe gouty knee arthritis%严重痛风性膝关节炎的膝关节表面置换

    Institute of Scientific and Technical Information of China (English)

    刘康; 郭国栋; 赵建宁

    2016-01-01

    BACKGROUND: The number of patients undergoing total knee replacement due to severe gouty arthritis is increasing rapidly in recent years, and the ages of patients also present younger and younger. However, its clinical efficacy remains controversial, and it is lack of retrospective systematic analysis. OBJECTIVE: To assess the clinical efficacy of total knee replacement for severe gouty knee arthritis from several aspects, such as pain, function, quality of life and complications. METHODS: From January 2006 to January 2015, 17 patients (20 knees) with severe knee gouty arthritis received total knee replacement in Department of Orthopedics of Nanjing General Hospital of Nanjing Military Region of Chinese PLA. They underwent knee joint surface replacement with posterior cruciate ligament, and patel a was not replaced. Posterior stabilized prosthesis was used. Al patients were successful y fol owed up postoperatively. The Hospital for SpecialSurgery Knee Score, range of motion of the knee, Visual Analogue Scale score and SF-36 scale scores were determined before and after replacement and during final fol ow-up. RESULTS AND CONCLUSION: Patients were fol owed up for 1-9 years. No serious complications occurred during and after replacement. The Hospital for Special Surgery Knee Score, range of motion of the knee, Visual Analogue Scale score and SF-36 scale scores were significantly higher after replacement and during final fol ow-up than those before replacement (P < 0.001). X-ray films showed good prosthesis position, satisfactory limb alignment without radiolucent lines or loosing. These findings verified that total knee replacement was considered as the final way to treat the severe gouty knee arthritis; its short-term clinical effect is significant, but systematic anti-uric acid, prevention and treatment of complications, pain control, function exercising, and healthy mood maintenance were needed to get a better long-term clinical efficacy.%背景:因严重痛风

  18. MRI Features and Differential Diagnosis of Gouty Arthritis of the Knee Joint%膝关节痛风性关节炎的MRI表现与鉴别诊断

    Institute of Scientific and Technical Information of China (English)

    罗丽; 韩福刚; 刘勇; 舒健; 屈春晖

    2011-01-01

    目的 探讨膝关节痛风性关节炎(GA)的MRI表现和鉴别诊断.方法 回顾性分析13例经关节镜、手术及病理证实的膝关节GA的MRI资料.结果 13例均有轻度滑膜增厚、不同程度关节积液.10例可见痛风石,其中8例位于关节滑囊和(或)关节腔,2例同时累及关节和周围软组织,痛风石为结节状或团块状.结节状痛风石在T1WI上,2例呈低信号,8例呈低及等信号;T2WI上,2例呈低信号,5例呈稍高信号,3例呈低及稍高混杂信号;团块状痛风石信号不均匀、边界清楚,其总体信号在T1WI上与肌肉相似,T2WI上略高于肌肉.骨质破坏11例,表现为局限性、边缘性的非对称骨质侵蚀;骨髓水肿2例.软组织多为非对称性不规则肿胀.结论 膝关节GA的MRI特征性表现为痛风石,结合膝关节其他改变,可提高其诊断准确率,指导临床治疗.%Objective To evaluate the MRI features and differential diagnosis of gouty arthritis of the knee. Methods MRI data of 13 cases with gouty arthritis of the knee joint proved by arthroscopes, surgery and pathology were analyzed retrospectively. Results All cases showed slightly synovial thickening and articular dropsy in varying degrees. There were 10 cases with gouty tophus , which located at synovial bursa and/or articular cavity in 8 , both joint and surrounding soft tissue in 2 , the gouty tophus displayed as nodosity or mass. Nodose gouty tophus showed hypointcnsity( n= 2) , iso-/hypo-intensity ( n= 8 ) on T1 WI, hypointensity( n= 2 ) , slight hyperintensity(n= 5) and hypo-/silght hyper-intensity(n=3) on T2 WI. Massive gouty tophus showed unhomogeneous signal intensity with definite boundary,the signal intensity was similar to that of muscles on T1 WI and slightly high than that of muscles on T2 WI.Destruction of bone(n=ll) manifested circumscribed, limbic and asymmetric bone erosion, oedema of bone marrow was seen in 2.Soft tissues often displayed asymmetric and irregular swelling

  19. 芪桂痛风舒颗粒治疗痛风性关节炎16例疗效观察%Observation of Qigui Tongfengshu granules in treatment of sixteen cases of gouty arthritis

    Institute of Scientific and Technical Information of China (English)

    杨保林; 丁岗

    2013-01-01

    Objective:To investigate the efficacy of Qigui Tongfengshu granule in treating gouty arthritis.Method:Qigui Tongfengshu granule was used to treat 16 patients with gouty arthritis for 14 d.Result:The recovery rate,marked effective rate,effective rate and improvement rate were 37.5%,50%,6.25%,6.25%,respectively.The total effective rate was 100%.Before and after treatment,the comparison showed statistical significance.Conclusion:Qigui Tongfengshu granule is significantly effective for gouty arthritis,and has the effect of anti-inflammation,analgesia and reduction in blood uric acid.%目的:评价芪桂痛风舒颗粒治疗痛风性关节炎的疗效.方法:临床选择16例痛风性关节炎患者给予芪桂痛风舒颗粒治疗,14d1个疗程.结果:患者痊愈率37.5%,显效率50%,有效率6.25%,好转率6.25%;总有效率100%.治疗前后比较具有统计学意义(P<0.01).结论:芪桂痛风舒颗粒治疗痛风性关节炎疗效显著,有较好的抗炎镇痛作用,且有一定的降低血尿酸作用.

  20. Acute gout presenting in the manubriosternal joint.

    Science.gov (United States)

    Kernodle, G W; Allen, N B

    1986-04-01

    A 54-year-old black man developed acute pain and swelling of the manubriosternal joint. Acute gouty arthritis was diagnosed by arthrocentesis and polarizing microscopy. The histology of the manubriosternal joint and its involvement in other arthritides are briefly discussed.

  1. 老年痛风性关节炎临床特点分析%Clinical features of gouty arthritis in elderly patients

    Institute of Scientific and Technical Information of China (English)

    许超; 张芳

    2015-01-01

    目的:痛风性关节炎是一种以高尿酸血症为病理基础,具有多种临床表现的炎症性关节疾病。本研究拟探索老年痛风性关节炎患者有别于中青年痛风性关节炎患者的临床特点。方法痛风性关节炎患者依照年龄分为老年组(年龄≥60岁)和非老年组(年龄0.05)。老年组发生慢性肾功能不全慢性肾脏病3(CKD3)期以上的患者更多(n =14,P 0.05)。老年组的平均体质量指数(BMI)23.08±3.14,明显低于非老年组患者(P 0.05),空腹总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)水平均低于非老年组,TC(3.98±0.19)mmol/L vs (4.54±0.15) mmol/L(P 0.05 ). Compared with the young group,chronic renal insufficiency above CKD3 occurred more in elderly group (n =14,P 0.05).The average BMI of elderly group was 23.08 ± 3.14,which was significantly lower than that of the young group (P 0.05).The total cholesterol (TC),triglyceride (TG),and low density lipoprotein cholesterol (LDL-C)of elderly group were significantly lower than those of the young group,TC (3.98 ±0.19)mmol/L vs (4.54 ±0.1 5 ) mmol/L (P <0.05);TG(1.13±0.13)mmol/L vs (1.79±0.79)mmol/L(P <0.01);LDL-C(2.48±0.1 7)mmol/L vs (3.04±0.12)mmol/L(P <0.01).Conclusion Compared with the young patients of gouty arthritis,the kidney lesion in the elderly patients was more severe,and the incidence rate of end-stage renal disease was higher.The treatment of elderly patients with gouty arthritis should show more attention to the protection of kidney.

  2. In vitro xanthine oxidase and albumin denaturation inhibition assay of Barringtonia racemosa L. and total phenolic content analysis for potential anti-inflammatory use in gouty arthritis

    Science.gov (United States)

    Osman, Nurul Izzati; Sidik, Norrizah Jaafar; Awal, Asmah; Adam, Nurul Athirah Mohamad; Rezali, Nur Inani

    2016-01-01

    Aim: This study was conducted to evaluate the in vitro anti-inflammatory activities and total phenolic content (TPC) of methanolic extracts of infloresence axes, endosperms, leaves, and pericarps of Barringtonia racemosa L. Methods: The anti-inflammatory study was conducted by assessing the potential through xanthine oxidase (XO) and albumin denaturation inhibition assays. Meanwhile, the TPC in the extracts were assessed by Folin-Ciocalteu assay. Results: In the XO inhibition assay, the infloresence axes extract was found to exert the highest inhibition capacity at 0.1% (w/v) with 59.54 ± 0.001% inhibition followed by leaves (58.82 ± 0.001%), pericarps (57.99 ± 0.003%), and endosperms (57.20 ± 0.003%) extracts. Similarly in the albumin denaturation inhibition assay, the infloresence axes extract had shown the greatest inhibition capacity with 70.58 ± 0.004% inhibition followed by endosperms (66.80 ± 0.024%), leaves (65.29 ± 0.006%), and pericarps extracts (43.33 ± 0.002%). Meanwhile, for TPC analysis, leaves extract was found to have the highest phenolic content (53.94 ± 0.000 mg gallic acid equivalent [GAE]/g DW) followed by infloresence axes (31.54 ± 0.001 mg GAE/g DW), endosperms (22.63 ± 0.001 mg GAE/g DW), and the least was found in pericarps (15.54 ± 0.001 mg GAE/g DW). Conclusion: The results indeed verified the in vitro anti-inflammatory activities of B. racemosa and supported its potential to be used in alleviating gouty arthritis and XO-related diseases. PMID:27757263

  3. 关节镜下射频气化联合碳酸氢钠灌洗治疗膝痛风性关节炎%The Treatment of Knee Gouty Arthritis with Radio Frequency and Sodium Bicarbonate by Arthroscope

    Institute of Scientific and Technical Information of China (English)

    臧学慧; 高立华; 孙辉; 苗贵强

    2014-01-01

    目的:探讨关节镜下射频气化联合酸氢钠灌洗治疗膝痛风性关节炎的疗效。方法对56例痛风性关节炎患者,术前碳酸氢钠灌洗,利用关节镜下射频气化清理膝关节痛风结石。结果56例患者膝关节疼痛均消失,随访时间16~38(24±4)个月,无复发。根据Lysholm膝关节评分方法,术前评分平均43.6分;术后终末复查评分平均89.8分,两者相比,差异有显著性(<0.05)。结论关节镜下利用射频气化联合碳酸氢钠灌洗清除关节内痛风结晶,具有效率高、清除完全,是一种见效快、创伤小、效果确切的治疗方法。%Objective To explore the effect of radio frequency and sodium bicarbonate by arthroscope in treatment of knee gouty arthritis .Methods 56 patients with knee gouty arthritis were treated by sodium bicarbonate preoperatively and then gouty stone was cleared out with radio frequency and sodium bicarbonate by arthroscope.Results Pain in 56 patients was significantly alleviated postoperatively and no case recurred after fol owing up 16~38 (24±4)months . Lysholm score improved from 43.6 preoperatively to 89.8 postoperatively and the dif erence was statistical y significant ( <0.05).Conclusion That the treatment of knee gouty arthritis with radio frequency and sodium bicarbonate by arthroscope is rapid,micro-traumatic and effective for high ef iciency and completely clearing up.

  4. Clinical Application of Acupuncture and Moxibustion to the Treatment of Gouty Arthritis and Analysis on Their Therapeutic Effects%针灸治疗痛风性关节炎的临床应用与疗效分析

    Institute of Scientific and Technical Information of China (English)

    林彩霞; 马惠芳; 马文珠; 周培娟

    2009-01-01

    本文对近10年来针灸治疗痛风性关节炎的临床应用与疗效进行了总结分析,以期为今后的临床科研提供参考依据.针灸治疗痛风性关节炎可选用毫针、火针、温针灸、三棱针,具有见效快、复发率低、无副作用的优点.%In the present paper, the authors make a summary on the clinical application of acu-moxibustion therapy in the treatment of gouty arthritis in recent 10 years. Acupuncture needles often used are filiform needle, red-hot needle, moxibustion-warmed needle and three-edged needle. Clinical studies have showed that acupuncture therapy has a definite efficacy in relieving gouty arthritis and has its clinical characteristics, such as faster efficacy, lower relapse rate, etc. in comparison with medication.

  5. Nursing Observation of Using Bizhongxiao Powder to Treat Gouty Arthritis%痹肿消散治疗急性痛风性关节炎护理观察

    Institute of Scientific and Technical Information of China (English)

    崔玉香; 于静

    2013-01-01

    目的:痛风性关节炎是由于嘌呤代谢紊乱所致的关节疾病,随着人们生活水平的提高,患病率逐年上升,对我国人民的健康及经济危害较大.本项目探讨我院自制中药痹肿消散对痛风性关节炎患者的临床疗效及护理方法.方法:选取住院病人70例,随机分为治疗组(35例)、对照组(35例),对照组给予扶他林乳胶剂外抹.结果:两组治疗后关节肿痛、CRP等较治疗前明显改善,治疗组有效率78.5%,痹肿消散消肿效果更佳,与扶他林乳胶剂比较,差异具有显著性意义(P<().05).结论:痹肿消散能有效治疗急性痛风性关节炎,对患者局部肿痛进行护理,减少病人的剧烈疼痛,同时给予生活上的照顾和心理调护,是痛风性关节炎护理工作的关键.%Objective:Gouty arthritis is a kind of joint disease which is caused by purine metabolic disorder.With the improvement of people's living standard,the prevalence of disease is rising year by year,and there is no denying that gouty arthritis has been a grave damage to people's health and economic.The project was to discuss gouty arthritis patient's clinical curative effect and nursing methods of Bizhongxiao Powder,a kind of Chinese herbal made by our hospital.Method:70 cases of patients were randomly divided into treatment group (35 cases) and the control group (35 cases).Control group was given Voltaren emulsion wiping outside.Results:After treatment,joint swelling,CRP and other indexes were significantly improved when compared with those before treatment,and the treatment group's effective rate was 78.5%.Qingbi Powder had good results in eliminating swelling.Compared with Voltaren emulsion,the difference was statistically significant (P<0.05).Conclusion:Bizhongxiao Powder can effectively treat gouty arthritis and patients' local pain and swelling,reduce the patients' severe pain,take care of their lives and give psychological nursing at the same time.Without doubt above all

  6. 御米油软胶囊干预痛风性关节炎缓解期的临床试验研究%Clinical Trial on the Effects of Yumi Oil Soft Capsules on Gouty Arthritis Remission

    Institute of Scientific and Technical Information of China (English)

    马方励; 徐强; 林昌松

    2011-01-01

    Objective: To evaluate the impact of Yumi oil soft capsules on gouty arthritis remission. Method: Using random comparison method ,50 cases of gouty arthritis patients were divided into test group and control group, respectively. The observation period was 8 weeks. Arthralgia indices, VAS score of overall disease condition, body weight, blood pressure, uric acid ( UA), erythrocyte sedimentation rate (ESR) and lipids ( triglyceride and total cholesterol) as the main efficacy indices,nocturia,urinary frequency,urinary urgency and dysuria as the minor efficacy indices,and blood tests,urine tests,stool check,liver function,kidney function and blood sugar level as the main security indices,the effect of Yumi oil soft capsules on gouty arthritis remission was studied. Result: Between the two groups,there was no statistical difference in the minor efficacy indices,while there was significant statistical difference in the other indices,especially in the joint pain and the blood level of UA,ESR and lipids. Conclusion: Under the premise of keeping the existing treatment programs of gouty arthritis patients, Yumi oil soft capsules can significantly improve the total score of clinical symptoms, tenderness and pain VAS score and reduce the uric acid and total cholesterol levels in serum,which enhance the overall efficacy of the treatment programs of gouty arthritis patients.%目的:评价御米油软胶囊对痛风性关节炎缓解期的干预作用.方法:采用随机对照方法,50例痛风性关节炎患者随机分为试验组和对照组,观察8周,疗效评价以关节痛指标、疾病总体状况的VAS评分、体质量、血压、血尿酸值(UA)、血沉(ESR)及血脂(三酰甘油、总胆固醇)为主要疗效指标,夜尿、尿频、尿急及尿痛为次要疗效指标;血尿常规、大便检查、肝肾功能及血糖等指标为主要安全性指标.结果:试验组与对照组除夜尿、尿频、尿急及尿痛次要疗效指标差异无统计学意义外,

  7. 痛风性关节炎患者临床超声影像学诊断的实效性%Efficiency of clinical ultrasound imaging in gouty arthritis

    Institute of Scientific and Technical Information of China (English)

    张前茜; 卢苇; 梁瑞钿; 傅仲带

    2014-01-01

    目的::探究痛风性关节炎患者在临床超声影像学中诊断的实效性。方法:研究本院确定患有痛风性关节炎的44例,且原来有痛风性关节炎复发经历的64个受到影响的关节通过超声影像来表现。结果:最终64个受累关节通过超声表现的结果为:关节积液60个(60/64,93.75%),滑膜增生32个(32/64,50.00%),骨侵蚀20个(20/64,31.25%),关节软骨“双边征”50个(50/64,78.13%),关节液内“暴雪样”回声20个(20/64,31.25%),关节内点状强回声16个(16/64,25.00%),关节内片状强回声团伴声影30个(30/64,46.88%),关节旁肌腱周围强回声16个(16/64,25.00%),关节周围滑囊积液8个(8/64,12.50%)。同时2个或者2个以上关节受累的人数与其他各个受累关节的人数上,男性患者普遍要比女性患者多一些。结论:在临床超声影像学里,痛风性关节炎有着不同种类的表现特征,而且其中一些超声影像学有差异性。痛风性关节炎患者临床超声影像学诊断具有实效性。%Objective:To investigate the efficiency of clinical ultrasound imaging in patients with gouty arthritis.Methods:Forty-four patients with confirmed gouty arthritis in our hospital were included in the study. From them,64 joints with experience of gouty arthritis relapse were studied by ultrasound imaging. Results:The results of the 64 affected joints examined by ultrasound:60 cases of joint effusion ( 60/64, 93. 75%) , 32 of synovial hyperplasia (32/64,50.00%),20 of bone erosion (20/64,31.25%),50 of "bilateral syndrome" in the articular cartilage (50/64,78.13%),20 of "blizzard-like" echoes in the joint fluid (20/64,31.25%),16 of dotty hyperecho in the joint (16/64,25.00%),30 of hyperechoic patches with acoustic shadow in the joint (30/64,46.88%),16 of juxta articular hyperecho surrounding the tendon (16/64,25.00%),and 8 of synovial effusion around the joint ( 8/64, 12. 50%) . There were more males than females among

  8. Crystal structures of Apo and GMP bound hypoxanthine-guanine phosphoribosyltransferase from Legionella pneumophila and the implications in gouty arthritis.

    Science.gov (United States)

    Zhang, Nannan; Gong, Xiaojian; Lu, Min; Chen, Xiaofang; Qin, Ximing; Ge, Honghua

    2016-06-01

    Hypoxanthine-guanine phosphoribosyltransferase (HGPRT) (EC 2.4.2.8) reversibly catalyzes the transfer of the 5-phophoribosyl group from 5-phosphoribosyl-alpha-1-pyrophosphate (PRPP) to hypoxanthine or guanine to form inosine monophosphate (IMP) or guanosine monophosphate (GMP) in the purine salvage pathway. To investigate the catalytic mechanism of this enzyme in the intracellular pathogen Legionella pneumophila, we determined the crystal structures of the L. pneumophila HGPRT (LpHGPRT) both in its apo-form and in complex with GMP. The structures reveal that LpHGPRT comprises a core domain and a hood domain which are packed together to create a cavity for GMP-binding and the enzymatic catalysis. The binding of GMP induces conformational changes of the stable loop II. This new binding site is closely related to the Gout arthritis-linked human HGPRT mutation site (Ser103Arg). Finally, these structures of LpHGPRT provide insights into the catalytic mechanism of HGPRT.

  9. Effect of Acupuncture on Clinical Symptoms and Serum Uric Acid of Gouty Arthritis%针刺对痛风性关节炎临床症状及血尿酸影响的研究

    Institute of Scientific and Technical Information of China (English)

    艾民; 赵娜; 王欣波

    2012-01-01

    目的:观察针刺治疗痛风关节炎的临床疗效及对血尿酸的影响.方法:选择活动性痛风关节炎患者50例,按照随机表将患者随机分为对照组25例,给予秋水仙碱治疗;治疗组25例,除给予秋水仙碱外,还根据中医辨证选用相应穴位针刺.结果:治疗组与对照组相比,临床症状改善有显著性差异(P<0.05),血尿酸变化有明显差异(P<0.05).结论:针刺配合西药治疗痛风性关节炎较单纯西药有更好的疗效.%Objective:To observe clinical curative effect of acupuncture treatment on gouty arthritis and effects on uric acid. Methods; We chose activity of gouty arthritis in 50 cases and randomly divided them into a control group of 25 cases which was given Colchieine ;25 cases of the treatment group which was selected according to syndrome differentiation of traditional Chinese medicine and point acupuncture besides Colchieine. Results: There were significant differences in efficacy comparison between the treatment group and the control group. Before and after treatment,Joint swelling and pain relief with significant difference(P <0. 05) , changes of serum uric acid with distinct differences (P<0.05). Conclusion: Acupuncture and western medicine in the treatment of gout arthritis has a better effect compared with relatively simple western medicine.

  10. Voltaren Emulgel Topical Treatment of Gouty Arthritis Efficacy and Nursing Analysis%扶他林乳胶剂外用治疗痛风性关节炎的疗效观察及护理分析

    Institute of Scientific and Technical Information of China (English)

    陈跃萍; 郑锦红

    2015-01-01

    目的:探讨扶他林乳胶剂外用治疗痛风性关节炎疗效和护理配合。方法选择我院治疗痛风性关节炎患者104例,采用随机数字表法分为观察组和对照组,两组均给予扶他林乳胶剂外治,对照组开展常规护理,观察组给予综合护理干预,记录两组治疗效果。结果观察组治疗总有效率为94.23%,对照组治疗总有效率为80.77%,组间对比差异有统计学意义(P<0.05)。结论扶他林乳胶剂外用治疗痛风性关节炎疗效可靠,配合综合护理干预能够有效改善患者症状。%ObjectiveTo investigate Voltaren Emulgel topical treatment of gouty arthritis and care complexes.Methods 104 cases of hospital treatment of gouty arthritis patients, divided into two groups and the control group using a random number table, two groups were given Voltaren Emulgel foreign rule, the control group to carry out routine care, observation group were given comprehensive nursing intervention, record two therapeutic effect. Results The total effective rate was 94.23%, the control group, the total effective rate 80.77%, compared to the differences between the two groups was statisticaly significant (P<0.05).Conclusion Voltaren Emulgel topical treatment of gouty arthritis and reliable, with comprehensive nursing intervention can improve the patient's symptoms, was to promote the use in clinical practice.

  11. The use of high frequency ultrasound examination in the ankle muscle bone in gouty arthritis%高频超声足踝肌骨检查在痛风性关节炎中的应用

    Institute of Scientific and Technical Information of China (English)

    陶宏

    2016-01-01

    目的:探讨高频超声在痛风性关节炎患者足踝病变的诊断价值。方法:选取住院痛风患者及门诊痛风患者40例作为研究组,同期就诊的骨性关节炎和类风湿关节炎患者31例作为对照组,观察两组患者的高频超声表现。结果:病变关节的超声表现:关节积液79个(79/96,82.2%),双轮廓征61个(61/96,63.5%),滑膜增厚及血流83个(83/96,86.4%),尿酸盐结晶沉积67个(67/96,69.7%),骨侵蚀22个(22/96,22.9%),肌腱炎、腱鞘炎18个(18/96,18.7%),痛风石形成25个(25/96,26%)。两组患者关节腔积液、滑膜增厚、肌腱炎和骨侵蚀等检出率差异无统计学意义(P >0.05),研究组双轮廓征、尿酸盐沉积、痛风石检出率高于对照组,差异有统计学意义(P <0.05)。结论:尿酸盐沉积、双轮廓征、痛风石为痛风性关节炎特征性表现,足踝肌骨检查对痛风性关节炎具有较高诊断价值。%Objective To investigate the value of high frequency ultrasound in the diagnosis of patients with gouty arthritis ankle lesions.Method 40 patients with gouty arthritis were selected as the study group,and 31 patients with osteoarthritis andrheumatoid arthritis during the same period were selected as the control group.The high frequency ultrasound features of the twogroups were observed.Results Sonographic features of the joint disease:joint effusion 79 (79/96,82.2%),double contour sign61 (61/96,63.5%),thickening of the synovium and blood 83 (83/96,86.4%),Uric acid salt crystal deposition 67 (67/96,69.7%),bone erosion in 22 (22/96,22.9%),tendonitis,tenosynovitis 18 (18/96,18.7%),tophi formation of 25 (25/96.26%).The detection rate of joint effusion,synovial thickening,tendinitis and bone erosion were no statistically significantdifference between two groups(P >0.05).The detection rate of dual contouring syndrome,deposition of sodium urate

  12. Meta Analysis of Herbs for External Use and Western Medicine in Treating Gouty Arthritis%中药外敷联合西药治疗痛风性关节炎Meta分析

    Institute of Scientific and Technical Information of China (English)

    吴燕

    2014-01-01

    目的:评价中药外敷联合西药对比单纯西药治疗痛风性关节炎的疗效与安全性。方法:从4个中文数据库检索文献,纳入中药外敷联合西药对比单纯西药治疗痛风性关节炎的随机对照试验。数据分析采用RevMan 5.3软件进行分析。结果:最终纳入13个研究。 Meta分析结果显示中药外敷联合西药与单纯西药治疗痛风性关节炎比较,在治愈率[OR=2.47,95%CI(1.94,3.14)]、总有效率[OR=4.15,95%CI(2.88,5.99)]和不良反应[OR=3.60,95%CI(1.30,9.98)]方面具有统计学差异。结论:目前国内研究显示中药外敷联合西药治疗痛风性关节炎具有更好的疗效,但须注意预防相应的不良反应。%Objective:To compare clinical effects and the safety of herbs for external use combined with west-ern medicine and western medicine only in treating gouty arthritis. Methods: The papers about randomized con-trolled trials of herbs for external use combined with western medicine in treating gouty arthritis compared with only western medicine were searched from four Chinese databases and included. Data analysis was performed with RevMan 5.3 software. Results:Consequently, 13 studies were included. The results of Meta analysis showed that the comparison between herbs for external use combined with western medicine and western medicine only in treating gouty arthritis had statistical difference in cure rate [OR=2.47, 95%CI (1.94, 3.14)], total effective rate[OR=4.15, 95%CI(2.88, 5.99)] and adverse reaction[OR=3.60, 95%CI(1.30, 9.98)]. Conclusion:Current domestic studies re-veal that herbs for external use combined with western medicine in treating gouty arthritis could obtain better effects, but when we use the therapy, we should pay attention to the corresponding adverse reaction.

  13. Observation of Arthroscopic Minimally Invasive Operation in the Treatment of Knee Gouty Arthritis%关节镜微创手术治疗膝关节痛风性关节炎的效果观察

    Institute of Scientific and Technical Information of China (English)

    张舸

    2015-01-01

    Objective By the experimental observation of arthroscopy of minimally invasive surgery in the treatment of gouty arthritis of knee joint effect. Methods 50 cases of patients with gouty arthritis of knee joint arthroscope under conventional surgery, postoperative medication, more patients of knee joint function changes before and after operation, observe the clinical effects of arthroscopic surgery. Results After 2 years of follow-up, all patients incision wereⅠhealing. Postoperatively, the Lysholm score and VAS scores were signiifcantly better than preoperative, P<0.05, the difference was statistically signiifcant. After surgery in patients with knee joint function were improved signiifcantly, P<0.05, the difference was statistically signiifcant. This group of 50 cases received surgical treatment for 3 weeks, 19 cases cured, 22 cases were markedly effective, 6 no effect, the total effective rate was 88%. Conclusion Arthroscopic surgery for the treatment of patients with gouty arthritis of knee joint clinical effect is good, obtained satisfactory curative effect, suggested that clinical widely used arthroscopy minimally invasive surgical treatment of patients with gouty arthritis of knee joint.%目的:通过试验观察关节镜微创手术治疗膝关节痛风性关节炎的临床效果。方法对50例膝关节痛风性关节炎的患者进行关节镜下常规手术治疗,术后坚持用药,比较患者手术前后的膝关节功能变化,观察关节镜手术的临床疗效。结果经过2年的随访,所有患者手术切口均为Ⅰ期愈合。术后患者的Lysholm评分和VAS评分均明显优于术前,P<0.05,差异有统计学意义。手术后患者的膝关节功能均明显改善,P<0.05,差异有统计学意义。本组50例患者接受手术治疗3周后,治愈19例,显效22例,无效6例,总有效率88%。结论关节镜手术对于治疗患者膝关节痛风性关节炎的临床效果良好,疗效较为满意,建议

  14. 提升中医体质学说在痛风性关节炎患者疼痛的影响%To Enhance the Effect of TCM Constitution Theory in the Pain of Patients with Gouty Arthritis

    Institute of Scientific and Technical Information of China (English)

    申霞

    2014-01-01

    To analyze the ef ect of improving the Physique Theory of Chinese medicine in the pain of patients with gouty arthritis. In our hospital from 2011 to 2014 April in our hospital 102 cases of gouty arthritis patients, randomly divided into control group and observation group of two groups, each group of 51 cases. The control group using the general methods of nursing, the observation group based in general care in accordance with the Constitution in Chinese medicine nursing. According to TCM constitution according to the medication and nursing of patients with no dif erent, can reduce the suf ering of patients, can significantly improve the cure rate of patients.%分析提升中医体质学说在痛风性关节炎患者疼痛的影响。选取我院2011年~2014年4月我院102例痛风性关节炎患者,随机分为对照组和观察组两组,每组51例。对照组采用一般护理方法,观察组在一般护理的基础上按照中医体质类型进行护理。依据中医体质分别针对不同患者不用用药和护理,可减少病患的痛苦,可明显提高患者的治愈率。

  15. 痛风饮治疗痛风性关节炎急性发作的临床观察%Clinical observation on treating gouty arthritis with Tongfeng Yin

    Institute of Scientific and Technical Information of China (English)

    张文霞; 孙元海; 刘淑芹

    2016-01-01

    目的::探讨痛风饮治疗痛风性关节炎急性发作的临床疗效。方法:将220例患者分为研究组和对照组,研究组患者给予自拟痛风饮治疗,对照组患者给予双氯芬酸钠片,秋水仙碱片和泼尼松片进行治疗。比较两组的临床疗效。结果:研究组总有效率为93.64%,高于对照组的79.09%;治疗后,研究组的关节症状评分、BUA、CRP及ESR均优于对照组,差异显著(P﹤0.05)。结论:痛风饮治疗痛风性关节炎效果显著。%Objective: To investigate clinical efficacy of Tongfeng Yin on gouty arthritis. Methods: 220 patients were divided into the study group and the control group. The study group was treated with Tongfeng Yin; and the control group was given the Diclofenac sodium tablets, Colchicine tablets and Prednisone. Clinical efficacy in two groups was compared. Results: The total efficiency was 93.64% in the study group, higher than 79.09% in the control group. After the treatment, articulation symptom score, BUA, CRP and ESR in study group were better, with significant differences (P﹤0.05). Conclusion: Tongfeng Yin on gouty arthritis shows a good effect.

  16. Clinical observation of "Qushi Huazhuo Decoction" in treating gouty arthritis of dampness-heat accumulation%祛湿化浊方治疗湿热蕴结型痛风性关节炎临床观察

    Institute of Scientific and Technical Information of China (English)

    石海林

    2013-01-01

    Objective To observe the clinical efficacy of " Qushi Huazhuo Decoction" in the treatment of gouty arthritis of dampness-heat accumulation. Methods Seventy-two subjects were equally randomized into treatment group and control group, and respectively treated with "Qushi Huazhuo Decoction" and Colchicine for 14 days. Results The comprehensive clinical efficacy was better in the treatment group than in the control group(P 0. 05 ) ; after treatment the symptoms scores were decreased in both groups ( P 0. 05). Conclusion "Qushi Huazhuo Decoction" is quite effective for gouty arthritis of dampness-heat accumulation.%目的 观察祛湿化浊方治疗湿热蕴结型痛风性关节炎的临床疗效.方法 将72例湿热蕴结型痛风性关节炎患者随机分为治疗组和对照组(各36例),分别给予祛湿化浊方和秋水仙碱治疗,疗程14天.结果 治疗组的综合临床疗效优于对照组(P<0.01),但两组中医证候疗效无显著差异(P>0.05);治疗后两组中医证候积分均显著降低(P<0.01),但两组间差异无统计学意义(P>0.05).结论 祛湿化浊方治疗湿热蕴结型痛风性关节炎临床疗效确切.

  17. Evaluation of Several Inflammatory Markers to Infectious and Gouty Arthritis%炎症标志物在感染性和痛风性关节炎中鉴别诊断的应用价值

    Institute of Scientific and Technical Information of China (English)

    万楠; 王璐; 孟冬娅; 郑伟; 胡晓芳

    2015-01-01

    目的:研究不同炎症标志物在不同类型关节炎中的鉴别诊断价值。方法2013年1月~2014年1月在沈阳军区总医院骨科病房住院患者中,33例感染性关节炎和29例痛风性关节炎病人中,检测血浆中白细胞数量、C 反应蛋白以及尿酸水平和关节滑液中乳酸、葡萄糖、尿酸、乳酸脱氢酶、白细胞等相关炎症标志物,再通过受试者工作曲线分析不同标志物的诊断价值。结果在两组患者中,只有血浆白细胞和 C 反应蛋白水平不存在统计学差异,关节滑液中乳酸浓度检测的诊断价值最高,曲线下面积(AUC)为0.898,特异度为72.4%,敏感度为96.9%;其次为血清尿酸和滑液尿酸两项指标, AUC 分别为0.818和0.808。结论在感染性关节炎中乳酸标志物有良好的诊断价值,滑液中乳酸水平高于1.7 mmol/L基本可以诊断为感染性关节炎。%Objective The aim of this study was to investigate which inflammatory markers allow an accurate differentiation of septic and gouty arthritis.Methods In 2013 January to 2014 January 33 patients with septic arthritis and 29 patients with gouty arthritis.Detected white blood cells,C-reactive protein and uric acid of inflammatory markers in plasma and tested lac-tate,glucose,uric acid,lactate dehydrogenase and white blood cell count inflammatory markers in the synovial fluid.MedCalc 13.0 software were used for statistical analysis.Results There were no significantly different between serum C-reaction protein and WBC counts with two groups.Synovial lactate showed the greatest diagnostic potential (AUC=0.898,sensitivi-ty=96.9%,specificity=72.4%)followed by serum uric acid (AUC=0.818)and synovial uric acid (AUC=0.808).Con-clusion Lactate in the synovial fluid has excellent diagnostic potential to differ septic arthritis from gouty arthritis.Synovial lactate levers above 1.7 mmol/L almost proofed septic arthritis.

  18. Sonographic findings in Gouty Nephropathy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Mi Young; Jeon, Woo Ki; Kim, Ho Kyun; Kim, Yong Soo; Han, Chang Yul; Kim, Young Tong; Han, Sung Tag; Lee, Yoon Woo [Inje University College of Medicine, Seoul (Korea, Republic of)

    1994-09-15

    Ultrasound(US) findings of hyperechoic renal medulla in gouty nephropathy were compared with clinical features such as serum uric acid level to evaluate its usefulness in determination of the treatment and prognosis. A retrospective review of US of 36 cases of qouty arthritis was classified into four groups according to the medullary echogenicity (O :normal, grade I: renal medulla as isoechoic as renal cortex, grade II; heterogeneous increased echogenicity of renal medulla than that of renal cortex, grade III: the echogenicity of all renal medulla higher than that of renal cortex with renal contour deformity) which were compared with the serum urate level and associated conditions. Nephrocalcinosis and nephrolithiasis were analyzed through the KUB and the RGB. The degree of hyperechoic renal medulla was related to the level of serum uric acid, and in group IV, six cases of obstructive uropathy (nephrocalcinosis and nephrolithiasis) showed deformed renal contour. Associated conditions such as hypertension, alcoholism, diabetes mellitus and drug abuse were distributed in relation to the degree of hyperechoic renal medullas. US findings of hyperechoic renal mebulla was related with uric acid level in gouty nephropathy and thus could be valuable for treatment decision and prediction of prognosis.

  19. “TLR2/4-NF-κB”信号转导通路在痛风性关节炎发病中的作用机制%Action Mechanism of TLR2/4-NF-κB Signal Pathway during the Attack of Gouty Arthritis

    Institute of Scientific and Technical Information of China (English)

    周琦; 刘树民; 董婉茹

    2016-01-01

    Toll 样受体家族( Toll-like receptors TLRs)是模式识别受体,在细胞膜和细胞质中均有存在,参与炎症反应的发生。已有研究表明,TLR2与TLR4介导的NF-κB信号转导通路调控炎症因子IL-β的产生,其在痛风性关节炎发病过程中发挥关键作用。本文以痛风性关节炎的发病机制为主线,从TLRs的结构与分布,配体与介导的信号通路,以该通路为靶点治疗痛风性关节炎的有效性,该通路与痛风性关节炎的相关性佐证及基于该信号通路为导向的中医药研究进展进行综述。%Toll-like receptors ( TLRs) are pattern recognition receptors, which exist in both cell membrane and cytoplasm, and participate in inflammatory reactions. Some studies have shown that TLR2/4-NF-κB signal pathways mediated by TLR2 and TLR4 could regulate the production of inflammatory factor IL-1β, which played an important role in the attack of gouty arthritis. The article focused on the pathogenesis of gouty arthritis, discussed the structure and distribution of TLRs, the ligands and its mediated signal pathways, the validity in the treatment of gouty arthritis using the signal pathways as the target points and the relationship between the signal pathways and gouty arthritis, and reviewed the research progress in Chinese medicines using the signal pathways as the guidance.

  20. 刺络放血联合中药外敷治疗急性痛风性关节炎的临床观察%Efficacy of Bloodletting of Ci collaterals and External Use of Chinese Medicine to Treat Gouty Arthritis

    Institute of Scientific and Technical Information of China (English)

    张园; 魏华

    2012-01-01

    Objective:To evaluate efficacy of bloodletting of Ci collaterals in combination of external use of Chinese medicine to treat gouty arthritis. Methods: A total of 102 patients of gouty arthritis was treated with bloodletting of Ci collaterals in combination of external use of Chinese medicine. Results: After treatment, biochemical parameter values and symptoms were improved significantly ( P < 0. 05 ) with a total effective rate of 96. 1% . Conclusion: bloodletting of Ci collaterals in combination of external use of Chinese medicine is an effective treatment of gouty arthritis.%目的:观察刺络放血联合中药外敷治疗急性痛风性关节炎的疗效.方法:将102例急性痛风性关节炎患者采用刺络放血联合中药外敷.结果:治疗后生化指标、症状评定改善明显(P<0 05),临床疗效总有效率达到96 1%.结论:刺络放血联合中药外敷治疗急性痛风性关节炎效果良好.

  1. Disability due to gouty arthritis

    NARCIS (Netherlands)

    ten Klooster, Peter M.; Vonkeman, Harald Erwin; van de Laar, Mart A F J

    2012-01-01

    Gout-related disability is an underestimated and understudied problem. More qualitative and quantitative studies are needed that examine the concept of disability in gout and its impact on patients’ lives, both during and between disease flares. Moreover, future studies should try to identify

  2. Disability due to gouty arthritis

    NARCIS (Netherlands)

    Klooster, ten Peter M.; Vonkeman, Harald E.; Laar, van de Mart A.F.J.

    2012-01-01

    Gout-related disability is an underestimated and understudied problem. More qualitative and quantitative studies are needed that examine the concept of disability in gout and its impact on patients’ lives, both during and between disease flares. Moreover, future studies should try to identify gout-s

  3. DSCT双能量技术在痛风性关节炎的临床应用研究%Clinical Analysis of DSCT Dual Energy Technique in the Treatment of Gouty Arthritis

    Institute of Scientific and Technical Information of China (English)

    王浩; 孟葳; 胡秋根; 杨少民

    2015-01-01

    Objective Investigate dual energy DSCT scan technology in gouty arthritis clinical diagnosis analysis. Methods In our hospital from 2009 to 2011 were col ected for 30 patients,aged 7-85 years old,male 22 cases,female 8 cases.Check the site including bilateral foot,hand,knee,elbow joint,sternoclavicular joint,joint DSCT dual energy technique in the treatment of patients with clinical diagnosis of ventilation.According to the clinical and laboratory data were divided into 3 groups:group A:10 cases of gouty arthritis clinical diagnosis,7 patients with elevated serum uric acid,blood uric acid in normal range in 3 cases.Group B:clinical y suspected but not confirmed 10 cases of gouty arthritis,5 cases of blood uric acid is not high.Group C (control group)10 cases,double foot in 4 cases,2 cases of double knee,3 cases of double elbow,are local trauma,tumors of bone and ligament repair postoperative treatment,without hyperuricemia,gout and gouty suspicious signs family history.DSCT dual energy technique the image transferred to GOUT software,in the color labeled MPR and VRT map display scanning parts of urate crystals are analyzed.Results The DSCT dual energy technique in the clinical application of gouty arthritis by using SIEMENS SOMATOM Definition Flash CT can accurately locate the disease,by dual energy CT scan were found in deposition of urate crystals in 30 limbs in 24 cases of gout patients joints,limbs and clinical physical examination can only detect the 8 joints of suspected lesions,only for dual energy CT scan lesions were found in 39.4%,the dif erence was statistical y significant ( =0.000).The control group showed no deposition of urate crystals. Conclusion Dual energy CT scan in the detection of suspected urate crystal deposition joint and soft tissue around the gout patients with sensitivity,specificity and noninvasive.%目的探讨DSCT双能量扫描技术在痛风性关节炎临床诊断中的价值分析。方法本院对收集2013年~2014年间就诊30

  4. RELATIONSHIP BETWEEN GOUTY ARTHRITIS AND DIETARY HABITS OF RESIDENTS IN QINGDAO%青岛居民膳食习惯与痛风性关节炎关系分析

    Institute of Scientific and Technical Information of China (English)

    程晓宇; 苗志敏; 刘柳; 韩琳; 李长贵

    2012-01-01

    目的 探讨青岛居民痛风性关节炎发病与膳食习惯的关系,为痛风的膳食防治提供科学依据.方法 对我院2009年青岛居民的流行病学调查收集的120例痛风性关节炎病人及135例对照人群的膳食习惯进行分析,所得资料采用SPSS 13.0软件进行非条件Logistic回归分析.结果 经常饮酒、每次过量摄入肉类、动物内脏、贝类为痛风发病的危险因素(OR=7.081、2.994、5.339、6.111),经常性蔬菜摄入是痛风发病的保护因素(OR=0.072).结论 痛风是一种与环境和生活方式有关的疾病,改变生活方式,减少酒类及富含嘌呤食物的摄入,增加蔬菜的摄入是预防或减少青岛居民痛风发生的重要措施.%Objective To explore the relationship between gouty arthritis and dietary habits of residents in Qingdao and provide a dietary guidance for gout prevention. Methods Based on our epidemiological study in residents of Qingdao in 2009, 120 patients with gouty arthritis were surveyed and compared with 135 control population in terms of their dietary habits. The data were analyzed by unconditioned Logistic regression using SPSS 13. 0 software. Results Habitual alcohol drinking, taking too much meats, animal internal organs, and shellfish were high-risk factors contributing to gout (OR=7. 081,2, 994,5. 339,6, 111 respectively) , while regular intake of vegetables was its protection (OR=0. 072). Conclusion Gout is a disease that associates with environment and lifestyle. Changing lifestyle, such as less alcohol consumption and purine-rich food intake, and more vegetable intake are important measures to prevent or decrease the prevalence of gout for residents of Qingdao.

  5. Clinical Study on Treatment of 85 Cases of Gouty Arthritis with Tong Feng Lotion%痛风洗剂治疗痛风性关节炎85例临床研究

    Institute of Scientific and Technical Information of China (English)

    张史昭; 马红珍; 李学铭

    2001-01-01

    150例患者分为两组,分别应用痛风洗剂(85例)及扶他林洗剂(65例)外用治疗,结果显示中药痛风洗剂对痛风患者具有改善临床症状及关节功能的作用,能降低血沉、C反应蛋白、血尿酸及血液粘度。治疗组总有效率为89.41%,与对照组(75.38%)比较差异有显著性(P<0.05)。无毒副作用,且治疗效果与中医证型无明显关系。%One hundred and fifty cases of gouty arthritis were divided into two groups.Treatment group(85 cases) were treated with Tong Feng lotion and control group(65 cases) with external application of Voltaren. Results indicated that Tong Feng lotion could improve clinical symptoms and function of joints, and decrease blood sedimentation,reaction protien C,blood uric acid and blood viscosity; the total effective rate was 89.42% in the treatment group and 75.38% in the control group, with significant difference between the two groups(P<0.05); there was no obvious relation between therapeutic effects and TCM syndrome types.

  6. Comparison of intramuscular compound betamethasone and oral diclofenac sodium in the treatment of acute attacks of gout.

    Science.gov (United States)

    Zhang, Y-K; Yang, H; Zhang, J-Y; Song, L-J; Fan, Y-C

    2014-05-01

    Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used for the treatment of acute gouty arthritis but have the risk of gastrointestinal bleeding and cardiovascular toxicity. Glucocorticoid was as effective as oral NSAIDs in the initial treatment of gout arthritis of patients intolerant of NSAIDs. However, whether glucocorticoid has the same or preferable effect as oral NSAIDs on patients with acute gouty arthritis irrespective of gastrointestinal and cardiovascular risks factor remains unknown. This study was to compare the efficacy, safety and tolerance of compound betamethasone (diprospan) 7 mg intramuscular injection (i.m.) once for all during the study with diclofenac sodium 75 mg twice a day in the treatment of acute gouty arthritis. Sixty patients with acute gouty arthritis were randomised (1 : 1) to receive compound betamethasone 7 mg i.m. once for all during the study or diclofenac sodium 75 mg twice a day for 7 days in this open-label study. Pain intensity, tenderness, swelling and global assessment of response to therapy were collected as end-points for the treatment. The mean change in pain intensity from baseline to Day 3 and Day 7 in both treatment groups demonstrated that compound betamethasone had preferable efficacy over diclofenac sodium on Day 3 and comparable efficacy on Day 7. The compound betamethasone group had fewer adverse effects (AEs) than diclofenac sodium group. No statistically significant differences were observed about serum uric acid levels at different pain intensity at baseline. A single dose of compound betamethasone may be better than diclofenac sodium for the treatment of acute gouty arthritis. © 2014 John Wiley & Sons Ltd.

  7. Haemodynamics in acute arthritis of the knee in puppies

    DEFF Research Database (Denmark)

    Bünger, C; Hjermind, J; Harving, S

    1984-01-01

    In order to study the haemodynamic changes of the juvenile knee in acute arthritis, an experimental model was developed in puppies by unilateral intra-articular injections of Carragheenin solution into the knee. Tissue blood flow was studied by the tracer microsphere technique in eight dogs...

  8. Gouty tophus simulating soft tissue tumor in a heart transplant recipient

    Energy Technology Data Exchange (ETDEWEB)

    Chaoui, A.; Garcia, J. [Department of Radiology, University Hospital of Geneva, 24, Rue Micheli-du-Crest, CH-1211 Geneva 14 (Switzerland); Kurt, A.M. [Department of Pathology, University Hospital of Geneva, Geneva (Switzerland)

    1997-10-01

    Gouty arthritis is the most frequent rheumatological complication among cyclosporine-treated organ transplant recipients. We report one case of pseudotumoral intramuscular tophaceous deposit of the forearm, in a heart transplant patient with a history of traumatic wound to the same area 17 years previously, and with no known arthritis. (orig.) With 4 figs., 10 refs.

  9. Clinical Research of Tongfenqing Powder Preparation for Infusion on Blood Lipid and Hemorheology for Gouty Arthritis%痛风清冲剂对痛风性关节炎患者血脂与血液流变学影响的临床研究

    Institute of Scientific and Technical Information of China (English)

    曾荣南; 吴启富; 接红宇; 孙德华; 王繁盛; 戚晶敏

    2012-01-01

    Objective To observe the impacts of tongfengqing powder preparation for infusion on blood lipid and hemorheology for the patients with gouty arthritis and explore the mechanism of it in the treatment of gouty arthritis. Methods 75 cases of gouty arthritis were selected and randomized into two groups. In a treatment group( 39 cases ), tongfengqing powder preparation for infusion was provided. In a control group ( 36 cases ), allopurinol tablets were prescribed. Either group was treated for one session( 4 weeks ). The blood lipid, blood uric acid, erythrocyte sedimentation rate( ESR),C -reactive protein( CRP )and hemorheology were detected and compared before and after treatment in two groups. Results After treatment, the levels of blood lipid, blood uric acid, ESR, CRP and hemorheology were all reduced significantly as compared with those before treatment! P < 0. 01 ). The statistical significant differences presented in comparison with the control group( P < 0. 01 ). Conclusion Tongfengqing powder preparation for infusion treats effectively gouty arthritis,which is probably related to the obvious improvements in blood lipid,blood uric acid,ESR,CRP and hemorheology.%目的 观察痛风清冲剂对痛风性关节炎患者血脂与血液流变学的影响,探讨其治疗痛风性关节炎的作用机制.方法 选取诊断为痛风性关节炎患者75例,随机分为两组.治疗组39例服用痛风清冲剂治疗,对照组36例服用别嘌醇片,两组均治疗1个疗程(4周);分别对两组患者治疗前后的血脂、血尿酸、血沉、CRP及血液流变学进行检测并进行比较.结果 治疗组治疗后血脂、血尿酸、血沉、C反应蛋白(CRP)及血液流变学指标较治疗前均显著降低(P<0.01);与对照组治疗后比较差异有统计学意义(P<0.01).结论 通风清冲剂能有效治疗痛风性关节炎,可能与其能明显改善患者血脂、血尿酸、血沉、CRP及血液流变学多项指标有关.

  10. Bilateral knee replacements for treatment of acute septic arthritis in both knees.

    Science.gov (United States)

    Ashraf, Muhammad Omer; Asumu, Theophilus

    2013-11-01

    A case report of bilateral acute septic arthritis of knees is presented, which was managed with staged total knee replacements for both knees. A literature review on septic arthritis treated with knee arthroplasty is also presented.

  11. Acute pseudo-septic arthritis following viscosuplementation of the knee.

    Science.gov (United States)

    Idrissi, Zineb; Benbouazza, Karima; Fourtassi, Maryam; Raissouni, Hanae; El Aadmi, Meriem; Zanat, Fatima; Hajjaj-Hassouni, Najia

    2012-01-01

    A 70-year-old woman with a history of medial femoro-tibial compartment of knee osteoarthritis was admitted for acute arthritis six days after a second intra-articular injection of Hyaluronic acid. The joint fluid was inflammatory, with no crystals, and laboratory tests showed marked inflammation leading to antibiotic treatment for suspected septic arthritis. The persistent symptoms and negative results of joint fluid and blood cultures led to discontinuation of the antibiotic therapy after 10 days. Anti-inflammatory with rehabilitation therapy of the knee relieved the symptoms, and the patient was discharged home 3 weeks after her admission. Aseptic arthritis induced by repeated Hyaluronic acid injection is the most likely diagnosis. Physicians should be conscious of this extremely severe complication.

  12. 走出痛风性关节炎诊断和治疗的误区%Redress the misconception of diagnosis and treatment for gouty arthritis

    Institute of Scientific and Technical Information of China (English)

    施桂英

    2006-01-01

    近20年,国内许多医院相继建立了血清类风湿因子和人类白细胞抗原(HLA)一B27的检测方法,尽管它们为临床诊断提供了参考依据,但也带来一些负面影响。尤其明显的是,一些医师不问其他,简单地将类风湿因子阳性或HLA-B27阳性者诊断为类风湿关节炎或强直性脊柱炎,于是造成了对一些患者的误诊和误治。与上述现象同出一辙的是,许多医师也简单地将血尿酸增高等同于痛风,或对急性发作的痛风性关节炎(gouty arthritis)患者给予别嘌醇治疗,而且这种误诊误治的现象屡见不鲜。为此,有必要呼吁医务人员应对发病率日益增加的痛风性关节炎的诊断和处理提高认识,走出误区,规范治疗,防治结合。

  13. Changes and Significance of Serum hs-CRP Level in Patients with Gouty Arthritis or Rheumatoid Arthritis%痛风性关节炎及类风湿性关节炎患者血清hs-CRP水平的变化和意义

    Institute of Scientific and Technical Information of China (English)

    孙际明

    2010-01-01

    目的 观察痛风性关节炎(gouty arthritis)及类风湿性关节炎(rheumatoid arthritis,RA)患者血清中超敏C反应蛋白(hypersensitive C reactive protein,hs-CRP)水平的变化.方法 选择健康体检者42例为对照组,痛风性关节炎组30例,类风湿性关节炎组20例及高尿酸血症组40例用全自动生化分析仪分别检测血清中hs-CRP、UA、RF的水平并进行统计学分析.结果 痛风性关节炎组及类风湿性关节炎组hs-CRP水平明显高于对照组(P<0.05),痛风性关节炎组hs-CRP水平明显高于高尿酸血症组(P<0.05).结论 hs-CRP可作为痛风性关节炎和类风湿性关节炎的诊断指标之一.

  14. 原发性高尿酸血症和痛风性关节炎患者亚甲基四氢叶酸还原酶基因C677T多态性的检测%Methylenetetrahydrofolate reductase C677T polymorphism for primary hyperuricemia and gouty arthritis

    Institute of Scientific and Technical Information of China (English)

    张巧慧; 柳洁

    2008-01-01

    采用PCR-限制性片段长度多态性分析方法,检测高尿酸血症、痛风性关节炎患者和对照组亚甲基四氢叶酸还原酶(MTHFR)基因C677T多态性及同型半胱氨酸(Hcy)水平.MTHFR基因C677T多态性与高尿酸血症相关,T等位基因是其危险因素,但与痛风性关节炎的发生无关.%The relation of methylenetetrahydrofolate(MTHFR)reductase C677T polymorphism with primary hyperuricemia and gouty arthritis was observed in People's Hospital of Shanxi Province.MTHFR reductase C677T pdymorphism in 195 subjects was examined by PCR-restriction fragment length polymorphism.The results showed that MTHFR gene mutation might be a risk factor for primary hyperuricemia.However,C677T polymorphism of the MTHFR gene was not related to the development of gouty arthritis.

  15. Observations on the Efficacy of Moxibustion plus Medicinal Tea in Treating Gouty Arthritis During the Interictal Period%艾灸配合药茶治疗痛风性关节炎发作间歇期疗效观察

    Institute of Scientific and Technical Information of China (English)

    张文君; 李建军; 孙秀凤; 吴子成; 汪怀

    2015-01-01

    目的:观察艾灸配合药茶治疗痛风性关节炎发作间歇期的临床疗效。方法治疗组64例采用艾灸配合药茶方法治疗,对照组64例采用饮食控制的方法。结果治疗组总有效率为95.3%,对照组总有效率为75.0%,两组比较差异有统计学意义(P<0.01)。结论采用艾灸配合药茶治疗痛风性关节炎发作间歇期疗效较好。%ObjectiveTo investigate the clinical efficacy of moxibustion plus medicinal tea in treating gouty arthritis during the interictal period.MethodA treatment group of 64 patients received moxibustion plus medicinal tea and the control groupof 64 patients, alimentary control.ResultThe total efficacy rate was 95.3% in the treatment group and 75.0% in the control group; there was a statistically significant difference between the two groups (P<0.01).ConclusionMoxibustion plus medicinal tea has a better therapeutic effect on gouty arthritis during the interictal period.

  16. Elbow septic arthritis associated with pediatric acute leukemia: a case report and literature review.

    Science.gov (United States)

    Uemura, Takuya; Yagi, Hirohisa; Okada, Mitsuhiro; Yokoi, Takuya; Shintani, Kosuke; Nakamura, Hiroaki

    2015-01-01

    Acute leukemia in children presents with various clinical manifestations that mimic orthopaedic conditions. The association of septic arthritis of the elbow with acute leukemia is very rare, and the correct diagnosis of acute leukemia is often established only after treatment of the septic arthritis. In this article, we present a three-year-old child patient with elbow septic arthritis related to acute leukemia, diagnosed promptly by bone marrow aspiration on the same day as emergency surgical debridement of the septic elbow joint due to the maintenance of a high index of suspicion, and treated with chemotherapy as soon as possible. The emergency physician and orthopaedist must recognize unusual patterns of presentation like this. Since delay in initiating treatment of septic arthritis may result in growth disturbance, elbow septic arthritis associated with pediatric acute leukemia must be treated promptly and appropriately. Early diagnosis is a good prognostic feature of childhood acute leukemia.

  17. Is this acute lymphoblastic leukaemia or juvenile rheumatoid arthritis.

    Science.gov (United States)

    Kirubakaran, Chellam; Scott, Julius Xavier; Ebenezer, Sam

    2011-08-01

    Arthritis could be a presenting feature of acute lymphoblastic leukaemia (ALL) and could be wrongly diagnosed as juvenile rheumatoid arthritis (JRA). Clinical and laboratory parameters might differentiate ALL and JRA in children who present with arthritis. Out of a total of 250 children of ALL, 10 were referred to the department of child health and paediatric haemato-oncology of Christian Medical College, Vellore during 1990-2002. They were compared with 10 age-matched children who had systematic onset of JRA. The age groups in ALL and JRA were 6.05 +/- 2.45 years and 5.47 +/- 4.4 years respectively. Severe pain as evidenced by inability to walk was found in children but one child with JRA was unable to walk (p JRA group. ESR was elevated in all cases in both the groups. One case in each group had antinuclear antibody positivity. It can be concluded that ALL can masquerade as systematic onset of JRA. So paediatricians should be careful enough while diagnosing the disease process.

  18. 四妙汤加味配合中药外敷治疗痛风性关节炎的临床效果观察%Clinical Efficacy of Modified Simiao Decoction Combined With External Application of Traditional Chinese Medicine in Treatment of Gouty Arthritis

    Institute of Scientific and Technical Information of China (English)

    王颂歌; 徐小燕

    2015-01-01

    Objective To explore the efficacy of modified Simiao decoction combined with external application of traditional Chinese medicine in treatment of gouty arthritis. Methods 76 cases of gouty arthritis patients were randomly divided into observation group and control group,38 cases in each group. The control group received conventional Western medicine treatment,the observation group received modified Simiao decoction combined with external application of traditional Chinese medicine treatment on the basis of the control group,the ef icacy of the two groups were compared. Results The total ef ective rate of observation group was 94.74%,significantly higher than the 76.32%of the control group(P<0.05),after treatment,the CRP and UA level of observation group were significantly lower than the control group(P<0.05). Conclusion Modified Simiao decoction combined with external application of traditional Chinese medicine in treatment of gouty arthritis can can ef ectively control inflammation,improve immune function and clinical symptoms and improve clinical outcomes.%目的:探讨痛风性关节炎应用四妙汤加味配合中药外敷治疗的效果。方法76例痛风性关节炎患者随机分为观察组与对照组,各38例。对照组予以常规西医治疗,观察组在对照组的基础上加用四妙汤加味口服及中药外敷,比较两组的疗效。结果观察组的总有效率为94.74%,高于对照组的76.32%(P<0.05);治疗后观察组的CRP、UA低于对照组(P<0.05)。结论四妙汤加味配合中药外敷治疗痛风性关节炎能够有效控制炎症、改善临床症状及免疫功能并提高临床疗效。

  19. Efficacy of Anakinra for Various Types of Crystal-Induced Arthritis in Complex Hospitalized Patients: A Case Series and Review of the Literature

    Directory of Open Access Journals (Sweden)

    A. Aouba

    2015-01-01

    Full Text Available Background. There are few data on anakinra use after failure of conventional medications for crystal-induced peripheral arthritis and/or crowned dens syndrome among complex hospitalized patients. Methods. We retrospectively analyzed the outcome of six patients affected with subacute crystal-induced arthritis who had received anakinra in second or third line therapy, including three patients with crowned dens syndrome and three others with gouty arthritis. Patients’ comorbidities, reasons for anakinra use and associated drugs, and outcomes were recorded. Results. All patients presented with elevated inflammatory syndrome, systemic symptoms with poly/oligoarthritis. Except for absolute contraindications, all patients were previously treated with full or decreased dose of NSAID, colchicine, and/or glucocorticoids, with unsatisfactory response. All three gouty patients exhibited complete responses in all acute involvements under anakinra within 3 to 5 days, including one of them who needed the reintroduction of colchicine treatment that was previously unsuccessful. Crowned dens syndrome patients, including two with pseudogout and one with subacute hydroxyapatite deposition disease, needed 9 to 11 days to achieve complete response. Tolerance to anakinra was good. Conclusion. In case series of complex hospitalized patients, anakinra showed good activity in crowned dens syndrome and associated crystal-induced peripheral arthritis, with longer treatment duration than in gouty arthritis.

  20. Acute arthritis as initial presentation of sarcoidosis: Significance of chest X-ray

    Directory of Open Access Journals (Sweden)

    Muhammed Emin Akkoyunlu

    2012-03-01

    Full Text Available Sarcoidosis is a multisystem granulomatous disease thatpredominantly affects the lungs. It usually presents withfatigue and respiratory findings. The rate of arthritis insarcoidosis is 15-25%. Arthritis as initial manifestation ofsarcoidosis has been reported rarely in the literature. Inpresent paper we highlighted the importance of sarcoidosisand conventional chest X-ray in differential diagnosisof acute arthritis. J Clin Exp Invest 2012; 3(1: 102-104

  1. Effect of swimming in cold water on gouty arthritis of rats with hyperuricemia%冷水泳浴对高尿酸血症模型大鼠诱发痛风性关节炎的影响

    Institute of Scientific and Technical Information of China (English)

    时乐; 徐立; 尹莲; 曾凡伟; 梅琦

    2012-01-01

    OBJECTIVE To investigate the effect of swimming in cold water to prepareing a gouty arthritis model with clinical pathogenesis. METHODS A persistant hyperuricemic model was prepared by giving rats oxonic acid 1 ml·kg-1 and feeding them with hypoxanthine. Rats swam in cold water 10 - 12℃ , 10 min every day, for 12 d during the model preparation. The rat hind limbs were observed every day to find out whether swelling occurred, and the number of rats with swelled hind limbs was recorded. Rat foot microcirculation was expressed as blood perfusion unit ( BPU) , which was determined by Doppler microcirculation radiometer. Uric acid concentrations in serum and joint cavity were determined by automatic biochemistry analyzer. The histopathological changes in hind ankle joints were observed with HE staining. RESULTS The incidence of swelling of hind limbs of rats in hyperuricemia + swimming in cold water group was 76. 7% , but no swelling was observed in other groups. Rat foot microcirculation was influenced obviously by swimming in cold water and hyperuricemia. Compared with normal group, BPU in swimming in cold water, hyperuricemia model and hyperuricemia + swimming in cold water groups significantly decreased ( P < 0.01). The microcirculation in hyperuricemia + swimming in cold water group was slower than that in swimming in cold water and hyperuricemia model groups (P <0. 01 ). On the 6th and 12th day after prepariation of the model, compared with normal group (80 ±13) and (81 ±41 ) |xmol·L-1, serum uric acid in swimming in cold water group did not change. Serum uric acid was (550 ±362) and (1073 ±332) μmol ? L-1 in hyperuricemia model group and (570 ± 458) and (817 ± 338 ) μmol ? L -1 in hyperuricemia + swimming in cold water group, which were all obviously higher than those in normal group (P<0.01). Uric acid concentration in joint cavity in three treatment groups were all higher than that normal group (18 ±16) μmol·L-1 , and uric acid in hyperuricemia

  2. Expression of high mobility group box 1 protein and the receptor for advanced glycation end products in patients with primary gouty arthritis%高迁移率族蛋白B1及其糖基化终产物受体在原发性痛风性关节炎患者的变化及其临床意义

    Institute of Scientific and Technical Information of China (English)

    潘舒月; 周京国; 青玉凤; 张梦云; 蒲梦君; 谢文光

    2014-01-01

    Objective To investigate the role of high mobility group box 1 protein(HMGB1) and the receptor for advanced glycation end products (RAGE) in the pathogenesis of primary gouty arthritis (GA).Methods Enzyme-linked immunosorbent assay(ELISA) was used to determine the level of plasma HMGB1 in 68 acute gout (AG),48 quiescent gout (QG) and 45 healthy control(HC).Real-time quantitative polymerase chain reaction (RT-qPCR) was employed to measure the expression of HMGB1 and RAGE mRNA in the peripheral blood mononuclear cells (PBMCs) in 68 AG,48 QG and 94 HC.One way ANOVA or Wilcoxon test and Spearman's correlations were used for statistical analysis.Results The level of plasma HMGB1,PBMCs HMGB1 and RAGE mRNA were significantly higher in GA than that in HC [(24±34) ng/ml,0.019±0.029,0.000 5±0.000 3] (P<0.05),while the level of plasma HMGB1 and PBMCs HMGB1 mRNA were significantly higher in AG [(222±178) ng/ml,0.235±0.954,0.001 5±0.003 5] than that in QG [(107±176) ng/ml,0.044±0.117,0.001 3±0.000 9] (P<0.05),and the level of PBMCs RAGE mRNA was higher in AG than that in QG (P>0.05).In the GA patients,the level of plasma HMGB1 was positively correlated with white blood cell count,neutrophile granulocytes count,mononuclear cells and erythrocyte sedimentation rate (r=0.34,0.44,0.39,0.33; P<0.05),while negatively correlated with apolipoprotein A1 (r=-0.28,P<0.05); the level of PBMCs HMGB1 mRNA was positively correlated with RAGE mRNA,white blood cell counts,neutrophil counts,lymphocyte counts,serum total cholesterol level,low density lipoprotein level and apolipoprotein B100 level (r=0.29,0.36,0.26,0.28,0.29; P<0.05),while negatively correlated with high density lipoprotein (r=-0.30,P<0.01); the level of PBMCs RAGE mRNA was positively correlated with lymphocyte counts,total cholesterol and apolipoprotein B100 (r=0.35,0.35,0.44; P<0.05).Conclusion HMGB1 and its signaling pathway may play important role in the pathogenesis of gouty arthritis,which may also

  3. Nasal gouty tophus: Report a rare case presenting as a nasal hump with nasal obstruction

    Directory of Open Access Journals (Sweden)

    John Chung-Han Wu

    2016-08-01

    Full Text Available Dorsal nasal gouty tophus are rare occurrences with limited documentation. Here we report a male patient who has a history of poorly controlled gouty arthritis. He had nasal obstruction with an enlarging mass over his left nasal ridge for the past three years. Image studies revealed a nasal bone defect underneath the nasal lesion. The firm mass was excised and confirmed to be of gouty origin. The nasal bone defect was repaired with a titanium mesh plate to prevent nasal depression. He has fully recovered with no more nasal obstruction or recurrence of nasal tophus. The case report illustrates a common illness, gout, with a rare clinical manifestation leading to a common symptom, nasal obstruction. It demonstrates the importance of a detailed history, a thorough physical examination and most important of all, an extensive differential diagnosis in our clinical practice.

  4. Anakinra for the treatment of acute severe gout in critically ill patients.

    Science.gov (United States)

    Thueringer, Jessica T; Doll, Natalie K; Gertner, Elie

    2015-08-01

    To report on the efficacy and safety of anakinra for treatment of acute gouty arthritis in medically complex, critically ill patients. Retrospective chart review of 13 critically ill hospitalized patients treated with anakinra for 20 episodes of acute gouty arthritis between 2009 and 2014 at a single health plan and institution (HealthPartners Medical Group and Regions Hospital) in Saint Paul, Minnesota. Data was obtained on baseline characteristics, medical comorbidities, reason for hospitalization, prior gout treatment, reason for choosing anakinra over standard therapy, anakinra dosing, response to treatment, and adverse outcomes. A total of 10 patients were in the Intensive Care Unit, 1 was in the Burn Unit for extensive 3rd degree burns, 1 was critically ill with a new diagnosis of hemophagocytic lymphohistiocytosis, and 1 was critically ill in isolation with active disseminated multidrug-resistant tuberculosis. Of these patients, 85% had active infections and 92% had renal insufficiency. All patients had a significant response to anakinra treatment: 50% (10/20 episodes) within 24h, an additional 40% (8/20 episodes) by 48h, and the remaining 10% (2/20 episodes) by 72h. Anakinra was well tolerated with only 1 case of leukopenia and 1 possible infectious complication. Anakinra is a safe and efficacious treatment for acute gouty arthritis in medically complex, critically ill patients when standard treatment modalities cannot be used. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Update on the Management of Pediatric Acute Osteomyelitis and Septic Arthritis

    Directory of Open Access Journals (Sweden)

    Luca Castellazzi

    2016-06-01

    Full Text Available Acute osteomyelitis and septic arthritis are two infections whose frequencies are increasing in pediatric patients. Acute osteomyelitis and septic arthritis need to be carefully assessed, diagnosed, and treated to avoid devastating sequelae. Traditionally, the treatment of acute osteoarticular infection in pediatrics was based on prolonged intravenous anti-infective therapy. However, results from clinical trials have suggested that in uncomplicated cases, a short course of a few days of parenteral antibiotics followed by oral therapy is safe and effective. The aim of this review is to provide clinicians an update on recent controversies and advances regarding the management of acute osteomyelitis and septic arthritis in children. In recent years, the emergence of bacterial species resistant to commonly used antibiotics that are particularly aggressive highlights the necessity for further research to optimize treatment approaches and to develop new molecules able to fight the war against acute osteoarticular infection in pediatric patients.

  6. Update on the Management of Pediatric Acute Osteomyelitis and Septic Arthritis.

    Science.gov (United States)

    Castellazzi, Luca; Mantero, Marco; Esposito, Susanna

    2016-01-01

    Acute osteomyelitis and septic arthritis are two infections whose frequencies are increasing in pediatric patients. Acute osteomyelitis and septic arthritis need to be carefully assessed, diagnosed, and treated to avoid devastating sequelae. Traditionally, the treatment of acute osteoarticular infection in pediatrics was based on prolonged intravenous anti-infective therapy. However, results from clinical trials have suggested that in uncomplicated cases, a short course of a few days of parenteral antibiotics followed by oral therapy is safe and effective. The aim of this review is to provide clinicians an update on recent controversies and advances regarding the management of acute osteomyelitis and septic arthritis in children. In recent years, the emergence of bacterial species resistant to commonly used antibiotics that are particularly aggressive highlights the necessity for further research to optimize treatment approaches and to develop new molecules able to fight the war against acute osteoarticular infection in pediatric patients.

  7. Low-intensity laser therapy efficacy evaluation in FVB mice subjected to acute and chronic arthritis.

    Science.gov (United States)

    Issa, João Paulo Mardegan; Trawitzki, Bianca Ferreira; Ervolino, Edilson; Macedo, Ana Paula; Lilge, Lothar

    2017-08-01

    Rheumatoid arthritis, an autoimmune inflammation, has a high prevalence in the population, and while therapy is available, it required often injection of drugs causing discomfort to patients. This study evaluates the clinical and histological effect of low-intensity laser therapy (LILT) as an alternative treatment, in a murine model of acute and chronic inflammation. FVB mice received either a Zymosan A injection into one knee joint inducing acute inflammation, followed after 15 min or 24 h by LILT or a collagen bovine type II injection emulsified in "Freund's Complete Adjuvant" to induce chronic arthritis, followed at 4 weeks with multiple LILT sessions. LILT mediated by either 660, 808, or 905 nm and tissue response was evaluated based on clinical symptoms and histological analysis of inflammatory infiltrate and damage to the articular surfaces. LILT can be effective in elevating clinical symptoms, so Kruskal-Wallis testing indicated no significant differences between knees affected by acute arthritis and treated once with LILT and an injured knee without treatment (p > 0.05) for 660 and 808 nm with some improvements for the 905-nm LILT. Mice receiving two treatments for acute arthritis showed exacerbation of inflammation and articular resorption following therapy with a 660-nm continuous laser (p  0.05). Among the lasers, the 905 nm tends to show better results for anti-inflammatory effect in acute arthritis, and the 660 nm showed better results in chronic arthritis. In conclusion, LILT wavelength selection depends on the arthritis condition and can demonstrate anti-inflammatory effects for chronic arthritis and reduced resorption area in this murine model.

  8. 慢性痛风性关节炎患者健康相关生命质量及影响因素分析%Health-related quality of life and influencing factors in patients with chronic gouty arthritis

    Institute of Scientific and Technical Information of China (English)

    包可久; 刘颖; 周丽娜; 陈兵

    2016-01-01

    Objective To analyze the health-related quality of life (HRQOL) in patients with chronic gouty arthritis (CGA), and to study the influencing factors of HRQOL. Methods A total of 157 patients with CGA who were treated in Departments of Endocrinology of Southwest Hospital, Third Military Medical University from June 2012 to June 2015 were selected as research subjects. Self-rating Depression Scale (SDS) was used to assess degree of depression in patients with CGA, and 36-Item Short Form Health Survey (SF-36) was applied to assess the HRQOL of these patients. One-way ANOVA and stepwise regression analysis were used to study the influence factors of HRQOL. Results SDS scores showed that there were 82 patients with depressive symptoms (52.3%), including 54 (34.4%) patients of mild depression, 18 patients (11.5%) of moderate depression, 10 patients (6.4%) of severe depres-sion. Stepwise regression analysis showed that SDS score, age, sex, treatment, physical exercise, health insurance, alco-hol consumption, diet control and sleep quality influenced the HRQOL scores of patients, and treatment, diet control, physical exercise, SDS score and age were the main influencing factors, with the unstandardized coefficients of 17.14, 16.33, 15.75,-14.24,-13.96. Conclusion Most of patients with CGA suffer from depressive symptoms, and the HRQOL scores of them is not optimistic. More attention must be paid to the elderly and male patients. Diet control, quit-ting drinking, receiving treatment, psychological treatment, strengthen exercise, improving sleep quality and expanding the scope of medical insurance all can improve patients' quality of life.%目的 调查慢性痛风性关节炎(CGA)患者健康相关生命质量(HRQOL),并探讨其影响因素.方法 选取2012年6月至2015年6月第三军医大学西南医院内分泌科收治的157例CGA患者进行调查,使用抑郁自评量表(SDS)评估CGA患者抑郁状况,使用简明健康调查问卷(SF-36)测量患者的HRQOL

  9. Viscosupplementation of the knee: Three cases of acute Pseudoseptic Arthritis with painful and irritating complications and a literature review

    Science.gov (United States)

    Aydın, Murat; Arıkan, Murat; Toğral, Güray; Varış, Onur; Aydın, Güle

    2017-01-01

    Acute pseudoseptic arthritis is a very rare complication that is associated with intra-articular hyaluronic acid injections, which normally involve minimal risk. The most common adverse events that are caused by hyaluronic acid injections are inflammatory reactions or flares at the injection site. In this study, we described three cases of acute pseudoseptic arthritis that was caused by hyaluronic acid; the symptoms in these cases were reminiscent of acute septic arthritis. Moreover, we performed a literature review on pseudoseptic arthritis following hyaluronic acid injections to determine the manner in which this condition can be described, diagnosed, and treated. PMID:28293455

  10. En-block切除术联合结构性植骨治疗第1跖趾关节痛风性关节炎%Treatment of first metatarsophalangeal joint gouty arthritis by arthrodesis with En-block resection and structural bone graft

    Institute of Scientific and Technical Information of China (English)

    宋国勋; 高鹏; 余伟林; 顾文奇; 施忠民

    2014-01-01

    背景:痛风性关节炎最常累及第1跖趾关节关节,伴有肿痛、畸形及关节僵硬,严重影响患者的生活质量。目的:探讨采用En-block切除术结合结构性植骨关节融合治疗第1跖趾关节痛风性关节炎的手术技术及疗效。方法:2012年6月至2013年6月,我院共收治8例第1跖趾关节痛风性关节炎患者。男7例,女1例,年龄25~68岁,平均47.6岁。所有患者均采用En-block病灶切除结合结构性植骨第1跖趾关节融合术。术后定期复查,摄片明确愈合情况,并采用美国骨科足踝外科协会(AOFAS)前足评分及疼痛直观模拟量表(VAS)评价治疗效果,记录相关并发症。结果:所有患者伤口均一期愈合,未见伤口感染、皮肤坏死等软组织并发症。术后7例患者获得12~24个月随访,平均18个月。影像学检查明确术后平均10周融合端骨性愈合。AOFAS评分从术前平均(44.4±10.5)分提高至术后(80.0±10.8)分,而VAS评分从术前平均(7.0±2.0)分降至术后(1.1±0.9)分,其差异均有统计学意义(P<0.0001)。随访期间未见骨不连、畸形愈合及固定失效等并发症。结论:En-block切除结合结构性植骨融合治疗第1跖趾关节痛风性关节炎具有症状缓解明显、融合率高、并发症少等优势,可有效改善患者生活质量,是一种安全有效的治疗方式。%Background:Gouty arthritis most commonly involves the first metatarsophalangeal joint (MTPJ), causing pain, deformity and anchylosis and reducing patients' quality of life. Objective:To investigate the technique and clinical outcome of arthrodesis with En-block resection and structural bone graft to treat the 1st MTPJ gouty arthritis. Methods: From June 2012 to June 2013, 8 patients suffering from 1st MTPJ gouty arthritis were treated in our hospital. There were 7 men and 1 woman with an average age of 47.6 years (range 25-68 years). The first MTPJ

  11. Hypouricemic and arthritis relapse-reducing effects of compound tufuling oral-liquid in intercritical and chronic gout

    Science.gov (United States)

    Xie, Zhijun; Wu, Huaxiang; Jing, Xiaoqing; Li, Xiuyang; Li, Yasong; Han, Yongmei; Gao, Xiangfu; Tang, Xiaopo; Sun, Jing; Fan, Yongshen; Wen, Chengping

    2017-01-01

    Abstract Trial Design: In the double-blind, randomized, controlled trial, we aimed to evaluate the effects of compound tufuling oral liquid (CoTOL) on serum uric acid (sUA) levels and recurrence of acute gouty arthritis in intercritical and chronic gout treatment. Methods: A total of 210 patients with gout were screened from 8 hospitals to observe the sUA and acute gouty arthritis recurrence rate-reducing effects of CoTOL in intercritical and chronic gout during a 12-week treatment. We treated 139 and 71 patients with CoTOL and the placebo, respectively, and evaluated their sUA levels, acute gouty arthritis recurrence rate, and adverse events at week 0, 6, and 12. Results: Twenty-five and 12 patients in the treatment and control groups, respectively, had interrupted treatments, whereas 114 and 59 cases, respectively, completed their treatments. At the end of the 12-week treatment, the average decrease in sUA was 74.26 (95% confidence interval [CI]: 56.74–91.77 μmol/L) and 28.81 μmol/L (95% CI: 4.91–52.71 μmol/L) in the treatment and control groups, respectively (P = 0.004). The average decrease rate of sUA was 12.76% (95% CI: 9.82%–15.70%) and 4.57% (95% CI: 0.42%–8.71%) in the treatment and control groups, respectively (P = 0.004), and the gouty arthritis recurrence rate of the treatment group was lower than that of the control group (from week 6 to 12, 21.93% and 50.88% in the treatment and control group, respectively, P leucopenia incidences were observed in the treatment group than those in the control group (3/139 vs. 7/71, respectively, P = 0.033). Conclusion: CoTOL reduced sUA levels and effectively prevented acute arthritis recurrence in intercritical and chronic gout without serious adverse events. PMID:28296744

  12. Septic arthritis as the first sign of Candida tropicalis fungaemia in an acute lymphoid leukemia patient

    Directory of Open Access Journals (Sweden)

    Vicari Perla

    2003-01-01

    Full Text Available Fungal infections caused by Candida species have increased in incidence during the past two decades in England, North America and Europe. Candidal arthritis is rare in patients who are not intravenous drug users or are who not using a prostheses. We report the case of a 24-year-old man with acute lymphoid leukemia, who developed Candida tropicalis arthritis during an aplastic period after chemotherapy. This is the eighth case described in the literature of C. tropicalis causing arthritis without intra-articular inoculation. We call attention to an unusual first sign of fungal infection: septic arthritis without intra-articular inoculation. However, this case differs from the other seven, since despite therapy a fast and lethal evolution was observed. We reviewed reported cases, incidence, risk factors, mortality and treatment of neutropenic patients with fungal infections.

  13. Discrimination of acute lymphoblastic leukemia from systemic-onset juvenile idiopathic arthritis at disease onset

    Directory of Open Access Journals (Sweden)

    Mirian S. Tamashiro

    2011-01-01

    Full Text Available OBJECTIVE: To assess clinical and laboratory features that differentiate acute lymphoblastic leukemia from systemic juvenile idiopathic arthritis at disease onset. METHODS: Fifty-seven leukemia patients with musculoskeletal involvement, without blasts on peripheral blood and without glucocorticoid therapy at disease onset and 102 systemic juvenile idiopathic arthritis patients (International League of Associations for Rheumatology criteria were retrospectively evaluated. The following features were examined: fever, rheumatoid rash, arthritis, limb pain, hepatomegaly, splenomegaly, pericarditis, myocarditis, pleuritis, weight loss, bleeding, anemia, leukopenia, neutropenia, thrombocytopenia, erythrocyte sedimentation rate, and lactic dehydrogenase levels. RESULTS: The median age at disease onset was significantly higher in leukemia patients than in those with systemic-onset juvenile idiopathic arthritis (5.8 vs. 3.8 years. In addition, the frequencies of limb pain, hepatomegaly, weight loss and hemorrhagic manifestations were significantly higher in leukemia patients than in systemic-onset juvenile idiopathic arthritis patients (70% vs. 1%, 54% vs. 32%, 30% vs. 8%, and 9% vs. 0%, respectively. Likewise, the frequencies of anemia, leukopenia, neutropenia, thrombocytopenia and high lactic dehydrogenase levels were statistically higher in leukemia patients than in patients with systemic-onset juvenile idiopathic arthritis (88% vs. 57%, 39% vs. 1%, 60% vs. 1%, 77% vs. 1%, and 56% vs. 14%, respectively. Remarkably, multivariate analysis revealed that limb pain (OR = 553; 95% CI =46.48-6580.42 and thrombocytopenia (OR = 754.13; 95% CI =64.57-8806.72 were significant independent variables that differentiated leukemia from systemic-onset juvenile idiopathic arthritis. The R2 of the Nagelkerke test was 0.91, and the Kaplan-Meier survival curves were similar for acute lymphoblastic leukemia patients with and without limb pain. CONCLUSION: Our study

  14. Hypouricemic and arthritis relapse-reducing effects of compound tufuling oral-liquid in intercritical and chronic gout: A double-blind, placebo-controlled, multicenter randomized trial.

    Science.gov (United States)

    Xie, Zhijun; Wu, Huaxiang; Jing, Xiaoqing; Li, Xiuyang; Li, Yasong; Han, Yongmei; Gao, Xiangfu; Tang, Xiaopo; Sun, Jing; Fan, Yongshen; Wen, Chengping

    2017-03-01

    In the double-blind, randomized, controlled trial, we aimed to evaluate the effects of compound tufuling oral liquid (CoTOL) on serum uric acid (sUA) levels and recurrence of acute gouty arthritis in intercritical and chronic gout treatment. A total of 210 patients with gout were screened from 8 hospitals to observe the sUA and acute gouty arthritis recurrence rate-reducing effects of CoTOL in intercritical and chronic gout during a 12-week treatment. We treated 139 and 71 patients with CoTOL and the placebo, respectively, and evaluated their sUA levels, acute gouty arthritis recurrence rate, and adverse events at week 0, 6, and 12. Twenty-five and 12 patients in the treatment and control groups, respectively, had interrupted treatments, whereas 114 and 59 cases, respectively, completed their treatments. At the end of the 12-week treatment, the average decrease in sUA was 74.26 (95% confidence interval [CI]: 56.74-91.77 μmol/L) and 28.81 μmol/L (95% CI: 4.91-52.71 μmol/L) in the treatment and control groups, respectively (P = 0.004). The average decrease rate of sUA was 12.76% (95% CI: 9.82%-15.70%) and 4.57% (95% CI: 0.42%-8.71%) in the treatment and control groups, respectively (P = 0.004), and the gouty arthritis recurrence rate of the treatment group was lower than that of the control group (from week 6 to 12, 21.93% and 50.88% in the treatment and control group, respectively, P treatment group than those in the control group (3/139 vs. 7/71, respectively, P = 0.033). CoTOL reduced sUA levels and effectively prevented acute arthritis recurrence in intercritical and chronic gout without serious adverse events.

  15. [Acute osteomyelitis and septic arthritis in children: one year experience].

    Science.gov (United States)

    Timsit, S; Pannier, S; Glorion, C; Chéron, G

    2005-01-01

    To describe bacteriologic epidemiology of bone and joint infections, a total of 52 osteomyelitis, 52 arthritis and 20 osteoarthritis of children aged one month to 15 years during a one-year period (2001) were included in a retrospective unicentric review. The mean age was 3,9 +/-3,6 years. Fever and pain were the most common clinical symptoms. The site of infection was single in 95%, involving lower extremities in 80%. Bone scintigraphy was abnormal in 71% of osteomyelitis. Positive cultures was obtained in 29% of all cases (blood cultures: 20%, aspiration cultures: 29%), but in 42% of cases which have both blood and aspiration cultures. Thirty-six bacteria were identified: 19 Staphylococcus (14 aureus), ten Streptococcus (four pneumoniae), three Salmonella, three Kingella kingae, one Moraxella. All the isolates were susceptible to the empiric antibiotic therapy. Outcome was good in 100% of osteomyelitis and in 96% of arthritis.

  16. 高尿酸血症及痛风性关节炎动物模型及其中药复方治疗概况%Overview of the animal model of hyperuricemia and gouty arthritis and treatment of tradition Chinese medicine compound

    Institute of Scientific and Technical Information of China (English)

    何泳龙; 青玉凤; 周京国

    2015-01-01

    痛风是嘌呤代谢紊乱和/或尿酸排泄减少而致血尿酸水平升高,尿酸盐( monosodium urate,MSU)晶体沉积于组织或器官并引起组织损伤的一组临床综合征,主要表现为反复发作性关节红、肿、热、痛与功能障碍,甚至关节畸形、肾石病及尿酸性肾病。高尿酸血症是痛风发生的生化基础。流行病学显示痛风的发病率在世界范围内呈逐年上升趋势。高尿酸血症/痛风严重危害人类健康,对于其发生发展机制的研究以及相关药物治疗的研究越来越受到科研工作者的重视。因此,对于高尿酸血症、痛风性关节炎动物模型的研究以及中药复方制剂在高尿酸血症/痛风中疗效的研究正如雨后春笋般如火如荼,它将从高尿酸血症、痛风性关节炎动物模型的研究及中药复方制剂在高尿酸血症/痛风中疗效的研究现状及概况做一综述。%Gout is a group of clinical syndrome caused by tissues damage,resulting from purine metabolic disorder and/or de-creasing uric acid excretion that cause blood uric acid levels to increase,and ( monosodium urate ( MSU) crystal to deposit in tissues or organs. The main symptoms of gout mainly include recurrent joint redness,swelling,heat,pain and dysfunction,even joint deformities, nephrolithiasis,and hyperuricaemia. Hyperuricaemia is a risk factor for gout. Epidemiological data show that the incidence of gout is in-creasing in the world. Since hyperuricemia/gout has been threatening people’s health,more attention of the researchers has been focus on the study of its development mechanism and the experiments of drugs. Therefore,the experiments of animal models and treatments and the studies of traditional Chinese compound medicine used to treat hyperuricemia and gouty arthritis have been developing like the bamboo shoots after the rain. The article will summarize the studies of the animal model and treatment and the curative effects of tradi

  17. Effect of self-made Chubi decoction combined with dietotherapy on joint pain and swelling in the patients with gouty arthritis%自拟除痹汤内服联合饮食疗法对痛风性关节炎患者关节疼痛、肿胀的影响

    Institute of Scientific and Technical Information of China (English)

    朱亚芹

    2015-01-01

    目的:探讨除痹汤内服联合饮食疗法辨治痛风性关节炎的临床效果及对患者关节疼痛、肿胀的影响。方法将92例痛风性关节炎患者随机分为对照组和治疗组各46例。2组均给予多喝水、以低嘌呤饮食为主,多食用蔬菜水果等基础饮食干预。对照组在此基础上给予双氯芬酸钠缓释片口服治疗;治疗组在对照组的基础上给予除痹汤口服治疗,1剂/d,7 d为1个疗程,治疗2个疗程。观察治疗前后2组患者关节疼痛、肿胀、活动受限等主要症状的改善情况及治疗前后血尿酸( UA)、血沉( ESR)、C反应蛋白( CRP)的变化情况,统计治疗效果。结果对照组有效率为72%,治疗组有效率为91%,治疗组的有效率明显高于对照组(P<0.05);治疗后2组关节疼痛、肿胀、活动受限等主要症状均有所改善,关节疼痛VAS评分、肿胀、活动受限证候评分均较治疗前下降(P均<0.05),且治疗组改善程度明显优于对照组(P均<0.05);2组治疗后UA、ESR、CRP均较治疗前明显下降(P均<0.05),且治疗组下降幅度更为明显(P均<0.05)。结论除痹汤内服联合饮食疗法能明显改善患者的临床症状,缓解患者的痛感,提高关节运动能力,降低患者UA、ESR、CRP水平,凸显出中医论治的优势与特色,值得临床深入研究。%Objective It is to investigate the clinical efficacy of self-made Chubi decoction combined with dietotherapy on gouty arthritis, and to explore the effect on joint pain and swelling in the patients.Methods 92 gouty arthritis patients were randomly divided into a control group of 46 cases and a treatment group of 46 cases.All the patients in the two groups were given dietotherapy, such as drinking more water, mainly giving low purine diet, and eating more fruits and vegetables; The control group were treated with diclofanac sodium sustained release

  18. Success rates of first-line antibiotics for culture-negative sub-acute and chronic septic arthritis.

    Science.gov (United States)

    Chuckpaiwong, Bavornrit; Phoompoung, Saravut

    2014-09-01

    A combination of surgical and medical treatment is normally required for patients with septic arthritis. Antibiotics selected for use on these patients are normally based on tissue culture results. However, in sub-acute and chronic septic arthritis cases, the results of the culture are usually negative as a result of prior treatment. The present study will investigate the incidence of culture-negative septic arthritis and the outcomes based on the use of first-line drug antibiotics for the treatment of sub-acute and chronic septic arthritis. For the present study, the authors retrospectively reviewed medical records of surgically treated septic arthritis cases over the past 10 years at Siriraj Hospital. The patient culture results, the antibiotics used, and the results of treatment were all recorded and analyzed. One hundredfifty-three septic arthritis patients were reviewed. Sixty-two patients were classified as having been diagnosed with either sub-acute or chronic septic arthritis. Thirty-six of 62 patients (58.1%) had a negative culture result. In the culture-positive patients, 42.3% had Streptococcus, 26.9% had Staphylococcus aureus, 11.5% had other gram positive bacteria, 15.4% had gram-negative bacteria, and 3.8% had tuberculus infection. In the culture-negative sub-acute and chronic group (36 of 62), 23 patients received Cefazolin, nine patients received Cloxacillin, and four patients received Clindamycin. Successful results were 69.9%, 66.7% and 75%, respectively. The present study reflects that the incidence ofculture-negative, sub-acute and chronic septic arthritis is approximately 58.1%. The first-line class of antibiotics remains the appropriate antibiotic choice for these patients because they are still effective for treatment of septic arthritis in up to 70% of all cases.

  19. Tumor Necrosis Factor, but Not Neutrophils, Alters the Metabolic Profile in Acute Experimental Arthritis.

    Directory of Open Access Journals (Sweden)

    Marina C Oliveira

    Full Text Available Metabolic alterations are associated with arthritis apart from obesity. However, it is still unclear which is the underlying process behind these metabolic changes. Here, we investigate the role of tumor necrosis factor (TNF in this process in an acute model of antigen-induced arthritis (AIA. Immunized male BALB/c mice received an intra-articular injection of PBS (control or methylated bovine serum albumin (mBSA into their knees, and were also pre-treated with different drugs: Etanercept, an anti-TNF drug, DF2156A, a CXCR1/2 receptor antagonist, or a monoclonal antibody RB6-8C5 to deplete neutrophils. Local challenge with mBSA evoked an acute neutrophil influx into the knee joint, and enhanced the joint nociception, along with a transient systemic metabolic alteration (higher levels of glucose and lipids, and altered adipocytokines. Pre-treatment with the conventional biological Etanercept, an inhibitor of TNF action, ameliorated the nociception and the acute joint inflammation dominated by neutrophils, and markedly improved many of the altered systemic metabolites (glucose and lipids, adipocytokines and PTX3. However, the lessening of metabolic changes was not due to diminished accumulation of neutrophils in the joint by Etanercept. Reduction of neutrophil recruitment by pre-treating AIA mice with DF2156A, or even the depletion of these cells by using RB6-8C5 reduced all of the inflammatory parameters and hypernociception developed after AIA challenge, but could not prevent the metabolic changes. Therefore, the induction of joint inflammation provoked acute metabolic alterations which were involved with TNF. We suggest that the role of TNF in arthritis-associated metabolic changes is not due to local neutrophils, which are the major cells present in this model, but rather due to cytokines.

  20. Adalimumab-induced acute interstitial lung disease in a patient with rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Olivia Meira Dias

    2014-01-01

    Full Text Available The use of immunobiological agents for the treatment of autoimmune diseases is increasing in medical practice. Anti-TNF therapies have been increasingly used in refractory autoimmune diseases, especially rheumatoid arthritis, with promising results. However, the use of such therapies has been associated with an increased risk of developing other autoimmune diseases. In addition, the use of anti-TNF agents can cause pulmonary complications, such as reactivation of mycobacterial and fungal infections, as well as sarcoidosis and other interstitial lung diseases (ILDs. There is evidence of an association between ILD and the use of anti-TNF agents, etanercept and infliximab in particular. Adalimumab is the newest drug in this class, and some authors have suggested that its use might induce or exacerbate preexisting ILDs. In this study, we report the first case of acute ILD secondary to the use of adalimumab in Brazil, in a patient with rheumatoid arthritis and without a history of ILD.

  1. Acute kidney injury, hyperbilirubinemia, and ischemic skin necrosis due to massive sulindac overdose.

    Science.gov (United States)

    Vaughn, John L; Shah, Kejal V; Ghossein, Maroun M; Meyer, William L; Kirkpatrick, Robert B

    2015-01-01

    Sulindac is a long-acting nonsteroidal anti-inflammatory drug (NSAID) widely used for the management of osteoarthritis, rheumatoid arthritis, ankylosing sponydlitis, and acute gouty arthritis. Reports of sulindac toxicity in the literature are rare. We report the case of a 22-year old male with a history of bipolar disorder who was brought to the emergency department after ingesting approximately 15 g of sulindac in a suicide attempt. He was found to have acute kidney injury and hyperbilirubinemia. Despite aggressive fluid resuscitation, his renal function progressively worsened requiring the initiation of hemodialysis. Ten days following ingestion of sulindac, he began to develop ischemic skin changes with a gangrenous appearance in his hands and feet. He continued to receive supportive treatment, and his acute kidney injury, hyperbillirubinemia, and ischemic skin necrosis eventually resolved. Clinicians should be aware of this long-acting NSAID and its ability to cause prolonged multisystem organ dysfunction.

  2. Gouty Arthropathy of the Cervical Spine in a Young Adult

    Directory of Open Access Journals (Sweden)

    Yi-Jie Kuo

    2007-04-01

    Full Text Available We report a young man with gouty discitis of the cervical spine. To our knowledge, our patient is the youngest patient with cervical gouty discitis reported in the literature. The clinical manifestation was similar to that of cervical spondylosis with radiculopathy. Gouty discitis was diagnosed only when tophi in the disc were found during surgery and proved by pathologic study. Surgical decompression followed by optimization of pharmacologic treatment enabled good recovery from neurologic complications.

  3. Effects of TGFbeta1 and extracts from Cervus korean TEMMINCK var. mantchuricus Swinhoe on acute and chronic arthritis in rats.

    Science.gov (United States)

    Kim, Kyung-Woon; Song, Kwon-Ho; Lee, Ji-Min; Kim, Kap-Sung; Kim, Sung-Il; Moon, Sung-Kwon; Kang, Bong-Seok; Kim, Dong-Soo; Chung, Kang-Hyun; Chang, Young-Chae; Kim, Cheorl-Ho

    2008-07-23

    To elucidate the pharmacological activities of deer antler acupuncture and TGF61538;1 on the acute and chronic phases of rheumatoid arthritis diseases. Polyarthritis rats were administered with TGF61538;1 and water extract of deer antler acupunture (DAA), prepared from the pilose antler of Cervus korean TEMMINCK var. mantchuricus Swinhoe. TGF61538; (0.1 to 2 61549;g/animal) and DAA (5-100 61549;g/kg animal) were initiated 1 day before an arthritogenic dose of streptococcal cell wall fragments to see the effects on the joint swelling and distortion during the acute phase and the chronic phase of the disease. Arthritic index suppression of rat arthritis model was examined by TGF61538; and DAA administrations. TGF61538;1 and DAA diminished the polyarthritis development in rats. TGF61538; and DAA eliminated the joint swelling and distortion observed during the acute phase and the chronic phase of the disease. The TGF61538; and DAA suppressed the arthritis progress when administration was begun after acute phase of arthritis. Consistent with the inhibition of inflammatory cell recruitment into the synovium, TGF61538;1 and DAA reversed the leukocytosis associated with the chronic phase of the arthritis, respectively.

  4. Post-streptococcal reactive arthritis in children: a distinct entity from acute rheumatic fever

    Directory of Open Access Journals (Sweden)

    Barash Judith

    2011-10-01

    Full Text Available Abstract There is a debate whether post-streptococcal reactive arthritis (PSRA is a separate entity or a condition on the spectrum of acute rheumatic fever (ARF. We believe that PSRA is a distinct entity and in this paper we review the substantial differences between PSRA and ARF. We show how the demographic, clinical, genetic and treatment characteristics of PSRA differ from ARF. We review diagnostic criteria and regression formulas that attempt to classify patients with PSRA as opposed to ARF. The important implication of these findings may relate to the issue of prophylactic antibiotics after PSRA. However, future trials will be necessary to conclusively answer that question.

  5. Changes of Platelet Indices in Juvenile Idiopathic Arthritis in Acute Phase and After Two Months Treatment

    Directory of Open Access Journals (Sweden)

    Marjan Vakili

    2016-05-01

    Full Text Available Background Various indices have been raised as predictors of activity and severity of juvenile idiopathic arthritis. Objectives This study was conducted to investigate the changes of platelet indices in acute phase and two months after treatment in these patients. Patients and Methods In a cohort study, platelet count, mean platelet volume (MPV, platelet distribution width (PDW, plateletcrit (PCT were evaluated in children referred to children’s medical center, Tehran due to juvenile idiopathic arthritis from March 2013 to March 2014 during the acute phase and two months after standard treatment. The statistical data were analyzed by SPSS 19 software, and the significance level was set as P < 0.05. Results In this study, 55 children (24 boys and 31 girls with mean ± SD age of 7.50 ± 3.35 years were studied. The mean ± SD value of platelet count was 441872.7 ± 151836.9 in the acute phase and reached 395418.2 ± 119601.6 two months after treatment (P = 0.01. The mean ± SD PCT in the acute phase of various subtypes of the disease was 0.32 ± 0.11, which reached 0.29 ± 0.10 after treatment (P = 0.09. However, the PDW range in different subtypes of the disease reached 13.4 ± 8.0 from 13.9 ± 2.9 and MPV reached 8.7 ± 0.9 from 8.8 ± 1.1 after treatment, but they were not significantly different from the results in the acute phase (P = 0.5. Conclusions Platelet count is one of the most remarkable indices in JIA. Evaluation of PCT can also help determine the severity of the inflammatory process in the follow-up and treatment process.

  6. Monoarticular Arthritis.

    Science.gov (United States)

    Singh, Namrata; Vogelgesang, Scott A

    2017-05-01

    Monoarticular arthritis is inflammation characterized by joint pain, swelling, and sometimes periarticular erythema. Although chronic causes are seen, the onset is often acute. An infected joint can quickly lead to permanent damage, making it a medical emergency. However, acute gout presenting as monoarticular arthritis is often so uncomfortable it requires urgent attention. Monoarticular crystalline arthritis is common and a septic joint is a medical emergency so it is no surprise that these diagnoses come to mind with complaint of inflammation in 1 joint. However, there are many causes of monoarticular arthritis that clinicians must consider. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Evaluation of the therapeutic effect of hydroxyapatite particles labeled with Ho sub 1 sub 6 sub 6 in rats with acute and chronic arthritis

    CERN Document Server

    Mendoza-Lopez, P

    2002-01-01

    with significantly statistical values (p<=0,01). This therapeutic effect was evident too when evaluating the measure of the articular perimeter in acute and chronic arthritis groups through the time with significantly statistical values (p<=0,01). In conclusion the hydroxyapatite particles labeled with Holmium-166 are biologically stable in vivo and have a therapeutic effect in the treatment of acute and chronic arthritis in rats. The therapeutic effect of an intraarticular injection of hydroxyapatite particles labeled with Holmium-166 ( Ho sub 1 sub 6 sub 6 HA) was evaluated. For this evaluation 72 antigen-induced arthritis rats; the arthritis was induced by an intraarticular injection of a suspension of ovoalbumin and Freund's adjuvant complete. The 72 rats were divided in three groups: control group, acute arthritis group and chronic arthritis group. The evaluation of the therapeutic effect was achieved by the measuring of the perimeter of the arthritic knee joint in different days after the intraart...

  8. [SEIP-SERPE-SEOP Consensus document on the treatment of uncomplicated acute osteomyelitis and septic arthritis].

    Science.gov (United States)

    Saavedra-Lozano, J; Calvo, C; Huguet Carol, R; Rodrigo, C; Núñez, E; Obando, I; Rojo, P; Merino, R; Pérez, C; Downey, F J; Colino, E; García, J J; Cilleruelo, M J; Torner, F; García, L

    2015-04-01

    This is a Consensus Document of the Spanish Society of Paediatric Infectious Diseases (Sociedad Española de Infectología Pediatrica), Spanish Society of Paediatric Rheumatology (Sociedad Española de Reumatología Pediátrica) and the Spanish Society of Paediatric Orthopaedics (Sociedad Española de Ortopedia Pediátrica), on the treatment of uncomplicated acute osteomyelitis and septic arthritis. A review is presented on the medical and surgical treatment of acute osteoarticular infection, defined as a process with less than 14 days of symptomatology, uncomplicated and community-acquired. The different possible options are evaluated based on the best available scientific knowledge, and a number of evidence-based recommendations for clinical practice are provided. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

  9. Acute lymphoblastic leukemia masquerading as juvenile rheumatoid arthritis: diagnostic pitfall and association with survival.

    Science.gov (United States)

    Marwaha, Ram Kumar; Kulkarni, Ketan Prasad; Bansal, Deepak; Trehan, Amita

    2010-03-01

    Acute lymphoblastic leukemia (ALL) often presents with osteoarthritic manifestations which may lead to misdiagnosis with juvenile rheumatoid arthritis (JRA). This study was designed to identify ALL patients with initial diagnosis of JRA, compare their clinicolaboratory characteristics and outcome with other ALL patients treated at our center. Case records of 762 patients with ALL were analyzed. Information regarding the clinical-demographic profile, therapy and outcome were recorded. Of the children, 49 (6.4%) had initial presentation mimicking JRA. Asymmetric oligoarthritis was the most common pattern of joint involvement. Majority presented with fever, pallor, arthritis, night pain, and bone pain. None of the routine prognostic factors including age, gender, lymphadenopathy, hepatosplenomegaly, total leukocytes count (TLC), and platelet count were significantly associated with relapse/death. The mean symptom-presentation interval (SPI), hemoglobin was significantly higher whilst the TLC was significantly lower in these patients compared to other ALL patients. The 5 year overall-survival was better than other patients with ALL (p = 0.06, by logrank test). Significantly longer SPI in these patients underscores the need for prompt and early investigations to rule out ALL in patients of JRA with atypical features and pointers of ALL. Children with ALL-mimicking JRA may belong to a subgroup of ALL with a better prognosis.

  10. Acute osteomyelitis and septic arthritis of the shoulder in premature neonates: Report of two cases

    Directory of Open Access Journals (Sweden)

    Matić Aleksandra

    2012-01-01

    Full Text Available Acute hematogenous osteomyelitis and septic arthritis are pyogenic infections of bone and joint, respectively. At the youngest age, they usually occur at the same time - hence the common name ”osteoarthritis”. When it comes to neonates, osteoarthritis is an infrequent finding, but it can give a permanent disability and can be even fatal unless early recognized and adequately and promptly treated. An early diagnosis is rather challenging because the signs and symptoms of this disease are subtle and/or nonspecific. The therapy involves a combination of intravenous antimicrobial therapy in high doses and of sufficient duration, with a mandatory decompression of affected joint by needle aspiration or artrhrotomy. The aim of this paper is to present two premature newborns with rare localization of osteoarthritis - the humerus and shoulder joint, as well as to point to the modern diagnostic and therapeutic approach to this disease.

  11. Protective effects of hydroxytyrosol-supplemented refined olive oil in animal models of acute inflammation and rheumatoid arthritis.

    Science.gov (United States)

    Silva, S; Sepodes, B; Rocha, J; Direito, R; Fernandes, A; Brites, D; Freitas, M; Fernandes, E; Bronze, M R; Figueira, M E

    2015-04-01

    Virgin olive oil is the primary source of fat in the Mediterranean diet, and its beneficial health effects have been related with oleic acid and phenolic compounds content. Hydroxytyrosol, a typical virgin olive oil phenolic compound, has beneficial antioxidant and anti-inflammatory properties as previously reported. The aim of this study was to evaluate the effect of hydroxytyrosol-supplemented refined olive oil at 0.5 and 5 mg/kg in a rodent model of rheumatoid arthritis. Rheumatoid arthritis was induced by intradermic administration, in male Wistar rats, of Freund's adjuvant with collagen type II on days 1 and 21. Hydroxytyrosol-supplemented refined olive oils were administrated by gavage from day 23 until day 35. The treatment at 5-mg/kg dose significantly decreased paw edema (Polive oil with hydroxytyrosol may be advantageous in rheumatoid arthritis with significant impact not only on chronic inflammation but also on acute inflammatory processes.

  12. Reactive Arthritis

    Directory of Open Access Journals (Sweden)

    Eren Erken

    2013-06-01

    Full Text Available Reactive arthritis is an acute, sterile, non-suppurative and inflammatory arthropaty which has occured as a result of an infectious processes, mostly after gastrointestinal and genitourinary tract infections. Reiter syndrome is a frequent type of reactive arthritis. Both reactive arthritis and Reiter syndrome belong to the group of seronegative spondyloarthropathies, associated with HLA-B27 positivity and characterized by ongoing inflammation after an infectious episode. The classical triad of Reiter syndrome is defined as arthritis, conjuctivitis and urethritis and is seen only in one third of patients with Reiter syndrome. Recently, seronegative asymmetric arthritis and typical extraarticular involvement are thought to be adequate for the diagnosis. However, there is no established criteria for the diagnosis of reactive arthritis and the number of randomized and controlled studies about the therapy is not enough. [Archives Medical Review Journal 2013; 22(3.000: 283-299

  13. 99m-Tc HMDP bone scintigraphic findings of gouty arthropathy of both hands. Extending soft tissue uptake adjacent to the joints

    Energy Technology Data Exchange (ETDEWEB)

    Shih, Wei-Jen; Domstad, P.A.; Purcell, M.; DeLand, F.H.

    The /sup 99m/Tc hydroxy methylene diphosphonate scintigraphic findings of both hands are correlated to the radiographic findings in a patient with a 30-year history of gouty arthropathy. Scintigraphic differentiation of the type of arthritis on the basis of uptake pattern is difficult. However, the findings of rheumatoid arthritis are confined to the joints and usually the involvement is symmetrical. With gout there is a tendency toward asymmetrical, bilateral, multifocal joint involvement with areas of intense abnormal uptake; because of the associated soft tissue swelling, the intense uptake usually extends beyond the involved joints.

  14. Acute anterior uveitis after discontinuation of tocilizumab in a patient with rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Sato T

    2014-01-01

    Full Text Available Tomohito Sato,1 Shinya Minakuchi,1 Manabu Mochizuki,2 Masaru Takeuchi11Department of Ophthalmology, National Defense Medical College, Saitama, Japan; 2Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, JapanBackground: Tocilizumab is a humanized monoclonal anti-interleukin-6 (IL-6 receptor antibody and has been approved in Japan for the treatment of Castleman's disease, rheumatoid arthritis (RA, and systemic juvenile idiopathic arthritis. Conjunctivitis and dry eye are known ocular adverse effects, but uveitis has not been reported.Case report: A 72-year-old woman had undergone bilateral cataract surgery without complications. Six months after the surgery, she was diagnosed with RA and treated with tocilizumab infusion every 4 weeks. However, severe malaise and dizziness occurred after the third tocilizumab infusion, and the treatment was suspended. Since the symptoms associated with RA had resolved, she was followed without any medication thereafter. At 5 weeks after the third tocilizumab infusion, she developed severe anterior inflammation with hypopyon in her left eye, and her visual acuity dropped to less than 2/200. Considering her age and history of cataract surgery, endophthalmitis was suspected and a vitrectomy was performed, but no pathogens were detected from the intraocular fluid samples collected during surgery. The ocular inflammation was gradually resolved with systemic antibiotics and corticosteroids. However, severe anterior uveitis recurred in the same eye during the tapering of the systemic corticosteroids, when the aqueous humor IL-6 level was 46,100 pg/mL. The recurrent ocular inflammation was resolved with increased doses of topical and systemic corticosteroids, and the patient has since remained relapse-free. No symptom of inflammation was observed in the right eye during the follow-up period.Conclusion: This case indicates a possibility that acute

  15. Acute Disseminated Melioidosis Presenting with Septic Arthritis and Diffuse Pulmonary Consolidation in an Otherwise Healthy Adult: A Case Report

    OpenAIRE

    Hai Sherng Lee; Abdul Azeez Ahamed Riyaaz; Seng Hong Yeoh

    2015-01-01

    Background: Melioidosis is an infectious disease caused by Burkholderia pseudomallei. It is most prevalent in South-East Asia, northern Australia, and the Indian subcontinent. Septic arthritis is a rare manifestation of melioidosis. Melioidosis is usually found in patients with diabetes, heavy alcohol use, or chronic lung disease. Results: We report a case of melioidosis in an otherwise healthy 44-year-old male, who presented with acute painful left knee swelling, high-grade fever associa...

  16. First experience with single-source dual-energy computed tomography in six patients with acute arthralgia: a feasibility experiment using joint aspiration as a reference

    Energy Technology Data Exchange (ETDEWEB)

    Diekhoff, Torsten; Kiefer, Tobias; Hamm, Bernd; Hermann, Kay-Geert A. [Charite - Universitaetsmedizin Berlin Campus Mitte, Humboldt-Universitaet zu Berlin, Freie Universitaet Berlin, Department of Radiology, Berlin (Germany); Ziegeler, Katharina; Feist, Eugen [Charite - Universitaetsmedizin Berlin Campus Mitte, Humboldt-Universitaet zu Berlin, Freie Universitaet Berlin, Department of Rheumatology and Clinical Immunology, Berlin (Germany); Mews, Juergen [Toshiba Medical Systems Europe, BV, Zoetermeer (Netherlands)

    2015-11-15

    Dual-energy computed tomography (DECT) is an emerging imaging technique for examining patients with suspected gout. Single-source dual-energy CT (S-DECT) is a new way of obtaining DECT information on conventional CT scanners rather than using special dual-source CT systems. We tested the feasibility of S-DECT (320-row CT; Aquilion ONE, Toshiba Medical Systems, Otawara, Japan) in 6 patients (5 men, 1 woman; mean age 61.3, range 48 to 69 years) with acute arthralgia and suspected gout, and compared the S-DECT findings with the results of joint aspiration. Three patients had a diagnosis of gouty arthritis with negatively birefringent crystals in synovial fluid, in addition to gouty tophi in S-DECT. Three patients had no detectable crystals by polarization microscopy and no tophi on DECT. Their final diagnoses were rheumatoid arthritis, activated osteoarthritis, and septic arthritis in one case each. This initial experience suggests that S-DECT might be a valuable alternative to dual-source CT. Hence, more patients may benefit from its additional diagnostic abilities in the future. (orig.)

  17. THE PREVALENCE AND CLINICAL FEATURES OF GOUT AND CALCIUM PYROPHOSPHATE DEPOSITION DISEASE IN PATIENTS WITH ACUTE ARTHRITIS

    Directory of Open Access Journals (Sweden)

    M. S. Eliseev

    2015-01-01

    Full Text Available Objective: to study the rate of gout and calcium pyrophosphate deposition disease (CPDD and to provide their clinical characteristics in patients with acute arthritis.Subjects and methods. The investigation enrolled 150 patients (97 men and 53 women with acute mono- or oligoarthritis of no more than 2 weeks’ duration who had visited the Outpatient Department of V.A. Nasonova Research Institute of Rheumatology. Their mean age was 60.2±12.0 years (range, 28–76 years. All the patients underwent inflamed joint puncture and synovial fluid (SF crystal identification by polarized microscopy using an Olympus CX31-P compensator.The diagnosis of CPDD was established in compliance with the criteria elaborated by D. McCarty. Gout was diagnosed only when sodium monourate (SMU crystals were found in SF.Results and discussion. The investigation revealed gout in 51 (34% patients, CPDD in 45 (30%, coincidence of gout and CPDD in 15 (14%, and 39 (26% patients had other diseases: 15 (10% – osteoarthritis, 6 (4% – rheumatoid arthritis, 5 (3% – septic arthritis, 5 (3% – psoriatic arthritis, 2 (1% – ankylosing spondyloarthritis, 4 (3% – injury, and 5 (3% – undifferentiated spondyloarthritis. There were 40 men and 11 women among the patients with gout and 13 men and 32 women among those with CPDD. The patients with gout were younger than those with CPDD (35.5±8.9 and 58.4±12.8 years, respectively; p < 0.05. In the patients with CPDD, knee, ankle, and first metatarsophalangeal joint arthritis was present in 34 (76.3%, 17 (30.3%, and 4 (9% cases, respectively. Arthritis developed within a few hours in 90% of the patients with gout and in 33.3% of those with CPDD (p < 0.001. Monoarthritis was significantly more common in gout whereas oligoarthritis – in CPDD (p < 0.05. Visual analog scale pain intensity averaged 78.4±12.5 mm and 54.32±22.02 mm (p < 0.05, duration of arthritis – 10.3±3.8 days and 3.4±2.1 days (p < 0.05 in gout

  18. Risk of acute gout among active smokers: data from nationwide inpatient sample.

    Science.gov (United States)

    Poudel, Dilli Ram; Karmacharya, Paras; Donato, Anthony

    2016-12-01

    Smoking has been found to be negatively correlated with serum uric acid levels by virtue of reduced production and increased consumption of endogenous antioxidant uric acid among smokers and has been reported to decrease incidence of gout. To shed further light on the question of association between active smoking and acute gout by examining this association using a large inpatient US database, using the Nationwide Inpatient Sample data from 2009 to 2011, we identified current smokers based on the International Classification of Diseases, Ninth Revision (ICD-9) code 305.1 and were assumed to have ceased smoking during hospital stay. Patients who developed acute gout inhospital were identified based on ICD-9 code 274.01 at secondary diagnosis position. Univariate and multivariate logistic regressions were used to derive odds ratio for measures of association. Statistical analysis was done using STATA version 13.0 (College Station, TX). A total of 17,847,045 discharge records were used which included 13,932 (0.08 %) inhospital acute gouty arthritis and 2,615,944 (14.66 %) active smokers. Both univariate (OR 0.59, CI 0.54-0.63, p < 0.0001) and multivariate (OR 0.64, CI 0.59-0.68, p < 0.0001) regressions showed statistically significant reduction of acute gout among hospitalized patients who were current smokers but were assumed to have ceased smoking during hospital stay. Active tobacco use was associated with a lower risk of acute inpatient gouty arthritis, even when controlling for conventional risk factors. More study is needed to correlate this finding with uric acid levels, and a better understanding of the mechanisms that explain this finding are necessary.

  19. Treatment of acute gout: a systematic review.

    Science.gov (United States)

    Khanna, Puja P; Gladue, Heather S; Singh, Manjit K; FitzGerald, John D; Bae, Sangmee; Prakash, Shraddha; Kaldas, Marian; Gogia, Maneesh; Berrocal, Veronica; Townsend, Whitney; Terkeltaub, Robert; Khanna, Dinesh

    2014-08-01

    Acute gout is traditionally treated with NSAIDs, corticosteroids, and colchicine; however, subjects have multiple comorbidities that limit the use of some conventional therapies. We systematically reviewed the published data on the pharmacologic and non-pharmacologic agents used for the treatment of acute gouty arthritis. A systematic search was performed using PubMed and Cochrane database through May 2013. We included only randomized controlled trials (RCTs) that included NSAIDs, corticosteroids, colchicine, adrenocorticotropic hormone (ACTH), interleukin-1 (IL-1) inhibitors, topical ice, or herbal supplements. Thirty articles were selected for systematic review. The results show that NSAIDs and COX-2 inhibitors are effective agents for the treatment of acute gout attacks. Systemic corticosteroids have similar efficacy to therapeutic doses of NSAIDs, with studies supporting oral and intramuscular use. ACTH is suggested to be efficacious in acute gout. Oral colchicine demonstrated to be effective, with low-dose colchicine demonstrating a comparable tolerability profile as placebo and a significantly lower side effect profile to high-dose colchicine. The IL-1β inhibitory antibody, canakinumab, was effective for the treatment of acute attacks in subjects refractory to and in those with contraindications to NSAIDs and/or colchicine. However, rilonacept was demonstrated to be not as effective, and there are no RCTs for the use of anakinra. NSAIDs, COX-2 selective inhibitors, corticosteroids, colchicine, ACTH, and canakinumab have evidence to suggest efficacy in treatment of acute gout. Published by Elsevier Inc.

  20. An autopsy case of acute pancreatitis with a high serum IgG4 complicated by amyloidosis and rheumatoid arthritis

    Institute of Scientific and Technical Information of China (English)

    Tatsuki Ichikawa; Kazuhiko Nakao; Keisuke Hamasaki; Kazuaki Ohkubo; Kan Toriyama; Katsumi Eguchi

    2005-01-01

    We report an autopsy case of acute pancreatitis with a high serum IgG4 concentration complicated by systemic amyloid A amyloidosis and rheumatoid arthritis (RA). The patient was a 42-year-old Japanese female with a 22-year history of rheumatoid arthritis. She was diagnosed with myasthenia gravis when she was 31-year old. At the onset of pancreatitis, the patient was anti-nuclear antibody-positive,and had high serum gamma globulin and IgG4 levels.Dexamethasone and conventional therapy induced clinical remission and significantly decreased the serum IgG4 and gamma globulin. However, despite the decreased disease parameters, the patient developed a bleeding pseudocyst and died of cardiac failure. In the autopsy examination, it was determined that pancreatitis was probably caused by ischemia due to vascular obstruction caused by amyloid deposition in the pancreas. Even though acute pancreatitis is a rare complication in RA patients, we speculate that an autoimmune pancreatitis-related mechanism and ischemia due to vascular obstruction by amyloid deposition might be attributable to a single source that leads to acute pancreatitis in our particular case.

  1. Acute phase protein haptoglobin as inflammatory marker in serum and synovial fluid in an equine model of arthritis.

    Science.gov (United States)

    Barrachina, Laura; Remacha, Ana Rosa; Soler, Lourdes; García, Natalia; Romero, Antonio; Vázquez, Francisco José; Vitoria, Arantza; Álava, María Ángeles; Lamprave, Fermín; Rodellar, Clementina

    2016-12-01

    Acute phase proteins are useful inflammatory markers in horses. Haptoglobin (Hp) serum level is increased in horses undergoing different inflammatory processes, including arthritis. However, Hp concentration has not been assessed in inflammatory synovial fluid (SF). The aim of the present study was to investigate the Hp response in serum and SF in horses undergoing experimentally induced arthritis. For this purpose, serum and SF samples were collected from 12 animals before amphotericin B-induced arthritis was created (T0, healthy) and 15days after the lesion induction (T1, joint inflammation) and Hp was determined by single radial immunodiffusion. The Hp increase between T0 and T1 was significant in both serum and SF, and serum Hp concentration at T0 was significantly higher than in SF, but significant differences were not found at T1, indicating a higher Hp increase in SF. A significant positive correlation for Hp concentration between serum and SF samples was found. These results highlight the potential usefulness of Hp as inflammatory marker in horses, showing for the first time the increase of Hp in SF from joint inflammation in the horse. Copyright © 2016 Elsevier B.V. All rights reserved.

  2. The humoral immune response to Chlamydia trachomatis in patients with acute reactive arthritis

    DEFF Research Database (Denmark)

    Larsen, B; Birkelund, Svend; Mordhorst, CH

    1994-01-01

    Sera from 25 patients with clinical signs of reactive arthritis were analysed for antibodies against Chlamydia trachomatis by immunoblotting. Purified elementary bodies, purified Chlamydia outer membrane complexes, and purified recombinant subcomponents were used as antigens. Antibodies against C...

  3. Acute septic arthritis of the acromioclavicular joint caused by Haemophilus parainfluenzae: a rare causative origin.

    Science.gov (United States)

    Hong, Myong-Joo; Kim, Yeon-Dong; Ham, Hyang-Do

    2015-04-01

    Septic arthritis of the acromioclavicular (AC) joint is a rare entity with symptoms that include erythema, swelling, and tenderness over the AC joint, fever, and limitation of shoulder motion with pain. In previous reports, Staphylococcus and Streptococcus species have been mentioned as common causative organisms. Haemophilus parainfluenzae is a normal inhabitant of the oral cavity, respiratory tract, gastrointestinal tract, and urogenital tract. However, it sometimes causes opportunistic infections leading to septic arthritis and osteomyelitis. AC joint infection associated with H.parainfluenzae is very rare, and only one case has been reported in the literature. Moreover, septic arthritis in immunocompetent patients is also very rare. Here, we report the case of a healthy patient with H. parainfluenzae-related septic arthritis of the AC joint.

  4. [SEIP-SERPE-SEOP Consensus Document on aetiopathogenesis and diagnosis of uncomplicated acute osteomyelitis and septic arthritis].

    Science.gov (United States)

    Saavedra-Lozano, J; Calvo, C; Huguet Carol, R; Rodrigo, C; Núñez, E; Pérez, C; Merino, R; Rojo, P; Obando, I; Downey, F J; Colino, E; García, J J; Cilleruelo, M J; Torner, F; García, L

    2015-09-01

    This is a Consensus Document of the Sociedad Española de Infectología Pediátrica, Sociedad Española de Reumatología Pediátrica and Sociedad Española de Ortopedia Pediátrica on the aetiology and diagnosis of uncomplicated acute osteomyelitis and septic arthritis. A review is presented of the aetiopathogenesis and pathophysiology of acute osteoarticular infection defined as a process with less than 14 days of symptomatology, uncomplicated, and community-acquired. The diagnostic approach to these conditions is summarised based on the best available scientific knowledge. Based on this evidence, a number of recommendations for clinical practice are provided. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

  5. Septic Arthritis of the Temporomandibular Joint Secondary to Acute Otitis Media in an Adult: A Rare Case with Achromobacter xylosoxidans

    Directory of Open Access Journals (Sweden)

    Ryan Chin Taw Cheong

    2017-01-01

    Full Text Available Septic arthritis of the temporomandibular joint (SATMJ is a rare complication of acute otitis media (AOM with only four reported cases in the English and Japanese literature. Based on the unusual nature of this clinical condition, we discuss the first documented case due to Achromobacter xylosoxidans and the utility of myringotomy with long-term intravenous antibiotics via a peripherally inserted central catheter (PICC. We describe the case of a 76-year-old male patient that was brought in by ambulance to the accident and emergency (A&E department due to severe right-sided otalgia with increased hearing impairment. A clinical diagnosis of acute otitis media with sepsis was made and the patient was commenced on the sepsis protocol. He then developed symptoms of septic arthritis of the TMJ which was confirmed on radiological imaging. After a multidisciplinary team discussion, the patient was treated with a myringotomy and intravenous ceftriaxone for 8 weeks in the community via a PICC rather than TMJ arthrocentesis with positive outcomes at 3 months’ follow-up.

  6. Septic arthritis of the neonatal hip: acute management and late reconstruction.

    Science.gov (United States)

    Samora, Julie Balch; Klingele, Kevin

    2013-10-01

    Septic arthritis of the hip in neonates is rare but can have devastating consequences. Presenting signs and symptoms may differ from those encountered in older children, which may result in diagnostic challenge or delay. Many risk factors predispose neonates to septic arthritis, including the presence of transphyseal vessels and invasive procedures. Bacterial infection of the joint occurs via hematogenous invasion, extension from an adjacent site, or direct inoculation. A strong correlation exists between younger age at presentation and severity of residual hip deformity. Diagnosis is based on clinical examination, laboratory markers, and ultrasound evaluation. Early management includes parenteral antibiotics and surgical drainage. Late-stage management options include femoral and pelvic osteotomies, trochanteric arthroplasty, arthrodesis, pelvic support procedures, and nonsurgical measures. Early diagnosis and management continues to be the most important prognostic factor for a favorable outcome in the neonate with septic arthritis.

  7. A dose-effect relationship study of gouty arthritis chicken model built by high-protein diet%基于高蛋白饮食建立鸡痛风性关节炎模型的量效关系研究

    Institute of Scientific and Technical Information of China (English)

    齐新宇; 向黎黎; 熊辉; 李腾龙; 周彪; 郭玉星; 陆小龙

    2015-01-01

    ,P=0.002,P=0.004),模型2组滑膜中中性粒细胞数量均多于模型1组和模型3组(P=0.027,P=0.022;P=0.015,P=0.013;P=0.002,P=0.003),模型1组与模型3组比较差异均无统计学意义(P=0.220,P=0.351,P=0.117)。结论:通过高蛋白饮食诱导可获得鸡痛风性关节炎模型,其中以蛋白含量为50%的饮食造模效果最好。%Objective:To explore the dose-effect relationship between feedstuff protein content and gouty arthritis chicken models built by high-protein diet.Methods:One hundred and sixty 30-day-old male XIANGHUANG chickens were randomly divided into control group, model group 1,model group 2 and model group 3,40 cases in each group.The chickens were fed for consecutive 21 days with feedstuff which protein content was 19.8%,40.19%,50% and 55.2% respectively.Ten chickens were randomly selected from each group at 1,7, 14 and 21 days after the beginning of modeling respectively;and the general state,ankle circumference and blood uric acid levels were de-tected.Then the chickens were executed,and the left ankle synovium were separated for observing the synovial tissue morphology.Results:There was statistical difference in general state scores between the 4 groups except at one day after the beginning of modeling(F=65.721, P=0.271;F=70.634,P=0.013;F=59.448,P=0.001;F=73.124,P=0.001).The scores of control group were higher than that of model group 1,model group 2 and model group 3 at 7,14 and 21 days after the beginning of modeling(P=0.021,P=0.013,P=0.020;P=0.001,P=0.001,P=0.001;P=0.000,P=0.000,P=0.000);and the scores of model group 2 were lower than that of model group 1 and model group 3(P=0.031,P=0.025;P=0.001,P=0.001;P=0.000,P=0.000);there was no statistical difference in general state scores between model group 1 and model group 3(P=0.125,P=0.112,P=0.141).There was statistical difference in ankle circum-ference between the 4 groups except at one day

  8. Targeting ASC in NLRP3 inflammasome by caffeic acid phenethyl ester: a novel strategy to treat acute gout

    Science.gov (United States)

    Lee, Hye Eun; Yang, Gabsik; Kim, Nam Doo; Jeong, Seongkeun; Jung, Yunjin; Choi, Jae Young; Park, Hyun Ho; Lee, Joo Young

    2016-01-01

    Gouty arthritis is caused by the deposition of uric acid crystals, which induce the activation of NOD-like receptor family, pyrin domain containing 3(NLRP3) inflammasome. The NLRP3 inflammasome, composed of NLRP3, the adaptor protein ASC, and caspase-1, is closely linked to the pathogenesis of various metabolic diseases including gouty arthritis. We investigated whether an orally administrable inhibitor of NLRP3 inflammasome was effective for alleviating the pathological symptoms of gouty arthritis and what was the underlying mechanism. In primary mouse macrophages, caffeic acid phenethyl ester(CAPE) blocked caspase-1 activation and IL-1β production induced by MSU crystals, showing that CAPE suppresses NLRP3 inflammasome activation. In mouse gouty arthritis models, oral administration of CAPE suppressed MSU crystals-induced caspase-1 activation and IL-1β production in the air pouch exudates and the foot tissues, correlating with attenuation of inflammatory symptoms. CAPE directly associated with ASC as shown by SPR analysis and co-precipitation, resulting in blockade of NLRP3-ASC interaction induced by MSU crystals. Our findings provide a novel regulatory mechanism by which small molecules harness the activation of NLRP3 inflammasome by presenting ASC as a new target. Furthermore, the results suggest the preventive or therapeutic strategy for NLRP3-related inflammatory diseases such as gouty arthritis using orally available small molecules. PMID:27934918

  9. Targeting ASC in NLRP3 inflammasome by caffeic acid phenethyl ester: a novel strategy to treat acute gout.

    Science.gov (United States)

    Lee, Hye Eun; Yang, Gabsik; Kim, Nam Doo; Jeong, Seongkeun; Jung, Yunjin; Choi, Jae Young; Park, Hyun Ho; Lee, Joo Young

    2016-12-09

    Gouty arthritis is caused by the deposition of uric acid crystals, which induce the activation of NOD-like receptor family, pyrin domain containing 3(NLRP3) inflammasome. The NLRP3 inflammasome, composed of NLRP3, the adaptor protein ASC, and caspase-1, is closely linked to the pathogenesis of various metabolic diseases including gouty arthritis. We investigated whether an orally administrable inhibitor of NLRP3 inflammasome was effective for alleviating the pathological symptoms of gouty arthritis and what was the underlying mechanism. In primary mouse macrophages, caffeic acid phenethyl ester(CAPE) blocked caspase-1 activation and IL-1β production induced by MSU crystals, showing that CAPE suppresses NLRP3 inflammasome activation. In mouse gouty arthritis models, oral administration of CAPE suppressed MSU crystals-induced caspase-1 activation and IL-1β production in the air pouch exudates and the foot tissues, correlating with attenuation of inflammatory symptoms. CAPE directly associated with ASC as shown by SPR analysis and co-precipitation, resulting in blockade of NLRP3-ASC interaction induced by MSU crystals. Our findings provide a novel regulatory mechanism by which small molecules harness the activation of NLRP3 inflammasome by presenting ASC as a new target. Furthermore, the results suggest the preventive or therapeutic strategy for NLRP3-related inflammatory diseases such as gouty arthritis using orally available small molecules.

  10. Simultaneous acute shoulder arthritis and multiple mononeuropathy in a newly diagnosed type 2 diabetes patient - First case report.

    Science.gov (United States)

    Kotlęga, Dariusz; Gołąb-Janowska, Monika; Zaborowski, Grzegorz; Ciećwież, Sylwester; Nowacki, Przemysław

    Diabetes is a common disorder that leads to the musculoskeletal symptoms such as the shoulder arthritis. The involvement of peripheral nervous system is one of the troublesome for the patients as it provokes chronic sensory symptoms, lower motor neuron involvement and autonomic symptoms. In the course of the disease there has been several types of neuropathies described. A 41-year-old male patient was admitted to the internal medicine department because of the general weakness, malaise, polydypsia and polyuria since several days. The initial blood glucose level was 780mg/dl. During the first day the continuous insulin infusion was administered. On the next day when he woke up, the severe pain in the right shoulder with limited movement, right upper extremity weakness and burning pain in the radial aspect of this extremity appeared. On examination right shoulder joint movement limitation was found with the muscle weakness and sensory symptoms in the upper limbs. The clinical picture indicated on the right shoulder arthritis and the peripheral nervous system symptoms such as the right musculocutaneous, supraspinatus, right radial nerve and left radial nerve damage. We present a first case report of simultaneous, acute involvement of the shoulder joint and multiple neuropathy in a patient with newly diagnosed type 2 diabetes, presumably in the state of ketoacidosis.

  11. Anti-Inflammatory Effects of Licorice and Roasted Licorice Extracts on TPA-Induced Acute Inflammation and Collagen-Induced Arthritis in Mice

    Directory of Open Access Journals (Sweden)

    Ki Rim Kim

    2010-01-01

    Full Text Available The anti-inflammatory activity of licorice (LE and roated licorice (rLE extracts determined in the murine phorbol ester-induced acute inflammation model and collagen-induced arthritis (CIA model of human rheumatoid arthritis. rLE possessed greater activity than LE in inhibiting phorbol ester-induced ear edema. Oral administration of LE or rLE reduced clinical arthritis score, paw swelling, and histopathological changes in a murine CIA. LE and rLE decreased the levels of proinflammatory cytokines in serum and matrix metalloproteinase-3 expression in the joints. Cell proliferation and cytokine secretion in response to type II collagen or lipopolysaccharide stimulation were suppressed in spleen cells from LE or rLE-treated CIA mice. Furthermore, LE and rLE treatment prevented oxidative damages in liver and kidney tissues of CIA mice. Taken together, LE and rLE have benefits in protecting against both acute inflammation and chronic inflammatory conditions including rheumatoid arthritis. rLE may inhibit the acute inflammation more potently than LE.

  12. Indicators for detection of septic arthritis in the acutely swollen joint cohort of those without joint prostheses.

    Science.gov (United States)

    Roberts, John; Schaefer, Eric; Gallo, Robert A

    2014-02-01

    Differentiating septic arthritis from culture-negative, acute atraumatic joint effusion is difficult. Studies have attempted to elucidate factors that herald infection, but, due to overlap, most conclude that the diagnosis ultimately relies on clinical judgment. Furthermore, studies are limited by broad inclusion criteria. The current retrospective case study sought to examine (1) which markers differentiate a culture-positive septic joint from culture-negative effusion in patients suspicious for infection despite no growth on Gram stain and without previous surgery in the affected joint and (2) whether threshold values of these markers exist that predict septic arthritis. The study was performed by reviewing records of those who underwent operative irrigation and debridement involving the shoulder, elbow, wrist, hip, knee, and ankle. Patients were included if they were older than 18 years and had an acutely swollen/painful joint and no organisms on initial Gram stain. Exclusion criteria were lack of serum markers or synovial fluid aspirate, antibiotics within 1 week, adjacent wound or skin infection, recent trauma to the joint, and previous joint infection or surgery to the joint. Several clinical, serological, and synovial parameters were collected and analyzed using paired t test with Bonferonni correction. Serum C-reactive protein was the only significantly different variable between groups. Serum C-reactive protein greater than 10.5 mg/dL was predictive of infection. In those suspicious for infection despite no growth on Gram stain and without previous surgery in the affected joint, C-reactive protein greater than 10.5 mg/dL is suspicious for joint sepsis and should warrant consideration for urgent irrigation and debridement.

  13. Acute Disseminated Melioidosis Presenting with Septic Arthritis and Diffuse Pulmonary Consolidation in an Otherwise Healthy Adult: A Case Report

    Directory of Open Access Journals (Sweden)

    Hai Sherng Lee

    2015-03-01

    Full Text Available Background: Melioidosis is an infectious disease caused by Burkholderia pseudomallei. It is most prevalent in South-East Asia, northern Australia, and the Indian subcontinent. Septic arthritis is a rare manifestation of melioidosis. Melioidosis is usually found in patients with diabetes, heavy alcohol use, or chronic lung disease. Results: We report a case of melioidosis in an otherwise healthy 44-year-old male, who presented with acute painful left knee swelling, high-grade fever associated with chills, rigors and night sweats, and a productive cough. Examination revealed active synovitis with effusion involving his left knee, ankle and elbow joints and scattered crackles over both lung fields. Chest X-ray showed diffuse pulmonary consolidation. Abdominal ultrasound showed splenic micro-abscesses. The diagnosis was made based on a positive blood culture for Burkholderia pseudomallei. He was started on appropriate antibiotics and responded well, becoming afebrile after 48 hours, while his joint effusions disappeared after one week. A repeat chest X-ray after two weeks of intensive antibiotic therapy showed marked improvement. At the time of writing, he was under uneventful outpatient follow-up and still had 12 weeks to complete his course of antibiotics. Conclusion: Septic arthritis only occurs in 4% of patients with melioidosis. When there is diffuse pulmonary involvement, melioidosis may mimic disseminated tuberculosis, other acute disseminated or focal sepsis syndromes, and systemic vasculitis syndromes. This case is relevant for medical literature as melioidosis is emerging and is expanding its known territories worldwide. It should be considered early in the differential diagnoses of patients presenting with constitutional symptoms in endemic areas, so that treatment can be started early to reduce its high mortality and morbidity.

  14. Arthritis - resources

    Science.gov (United States)

    Resources - arthritis ... The following organizations provide more information on arthritis : American Academy of Orthopaedic Surgeons -- orthoinfo.aaos.org/menus/arthritis.cfm Arthritis Foundation -- www.arthritis.org Centers for Disease Control and Prevention -- www. ...

  15. Serum-sickness-like disease is a common cause of acute arthritis in children.

    Science.gov (United States)

    Kunnamo, I; Kallio, P; Pelkonen, P; Viander, M

    1986-11-01

    Among 283 children in a prospective study of arthritis we found 15 patients with a self-limited serum-sickness-like disease consisting of urticaria or joint erythema and mostly polyarticular arthritis. The mean duration of joint symptoms was 5.9 days. A preceding infection was reported in 12 patients and 12 had received drugs, the therapy starting on average 12.8 days before the onset of joint symptoms. In 9 cases the drug was penicillin. Four patients had recurrent attacks. Circulating immune complexes were detected in the serum of 12 patients, but specific IgE antibodies to penicillin only in 3 patients. The estimated annual incidence of the condition was 4.7/100,000 children under age 16.

  16. 间歇应用消炎止痛药治疗急性痛风关节炎%Application of Intermittent Anti - inflammatory Painkiller in Treatment of Acute Gouty Arthritis

    Institute of Scientific and Technical Information of China (English)

    李芳勇

    2007-01-01

    目的 探讨小剂量、间歇及联合应用消炎止痛药治疗急性痛风性关节炎的方法.方法 将急性痛风性关节炎病患者50例,分为小剂量组,常规剂量组.观察治疗后各组疗效及副作用情况变化.结果 常规剂量组显效率为90%,消化道副作用发生率为80%,小剂量组显效率为87%,消化道副作用发生率为6.7%.结论 小剂量、间歇及联合应用消炎止痛药,与常规剂量联合应用消炎止痛药治疗急性痛风性关节炎相比,疗效相同,但患者耐受性好,安全、不良反应小.

  17. Acute osteomyelitis, septic arthritis and discitis: Differences between neonates and older children

    Energy Technology Data Exchange (ETDEWEB)

    Offiah, A.C. [Department of Radiology, Great Ormond Street Hospital for Children, London WC1N 3JH (United Kingdom)]. E-mail: offiaa@gosh.nhs.uk

    2006-11-15

    There are aetiological, clinical, radiological and therapeutic differences between musculoskeletal infection in the neonate (and infant) and in older children and adults. Due to the anatomy and blood supply in neonates, osteomyelitis often co-exists with septic arthritis. Discitis is more common in infants whereas vertebral body infection is more common in adults. This review article discusses the important clinical and radiological differences that in the past have led many authors to consider neonatal osteomyelitis a separate entity from osteomyelitis in the older child.

  18. Concomitant early avascular necrosis of the femoral head and acute bacterial arthritis by enteric Gram-negative bacilli in four oncologic patients.

    Science.gov (United States)

    Tan, Tien Jin; Tan, Suan Cheng

    2013-05-01

    We present four cases of concomitant early (modified Ficat-Arlet stage I) avascular necrosis of the femoral head and acute bacterial arthritis of the hip joint by Gram-negative enteric bacilli. This was found in immunosuppressed oncologic patients whose clinical presentations and radiological findings were not entirely specific for joint sepsis. It is important to recognise the coexistence of these two pathologies, so as to avoid a delay in diagnosis and prevent significant morbidity and mortality.

  19. Acute-onset opioid-induced hyperalgesia in a child with juvenile idiopathic arthritis.

    Science.gov (United States)

    Vijayan, Vini; Moran, Ryan; Elder, Melissa E; Sukumaran, Sukesh

    2012-10-01

    We describe a child with polyarticular juvenile idiopathic arthritis (JIA) presenting with severe diffuse pain refractory to nonsteroidal anti-inflammatory agents and high-dose opioids. Her JIA involved her knees and ankles and was mildly active on etanercept and nonsteroidal anti-inflammatory agents. At presentation, she complained of hip pain progressing to severe diffuse pain and allodynia involving her extremities. No abnormalities were seen in her laboratory parameters and imaging of her lower extremities. After appreciating no substantial benefit by increasing her opioids, her opioids were tapered and discontinued, and this was followed by significant alleviation in her pain, and a diagnosis of opioid-induced hyperalgesia (OIH) was made. Despite reports in adults, the phenomenon of OIH has been reported infrequently in children. To our knowledge, OIH has not been described in children with rheumatologic conditions. We recommend investigating the possibility of OIH when treating a child with JIA and severe refractory pain.

  20. Infections and arthritis.

    Science.gov (United States)

    Mathew, Ashish Jacob; Ravindran, Vinod

    2014-12-01

    Bacteria, viruses, fungi, and parasites can all cause arthritis of either acute or chronic nature, which can be divided into infective/septic, reactive, or inflammatory. Considerable advances have occurred in diagnostic techniques in the recent decades resulting in better treatment outcomes in patients with infective arthritis. Detection of emerging arthritogenic viruses has changed the epidemiology of infection-related arthritis. The role of viruses in the pathogenesis of chronic inflammatory arthritides such as rheumatoid arthritis is increasingly being recognized. We discuss the various causative agents of infective arthritis and emphasize on the approach to each type of arthritis, highlighting the diagnostic tests, along with their statistical accuracy. Various investigations including newer methods such as nucleic acid amplification using polymerase chain reaction are discussed along with the pitfalls in interpreting the tests.

  1. Similar erythrocyte sedimentation rate and C-reactive protein sensitivities at the onset of septic arthritis, osteomyelitis, acute rheumatic fever

    Directory of Open Access Journals (Sweden)

    Jonathan E. Reitzenstein

    2010-03-01

    Full Text Available The erythrocyte sedimentation rate (ESR and C-reactive protein (CRP are employed in the evaluation of patients with suspected septic arthritis, osteomyelitis, and acute rheumatic fever. The purpose of this study is to determine if one test has greater sensitivity (rises earlier than the other. Laboratory data were retrieved for pediatric patients hospitalized with one of the above three conditions, who had both ESR and CRP tests done on or shortly prior to admission. Sensitivity calculations were performed for mild, moderate, and severe degrees of ESR and CRP elevation. Microcytic erythrocytes, as defined by mean corpuscular volume (MCV less than 80 μL, were identified to see if this affects the ESR. ESR or CRP sensitivities depend on the cutoff value (threshold chosen as a positive test. The sensitivities were similar for similar degrees of elevation. ESR and CRP discordance was not significantly related to MCV. We concluded that the CRP does not rise earlier than the ESR (their sensitivities are similar. Previously published conclusions are dependent on arbitrary thresholds. We could not find any evidence that MCV affects the ESR.

  2. How to optimize treatment in patients with gout and chronic arthritis Urisan is in focus

    Directory of Open Access Journals (Sweden)

    A E Ilyina

    2009-01-01

    Full Text Available The paper outlines the specific features of the clinical picture and diagnosis of chronic gouty arthritis. It describes difficulties in treating chronic gout when one has to face the so-called vicious circle, to which is contributed by comorbidity that is present in most patients. A way out of this clinical difficulty is proposed to use the herbal complex Urisan that has antihyperuricemic and inflammatory properties.

  3. How to optimize treatment in patients with gout and chronic arthritis Urisan is in focus

    Directory of Open Access Journals (Sweden)

    A E Ilyina

    2009-03-01

    Full Text Available The paper outlines the specific features of the clinical picture and diagnosis of chronic gouty arthritis. It describes difficulties in treating chronic gout when one has to face the so-called vicious circle, to which is contributed by comorbidity that is present in most patients. A way out of this clinical difficulty is proposed to use the herbal complex Urisan that has antihyperuricemic and inflammatory properties.

  4. A Rare Case of Lateral Canthal Gouty Tophus Presenting as an Eyelid Mass

    Directory of Open Access Journals (Sweden)

    Austin S. Nakatsuka

    2016-01-01

    Full Text Available A 41-year-old man with a history of gout presented with an enlarging eyelid growth. Clinical examination revealed a mildly indurated nodule at the lateral canthus. Following resection, histopathological examination revealed needle-shaped, crystalline material surrounded by multinucleated giant cells, findings consistent with gouty tophus. This represents just the sixth case of gouty tophus of the eyelid reported in the literature.

  5. Gouty Tophi in the Penis: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    José Francisco Flores Martín

    2012-01-01

    Full Text Available Gout is a metabolic disease characterized by hyperuricemia and the deposition of monosodium urate crystals in different anatomical locations. We report the case of a 61-year-old man who received consultation for gouty tophi in the penis, which is an unusual location for this type of pathology, that was resolved with the surgical removal of the tophi. We provide a review on gout and its treatment as well as other locations where atypical gouty tophi have been described.

  6. Acutely developed elbow arthritis in a patient with Brucellosis: Familial Mediterranean Fever

    Directory of Open Access Journals (Sweden)

    Erkan Yula

    2011-12-01

    Full Text Available Familial Mediterranean Fever (FMF is an autosomal recessivedisorder that is prevalent in non-Ashkenazi Jews,Armenians, Turks and Arabs. The characteristic featuresof FMF is recurrent self-limited attacks of fever, polyserositis(synovitis, peritonitis, and pleuritis, and secondaryamyloidosis. Genetic studies have shown that the genefor FMF is located on chromosome 16p is designatedMEFV. The diagnosis of FMF is based on a clinical historyof typical acute attacks, ethnic background, and familyhistory.Brucellosis is a systemic infectious disease caused bygram-negative bacillus. The prevalence of the disease ishigher in developing countries. It is frequently transmittedto humans via consumption of infected unpasteurizeddairy products and infected by direct contact with infectedanimals.In this article, we discussed a patient who was in our followup with diagnosis of brucellosis, after sudden effusionof elbow; we diagnosed the case FMF together with brucellosis.J Clin Exp Invest 2011; 2 (4: 437-440

  7. Gonococcal arthritis

    Science.gov (United States)

    Disseminated gonococcal infection (DGI); Disseminated gonococcemia; Septic arthritis - gonococcal arthritis ... Gonococcal arthritis is an infection of a joint. It occurs in people who have gonorrhea , which is caused by ...

  8. Viral arthritis

    Science.gov (United States)

    Infectious arthritis - viral ... Arthritis may be a symptom of many virus-related illnesses. It usually disappears on its own without ... the rubella vaccine, only a few people develop arthritis. No risk factors are known.

  9. Rheumatoid Arthritis

    Science.gov (United States)

    Rheumatoid arthritis (RA) is a form of arthritis that causes pain, swelling, stiffness and loss of function in ... wrist and fingers. More women than men get rheumatoid arthritis. It often starts in middle age and is ...

  10. Lumbar facet joint septic arthritis presenting atypically as acute abdomen – A case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Aysha Rajeev

    2016-01-01

    Conclusion: The atypical presentation of facet joint septic arthritis is one of the reasons why early diagnosis is elusive. Definitive diagnoses with MRI and bacterial culture as well as prolonged antibiotic therapy are recommended in this condition.

  11. 桂芍知母汤治疗急性期类风湿关节炎配伍探析%Compatibility analysis on treating acute rheumatoid arthritis with the Guishao Zhimu decoction

    Institute of Scientific and Technical Information of China (English)

    盛锦辉

    2014-01-01

    Through analysis of the pathogenesis of acute rheumatoid arthritis, discuss the feasibility of Guishao Zhimu decoction on treating acute rheumatoid arthritis, and explore the type treatment method and medicine addition and subtraction to further.%通过对急性类风湿关节炎病因病机的分析,讨论桂芍知母汤治疗急性期类风湿关节炎的可行性,并进一步探讨分型论治加减用药的方法。

  12. Efficacy and safety profile of combination of tramadol-diclofenac versus tramadol-paracetamol in patients with acute musculoskeletal conditions, postoperative pain, and acute flare of osteoarthritis and rheumatoid arthritis: a Phase III, 5-day open-label study

    Science.gov (United States)

    Chandanwale, Ajay S; Sundar, Subramanian; Latchoumibady, Kaliaperumal; Biswas, Swati; Gabhane, Mukesh; Naik, Manoj; Patel, Kamlesh

    2014-01-01

    Objective We aimed to evaluate the safety and efficacy of a fixed-dose combination (FDC) of tramadol and diclofenac versus a standard approved FDC of tramadol and paracetamol, in patients with acute moderate to severe pain. Methods A total of 204 patients with moderate to severe pain due to acute musculoskeletal conditions (n=52), acute flare of osteoarthritis (n=52), acute flare of rheumatoid arthritis (n=50), or postoperative pain (n=50) were enrolled in the study at baseline. Each disease category was then randomized to receive either of two treatments for 5 days: group A received an FDC of immediate-release tramadol hydrochloride (50 mg) and sustained-release diclofenac sodium (75 mg) (one tablet, twice daily), and group B received an FDC of tramadol hydrochloride (37.5 mg) and paracetamol (325 mg) (two tablets every 4–6 hours, up to a maximum of eight tablets daily). The primary efficacy end points were reductions in pain intensity from baseline at day 3 and day 5 as assessed by a Visual Analog Scale (VAS) score. Results Group A showed a significant reduction in the VAS score for overall pain from baseline on day 3 (P=0.001) and day 5 (P<0.0001) as compared with group B. The combination of tramadol-diclofenac resulted in few mild to moderate adverse events (nausea, vomiting, epigastric pain, and gastritis), which required minimal management, without any treatment discontinuation. The number of adverse events in group A was nine (8.82%) compared with 22 (21.78%) in group B, after 5 days of treatment. Conclusion An FDC of tramadol-diclofenac showed a significantly greater reduction in pain intensity and was well tolerated compared with tramadol-paracetamol, resulting in better analgesia in patients suffering from moderate to severe pain due to acute musculoskeletal conditions, postoperative pain following orthopedic surgery, or acute flare of osteoarthritis and rheumatoid arthritis. PMID:25152629

  13. Femur chondrosarcoma misdiagnosed as acute knee arthritis and osteomyelitis--further developing a hitherto unreported complication of tumor embolic ischemic ileal perforation after arthroscopic lavage.

    Science.gov (United States)

    Chow, Louis Tsun Cheung

    2014-12-01

    The differentiation between osteomyelitis and bone tumor may be difficult due to their overlapping clinical and radiological features. A 25-year-old lady presented with left knee pain and joint effusion associated with redness and hotness. A sub-optimally taken plain radiograph showed mixed osteolytic and osteoblastic lesion in the left lower femur with surrounding soft tissue swelling. Since the clinical diagnosis was acute osteomyelitis and arthritis, arthroscopic lavage was performed as a diagnostic and therapeutic procedure. The removed loose bodies and fibrinous tissue showed pathological features suspicious of chondrosarcoma. Subsequent MRI revealed an infiltrative tumor eroding through the cortex and joint cartilage. En bloc excision of the left lower femur, upper tibia including the knee joint and patella was performed, and the final diagnosis was grade 2 chondrosarcoma. The patient developed bilateral pulmonary metastasis 33 months after operation. Five months later, she suffered from a hitherto undescribed complication of ischemic perforation of the terminal ileum secondary to tumor embolic arterial obstruction with no macroscopic intestinal or peritoneal tumor deposit. The patient developed multiple brain metastases and died 43 months after initial presentation. Our case illustrates that malignant bone tumor as a differential diagnosis of acute osteomyelitis and arthritis merits recognition and exclusion before arthroscopic lavage, which may enhance tumor dissemination and in our patient results in embolic ischemic ileal perforation.

  14. Some historical remarks on microcrystalline arthritis (gout and chondrocalcinosis

    Directory of Open Access Journals (Sweden)

    G. Pasero

    2012-01-01

    Full Text Available The history of microcrystalline arthritis only began in 1961 when Daniel McCarty and Joseph Lee Hollander demonstrated the presence of sodium monourate crystals in the synovial fluid of gouty patients. However, gout is a historical disease, thanks to the descriptions of Hippocrates, Caelius Aurelianus, Soranus of Ephesus and Araeteus of Cappadocia. The relationship between hyperuricemia and gout was first documented in the nineteenth century by Alfred Baring Garrod, who demonstrated deposits of uric acid crystals on a linen thread held dipped in acidified blood (the so-called “thread method”. Gout has always been considered a prerogative of the moneyed classes (arthritis divitum, and history is full of famous gouty personalities, including kings, emperors, popes, commanders, politicians, artists, writers, philosophers and scientists. Another form of microcrystalline arthritis, chondrocalcinosis, was identified as being a rheumatic disorder different from gout in the 1960s. As a specific clinical entity, it was first identified in 1958 by Dušan Žitnˇan and Štefan Sit’aj in a few Slovak families.

  15. Juvenile Arthritis

    Science.gov (United States)

    Juvenile arthritis (JA) is arthritis that happens in children. It causes joint swelling, pain, stiffness, and loss of motion. It can affect any joint, but ... of JA that children get is juvenile idiopathic arthritis. There are several other forms of arthritis affecting ...

  16. Acute paraplegia in a patient with spinal tophi: a case report.

    Science.gov (United States)

    Wang, L C; Hung, Y C; Lee, E J; Chen, H H

    2001-03-01

    A 28-year-old man with a 5-year history of gouty arthritis suffered from an acute episode of lower back pain. He visited a rehabilitative clinic and received physical therapy following his examination. Weakness and numbness of both lower legs developed rapidly after physical therapy. He was sent to our hospital with complete paralysis of both lower limbs and complete sensory loss below the umbilicus 3 hours after the physical therapy. No peripheral tophi were found. Myelography showed an extrinsic compression of the dura sac at T10. Emergency decompressive laminectomy of T9 to T11 was performed. During the surgery, caseous material was found deposited in the ligamentum flavum and the left T9 to T10 facet joint, with indentation of the dura sac. The pathologic diagnosis was spinal tophi. After surgery, the patient's neurologic function recovered rapidly. It was suspected that inappropriate physical therapy might have aggravated acute inflammation of spinal gout and resulted in a rapid deterioration of neurologic function. Though gout is a chronic medical disease, an acute attack of spinal gout may be disastrous and requires emergency neurosurgical intervention.

  17. Olecranon bursitis as initial presentation of gout in asymptomatic normouricemic patients

    NARCIS (Netherlands)

    Emad, Yasser; Ragab, Yasser; El Shaarawy, Nashwa; Rasker, Hans J.

    2014-01-01

    Background Acute bursitis is a less frequent presentation of gout, especially in normouricemic subjects compared to the typical pattern of acute gouty arthritis. Aim of the work The aim of the current case reports is to describe the clinical and the magnetic resonance imaging features of acute gouty

  18. Reactive Arthritis Secondary to Cauda Equina Injury following Spine Fracture: A Case Report

    Directory of Open Access Journals (Sweden)

    Xiao Li

    2011-01-01

    Full Text Available A 38-year-old man presented with a one-month history of muscle weakness and dysesthesia in the lower extremities, urinary retention, and urinary tract infection after lumbar burst fracture resulted from high fall. During the rehabilitation in our hospital, he had arthritis in both the ankle and knee. However, the patient was treated as gouty arthropathy initially. The arthritis was completely remitted in a few days after the patient was diagnosed as reactive arthritis and started with sulfasalazine therapy and there was no recurrence during 4 months of follow-up. Based on this case, early recognition of reactive arthritis is of major importance to avoid delayed initiation of appropriate treatment in the patients with polyarthritis secondary to neurogenic bladder following cauda equina injury after spine fracture.

  19. Acute Retropharyngeal Calcific Tendinitis in an Unusual Location: a Case Report in a Patient with Rheumatoid Arthritis and Atlantoaxial Subluxation

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Seung Hun; Joo, Kyung Bin; Lee, Kyu Hoon; Uhm, Wan Sik [Hanyang University Hospital, Seoul (Korea, Republic of)

    2011-08-15

    Retropharyngeal calcific tendinitis is defined as inflammation of the longus colli muscle and is caused by the deposition of calcium hydroxyapatite crystals, which usually involves the superior oblique fibers of the longus colli muscle from C1-3. Diagnosis is usually made by detecting amorphous calcification and prevertebral soft tissue swelling on radiograph, CT or MRI. In this report, we introduce a case of this disease which was misdiagnosed as a retropharyngeal tuberculous abscess, or a muscle strain of the ongus colli muscle. No calcifications were visible along the vertical fibers of the longus colli muscle. The lesion was located anterior to the C4-5 disc, in a rheumatoid arthritis patient with atlantoaxial subluxation. Calcific tendinitis of the longus colli muscle at this location in a rheumatoid arthritis patient has not been reported in the English literature.

  20. Infectious Arthritis

    Science.gov (United States)

    Most kinds of arthritis cause pain and swelling in your joints. Joints are places where two bones meet, such as your elbow or knee. Infectious arthritis is an infection in the joint. The infection ...

  1. Psoriatic Arthritis

    Science.gov (United States)

    ... your body. Some people with psoriasis have psoriatic arthritis. It causes pain, stiffness, and swelling of the ... physical exam and imaging tests to diagnose psoriatic arthritis. There is no cure, but medicines can help ...

  2. Thumb Arthritis

    Science.gov (United States)

    ... Media Find a Hand Surgeon Home Anatomy Thumb Arthritis Email to a friend * required fields From * To * ... A joint is where bones connect and move. Arthritis is thinning of the cartilage, which is the ...

  3. Fungal arthritis

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/000444.htm Fungal arthritis To use the sharing features on this page, please enable JavaScript. Fungal arthritis is swelling and irritation (inflammation) of a joint ...

  4. Sporotrichal arthritis.

    OpenAIRE

    1991-01-01

    Sporotrichal arthritis is a rare disease entity. Diagnosis is often difficult and delayed. Presentation may be either monoarticular or polyarticular. A case of polyarticular sporotrichal arthritis which exemplifies these problems is reported.

  5. Psoriatic Arthritis

    Science.gov (United States)

    ... Call for Letters of Interest Call for Topics Axial Spondyloarthritis Glucocorticoid-Induced Osteoporosis Gout Juvenile Idiopathic Arthritis ... be affected. Psoriatic arthritis in the spine, called spondylitis , causes stiffness in the back or neck, and ...

  6. A genetic association study of serum acute-phase C-reactive protein levels in rheumatoid arthritis: implications for clinical interpretation.

    Directory of Open Access Journals (Sweden)

    Benjamin Rhodes

    2010-09-01

    Full Text Available BACKGROUND: The acute-phase increase in serum C-reactive protein (CRP is used to diagnose and monitor infectious and inflammatory diseases. Little is known about the influence of genetics on acute-phase CRP, particularly in patients with chronic inflammation. METHODS AND FINDINGS: We studied two independent sets of patients with chronic inflammation due to rheumatoid arthritis (total 695 patients. A tagSNP approach captured common variation at the CRP locus and the relationship between genotype and serum CRP was explored by linear modelling. Erythrocyte sedimentation rate (ESR was incorporated as an independent marker of inflammation to adjust for the varying levels of inflammatory disease activity between patients. Common genetic variants at the CRP locus were associated with acute-phase serum CRP (for the most associated haplotype: p = 0.002, p<0.0005, p<0.0005 in patient sets 1, 2, and the combined sets, respectively, translating into an approximately 3.5-fold change in expected serum CRP concentrations between carriers of two common CRP haplotypes. For example, when ESR = 50 mm/h the expected geometric mean CRP (95% confidence interval concentration was 43.1 mg/l (32.1-50.0 for haplotype 1 and 14.2 mg/l (9.5-23.2 for haplotype 4. CONCLUSIONS: Our findings raise questions about the interpretation of acute-phase serum CRP. In particular, failure to take into account the potential for genetic effects may result in the inappropriate reassurance or suboptimal treatment of patients simply because they carry low-CRP-associated genetic variants. CRP is increasingly being incorporated into clinical algorithms to compare disease activity between patients and to predict future clinical events: our findings impact on the use of these algorithms. For example, where access to effective, but expensive, biological therapies in rheumatoid arthritis is rationed on the basis of a DAS28-CRP clinical activity score, then two patients with identical

  7. Refractory polyarticular gouty arthritis as a manifestation of immune reconstitution inflammatory syndrome.

    Science.gov (United States)

    Sebeny, Peter J; Keith, Michael P; Love, Kathleen M; Dwyer, Terrence X; Ganesan, Anuradha

    2010-01-01

    Immune reconstitution inflammatory syndrome (IRIS) describes the initial clinical deterioration some patients manifest upon initiation of effective antiretroviral therapy (ART) for HIV infection. In this report we describe a case of IRIS manifesting as polyarticular gout, a previously unreported rheumatological manifestation of IRIS. A 53-year-old HIV-infected man with a history of intermittent attacks of gout and an initial CD4 count of 112 cells/microL and a viral load of >100,000 copies/mL presented to our institution with severe, refractory, polyarticular gout approximately 4 weeks after initiating ART. At this point, the patient demonstrated significant gains in his CD4 counts (103 cells/microL) and a greater than 3 log decline in his HIV-1- viral load. This episode was prolonged lasting for approximately 10 weeks and required hospitalization for the management of pain and control of inflammation. The temporal associations of this attack with the initiation of ART and the observed immunologic reconstitution make IRIS a clinical possibility.Monosodium urate crystals through their interactions with interleukin 1- beta, and neutrophilic synovitis play a critical role in the pathophysiology of gout. Defects in both neutrophil and macrophage function and imbalances in the cytokine milieu are documented in HIV infected patients. The introduction of ART results in restoration of neutrophil and macrophage function, declines in levels of the anti-inflammatory cytokine IL-10, and increases in levels of proinflammatory cytokines including IL-1 beta, which may provide the necessary milieu for the precipitation of attacks of severe polyarticular gout in the context of ART initiation.

  8. Gouty wrist arthritis causing carpal tunnel syndrome--a case report.

    Science.gov (United States)

    Sikkandar, M F; Sapuan, J; Singh, R; Abdullah, S

    2012-06-01

    A 63 year old male with a history of gout and hypertension presented with carpal tunnel syndrome. He gave history of bilateral wrist pain associated with numbness over the median nerve distribution of the hand. Tinels sign and Phalens test were positive with no obvious thenar muscle wasting on examination. Tophaceous deposits in the flexor tendons and within the synovium of the wrist joint was seen during surgery and this established gout as the cause of median nerve entrapment in this patient.

  9. 关节镜下清理配合术后灌洗治疗膝痛风性关节炎的临床研究%Clinical study of arthroscopic debridement combined with lavage for treating gouty arthritisof the knee

    Institute of Scientific and Technical Information of China (English)

    崔操; 郭一行; 李厚成; 李彬彬

    2014-01-01

    Objective To study the therapeutic effects of the debridement combined with continuous drainage after surgery in the treatment of joint gouty arthritis under arthroscopy and also to explore the value of arthroscopy in the treatment of recurrent gouty ar -thritis of the knee .Methods There were 17 patients with joint gouty arthritis who received joint debridement and synovectomy under arthroscopy combined with lavage and continuous drainage .After surgery, the patients were given routine drug therapy and early func-tional exercise .Lysholm scores of the knee were compared before surgery and 6 months after surgery .Results Gouty arthritis under ar-throscopy displayed specific white ball -like crystal deposited on the surfaces of synovium , cartilage and other joint structure .All the patients had medical follow -ups for a duration of 6 to 24 months, averaging 16.3 months.Last follow-up revealed that there was not a significant recurrent case after surgery .In accordance with the Lysholm knee scores , the patient function scores before surgery were (50.0 ±3.1), and the function scores 6 months after surgery were (90.0 ±4.8) on the average.Significant statistical differences could be noted in Lysholm scores, when comparisons were made before surgery and 6 months after surgery (P<0.01).Conclusion Arthroscopy displayed a high diagnostic rate of gouty arthritis , at the same time , joint debridement and synovectomy under arthroscopy combined with lavage and continuous drainage were a good treatment method with quick response , minimal invasion and positive efficacy for the treatment of joint gouty arthritis .%目的:探讨关节镜在治疗反复发作性痛风性膝关节炎中的应用价值,并探讨和观察运用关节镜下清理术联合术后置管持续引流治疗痛风性关节炎的方法和疗效。方法17例膝关节痛风性关节炎患者,行关节镜下清理及滑膜切除术,术后灌洗并常规服用降血尿酸药物、早期功能锻炼

  10. What Is Reactive Arthritis?

    Science.gov (United States)

    ... Arthritis PDF Version Size: 69 KB November 2014 What is Reactive Arthritis? Fast Facts: An Easy-to- ... Information About Reactive Arthritis and Other Related Conditions What Causes Reactive Arthritis? Sometimes, reactive arthritis is set ...

  11. Sex and Arthritis

    Science.gov (United States)

    ... Well with Rheumatic Disease Sex & Arthritis Sex and Arthritis Fast Facts Sex and arthritis can coexist. Open ... ability for sexual expression and enjoyment. Impact of Arthritis on Sexual Expression Aspects of arthritis which can ...

  12. Observation of Fire Needle on Acute Attack of Rheumatoid Arthritis%火针治疗类风湿关节炎急性发作临床观察

    Institute of Scientific and Technical Information of China (English)

    张彩荣; 闫改霞; 徐长松; 徐媚媚; 沈甜; 周玉艳

    2012-01-01

    目的 观察火针治疗类风湿关节炎急性发作的临床疗效.方法 采用火针针刺患关节局部阿是穴为主,配合华佗夹脊穴;观测治疗前后晨僵、肿胀、血沉及C反应蛋白情况.结果 总有效率为85.71%,各项指标均有明显改善.结论 火针治疗类风湿关节炎急性发作疗效可靠.%Objective:To observer the effects of the fire needle on the acute attack of the rheumatoid arthritis. Methods: 28 cases with acute attack of rheumatoid arthritis were treated by fire needles on the Ashi points around joints and Huatuo Jiaji points. Some indices were compared before and after treatment including the morning stiffness,the ESR and the CRP. Results:The total curative rate was 85.71% . There were some obvious improvements in these indices. Conclusion: The effect of fire needle was a reliable effect on acute attack of rheumatoid arthritis.

  13. Polyarticular septic arthritis following septic circumcision.

    Science.gov (United States)

    Millar, Tim M; McGrath, Patrick; McConnachie, Charles C

    2007-01-01

    Ritual circumcision during an initiation ceremony for young adults is common practice in parts of South Africa. We report on a case of polyarticular septic arthritis in a seventeen-year-old man following septicaemia after circumcision, resulting in severe fixed flexion deformities of both knees. This case illustrates an unusual cause of polyarticular septic arthritis and the treatment difficulties associated with delayed presentation. It is also a reminder of the consequences of untreated acute septic arthritis.

  14. The potential use of microcalorimetry in rapid differentiation between septic arthritis and other causes of arthritis.

    Science.gov (United States)

    Yusuf, E; Hügle, T; Daikeler, T; Voide, C; Borens, O; Trampuz, A

    2015-03-01

    Current diagnostic methods in differentiating septic from non-septic arthritis are time-consuming (culture) or have limited sensitivity (Gram stain). Microcalorimetry is a novel method that can rapidly detect microorganisms by their heat production. We investigated the accuracy and time to detection of septic arthritis by using microcalorimetry. Patients older than 18 years of age with acute arthritis of native joints were prospectively included. Synovial fluid was aspirated and investigated by Gram stain, culture and microcalorimetry. The diagnosis of septic arthritis and non-septic arthritis were made by experienced rheumatologists or orthopaedic surgeons. Septic arthritis was diagnosed by considering the finding of acute arthritis together with findings such as positive Gram stain or positive culture of synovial fluid or positive blood culture. The sensitivity and specificity for diagnosing septic arthritis and the time to positivity of microcalorimetry were determined. Of 90 patients (mean age 64 years), nine had septic arthritis, of whom four (44 %) had positive Gram stain, six (67 %) positive synovial fluid culture and four (44 %) had positive blood culture. The sensitivity of microcalorimetry was 89 %, the specificity was 99 % and the mean detection time was 5.0 h (range, 2.2-8.0 h). Microcalorimetry is an accurate and rapid method for the diagnosis of septic arthritis. It has potential to be used in clinical practice in diagnosing septic arthritis.

  15. Observation of Curative Efficacy of Traditional Chinese Medicine Comprehensive Treatment on Acute Attack of Rheumatoid Arthritis%中医综合治疗类风湿关节炎急性发作疗效观察

    Institute of Scientific and Technical Information of China (English)

    牛彦红; 李荣唐

    2014-01-01

    Objective:To study the curative efficacy of Traditional Chinese Medicine on acute attack of rheumatoid arthritis. Methods:126 cases of acute attack of rheumatoid arthritis were divided into treatment group and control group. Patients in control group were given immunosuppressants and symptomatic treatment. Patients in treatment group received syndrome differentiation according to their tongue and pulse and were given comprehensive treatment of TCM. Results:The curative efficacy of treatment group was significantly better than that of the control group. Conclusion:Comprehensive treatment of TCM can increase the curative efficacy of rheumatoid arthritis.%目的:了解类风湿关节炎急性发作期中医治疗的疗效。方法:将126例类风湿关节炎急性发作期患者分为治疗组和对照组:对照组给予:①免疫抑制剂;②对症治疗。治疗组依据舌脉症象辨证分型,给予中医综合治疗。结果:治疗组疗效明显优于对照组。结论:中医综合法疗可提高类风湿关节炎的疗效。

  16. Pseudoseptic pseudogout in progressive pseudorheumatoid arthritis of childhood.

    OpenAIRE

    Bradley, J D

    1987-01-01

    Progressive pseudorheumatoid arthritis of childhood is an uncommon arthropathy of unknown aetiology, which is related to spondyloepiphyseal dysplasia tarda. Previous reports have noted the absence of joint inflammation in this disease. An adult is described here with this arthropathy, who developed episodic acute inflammatory arthritis that mimicked septic arthritis, but proved to be pseudogout. The relation between pseudogout and progressive pseudorheumatoid arthritis of childhood is discussed.

  17. Sea urchin spine arthritis in the foot.

    Science.gov (United States)

    Schefflein, Javin; Umans, Hilary; Ellenbogen, David; Abadi, Maria

    2012-09-01

    We present a case of sea urchin spine arthritis (SUSA) in a 33-year-old woman who sustained penetrating trauma to the interphalangeal (IP) joint of the hallux while snorkeling in Japan. Serial radiographs and MRI were obtained over a period from 7 weeks to 10 months following injury. At 7 weeks radiographs revealed periarticular osteopenia and subtle marginal erosion, similar to the appearance of tuberculous arthritis. Over the ensuing months, radiographs and MRI documented progressive marginal and periarticular erosions with synovitis, despite preservation of cartilage space and restoration of bone mineral density. Delayed radiographs and imaging features mimic gouty arthropathy. Only the history points to the proper diagnosis, which was confirmed by histopathology, demonstrating necrobiotic granuloma with central fibrinoid necrosis following synovectomy and arthrodesis. The majority of previous case reports affected the hand, with few cases in the feet. In all, radiographic illustrations were limited and demonstrated only minimal osteolysis and periosteal reaction. No other report included MRI or serial radiographs over a long period to illustrate the natural progression of the disease.

  18. Effect of allopurinol combined with Tongfengding capsule on inflammatory factors, hepatorenal functions and related indicators in gouty patients

    Institute of Scientific and Technical Information of China (English)

    Li Tang

    2016-01-01

    Objective:To observe the effects of allopurinol combined with Tongfengding capsule on inflammatory factors, hepatorenal functions and the related indicators in gouty patients, for helping clinical treatment of gouty patients.Methods:A total of 180 gouty patients in our hospital were selected and randomly divided into observation group and control group, 90 cases in each group. Control group was treated with conventional therapy and allopurinol therapy, observation group was treated with allopurinol combined with Tongfengding capsule based on conventional therapy, the changes of inflammatory factors, hepatorenal functions and the related indicators were detected before and after treatment.Results:The difference of inflammatory factors, hepatorenal functions and the related indicators in the two groups before treatment was not statistically significant (P>0.05). Inflammatory factors (IL-6, IL-8, TNF-α and CRP), hepatorenal functions (ALT, AST, BUN and Cr) and gout related indicators (ESR, UA, 24 h urine protein and XOD) in observation group after treatment significantly decreased compared with that before treatment. Inflammatory factors, hepatorenal functions and gout related indicators in control group after treatment significantly decreased (P<0.05). Inflammatory factors, hepatorenal functions and gout related indicators in observation group after treatment decreased more significantly than that in control group (P<0.05).Conclusions:Allopurinol combined with Tongfengding capsule could improve inflammatory factors, hepatorenal functions and the related indicators in gouty patients, and help clinical treatment of gouty patients.

  19. Arthritis and the Feet

    Science.gov (United States)

    ... RSS Home » Learn About Feet » Foot Health Information Arthritis What is Arthritis? Arthritis, in general terms, is inflammation and swelling of ... an increase in the fluid in the joints. Arthritis has multiple causes; just as a sore throat ...

  20. Imaging of the temporomandibular joint in juvenile idiopathic arthritis.

    Science.gov (United States)

    Vaid, Yoginder N; Dunnavant, F Daniel; Royal, Stuart A; Beukelman, Timothy; Stoll, Matthew L; Cron, Randy Q

    2014-01-01

    Temporomandibular joint (TMJ) arthritis in children with juvenile idiopathic arthritis (JIA) is extremely common but frequently asymptomatic. Magnetic resonance imaging (MRI) with contrast remains the gold standard for identifying TMJ arthritis in JIA. A reliable scoring system with published MRI examples of typical acute and chronic TMJ arthritis changes will be invaluable for future prospective treatment trials of TMJ arthritis in JIA. MRIs were collected from routine clinical studies assessing TMJ arthritis in JIA. Representative images were selected for publication to depict acute (synovial fluid, bone marrow edema, and synovial enhancement) and chronic (pannus, disc derangement, and condylar head flattening and erosions) TMJ arthritis findings. A preliminary MRI-based scoring system for assessing degrees of acute and chronic TMJ arthritis was developed and tested for inter- and intrareader reliability. TMJ MRIs representative of acute and chronic TMJ arthritis in JIA were selected from among thousands taken (>500 TMJ MRI studies annually at Children's of Alabama) since September 2007. Moreover, computed tomography scans depicting select bony changes (osteophyte formation, micrognathia) were chosen for publication. A description of the MRI protocol for assessing TMJ arthritis is included. A preliminary scoring system weighted for degree of acute and chronic TMJ arthritis MRI findings was found to have substantial inter- and intrareader reliability. A published set of MRIs depicting representative acute and chronic changes will help establish a standardized scoring system to assess TMJ arthritis in children with JIA. Future validation will aid in assessing improvement during treatment trials of TMJ arthritis. Copyright © 2014 by the American College of Rheumatology.

  1. Juvenile Arthritis

    Science.gov (United States)

    ... increased risk of developing an inflammatory eye problem (iritis or uveitis). Eye inflammation may persist independently of the arthritis. Because iritis usually does not cause symptoms, regular exams by ...

  2. Rheumatoid arthritis

    African Journals Online (AJOL)

    Mahmood Ally

    ... therapy in RA. Keywords: immune, inflammatory, rheumatoid arthritis, therapy ... are more sensitive and care needs to be taken to exclude viral infections, conditions .... RF is an antibody to immunoglobulin G, seen in 80–90% of patients with ...

  3. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... is Happening to the Joints? Rheumatoid Arthritis: Gaining Control – Working with your Rheumatologist Rheumatoid Arthritis: Additional Conditions ... Arthritis Nutrition & Rheumatoid Arthritis Arthritis and Health-related Quality of Life Rehabilitation Management for Rheumatoid Arthritis Patients ...

  4. Rheumatoid Arthritis Educational Video Series

    Science.gov (United States)

    ... Corner / Patient Webcasts / Rheumatoid Arthritis Educational Video Series Rheumatoid Arthritis Educational Video Series This series of five videos ... Your Arthritis Managing Chronic Pain and Depression in Arthritis Nutrition & Rheumatoid Arthritis Arthritis and Health-related Quality of Life ...

  5. Posttraumatic Arthritis

    OpenAIRE

    Pickering, Robert D.

    1984-01-01

    Posttraumatic arthritis (i.e., degenerative joint disease secondary to injury) is a particular problem in young, active patients. It limits the activities of these vigorous individuals, and the compromised joint must be endured for a long time. The knee is used as an example of a joint commonly involved in this process. Conditions predisposing patients to posttraumatic arthritis are discussed, as are some treatment modalities, including rest, ice therapy, anti-inflammatory medications, physio...

  6. Septic arthritis of the temporomandibular joint as a complication of acute otitis media in a child: A rare case and the importance of real-time PCR for diagnosis.

    Science.gov (United States)

    Bast, F; Collier, S; Chadha, P; Collier, J

    2015-11-01

    We document the case of a 7-year-old boy who presented with pain in his left ear and trismus after a diagnosis of acute otitis media one week previously. His blood inflammatory markers were raised and magnetic resonance imaging (MRI) showed significant left temporomandibular joint effusion and partial attenuation of the left mastoid. A clinical diagnosis of septic arthritis of the TMJ was made and the patient was commenced on broad-spectrum antibiotics. Analysis using real time PCR enabled identification of the offending organism, confirmation of the diagnosis and antibiotic treatment to be specifically tailored for treatment.

  7. Gout Initially Mimicking Rheumatoid Arthritis and Later Cervical Spine Involvement

    Directory of Open Access Journals (Sweden)

    Eduardo Araújo Santana Nunes

    2014-01-01

    Full Text Available Gout is clinically characterized by episodes of monoarthritis, but if not treated properly, it can lead to a chronic polyarthritis, which may eventually mimic rheumatoid arthritis (RA. We present the case of a 59-year-old man, with a history of symmetrical polyarthritis of the large and small joints with later development of subcutaneous nodules, which was initially misdiagnosed as RA, being treated with prednisone and methotrexate for a long period of time. He complained of occipital pain and paresthesia in his left upper limb, and computed tomography (CT and magnetic resonance imaging (MRI revealed the presence of an expansive formation in the cervical spine with compression of the medulla. He was admitted for spinal decompressive surgery and the biopsy specimen demonstrated a gouty tophus. Chronic gout can mimic RA and rarely involves the axial skeleton, and thus its correct diagnosis and the implementation of adequate therapy can halt the development of such damaging complications.

  8. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Arthritis Information Disease Information Rheumatoid Arthritis Psoriatic Arthritis Ankylosing Spondylitis Osteoarthritis Gout Lyme Disease Osteoporosis News Rheumatoid Arthritis ...

  9. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Arthritis Nutrition & Rheumatoid Arthritis Arthritis and Health-related Quality of Life Rehabilitation Management for Rheumatoid Arthritis Patients Rehabilitation of Older Adult ...

  10. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Arthritis Managing Chronic Pain and Depression in Arthritis Nutrition & Rheumatoid Arthritis Arthritis and Health-related Quality of Life Rehabilitation Management for Rheumatoid ...

  11. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available Appointments • Support Our Research Arthritis Information Disease Information Rheumatoid Arthritis Psoriatic Arthritis Ankylosing Spondylitis Osteoarthritis Gout Lyme Disease Osteoporosis News Rheumatoid Arthritis News ...

  12. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Arthritis Nutrition & Rheumatoid Arthritis Arthritis and Health-related Quality of Life Rehabilitation Management for Rheumatoid Arthritis Patients Rehabilitation of Older Adult ...

  13. Rapidly progressing polyarticular septic arthritis in a patient with rheumatoid arthritis.

    Science.gov (United States)

    Dhaliwal, Sandeep; LeBel, Marie-Eve

    2012-07-01

    Septic arthritis is an orthopedic emergency that can lead to significant morbidity and mortality. Polyarticular involvement is a relatively rare phenomenon occurring primarily in high-risk patients. In this article, we report the rare case of a patient with rheumatoid arthritis presenting with an acute episode of septic arthritis involving most of the joints of the body. Surprisingly, his bilateral total hip arthroplasties were completely unaffected. Unusual polyarticular presentations of septic arthritis, though rare, must still be considered within the differential diagnosis by all healthcare providers when treating certain high-risk groups.

  14. Merlin's 'invalid or gouty chair' and the origin of the self-propelled wheelchair.

    Science.gov (United States)

    Weiner, Marie-France; Silver, John R

    2016-08-01

    Wheelchairs are a major advance in enabling independence for people with walking difficulties. The first self-propelled wheelchair has been attributed to John Joseph Merlin, the 'ingenious mechanick', in the early 19th century and his 'gouty chair' is exhibited at Kenwood House. Research would suggest that comparable chairs existed in France as early as 1751 and the French Revolutionary, Georges Couthon, used one to get around Paris. A later design, also attributed to Merlin, the invalid wheelchair, features large wheels with outer hoops for the occupant to grasp and this is the true ancestor of the modern wheelchair. © The Author(s) 2016.

  15. Ozonated autohemotherapy modulates the serum levels of inflammatory cytokines in gouty patients

    Directory of Open Access Journals (Sweden)

    Li L

    2017-08-01

    Full Text Available Lian-Yun Li,1,2 Ruo-Lan Ma,3 Liqin Du,4 An-Shi Wu5 1Department of Anesthesiology, Dongfang Hospital of Beijing University of Chinese Medicine, 2Department of Pain, Beijing Electric Power Hospital, 3Department of Anesthesiology, Beijing Stomatological Hospital, Capital Medical University, Beijing, People’s Republic of China; 4Department of Chemistry & Biochemistry, Texas State University, San Marcos, TX, USA; 5Department of Anesthesiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People’s Republic of China Objectives: Ozonated autohemotherapy (O3-AHT has been used to effectively treat gout, but the underlying therapeutic mechanisms remain unknown. In this study, as an initial effort to understand the therapeutic mechanisms of O3-AHT, we aim to examine the effect of O3-AHT on serum inflammatory cytokine levels in gouty patients. Patients and methods: Three groups of patients and healthy subjects were recruited, including the gouty (n=10, hyperuricemia (n=10, and healthy control (n=11 groups. Cytometric bead array was applied to examine 12 cytokines before (T0, during (T1, and after (T2 therapies. Results: Three cytokines, IL-8, IL-12, and MCP-1, were detectable in all participants. Before O3-AHT, the average serum levels of IL-8 and MCP-1 were higher in the gout group than in the hyperuricemia and healthy control groups, confirming the inflammation status in gouty patients. After the 5th course of O3-AHT (T1, IL-8 level was significantly increased compared to that at T0. IL-12 level was also raised at T1, although the difference did not reach statistical significance. After completing the therapy, both IL-8 and IL-12 levels decreased to levels lower than those at T0. MCP-1 level remained essentially unchanged during and after treatment. Conclusion: Our results indicate that O3-AHT induces a significant change in serum cytokine levels, suggesting that modulating the inflammatory process is one of the therapeutic

  16. Cutaneous manifestations of rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Bhanu Prakash

    2015-02-01

    Full Text Available Rheumatoid arthritis (RA is a multisystem autoimmune disease, affecting the joints predominantly, and extra-articular sites like skin, lungs, heart etc. The American College of Rheumatology (ACR in collaboration with the European League Against Rheumatism (EULAR in 2010, revised the 1987 ACR classification criteria for RA. The criteria covered four areas (joint involvement, serodiagnosis, acute phase reactants, duration of arthritis and established a point value on a scale of 0 to 10. Patients with a value of 6 or higher are classified as having RA.

  17. Parvovirus infection in early arthritis.

    Science.gov (United States)

    Mauermann, Maria; Hochauf-Stange, Kristina; Kleymann, Alexander; Conrad, Karsten; Aringer, Martin

    2016-01-01

    To analyse the subgroup of early arthritis patients with new onset parvovirus infections for details that may help narrow the population tested. From their routine patient charts, patient histories and clinical and serological data were obtained for all 130 patients of the Rheumatology division with parvovirus serology performed. 11 patients had acute parvovirus infections, defined by specific IgM antibodies. 95 patients had a previous infection, 16 were never infected, together forming the n=111 control group, and 8 patients had to be excluded. Most patients with acute parvovirus infection had an acute onset, highly symmetrical polyarthritis of small joints, which was preceded by prodromal symptoms. Positive ANA were frequently found, whereas C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were only mildly elevated. No frank synovitis was found longer than two weeks after disease onset. Most patients were free of symptoms within three months, and no patient in the parvovirus group developed rheumatoid arthritis or a connective tissue disease. Parvovirus serology may be helpful in patients with acute polyarthritis of very recent onset, and if they give a history of prodromal symptoms, in particular. In most instances, parvovirus arthritis is an acute disease, which is rapidly self-limiting.

  18. Expression of PADI4 during rheumatoid arthritis development

    Directory of Open Access Journals (Sweden)

    Cuirong Bian

    2009-07-01

    Full Text Available Peptidyl deiminase 4 (PADI4 catalyzes peptidylarginine to citrulline. The gene encoding PADI4 is associated with rheumatoid arthritis (RA in some populations. The levels of PADI4, anti-CCP, and RF were measured in the blood of patients suffering from RA and osteoarthritis (OA for less than six months using ELISA. The levels were also measured in the blood of patients that have been diagnosed with RA for more than three years. As controls, samples from healthy subjects or patients with ankylosing spondylitis (AS, epidemic pleurodynia (EP, OA, psoriatic arthritis (PA, systemic lupus erythematosus (SLE, gouty arthritis (GA, or Still’s disease (ST were also assayed. Of patients with early RA, 68.7% had significantly higher levels of PADI4 than patients with early OA. Patients with RA for a longer period of time had a higher expression of PADI4 than patients with SLE, ST, and GA, but they were similar to healthy subjects or patients with AS, EP, OA, or PA. The level of PADI4 was significantly correlated to the levels of RF and anti-CCP in blood samples of RA, but not in the samples of other diseases and those of healthy subjects. The level of PADI4 relates to the disease activity and clinical performance.

  19. Acute serum amyloid A induces migration, angiogenesis, and inflammation in synovial cells in vitro and in a human rheumatoid arthritis/SCID mouse chimera model.

    LENUS (Irish Health Repository)

    Connolly, Mary

    2010-06-01

    Serum amyloid A (A-SAA), an acute-phase protein with cytokine-like properties, is expressed at sites of inflammation. This study investigated the effects of A-SAA on chemokine-regulated migration and angiogenesis using rheumatoid arthritis (RA) cells and whole-tissue explants in vitro, ex vivo, and in vivo. A-SAA levels were measured by real-time PCR and ELISA. IL-8 and MCP-1 expression was examined in RA synovial fibroblasts, human microvascular endothelial cells, and RA synovial explants by ELISA. Neutrophil transendothelial cell migration, cell adhesion, invasion, and migration were examined using transwell leukocyte\\/monocyte migration assays, invasion assays, and adhesion assays with or without anti-MCP-1\\/anti-IL-8. NF-kappaB was examined using a specific inhibitor and Western blotting. An RA synovial\\/SCID mouse chimera model was used to examine the effects of A-SAA on cell migration, proliferation, and angiogenesis in vivo. High expression of A-SAA was demonstrated in RA patients (p < 0.05). A-SAA induced chemokine expression in a time- and dose-dependent manner (p < 0.05). Blockade with anti-scavenger receptor class B member 1 and lipoxin A4 (A-SAA receptors) significantly reduced chemokine expression in RA synovial tissue explants (p < 0.05). A-SAA induced cell invasion, neutrophil-transendothelial cell migration, monocyte migration, and adhesion (all p < 0.05), effects that were blocked by anti-IL-8 or anti-MCP-1. A-SAA-induced chemokine expression was mediated through NF-kappaB in RA explants (p < 0.05). Finally, in the RA synovial\\/SCID mouse chimera model, we demonstrated for the first time in vivo that A-SAA directly induces monocyte migration from the murine circulation into RA synovial grafts, synovial cell proliferation, and angiogenesis (p < 0.05). A-SAA promotes cell migrational mechanisms and angiogenesis critical to RA pathogenesis.

  20. Clinical Analysis for the Acupuncture Treatment in 42 Cases of Gouty Renal Damage

    Institute of Scientific and Technical Information of China (English)

    马小平

    2004-01-01

    Objective:To observe the therapeutic efiects of acupuncture on gouty renal damage.Method:72 cases of gouty renal damage were randomiy divided into a treatment group of 42 cases and a control group of 30cases to observe the therapeutic efiects and the changes in 24-hour urinary protein content,blood creatinine,uric acid and urea nitrogen in blood beforetreatment and one month after treatment.Results:The total effective rate in the treatment group reached 95.24%,which was remarkably higher than 63.33%in the control group.Atier one month of treatment,the indexes were found reduced in both groups,but the reduction rate in the treatment group was obviously superior to that in the control group.Conclusion:The patients with repeated attacks of gout may have a higher possibility to sufierfrom renal damage.Therefore,attention should be paid to its early diagnosis and treatment.Acupuncture may exert good theraputic efiects on early gout comp1icated with renal damage by adjusting the metabolism and improving the reaal function.

  1. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Arthritis Managing Chronic Pain and Depression in Arthritis Nutrition & Rheumatoid Arthritis Arthritis and Health-related Quality of ... on this website. Copyright Johns Hopkins Arthritis Center © 2017 Patient Privacy Johns Hopkins Rheumatology

  2. Juanbilijieqing Fang(蠲痹历节清方)interfere with acute gouty arthritis chiken model%蠲痹历节清方干预鸡急性痛风性关节炎模型的实验研究

    Institute of Scientific and Technical Information of China (English)

    齐新宇; 熊辉; 周彪; 向黎黎; 李腾龙; 郭玉星; 陆小龙

    2015-01-01

    目的:观察蠲痹历节清方干预鸡急性痛风性关节炎模型的疗效,并探讨其可能的作用机制。方法:将160只30日龄雄性湘黄鸡随机分为对照组、模型组、蠲痹历节清方组及别嘌醇组,每组40只。对照组以正常饲料喂养;其余3组以蛋白含量为50%的饲料喂养,连续喂养21 d制成急性痛风性关节炎模型。自造模结束后第1天开始,蠲痹历节清方组及别嘌醇组分别以蠲痹历节清方汤剂和别嘌醇溶液灌胃,其余2组均以生理盐水灌胃,每日2次,共21 d。分别于药物干预开始后1、7、14、21 d在每组随机选出10只鸡,分别观察其一般状态、踝关节周径、血尿酸含量和血清黄嘌呤氧化酶(xanthine oxidase,XOD)活性,随后处死动物,分离出左侧踝关节滑膜组织,光镜下观察其滑膜组织形态。结果:①一般状态。除对照组外,其余3组动物药物干预开始时精神萎顿,羽毛松乱、灰暗无光泽,饮食减退,双膝与双踝关节肿大,跛行,站立不稳,粪便中白色物质增多。至药物干预后21 d时,蠲痹历节清方组和别嘌醇组动物一般状态基本恢复正常;模型组动物一般状态较开始时好转,但表现较蠲痹历节清方组和别嘌醇组差;对照组动物除体质量增加外,其余表现与造模前一致。造模及实验过程中各组均无动物死亡。②踝关节周径。药物干预开始后各时点,4组动物踝关节周径比较,组间差异均有统计学意义(F=25.172,P=0.000;F=24.445,P=0.000;F=21.237,P=0.014;F=29.881,P=0.041)。药物干预开始后1、7、14 d时,模型组、蠲痹历节清方组及别嘌醇组踝关节周径均大于对照组(P=0.001,P=0.001,P=0.001;P=0.002,P=0.002,P=0.001;P=0.001,P=0.002,P=0.001);药物干预开始后7、14 d时,蠲痹历节清方组和别嘌醇组踝关节周径均小于模型组(P=0.025,P=0.014;P=0.012,P=0.011);药物干预开始后21 d时,对照组、蠲痹历节清方组及别嘌醇组踝关节周径均小于模型组(P=0.001,P=0.015,P=0.013);其余各时点各组间两两比较,组间差异均无统计学意义。③血尿酸含量。药物干预开始后各时点,4组动物血尿酸含量比较,组间差异均有统计学意义(F=25.361,P=0.003;F=32.371,P=0.005;F=36.734,P=0.021;F=48.336,P=0.023)。药物干预开始后1、7、14 d时,模型组、蠲痹历节清方组及别嘌醇组血尿酸含量均大于对照组(P=0.000,P=0.001,P=0.001;P=0.001,P=0.001,P=0.002;P=0.001,P=0.000, P=0.001);药物干预开始后7、14 d时,蠲痹历节清方组和别嘌醇组血尿酸含量均小于模型组(P=0.011,P=0.010;P=0.014, P=0.002);药物干预开始后21 d时,对照组、蠲痹历节清方组及别嘌醇组血尿酸含量均小于模型组(P=0.001,P=0.012,P=0.011);其余各时点各组间两两比较,组间差异均无统计学意义。④血清XOD活性。药物干预开始后各时点,4组动物血清XOD活性比较,组间差异均有统计学意义(F=45.721,P=0.001;F=50.634,P=0.002;F=49.448,P=0.013;F=63.124,P=0.027)。药物干预开始后1、7、14 d时,模型组、蠲痹历节清方组及别嘌醇组血清XOD活性均高于对照组(P=0.002,P=0.001,P=0.001;P=0.001,P=0.000,P=0.001;P=0.001,P=0.001,P=0.000);药物干预开始后7、14 d时,蠲痹历节清方组和别嘌醇组血清XOD活性均低于模型组(P=0.001,P=0.013;P=0.002,P=0.015);药物干预开始后21 d时,对照组、蠲痹历节清方组及别嘌醇组血清XOD活性均低于模型组(P=0.001,P=0.013,P=0.017);其余各时点各组间两两比较,

  3. Arthritis in America

    Science.gov (United States)

    ... Digital Press Kit Read the MMWR Science Clips Arthritis in America Time to Take Action! Language: English ( ... by about 40% by being physically active. Problem Arthritis is common and a growing health threat. Arthritis ...

  4. Arthritis: Frequently Asked Questions

    Science.gov (United States)

    ... Recommend on Facebook Tweet Share Compartir What is Arthritis? The word arthritis actually means joint inflammation, but ... provided for you. Who is at risk for arthritis? Certain factors are associated with a greater risk ...

  5. Juvenil idiopatisk arthritis

    DEFF Research Database (Denmark)

    Herlin, Troels

    2002-01-01

    The new classification of juvenile idiopathic arthritis (JIA) is described in this review. Clinical characteristics divide JIA in to subtypes: systemic, oligoarticular (persistent and extended type), RF-positive and--negative polyarticular, enthesitis-related arthritis and psoriatic arthritis...

  6. Arthritis of the Hand

    Science.gov (United States)

    .org Arthritis of the Hand Page ( 1 ) The hand and wrist have multiple small joints that work together to ... a shoelace. When the joints are affected by arthritis, activities of daily living can be difficult. Arthritis ...

  7. CD1d-dependent NKT cells play a protective role in acute and chronic arthritis models by ameliorating antigen-specific Th1 responses

    DEFF Research Database (Denmark)

    Teige, Anna; Bockermann, Robert; Hasan, Maruf

    2010-01-01

    A protective and anti-inflammatory role for CD1d-dependent NKT cells (NKTs) has been reported in experimental and human autoimmune diseases. However, their role in arthritis has been unclear, with conflicting reports of CD1d-dependent NKTs acting both as regulatory and disease-promoting cells...

  8. Case Report: Juvenile Tophaceous Gout

    Directory of Open Access Journals (Sweden)

    Seyma Gunes

    2016-01-01

    Full Text Available Gout is a metabolic disease that manifests as recurrent arthritis. Its incidance increases with age. Clinical findings include recurrent acute arthritis, tophus at joints and tissues, uricacid stones and gouty nephropathy. Tophi is a late period complication of arthritis. In this casereport we presented  a patient with early-onset juvenile tophaceous gout.

  9. Rheumatoid arthritis.

    Science.gov (United States)

    Smolen, Josef S; Aletaha, Daniel; McInnes, Iain B

    2016-10-22

    Rheumatoid arthritis is a chronic inflammatory joint disease, which can cause cartilage and bone damage as well as disability. Early diagnosis is key to optimal therapeutic success, particularly in patients with well-characterised risk factors for poor outcomes such as high disease activity, presence of autoantibodies, and early joint damage. Treatment algorithms involve measuring disease activity with composite indices, applying a treatment-to-target strategy, and use of conventional, biological, and newz non-biological disease-modifying antirheumatic drugs. After the treatment target of stringent remission (or at least low disease activity) is maintained, dose reduction should be attempted. Although the prospects for most patients are now favourable, many still do not respond to current therapies. Accordingly, new therapies are urgently required. In this Seminar, we describe current insights into genetics and aetiology, pathophysiology, epidemiology, assessment, therapeutic agents, and treatment strategies together with unmet needs of patients with rheumatoid arthritis.

  10. IL-17/Th17 targeting: On the road to prevent chronic destructive arthritis?

    NARCIS (Netherlands)

    E.W. Lubberts (Erik)

    2008-01-01

    textabstractInterleukin-17A (IL-17A) contributes to the pathogenesis of arthritis. Data from experimental arthritis indicate IL-17 receptor signaling as a critical pathway in turning an acute synovitis into a chronic destructive arthritis. The identification of six IL-17 family members (IL-17A-F) ma

  11. Preliminary identification of children with acute lymphoblastic leukemia and juvenile idiopathic arthritis%儿童急性淋巴细胞白血病和幼年特发性关节炎的初步鉴别

    Institute of Scientific and Technical Information of China (English)

    李琛(综述); 曹兰芳; 薛海燕(审校)

    2014-01-01

    部分急性淋巴细胞白血病患儿以骨骼肌肉表现为首发症状,这些患儿中有一部分会被误诊为幼年特发性关节炎,如何早期区分这些患儿对于及时治疗、改善预后很有意义。该文根据病史及常规的实验室检查和影像学检查,提出在疾病早期如何通过分析有关节症状患儿关节肿痛、血象及影像学特点初步鉴别儿童急性淋巴细胞白血病和幼年特发性关节炎,降低误诊率。%With acute lymphoblastic leukemia in skeletal muscle symptom,part of these patients may be misdiagnosed as juvenile idiopathic arthritis. How to distinguish these children has significance for the timely and proper treatment and good prognosis. This article from the history and routine laboratory examination and ima-ging examination put forward early in the disease through the analysis of joint symptoms from juvenile joint pain,blood and imaging characteristics and preliminary identification of childhood leukemia from juvenile idio-pathic arthritis in order to decrease the rate of misdiagnosis.

  12. Septic arthritis in patients with rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Al-Ahaideb Abdulaziz

    2008-07-01

    Full Text Available Abstract There is an increasing number of rheumatoid patients who get septic arthritis. Chronic use of steroids is one of the important predisposing factors. The clinical picture of septic arthritis is different in immunocompromised patients like patients with rheumatoid arthritis. The diagnosis and management are discussed in this review article.

  13. Septic arthritis in patients with rheumatoid arthritis

    OpenAIRE

    Al-Ahaideb Abdulaziz

    2008-01-01

    Abstract There is an increasing number of rheumatoid patients who get septic arthritis. Chronic use of steroids is one of the important predisposing factors. The clinical picture of septic arthritis is different in immunocompromised patients like patients with rheumatoid arthritis. The diagnosis and management are discussed in this review article.

  14. 血必净注射液治疗急性痛风性关节炎的临床观察%Clinical observation of Xuebijing injection in treating acute gout arthritis

    Institute of Scientific and Technical Information of China (English)

    佟强

    2013-01-01

    [目的]观察血必净注射液治疗急性痛风性关节炎的临床疗效.[方法]将60例急性痛风性关节炎患者随机分为对照组与治疗组,每组各30例,均予常规西医治疗,治疗组加用血必净注射液,治疗两周观察疗效,比较两组临床总有效率、C反应蛋白(CRP)及血尿酸(SUA)水平的变化.[结果]治疗组临床总有效率为93%,对照组为73%,治疗组与对照组相比有统计学差异(P<0.05).[结论]血必净注射液治疗急性痛风性关节炎疗效满意.%[Objective] Observe the clinical curative effect of Xuebijing injection in treating acute gout arthritis.[Methods] Sixty patients were divided into two groups.All patients were given Western medicine treatment,while in treatment group Xuebijing injection was supplemented.They were all observed for two weeks.The changes of total effective rate,CRP and SUA were compared.[Results] The total effective rate was 93% and 73% in treatment group and control group respectively with statistical difference between them (P<0.05).[Conclusion] The therapeutic effect of Xuebijing injection is satisfactory in treating acute gout arthritis.

  15. New real-time PCR-based method for Kingella kingae DNA detection: application to samples collected from 89 children with acute arthritis.

    Science.gov (United States)

    Ilharreborde, Brice; Bidet, Philippe; Lorrot, Mathie; Even, Julien; Mariani-Kurkdjian, Patricia; Liguori, Sandrine; Vitoux, Christine; Lefevre, Yann; Doit, Catherine; Fitoussi, Franck; Penneçot, Georges; Bingen, Edouard; Mazda, Keyvan; Bonacorsi, Stéphane

    2009-06-01

    Inoculation of blood culture vials with joint fluid samples has revealed the important pathogenic role of Kingella kingae in pediatric arthritis. However, recent studies based on broad-range 16S ribosomal DNA PCR and real-time PCR without a probe suggest that conventional methods remain suboptimal. We developed a new real-time PCR method with a probe that is highly specific for K. kingae and applied it to joint fluid samples collected from 89 children with suspected arthritis admitted to our institution during a 2-year period. Real-time PCR was also applied to blood samples obtained before surgery and to joint drainage fluid samples obtained during several days after surgery. Thirty-six (40%) of the 89 cases of suspected septic arthritis had positive culture. Staphylococcus aureus was the main isolate (n = 19/36, 53%), followed by K. kingae (n = 7/36, 19%). Specific real-time PCR identified K. kingae in 24 of the 53 culture-negative cases. Thus, K. kingae was present in 31 (52%) of the 60 documented cases, making it the leading pathogen. Real-time PCR on all 15 blood DNA extracts from patients with K. kingae infection was negative, demonstrating that joint fluid positivity did not result from DNA circulating in blood. Real-time PCR amplification of drainage fluid samples showed that the pathogen could be detected for up to 6 days after antibiotic initiation. K. kingae real-time PCR applied to DNA extracted from joint fluid samples, but not from blood samples, markedly improved the etiological diagnosis of septic arthritis in children. Retrospective diagnosis is feasible for up to 6 days after treatment initiation.

  16. MicroPure imaging for the evaluation of microcalcifications in gouty arthritis involving the first metatarsophalangeal joint: a preliminary study.

    Directory of Open Access Journals (Sweden)

    Lu Yin

    Full Text Available OBJECTIVE: To assess the value of MicroPure, a new ultrasound image processing technique, in identifying microcalcifications (formed by monosodium urate crystals in the first metatarsophalangeal joints attacked by gout compared to gray-scale ultrasound images. MATERIALS AND METHODS: Thirty-six patients who fulfilled the study inclusion criteria underwent gray-scale ultrasound and MicroPure examinations of the first metatarsophalangeal joints attacked by gout. Static images of the target areas were acquired using gray-scale ultrasound and MicroPure. Two independent and blinded investigators analyzed the images to determine the number of microcalcifications and to score for image quality and artifacts. RESULTS: The two investigators observed significantly more microcalcifications with MicroPure compared to gray-scale ultrasound (ρ<0.001. The level of agreement between the investigators consistently increased from gray-scale ultrasound to MicroPure imaging (gray-scale interclass correlation coefficient of 0.69 vs. MicroPure interclass correlation coefficient of 0.81. One investigator preferred the MicroPure image quality over gray-scale ultrasound (ρ<0.001, but the other investigator disagreed (ρ<0.001. Both investigators observed fewer artifacts with MicroPure than with gray-scale ultrasound (ρ<0.009. CONCLUSION: MicroPure imaging identified significantly more microcalcifications than gray-scale ultrasound.

  17. Pain and microcrystalline arthritis

    Directory of Open Access Journals (Sweden)

    R. Ramonda

    2014-06-01

    Full Text Available Microcrystals are responsible for some of the most common and complex arthropathies which are often accompanied by intense, severe pain and inflammatory reactions. The main pathogens are crystals of monosodium urate (MSU, responsible for the gout, calcium pyrophosphate (CPP, which deposits also in various clinical forms of arthopathies, and basic calcium phosphate associated with osteoarthritis. In this context, the microcrystal arthritis is characterized by multiple, acute attacks followed by chronic pain, disability, impaired quality of life, and increased mortality. Given their chronic nature, they represent an ever more urgent public health problem. MSU and CPP crystals are also able to activate nociceptors. The pain in mycrocrystalline arthritis (MCA is an expression of the inflammatory process. In the course of these diseases there is an abundant release of inflammatory molecules, including prostaglandins 2 and kinins. Interleukin-1 represents the most important cytokine released during the crystal-induced inflammatory process. Therefore, clinically, pain is the most important component of MCA, which lead to functional impairment and disability in a large proportion of the population. It is fundamental to diagnose these diseases as early as possible, and to this aim, to identify appropriate and specific targets for a timely therapeutic intervention.

  18. Midcarpal and STT Arthritis in Patients With CMC Arthritis

    National Research Council Canada - National Science Library

    Katzel, Evan B; Shakir, Sameer; Fowler, John; Buterbaugh, Glenn A; Imbriglia, Joseph E

    2016-01-01

    .... The prevalence of midcarpal arthritis in patients with basal joint arthritis is unknown. The goal of this study is to establish the radiographic prevalence of midcarpal arthritis in patients with CMC arthritis and/or STT...

  19. [Rheumatoid arthritis].

    Science.gov (United States)

    Strunk, J; Lange, U; Müller-Ladner, U

    2005-07-29

    The development of novel anti-rheumatic drugs revolutionizes currently therapeutic strategies and diagnostic management of patients with rheumatoid arthritis, facilitating the goal of true remission instead of only symptomatic treatment as in former years. Since early treatment is known to be crucial for the longterm outcome, imaging modalities such as magnetic resonance imaging and high-frequency ultrasonography including Doppler sonography, which allow direct visualization of very early pathologic alterations of synovitis, or even initial destruction, become increasingly important. Besides the established therapy with methotrexate, new drugs such as leflunomide or the use of various combination therapies have been successfully introduced into the therapeutic armamentarium. Especially the introduction of cytokine-antagonists such as TNF-a inhibitors target the aim of remission. In addition, the upcoming therapeutic agents, which influence very effectively the inflammatory and destructive process need also to be integrated into the concert of different therapeutic strategies in the management of patients with rheumatoid arthritis, which includes the mandatory complementary factors such as physiotherapy, ergotherapy and orthopedic surgery.

  20. Four-week effects of allopurinol and febuxostat treatments on blood pressure and serum creatinine level in gouty men.

    Science.gov (United States)

    Kim, Hyun Ah; Seo, Young-Il; Song, Yeong W

    2014-08-01

    The aim of this study was to observe the effects of uric acid lowering therapy (UALT), febuxostat and allopurinol, on blood pressure (BP) and serum creatinine level. Post-hoc data were derived from a phase-III, randomised, double-blind, 4-week trial of male gouty patients that compared the safety and efficacy of febuxostat and allopurinol in adults with gout. The subjects were randomly assigned to one of five groups, 35-37 in each group (febuxostat: 40, 80, 120 mg/d; allopurinol: 300 mg/d; control group: placebo). Blood pressure and serum creatinine level were measured at baseline and at weeks 2 and 4. Diastolic BP and creatinine level had decreased significantly in the UALT groups compared to the control group at week 4. Diastolic BP had decreased significantly in the allopurinol group and serum creatinine level had decreased significantly in the febuxostat groups at week 4. After adjusting for confounding variables, serum uric acid changes were found to be significantly correlated with changes in serum creatinine level but were not associated with changes in systolic or diastolic BP. UALT in gouty subjects significantly decreased diastolic BP and serum creatinine level. Changes in uric acid were significantly correlated with those in serum creatinine level, suggesting the feasibility of renal function improvement through UALT in gouty men.

  1. Isolated polyarticular septic arthritis: an atypical presentation of meningococcal infection.

    Science.gov (United States)

    McCulloch, Michael; Brooks, Heather; Kalantarinia, Kambiz

    2008-04-01

    We are presenting a case of a 19-year-old college student with sudden-onset, asymmetric polyarticular arthritis with Neisseria meningitidis 10 days after an acute upper respiratory infection consisting of fevers, chills, pharyngitis, and productive cough. Primary meningococcal septic arthritis is a rare entity. A majority of these cases present in a monoarticular fashion. The synovial fluid findings, although compatible with inflammatory arthritis, are not typical of septic arthritis. This entity, although rare, should be considered in the differential diagnosis of septic arthritis of large joints, especially since N. meningitiditis does not grow well on routine culture media. A literature review on the diagnosis, treatment, and prevention of primary meningococcal septic arthritis is presented.

  2. Diagnosis and treatment of enthesitis-related arthritis

    Directory of Open Access Journals (Sweden)

    Weiss PF

    2012-06-01

    Full Text Available Pamela F WeissDivision of Rheumatology and Center for Pediatric Clinical Effectiveness, The Children's Hospital of Philadelphia, Departments of Pediatrics and Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, PA, USAAbstract: Juvenile idiopathic arthritis (JIA is a chronic, inflammatory disease of unknown etiology. The enthesitis-related arthritis (ERA JIA category describes a clinically heterogeneous group of children including some who have predominately enthesitis, enthesitis and arthritis, juvenile ankylosing spondylitis, or inflammatory bowel disease-associated arthropathy. ERA accounts for 10%–20% of JIA. Common clinical manifestations of ERA include arthritis, enthesitis, and acute anterior uveitis. Axial disease is also common in children with established ERA. Treatment regimens for ERA, many of them based on adults with rheumatoid arthritis and ankylosing spondylitis, include the use of nonsteroidal anti-inflammatory drugs, disease-modifying antirheumatic drugs, and biologic agents either individually or in combination.Keywords: juvenile arthritis, enthesitis, sacroillitis, epidemiology, therapy

  3. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Patient Webcasts / Rheumatoid Arthritis Educational Video Series Rheumatoid Arthritis Educational Video Series This series of five videos ... member of our patient care team. Managing Your Arthritis Managing Your Arthritis Managing Chronic Pain and Depression ...

  4. Rheumatoid Arthritis Educational Video Series

    Science.gov (United States)

    ... Patient Webcasts / Rheumatoid Arthritis Educational Video Series Rheumatoid Arthritis Educational Video Series This series of five videos ... member of our patient care team. Managing Your Arthritis Managing Your Arthritis Managing Chronic Pain and Depression ...

  5. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Arthritis Center since 2000, currently serving as the Nurse Manager. She is a critical member of our patient care team. Managing Your Arthritis Managing Your Arthritis Managing Chronic Pain and Depression in Arthritis Nutrition & Rheumatoid Arthritis Arthritis and Health-related Quality of ...

  6. Campylobacter jejuni enteritis and reactive arthritis

    OpenAIRE

    Short, C. D.; Klouda, P T; Smith, Lorna

    1982-01-01

    A further case of reactive arthritis following Campylobacter jejuni enteritis is reported. The interim results of a small prospective study are discussed. It may be desirable to do serological studies for campylobacter infection in the investigation of mono- or polyarthritis of acute onset.

  7. What Is Juvenile Arthritis?

    Science.gov (United States)

    ... Analgesics for Osteoarthritis (Report from AHRQ) Joint Replacement Surgery: Health Information Basics for You and Your Family NIH Pediatric Rheumatology Clinic Health Information Juvenile Arthritis Find a Clinical Trial Journal Articles Juvenile Arthritis PDF Version Size: 123 KB ...

  8. MP Joint Arthritis

    Science.gov (United States)

    ... Find a Hand Surgeon Home Anatomy MP Joint Arthritis Email to a friend * required fields From * To * ... important for both pinching and gripping. MP joint arthritis is most common in the thumb and index ...

  9. Juvenile idiopathic arthritis

    Science.gov (United States)

    Juvenile rheumatoid arthritis (JRA); Juvenile chronic polyarthritis; Still disease; Juvenile spondyloarthritis ... The cause of juvenile idiopathic arthritis (JIA) is not known. It ... illness . This means the body attacks and destroys healthy body ...

  10. Forms of Arthritis

    Science.gov (United States)

    ... this page please turn Javascript on. Forms of Arthritis Past Issues / Fall 2006 Table of Contents Today, ... of Linda Saisselin Osteoarthritis (OA) — the form of arthritis typically occurring during middle or old age, this ...

  11. Imaging in Psoriatic Arthritis

    DEFF Research Database (Denmark)

    Poggenborg, René Panduro; Østergaard, Mikkel; Terslev, Lene

    2015-01-01

    Psoriatic arthritis (PsA) is an inflammatory joint disease characterized by arthritis and often enthesitis in patients with psoriasis, presenting a wide range of manifestations in various patterns. Imaging procedures are primarily conventional radiography, ultrasonography (US), and magnetic...

  12. Rheumatoid arthritis (image)

    Science.gov (United States)

    Rheumatoid arthritis is an autoimmune disease in which the body's immune system attacks itself. The pattern of joints ... other joints and is worse in the morning. Rheumatoid arthritis is also a systemic disease, involving other body ...

  13. Sex and Arthritis

    Science.gov (United States)

    ... Call for Letters of Interest Call for Topics Axial Spondyloarthritis Glucocorticoid-Induced Osteoporosis Gout Juvenile Idiopathic Arthritis ... fibromyalgia , scleroderma , osteoarthritis , rheumatoid ... spondylitis , Raynaud’s phenomenon and juvenile arthritis also may experience: ...

  14. Elevation of proinflammatory cytokines in patients with Aicardi-Goutières syndrome

    Science.gov (United States)

    Takanohashi, Asako; Prust, Morgan; Wang, Jichuan; Gordish-Dressman, Heather; Bloom, Miriam; Rice, Gillian I.; Schmidt, Johanna L.; Crow, Yanick J.; Lebon, Pierre; Kuijpers, Taco W.; Nagaraju, Kanneboyina

    2013-01-01

    Objective: This study explores a large panel of cytokines in plasma and CSF of patients with Aicardi-Goutières syndrome (AGS) at different ages, in order to establish signatures of cytokines most predictive of AGS. Methods: Plasma from 22 subjects with known mutations were assayed for cytokines using the Milliplex MAP Immunobead system, and compared to results from 8 age-matched normal controls. CSF of 11 additional patients with mutation-proven AGS was tested in an identical manner and compared to results from age-matched controls. Samples were banked and analysis was carried out retrospectively. Results: Significant elevations were seen in FMS-related tyrosine kinase 3 ligand, IP-10, interleukin (IL)–12p40, IL-15, tumor necrosis factor α, and soluble IL 2 receptor α in both AGS patient plasma and CSF relative to controls. Additionally, this cytokine signature was able to correctly cluster 9 of 11 AGS cases based on CSF values. While most cytokines decreased exponentially with age, a subgroup including IP-10 demonstrated persistent elevation beyond early childhood. Conclusion: Patients with AGS exhibit plasma and CSF elevations of proinflammatory cytokines. Selected cytokines remain persistently elevated beyond the initial disease phase. This panel of proinflammatory cytokines may be considered for use as diagnostic and therapeutic markers of disease, and may permit improved understanding of disease pathogenesis. PMID:23408864

  15. Histopathology of Lyme arthritis in LSH hamsters

    Energy Technology Data Exchange (ETDEWEB)

    Hejka, A.; Schmitz, J.L.; England, D.M.; Callister, S.M.; Schell, R.F.

    1989-05-01

    The authors studied the histopathologic evolution of arthritis in nonirradiated and irradiated hamsters infected with Borrelia burgdorferi. Nonirradiated hamsters injected in the hind paws with B. burgdorferi developed an acute inflammatory reaction involving the synovium, periarticular soft tissues, and dermis. This acute inflammatory reaction was short-lived and was replaced by a mild chronic synovitis as the number of detectable spirochetes in the synovium, periarticular soft tissues, and perineurovascular areas diminished. Exposing hamsters to radiation before inoculation with B. burgdorferi exacerbated and prolonged the acute inflammatory phase. Spirochetes also persisted longer in the periarticular soft tissues. A major histopathologic finding was destructive and erosive bone changes of the hind paws, which resulted in deformation of the joints. These studies should be helpful in defining the immune mechanism participating in the onset, progression, and resolution of Lyme arthritis.

  16. Psoriatic arthritis: genetics and pathogenesis

    Directory of Open Access Journals (Sweden)

    A. Mathieu

    2012-06-01

    Full Text Available Psoriatic arthritis is a complex disease affecting primarily peripheral and axial joints and entheses together with the skin. The pathogenesis is characterized by a genetic background and by inflammatory mechanisms which may be triggered by environmental factors. Several susceptibility genes have been investigated; they include HLA genes, genes within the HLA region and genes outside the HLA region. T cells, including the recently described subset Th17, are thought to play an important role in the acute and chronic phases of the disease. Some of these findings allowed novel therapeutic interventions or opened new promising approaches in treatment. The most relevant data of the literature are summarized and discussed.

  17. Anticollagen type II antibodies are associated with an acute onset rheumatoid arthritis phenotype and prognosticate lower degree of inflammation during 5 years follow-up.

    Science.gov (United States)

    Manivel, Vivek Anand; Mullazehi, Mohammed; Padyukov, Leonid; Westerlind, Helga; Klareskog, Lars; Alfredsson, Lars; Saevarsdottir, Saedis; Rönnelid, Johan

    2017-09-01

    Antifibrillar collagen type II (anti-CII) antibody-positive patients with rheumatoid arthritis (RA) have early but not late signs of increased inflammation and joint erosions. We wanted to replicate this in a large RA cohort, and to relate to human leukocyte antigen (HLA)-DRB1* alleles. Anti-CII and anti-cyclic citrullinated peptide (CCP)2 were measured at baseline in 773 patients with RA from the Swedish Epidemiological Investigation in Rheumatoid Arthritis (EIRA) study with clinical follow-up data from the Swedish Rheumatology Quality Register (SRQ) registry, and 1476 with HLA-DRB1* information. Comparisons were done concerning C reactive protein (CRP), erythrocyte sedimentation rate (ESR), tender joint count (TJC), swollen joint count (SJC), Disease Activity Score encompassing 28 joints based on ESR (DAS28), DAS28CRP, pain-Visual Analogue Scale (VAS), global-VAS and Health Assessment Questionnaire Score (HAQ) at eight occasions during 5 years, and association with HLA-DRB1* alleles. Anti-CII associated with elevated CRP, ESR, SJC, DAS28 and DAS28CRP at diagnosis and up to 6 months, whereas anti-CCP2 associated with SJC and DAS28 from 6 months to 5 years, but not earlier. The anti-CII-associated phenotype was strong, and predominated in anti-CII/anti-CCP2 double-positive patients. Anti-CII was associated with improvements in CRP, ESR, SJC, TJC and DAS28, whereas anti-CCP2 was associated with deteriorations in SJC and DAS28 over time. Anti-CII-positive patients achieved European League Against Rheumatism good or moderate response more often than negative patients. Anti-CII was positively associated with HLA-DRB1*01 and HLA-DRB1*03, with significant interaction, and double-positive individuals had >14 times higher mean anti-CII levels than HLA double negatives. Whereas smoking was associated with elevated anti-CCP2 levels, smokers had lower anti-CII levels. Anti-CII seropositive RA represents a distinct phenotype, in many respects representing the converse

  18. In Vitro TNF-α Inhibitory Activity of Brazilian Plants and Anti-Inflammatory Effect of Stryphnodendron adstringens in an Acute Arthritis Model

    Science.gov (United States)

    Henriques, Bárbara O.; Corrêa, Olívia; Azevedo, Elaine Patrícia C.; Pádua, Rodrigo M.; de Oliveira, Vívian Louise S.; Oliveira, Thiago Henrique C.; Boff, Daiane; Dias, Ana Carolina F.; Amaral, Flávio A.; Castilho, Rachel O.

    2016-01-01

    Stryphnodendron species, popularly named “barbatimão,” are traditionally used in Brazil as anti-inflammatory agents. This study aimed to investigate the effect of barbatimão and 11 other species on the production of tumor necrosis factor-alpha (TNF-α) in lipopolysaccharide- (LPS-) stimulated THP-1 cells, as well as their anti-arthritis activity. The extracts of Stryphnodendron adstringens, Stryphnodendron obovatum, Campomanesia lineatifolia, and Terminalia glabrescens promoted a concentration-dependent inhibition of TNF-α. Mice injected with LPS in the knee joint were treated per os with fractions from the selected extracts. Both the organic (SAO) and the aqueous (SAA) fractions of S. adstringens promoted a dose-dependent reduction of leukocyte migration and neutrophil accumulation into the joint, but none of them reduced CXCL1 concentration in the periarticular tissue. In contrast, treatment with C. lineatifolia and T. glabrescens fractions did not ameliorate the inflammatory parameters. Analyses of SAO by Ultra Performance Liquid Chromatography (UPLC) coupled to electrospray ionization mass spectrometry (ESI-MS) led to the identification of gallic acid along with 11 prodelphinidins, characterized as monomers and dimers of the B-type. Our findings contribute to some extent to corroborating the traditional use of S. adstringens as an anti-inflammatory agent. This activity is probably related to a decrease of leukocyte migration into the inflammatory site. Polyphenols like gallic acid and prodelphinidins, identified in the active fraction, may contribute to the observed activity. PMID:27867403

  19. In Vitro TNF-α Inhibitory Activity of Brazilian Plants and Anti-Inflammatory Effect of Stryphnodendron adstringens in an Acute Arthritis Model

    Directory of Open Access Journals (Sweden)

    Bárbara O. Henriques

    2016-01-01

    Full Text Available Stryphnodendron species, popularly named “barbatimão,” are traditionally used in Brazil as anti-inflammatory agents. This study aimed to investigate the effect of barbatimão and 11 other species on the production of tumor necrosis factor-alpha (TNF-α in lipopolysaccharide- (LPS- stimulated THP-1 cells, as well as their anti-arthritis activity. The extracts of Stryphnodendron adstringens, Stryphnodendron obovatum, Campomanesia lineatifolia, and Terminalia glabrescens promoted a concentration-dependent inhibition of TNF-α. Mice injected with LPS in the knee joint were treated per os with fractions from the selected extracts. Both the organic (SAO and the aqueous (SAA fractions of S. adstringens promoted a dose-dependent reduction of leukocyte migration and neutrophil accumulation into the joint, but none of them reduced CXCL1 concentration in the periarticular tissue. In contrast, treatment with C. lineatifolia and T. glabrescens fractions did not ameliorate the inflammatory parameters. Analyses of SAO by Ultra Performance Liquid Chromatography (UPLC coupled to electrospray ionization mass spectrometry (ESI-MS led to the identification of gallic acid along with 11 prodelphinidins, characterized as monomers and dimers of the B-type. Our findings contribute to some extent to corroborating the traditional use of S. adstringens as an anti-inflammatory agent. This activity is probably related to a decrease of leukocyte migration into the inflammatory site. Polyphenols like gallic acid and prodelphinidins, identified in the active fraction, may contribute to the observed activity.

  20. Anterior uveitis in juvenile rheumatoid arthritis.

    Science.gov (United States)

    Kanski, J J

    1977-10-01

    The ocular and systemic characteristics of 160 patients with anterior uveitis and seronegative juvenile rheumatoid arthritis are reviewed. Chronic uveitis occurred in 131 patients, 76% of whom were girls. Both eyes were involved in 70% of the cases. Band keratopathy occurred in 41% of the eyes, cataract in 42%, and secondary glaucoma in 19%. Only 11 patients had uveitis before the onset of arthritis. Notable correlations included a pauciarticular onset of arthritis in 95% of the patients, and positive tests for antinuclear antibody in 82%. Of 29 patients with acute anterior uveitis, 27 were boys. The inflammation responded well to therapy, and serious complications did not occur. At follow-up 21 patients had typical ankylosing spondylitis, and five had sacroiliitis. The incidence of positive results of tests for HLA-B27 antigen was 94%.

  1. Olecranon bursitis as initial presentation of gout in asymptomatic normouricemic patients

    NARCIS (Netherlands)

    Emad, Yasser; Ragab, Yasser; El-Shaarawy, Nashwa; Rasker, J.J.

    2014-01-01

    Background Acute bursitis is a less frequent presentation of gout, especially in normouricemic subjects compared to the typical pattern of acute gouty arthritis. Aim of the work The aim of the current case reports is to describe the clinical and the magnetic resonance imaging features of acute gout

  2. Bacillus pumilus Septic Arthritis in a Healthy Child.

    Science.gov (United States)

    Shivamurthy, V M; Gantt, Soren; Reilly, Christopher; Tilley, Peter; Guzman, Jaime; Tucker, Lori

    2016-01-01

    We report a case of septic arthritis caused by a Bacillus species, B. pumilus, occurring in a healthy child. This organism rarely causes serious infections and has only been described in newborns and immunocompromised individuals or as a skin infection. This child developed an indolent joint swelling after a minor skin injury, and symptoms were initially thought most consistent with chronic arthritis. The case demonstrates that clinicians should consider joint infection in children presenting with acute monoarticular swelling, even without prominent systemic features.

  3. Cricoarytenoid joint involvement in rheumatoid arthritis: radiologic evaluation.

    Science.gov (United States)

    Greco, Antonio; Fusconi, Massimo; Macri, Gian Franco; Marinelli, Caterina; Polettini, Elisabetta; Benincasa, Anna Teresa; de Vincentiis, Marco

    2012-01-01

    Rheumatoid arthritis rarely involves the cricoarytenoid joint. The possible consequent symptom includes hoarseness, dysphagia, odynophagia, dysfunctional dysphonia, and acute dyspnea. Etiologic diagnosis is possible with high-resolution computed tomography, which can show spacing of the articular cartilage, density and volume alterations, and subluxation of the cartilage. However, these radiologic signs are not pathognomonic for rheumatoid arthritis, and they should be combined with anamnestic data.

  4. Bone and Joint Infections in Children: Septic Arthritis.

    Science.gov (United States)

    Agarwal, Anil; Aggarwal, Aditya N

    2016-08-01

    The pathological invasion of a joint and subsequent inflammation is known as septic arthritis. The knee and hip are the most frequently involved joints. Staphylococcus aureus is the most common cause of septic arthritis in children. An acute onset of illness with an inflamed painful joint and restricted movements and inability to use joint (pseudoparalysis) clinically indicates septic arthritis. The diagnosis is difficult in a neonate or young child where refusal to feed, crying, discomfort during change of diaper (if hip is involved) or attempted joint movement may be the only findings. Fever and other systemic signs may also be absent in neonates. Septic arthritis is diagnosed clinically, supported by appropriate radiological and laboratory investigations. The peripheral blood white cell count is frequently raised with a predominance of polymorphonuclear cells. The acute phase reactants such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) are often markedly raised. Ultrasonography and MRI are preferred investigations in pediatric septic arthritis. Determination of infecting organism in septic arthritis is the key to the correct antibiotic choice, treatment duration and overall management. Joint aspirate and/or blood culture should be obtained before starting antibiotic treatment. Several effective antibiotic regimes are available for managing septic arthritis in children. Presence of large collections, thick pus, joint loculations and pus evacuating into surrounding soft tissues are main indications for surgical drainage. Joint aspiration can be a practical alternative in case the lesion is diagnosed early, with uncomplicated presentations and superficial joints.

  5. Septic arthritis of the temporomandibular joint: a case report.

    Science.gov (United States)

    Yang, Sung-Won; Cho, Jin-Yong; Kim, Hyeon-Min

    2016-08-01

    Septic arthritis of the temporomandibular joint (TMJ) is a rare disease. The most common symptoms of this disease are acute malocclusion, limited mouth opening, swelling, and tenderness of affected TMJ. These symptoms are often confused with internal derangement of the articular disc, rheumatoid arthritis, retrodiscitis, or osteoarthritis. Therefore, differential diagnosis by image examination is required. Usually, antimicrobial treatment and surgical drainage by needle aspiration, arthroscopy, or arthrotomy are effective treatment approaches. In this study, a patient who was diagnosed with septic arthritis was treated with arthrocentesis and antibiotics without significant complications. We present a case report with a review of the literature.

  6. Clinical and Molecular Phenotype of Aicardi-Goutières Syndrome

    Science.gov (United States)

    Rice, Gillian ; Patrick, Teresa ; Parmar, Rekha ; Taylor, Claire F. ; Aeby, Alec ; Aicardi, Jean ; Artuch, Rafael ; Montalto, Simon Attard ; Bacino, Carlos A. ; Barroso, Bruno ; Baxter, Peter ; Benko, Willam S. ; Bergmann, Carsten ; Bertini, Enrico ; Biancheri, Roberta ; Blair, Edward M. ; Blau, Nenad ; Bonthron, David T. ; Briggs, Tracy ; Brueton, Louise A. ; Brunner, Han G. ; Burke, Christopher J. ; Carr, Ian M. ; Carvalho, Daniel R. ; Chandler, Kate E. ; Christen, Hans-Jürgen ; Corry, Peter C. ; Cowan, Frances M. ; Cox, Helen ; D’Arrigo, Stefano ; Dean, John ; De Laet, Corinne ; De Praeter, Claudine ; Déry, Catherine ; Ferrie, Colin D. ; Flintoff, Kim ; Frints, Suzanna G. M. ; Garcia-Cazorla, Angels ; Gener, Blanca ; Goizet, Cyril ; Goutières, Françoise ; Green, Andrew J. ; Guët, Agnès ; Hamel, Ben C. J. ; Hayward, Bruce E. ; Heiberg, Arvid ; Hennekam, Raoul C. ; Husson, Marie ; Jackson, Andrew P. ; Jayatunga, Rasieka ; Jiang, Yong-Hui ; Kant, Sarina G. ; Kao, Amy ; King, Mary D. ; Kingston, Helen M. ; Klepper, Joerg ; van der Knaap, Marjo S. ; Kornberg, Andrew J. ; Kotzot, Dieter ; Kratzer, Wilfried ; Lacombe, Didier ; Lagae, Lieven ; Landrieu, Pierre Georges ; Lanzi, Giovanni ; Leitch, Andrea ; Lim, Ming J. ; Livingston, John H. ; Lourenco, Charles M. ; Lyall, E. G. Hermione ; Lynch, Sally A. ; Lyons, Michael J. ; Marom, Daphna ; McClure, John P. ; McWilliam, Robert ; Melancon, Serge B. ; Mewasingh, Leena D. ; Moutard, Marie-Laure ; Nischal, Ken K. ; Østergaard, John R. ; Prendiville, Julie ; Rasmussen, Magnhild ; Rogers, R. Curtis ; Roland, Dominique ; Rosser, Elisabeth M. ; Rostasy, Kevin ; Roubertie, Agathe ; Sanchis, Amparo ; Schiffmann, Raphael ; Scholl-Bürgi, Sabine ; Seal, Sunita ; Shalev, Stavit A. ; Corcoles, C. Sierra ; Sinha, Gyan P. ; Soler, Doriette ; Spiegel, Ronen ; Stephenson, John B. P. ; Tacke, Uta ; Tan, Tiong Yang ; Till, Marianne ; Tolmie, John L. ; Tomlin, Pam ; Vagnarelli, Federica ; Valente, Enza Maria ; Van Coster, Rudy N. A. ; Van der Aa, Nathalie ; Vanderver, Adeline ; Vles, Johannes S. H. ; Voit, Thomas ; Wassmer, Evangeline ; Weschke, Bernhard ; Whiteford, Margo L. ; Willemsen, Michel A. A. ; Zankl, Andreas ; Zuberi, Sameer M. ; Orcesi, Simona ; Fazzi, Elisa ; Lebon, Pierre ; Crow, Yanick J. 

    2007-01-01

    Aicardi-Goutières syndrome (AGS) is a genetic encephalopathy whose clinical features mimic those of acquired in utero viral infection. AGS exhibits locus heterogeneity, with mutations identified in genes encoding the 3′→5′ exonuclease TREX1 and the three subunits of the RNASEH2 endonuclease complex. To define the molecular spectrum of AGS, we performed mutation screening in patients, from 127 pedigrees, with a clinical diagnosis of the disease. Biallelic mutations in TREX1, RNASEH2A, RNASEH2B, and RNASEH2C were observed in 31, 3, 47, and 18 families, respectively. In five families, we identified an RNASEH2A or RNASEH2B mutation on one allele only. In one child, the disease occurred because of a de novo heterozygous TREX1 mutation. In 22 families, no mutations were found. Null mutations were common in TREX1, although a specific missense mutation was observed frequently in patients from northern Europe. Almost all mutations in RNASEH2A, RNASEH2B, and RNASEH2C were missense. We identified an RNASEH2C founder mutation in 13 Pakistani families. We also collected clinical data from 123 mutation-positive patients. Two clinical presentations could be delineated: an early-onset neonatal form, highly reminiscent of congenital infection seen particularly with TREX1 mutations, and a later-onset presentation, sometimes occurring after several months of normal development and occasionally associated with remarkably preserved neurological function, most frequently due to RNASEH2B mutations. Mortality was correlated with genotype; 34.3% of patients with TREX1, RNASEH2A, and RNASEH2C mutations versus 8.0% RNASEH2B mutation–positive patients were known to have died (P=.001). Our analysis defines the phenotypic spectrum of AGS and suggests a coherent mutation-screening strategy in this heterogeneous disorder. Additionally, our data indicate that at least one further AGS-causing gene remains to be identified. PMID:17846997

  7. 痛风性关节炎83例临床分析%Clinical Analysis of 83 Patients with Gout Arthritis

    Institute of Scientific and Technical Information of China (English)

    吴荷梅

    2012-01-01

      目的总结痛风性关节炎临床特点,加强对该病认识.方法回顾性分析本院83例痛风性关节炎患者的临床资料.结果男性患者发病率明显高于女性,男性80例,女性3例,平均发病年龄为(51±13)岁.因高嘌呤饮食诱发及饮酒诱发分别为37例(占46.3%)32例(占40%),以足第一跖趾、跗骨、踝和膝关节炎为首发表现者分别为45例(占56.3%)、12例(占15%)、6例(占7.5%)和5例(占6.3%).结论痛风性关节炎是一种以单关节急性炎症为主要表现,男性发病率明显高于女性的疾病,第一跖趾关节最常受累,高嘌呤饮食及饮酒容易诱发痛风发作.%  Objective To gain a deep understanding in gouty arthritis by summarizing clinical charactcristics. Methods 83 cases of gouty arthritis were reviewed and analyzed clinical characteristics. Results Male patients with a significantly higher incidence of female, there were 80 male patients and 3 female patients , The average onset age was (51+-13)years old ,The onset was induced by purine rich diet in 37 cases(46.3%) and by alcohol consumption in 32cases (40%). Conclusion Gouty arthritis is a kind of acurt sing joint arthritis and more common males , with the first metatarsophalangeal joint being the most commonly affected site ,purine-rich diet and alcohol consumption can induce the onset of gout.

  8. Arthritis of the hand - Rheumatoid

    Science.gov (United States)

    ... Media Find a Hand Surgeon Home Anatomy Rheumatoid Arthritis Email to a friend * required fields From * To * DESCRIPTION In its most literal sense, arthritis means “inflamed joint.” Arthritis describes any condition where ...

  9. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Corner / Patient Webcasts / Rheumatoid Arthritis Educational Video Series Rheumatoid Arthritis Educational Video Series This series of five videos was designed to help you learn more about Rheumatoid Arthritis (RA). You will learn how the diagnosis of ...

  10. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... is Happening to the Joints? Rheumatoid Arthritis: Gaining Control – Working with your Rheumatologist Rheumatoid Arthritis: Additional Conditions Rheumatoid Arthritis: The Immune System Don’t have SilverLight? Get it here. A ...

  11. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... for Patients Arthritis Drug Information Sheets Benefits and Risks of Opioids in Arthritis ... within the Johns Hopkins Arthritis Center website is intended for educational purposes only. Physicians and other health care professionals ...

  12. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Management for Rheumatoid Arthritis Patients Rehabilitation of Older Adult Patients with Arthritis Complementary and Alternative Medicine for ... Patient Update Transitioning the JRA Patient to an Adult Rheumatologist Drug Information for Patients Arthritis Drug Information ...

  13. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Arthritis and Health-related Quality of Life Rehabilitation Management for Rheumatoid Arthritis Patients Rehabilitation of Older Adult ... Sheets Benefits and Risks of Opioids in Arthritis Management How to Give a Subcutaneous Injection Connect With ...

  14. How undifferentiated arthritis evolves into chronic arthritis.

    Science.gov (United States)

    van der Woude, D; Toes, R E M; Scherer, H U

    2014-08-01

    Undifferentiated arthritis (UA) is a frequently occurring clinical presentation with a variable outcome. While some forms of UA will spontaneously remit, other forms will progress to chronic arthritis; an outcome that would preferably be prevented. Which immunological factors are normally at the basis of resolution of inflammation, and what, on the other hand, causes inflammation to persist? This review provides an overview of the immunological mechanisms involved in these two scenarios, including specific examples of how these mechanisms apply, or can be influenced in rheumatic diseases. Furthermore, what do we know about risk factors for chronic arthritis, such as the development of autoantibodies? The recent years have provided many insights concerning risk factors for autoantibody-positive versus autoantibody-negative rheumatoid arthritis, which are discussed along with a possible pathophysiological model incorporating autoantibodies into the larger process of disease development. Finally, the evolution of the autoantibody response over time is described.

  15. Salmonella enteridis Septic Arthritis: A Report of Two Cases

    Directory of Open Access Journals (Sweden)

    Esat Uygur

    2013-01-01

    Full Text Available Introduction. Nontyphoidal salmonellosis causes significant morbidity, is transmitted via fecal-oral route, and is a worldwide cause of gastroenteritis, bacteremia, and local infections. Salmonella is a less common etiologic factor for septic arthritis compared with other gram-negative bacteria. Cases. We present two septic arthritis cases with Salmonella enteridis as a confirmed pathogen and also discuss the predisposing factors and treatment. Discussion. Septic arthritis is an orthopedic emergency. The gold standard treatment of septic arthritis is joint debridement, antibiotic therapy according to the culture results, and physiotherapy, which should start in the early postoperative period to prevent limitation of motion. Salmonella is an atypical agent for septic arthritis. It must be particularly kept in mind as an etiologic factor for the acute arthritis of a patient with sickle cell anemia and systemic lupus erythematosus. Clinicians should be cautious that the white blood cell count in synovial fluid can be under 50.000/mm3 in immune compromised individuals with septic arthritis. The inflammatory response can be deficient, or the microorganism may be atypical. Conclusion. Atypical bacteria such as Salmonella species in immune compromised patients can cause joint infections. Therefore, Salmonella species must always be kept in mind for the differential diagnosis of septic arthritis in a clinically relevant setting.

  16. Modulation of LINE-1 and Alu/SVA Retrotransposition by Aicardi-Goutières Syndrome-Related SAMHD1

    Directory of Open Access Journals (Sweden)

    Ke Zhao

    2013-09-01

    Full Text Available Long interspersed elements 1 (LINE-1 occupy at least 17% of the human genome and are its only active autonomous retrotransposons. However, the host factors that regulate LINE-1 retrotransposition are not fully understood. Here, we demonstrate that the Aicardi-Goutières syndrome gene product SAMHD1, recently revealed to be an inhibitor of HIV/simian immunodeficiency virus (SIV infectivity and neutralized by the viral Vpx protein, is also a potent regulator of LINE-1 and LINE-1-mediated Alu/SVA retrotransposition. We also found that mutant SAMHD1s of Aicardi-Goutières syndrome patients are defective in LINE-1 inhibition. Several domains of SAMHD1 are critical for LINE-1 regulation. SAMHD1 inhibits LINE-1 retrotransposition in dividing cells. An enzymatic active site mutant SAMHD1 maintained substantial anti-LINE-1 activity. SAMHD1 inhibits ORF2p-mediated LINE-1 reverse transcription in isolated LINE-1 ribonucleoproteins by reducing ORF2p level. Thus, SAMHD1 may be a cellular regulator of LINE-1 activity that is conserved in mammals.

  17. Fungal arthritis simulating juvenile rheumatoid arthritis.

    OpenAIRE

    Haapasaari, J; Essen, R V; Kahanpää, A; Kostiala, A A; Holmberg, K; Ahlqvist, J

    1982-01-01

    Petriellidium boydii is often isolated from maduromycosis but has recently been associated with arthritis. A previously healthy 6-year-old boy developed chronic purulent arthritis of the knee after a bicycle accident. Culture of aspirate grew no pathogens and antibiotic treatment had no effect. Culture of synovial fluid grew P boydii, which responded initially to amphotericin but reappeared after six months. Subsequent treatment with miconazole was stopped after development of haematuria. The...

  18. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Spondylitis News Osteoarthritis News Gout News Osteoporosis News Lupus News Fibromyalgia News Patient Corner Arthritis Drug Information Sheets Managing Your Arthritis Educational Videos for Patients ...

  19. Ultrasound in Arthritis.

    Science.gov (United States)

    Sudoł-Szopińska, Iwona; Schueller-Weidekamm, Claudia; Plagou, Athena; Teh, James

    2017-09-01

    Ultrasound is currently performed in everyday rheumatologic practice. It is used for early diagnosis, to monitor treatment results, and to diagnose remission. The spectrum of pathologies seen in arthritis with ultrasound includes early inflammatory features and associated complications. This article discusses the spectrum of ultrasound features of arthritides seen in rheumatoid arthritis and other connective tissue diseases in adults, such as Sjögren syndrome, lupus erythematosus, dermatomyositis, polymyositis, and juvenile idiopathic arthritis. Ultrasound findings in spondyloarthritis, osteoarthritis, and crystal-induced diseases are presented. Ultrasound-guided interventions in patients with arthritis are listed, and the advantages and disadvantages of ultrasound are discussed. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. The abnormal cannabidiol analogue O-1602 reduces nociception in a rat model of acute arthritis via the putative cannabinoid receptor GPR55.

    Science.gov (United States)

    Schuelert, Niklas; McDougall, Jason J

    2011-08-01

    Cannabinoids classically act via CB₁ and CB₂ receptors to modulate nociception; however, recent findings suggest that some cannabinoids bind to atypical receptors. One such receptor is GPR55 which is activated by the abnormal cannabidiol analogue O-1602. This study investigated whether the synthetic GPR55 agonist O-1602 can alter joint nociception in a rat model of acute joint inflammation. Acute (24 h) inflammatory joint pain was induced in male Wistar rats by intra-articular injection of 2% kaolin and 2% carrageenan. Single unit extracellular recordings were made from arthritic joint afferents in response to mechanical rotation of the knee. Peripheral administration of O-1602 significantly reduced movement-evoked firing of nociceptive C fibres and this effect was blocked by the GPR55 receptor antagonist O-1918. Co-administration of the CB₁ and CB₂ antagonists (AM281 and AM630 respectively) had no effect on O-1602 responses. This study clearly shows that atypical cannabinoid receptors are involved in joint nociception and these novel targets may be advantageous for the treatment of inflammatory pain.

  1. Chronic arthritis in chikungunya virus infection.

    Science.gov (United States)

    Mateo, Lourdes; Roure, Silvia

    2017-07-24

    Chikungunya virus infection causes arthralgia and arthritis in the acute phase of the disease but, in more than half of the cases, musculoskeletal manifestations can be prolonged over time and, in some cases, become chronic. Although polyarthralgia is the most frequent chronic manifestation, forms with polyarthritis, tenosynovitis and enthesopathy are also common. To analyze the clinical characteristics of patients with persistent articular manifestations after infection with the Chikungunya virus. Report of 3 cases of chronic arthritis after infection with chikungunya virus diagnosed at outpatient care in a university hospital of Catalonia, all of them imported after exposure in areas of epidemic infection between 2013-2015. All three patients had inflammatory joint pain for more than one year after acute disease (3, 2 and 1 years, respectively). In all cases, it appeared as polyarthritis with involvement of small joints of hands and feet (pseudorheumatoid arthritis-like). Laboratory tests showed a slight elevation of acute phase reactants, and analyses for immune markers were negative. Two of the patients required treatment with glucocorticoids and hydroxychloroquine. The course led to slow clinical improvement, but only one of them came to be completely asymptomatic. In the differential diagnosis of chronic polyarthritis, Chikungunya virus disease should also be considered in areas in which it is not endemic. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  2. Arthritis and Veterans

    Centers for Disease Control (CDC) Podcasts

    2015-11-09

    One in three veterans has arthritis. This podcast provides information on how veterans can improve their quality of life with physical activity and other arthritis management strategies.  Created: 11/9/2015 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 11/9/2015.

  3. What Is Rheumatoid Arthritis?

    Science.gov (United States)

    ... in Chinese 繁體中文 ) What Is Rheumatoid Arthritis? (in Korean 한국어 ) What Is Rheumatoid Arthritis? (in Vietnamese bằng ... his or her own body tissues. Researchers are learning many things about why and how this happens. ...

  4. Juvenile idiopathic arthritis

    NARCIS (Netherlands)

    Prakken, Berent; Albani, Salvatore; Martini, Alberto

    2011-01-01

    Juvenile idiopathic arthritis is a heterogeneous group of diseases characterised by arthritis of unknown origin with onset before age of 16 years. Pivotal studies in the past 5 years have led to substantial progress in various areas, ranging from disease classification to new treatments. Gene expres

  5. Arthritis in the highlands of Papua New Guinea.

    Science.gov (United States)

    Pile, K D; Richens, J E; Laurent, R M; Bhatia, K; Prasad, M L; Lupiwa, T; Hudson, B J; Tapsall, J; McPetrie, R

    1993-01-01

    Acute polyarthritis is an important cause of morbidity in many tropical countries. Classification has often been difficult, with the term tropical polyarthritis used for those in whom a diagnosis could not be made. The implication that this is a distinct entity is probably incorrect, with likely causes being septic arthritis or post-infective reactive arthritis. This study aimed to determine the types of arthritis found in 43 patients (30 men) presenting consecutively to the Goroka Base Hospital in the Eastern Highlands of Papua New Guinea. Gonococcal arthritis was diagnosed in eight patients (six men) on the basis of isolation of Neisseria gonorrhoeae from the joint aspirate. In all cases the N gonorrhoeae was identified by the closed culture system on chocolate agar, but not always by routine plating. There were no specific clinical features that identified patients with a gonococcal septic arthritis. The remaining 34 patients had an undifferentiated oligoarthritis. The pattern of arthritis in men and women was of a lower limb pauciarticular arthritis with a predilection for the knee and ankle joints. A total of 30% of male patients had a history of urethral discharge and 44% of all patients had preceding diarrhoea. Arthritis was the only feature in 59% of patients and in 32% there was an associated enthesitis. In this study most patients had an oligoarthritis consistent with a reactive arthritis or a septic arthritis due to N gonorrhoeae. Broth inoculation of synovial fluid was the best method to isolate N gonorrhoeae, with standard methods for gonococcal isolation failing in some patients. It is recommended that the term 'tropical polyarthritis' is no longer used as it does not refer to a specific entity but consists of several known arthritides.

  6. Cardiovascular comorbidity in rheumatoid arthritis

    OpenAIRE

    Holmqvist, Marie E

    2010-01-01

    This thesis is based on four different studies, all focusing on co-morbidities in rheumatoid arthritis. Diabetes mellitus is assessed as a risk factor for rheumatoid arthritis, the temporal relationship between ischemic heart disease and rheumatoid arthritis, and the extent of coronary stenosis in rheumatoid arthritis, is studied. The rationale for this is that patients with rheumatoid arthritis suffer an increased risk of ischemic heart disease that cannot be explained by traditional risk fa...

  7. Mutations in ADAR1 cause Aicardi-Goutières syndrome associated with a type I interferon signature.

    Science.gov (United States)

    Rice, Gillian I; Kasher, Paul R; Forte, Gabriella M A; Mannion, Niamh M; Greenwood, Sam M; Szynkiewicz, Marcin; Dickerson, Jonathan E; Bhaskar, Sanjeev S; Zampini, Massimiliano; Briggs, Tracy A; Jenkinson, Emma M; Bacino, Carlos A; Battini, Roberta; Bertini, Enrico; Brogan, Paul A; Brueton, Louise A; Carpanelli, Marialuisa; De Laet, Corinne; de Lonlay, Pascale; del Toro, Mireia; Desguerre, Isabelle; Fazzi, Elisa; Garcia-Cazorla, Angels; Heiberg, Arvid; Kawaguchi, Masakazu; Kumar, Ram; Lin, Jean-Pierre S-M; Lourenco, Charles M; Male, Alison M; Marques, Wilson; Mignot, Cyril; Olivieri, Ivana; Orcesi, Simona; Prabhakar, Prab; Rasmussen, Magnhild; Robinson, Robert A; Rozenberg, Flore; Schmidt, Johanna L; Steindl, Katharina; Tan, Tiong Y; van der Merwe, William G; Vanderver, Adeline; Vassallo, Grace; Wakeling, Emma L; Wassmer, Evangeline; Whittaker, Elizabeth; Livingston, John H; Lebon, Pierre; Suzuki, Tamio; McLaughlin, Paul J; Keegan, Liam P; O'Connell, Mary A; Lovell, Simon C; Crow, Yanick J

    2012-11-01

    Adenosine deaminases acting on RNA (ADARs) catalyze the hydrolytic deamination of adenosine to inosine in double-stranded RNA (dsRNA) and thereby potentially alter the information content and structure of cellular RNAs. Notably, although the overwhelming majority of such editing events occur in transcripts derived from Alu repeat elements, the biological function of non-coding RNA editing remains uncertain. Here, we show that mutations in ADAR1 (also known as ADAR) cause the autoimmune disorder Aicardi-Goutières syndrome (AGS). As in Adar1-null mice, the human disease state is associated with upregulation of interferon-stimulated genes, indicating a possible role for ADAR1 as a suppressor of type I interferon signaling. Considering recent insights derived from the study of other AGS-related proteins, we speculate that ADAR1 may limit the cytoplasmic accumulation of the dsRNA generated from genomic repetitive elements.

  8. Artrite da gota tofácea crônica mimetizando artrite reumatoide Chronic tophaceous gout mimicking rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Juliana F. Sarmento

    2009-12-01

    Full Text Available A gota é um distúrbio no metabolismo das purinas, usualmente associado à ocorrência de crises recorrentes de artrite nas articulações dos membros inferiores em homens entre 40-50 anos, e com o desenvolvimento de tofos subcutâneos nos pacientes com doença de longa evolução. Casos de pacientes com artrite gotosa crônica que mimetizam quadros de artrite reumatoide e vice-versa são raros. Descrevemos o caso de um paciente de 56 anos, com quadro de artrite poliarticular, simétrica e deformante, comprometendo principalmente as articulações de mãos e punhos, com nódulos subcutâneos difusos pelo corpo, alterações radiográficas atípicas e urolitíase, que, após avaliação clínica e dos exames complementares, recebeu diagnóstico de gota tofácea crônica mutilante mimetizando artrite reumatoide.Gout is a disorder of purine metabolism, usually associated with recurrent bouts of arthritis in the joints of the lower limbs, affecting men 40 to 50 years of age, which leads to the development of subcutaneous tophi in patients with long-lasting disease. Cases of patients with chronic gouty arthritis mimicking rheumatoid arthritis, and vice-versa, are rare. This report describes the case of a 56-year old male with symmetric, deforming, and polyarticular arthritis affecting, specially, the joints of the hands and wrists, with diffuse subcutaneous nodules throughout his body, atypical radiographic findings, and urolithiasis. Following clinical evaluation and additional tests, this patient received a diagnosis of chronic tophaceous gout mimicking mutilating rheumatoid arthritis.

  9. Acute Lymphoblastic Leukaemia presenting as Juvenile Idiopathic ...

    African Journals Online (AJOL)

    Acute Lymphoblastic Leukaemia presenting as Juvenile Idiopathic Arthritis in a Nigerian boy. ... lead to delay in commencing appropriate treatment. ... of two months duration, had an elevated Rheumatoid factor and X-ray findings suggestive of ...

  10. [Septic arthritis and spondylitis].

    Science.gov (United States)

    Fujikawa, Yosuke

    2014-10-01

    Septic arthritis and spondylitis in elderly adult are uncommon disease. But symptoms and signs of septic arthritis and spondylitis are an important medical emergency, with high mortality and morbidity. Delayed or inadequate treatment can result in irreversible joint destruction and neurological condition. Early diagnoses as well as prompt and effective treatment are essential for avoiding severe outcomes. In spite of advances in diagnostic imaging techniques, the incidence of septic arthritis and spondylitis appears to have been increased. The aging of the population, the widespread use of immunosuppressant therapies, including systemic corticosteroids, cytokines and anticytokines, and growing resistance to conventional antibiotics seem to be the major cause.

  11. LABORATORY FINDINGS IN PSORIATIC ARTHRITIS

    Directory of Open Access Journals (Sweden)

    S. Todesco

    2011-09-01

    Full Text Available Psoriatic arthritis (PsA has been classically defined as an inflammatory arthritis associated with psoriasis. However, in comparison with other relevant inflammatory arthropathies, in which a definite diagnosis is frequently possible only by means of laboratory investigations, in PsA true laboratory diagnostic markers are lacking. Some markers are utilised more to differentiate other diseases than to characterise PsA. For example in polyarticular PsA, which may be in some cases indistinguishable from RA, the rheumatoid factor (RF or the more specific and recently introduced antibodies to cyclic citrullinated peptides (anti-CCP, may be useful to better identify RA. However, RF was found in 5% to 13% of patients with PsA, and anti-CCP may be observed in almost similar percentage. The determination of ESR and/or CRP is frequently disappointing in PsA, since they are both elevated in only half of the patients with PsA. However, ESR and/or CRP are included in the most utilised response criteria for RA, such as ACR and DAS, and, in addition are also considered reliable in the assessment of PsA. Furthermore, elevated levels of ESR have been proposed as one of the best predictors of damage progression and, in addition, a low ESR seems protective, while an ESR >15 mm/h is one of the factors associated with an increased mortality in PsA. The synovial fluid (SF effusion is much higher in PsA, in comparison with other arthropathies. When available, SF analysis may offer additive information useful for the diagnosis, such as the increased number of leukocytes, which underlines the inflammatory nature of the effusion even in a patient with normal serum levels of acute phase response. We found that elevated IL-1 levels in SF of patients with early disease (<6 months, may be predictive of an evolution in polyarticular form at follow-up. This observation is in keeping with the crucial role that inflammatory cytokines play in PsA, probably related to a genetic

  12. Juvenile chronic arthritis.

    Science.gov (United States)

    Southwood, T R; Woo, P

    1995-05-01

    The nomenclature and classification criteria for arthritis in children should be dealt with initially as separate issues, although they are undoubtedly intertwined. The classification criteria should aim to delineate homogeneous patient populations, yet should be flexible enough to incorporate advances in disease knowledge. It should be recognized that arriving at an international consensus for classification criteria will merely provide a set of operational definitions to facilitate research, and not a set of diagnostic criteria. Indeed the only point to obtaining consensus is to begin a process of systematic ongoing review of the criteria. The labels attached to any of these diseases should facilitate accurate communication. In view of the heterogeneous nature of childhood arthritis, consideration should be given to using a broad umbrella term such as juvenile or childhood arthritis only for communicating with the lay public. Medical nomenclature should be formulated to reflect accurately homogeneous subgroups of arthritis, and should not artificially proscribe a relationship between paediatric and adult disease.

  13. Arthritis in Children

    Science.gov (United States)

    ... Asthma Autism Cancer Chest & Lungs Chronic Conditions Cleft & Craniofacial ... Content Article Body Arthritis is an inflammation of the joints that produces swelling, redness, heat, and pain. Although it is typically thought of as a ...

  14. Arthritis and IBD

    Science.gov (United States)

    ... pain and stiffness in the lower spine and sacroiliac joints (at the bottom of the back). Interestingly, and ... addition to causing arthritis of the spine and sacroiliac joints, ankylosing spondylitis can cause inflammation of the eyes, ...

  15. Anterior Cruciate Ligament OsteoArthritis Score (ACLOAS)

    DEFF Research Database (Denmark)

    Roemer, Frank W; Frobell, Richard; Lohmander, Stefan

    2014-01-01

    OBJECTIVE: To develop a whole joint scoring system, the Anterior Cruciate Ligament OsteoArthritis Score (ACLOAS), for magnetic resonance imaging (MRI)-based assessment of acute anterior cruciate ligament (ACL) injury and follow-up of structural sequelae, and to assess its reliability. DESIGN...... and longitudinal changes including osteoarthritis (OA) features. Joint features assessed were acute osteochondral injury, traumatic and degenerative bone marrow lesions (BMLs), meniscus morphology and extrusion, osteophytes, collateral and cruciate ligaments including ACL graft, Hoffa-synovitis and effusion...

  16. Native type II collagen-induced arthritis in the rat. I. Incidence and humoral response to collagen.

    OpenAIRE

    Morgan, K; Clague, R B; Shaw, M J; Holt, P J

    1980-01-01

    An acute inflammatory arthritis has been induced in 76% of rats injected intradermally with native bovine type II collagen emulsified in Freund's complete (CFA) or incomplete (ICFA) adjuvant. The arthritis became chronic in 14 out of 31 rats, and ear and tail lesions were noted in some rats. No arthritis was induced by native type I collagen, denatured type II collagen, rabbit IgG, or buffer alone injected intradermally with adjuvant. Using a solid-phase radioimmunoassay for serum antibodies ...

  17. Induction of lyme arthritis in LSH hamsters

    Energy Technology Data Exchange (ETDEWEB)

    Schmitz, J.L.; Schell, R.F.; Hejka, A.; England, D.M.; Konick, L.

    1988-09-01

    In studies of experimental Lyme disease, a major obstacle has been the unavailability of a suitable animal model. We found that irradiated LSH/Ss Lak hamsters developed arthritis after injection of Borrelia burgdorferi in the hind paws. When nonirradiated hamsters were injected in the hind paws with B. burgdorferi, acute transient synovitis was present. A diffuse neutrophilic infiltrate involved the synovia and periarticular structures. The inflammation was associated with edema, hyperemia, and granulation tissue. Numerous spirochetes were seen in the synovial and subsynovial tissues. The histopathologic changes were enhanced in irradiated hamsters. The onset and duration of the induced swelling were dependent on the dose of radiation and the inoculum of spirochetes. Inoculation of irradiated hamsters with Formalin-killed spirochetes or medium in which B. burgdorferi had grown for 7 days failed to induce swelling. This animal model should prove useful for studies of the immune response to B. burgdorferi and the pathogenesis of Lyme arthritis.

  18. Understanding Rheumatoid Arthritis (RA): Research

    Science.gov (United States)

    ... page please turn JavaScript on. Feature: Understanding Rheumatoid Arthritis (RA) Research Past Issues / Summer 2014 Table of ... project plan to address relevant challenges for rheumatoid arthritis. Read Part 1 on Lupus in MedlinePlus magazine, ...

  19. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... any advice you receive from your rheumatologist. Click A Link Below To Play Rheumatoid Arthritis: Symptoms and ... About Victoria Ruffing, RN Ms. Ruffing has been a member of the Arthritis Center since 2000, currently ...

  20. Handout on Health: Rheumatoid Arthritis

    Science.gov (United States)

    ... that are prone to fracture). Like many other rheumatic diseases, rheumatoid arthritis is an autoimmune disease ( auto means self), so ... arthritis than men. The disease may improve during pregnancy and flare after pregnancy. Breastfeeding may also aggravate ...

  1. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Arthritis Vital Education Initiative Rheumatology Conference Rheumatology Rounds Case Rounds Radiology Rounds Pathophysiology of the Rheumatic Diseases Our Research Patient-Centered Outcomes Research Research Studies The Camille Julia Morgan Arthritis Research and Education ...

  2. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Ruffing has been a member of the Arthritis Center since 2000, currently serving as the Nurse Manager. She is a critical ... Management for Rheumatoid Arthritis Patients Rehabilitation of Older ...

  3. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Adult Rheumatologist Drug Information for Patients Arthritis Drug Information Sheets Benefits and Risks of Opioids in Arthritis Management How to Give a Subcutaneous Injection Connect With ...

  4. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Spondylitis News Osteoarthritis News Gout News Osteoporosis News Lupus News Fibromyalgia News Patient Corner Arthritis Drug Information ... Connect With Us Johns Hopkins Rheumatology Arthritis Center Lupus Center Lyme Disease Clinical Research Center Myositis Center ...

  5. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Spondylitis News Osteoarthritis News Gout News Osteoporosis News Lupus News Fibromyalgia News Patient Corner Arthritis Drug Information ... Connect With Us Johns Hopkins Rheumatology Arthritis Center Lupus Center Lyme Disease Clinical Research Center Myositis Center ...

  6. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... are available, what is happening in the immune system and what other conditions are associated with RA. ... Rheumatoid Arthritis: Additional Conditions Rheumatoid Arthritis: The Immune System Don’t have SilverLight? Get it here. A ...

  7. A new arthritis therapy with oxidative burst inducers.

    Directory of Open Access Journals (Sweden)

    Malin Hultqvist

    2006-09-01

    Full Text Available BACKGROUND: Despite recent successes with biological agents as therapy for autoimmune inflammatory diseases such as rheumatoid arthritis (RA, many patients fail to respond adequately to these treatments, making a continued search for new therapies extremely important. Recently, the prevailing hypothesis that reactive oxygen species (ROS promote inflammation was challenged when polymorphisms in Ncf1, that decrease oxidative burst, were shown to increase disease severity in mouse and rat arthritis models. Based on these findings we developed a new therapy for arthritis using oxidative burst-inducing substances. METHODS AND FINDINGS: Treatment of rats with phytol (3,7,11,15-tetramethyl-2-hexadecene-1-ol increased oxidative burst in vivo and thereby corrected the effect of the genetic polymorphism in arthritis-prone Ncf1(DA rats. Importantly, phytol treatment also decreased the autoimmune response and ameliorated both the acute and chronic phases of arthritis. When compared to standard therapies for RA, anti-tumour necrosis factor-alpha and methotrexate, phytol showed equally good or better therapeutic properties. Finally, phytol mediated its effect within hours of administration and involved modulation of T cell activation, as injection prevented adoptive transfer of disease with arthritogenic T cells. CONCLUSIONS: Treatment of arthritis with ROS-promoting substances such as phytol targets a newly discovered pathway leading to autoimmune inflammatory disease and introduces a novel class of therapeutics for treatment of RA and possibly other chronic inflammatory diseases.

  8. Probenecid

    Science.gov (United States)

    Probenecid is used to treat chronic gout and gouty arthritis. It is used to prevent attacks related to ... a day when prescribed for chronic gout or gouty arthritis and four times a day when prescribed with ...

  9. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Arthritis 101 2010 E.S.C.A.P.E. Study Patient Update Transitioning the JRA Patient to an Adult Rheumatologist Drug Information for Patients Arthritis Drug Information Sheets Benefits and Risks of Opioids in Arthritis Management How ...

  10. Th17 cytokines and arthritis

    NARCIS (Netherlands)

    E.W. Lubberts (Erik)

    2010-01-01

    textabstractTh17 cells are implicated in human autoimmune diseases, such as rheumatoid arthritis (RA), although it has not been established whether this persistent destructive arthritis is driven by Th1 and/or Th17 cells. Interleukin-17A (IL-17A) contributes to the pathogenesis of arthritis as has b

  11. Experimental arthritis induced by a clinical Mycoplasma fermentans isolate

    Directory of Open Access Journals (Sweden)

    Giono Silvia

    2002-06-01

    Full Text Available Abstract Background Mycoplasma fermentans has been associated with rheumatoid arthritis. Recently, it was detected in the joints and blood of patients with rheumatoid arthritis, but it is not clear yet how the bacteria enter the body and reach the joints. The purpose of this study was to determine the ability of M. fermentans to induce experimental arthritis in rabbits following inoculation of the bacteria in the trachea and knee joints. Methods P-140 and PG-18 strains were each injected in the knee joints of 14 rabbits in order to evaluate and compare their arthritogenicity. P-140 was also injected in the trachea of 14 rabbits in order to test the ability of the bacteria to reach the joints and induce arthritis. Results M. fermentans produced an acute arthritis in rabbits. Joint swelling appeared first in rabbits injected with P-140, which caused a more severe arthritis than PG-18. Both strains were able to migrate to the uninoculated knee joints and they were detected viable in the joints all along the duration of the experiment. Changes in the synovial tissue were more severe by the end of the experiment and characterized by the infiltration of neutrophils and substitution of adipose tissue by connective tissue. Rabbits intracheally injected with P-140 showed induced arthritis and the bacteria could be isolated from lungs, blood, heart, kidney, spleen, brain and joints. Conclusion M. fermentans induced arthritis regardless of the inoculation route. These findings may help explain why mycoplasmas are commonly isolated from the joints of rheumatic patients.

  12. Septic arthritis of the temporomandibular joint in an infant

    Directory of Open Access Journals (Sweden)

    Raymond Chuk

    2015-07-01

    Full Text Available Infantile temporomandibular joint septic arthritis is an uncommon paediatric infection, but one which carries the potential for severe morbidity and mortality. Early diagnosis and aggressive medical and possibly surgical management is indicated for the best outcomes. The presenting clinical features are non-specific in a neonate and an infant; as such a high degree of clinical suspicion is required. We present the case of an eleven-month-old boy who has made a full recovery from an acute temporomandibular joint septic arthritis and review the relevant literature.

  13. Septic Arthritis of the Temporomandibular Joint in an Infant.

    Science.gov (United States)

    Chuk, Raymond; Arvier, John; Laing, Barbara; Coman, David

    2015-04-24

    Infantile temporomandibular joint septic arthritis is an uncommon paediatric infection, but one which carries the potential for severe morbidity and mortality. Early diagnosis and aggressive medical and possibly surgical management is indicated for the best outcomes. The presenting clinical features are non-specific in a neonate and an infant; as such a high degree of clinical suspicion is required. We present the case of an eleven-month-old boy who has made a full recovery from an acute temporomandibular joint septic arthritis and review the relevant literature.

  14. Bacillus pumilus Septic Arthritis in a Healthy Child

    Directory of Open Access Journals (Sweden)

    V. M. Shivamurthy

    2016-01-01

    Full Text Available We report a case of septic arthritis caused by a Bacillus species, B. pumilus, occurring in a healthy child. This organism rarely causes serious infections and has only been described in newborns and immunocompromised individuals or as a skin infection. This child developed an indolent joint swelling after a minor skin injury, and symptoms were initially thought most consistent with chronic arthritis. The case demonstrates that clinicians should consider joint infection in children presenting with acute monoarticular swelling, even without prominent systemic features.

  15. [Juvenile idiopathic arthritis].

    Science.gov (United States)

    Herlin, Troels

    2002-08-19

    The new classification of juvenile idiopathic arthritis (JIA) is described in this review. Clinical characteristics divide JIA in to subtypes: systemic, oligoarticular (persistent and extended type), RF-positive and--negative polyarticular, enthesitis-related arthritis and psoriatic arthritis. In addition to the clinical characteristics, genetic and biochemical differences suggest that JIA could be regarded as a general term covering various diseases. Complications described are uveitis, temporomandibular joint affection and growth disturbances. The therapeutic strategy should be planned individually according to age, subtype and disease activity and carried out as teamwork with several specialties. Drugs showing significant effectiveness in controlled studies are primarily methotrexate and sulphasalazine. An immunomodulating agent, etanercept, a soluble TNF alpha-receptor fusion protein, has shown a promising effect in severe polyarticular JIA refractory to methotrexate treatment.

  16. Dermatoglyphics in rheumatoid arthritis.

    Directory of Open Access Journals (Sweden)

    Ravindranath R

    2003-10-01

    Full Text Available Patients with rheumatoid arthritis have been referred to Division of Human Genetics for counselling. Qualitative dermatoglyphics comprising of finger print pattern, interdigital pattern, hypothenar pattern and palmar crease were studied on 26 female and 11 male rheumatoid arthritis patients. Comparison between patient male and control male; and patient female and control female has been done. ′Chi′ square test was performed. In male patients, with hands together, arches were increased, loops/ whorls were decreased. Partial Simian crease was significantly increased. In the right hand, patterns were increased in the 3rd interdigital area. On the other hand, in female patients there was a significant increase in whorls and decrease in loops on the first finger on both the hands, increase in arches on the 3rd finger; both arches and whorls on the 4th finger of left hand. Present study has emphasized that dermatoglyphics could be applied as a diagnostic tool to patients with rheumatoid arthritis.

  17. [Arthritis and clinical history].

    Science.gov (United States)

    Silva, Lígia; Sampaio, Luzia; Pinto, José; Ventura, Francisco S

    2011-01-01

    In front of a patient with arthritis, clinical good-sense tells that the most probable diagnosis are the most prevalent ones. Nevertheless, we have to exclude a multiplicity of other aetiologies, less frequent, but with highest implications in the therapeutic conduct. Infections by Brucella and by Borrelia are rare causes of chronic arthritis, yet are diagnosis to consider, even when the clinical manifestations aren't the most typical, as there still exist endemic areas in Portugal. Here we report two clinical cases about patients with arthritis for more than one year, subject to ineffective exams ant treatments. Only the clinical history could put on evidence clinical-epidemiological data, suggestive of Brucellosis and Lyme Disease, namely the professional contact with infected animals, and the history of probable erythema migrans, that pointed toward the correct diagnosis. So, with directed therapeutic, there was complete resolution of the inflammatory symptoms.

  18. [Interstitial lung disease in rheumatoid arthritis].

    Science.gov (United States)

    Froidevaux-Janin, Sylvie; Dudler, Jean; Nicod, Laurent P; Lazor, Romain

    2011-11-23

    Interstitial lung disease (ILD) is found in up to 30% of patients with rheumatoid arthritis (RA) and is clinically manifest in 5 to 10%, resulting in significant morbidity and mortality. The most frequent histopathological forms are usual interstitial pneumonia and nonspecific interstitial pneumonia. Another recently described presentation is combined pulmonary fibrosis and emphysema. Similarly to idiopathic pulmonary fibrosis, acute exacerbation of ILD may occur in RA and is associated with severe prognosis. Smoking is a known risk factor of RA and may also play a role in the pathogenesis of RA-associated ILD, in combination with genetic and immunologic mechanisms. Several treatments of RA may also lead to drug-induced ILD.

  19. Acute Renal Failure: Unusual Complication of Epstein-Barr Virus-Induced Infectious Mononucleosis

    National Research Council Canada - National Science Library

    Paul S. Lei; Amy Lowichik; Wain Allen; Teri Jo Mauch

    2000-01-01

    A 17-year-old boy with juvenile rheumatoid arthritis presented with jaundice, confusion, hemolytic anemia, thrombocytopenia, and acute renal failure secondary to titer-confirmed acute Epstein-Barr virus (EBV...

  20. Neonatal Candida arthritis

    Directory of Open Access Journals (Sweden)

    Saurabh Sharma

    2014-01-01

    Full Text Available Fungal arthritis is an uncommon yet serious disorder in the newborn. Delay in diagnosis and management can lead to significant morbidity. We report our experience with management of two such cases. Two preterm neonates with multifocal arthritis caused by Candida were studied. Diagnosis was made by clinical examination, laboratory investigations, radiological investigations and culture. Both were treated by aspiration, arthrotomy and antifungal therapy. One patient recovered fully from the infection while the other had growth disturbances resulting in limb length inequality at recent followup. Prompt and expeditious evacuation of pus from joints and antifungal therapy is imperative for treatment. Associated osteomyelitis leads to further difficulty in treatment.

  1. Psoriatic Arthritis Registries.

    Science.gov (United States)

    Sarzi-Puttini, Piercarlo; Varisco, Valentina; Ditto, Maria Chiara; Benucci, Maurizio; Atzeni, Fabiola

    2015-11-01

    The introduction of new biological drugs for the treatment of rheumatoid arthritis and spondyloarthritis has led to the creation of a number of registries in Europe and the United States. Most of them are sponsored by national rheumatology societies, and provide information that is useful in clinical practice concerning the clinical characteristics, efficacy, and safety of all licensed biological drugs. Their findings also help to improve our understanding of the quality of life and working ability of patients receiving biological drugs, and suggest methods for allocating resources. However, there are only a few registries for psoriatic arthritis, and efforts should be made to increase their number to obtain further reliable and useful data.

  2. Vasculitis and inflammatory arthritis.

    Science.gov (United States)

    Watts, Richard A; Scott, David G I

    2016-10-01

    Vasculitis has been described in most types of inflammatory arthritis. The best described and most widely recognised form is rheumatoid vasculitis. The incidence of systemic rheumatoid vasculitis has declined significantly following the general early use of methotrexate in the 1990s, and it is now a rare form of vasculitis. Treatment of rheumatoid vasculitis is conventionally with glucocorticoids and cyclophosphamide, but there is an increasing role for rituximab similar to that in other types of vasculitis. Despite these developments the mortality of rheumatoid vasculitis remains high. Vasculitis in other types of inflammatory arthritis is less well described and the treatment remains empirical. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Total lymphoid irradiation of intractable rheumatoid arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Herbst, M.; Fritz, H.; Sauer, R.

    1986-12-01

    Eleven patients with intractable rheumatoid arthritis were treated with fractionated total lymphoid irradiation, (total dose 20 Gy). Lasting improvement in clinical symptoms was found in four patients during treatment and the remaining patients experienced similar benefit within 2 months of irradiation. There was marked reduction in exacerbations and number of joints involved. Morning stiffness, joint swelling and tenderness decreased. Complications included severe fatigue during treatment and acute bacterial arthritis in multiple joints in one patient. Four patients have since died, one of renal failure, another of cardiogenic shock following surgery 3 and 24 months after total lymphoid irradiation. Both had generalised amyloidosis. The third patient developed joint empyema and died of toxic cardiac failure. The fourth died 3 months after resection of a Kaposi's sarcoma complicated by wound infection which responded to treatment. Immunologically, total lymphoid irradiation resulted in suppression of the absolute lymphocyte count and reduction in T-helper cells, the number of T-suppressor cells remaining unchanged. These data provide evidence of T-cell involvement in the pathogenesis of rheumatoid arthritis. Total lymphoid irradiation can induce sustained improvement in clinical disease activity, but severe, possibly fatal, side-effects cannot be ignored.

  4. Crystals of monosodium urate monohydrate enhance lipopolysaccharide-induced release of interleukin 1 beta by mononuclear cells through a caspase 1-mediated process.

    NARCIS (Netherlands)

    Giamarellos, E.J.; Mouktaroudi, M.; Bodar, E.J.; Ven, J. van de; Kullberg, B.J.; Netea, M.G.; Meer, J.W.M. van der

    2009-01-01

    OBJECTIVE: Recent studies suggest that crystals of monosodium urate (MSU), deposited in joints of patients with acute gouty arthritis, activate the NACHT domain, leucine-rich repeat and pyrin domain-containing protein (NALP)3 inflammasome. In the present study we have investigated whether production

  5. Arthritis Pain Reliever

    Centers for Disease Control (CDC) Podcasts

    2011-12-27

    Learn more about the benefits of physical activity and the types and amounts of exercise helpful for people with arthritis.  Created: 12/27/2011 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 12/27/2011.

  6. Monitoring rheumatoid arthritis

    NARCIS (Netherlands)

    Gvozdenovic, Emilia

    2016-01-01

    In this thesis we focussed on so-called ‘treat to target’ therapy in rheumatoid arthritis (RA). Treat to target relies on repetitive measurements of disease activity using a composite score that incorporates signs of disease activity such as laboratory results, findings of physical joint assessments

  7. Juvenile arthritis and uveitis.

    Science.gov (United States)

    Kanski, J J

    1990-01-01

    The association between juvenile arthritis and uveitis is reviewed. Some children with the HLA-B27 related spondyloarthropathies develop anterior uveitis. About 20% of patients with juvenile rheumatoid arthritis (JRA) who are negative for IgM rheumatoid factor develop a frequently bilateral, nongranulomatous chronic anterior uveitis. Risk factors for uveitis in JRA patients are: female gender, pauciarticular onset of arthritis, presence of circulating antinuclear antibodies, and the antigens HLA-DW5 and HLA-DPw2. Uveitis is rare after seven years or more have elapsed from the onset of arthritis. The visual prognosis in patients with uveitis is good in 25% and fair in 50%. The remaining 25% develop visual impairment from complicated cataract and/or secondary inflammatory glaucoma. The potential benefit of cytotoxic agents in the treatment of intractable uveitis is outweighed by the risk of serious side effects. The management of secondary inflammatory glaucoma is unsatisfactory, but the results of treatment of complicated cataracts by lensectomy-vitrectomy are good.

  8. Neonatal septic arthritis.

    Science.gov (United States)

    Halder, D; Seng, Q B; Malik, A S; Choo, K E

    1996-09-01

    Neonatal septic arthritis has always been considered as separate from its counterpart in older children. The condition is uncommon but serious. Affected neonates usually survive, but with permanent skeletal deformities. Ten cases of neonatal septic arthritis were diagnosed between January 1989 and December 1993 in the neonatal intensive care units of two referral hospitals in the state of Kelantan, Malaysia. All except one neonate was born prematurely. The mean age of presentation was 15.6 days. Joint swelling (10/10), increased warmth (7/10) and erythema of the overlying skin (7/10) were the common presenting signs. Vague constitutional symptoms preceded the definitive signs of septic arthritis in all cases. The total white cell counts were raised with shift to the left. The knee (60%) was not commonly affected, followed by the hip (13%) and ankle (13%). Three neonates had multiple joint involvement. Coexistence of arthritis with osteomyelitis was observed in seven neonates. The commonest organism isolated was methicillin resistant Staphylococcus aureus (9/10). Needle aspiration was performed in nine neonates and one had incision with drainage. Follow up data was available for five neonates and two of these had skeletal morbidity. Early diagnosis by frequent examination of the joints, prompt treatment and control of nosocomial infection are important for management.

  9. Case report 445: Bilateral acromioclavicular gouty arthritis with pseudo-tumor of the outer end of the right clavicle: Saturnine gout

    Energy Technology Data Exchange (ETDEWEB)

    Podgorski, M.R.; Ibels, L.S.; Webb, J.

    1987-10-01

    An example of extensive, bilateral, distal clavicular erosion due to tophaceous saturnine gout is discussed, including the differential diagnosis of such lesions. The importance of unrecognized chronic lead nephropathy apparently causing primary gout is emphasized.

  10. Evaluation of Dual-energy CT in Patients With Gouty Arthritis%双源CT诊断痛风性关节炎临床分析

    Institute of Scientific and Technical Information of China (English)

    曹红岩

    2015-01-01

    Objective To explore the value of non-invasive dual-energy CT in the diagnosis of gout and the differential diagnosis of other joint diseases by observing urate crystals surrounding tissues. Methods 19 patients, who experienced unilateral arthrocele or joint pain in the past two weeks, were enrolled into our study, dual-energy CT was performed in all patients and ultrasound-guided joint aspiration were performed in some patients, the location, quantity and size of urate crystals were analyzed by dual-energy CT. Results Thirty-six urate crystals were found in 16 gout patients, and the most common sites of deposition were bilateral inter-phalangeal joints of foot, proximal inter-phalangeal joints, tissues around distal interphalangeal joint, metatarsal joints and the lower part of the tibia, the data indicated that urate crystals were more likely to deposit in the soft tissues around joints such as muscles, ligaments and so on, and the sites of deposition were consistent with the locations of arthralgia, the size of urate crystals could also be measured by dual-energy CT. Conclusion Urate crystals can be displayed by dual-energy CT, In addition, dual-energy CT is a non-invasive measure and it has great value in the differential diagnosis of joint diseases.%目的:使用双源 CT 观察关节及周围组织的尿酸盐结晶,探索临床诊断痛风及鉴别诊断其他关节疾病。方法选择最近2周发作过单关节肿或关节痛患者19例,行双源 CT 检查,部分患者在 B 超下穿刺取关节液镜检。结果16例痛风患者发现有36处有尿酸盐结晶,好发于双侧足趾关节、近端指关节、远端指间关节周围、跖关节、胫骨下端,尿酸盐结晶易沉淀在近关节骨表面,肌肉、韧带等关节周边软组织,并且关节疼痛的部位与尿酸盐结晶沉淀部位一致,尿酸盐结晶的大小可以测量。结论双源 CT 可以清晰显示尿酸盐结晶,为无创检测手段,在鉴别诊断不明原因单关节肿痛方面有很高的临床价值。

  11. IMAGING OF PSORIATIC ARTHRITIS

    Directory of Open Access Journals (Sweden)

    S. D'Angelo

    2011-09-01

    Full Text Available Imaging of psoriatic arthritis (PsA is important for two reasons: the differential diagnosis from other arthritides and the assessment of structural damage that can be inhibited by the new drugs such as the anti-TNFα agents. Plain film radiographic findings of peripheral arthritis have been important in elaborating the concept of PsA as a separate disease entity. Characteristic aspects of psoriatic peripheral arthritis help the differentiation from rheumatoid arthritis. High-resolution ultrasonography (US, US combined with power Doppler (PDUS and magnetic resonance imaging (MRI can be used to image joint synovitis of PsA. Radiologic features of spondylitis associated with psoriasis are similar to spondylitis associated with reactive arthritis and differ from those of primary ankylosing spondylitis (AS and the spondylitis associated with inflammatory bowel disease. MRI is very sensitive for the early diagnosis of sacroiliitis. There have been no MRI studies on the spine of patients with PsA. In primary AS bone oedema in the vertebral bodies is an indicator of active disease and can ameliorate during anti-TNFα therapy. Historically, plain film radiography have played a pivotal role in defining enthesitis lesions of SpA. However, entheseal bone changes appear late. US and MRI have proved to be a highly sensitive and non invasive tools. Recent US and MRI studies on both finger and toe dactylitis have established that dactylitis is due to flexor tenosynovitis and marked adjacent soft tissue swelling with a variable degree of small joint synovitis. There is no evidence of enthesitis of the insertion of the flexor digitorum tendons and of the attachment of the caspsule of the digit joints. Key words: Enthesitis, dactylitis, spondyloarthritis, ultrasound, magnetic resonance, imaging

  12. In vivo role of phagocytic synovial lining cells in onset of experimental arthritis.

    OpenAIRE

    van Lent, P. L.; Van den Hoek, A. E.; van den Bersselaar, L. A.; Spanjaards, M. F.; van Rooijen, N; Dijkstra, C.D.; Van De Putte, L B; van den Berg, W B

    1993-01-01

    The in vivo role of phagocytic synovial lining cells (SLC) was studied in acute experimental arthritis in the mouse. SLCs were selectively depleted by injecting liposomes encapsulating the drug dichloromethylene diphosphonate (CL2MDP, Clodronate). Optimal depletion of phagocytic lining cells occurred 7 days after CL2MDP liposome injection. Eliciting an immune complex-mediated arthritis in SLC-depleted knee joints largely prevented inflammation if compared to control arthritic knee joints. Joi...

  13. Chondrosternal Arthritis in Infant: An Unusual Entity

    Directory of Open Access Journals (Sweden)

    Athina Nikolarakou

    2014-01-01

    Full Text Available Primary arthritis of chondrosternal joint is very rare and occurs in infants less than 18 months of age. Presentation is most often subacute but may be acute. Child presents with a parasternal mass with history of fever and/or local signs of infection. Clinical symptoms vary from a painless noninflammatory to a painful mass with local tenderness and swelling, while fever may be absent. Laboratory data show low or marginally raised levels of white blood cells and C-reactive protein, reflecting, respectively, the subacute or acute character of the infection. It is a self-limiting affection due to the adequate immune response of the patient. Evolution is generally good without antibiotherapy with a progressive spontaneous healing. A wait-and-see approach with close follow-up in the first weeks is the best therapeutic option.

  14. Gonococcal arthritis in human immunodeficiency virus-infected patients. Review of the literature.

    Science.gov (United States)

    Sena Corrales, Gabriel; Mora Navas, Laura; Palacios Muñoz, Rosario; García López, Victoria; Márquez Solero, Manuel; Santos González, Jesús

    We report a case of gonococcal arthritis in a patient with human immunodeficiency virus (HIV) infection and review 17 previously published cases; only one patient presented urethritis, and blood cultures were positive in one case. Gonococcal arthritis is rare in HIV-infected patients and is not usually associated with other symptoms. It should be considered in the differential diagnosis of acute arthritis in patients with HIV infection. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  15. Postoperative Surgical Infection After Spinal Surgery in Rheumatoid Arthritis.

    Science.gov (United States)

    Koyama, Kensuke; Ohba, Tetsuro; Ebata, Shigeto; Haro, Hirotaka

    2016-05-01

    Individuals with rheumatoid arthritis are at higher risk for infection than the general population, and surgical site infection after spinal surgery in this population can result in clinically significant complications. The goal of this study was to identify risk factors for acute surgical site infection after spinal surgery in patients with rheumatoid arthritis who were treated with nonbiologic (conventional) disease-modifying antirheumatic drugs (DMARDs) alone or with biologic DMARDs. All patients treated with biologic agents were treated with nonbiologic agents as well. The authors performed a retrospective, single-center review of 47 consecutive patients with rheumatoid arthritis who underwent spinal surgery and had follow-up of 3 months or longer. The incidence of surgical site infection was examined, and multivariate logistic regression analysis was performed to test the association of surgical site infection with putative risk factors, including the use of biologic agents, methotrexate, and prednisolone, as well as the duration of rheumatoid arthritis, the presence of diabetes, patient age, length of surgery, and number of operative levels. After spinal surgery, 14.89% (7 of 47) of patients had surgical site infection. Use of methotrexate and/or prednisolone, patient age, diabetes, duration of rheumatoid arthritis, length of surgery, number of operative levels, and use of biologic DMARDs did not significantly increase the risk of infection associated with spinal surgery. All patients who had surgical site infection had undergone spinal surgery with instrumentation. The findings show that greater attention to preventing surgical site infection may be needed in patients with rheumatoid arthritis who undergo spinal surgery with instrumentation. To the authors' knowledge, this is the first study to show that the use of biologic agents did not increase the incidence of surgical site infection after spinal surgery in patients with rheumatoid arthritis

  16. Genetics Home Reference: juvenile idiopathic arthritis

    Science.gov (United States)

    ... Home Health Conditions juvenile idiopathic arthritis juvenile idiopathic arthritis Printable PDF Open All Close All Enable Javascript ... view the expand/collapse boxes. Description Juvenile idiopathic arthritis refers to a group of conditions involving joint ...

  17. Rheumatoid Arthritis: Can It Affect the Eyes?

    Science.gov (United States)

    ... arthritis: Can it affect the eyes? Can rheumatoid arthritis affect the eyes? Answers from April Chang-Miller, M.D. Rheumatoid arthritis is a chronic inflammatory disease that primarily affects ...

  18. Rheumatoid Arthritis and Complementary Health Approaches

    Science.gov (United States)

    ... T U V W X Y Z Rheumatoid Arthritis: In Depth Share: On This Page Key Points ... help ensure coordinated and safe care. About Rheumatoid Arthritis Rheumatoid arthritis is an inflammatory autoimmune disease—a ...

  19. Accommodation and Compliance Series: Employees with Arthritis

    Science.gov (United States)

    ... Resources Home | Accommodation and Compliance Series: Employees with Arthritis By Beth Loy, Ph.D. Preface Introduction Information ... SOAR) at http://AskJAN.org/soar . Information about Arthritis How prevalent is arthritis? An estimated 50 million ...

  20. Rheumatoid Arthritis: Can It Affect the Lungs?

    Science.gov (United States)

    ... arthritis: Can it affect the lungs? Can rheumatoid arthritis affect your lungs? Answers from April Chang-Miller, M.D. Although rheumatoid arthritis primarily affects joints, it sometimes causes lung disease ...

  1. INVESTIGATION OF CYTOKINE PROFILE IN PATIENTS WITH REACTIVE ARTHRITIS

    Directory of Open Access Journals (Sweden)

    T. V. Gaponova

    2008-01-01

    Full Text Available Abstract. Pathogenesis of reactive arthritis (ReA is not clear yet. Several trials suggest that increased production of proinflammatory cytokines is responsible for development of arthritis in ReA, while other studies report that Th1 cytokine response in ReA is impaired in favor of Th2 response. The aim of our study was to investigate serum levels of cytokines IL-1β, IL-4, IL-6, TNFα, IFNγ and IL-1Ra in the patients with ReA of different etiology, as compared with infection-related arthritis. The results of our study had demonstrated that serum levels of IL-1β and TNFα in the patients with ReA were significantly higher, whereas IL-1Ra, IL-4, IL-6 proved to be significantly lower than in healthy controls. Serum levels of IL-6 were significantly higher in patients with chronic ReA, as compared to the cases of acute and recurrent ReA. No significant differences in cytokine profiles were found between the patients with ReA, and the persons with infection-related arthritis. The data obtained are, generally, suggestive for proinflammatory Th1 cytokine profile in ReA patients studied, this confirming the mostly assumed pathogenetic hypothesis for reactive arthritis where an underlying cytokine imbalance is suggested. (Med. Immunol., 2008, vol. 10, N 2-3, pp 167-172.

  2. MR imaging of transient synovitis: differentiation from septic arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Yang, W.J.; Im, S.A.; Lim, G.Y.; Chun, H.J.; Jung, N.Y.; Sung, M.S.; Choi, B.G. [Catholic Univ. of Korea, Seoul (Korea). Dept. of Radiology

    2006-11-15

    Transient synovitis is the most common cause of acute hip pain in children. However, MR imaging findings in transient synovitis and the role of MR imaging in differentiating transient synovitis from septic arthritis have not been fully reported. To describe the MR findings of transient synovitis and to determine whether the MR characteristics can differentiate this disease entity from septic arthritis. Clinical findings and MR images of 49 patients with transient synovitis (male/female 36/13, mean age 6.1 years) and 18 patients with septic arthritis (male/female 10/8, mean age 4.9 years) were retrospectively reviewed. MR findings of transient synovitis were symptomatic joint effusion, synovial enhancement, contralateral joint effusion, synovial thickening, and signal intensity (SI) alterations and enhancement in surrounding soft tissue. Among these, SI alterations and enhancement in bone marrow and soft tissue, contralateral joint effusion, and synovial thickening were statistically significant MR findings in differentiating transient synovitis from septic arthritis. The statistically significant MR findings in transient synovitis are contralateral (asymptomatic) joint effusions and the absence of SI abnormalities of the bone marrow. It is less common to have SI alterations and contrast enhancement of the soft tissues. The statistically significant MR findings in septic arthritis are SI alterations of the bone marrow, and SI alterations and contrast enhancement of the soft tissue. Ipsilateral effusion and synovial thickening and enhancement are present in both diseases.

  3. Alternative for anti-TNF antibodies for arthritis treatment.

    Science.gov (United States)

    Paquet, Joseph; Henrionnet, Christel; Pinzano, Astrid; Vincourt, Jean-Baptiste; Gillet, Pierre; Netter, Patrick; Chary-Valckenaere, Isabelle; Loeuille, Damien; Pourel, Jacques; Grossin, Laurent

    2011-10-01

    Tumor necrosis factor-α (TNF-α), a proinflammatory cytokine, plays a key role in the pathogenesis of many inflammatory diseases, including arthritis. Neutralization of this cytokine by anti-TNF-α antibodies has shown its efficacy in rheumatoid arthritis (RA) and is now widely used. Nevertheless, some patients currently treated with anti-TNF-α remain refractory or become nonresponder to these treatments. In this context, there is a need for new or complementary therapeutic strategies. In this study, we investigated in vitro and in vivo anti-inflammatory potentialities of an anti-TNF-α triplex-forming oligonucleotide (TFO), as judged from effects on two rat arthritis models. The inhibitory activity of this TFO on articular cells (synoviocytes and chondrocytes) was verified and compared to that of small interfering RNA (siRNA) in vitro. The use of the anti-TNF-α TFO as a preventive and local treatment in both acute and chronic arthritis models significantly reduced disease development. Furthermore, the TFO efficiently blocked synovitis and cartilage and bone destruction in the joints. The results presented here provide the first evidence that gene targeting by anti-TNF-α TFO modulates arthritis in vivo, thus providing proof-of-concept that it could be used as therapeutic tool for TNF-α-dependent inflammatory disorders.

  4. A case of reactive arthritis due to Clostridium difficile colitis

    Directory of Open Access Journals (Sweden)

    Alex C. Essenmacher

    2016-02-01

    Full Text Available Reactive arthritis is an acute, aseptic, inflammatory arthropathy following an infectious process but removed from the site of primary infection. It is often attributed to genitourinary and enteric pathogens, such as Chlamydia, Salmonella, Shigella, Campylobacter, and Yersinia, in susceptible individuals. An uncommon and less recognized cause of this disease is preceding colonic infection with Clostridium difficile, an organism associated with pseudomembranous colitis and diarrhea in hospitalized patients and those recently exposed to antibiotics. Recognition of this association may be complicated by non-specific presentation of diarrhea, the interval between gastrointestinal and arthritic symptoms, and the wide differential in mono- and oligoarthritis. We present the case of a 61-year-old, hospitalized patient recently treated for C. difficile colitis who developed sudden, non-traumatic, right knee pain and swelling. Physical examination and radiographs disclosed joint effusion, and sterile aspiration produced cloudy fluid with predominant neutrophils and no growth on cultures. Diagnostic accuracy is enhanced by contemporaneous laboratory investigations excluding other entities such as gout and rheumatoid arthritis and other infections that typically precede reactive arthritis. Contribution of Clostridium infection to reactive arthritis is an obscure association frequently difficult to prove, but this organism is warranted inclusion in the differential of reactive arthritis.

  5. Multiple Intramuscular Gouty Tophi Mimicking Deep Tissue Abscesses: A Case Report

    Science.gov (United States)

    Luu, Van T

    2014-01-01

    Introduction: Gout is a common metabolic disorder resulting from supersaturation of uric acid in extracellular fluid and deposition of monosodium urate monohydrate crystals in tissues triggering inflammatory response. Depositions of uric acid crystal outside articular structures cause tophi and are commonly found at peripheral areas of the body which have a lower temperature. Deposition of uric acid crystals in the central area of the body is not uncommon and may be overlooked. Case presentation: A 55-year-old Pacific Islander man with a history of chronic tophaceous gout was admitted because of acute right knee pain. Physical examination revealed signs of inflammation over the right knee. Arthrocentesis was performed but no synovial fluid obtained. The patient was empirically treated with prednisone, colchicine, and febuxostat. On the next day, there was progression of inflammation up to the right mid-thigh. MRI of the right femur was obtained to exclude abscess and necrotizing faciitis. Multiple pockets of abscesses were identified within the vastus medialis and vastus intermedius adjacent to the femoral shaft. This prompted immediate surgical consultation and incision and drainage. Intraoperative findings revealed healthy muscles and deposition of soft-tan material in the vastus medialis and vastus intermedius along and above the shaft of the femur. Culture of the surgical aspirate was negative and pathology showed needle-shaped structures consistent with uric acid crystals. Empiric antibiotic was discontinued. The patient's condition improved after treatment for acute gout. Pegloticase was also added to the treatment regimen during an outpatient follow up visit with his rheumatologist. At six month follow up, the patient reported excellent improvements in clinical symptoms. Discussion: Atypical presentations of chronic tophaceous gout can be a great mimicker, causing diagnostic challenges for clinicians. Our patient who had multiple intramuscular tophi

  6. Pneumococcal polyarticular septic arthritis after a single infusion of infliximab in a rheumatoid arthritis patient: a case report

    Directory of Open Access Journals (Sweden)

    Hayashi Masatoshi

    2012-03-01

    Full Text Available Abstract Introduction We present a case of Streptococcus pneumoniae polyarticular septic arthritis in a patient with rheumatoid arthritis receiving a single infusion of infliximab. Case presentation A 38-year-old Japanese man with a 5-year history of seronegative rheumatoid arthritis had previously received sulphasalazine and methotrexate therapies and was on regular low-dose prednisolone therapy. Despite these treatments, his disease activity remained high and infliximab was introduced in addition to methotrexate, prednisolone, and folic acid. However, he was admitted to hospital with a fever of 40.6°C, chills, and polyarthralgia eight days after the first infusion of infliximab. His joints were swollen, painful, and warm. Laboratory data showed marked acute inflammation. He was diagnosed with bacterial septic polyarthritis, and emergency surgical joint lavage and drainage was performed at the knees along with needle aspiration and lavage of the ankles and right wrist. He was then given intravenous antibiotic therapy for 31 days. He made a good recovery and was discharged on day 37. Conclusions We believe this is the first reported case of severe pneumococcal septic arthritis requiring hospitalization in a patient treated with infliximab. S. pneumonia is now a well-recognized but uncommon cause of polyarticular septic arthritis that can lead to cessation of therapy, as in our patient's case.

  7. Clinical management of septic arthritis.

    Science.gov (United States)

    Sharff, Katie A; Richards, Eric P; Townes, John M

    2013-06-01

    Septic arthritis is a rheumatologic emergency as joint destruction occurs rapidly and can lead to significant morbidity and mortality. Accurate diagnosis can be particularly challenging in patients with underlying inflammatory joint disease. This review outlines the risk factors for septic arthritis and summarizes the causative bacterial organisms. We highlight advances in antibiotic management with a focus on new drugs for methicillin-resistant Staphylococcus aureus (MRSA) and discuss the use of adjunctive therapies for treatment of septic arthritis in adults.

  8. [Sport and rheumatoid arthritis].

    Science.gov (United States)

    Proschek, D; Rehart, S

    2014-06-01

    Sport is becoming increasingly more important in our society. Due to the changing age spectrum with a greater number of elderly and substantially more active people, an increasing number of people with underlying orthopedic diseases are becoming interested in participating in sport. This article deals with the possibilities and effects of sporting activities for people with rheumatoid arthritis within the framework of a conservative therapy. A literature search was carried out using medical search engines, in particular PubMed, and also via the recommendations of specialist societies and patient help groups. The quality of life of patients with rheumatoid arthritis consists of physical, mental and social components. Sport as a means of rehabilitation influences all of these components. Sport should be comprehended as a form of therapy and be adapted to the needs of the individual patient. The willingness to actively participate in sport should always be highly rated and encouraged. Sport is therefore an important pillar of therapy in a conservative total concept. The main aspects of sport therapeutic activities are functional, pedagogical and experience-oriented aspects. The clinical symptoms, extent of damage and physical impairment must, however, be evaluated and taken into consideration for the therapeutic concept. The amount of data on the complex topic of sport and rheumatoid arthritis is low and is mainly dealt with as retrospective reviews. A prospective randomized study basis is lacking. The aim must therefore be to confirm the currently available recommendations for various types of sport in controlled studies.

  9. Arthritis and iritis after BCG therapy for bladder cancer.

    Science.gov (United States)

    Price, G E

    1994-03-01

    A patient with preexisting inactive ankylosing spondylitis experienced a recurrence of back pain and his first episode of acute peripheral arthritis and iritis after a second course of treatment with BCG for bladder cancer. The occurrence of iritis after BCG therapy has not been reported. The recurrence of spondyloarthropathy and the new appearance of iritis may have been part of a generalized enhancement of immunological reactivity produced by the BCG.

  10. Imaging of Posttraumatic Arthritis, Avascular Necrosis, Septic Arthritis, Complex Regional Pain Syndrome, and Cancer Mimicking Arthritis.

    Science.gov (United States)

    Rupasov, Andrey; Cain, Usa; Montoya, Simone; Blickman, Johan G

    2017-09-01

    This article focuses on the imaging of 5 discrete entities with a common end result of disability: posttraumatic arthritis, a common form of secondary osteoarthritis that results from a prior insult to the joint; avascular necrosis, a disease of impaired osseous blood flow, leading to cellular death and subsequent osseous collapse; septic arthritis, an infectious process leading to destructive changes within the joint; complex regional pain syndrome, a chronic limb-confined painful condition arising after injury; and cases of cancer mimicking arthritis, in which the initial findings seem to represent arthritis, despite a more insidious cause. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Laboratory findings in psoriatic arthritis.

    Science.gov (United States)

    Punzi, L; Podswiadek, M; Oliviero, F; Lonigro, A; Modesti, V; Ramonda, R; Todesco, S

    2007-01-01

    Psoriatic arthritis (PsA) has been classically defined as an inflammatory arthritis associated with psoriasis. However, in comparison with other relevant inflammatory arthropathies, in which a definite diagnosis is frequently possible only by means of laboratory investigations, in PsA true laboratory diagnostic markers are lacking. Some markers are utilised more to differentiate other diseases than to characterise PsA. For example in polyarticular PsA, which may be in some cases indistinguishable from RA, the rheumatoid factor (RF) or the more specific and recently introduced antibodies to cyclic citrullinated peptides (anti-CCP), may be useful to better identify RA. However, RF was found in 5% to 13% of patients with PsA, and anti-CCP may be observed in almost similar percentage. The determination of ESR and/or CRP is frequently disappointing in PsA, since they are both elevated in only half of the patients with PsA. However, ESR and/or CRP are included in the most utilised response criteria for RA, such as ACR and DAS, and, in addition are also considered reliable in the assessment of PsA. Furthermore, elevated levels of ESR have been proposed as one of the best predictors of damage progression and, in addition, a low ESR seems protective, while an ESR >15 mm/h is one of the factors associated with an increased mortality in PsA. The synovial fluid (SF) effusion is much higher in PsA, in comparison with other arthropathies. When available, SF analysis may offer additive information useful for the diagnosis, such as the increased number of leukocytes, which underlines the inflammatory nature of the effusion even in a patient with normal serum levels of acute phase response. We found that elevated IL-1 levels in SF of patients with early disease (anti-TNF-alpha agents and the demonstration of their efficacy in the management of many clinical disease expressions including peripheral arthropathy, axial involvement, enthesopathy and skin manifestations, have stimulated

  12. TCM Dietotherapy for Gout

    Institute of Scientific and Technical Information of China (English)

    LI Hong-wei; ZHANG Yuan-zhen; LIU Zhen-hai; JIA Shou-kai

    2010-01-01

    @@ Gout is caused by purine metabolic disorder, clinically characterized by hyperuricemia, and the hyperuricemia-induced gouty acute arthritis, tophus sedimentation, tophus chronic arthritis and joint deformity. And it may involve the kidney, resulting in chronic interstitial nephritis and uric-acid nephr-olithiasis. The disease may be primary or secondary. The incidence rises with aging, and it is higher in males than that in females with ratio of 10:1.

  13. Septic arthritis in adult horses.

    Science.gov (United States)

    Carstanjen, B; Boehart, S; Cislakova, M

    2010-01-01

    Septic arthritis in horses is a serious disease which can become life-threatening. In case the infection can be eliminated before irreversible joint damage occurs, complete recovery is possible. This article gives an overview of the literature concerning etiology, diagnosis and strategies of therapy in cases of septic arthritis in adult horses, with special reference to novel options of treatment.

  14. Mouse Models of Rheumatoid Arthritis.

    Science.gov (United States)

    Caplazi, P; Baca, M; Barck, K; Carano, R A D; DeVoss, J; Lee, W P; Bolon, B; Diehl, L

    2015-09-01

    Rheumatoid arthritis (RA) is a chronic debilitating autoimmune disorder characterized by synovitis that leads to cartilage and bone erosion by invading fibrovascular tissue. Mouse models of RA recapitulate many features of the human disease. Despite the availability of medicines that are highly effective in many patient populations, autoimmune diseases (including RA) remain an area of active biomedical research, and consequently mouse models of RA are still extensively used for mechanistic studies and validation of therapeutic targets. This review aims to integrate morphologic features with model biology and cover the key characteristics of the most commonly used induced and spontaneous mouse models of RA. Induced models emphasized in this review include collagen-induced arthritis and antibody-induced arthritis. Collagen-induced arthritis is an example of an active immunization strategy, whereas antibody- induced arthritis models, such as collagen antibody-induced arthritis and K/BxN antibody transfer arthritis, represent examples of passive immunization strategies. The coverage of spontaneous models in this review is focused on the TNFΔ (ARE) mouse, in which arthritis results from overexpression of TNF-α, a master proinflammatory cytokine that drives disease in many patients.

  15. Occupational therapy for rheumatoid arthritis.

    NARCIS (Netherlands)

    Steultjens, E.M.J.; Dekker, J.; Bouter, L.M.; Schaardenburg, D.J. van; Kuyk, M.A.H. van; Ende, C.H.M. van den

    2004-01-01

    Background: For persons with rheumatoid arthritis (RA) the physical, personal, familial, social and vocational consequences are extensive. Occupational therapy (OT), with the aim to facilitate task performance and to decrease the consequences of rheumatoid arthritis for daily life activities, is con

  16. Kartagener syndrome and rheumatoid arthritis.

    Science.gov (United States)

    Rébora, Martin Esteban; Cuneo, Julia Ana; Marcos, Josefina; Marcos, Juan Carlos

    2006-02-01

    We report the case of a 38-year-old female patient, affected with Kartagener syndrome (primary ciliary dyskinesia), who developed seropositive and erosive rheumatoid arthritis. According to our review, there are only 6 cases reported so far with this association without a definite etiopathogenic linkage recognized in common. Chronic infections resulting from the ciliary dysfunction might be a trigger for rheumatoid arthritis.

  17. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Sheets Benefits and Risks of Opioids in Arthritis Management How to Give a Subcutaneous Injection Connect With Us Johns Hopkins Rheumatology Arthritis Center Lupus Center Lyme Disease Clinical Research Center Myositis Center Scleroderma Center Sjogren’s Syndrome Center ...

  18. Psoriatic arthritis as a mountain

    Directory of Open Access Journals (Sweden)

    J.M. Berthelot

    2011-09-01

    Full Text Available There is no doubt that inflammatory arthritis/enthesitis and psoriasis coexist more frequently than would be expected by chance: for instance, in a study of 1285 patients with psoriasis seen in an hospital, 483 (38% were suffering from arthritis/ enthesitis, including 40 patients classified as Rheumatoid Arthritis (RA (3%, 177 (14% as undifferentiated arthritis (UA, and 266 (21% as Psoriatic Arthritis (PsA (1. Although lower percentages have been noticed in the general population with psoriasis (6% of PsA in an extensive study of 1844 patients with psoriasis (2, they were superior to 5% (i.e. at least 5 times greater than the figures found for patients without psoriasis (3-7.

  19. Prevalence of acute and chronic viral seropositivity and characteristics of disease in patients with psoriatic arthritis treated with cyclosporine: a post hoc analysis from a sex point of view on the observational study of infectious events in psoriasis complicated by active psoriatic arthritis

    Directory of Open Access Journals (Sweden)

    Colombo D

    2015-12-01

    Full Text Available Delia Colombo,1 Sergio Chimenti,2 Paolo Antonio Grossi,3 Antonio Marchesoni,4 Federico Bardazzi,5 Fabio Ayala,6 Lucia Simoni,7 Donatella Vassellatti,1 Gilberto Bellia1 On behalf of SYNERGY Study Group 1Novartis Farma Italia, Origgio (VA, 2Tor Vergata Polyclinic Rome, 3Macchi Hospital and Foundation, Varese, 4Orthopaedic Institute Pini, Milan, 5S Orsola-Malpighi Polyclinic, Bologna, 6University Federico II Naples, 7MediData srl, Modena, Italy Background: Sex medicine studies have shown that there are sex differences with regard to disease characteristics in immune-mediated inflammatory diseases, including psoriasis, in immune response and susceptibility to viral infections. We performed a post hoc analysis of the Observational Study of infectious events in psoriasis complicated by active psoriatic arthritis (SYNERGY study in patients with psoriatic arthritis (PsA treated with immunosuppressive regimens including cyclosporine, in order to evaluate potential between-sex differences in severity of disease and prevalence of viral infections.Methods: SYNERGY was an observational study conducted in 24 Italian dermatology clinics, which included 238 consecutively enrolled patients with PsA, under treatment with immunosuppressant regimens including cyclosporin A. In this post hoc analysis, patients' demographical data and clinical characteristics of psoriasis, severity and activity of PsA, prevalence of seropositivity for at least one viral infection, and treatments administered for PsA and infections were compared between sexes.Results: A total of 225 patients were evaluated in this post hoc analysis, and 121 (54% were males. Demographic characteristics and concomitant diseases were comparable between sexes. Statistically significant sex differences were observed at baseline in Psoriasis Area and Severity Index score (higher in males, mean number of painful joints, Bath Ankylosing Spondylitis Disease Activity Index, and the global activity of disease

  20. 环氧化酶-2抑制剂依托考昔治疗急性痛风性关节炎的疗效和安全性分析%Analysis of the clinical effect and safety of cyclooxygenase -2 (COX -2)inhibitors of etoricoxib in treatment of acute gout arthritis

    Institute of Scientific and Technical Information of China (English)

    李善敬; 陈玲; 陈艳; 陈庞何; 苏成标

    2016-01-01

    Objective To probe into the clinical effects and safety of cyclooxygenase -2 (COX -2)inhibitors of etoricoxib in treatment of acute gout arthritis.Method 94 patients with acute gout arthritis who accepted treatments were taken as the re-search objects,and these patients were randomly divided into the control group (47 cases)and the observation group (47 cases) according to the different treatment methods.In the control group,they were given diclofenac sodium treatment while in the obser-vation group,they were treated with the etoricoxib.Then,the treatment effects of these two groups of patients were com-pared.Results The indexes in the observation group were significantly better than those of the control group,the difference was statistically significant (P <0.05);After the treatment,the pain scores of the two groups were decreased,and the pain score of the observation group was significantly better than that of the control group,the difference was statistically significant (P <0.05).Conclusion The clinical effects of yclooxygenase -2 (COX -2)inhibitors of etoricoxib in treatment of acute gout arthritis are good enough,and it is safety and reliable.%目的:探讨环氧化酶-2抑制剂依托考昔治疗急性痛风性关节炎的疗效和安全性。方法:选择收治的急性痛风性关节炎患者94例作为研究对象,根据治疗方式的不同随机将患者分为对照组(47例)和观察组(47例),对照组给予患者双氯芬酸钠治疗,观察组给予患者依托考昔治疗。观察两组患者治疗效果。结果:观察组各项指标显著优于对照组,差异有统计学意义(P <0.05);两组患者治疗后疼痛评分均下降,观察组疼痛评分显著优于对照组,差异有统计学意义(P <0.05)。结论:环氧化酶-2抑制剂依托考昔治疗急性痛风性关节炎的疗效佳,安全可靠。

  1. Combination therapy for pain management in inflammatory arthritis (rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, other spondyloarthritis)

    NARCIS (Netherlands)

    S. Ramiro; H. Radner; D. van der Heijde; A. van Tubergen; R. Buchbinder; D. Aletaha; R.B.M. Landewé

    2011-01-01

    Despite optimal therapy with disease-modifying antirheumatic drugs, many people with inflammatory arthritis (IA) continue to have persistent pain that may require additional therapy. To assess the benefits and safety of combination pain therapy for people with IA (rheumatoid arthritis (RA), ankylosi

  2. Prevalence of acute and chronic viral seropositivity and characteristics of disease in patients with psoriatic arthritis treated with cyclosporine: a post hoc analysis from a sex point of view on the observational study of infectious events in psoriasis complicated by active psoriatic arthritis

    Science.gov (United States)

    Colombo, Delia; Chimenti, Sergio; Grossi, Paolo Antonio; Marchesoni, Antonio; Bardazzi, Federico; Ayala, Fabio; Simoni, Lucia; Vassellatti, Donatella; Bellia, Gilberto

    2016-01-01

    Background Sex medicine studies have shown that there are sex differences with regard to disease characteristics in immune-mediated inflammatory diseases, including psoriasis, in immune response and susceptibility to viral infections. We performed a post hoc analysis of the Observational Study of infectious events in psoriasis complicated by active psoriatic arthritis (SYNERGY) study in patients with psoriatic arthritis (PsA) treated with immunosuppressive regimens including cyclosporine, in order to evaluate potential between-sex differences in severity of disease and prevalence of viral infections. Methods SYNERGY was an observational study conducted in 24 Italian dermatology clinics, which included 238 consecutively enrolled patients with PsA, under treatment with immunosuppressant regimens including cyclosporin A. In this post hoc analysis, patients’ demographical data and clinical characteristics of psoriasis, severity and activity of PsA, prevalence of seropositivity for at least one viral infection, and treatments administered for PsA and infections were compared between sexes. Results A total of 225 patients were evaluated in this post hoc analysis, and 121 (54%) were males. Demographic characteristics and concomitant diseases were comparable between sexes. Statistically significant sex differences were observed at baseline in Psoriasis Area and Severity Index score (higher in males), mean number of painful joints, Bath Ankylosing Spondylitis Disease Activity Index, and the global activity of disease assessed by patients (all higher in females). The percentage of patients with at least one seropositivity detected at baseline, indicative of concomitant or former viral infection, was significantly higher among women than among men. No between-sex differences were detected in other measures, at other time points, and in treatments. Patients developed no hepatitis B virus or hepatitis C virus reactivation during cyclosporine treatment. Conclusion Our post hoc

  3. Bone pathology inpsoriatic arthritis

    Directory of Open Access Journals (Sweden)

    V. V. Badokin

    2007-01-01

    Full Text Available Objective. To study different variants of osteolysis in pts with psoriatic arthritis (PA and to reveal their relationship with other clinico-radiological features of joint damage. Material and methods. 370 pts with definite PA having different variants of joint damage were included. Radiological examination of bones and joints (in some cases large picture frame was performed. Morphological evaluation of synovial biopsies was done in 34 pts with PA and 10 pts with rheumatoid arthritis (RA. Results. Different types of osteolysis were revealed in 80 (21,6% pts. Osteolytic variant of joint damage was present in 29 pts. 33 pts had acral, 48 — intra-articular osteolysis and 16 - true bone atrophy. Frequency and intensity of bone resorption were associated with severity of PA. Acral osteolysis correlated with arthritis of distal interphalangeal joints and onychodystrophy. Intra-articular osteolysis was most often present in distal interphalangeal joints of hands and metacarpophalangeal joints (39,6% and 41,7% respectively. Characteristic feature of PA was combination of prominent resorption with formation of bone ankylosis and periosteal reaction. Ankylosis was present in 33,3% of pts with intra-articular osteolysis and in 60% of pts with combination of different osteolysis variants. Systemic reaction of microcirculation in synovial biopsies was most prominent in osteolytic variant: marked thickening of capillary and venule basal membrane with high level of acid phosphatase, increased capillary and precapillary blood flow with stasis features, vascular lymphocyte and macrophage infiltration, productive vasculitis with annular wall thickening, thrombovasculitis and villi deep layer sclerosis. Conclusion. Different variants of osteolysis show bone involvement in PA. Acral and intra- articular osteolysis association with bone ankylosis and periostitis proves their common pathogenetic entity.

  4. Autoantibodies in inflammatory arthritis.

    Science.gov (United States)

    Conigliaro, P; Chimenti, M S; Triggianese, P; Sunzini, F; Novelli, L; Perricone, C; Perricone, R

    2016-07-01

    Rheumatoid arthritis (RA) is a systemic chronic inflammatory disease characterized by extensive synovitis resulting in erosions of articular cartilage and marginal bone with joint destruction. The lack of immunological tolerance in RA represents the first step toward the development of autoimmunity. Susceptible individuals, under the influence of environmental factors, such as tobacco smoke, and silica exposure, develop autoimmune phenomena that result in the presence of autoantibodies. HLA and non-HLA haplotypes play a major role in determining the development of specific autoantibodies differentiating anti-citrullinated antibodies (ACPA)-positive and negative RA patients. Rheumatoid factor (RF) and ACPA are the serological markers for RA, and during the preclinical immunological phase, autoantibody titers increase with a progressive spread of ACPA antigens repertoire. The presence of ACPA represents an independent risk factor for developing RA in patients with undifferentiated arthritis or arthralgia. Moreover, anti-CarP antibodies have been identified in patients with RA as well as in individuals before the onset of clinical symptoms of RA. Several autoantibodies mainly targeting post-translational modified proteins have been investigated as possible biomarkers to improve the early diagnosis, prognosis and response to therapy in RA patients. Psoriatic arthritis (PsA) is distinguished from RA by infrequent positivity for RF and ACPA, together with other distinctive clinical features. Actually, specific autoantibodies have not been described. Recently, anti-CarP antibodies have been reported in sera from PsA patients with active disease. Further investigations on autoantibodies showing high specificity and sensibility as well as relevant correlation with disease severity, progression, and response to therapy are awaited in inflammatory arthritides.

  5. Fungal arthritis and osteomyelitis.

    Science.gov (United States)

    Kohli, Rakhi; Hadley, Susan

    2005-12-01

    Fungal arthritis and osteomyelitis are uncommon diseases and generally present in an indolent fashion. The incidence of fungal bone and joint dis-ease is increasing with an increase in the prevalence of factors predisposing to invasive fungal disease, such as the use of central venous catheters, broad spectrum antibiotics, immunosuppression, and abdominal surgery. Definitive diagnosis relies on bone or synovial culture or biopsy. Successful management has traditionally consisted of amphotericin B in combination with surgical debridement. Given the rarity of this disease, treatment is not well defined, but reports of success with the use of azole antifungal agents, including itraconazole, fluconazole, voriconazole, and posaconazole, are promising.

  6. Copper chelation with tetrathiomolybdate suppresses adjuvant-induced arthritis and inflammation-associated cachexia in rats

    Science.gov (United States)

    Omoto, Atsushi; Kawahito, Yutaka; Prudovsky, Igor; Tubouchi, Yasunori; Kimura, Mizuho; Ishino, Hidetaka; Wada, Makoto; Yoshida, Makie; Kohno, Masataka; Yoshimura, Rikio; Yoshikawa, Toshikazu; Sano, Hajime

    2005-01-01

    Tetrathiomolybdate (TM), a drug developed for Wilson's disease, produces an anti-angiogenic and anti-inflammatory effect by reducing systemic copper levels. TM therapy has proved effective in inhibiting the growth of tumors in animal tumor models and in cancer patients. We have hypothesized that TM may be used for the therapy of rheumatoid arthritis and have examined the efficacy of TM on adjuvant-induced arthritis in the rat, which is a model of acute inflammatory arthritis and inflammatory cachexia. TM delayed the onset of and suppressed the severity of clinical arthritis on both paw volume and the arthritis score. Histological examination demonstrated that TM significantly reduces the synovial hyperplasia and inflammatory cell invasion in joint tissues. Interestingly, TM can inhibit the expression of vascular endothelial growth factor in serum synovial tissues, especially in endothelial cells and macrophages. Moreover, the extent of pannus formation, which leads to bone destruction, is correlated with the content of vascular endothelial growth factor in the serum. There was no mortality in TM-treated rat abnormalities. TM also suppressed inflammatory cachexia. We suggest that copper deficiency induced by TM is a potent approach both to inhibit the progression of rheumatoid arthritis with minimal adverse effects and to improve the well-being of rheumatoid arthritis patients. PMID:16277669

  7. Kidney involvement in rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    P. Lazzarini

    2011-09-01

    Full Text Available Rheumatoid Arthritis (RA is a widespread disease and its renal involvement, relatively common, is clinically significant because worsens course and mortality of the primary disease. There is still no agreement on the prevalence of renal disorders in RA: data analysis originates from different sources, as death certificates, autopsies, clinical and laboratory findings and kidney biopsies, each with its limitations. Histoimmunological studies on bioptical specimens of patients with RA and kidney damage, led to clarify prevalent pathologies. In order of frequency: glomerulonephritis and amyloidosis (60-65% and 20-30% respectively, followed by acute or chronic interstitial nephritis. Kidney injury during RA includes secondary renal amyloidosis, nephrotoxic effects of antirheumatic drugs and nephropathies as extra-articular manifestations (rheumatoid nephropathy. Amyloidosis affects survival, increases morbidity and is the main cause of end stage renal disease in patients with RA and nephropathy. Strong association between RA activity and amyloidosis needs the use of immunosuppressive and combined therapies, to prevent this complication and reduce risk of dialysis. Long-lasting and combined RA pharmacotherapy involves various renal side effects. In this review we describe NSAIDs and DMARDs (Disease-Modifying Antirheumatic Drugs nephrotoxicity, particularly by gold compounds, D-penicillamine, cyclosporine A and methotrexate. Rare cases of IgA glomerulonephritis during immunomodulating therapy with leflunomide and TNF blocking receptor (etanercept are reported; real clinical significance of this drug-related nephropathy will be established by development of RA treatment. In RA nephropathies, mesangial glomerulonephritis is the most frequent histological lesion (35-60 % out of biopsies from patients with urinary abnormalities and/or kidney impairment, followed by minimal change glomerulopathy (3-14% and p-ANCA positive necrotizing crescentic

  8. [Optic neuritis in juvenile idiopathic arthritis patient].

    Science.gov (United States)

    Lourenço, Daniela M R; Buscatti, Izabel M; Lourenço, Benito; Monti, Fernanda C; Paz, José Albino; Silva, Clovis A

    2014-01-01

    Optic neuritis (ON) was rarely reported in juvenile idiopathic arthritis (JIA) patients, particularly in those under anti-tumor necrosis factor alpha blockage. However, to our knowledge, the prevalence of ON in JIA population has not been studied. Therefore, 5,793 patients were followed up at our University Hospital and 630 (11%) had JIA. One patient (0.15%) had ON and was reported herein. A 6-year-old male was diagnosed with extended oligoarticular JIA, and received naproxen and methotrexate subsequently replaced by leflunomide. At 11 years old, he was diagnosed with aseptic meningitis, followed by a partial motor seizure with secondary generalization. Brain magnetic resonance imaging (MRI) and electroencephalogram showed diffuse disorganization of the brain electric activity and leflunomide was suspended. Seven days later, the patient presented acute ocular pain, loss of acuity for color, blurred vision, photophobia, redness and short progressive visual loss in the right eye. A fundoscopic exam detected unilateral papilledema without retinal exudates. Orbital MRI suggested right ON. The anti-aquaporin 4 (anti-AQP4) antibody was negative. Pulse therapy with methylprednisolone was administered for five days, and subsequently with prednisone, he had clinical and laboratory improvement. In conclusion, a low prevalence of ON was observed in our JIA population. The absence of anti-AQP4 antibody and the normal brain MRI do not exclude the possibility of demyelinating disease associated with chronic arthritis. Therefore, rigorous follow up is required.

  9. APLAR rheumatoid arthritis treatment recommendations.

    Science.gov (United States)

    Lau, Chak Sing; Chia, Faith; Harrison, Andrew; Hsieh, Tsu-Yi; Jain, Rahul; Jung, Seung Min; Kishimoto, Mitsumasa; Kumar, Ashok; Leong, Khai Pang; Li, Zhanguo; Lichauco, Juan Javier; Louthrenoo, Worawit; Luo, Shue-Fen; Nash, Peter; Ng, Chin Teck; Park, Sung-Hwan; Suryana, Bagus Putu Putra; Suwannalai, Parawee; Wijaya, Linda Kurniaty; Yamamoto, Kazuhiko; Yang, Yue; Yeap, Swan Sim

    2015-09-01

    Rheumatoid arthritis is a chronic inflammatory condition that affects approximately 1% of the world's population. There are a wide number of guidelines and recommendations available to support the treatment of rheumatoid arthritis; however, the evidence used for these guidelines is predominantly based on studies in Caucasian subjects and may not be relevant for rheumatoid arthritis patients in the Asia-Pacific region. Therefore, the Asia Pacific League of Associations for Rheumatology established a Steering Committee in 2013 to address this issue. The AGREE II instrument and the ADAPTE Collaboration framework were applied to systematically identify, appraise, synthesize, and adapt international rheumatoid arthritis guidelines for use in the Asia-Pacific region. Forty rheumatoid arthritis treatment recommendations, based on evidence and expert opinion, were drafted and are presented in this report. The Asia Pacific of Associations for Rheumatology rheumatoid arthritis treatment recommendations are intended to serve as a reference for best practice management of rheumatoid arthritis in Asia-Pacific, focusing on local issues to ensure the delivery of basic care for these patients, and to improve their outcomes. In addition, the document will serve as a reference for national rheumatology associations in Asia-Pacific for developing guidelines in their respective countries. © 2015 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

  10. [Lower costovertebral arthritis in rheumatic pelvispondylitis. Pseudourologic manifestation].

    Science.gov (United States)

    Benhamou, C L; Roux, C; Benhamou-Mayoux, A; Gauvain, J B; Corlieu, P; Viala, J F; Amor, B

    1987-03-01

    Costo-vertebral and costo-transverse joints are often involved during rheumatoid pelvispondylitis. Their involvement may lead to thoracic ankylosis and decreased respiratory capabilities. These arthritis may also cause intercostal or pseudo-visceral pains. The authors report three cases of lower costo-vertebral arthritis, revealed by pseudo-urological, acute or subacute pains. The diagnosis was made on clinical findings (especially mobilization of the lower ribs) and confirmed by X-Rays (especially tomodensitometry). One of the cases presents an image of unilateral pedicle opacity secondary to costovertebral arthritis. The pseudo-urological manifestation of the pain is likely explained by the anatomical relationship between costo-vertebral joints and the sympathetic communicating rami. This close anatomical relationship was confirmed by dissection. Through the communicating rami, the costo-vertebral joints are thus in relation with the sympathetic system, which is responsible for the sensory innervation of the renal space. The pseudo-urological revelation of this arthritis should be compared to that of costal sprains.

  11. JUVENILE RHEUMATOID ARTHRITIS

    Directory of Open Access Journals (Sweden)

    I N Sartika

    2012-11-01

    Full Text Available Juvenile rheumatoid arthritis (JRA is the most common rheumatic condition in children. JRA is defined as persistent arthritis in 1 or more joints for at least 6 weeks, with the onset before age 16 years. The etiology of JRA is unknown. Antigen activated CD4+ T cell stimulate monocytes, macrophages, and synovial fibroblasts to produce the cytokines Interleukin-1 (IL-1, IL-6, and tumor necrosis factor ? (TNF-? and to secrete matrix metalloproteinases, which lead to chronic inflammation due to infiltration of inflammatory cell, angiogenesis, destruction of cartilage and bone with pannus formation. The 3 major subtypes of JRA are based on the symptoms at disease onset and are designated systemic onset, pauciarticular onset, and polyarticular onset. For all patients, the goals of therapy are to decrease chronic joint pain and suppress the inflammatory process. Poor prognostic have been observed in patients with polyarticular onset, rheumatoid factor, persistent morning stiffness, tenosynovitis, involvement of the small joints, rapid appearance of erosions, active late onset childhood, subcutaneous nodules, or antinuclear antibody.

  12. Evaluation of Anti-Cyclic Citrullinated Peptide Autoantibodies and C-Reactive Protein in Common Autoimmune Skin Diseases with and without Arthritis.

    Science.gov (United States)

    Kumari, Bandana; Kumar, Pawan; Chaudhary, Radha Krishna Prasad

    2017-07-01

    Anti-Cyclic Citrullinated Peptides (CCPs) are a well known diagnostic and prognostic noble marker for rheumatoid arthritis. C-Reactive Protein (CRP) is an acute phase protein whose level rises in response to inflammation. This study was undertaken to show the role of the two markers (anti-CCPs and CRP) in autoimmune skin disorder and their association with associated arthritis in these disorder. Serum anti-CCP antibodies and CRP was measured in 50 patients of autoimmune skin disease of which 28 were of psoriasis, 12 of Systemic Lupus Erythematosus (SLE) and 10 of Pemphigus Vulgaris (PV). These patients were categorised in two groups, with associated arthritis and without arthritis. The serum level of anti-CCP and CRP was correlated with the presence or absence of arthritis in these patients. Control group consists of 20 healthy subjects in which these two parameters were measured. Out of total of 50 patients, anti-CCP was raised in 36.37% of patients with associated arthritis and 12.82% of patients without arthritis whereas CRP was raised in 63.63% of patients with arthritis and 35.89% of patients without arthritis. Mean serum anti-CCP in patient with arthritis was 15.78±13.94 U/ml and without arthritis was 7.56±7.68 U/ml with p=0.01 which was statistically significant. Mean serum CRP in arthritis was 21.11±15.51 mg/l and CRP without arthritis was 13.14±12.27 mg/l with p=0.07 which was statistically not significant. Although both anti-CCP and CRP are valuable markers for autoimmune skin disorder, anti-CCP seems to show significant association with arthritis.

  13. Radiological aspects of rheumatoid arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Schacherl, M.

    1985-09-23

    An introductory summary of the imaging-diagnosis will be given. The necessity of acquiring a catalogue of application to particular imaging methods is emphasized. Discussion of step by step diagnosis regarding rheumatologic questions is given on example of the hand. Technically insufficient radiographs and bad habits during diagnostic analysis are pointed out. Radiologic problems in differentiating arthritis/osteoarthrosis will be mentioned. The discussion of these points is followed by outlining the radiology of rheumatoid arthritis and the complexity of this disease. Introduction of a new stage classification. Finally twelve basic radiologic types of rheumatoid arthritis will be presented.

  14. Promising Results for Drug to Fight Arthritis Linked to Psoriasis

    Science.gov (United States)

    ... Results for Drug to Fight Arthritis Linked to Psoriasis Psoriatic arthritis causes painful joint swelling, but new ... of a form of arthritis often linked to psoriasis. According to Stanford University researchers, psoriatic arthritis is ...

  15. The nonpsychoactive cannabis constituent cannabidiol is an oral anti-arthritic therapeutic in murine collagen-induced arthritis

    OpenAIRE

    Malfait, A. M.; Gallily, R; Sumariwalla, P. F.; Malik, A. S.; Andreakos, E; Mechoulam, R.; Feldmann, M

    2000-01-01

    The therapeutic potential of cannabidiol (CBD), the major nonpsychoactive component of cannabis, was explored in murine collagen-induced arthritis (CIA). CIA was elicited by immunizing DBA/1 mice with type II collagen (CII) in complete Freund's adjuvant. The CII used was either bovine or murine, resulting in classical acute CIA or in chronic relapsing CIA, respectively. CBD was administered after onset of clinical symptoms, and in both models of arthritis the treatment effectively blocked pro...

  16. Pyogenic knee arthritis caused by group A β-hemolytic Streptococcus: a toxic shock-prevented case.

    Science.gov (United States)

    Goto, Masafumi; Gotoh, Masafumi; Mitsui, Yasuhiro; Shibata, Hideaki; Okawa, Takahiro; Higuchi, Fujio; Shiba, Naoto

    2014-01-01

    Pyogenic knee arthritis caused by group A β-hemolytic Streptococcus (GAS) is rare. GAS sometimes causes group A β-hemolytic streptococcal toxic shock syndrome. We encountered a case of pyogenic knee arthritis caused by GAS that resolved after appropriate treatment (emergency arthroscopic synovectomy and medication) administered within 48 h of onset. In cases of a history of another infection with acute knee joint pain, the possibility of GAS-induced pyogenic knee arthritis should be considered, and proper treatment should be administered immediately.

  17. Dermatitis herpetiformis and rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Singal Archana

    2002-01-01

    Full Text Available A 35- year-old deaf and dumb woman with clinical and histopothological diagnosis of dermatitis herpetiforrnis (DH is reported for its rare association with rheumatoid arthritis (PA.

  18. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... a Question Physician Corner Rheumatology Conference Rheumatology Rounds Case Rounds Radiology Rounds Pathophysiology of the Rheumatic Diseases Our Research Patient-Centered Outcomes Research Research Studies The Camille Julia Morgan Arthritis Research and Education ...

  19. Genetics Home Reference: rheumatoid arthritis

    Science.gov (United States)

    ... D; Biologics in Rheumatoid Arthritis Genetics and Genomics Study Syndicate; Wellcome Trust Case Control Consortium, Concannon P, Onengut-Gumuscu S, Rich SS, Deloukas P, Gonzalez-Gay MA, Rodriguez-Rodriguez L, Ärlsetig L, Martin J, ...

  20. Therapy strategies in psoriatic arthritis.

    Science.gov (United States)

    Coates, Laura C

    2015-01-01

    Psoriatic arthritis (PsA) is a heterogeneous condition with a myriad of different clinical presentations. It commonly affects the skin and musculoskeletal system causing psoriasis, peripheral arthritis, axial arthritis, enthesitis and dactylitis. Many patients also have related conditions, such as those within the metabolic syndrome and associated spondyloarthritis (SpA) conditions including inflammatory bowel disease and uveitis. Any therapeutic strategy must be tailored to the individual patient, taking into account her/his complete clinical presentation and comorbidities. New treatment recommendations from the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) provide evidence based recommendations on effective therapies for the management of each different manifestation of PsA, and how treatment may be affected by comorbidities (1). However, the limited evidence comparing different treatment strategies in PsA is recognised as a limitation in these recommendations and further information is detailed below.