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Sample records for acute gouty arthritis

  1. 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, Johannes J.

    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

  2. P2X7R: a potential key regulator of acute gouty arthritis.

    Science.gov (United States)

    Tao, Jin-Hui; Zhang, Yong; Li, Xiang-Pei

    2013-12-01

    Acute gouty arthritis is an inflammatory disease resulting from the precipitation of long-term hyperuricemia-induced monosodium urate (MSU) crystals in joints, which stimulates the production of interleukin-1beta (IL-1β) and initiates an inflammatory reaction. However, some patients having MSU crystals in the joints never develop acute gouty arthritis, indicating that other predisposing factors are required for the disease onset. This review described the mechanism of production of IL-1β by MSU crystals and other possible factors during a gout attack. The relevant English literature on IL-1β secretion stimulated by MSU crystals and other possible factors during acute gouty arthritis flares was searched and carefully reviewed. MSU crystals lead to the onset of acute gouty arthritis mainly through the activation of Toll-like receptors (TLRs) and NACHT-LRR-PYD-containing protein 3 (NALP3) inflammasome signaling and downstream IL-1β production. The predisposing factors of acute gouty arthritis, such as strenuous exercise, cold, alcolholism, and overeating have a common characteristic inducing dramatic changes of adenosine triphosphate (ATP) in the body. The ATP changes can activate the purinergic receptor P2X ligand-gated ion channel 7 (P2X7R) signaling system to regulate IL-1β secretion. We hypothesize that acute gouty arthritis is induced by two synergistic effects; one is the stimulation of MSU crystals and the other is the activation of P2X7R signaling pathways by extracellular ATP changes, which together lead to the production of IL-1β and the initiation of acute gouty arthritis. This hypothesis will provide a new avenue for the prevention and treatment of acute gouty arthritis. Copyright © 2013 Elsevier Inc. All rights reserved.

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

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    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

  4. 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

  5. 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 septic 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 septic 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.

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

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    O.V. Gudym

    2017-08-01

    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

  7. The tyrosine kinase inhibitor imatinib mesylate suppresses uric acid crystal-induced acute gouty arthritis in mice.

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    Laurent L Reber

    Full Text Available Gouty arthritis is caused by the deposition of monosodium urate (MSU crystals in joints. Despite many treatment options for gout, there is a substantial need for alternative treatments for patients unresponsive to current therapies. Tyrosine kinase inhibitors have demonstrated therapeutic benefit in experimental models of antibody-dependent arthritis and in rheumatoid arthritis in humans, but to date, the potential effects of such inhibitors on gouty arthritis has not been evaluated. Here we demonstrate that treatment with the tyrosine kinase inhibitor imatinib mesylate (imatinib can suppress inflammation induced by injection of MSU crystals into subcutaneous air pouches or into the ankle joint of wild type mice. Moreover, imatinib treatment also largely abolished the lower levels of inflammation which developed in IL-1R1-/- or KitW-sh/W-sh mice, indicating that this drug can inhibit IL-1-independent pathways, as well as mast cell-independent pathways, contributing to pathology in this model. Imatinib treatment not only prevented ankle swelling and synovial inflammation when administered before MSU crystals but also diminished these features when administrated after the injection of MSU crystals, a therapeutic protocol more closely mimicking the clinical situation in which treatment occurs after the development of an acute gout flare. Finally, we also assessed the efficiency of local intra-articular injections of imatinib-loaded poly(lactic-co-glycolic acid (PLGA nanoparticles in this model of acute gout. Treatment with low doses of this long-acting imatinib:PLGA formulation was able to reduce ankle swelling in a therapeutic protocol. Altogether, these results raise the possibility that tyrosine kinase inhibitors might have utility in the treatment of acute gout in humans.

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

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    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

  9. 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

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

    Science.gov (United States)

    Hueskes, Berdine A A; Roovers, Elisabeth A; Mantel-Teeuwisse, Aukje K; Janssens, Hein J E M; van de Lisdonk, Eloy H; Janssen, Matthijs

    2012-06-01

    To systematically review the literature investigating the relationship between use of diuretics and the risk of gouty arthritis. PubMed (1950-October 2009), Embase (1974-October 2009), and the Cochrane Library (up to October 2009) were searched using keywords and MeSH terms diuretics, adverse effects, and gout. For this review, the technique of "best evidence synthesis" was used. Studies reporting frequency, absolute or relative risks, odds ratio, or rate ratio of gouty arthritis in diuretic users compared with nonusers were selected and evaluated. Studies had to be published in English. Checklists from the Dutch Cochrane Centre were used to assess the quality of randomized controlled trials (RCTs), cohort, and case-control studies. Two RCTs, 6 cohort studies, and 5 case-control studies met the inclusion criteria. The overall quality of the studies was moderate. In a RCT the rate ratio of gout for use of bendrofluazide vs placebo was 11.8 (95% CI 5.2-27.0). The other RCT found a rate ratio of 6.3 (95% CI 0.8-51) for use of hydrochlorothiazide plus triamterene vs placebo. Three cohort studies and 4 case-control studies found higher risks of gouty arthritis in users compared with nonusers of diuretics. There is a trend toward a higher risk for acute gouty arthritis attacks in patients on loop and thiazide diuretics, but the magnitude and independence is not consistent. Therefore, stopping these useful drugs in patients who develop gouty arthritis is not supported by the results of this review. Copyright © 2012 Elsevier Inc. All rights reserved.

  11. Overinfection by Paracoccidioides brasiliensis in Gouty Crystal Arthritis

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    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.

  12. Gouty arthritis in the acquired immunodeficiency syndrome. An unusual but aggressive case.

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    Disla, E; Stein, S; Acevedo, M; Cuppari, G

    1995-04-01

    Patients with the acquired immunodeficiency syndrome (AIDS) are characteristically hypouricemic. Therefore, the occurrence of gouty arthritis in association with AIDS would be expected to be a rare phenomenon. We describe a patient with AIDS in whom gouty arthritis developed. Features of both diseases in relation to their coexistence in this patient are discussed.

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

    International Nuclear Information System (INIS)

    Schueller-Weidekamm, Claudia; Schueller, Gerd; Aringer, Martin; Weber, Michael; Kainberger, Franz

    2007-01-01

    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

  14. Pitfalls in management of acute gouty attack, a qualitative research ...

    African Journals Online (AJOL)

    Hamid Mustafa

    2014-05-17

    May 17, 2014 ... Abstract Objective: To probe doctors' attitudes and reveal wrong perception in the management of acute gouty attacks. Design: A descriptive study using a designed questionnaire that was completed through face to face interviews in hospitals, health units and polyclinics in the Makah Region. Method: This ...

  15. Pitfalls in management of acute gouty attack, a qualitative research ...

    African Journals Online (AJOL)

    Objective: To probe doctors' attitudes and reveal wrong perception in the management of acute gouty attacks. Design: A descriptive study using a designed questionnaire that was completed through face to face interviews in hospitals, health units and polyclinics in the Makah Region. Method: This is a qualitative study of ...

  16. Single nucleotide polymorphisms associated with P2X7R function regulate the onset of gouty arthritis.

    Science.gov (United States)

    Tao, Jin-Hui; Cheng, Miao; Tang, Jiang-Ping; Dai, Xiao-Juan; Zhang, Yong; Li, Xiang-Pei; Liu, Qin; Wang, Ya-Ling

    2017-01-01

    Gout is an inflammatory disease that is caused by the increased production of Interleukin-1β (IL-1β) stimulated by monosodium urate (MSU) crystals. However, some hyperuricemia patients, even gouty patients with tophi in the joints, never experience gout attack, which indicates that pathogenic pathways other than MSU participate in the secretion of IL-1β in the pathogenesis of acute gouty arthritis. The ATP-P2X7R-IL-1β axis may be one of these pathways. This study examines the role of Adenosine triphosphate (ATP) in the pathogenesis of gout and the association of ATP receptor (P2X7R) function with single nucleotide polymorphisms and gout arthritis. Non-synonymous single nucleotide polymorphisms (SNP) loci of P2X7R in Chinese people were screened to compare the frequencies of different alleles and genotype distribution of selective SNPs in 117 gouty patients and 95 hyperuricemia patients. Peripheral white blood cells were purified from the peripheral blood of 43 randomly selected gout patients and 36 hyperuricemia patients from the total group. Cells were cultured with MSU or MSU + ATP, and supernatants were collected for the detection of IL-1β concentrations using enzyme-linked immunosorbent assay (ELISA). 1. Eight SNP loci, including rs1653624, rs10160951, rs1718119, rs7958316, rs16950860, rs208294, rs17525809 and rs2230912, were screened and detected, and rs1653624, rs7958316 and rs17525809 were associated with gout arthritis. 2. IL-1β concentrations in supernatants after MSU + ATP stimulation were significantly higher in gouty patients than in the hyperuricemia group [(131.08 ± 176.11) pg/ml vs. (50.84 ± 86.10) pg/ml]; Patients (including gout and hyperuricemia) carrying the susceptibility genotype AA or AT of rs1653624 exhibited significantly higher concentrations of IL-1β than patients carrying the non-susceptibility genotype TT [(104.20 ± 164.25) pg/ml vs. (21.90 ± 12.14) pg/ml]; However, no differences were found with MSU stimulation alone. ATP

  17. Single nucleotide polymorphisms associated with P2X7R function regulate the onset of gouty arthritis.

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    Jin-Hui Tao

    Full Text Available Gout is an inflammatory disease that is caused by the increased production of Interleukin-1β (IL-1β stimulated by monosodium urate (MSU crystals. However, some hyperuricemia patients, even gouty patients with tophi in the joints, never experience gout attack, which indicates that pathogenic pathways other than MSU participate in the secretion of IL-1β in the pathogenesis of acute gouty arthritis. The ATP-P2X7R-IL-1β axis may be one of these pathways.This study examines the role of Adenosine triphosphate (ATP in the pathogenesis of gout and the association of ATP receptor (P2X7R function with single nucleotide polymorphisms and gout arthritis.Non-synonymous single nucleotide polymorphisms (SNP loci of P2X7R in Chinese people were screened to compare the frequencies of different alleles and genotype distribution of selective SNPs in 117 gouty patients and 95 hyperuricemia patients. Peripheral white blood cells were purified from the peripheral blood of 43 randomly selected gout patients and 36 hyperuricemia patients from the total group. Cells were cultured with MSU or MSU + ATP, and supernatants were collected for the detection of IL-1β concentrations using enzyme-linked immunosorbent assay (ELISA.1. Eight SNP loci, including rs1653624, rs10160951, rs1718119, rs7958316, rs16950860, rs208294, rs17525809 and rs2230912, were screened and detected, and rs1653624, rs7958316 and rs17525809 were associated with gout arthritis. 2. IL-1β concentrations in supernatants after MSU + ATP stimulation were significantly higher in gouty patients than in the hyperuricemia group [(131.08 ± 176.11 pg/ml vs. (50.84 ± 86.10 pg/ml]; Patients (including gout and hyperuricemia carrying the susceptibility genotype AA or AT of rs1653624 exhibited significantly higher concentrations of IL-1β than patients carrying the non-susceptibility genotype TT [(104.20 ± 164.25 pg/ml vs. (21.90 ± 12.14 pg/ml]; However, no differences were found with MSU stimulation alone

  18. [Is there a relationship between gouty arthritis and Mediterranean fever gene mutations?].

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    Sari, Ismail; Simsek, Ismail; Tunca, Yusuf; Kisacik, Bunyamin; Erdem, Hakan; Pay, Salih; Cay, Hasan Fatih; Gul, Davut; Dinc, Ayhan

    2015-01-01

    Gouty arthritis and familial Mediterranean fever (FMF) share some clinical and pathological features such as being classified as auto inflammatory disease, association with inflammasome, short-lived intermittent arthritis, and good response to colchicine and anti-interleukin-1 treatments. As Mediterranean fever (MEFV) gene is the causative factor of FMF, we aimed to investigate the prevalence of MEFV gene mutations and their effect on disease manifestations in Turkish gouty arthritis patients. Ninety-seven patients diagnosed with primary gouty arthritis (93M and 4 F, 54 [37-84] years) and 100 healthy controls (94M and 6 F, 57 [37-86] years) included in the study. All subjects were genotyped for the MEFV variations. Number of gout attacks, diuretic use, and history of nephrolithiasis and presence of tophus were also recorded. The carriage rate of MEFV mutations for patients and controls were 22.7% (n=22) and 24% (n=24) respectively. The comparison of the patient and control groups yielded no significant difference in terms of the MEFV mutations carriage rate (p=0.87). The allelic frequencies of the MEFV mutations in patients were 11.9% (n=23) and 14% (n=28) in controls (p=0.55). The presence of MEFV variants did not show any association with clinical features of gouty arthritis. The subgroup analysis of patients revealed that gouty arthritis patients with mutations had similar frequencies of tophus, history of nephrolithiasis and podogra compared to the ones without mutations (p>0.05). This study does not provide support for a major role of MEFV mutations in Turkish gouty arthritis patients. Copyright © 2014 Elsevier Editora Ltda. All rights reserved.

  19. Correlation of serum Dickkopf-1 content with bone destruction, inflammatory response and oxidation reaction in patients with gouty arthritis

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    Yu-Mei He

    2017-09-01

    Full Text Available Objective: To study the correlation of serum Dickkopf-1 (DKK-1 content with bone destruction, inflammatory response and oxidation reaction in patients with gouty arthritis. Methods: A total of 40 patients with acute gouty arthritis who were treated in our hospital between 2013 and 2016 were selected as the group A of the study, 56 patients with asymptomatic hyperuricemia who were treated in our hospital during the same period were selected as the group B of the study, and 60 healthy volunteers who received physical examination in our hospital during the same period were selected as the control group of the study. The serum was collected to detect the contents of DKK-1, bone destruction indexes, inflammatory response indexes and oxidation reaction indexes. Results: Serum DKK-1, TRACP5b, RANKL, β-CTX, PGE2, sICAM-1, sVCAM-1, sCD14, MDA, 8-OHdG and 3-NT levels of group A and group B were significantly higher than those of control group while SOD and GSH-Px levels were significantly lower than those of control group; serum DKK-1, TRACP5b, RANKL, β-CTX, PGE2, sICAM-1, sVCAM-1, sCD14, MDA, 8-OHdG and 3-NT levels of group A were significantly higher than those of group B while SOD and GSH-Px levels were significantly lower than those of group B; serum DKK-1 level was positively correlated with TRACP5b, RANKL, β-CTX, PGE2, sICAM-1, sVCAM-1, sCD14, MDA, 8-OHdG and 3-NT levels, and negatively correlated with SOD and GSH-Px levels. Conclusion: Abnormally elevated DKK-1 in patients with gouty arthritis can induce articular bone destruction as well as inflammatory response and oxidative stress response activation.

  20. Treatment of asymptomatic hyperuricemia for the prevention of gouty arthritis, renal disease, and cardiovascular events: a systematic literature review.

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    Vinik, Ophir; Wechalekar, Mihir D; Falzon, Louise; Buchbinder, Rachelle; van der Heijde, Désirée M; Bombardier, Claire

    2014-09-01

    To systematically review available literature on treatment of hyperuricemia (HU) as a measure of preventing gouty arthritis, renal disease, or cardiovascular events in asymptomatic patients. A systematic literature search was conducted in the Cochrane Library, Medline, Embase, clinical trials registries of the World Health Organization and the US National Institutes of Health, and abstracts from American College of Rheumatology/European League Against Rheumatism meetings, for interventional studies involving adults with no history of gouty arthritis, who were treated for HU. Outcomes of interest included gouty arthritis, renal disease (i.e., renal insufficiency, urate nephropathy, nephrolithiasis), and cardiovascular events (i.e., myocardial infarction, heart failure, ischemic stroke). A total of 3 studies met the inclusion criteria, 2 studies assessing the prevention of renal disease and 1 study evaluating the potential for delaying progression of preexisting renal disease. In hyperuricemic patients without renal disease, treatment resulted in increased estimated glomerular filtration rate. In hyperuricemic patients with preexisting renal disease, treatment resulted in no significant elevation of serum creatinine over a 1-year followup. However, differences in renal function between the treatment and no-treatment groups were not statistically significant in any of the identified studies. Very limited data are available on the treatment of HU in asymptomatic patients. There is currently insufficient empiric evidence to suggest that lowering serum uric acid level in asymptomatic patients with HU can prevent gouty arthritis, renal disease, or cardiovascular events.

  1. Severe Acrosteolisis In gouty arthritis and Down syndrome

    International Nuclear Information System (INIS)

    Toro Gutierrez, Carlos Enrique; Medina, John Jairo; Coral Alvarado, Paola; Mejia Vallejo, Jimi; Rondon, Federico; Restrepo, Jose Felix; Iglesias Gamarra Antonio

    2007-01-01

    The association between gout and Down Syndrome (DS) is very in frequent, in spite that both diseases are common in general population. Surprisingly, hyperuricemia is a common metabolic impairment in DS. In this report we describe a 35-years old man with DS presenting with arthritis in the fifth and then in the first toe of his Ieft foot. Severe osteolysis of the first and fifth toe was seen by radiography. Because of this, neoplasm was suspected but later ruled out by oncologic orthopedist. After we found hyperuricemia a diagnosis of gout was made, and then confirmed by examination of a sample obtained from a subcutaneous node. This report is one of the few cases previously published. In addition development of gout in this patient has unusual features like its onset in the fifth toe and its severity at presentation. In spite that hyperuricemia is common in DS, in not clear why these patients mostly do not develop gout

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

    Science.gov (United States)

    Jiang, Yan; You, Xiao-Ying; Fu, Kong-Long; Yin, Wan-Le

    2012-01-01

    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. PMID:23304232

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

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    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. Keywords: Gouty arthritis, Creatinine, Uric acid, Hypoxanthine, Xanthine, High-performance liquid chromatography

  4. 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.)

  5. Sonographic findings in Gouty Nephropathy

    International Nuclear Information System (INIS)

    Kim, Mi Young; Jeon, Woo Ki; Kim, Ho Kyun; Kim, Yong Soo; Han, Chang Yul; Kim, Young Tong; Han, Sung Tag; Lee, Yoon Woo

    1994-01-01

    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

  6. 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

  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...... and simultaneous intra-articular and intraosseous pressure recordings were performed in seven other dogs. The intra-articular pressure was elevated in all arthritic knees. Hyperaemia was found in the knee-joint capsule and distal femoral metaphysis, whereas juxta-articular epiphyseal blood flow rates were...... not significantly changed. A decrease of femoral muscle blood flow was encountered. Intraosseous pressure recordings during venous tamponade of the knee-joint capsules suggested a qualitative change of bone vasculature in acute arthritis. The juxta-articular bone blood flow in arthritis appears to be influenced...

  8. Acute pseudo-septic arthritis following viscosuplementation of the ...

    African Journals Online (AJOL)

    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 ...

  9. Septic Arthritis of The Hip Joint presenting as Acute Abdomen ...

    African Journals Online (AJOL)

    Septic arthritis of the hip joint in two children, originally thought to be cases of acute abdomen is presented. In one case, the discovery of extra-peritoneal purulent fluid at surgery, obviated the need for laparotomy and in the other, the true nature of the disease became apparent one week after laparotomy. These cases ...

  10. Acute Rheumatic Fever versus Post-Streptococcal Reactive Arthritis

    International Nuclear Information System (INIS)

    Ashry, K.M.

    2009-01-01

    Rheumatic fever is an inflammatory disease that may develop after a Group A streptococcal infection and can involve the heart, joints, skin, and brain. A migrating polyarthritis after throat infection with group A β-haemolytic streptococci is classically attributed to acute rheumatic fever (ARF). Sterile non-migratory arthritis may occur as a separate entity, the so called post streptococcal reactive arthritis (PSRA). This study aimed to identify clinical and serological differences of patients with reactive arthritis after infection with Lance field group Aβ-haemolytic streptococci, compared with acute rheumatic fever. Hundred and twenty patients were recruited for the study , they were classified into two groups according to the diagnosis of ARF and PSRA patients consecutively seen in the Rheumatology and the Pediatric wards. Clinical and laboratory data were assessed through a questionnaire. The diagnosis of rheumatic fever was made based on revised modified Jones' criteria, while the diagnosis of post streptococcal reactive arthritis was made based on Deighton criteria; these associated with laboratory data, electrocardiography, chest X-ray, and bi-dimensional echocardiography. Results revealed no significant differences between both groups as regard age where ρ>0.05, while there were a significant difference regarding the date of antecedent upper respiratory tract infection (ρ 0.05). Regarding the cardio logical changes P-R interval by ECG was prolonged in 19 patients (31.67%)and Echo study showed changes in 12 patient (20%) of cases of ARF patient only. On the basis of simple laboratory variables and management, it ws possible to differentiate ARF from PSRA patients. So it could be concluded that these two conditions are actually distinct identities

  11. 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.

  12. Unusual acute crystal-induced hip arthritis: hydroxyapatite deposition of the round ligament.

    Science.gov (United States)

    Arlet, J-B; André, H; Mutschler, C; Dupeux, S; Pouchot, J

    2009-04-01

    Hydroxyapatite (HA) crystal deposition disease is a common cause of acute inflammatory articular or periarticular pain. Here we report a patient with an acute hip arthritis due to HA crystal deposition of the round ligament. Therefore, HA crystal deposition in periarticular tendons and ligaments of the hip should be added to the differential diagnosis of an acute hip arthritis. Computed tomographic scan may be useful when standard radiographs do not evidence the calcification.

  13. Arthritis

    Science.gov (United States)

    ... common type of arthritis. It's often related to aging or to an injury. Autoimmune arthritis happens when your body's immune system attacks healthy cells in your body by mistake. Rheumatoid arthritis is ...

  14. 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.

  15. Treatment of acute gout in patients with coronary artery disease

    Directory of Open Access Journals (Sweden)

    Chan CW

    2013-10-01

    Full Text Available Case ScenarioMr. L, aged 63 years, was recently diagnosed to have with acute gouty arthritis. He had an acute gout flare last month and was given diclofenac injection by a private general practitioner. He comes to you for advice whether he should take the injection if he has another flare. Mr. L has been on treatment for his chronic essential hypertension and dyslipidaemia for the past 10 years. He also had two previous episodes of myocardial infarction in year 2005 and 2010, and he had angioplasty done twice. He stopped smoking and consuming alcohol three months ago.

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

    Science.gov (United States)

    Castellazzi, Luca; Mantero, Marco; Esposito, Susanna

    2016-06-01

    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.

  17. Arthritis

    Science.gov (United States)

    ... prevent joint damage. If you have a family history of arthritis, tell your provider, even if you do not have joint pain. Avoiding ... in hip Rheumatoid arthritis Knee joint replacement - series Hip joint ...

  18. Septic arthritis and acute rheumatic fever in children: the diagnostic value of serological inflammatory markers.

    Science.gov (United States)

    Mistry, Raakhi M; Lennon, Diana; Boyle, Matthew J; Chivers, Karel; Frampton, Chris; Nicholson, Ross; Crawford, Haemish

    2015-01-01

    Joint pain and raised inflammatory markers are features of both acute rheumatic fever (ARF) and septic arthritis, often posing a diagnostic challenge to clinicians. Important differences in the presenting serological inflammatory marker profile may assist patient diagnosis, however, as clinical experience suggests that ARF is associated with a higher erythrocyte sedimentation rate (ESR), whereas other serological markers may be similarly elevated in these 2 conditions. The goal of this study was to determine the diagnostic value of serological inflammatory markers and white cell count (WCC) in children presenting with acute joint pain secondary to ARF or septic arthritis. Data were obtained from the Auckland regional rheumatic fever database and hospital computer records between 2005 and 2012. Records of all patients under the age of 16 years who were admitted with a new diagnosis of ARF or septic arthritis were analyzed. The diagnosis of ARF was defined on the basis of the New Zealand modification of the Jones Criteria, and the diagnosis of septic arthritis was defined on the basis of joint fluid cytology and culture. Baseline characteristics, serological inflammatory markers, and serum WCC were compared between the ARF and septic arthritis patient groups. Children with ARF displayed significantly higher ESR, higher serum C-reactive protein, and lower serum WCC than children with septic arthritis on presentation to hospital. In children presenting with monoarthritis, an ESR>64.5, serum WCCseptic arthritis. A significant proportion (30%) of children with the final diagnosis of ARF initially presented with monoarthritis; 14% of these children (5/34) had received nonsteroidal anti-inflammatory medication before hospital presentation, and 74% of these children (25/34) had abnormal echocardiograms on admission. ARF and septic arthritis are important diagnoses to consider in children presenting with acute joint pain in New Zealand. A significant proportion of patients

  19. Electroacupuncture Alleviates Pain Responses and Inflammation in a Rat Model of Acute Gout Arthritis

    Directory of Open Access Journals (Sweden)

    Wenxin Chai

    2018-01-01

    Full Text Available Acute gout arthritis is one of the most painful inflammatory conditions. Treatments for gout pain are limited to colchicine, nonsteroidal anti-inflammatory drugs, and corticosteroids, which oftentimes result in severe adverse effects. Electroacupuncture (EA has been proved to be effective in relieving many inflammatory pain conditions with few side effects. Here, we aim to investigate the therapeutic potentials of EA on pain and inflammation of a rat model of acute gout arthritis and underlying mechanisms. We found that 2/100 Hz EA produced the most robust analgesic effect on mechanical hyperalgesia of acute gout arthritis rat model compared with 2 and 100 Hz. EA produced similar analgesic effect compared with indomethacin. 2/100 Hz EA also significantly alleviates the ongoing pain behavior, thermal hyperalgesia, and ankle edema. Locally applied μ and κ-opioid receptor antagonists but not adenosine A1 receptor antagonist significantly abolished the analgesic effect of EA. Locally applied μ and κ-opioid receptor agonists produced significant antiallodynia on acute gout arthritis rats, mimicking EA. Furthermore, 2/100 Hz EA upregulated β-endorphin expression in inflamed ankle skin tissue. Our results demonstrated, for the first time, that EA can be used for relieving acute gout arthritis with effect dependent on peripheral opioid system and comparable with the one obtained with indomethacin.

  20. Invariant Natural Killer T Cells Ameliorate Monosodium Urate Crystal-Induced Gouty Inflammation in Mice

    Directory of Open Access Journals (Sweden)

    Jie Wang

    2017-12-01

    Full Text Available Gout is an inflammatory arthritis caused by deposition of intra-articular monosodium urate (MSU crystal. Previous studies have focused on resident macrophage, infiltrating monocyte, and neutrophil responses to MSU crystal; yet the mechanisms of cellular changes and the potential involvement of other regulatory immune cells remain largely unknown. Invariant natural killer T (iNKT cells, an innate type of T cell, are involved in the development of various inflammatory diseases. Here, we investigate the role of iNKT cells in MSU crystal-induced gouty inflammation. MSU crystal-induced inflammatory profiles in an air-pouch model were examined in iNKT-deficient CD1d knockout (KO and wild-type (WT control mice. To explore potential mechanisms of iNKT cell regulation of gouty inflammation, we cocultured CD4+ or CD4−iNKT cells with bone marrow-derived macrophages (BMDMs. We found that iNKT cells quickly migrated to the site of inflammation upon MSU crystal stimulation in WT mice. The total number of infiltrating cells in CD1d KO mice, especially neutrophils, was dramatically increased at 6 and 12 h (P < 0.01 post-MSU crystal challenge, compared with WT controls. BMDMs cocultured with CD4+iNKT cells produced less tumor necrosis factor-α and expressed higher levels of M2 macrophage markers, including Clec7a, Pdcd1Ig2, and interleukin-4 (P < 0.01, compared with BMDMs cocultured with CD4−iNKT cells or conventional CD4+ T cells. CD4+iNKT cells are one of the key regulators of MSU crystal-induced gouty inflammation through the control of macrophage polarization. iNKT cells may serve as a new therapeutic target for gout.

  1. Serum procalcitonin as a diagnostic aid in patients with acute bacterial septic arthritis.

    Science.gov (United States)

    Paosong, Suangkanok; Narongroeknawin, Pongthorn; Pakchotanon, Rattapol; Asavatanabodee, Paijit; Chaiamnuay, Sumapa

    2015-03-01

    Septic arthritis is a common and serious problem. Early detection and prompt treatment improve outcomes. To evaluate serum procalcitonin for diagnosis of acute bacterial septic arthritis and to compare its diagnostic utility with synovial white blood cells (WBC), erythrocyte sedimentation rate (ESR) and high-sensitivity C-reactive protein (hs-CRP). A prospective cross-sectional study was performed in 78 Thai patients with acute arthritis. Patients with concomitant infections were excluded. Twenty-eight patients were diagnosed with acute bacterial septic arthritis and 50 patients were diagnosed with acute inflammatory arthritis. Blood samples were collected for complete blood count, ESR, hs-CRP, procalcitonin and hemoculture. Synovial fluid was sent for cell count, Gram stain, crystals identification and culture. The diagnostic accuracy by area under receiver operating characteristic (ROC) curve was calculated. Patients with acute bacterial septic arthritis had higher procalcitonin levels than in acute inflammatory arthritis (mean ± SD = 1.48 ± 2.30 vs. 0.44 ± 0.92 ng/mL, P = 0.032). The cut-off level of procalcitonin was 0.5 ng/mL for which sensitivity, specificity and accuracy for diagnosis of bacterial septic arthritis were 59.3%, 86% and 75.3%, respectively. The ROC curve analysis showed that procalcitonin had a good diagnostic performance (area under the curve = 0.78, 95% CI 0.69-0.89). The area under the curve of hs-CRP and synovial fluid WBC were 0.67 (95% CI 0.55-0.79) and 0.821 (95% CI 0.720-0.923), respectively. Combining procalcitonin with other markers did not provide better sensitivity or specificity than procalcitonin alone. Serum procalcitonin has a potential role in diagnosing acute bacterial septic arthritis, especially if arthrocenthesis cannot be performed. © 2014 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

  2. Arthritis

    Science.gov (United States)

    ... Psoriatic Arthritis can occur in people who have psoriasis (scaly red and white skin patches). It affects ... Cómo vivir con artritis: Información básica de salud para usted y su familia Rheumatoid Arthritis: Handout on ...

  3. 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.

  4. Gouty arthritis: An approach for general practice | Tikly | South ...

    African Journals Online (AJOL)

    Prophylactic colchicine use, during the intercritical period, reduces gout flares, a common complication on initiation of urate-lowering therapy (ULT). Allopurinol is the treatment of choice when ULT is indicated. Gout management is suboptimal in many patients because of non-adherence to treatment and underutilisation of ...

  5. Gouty arthritis in Nigerians: clinical and laboratory correlates ...

    African Journals Online (AJOL)

    Background: Gout has been infrequently reported in black Africans despite the high prevalence in black Americans. There are even fewer reports in West Africans. However, there is a current trend towards increasing frequency among Caucasians, which is mostly due to increasing incidence of obesity, hypertension as well ...

  6. Open Compared with Arthroscopic Treatment of Acute Septic Arthritis of the Native Knee.

    Science.gov (United States)

    Johns, Brenton P; Loewenthal, Mark R; Dewar, David C

    2017-03-15

    Acute native knee septic arthritis is a joint-threatening emergency. Operative treatments by open or arthroscopic methods are available to surgeons. To our knowledge, the literature to date has primarily consisted of case series and no large study has yet compared these methods. The aim of this study was to compare open and arthroscopic treatment for acute native knee septic arthritis. All adult patients with acute native knee septic arthritis treated at our institution with either open or arthroscopic irrigation from 2000 to 2015 were retrospectively evaluated. The clinical findings, laboratory evidence, arthrocentesis and microbiology results, knee radiographs, and outcomes were compared. There were 161 patients (166 knees) with acute native knee septic arthritis treated between 2000 and 2015. Initially, 123 knees were treated by arthroscopic irrigation and 43 knees were treated by open irrigation; however, 71% in the open treatment group required repeat irrigation compared with 50% in the arthroscopic treatment group. The superiority of an arthroscopic procedure persisted after adjustment for potential confounders by multivariable analysis, with an odds ratio of 2.56 (95% confidence interval, 1.1 to 5.9; p = 0.027). After 3 irrigation procedures, the cumulative success rate was 97% in the arthroscopic treatment group and 83% in the open treatment group (p = 0.011). The total number of irrigation procedures required was fewer in the arthroscopic treatment group (p = 0.010). In the arthroscopic treatment group, the mean postoperative range of motion was greater (p = 0.016) and there was a trend toward a shorter median length of stay (p = 0.088). Arthroscopic treatment for acute native knee septic arthritis was a more successful index procedure and required fewer total irrigation procedures compared with open treatment. Long-term postoperative range of motion was significantly greater following arthroscopic treatment. Therapeutic Level III. See Instructions for

  7. Risk factors for failure of a single surgical debridement in adults with acute septic arthritis.

    Science.gov (United States)

    Hunter, Joshua G; Gross, Jonathan M; Dahl, Jason D; Amsdell, Simon L; Gorczyca, John T

    2015-04-01

    Acute septic arthritis in a native joint may require more than one surgical debridement to eradicate the infection. Our objectives were to determine the prevalence of failure of a single surgical debridement for acute septic arthritis, to identify risk factors for failure of a single debridement, and to develop a prognostic probability algorithm to predict failure of a single surgical debridement for acute septic arthritis in adults. We collected initial laboratory and medical comorbidity data of 128 adults (132 native joints) with acute septic arthritis who underwent at least one surgical debridement at our institution between 2000 and 2011. Univariate and logistic regression analyses were used to identify potential risk factors for failure of a single surgical debridement. Stepwise variable selection was used to develop a prediction model and identify probabilities of failure of a single surgical debridement. Of the 128 patients (132 affected joints) who underwent surgical debridement for acute septic arthritis, forty-nine (38%) of the patients (fifty joints) experienced failure of a single debridement and required at least two debridements (range, two to four debridements). Staphylococcus aureus was the most common bacterial isolate (in sixty, or 45%, of the 132 joints). Logistic regression analysis identified five independent clinical predictors for failure of a single surgical debridement: a history of inflammatory arthropathy (odds ratio [OR], 7.3; 95% confidence interval [CI], 2.4 to 22.6; p 85.0 x 10(9) cells/L (OR, 4.7; 95% CI, 1.8 to 17.7; p = 0.002), S. aureus as the bacterial isolate (OR, 4.6; 95% CI, 1.8 to 11.9; p = 0.002), and a history of diabetes (OR, 2.6; 95% CI, 1.1 to 6.2; p = 0.04). Most (62%) of the septic joints were managed effectively with a single surgical debridement. Adults with a history of inflammatory arthropathy, involvement of a large joint, a synovial-fluid nucleated cell count of >85.0 x 10(9) cells/L, an infection with S. aureus

  8. Value of ultrasonography in the diagnosis of gout in patients presenting with acute arthritis.

    Science.gov (United States)

    Pattamapaspong, Nuttaya; Vuthiwong, Withawat; Kanthawang, Thanat; Louthrenoo, Worawit

    2017-06-01

    To evaluate the value of ultrasonographic features of crystal deposition for diagnosing gout in patients presenting with acute arthritis. Ultrasound scanning of the most inflamed joint was performed on 89 consecutively enrolled patients with acute arthritis. Two radiologists independently reviewed the ultrasound images, and a consensus was achieved with a third radiologist when the interpretations of four key ultrasound features of gout differed. Arthrocentesis and crystal analysis using compensated polarized light microscopy of aspirates are considered the gold standards for gout diagnosis. Fifty-three (60%) patients had gout, whereas the remaining 36 (40%) had non-gout arthritis. The mean serum uric acid level was 7.1 mg/dl in patients with gout and 4.7 mg/dl in patients with non-gout arthritis. Three US features differed significantly (p arthritis: the double contour sign (42 vs. 8%, respectively), intra-articular aggregates (58 vs. 8%), and tophi (40 vs. 0%). No statistically significant differences in detecting intra-tendinous aggregates (32 vs. 17%, p = 0.14) were observed. The sensitivity and specificity of the double contour sign were 42 and 92%, respectively; those of the intra-articular aggregates were 58 and 92%; and those of tophi were 40 and 100%. The positive predictive values for these three features ranged from 88 to 100%, whereas the negative predictive values ranged from 52 to 60%. When the prevalence is high, these three ultrasound features may be a useful adjunct in the diagnosis of acute gout, particularly when specialized microscopic techniques are not available.

  9. Identification of health problems in patients with acute inflammatory arthritis, using the International Classification of Functioning, Disability and Health (ICF).

    Science.gov (United States)

    Zochling, J; Grill, E; Scheuringer, M; Liman, W; Stucki, G; Braun, J

    2006-01-01

    To identify the most common health problems experienced by patients with acute inflammatory arthritis using the International Classification of Functioning, Disability and Health (ICF), and to provide empirical data for the development of an ICF Core Set for acute inflammatory arthritis. Cross-sectional survey of patients with acute inflammatory arthritis of two or more joints requiring admission to an acute hospital. The second level categories of the ICF were used to collect information on patients' health problems. Relative frequencies of impairments, limitations and restrictions in the study population were reported for the ICF components Body Functions, Body Structures, and Activities and Participations. For the component Environmental Factors absolute and relative frequencies of perceived barriers or facilitators were reported. In total, 130 patients were included in the survey. The mean age of the population was 59.9 years (median age 63.0 years), 75% of the patients were female. Most had rheumatoid arthritis (57%) or early inflammatory polyarthritis (22%). Fifty-four second-level ICF categories had a prevalence of 30% or more: 3 (8%) belonged to the component Body Structures and 10 (13%) to the component Body Functions. Most categories were identified in the components Activities and Participation (19; 23%) and Environmental Factors (22; 56%). Patients with acute inflammatory arthritis can be well described by ICF categories and components. This study is the first step towards the development of an ICF Core Set for patients with acute inflammatory arthritis.

  10. 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.

  11. The effects of combined therapy of rheumatoid arthritis on the acute phase reactants.

    Science.gov (United States)

    Rexhepi, Sylejman; Rexhepi, Mjellma; Sahatçiu-Meka, Vjollca; Pllana, Ejup; Dragusha, Gani; Gashi, Masar; Rexhepi, Blerta

    2009-01-01

    The paper presents the results of studies of acute phase reactants in the 60 treated patients with rheumatoid arthritis. Patients were divided into two groups, depending on the applied treatment: group I (n = 30) was treated with methotrexate, sulfasalazine and hydroxychloroquine, and group II (n = 30) with methotrexate. The results of our study shows that there is a statistically significant reduction in the value of acute phase reactants and clinical parameters after treatment in both investigated groups of patients, and also a significant statistical difference between the first and second group of treated patients.

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

    Science.gov (United States)

    Vakili, Marjan; Ziaee, Vahid; Moradinejad, Mohammad Hassan; Raeeskarami, Seyed Reza; Kompani, Farzad; Rahamooz, Tayebeh

    2016-06-01

    Various indices have been raised as predictors of activity and severity of juvenile idiopathic arthritis. This study was conducted to investigate the changes of platelet indices in acute phase and two months after treatment in these patients. 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 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). 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.

  13. Clinical significance of delta neutrophil index in the differential diagnosis between septic arthritis and acute gout attack within 24 hours after hospitalization.

    Science.gov (United States)

    Pyo, Jung Yoon; Kim, Dae Sik; Jung, Seung Min; Song, Jason Jungsik; Park, Yong-Beom; Lee, Sang-Won

    2017-07-01

    The most important differential diagnoses of acute monoarticular arthritis are septic arthritis and acute gout attack. Identifying infection is crucial in preventing the devastating outcome of septic arthritis. The delta neutrophil index (DNI) is a value that corresponds to the fraction of circulating immature granulocytes. As DNI reflects the burden of infection, we evaluated this index as a differentiating marker between septic arthritis and acute gout attack.The medical records of 149 patients with septic arthritis and 194 patients with acute gout attack were reviewed. A specific cell analyzer, ADVIA 2120, was used to measure DNI. Clinical and laboratory markers associated with predicting septic arthritis were assessed by using logistic regression.Patients with septic arthritis showed higher levels of DNI than those with acute gout attack (3.3 vs 0.6%, P septic arthritis. In the multivariate analysis, DNI was the most powerful independent value for predicting septic arthritis (odds ratio 14.003).This study showed the possibility of using DNI as a differentiating marker between septic arthritis and acute gout attack at the crucial early phase. DNI showed its relevance regardless of confirmation of MSU crystal deposition or serum level of uric acid.

  14. 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.

  15. [Acute anterior myocardial infarction as presenting feature of antiphospholipid syndrome related lupus arthritis].

    Science.gov (United States)

    Capilla-Geay, E; Poyet, R; Brocq, F X; Pons, F; Kerebel, S; Foucault, G; Jego, C; Cellarier, G R

    2016-05-01

    Antiphospholipid syndrome is an autoimmune disorder causing venous and arterial thrombosis. Acute coronary complications are rare but potentially dramatic. We report a 39-year-old woman who presented with an acute anterior myocardial infarction after intravenous corticosteroids as part of the treatment of lupus arthritis and revealing antiphospholipid syndrome. Emergency coronary angiography was performed with drug-eluting stent angioplasty despite the need for anticoagulation and dual antiplatelet therapy. Antiplatelet and anticoagulant therapy management is pivotal in patients with antiphospholipid syndrome and acute coronary syndrome to prevent thrombosis recurrence. Copyright © 2015 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  16. 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.

  17. Increased Risk of Acute Pancreatitis in Patients with Rheumatoid Arthritis: A Population-Based Cohort Study

    Science.gov (United States)

    Chang, Chi Ching; Chiou, Chi Sheng; Lin, Hsiu Li; Wang, Li Hsuan; Chang, Yu Sheng; Lin, Hsiu-Chen

    2015-01-01

    The study was conducted to determine whether patients with rheumatoid arthritis (RA) are at increased risk of acute pancreatitis compared with those without RA and to determine if the risk of acute pancreatitis varied by anti-RA drug use. We used the large population-based dataset from the National Health Insurance (NHI) program in Taiwan to conduct a retrospective cohort study. Patients newly diagnosed with RA between 2000 and 2011 were referred to as the RA group. The comparator non-RA group was matched with propensity score, using age and sex, in the same time period. We presented the incidence density by 100,000 person-years. The propensity score and all variables were analyzed in fully adjusted Cox proportional hazard regression. The cumulative incidence of acute pancreatitis was assessed by Kaplan-Meier analysis, with significance based on the log-rank test. From claims data of one million enrollees randomly sampled from the Taiwan NHI database, 29,755 adults with RA were identified and 119,020 non- RA persons were matched as a comparison group. The RA cohort had higher incidence density of acute pancreatitis (185.7 versus 119.0 per 100,000 person-years) than the non-RA cohort. The adjusted hazard ratio (HR) was 1.62 (95% CI [confidence interval] 1.43–1.83) for patients with RA to develop acute pancreatitis. Oral corticosteroid use decreased the risk of acute pancreatitis (adjusted HR 0.83, 95% CI 0.73–0.94) but without a dose-dependent effect. Current use of disease modifying anti-rheumatic drugs or tumor necrosis factor blockers did not decrease the risk of acute pancreatitis. In conclusion, patients with RA are at an elevated risk of acute pancreatitis. Use of oral corticosteroids may reduce the risk of acute pancreatitis. PMID:26262880

  18. 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.)

  19. 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...

  20. Diagnostic and predictive value of acute-phase reactants in adult undifferentiated peripheral inflammatory arthritis: a systematic review.

    Science.gov (United States)

    Vercoutere, Ward; Thevissen, Kristof; Bombardier, Claire; Landewé, Robert B M

    2011-03-01

    To review the available literature on the diagnostic and predictive value of acute-phase reactants in adult undifferentiated peripheral inflammatory arthritis (UPIA) as an evidence base for generating multinational clinical practice recommendations in the 3e Initiative in Rheumatology. A systematic literature search was carried out using Medline, Embase, the Cochrane Library, and abstracts presented at the 2007 and 2008 meetings of the American College of Rheumatology and European League Against Rheumatism, searching for prognostic and diagnostic markers of acute-phase reactants in adult UPIA. Articles that fulfilled predefined inclusion criteria were systematically reviewed, and the quality was appraised. Likelihood ratios (LR), sensitivity, and specificity for diagnostic and prognostic outcomes were calculated. A total of 18 publications out of 3699 identified references were included in the review. Only a small number of studies with significant heterogeneity, including different outcome measures and different cutoff values, were eligible for review, so pooling data was not possible. Overall, LR showed poor diagnostic and prognostic performance for most investigated acute-phase reactants. Available data showed some value for erythrocyte sedimentation rate in establishing a diagnosis in patients with undifferentiated arthritis; some prognostic and diagnostic value for C-reactive protein; some prognostic value for plasma viscosity in predicting persistence of arthritis; and some diagnostic value for sulfhydryl levels and matrix metalloproteinase-3 in establishing a diagnosis of rheumatoid arthritis. There is little published evidence concerning the diagnostic and predictive value of acute-phase reactants in patients with UPIA. Studies were heterogeneous, and "undifferentiated arthritis" was not well defined or was equivocally defined. The role of acute-phase reactants in diagnosing and predicting outcome in patients presenting with undifferentiated arthritis is

  1. Acute neck pain caused by arthritis of atlanto-axial joint

    International Nuclear Information System (INIS)

    Kobayashi, Takashi; Ishikawa, Yoshinori; Abe, Eiji; Konno, Norikazu; Noguchi, Hideaki

    2009-01-01

    We reviewed 27 cases in which the patient complained of acute neck pain. We had performed arthrocentesis of the atlanto-axial joint in every case. An aspirate was obtained in 16 of the cases, and calcium pryophosphate dihydrate (CPPD) crystals were demonstrated in 10 of them. The patients' scores on the visual analogue scale decreased 30 minutes after aspiration of the crystals (p<0.001). CT demonstrated calcification of the transverse ligament in 22 cases, calcification anterior to the body of C2 in 2 cases, and no calcification in 3 cases. The results in these patients suggest that acute neck pain in some elderly patients is related to arthritis of the atlanto-axial joint. (author)

  2. [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.

  3. Acute neck pain caused by septic arthritis of the lateral atlantoaxial joint with subluxation: a case report.

    Science.gov (United States)

    Kobayashi, Takashi; Miyakoshi, Naohisa; Abe, Eiji; Abe, Toshiki; Kikuchi, Kazuma; Shimada, Yoichi

    2015-08-15

    Crystal-induced arthritis of the lateral atlantoaxial joint may be intimately involved in acute neck pain in the elderly. Patients typically have a good prognosis, and symptoms usually subside within a few weeks. On the other hand, septic arthritis of the lateral atlantoaxial joint requires early diagnosis and antibiotic treatment. Diagnostic delay is a risk factor for an unfavorable outcome of vertebral osteomyelitis. Even though septic arthritis of the lateral atlantoaxial joint is a very rare clinical entity, it is important to differentiate septic arthritis from crystal-induced arthritis. A 53-year-old Japanese man presented with neck pain, stiffness, and loss of power of his left upper extremity which started 20 days before his visit to our hospital. A physical examination revealed a limited range of motion of his neck, with rotation being especially very restricted. Atlantoaxial subluxation was seen on plain radiography of his cervical spine. During puncture of the lateral atlantoaxial joint, clear yellow fluid was collected. Cultures later grew methicillin-sensitive Staphylococcus aureus. He was diagnosed with septic arthritis of the lateral atlantoaxial joint with atlantoaxial subluxation. After diagnosis, intravenous administration of antibiotics was begun. The atlantoaxial region was stabilized with the Brooks procedure. Plain radiography showed complete bone union 8 months after operation. At a follow-up evaluation 7 years after initial onset, he had complete relief of neck pain, and there were no neurological abnormalities. A patient with septic arthritis of the lateral atlantoaxial joint with subluxation presenting with acute neck pain was successfully treated with antibiotics and fusion surgery. In patients with persistent neck pain, septic arthritis of the lateral atlantoaxial joint should be considered and further examinations performed.

  4. Diagnostic and predictive value of acute-phase reactants in adult undifferentiated peripheral inflammatory arthritis: a systematic review

    NARCIS (Netherlands)

    Vercoutere, Ward; Thevissen, Kristof; Bombardier, Claire; Landewé, Robert B. M.

    2011-01-01

    To review the available literature on the diagnostic and predictive value of acute-phase reactants in adult undifferentiated peripheral inflammatory arthritis (UPIA) as an evidence base for generating multinational clinical practice recommendations in the 3e Initiative in Rheumatology. A systematic

  5. The acute-phase response is not predictive for the development of arthritis in seropositive arthralgia - A prospective cohort study

    NARCIS (Netherlands)

    M. Limper (Maarten); L. van de Stadt (Lotte); W.H. Bos (Wouter); M.D. de Kruif (Martijn); A. van der Spek (Ashley); G.J. Wolbink (Gertjan); D. van Schaardenburg (Dirkjan); E.C.M. van Gorp (Eric)

    2012-01-01

    textabstractObjective. To evaluate whether markers of the acute-phase response in patients presenting with arthralgia and positive anticitrullinated protein antibodies (ACPA) and/or immunoglobulin M rheumatoid factor (IgM-RF) could be predictive for the development of arthritis. Methods. In total,

  6. The Acute-phase Response Is Not Predictive for the Development of Arthritis in Seropositive Arthralgia - A Prospective Cohort Study

    NARCIS (Netherlands)

    Limper, Maarten; van de Stadt, Lotte; Bos, Wouter; de Kruif, Martijn; Spek, Arnold; Wolbink, Gertjan; van Schaardenburg, Dirkjan; van Gorp, Eric

    2012-01-01

    To evaluate whether markers of the acute-phase response in patients presenting with arthralgia and positive anticitrullinated protein antibodies (ACPA) and/or immunoglobulin M rheumatoid factor (IgM-RF) could be predictive for the development of arthritis. In total, 137 ACPA- and/or IgM-RF-positive

  7. Evaluation of the therapeutic effect of hydroxyapatite particles labeled with Ho166 in rats with acute and chronic arthritis

    International Nuclear Information System (INIS)

    Mendoza Lopez, Patricia

    2002-01-01

    The therapeutic effect of an intraarticular injection of hydroxyapatite particles labeled with Holmium-166 ( Ho 166 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 intraarticular injection of 0,5 μCi of Ho 166 -HA (day 0, 4, 9, 14, 19, 30). Also a biological distribution study was done at 4, 24 and 48 hours in different organs, through the counting of its radiation. The results of the biological distribution showed that a very high percent of the injected activity remains inside the joint, with minimal activity in other organs, which indicates that the extra articular leakage is very low. The evaluation of the articular perimeter, demonstrated that Ho 166 -HA has a therapeutic effect , which was shown by comparing the control group (6.42 ±0.43 cm right knee; 6.14 ±0.31 cm left knee) with the acute arthritis group (5.11 ±0.3 cm right knee; 4.95 ±0.39 cm left knee) with significantly statistical values (p≤0,01); also the control group was compared with the chronic arthritis group (5.6 ±0.56 cm right knee; 5.47 ±0.51 cm left knee), 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 [es

  8. 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

  9. Protective effects of a blueberry extract in acute inflammation and collagen-induced arthritis in the rat.

    Science.gov (United States)

    Figueira, Maria-Eduardo; Oliveira, Mónica; Direito, Rosa; Rocha, João; Alves, Paula; Serra, Ana-Teresa; Duarte, Catarina; Bronze, Rosário; Fernandes, Adelaide; Brites, Dora; Freitas, Marisa; Fernandes, Eduarda; Sepodes, Bruno

    2016-10-01

    Here we investigated the anti-inflammatory effect of a blueberry extract in the carrageenan-induced paw edema model and collagen-induced arthritis model, both in rats. Along with the chemical characterization of the phenolic content of the fruits and extract, the antioxidant potential of the extract, the cellular antioxidant activity and the effects over neutrophils' oxidative burst, were studied in order to provide a mechanistic insight for the anti-inflammatory effects observed. The extract significantly inhibited paw edema formation in an acute model the rat. Our results also demonstrate that the standardized extract had pharmacological activity when administered orally in the collagen-induced arthritis model in the rat and was able to significantly reduce the development of clinical signs of arthritis and the degree of bone resorption, soft tissue swelling and osteophyte formation, consequently improving articular function in treated animals. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  10. 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.

  11. Combined measurement of multiple acute phase reactants to predict relapse of rheumatoid arthritis.

    Science.gov (United States)

    Lv, Fang; Song, Li-Jun; Li, Xing-Fu

    2015-09-01

    Acute phase reactants (APRs), such as serum C-reactive protein (CRP), ferritin, plasma fibrinogen and platelet count, are common biomarkers used to monitor the status of inflammatory diseases. The aim of this study was to determine whether APRs are predictive markers of relapse in rheumatoid arthritis (RA). We analyzed forty RA patients in clinical remission (disease activity score [DAS28] < 2.6; baseline [t(0)]) or with low disease activity (DAS28 score ≤ 3.2; t(0)). The pre-existing therapeutic regimens were retained for each patient during a 4-week study period. APRs and patient characteristics were analyzed for normality of distribution by using the Kolmogorov-Smirnov test and correlations were assessed by Pearson's or Spearman's rank correlation coefficient. APR levels were found to be significantly correlated with DAS28 score of RA, and serum CRP was the most strongly correlated APR for both the clinical remission and high disease activity groups. For all APRs, the correlation strength paralleled the increase in disease activity. Measurement of multiple APRs in remission or low disease activity RA patients may predict relapse to active disease, thereby facilitating more timely clinical management and promoting efficacy of therapeutic intervention. © 2013 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

  12. 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 (P<.01), histological damage, cyclooxygenase-2 and inducible nitric oxide synthase expression, and markedly reduced the degree of bone resorption, soft tissue swelling and osteophyte formation, improving articular function in treated animals. Acute inflammation, induced by carrageenan, was also evaluated for hydroxytyrosol-supplemented refined olive oils at 0.5 and 5 mg/kg. Both doses significantly reduced paw edema (P<.001). Our results suggest that the supplementation of refined olive oil with hydroxytyrosol may be advantageous in rheumatoid arthritis with significant impact not only on chronic inflammation but also on acute inflammatory processes. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. [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.

  14. 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

    -induced arthritis (AIA) and collagen-induced arthritis (CIA), to evaluate acute and chronic arthritis in CD1d knockout mice and mice depleted of NK1.1(+) cells. CD1d-deficient mice developed more severe AIA compared with wild-type littermates, with a higher degree of inflammation and proteoglycan depletion. Chronic...... arthritis in CIA was also worse in the absence of CD1d-dependent NKTs. Elevated levels of Ag-specific IFN-gamma production accompanied these findings rather than changes in IL-17alpha. Depletion of NK1.1(+) cells supported these findings in AIA and CIA. This report provides support for CD1d-dependent NKTs...

  15. 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.

  16. Development of a new humanized mouse model to study acute inflammatory arthritis

    Directory of Open Access Journals (Sweden)

    Misharin Alexander V

    2012-09-01

    Full Text Available Abstract Background Substantial advances have been generated in understanding the pathogenesis of rheumatoid arthritis (RA. Current murine models of RA-like disease have provided great insights into the molecular mechanism of inflammatory arthritis due to the use of genetically deficient or transgenic mice. However, these studies are limited by differences that exist between human and murine immune systems. Thus, the development of an animal model that utilizes human immune cells, will afford the opportunity to study their function in the initiation and propagation of inflammatory arthritis. Methods One to two-day old irradiated NOD-scid IL2rγnull (NSG mice were reconstituted with human CD34+ cord blood stem cells. Leukocytes were analyzed by flow cytometry and circulating antibodies were determined by ELISA. Arthritis was induced by injecting complete Freund’s adjuvant into knee or ankle joints. Mice were also treated with the TNF inhibitor, Etanercept, or PBS and joints were analyzed histologically. Results Humanized mice were established with high reconstitution rates and were able to spontaneously produce human immunoglobulins as well as specific IgG in response to immunization. Intraperitoneal injection of thioglycolate or injection of complete Freund’s adjuvant into joints resulted in migration of human immune cells to the injected sites. Arthritic humanized mice treated with Etanercept had markedly less inflammation, which was associated with decreased total numbers of human CD45+ cells, including human lymphocytes and neutrophils. Conclusions The humanized mouse model is a new model to study inflammatory arthritis disease using human leukocytes without rejection of engrafted tissue. Future studies may adapt this system to incorporate RA patient cord blood and develop a chimeric animal model of inflammatory arthritis using genetically predisposed immune cells.

  17. 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. ...

  18. 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. Copyright © 2016 Polish Neurological Society. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  19. 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.

  20. 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.

  1. Effectiveness of leucocyte esterase as a diagnostic test for acute septic arthritis.

    Science.gov (United States)

    Gautam, V K; Saini, Rishabh; Sharma, Siddharth

    2017-01-01

    We hypothesized that leucocyte esterase strip test can aid in diagnosing septic arthritis in native synovial fluid because leucocyte esterase concentrations would be elevated at the infection site because of secretion by recruited neutrophils. The cohort included 27 patients (suspected septic arthritis and normal subjects). A standard chemical test strip (graded as negative, trace, +, ++ or +++) was used to detect the presence of leucocyte esterase. Fluid leucocyte count, Gram staining, culture, erythrocyte sedimentation rate and C-reactive protein were also assessed. The leucocyte esterase test with a threshold of ++/+++ had a sensitivity of 79.2% (95% CI [confidence interval], 65.9% to 89.2%), specificity of 80.8% (95% CI, 73.3% to 87.1%), positive predictive value (PPV) of 61.8% (95% CI, 49.2% to 73.3%) and negative predictive value (NPV) of 90.1% (95% CI, 84.3% to 95.4%). The leucocyte esterase strip test yielded a high specificity, PPV, NPV, high sensitivity and high diagnostic accuracy. Leucocyte esterase is an accurate, quick and bedside test for septic arthritis and can be used effectively for diagnosing periprosthetic joint infections along with other battery of tests according to the Musculoskeletal Infection Society criteria.

  2. Retrospective study on the epidemiology of the septic arthritis and acute osteomyelitis by Staphylococcus aureus in patients hospitalized at the Hospital Nacional de Ninos Dr. Carlos Saenz Herrera January 2007- September 2013

    International Nuclear Information System (INIS)

    Sanabria Leiva, Mariana

    2014-01-01

    The general epidemiology and microbiology of acute osteomyelitis and septic arthritis by Staphylococcus aureus (S. aureus) are described in children hospitalized at the Hospital de Ninos between January 2007 and September 2013. 88 patients are included in the study, of which 64% have corresponded to acute osteomyelitis, septic arthritis 21% and 15% both diagnoses. Age groups, joints and bones most affected are identified. Antibiotic sensitivity changes of the S. aureus are determined in the last 5 years. The use of imaging studies and diagnostic tests are specified in patients with acute osteomyelitis and septic arthritis. Complications, mortality and sequelae most common are established in patients. The surgical procedures are described. The clindamycin and TMP-SMX are recommended as drugs of first choice for the treatment of acute osteomyelitis and septic arthritis [es

  3. Circulating cytokine profiles and their relationships with autoantibodies, acute phase reactants, and disease activity in patients with rheumatoid arthritis.

    Science.gov (United States)

    Meyer, Pieter W A; Hodkinson, Bridget; Ally, Mahmood; Musenge, Eustasius; Wadee, Ahmed A; Fickl, Heidi; Tikly, Mohammed; Anderson, Ronald

    2010-01-01

    Our objective was to analyse the relationship between circulating cytokines, autoantibodies, acute phase reactants, and disease activity in DMARDs-naïve rheumatoid arthritis (RA) patients (n = 140). All cytokines were significantly higher in the RA cohort than in healthy controls. Moderate-to-strong positive intercorrelations were observed between Th1/Th2/macrophage/fibroblast-derived cytokines. RF correlated significantly with IL-1β, IL-2, IL-4, IL-10, IL-12, G-CSF, GM-CSF, IFN-γ, and TNF (P acute phase reactants, CRP, and SAA (P < .0001). In patients with a DAS28 score of ≥5.1, IFN-γ, IL-1β, IL-1Ra, TNF, GM-CSF, and VEGF were significantly correlated (P < .04-.001) with high disease activity (HDA). Circulating cytokines in RA reflect a multifaceted increase in immune reactivity encompassing Th1 and Th2 cells, monocytes/macrophages, and synovial fibroblasts, underscored by strong correlations between these cytokines, as well as their relationships with RF, aCCP, and aMCV, with some cytokines showing promise as biomarkers of HDA.

  4. Thumb Arthritis

    Science.gov (United States)

    ... Figure 4 - Treatment Diagram PDF Arthritis - Base of the Thumb Related Conditions Rheumatoid Arthritis Psoriatic Arthritis Osteoarthritis MP Joint Arthritis de Quervain's Tenosynovitis Other Links CME Mission Statement and Disclaimer Policies ...

  5. 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.

  6. 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.

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

    NARCIS (Netherlands)

    Emad, Yasser; Ragab, Yasser; El Shaarawy, Nashwa; Rasker, Johannes 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

  8. Seroprevalence of Toxoplasma gondii infection in arthritis patients in eastern China.

    Science.gov (United States)

    Tian, Ai-Ling; Gu, Yuan-Lin; Zhou, Na; Cong, Wei; Li, Guang-Xing; Elsheikha, Hany M; Zhu, Xing-Quan

    2017-10-25

    There is accumulating evidence for an increased susceptibility to infection in patients with arthritis. We sought to understand the epidemiology of Toxoplasma gondii infection in arthritis patients in eastern China, given the paucity of data on the magnitude of T. gondii infection in these patients. Seroprevalence of T. gondii infection was assessed by enzyme-linked immunosorbent assay using a crude antigen of the parasite in 820 arthritic patients, and an equal number of healthy controls, from Qingdao and Weihai cities, eastern China. Sociodemographic, clinical and lifestyle information on the study participants were also obtained. The prevalence of anti-T. gondii IgG was significantly higher in arthritic patients (18.8%) compared with 12% in healthy controls (P arthritis had anti-T. gondii IgM antibodies - comparable with 10 control patients (1.5% vs 1.2%). Demographic factors did not significantly influence these seroprevalence frequencies. The highest T. gondii infection seropositivity rate was detected in patients with rheumatoid arthritis (24.8%), followed by reactive arthritis (23.8%), osteoarthritis (19%), infectious arthritis (18.4%) and gouty arthritis (14.8%). Seroprevalence rates of rheumatoid arthritis and reactive arthritis were significantly higher when compared with controls (P arthritis patients in China. Implications for better prevention and control of T. gondii infection in arthritis patients are discussed. This is an epidemiological survey, therefore trial registration was not required.

  9. [Proteus mirabilis septic arthritis].

    Science.gov (United States)

    Sbiti, Mohammed; Bouhamidi, Bahia; Louzi, Lhoussaine

    2017-01-01

    Acute septic arthritis is rare. It is associated with poor prognosis in terms of mortality and morbidity. We report the case of a 61-year old patient with spontaneous Proteus mirabilis septic arthritis. He suffered from complicated diabetes associated with positive blood cultures and synovial fluid cultures. Patient's evolution was favorable thanks to early diagnosis and initiation of adequate antibiotic therapy. Proteus mirabilis septic arthritis is rare. On that basis we conducted a literature review of cases of Proteus mirabilis pyogenic arthritis to highlight the risk factors, pathogenesis, treatment and evolution of these diseases. Diagnosis is commonly based on microbiological analysis, early articular puncture biopsy is performed before the initiation of antibiotic treatment, direct examination, culture and antibiogram which are useful as guidance for antibiotic therapy. Septic arthritis is a diagnostic and therapeutic emergency; early management of this disease allows total healing without after-effects.

  10. Chikungunya Arthritis: Implications of Acute and Chronic Inflammation Mechanisms on Disease Management.

    Science.gov (United States)

    Zaid, Ali; Gérardin, Patrick; Taylor, Adam; Mostafavi, Helen; Malvy, Denis; Mahalingam, Suresh

    2018-04-01

    In the past decade, arboviruses-arthropod-borne viruses-have been the focus of public health institutions worldwide following a spate of devastating outbreaks. Chikungunya virus, an arbovirus that belongs to the alphavirus genus, is a reemerging arthritogenic virus that has caused explosive outbreaks since 2006, notably on Réunion Island, and more recently in the Caribbean, South America, India, and Southeast Asia. The severity of arthritic disease caused by chikungunya virus has prompted public health authorities in affected countries to develop specific guidelines to tackle this pathogen. Chikungunya virus disease manifests first as an acute stage of severe joint inflammation and febrile illness, which later progresses to a chronic stage, during which patients may experience debilitating and persisting articular pain for extended periods. This review aims to provide a broad perspective on current knowledge of chikungunya virus pathogenesis by identifying key clinical and experimental studies that have contributed to our understanding of chikungunya virus to date. In addition, the review explores the practical aspects of treatment and management of both acute and chronic chikungunya virus based on clinical experience during chikungunya virus outbreaks. Finally, recent findings on potential therapeutic solutions-from antiviral agents to immunomodulators-are reviewed to provide both viral immunologists and clinical rheumatologists with a balanced perspective on the nature of a reemerging arboviral disease of significant public health concern, and insight into future therapeutic approaches to better address the treatment and management of chikungunya virus. © 2017, American College of Rheumatology.

  11. Rapid and deep control of inflammation in rheumatoid arthritis with infliximab and its correlation with acute-phase reactants.

    Science.gov (United States)

    Scali, J J; Visentini, S; Salomón, J; Sevilla, D; Ju, Y C; Morales, E; Ugarte, L; Tachdjian, A; Pacheco, G; Veiga, S

    2007-09-01

    Rheumatoid arthritis (RA) is a chronic inflammatory disease with predominant joint involvement and possible systemic compromise, which leads to a handicapped status and poor quality of life. An optimal approach to treat RA requires early and intensive intervention with close monitoring of treatment response. Tumor necrosis factor (TNF) blockers are recommended in cases of active RA after the unsuccessful use of effective disease-modifying antirheumatic drugs (DMARDs); even adding them to treatment or replacing these drugs. Anti-TNF therapies have been demonstrated to reduce significant joint damage and to relieve symptoms during a prolonged time (see Scott and Kingsley, 2006). The efficacy of infliximab in an open-label trial is summarized with respect to speed of onset of action, durability of response, and its correlation between clinical and laboratory parameters. Safety for long-term treatment is also summarized. We studied 105 RA patients with more than 3 years' history of disease during 24 months on i.v. infliximab (75 completed study). We evaluated ACR responses at base line, and at 1, 6, 12, 16, 52, 77, and 104 weeks. Morning stiffness, swollen and tender joints, HAQ, SF-36% (PCS/MCS), polymerase chain reaction (PCR), erythrosedimentation rate (ESR), transaminases, rheumatoid factor (RF) levels, hemogram, and adverse events profile were all assessed. The treatment offered rapid and sustained clinical improvements as revealed by ACR responses and marked changes in the parameters previously described. Important changes were made in functional status and acute-phase reactants. Finally, infliximab was considered well tolerated and did not affect the safety profile of this trial.

  12. 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 ...

  13. 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 ...

  14. Arthritis Foundation

    Science.gov (United States)

    ... our position statement on health care transparency, patient representation and collaboration in finding shared solutions. The Role ... Kids Get Arthritis Too Español Arthritis Today Social Media Newsletters Sign Up for E-Newsletters Arthritis Foundation ...

  15. 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.

  16. Human Leukocyte Antigen-B27: The Genetic Predisposition Leading to Reactive Arthritis during Induction Phase Chemotherapy for Acute Myeloid Leukemia

    Science.gov (United States)

    Bartakke, Sandip P; Sampagar, Abhilasha Ashok; Bafna, Vibha Sanjay; Patel, Putun

    2017-01-01

    We report a case of reactive arthritis (ReA) during induction phase chemotherapy of a 15-year-old male patient with acute myeloid leukemia (AML) M4 with inv(16), most probably due to a genetic predisposition of being human leukocyte antigen b27 (HLA-B27) positive. The episode of ReA recurred during consolidation therapy; however, the patient was asymptomatic after the completion of treatment. The link between HLA-B27 and a large family of inflammatory rheumatic diseases is a well-established fact, but interestingly, there is also a molecular link between HLA-B27 and hematological malignancies. This case brings to our notice, the common immunological, molecular, and microbiological link between AML, HLA-B27, and ReA. It also emphasizes the fact that clinicians should have a high index of suspicion of HLA-B27 positivity, if a case of AML develops arthritis during chemotherapy, since early introduction of immunosuppressive medications for arthritis may reduce morbidity and prevent delay in the administration of further chemotherapy cycles. PMID:29200696

  17. 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.

  18. Isolated septic facet joint arthritis as a rare cause of acute and chronic low back pain – a case report and literature review

    International Nuclear Information System (INIS)

    Klekot, Dominika; Zimny, Anna; Czapiga, Bogdan; Sąsiadek, Marek

    2012-01-01

    The most common cause of low back pain is degenerative disease of the intervertebral disc and other structures of the lumbar spine. However, in some cases other less frequent causes of such pain can be seen, for example septic facet joint arthritis. Until now, only 40 cases of such inflammatory changes within the spine have been reported in the literature. The disease is probably underestimated due to improper diagnostic pathway. The authors describe a case of a 53-year-old woman who was repeatedly hospitalized during a five-month period because of an acute, severe low back pain, with sphincter dysfunction, partially resembling sciatic symptoms. Physical examinations revealed also focal tenderness in the area of the lumbar spine. Inflammatory markers (ESR – erythrocyte sedimentation rate, CRP – C-reactive protein) were elevated. Conservative analgetic treatment brought only partial and temporary relief of the pain and symptoms. The final accurate diagnosis of isolated septic facet joint arthritis at the level of L5/S1 was established after several months from the onset of the first symptoms, after performing various imaging examinations, including bone scintigraphy as well as CT and MRI of the lumbosacral spine. The patient fully recovered after antibiotic therapy and surgery, which was proven in several follow-up examinations showing no relevant pathology of the lumbar spine. The authors broadly describe the etiology and clinical symptoms of the septic facet joint arthritis as well as the significant role of imaging methods, especially MRI, in diagnostic process. The authors also discuss currently available treatment options, both conservative and surgical. The diagnostic procedure of septic facet joint arthritis requires several steps to be taken. Establishing a correct diagnosis may be difficult, that is why it is important to remember about rare causes of low back pain and to perform detailed physical examination, laboratory tests and choose appropriate

  19. 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 ...

  20. Acute phase reactants add little to composite disease activity indices for rheumatoid arthritis: validation of a clinical activity score

    Science.gov (United States)

    Aletaha, Daniel; Nell, Valerie PK; Stamm, Tanja; Uffmann, Martin; Pflugbeil, Stephan; Machold, Klaus; Smolen, Josef S

    2005-01-01

    Introduction Frequent assessments of rheumatoid arthritis (RA) disease activity allow timely adaptation of therapy, which is essential in preventing disease progression. However, values of acute phase reactants (APRs) are needed to calculate current composite activity indices, such as the Disease Activity Score (DAS)28, the DAS28-CRP (i.e. the DAS28 using C-reactive protein instead of erythrocyte sedimentation rate) and the Simplified Disease Activity Index (SDAI). We hypothesized that APRs make limited contribution to the SDAI, and that an SDAI-modification eliminating APRs – termed the Clinical Disease Activity Index (CDAI; i.e. the sum of tender and swollen joint counts [28 joints] and patient and physician global assessments [in cm]) – would have comparable validity in clinical cohorts. Method Data sources comprised an observational cohort of 767 RA patients (average disease duration 8.1 ± 10.6 years), and an independent inception cohort of 106 patients (disease duration 11.5 ± 12.5 weeks) who were followed prospectively. Results Our clinically based hypothesis was statistically supported: APRs accounted only for 15% of the DAS28, and for 5% of the SDAI and the DAS28-CRP. In both cohorts the CDAI correlated strongly with DAS28 (R = 0.89–0.90) and comparably to the correlation of SDAI with DAS28 (R = 0.90–0.91). In additional analyses, the CDAI when compared to the SDAI and the DAS28 agreed with a weighted kappa of 0.70 and 0.79, respectively, and comparably to the agreement between DAS28 and DAS28-CRP. All three scores correlated similarly with Health Assessment Questionnaire (HAQ) scores (R = 0.45–0.47). The average changes in all scores were greater in patients with better American College of Rheumatology response (P < 0.0001, analysis of variance; discriminant validity). All scores exhibited similar correlations with radiological progression (construct validity) over 3 years (R = 0.54–0.58; P < 0.0001). Conclusion APRs add little information on

  1. Two siblings with a new Aicardi-Goutières-like syndrome.

    Science.gov (United States)

    Schwarz, K B; Ferrie, C D; Woods, C G

    2002-06-01

    We present two siblings (male and female) with very similar characteristics comprising dysmorphic features, severe developmental delay, progressive microcephaly, tonic seizures, and hypothyroidism. The male also had micropenis and cryptorchidism. Both children developed pericardial effusions which caused the death of the female at age 16 months. The male's cardiac function was stable at last follow-up at the age of 15 months. Cerebral imaging showed widespread intracranial calcifications, delay in myelination, hypoplasia of the corpus callosum, and cerebral atrophy. CSF examination showed normal CSF white-cell count and was negative for interferon, although a cytotoxic antibody was thought to be present. Other causes of a neurodegenerative condition and congenital infection were excluded. The combination of these features has not been described before. We believe that these patients represent a new syndrome which has some of the features of Aicardi-Goutières syndrome but is distinct from it.

  2. Multiparameter analysis of biomarkers in the laboratory diagnosis of early rheumatoid arthritis

    OpenAIRE

    Aleksandr Aleksandrovich Novikov; E N Aleksandrova; A N Gerasimov; M V Cherkasova; D E Karateev; E L Luchikhina; E L Nasonov

    2013-01-01

    Subjects and methods. 102 patients with early RA (79 women and 23 men; median age 51 years [41 to 62, 25th to 75th percentile]; disease duration 4 months [2.5 to 6.0]; DAS28 5.4 [4.1 to 5.9]) were examined. A comparison group consisted of 616 patients including 27 with systemic lupus erythematosus, 15 with Sjö gren’s syndrome, 25 with ankylosing spondyloarthritis; 33 with osteoarthritis, 20 with overlap syndrome, 9, 22, and 168 patients with gouty, psoriatic, and undifferentiated arthritis, r...

  3. Inflammatory Gout: Observations over a Half-Century

    Science.gov (United States)

    Malawista, Stephen E.; Chevance de Boisfleury, Anne; Naccache, Paul H.

    2011-01-01

    This is a discussion of acute gouty arthritis, seen for over 50 years of engagement. It addresses the evolution of our current understanding of the interaction between urate crystals and key cellular components of the gouty inflammatory paroxysm, with new material on pathogenesis. PMID:22131362

  4. Inflammatory Gout: Observations over a Half-Century

    OpenAIRE

    Malawista, Stephen E.; Chevance de Boisfleury, Anne; Naccache, Paul H.

    2011-01-01

    This is a discussion of acute gouty arthritis, seen for over 50 years of engagement. It addresses the evolution of our current understanding of the interaction between urate crystals and key cellular components of the gouty inflammatory paroxysm, with new material on pathogenesis.

  5. 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 ...

  6. 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 ...

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

    International Nuclear Information System (INIS)

    Lee, Seung Hun; Joo, Kyung Bin; Lee, Kyu Hoon; Uhm, Wan Sik

    2011-01-01

    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.

  8. 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.

  9. Serum Calprotectin Versus Acute-Phase Reactants in the Discrimination of Inflammatory Disease Activity in Rheumatoid Arthritis Patients Receiving Tumor Necrosis Factor Inhibitors.

    Science.gov (United States)

    Inciarte-Mundo, José; Victoria Hernández, Maria; Ruiz-Esquide, Virginia; Raquel Cabrera-Villalba, Sonia; Ramirez, Julio; Cuervo, Andrea; Pascal, Mariona; Yagüe, Jordi; Cañete, Juan D; Sanmarti, Raimon

    2016-07-01

    To compare the accuracy of serum calprotectin and acute-phase reactants (C-reactive protein [CRP] and erythrocyte sedimentation rate [ESR]) in stratifying disease activity in rheumatoid arthritis (RA) patients receiving tumor necrosis factor inhibitors (TNFi), and to correlate calprotectin levels with TNFi trough serum levels. We conducted a cross-sectional study of 87 RA patients receiving adalimumab, etanercept (ETN), or infliximab (IFX); 56 psoriatic arthritis (PsA) patients and 40 healthy blood donors were included as controls. Associations between calprotectin, CRP, and ESR and composite articular indices (Disease Activity Score in 28 joints [DAS28], Simplified Disease Activity Index [SDAI], and Clinical Disease Activity Index) were analyzed by correlation and linear regression and the accuracy and discriminatory capacity of calprotectin by receiver operator characteristic curves (area under the curve [AUC]). Calprotectin levels correlated better with all composite activity indices than CRP and ESR (all r coefficients >0.70). Calprotectin levels were significantly lower in RA and PsA patients in clinical remission compared with those with low disease activity for all articular indices. In RA, ESR discriminated between remission and low disease activity only when using DAS28, and CRP only with SDAI. In RA patients in remission/low disease activity, calprotectin but not CRP or ESR distinguished between patients with no swollen joints and those with ≥1 swollen joint (1.74 μg/ml versus 3.04 μg/ml; P = 0.010). Using DAS28 ≥2.6 as the reference variable, calprotectin showed an AUC of 0.92; the best cutoff was ≥2.47 μg/ml with a likelihood ratio of 6.3 (95% confidence interval 2.5-15.8). Calprotectin serum levels inversely correlated with trough serum drug levels of ETN (ρ = -0.671, P acute-phase reactants, even in patients with low inflammatory activity. © 2016, American College of Rheumatology.

  10. Preserved skeletal muscle protein anabolic response to acute exercise and protein intake in well-treated rheumatoid arthritis patients

    DEFF Research Database (Denmark)

    Mikkelsen, Ulla Ramer; Dideriksen, Kasper; Andersen, Mads Bisgaard

    2015-01-01

    INTRODUCTION: Rheumatoid arthritis (RA) is often associated with diminished muscle mass, reflecting an imbalance between protein synthesis and protein breakdown. To investigate the anabolic potential of both exercise and nutritional protein intake we investigated the muscle protein synthesis rate...... and in combination with physical exercise in patients with well-treated RA to a similar extent as in healthy individuals. This indicates that moderately inflamed RA patients have maintained their muscle anabolic responsiveness to physical activity and protein intake....

  11. 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.

  12. Indomethacin

    Science.gov (United States)

    ... bone). Indomethacin immediate-release capsules, suspension (liquid) and suppositories are also used to treat acute gouty arthritis ( ... suspension to take by mouth and as a suppository to be used rectally. Indomethacin capsules and liquid ...

  13. Pediatric Septic Arthritis.

    Science.gov (United States)

    Montgomery, Nicole I; Epps, Howard R

    2017-04-01

    Acute septic arthritis is a condition with the potential for joint destruction, physeal damage, and osteonecrosis, which warrants urgent identification and treatment. The organism most frequently responsible is Staphylococcus aureus; however, our understanding of pathogens continues to evolve as detection methods continue to improve. MRI has improved our ability to detect concurrent infections and is a useful clinical tool where available. The treatment course involves intravenous antibiotics followed by transition to oral antibiotics when clinically appropriate. The recommended surgical treatment of septic arthritis is open arthrotomy with decompression of the joint, irrigation, and debridement and treatment of concurrent infections. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Serum Matrix Metalloproteinase-3 in Comparison with Acute Phase Proteins as a Marker of Disease Activity and Radiographic Damage in Early Rheumatoid Arthritis

    Science.gov (United States)

    Ally, Mahmood M. T. M.; Hodkinson, Bridget; Meyer, Pieter W. A.; Musenge, Eustasius; Tikly, Mohammed; Anderson, Ronald

    2013-01-01

    Matrix metalloproteinase-3 (MMP-3) is involved in the immunopathogenesis of rheumatoid arthritis (RA), but little is known about its relationship to genetic susceptibility and biomarkers of disease activity, especially acute phase reactants in early RA. MMP-3 was measured by ELISA in serum samples of 128 disease-modifying, drug-naïve patients and analysed in relation to shared epitope genotype, a range of circulating chemokines/cytokines, acute phase reactants, autoantibodies, cartilage oligomeric protein (COMP), and the simplified disease activity index (SDAI). MMP-3 was elevated >1.86 ng/ml in 56.25% of patients (P < 0.0001), correlated with several biomarkers, notably IL-8, IL-6, IFN γ, VEGF and COMP (r values = 0.22–0.33, P < 0.014–0.0001) and with CRP and SAA levels (r = 0.40 and 0.41, resp., P < 0.0000) and SDAI (r = 0.29, P < 0.0001), but not with erosions or nodulosis. However, the correlations of CRP and SAA with SDAI were stronger (respective values of 0.63 and 0.54, P < 0.001 for both). COMP correlated with smoking, RF, and MMP-3. MMP-3 is significantly associated with disease activity, inflammatory mediators and cartilage breakdown, making it a potential biomarker of disease severity, but seemingly less useful than CRP and SAA as a biomarker of disease activity in early RA. PMID:23690656

  15. Serum Matrix Metalloproteinase-3 in Comparison with Acute Phase Proteins as a Marker of Disease Activity and Radiographic Damage in Early Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    Mahmood M. T. M. Ally

    2013-01-01

    Full Text Available Matrix metalloproteinase-3 (MMP-3 is involved in the immunopathogenesis of rheumatoid arthritis (RA, but little is known about its relationship to genetic susceptibility and biomarkers of disease activity, especially acute phase reactants in early RA. MMP-3 was measured by ELISA in serum samples of 128 disease-modifying, drug-naïve patients and analysed in relation to shared epitope genotype, a range of circulating chemokines/cytokines, acute phase reactants, autoantibodies, cartilage oligomeric protein (COMP, and the simplified disease activity index (SDAI. MMP-3 was elevated >1.86 ng/ml in 56.25% of patients (P<0.0001, correlated with several biomarkers, notably IL-8, IL-6, IFN γ, VEGF and COMP (r values = 0.22–0.33, P<0.014–0.0001 and with CRP and SAA levels (r=0.40 and 0.41, resp., P<0.0000 and SDAI (r=0.29, P<0.0001, but not with erosions or nodulosis. However, the correlations of CRP and SAA with SDAI were stronger (respective values of 0.63 and 0.54, P<0.001 for both. COMP correlated with smoking, RF, and MMP-3. MMP-3 is significantly associated with disease activity, inflammatory mediators and cartilage breakdown, making it a potential biomarker of disease severity, but seemingly less useful than CRP and SAA as a biomarker of disease activity in early RA.

  16. Suppressive effect of Withania somnifera root powder on experimental gouty arthritis: An in vivo and in vitro study.

    Science.gov (United States)

    Rasool, Mahaboobkhan; Varalakshmi, Palaninathan

    2006-12-15

    The effect of Withania somnifera L. Dunal root powder on paw volume and serum lysosomal enzyme activities was investigated in monosodium urate crystal-induced rats. The levels of beta-glucuronidase and lactate dehydrogenase were also measured in monosodium urate crystal incubated polymorphonuclear leucocytes (PMNL). A significant increase in the level of paw volume and serum lysosomal enzymes was observed in monosodium urate crystal-induced rats. The increased beta-glucuronidase and lactate dehydrogenase level were observed in untreated monosodium urate crystal incubated polymorphonuclear leucocytes. On treatment with the W. somnifera root powder (500/1000 mg/kg body weight), the above changes were reverted back to near normal levels. W. somnifera also showed potent analgesic and antipyretic effect with the absence of gastric damage at different dose levels in experimental rats. For comparison purpose, non-steroidal anti-inflammatory drug (NSAID) indomethacin was used as a standard. These results provide evidence for the suppressive effect of W. somnifera root powder by retarding amplification and propagation of the inflammatory response without causing any gastric damage.

  17. Psoriatic arthritis

    International Nuclear Information System (INIS)

    Espinoza, L.R.

    1985-01-01

    In the past 10 years, a number of well-controlled surveys of psoriatic patients selective for the presence of arthritis have been conducted. A Canadian group reported that of 100 patients admitted to the hospital for treatment of psoriasis, 32 had clinical or radiologic evidence of psoriatic arthritis, and 17 had both types of evidence. Eighty patients with radiologic evidence of spinal or sacroiliac involvement were asymptomatic, and seven had clinical evidence of peripheral arthritis but without radiologic evidence. The authors concluded that psoriatic arthritis is a common event in patients with severe psoriasis and that it is associated with more extensive skin disease than is found in patients without arthritis. The information gathered from these epidemiologic studies coupled with clinical, radiologic, and serologic characteristics have provided the basis for the current belief that psoriatic arthritis is indeed a distinct entity

  18. Rheumatoid Arthritis Educational Video Series

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

  19. 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.

  20. Interleukin-6 receptor inhibition with tocilizumab and attainment of disease remission in rheumatoid arthritis: the role of acute-phase reactants.

    Science.gov (United States)

    Smolen, Josef S; Aletaha, Daniel

    2011-01-01

    To determine the effects of tocilizumab on rheumatoid arthritis (RA) disease activity and remission assessment, using measures that do or do not comprise acute-phase reactants. Simplified Disease Activity Index (SDAI) scores, Clinical Disease Activity Index (CDAI) scores, and the Disease Activity Score in 28 joints (DAS28) were calculated using data from tocilizumab trials in patients with RA in whom disease had remained active despite treatment with disease-modifying antirheumatic drugs. The CDAI does not contain an acute-phase reactant component. Disease activity states, including remission, were defined using established cut points; for the DAS28, an alternative cut point of acute-phase reactant values in order to fulfill the criteria. However, DAS28 remission rates were higher (even when using the lower cut point) than the SDAI and CDAI remission rates. Only a minority of tocilizumab-treated patients with DAS28 remission also had disease remission according to the SDAI (26%) or CDAI (∼21%). With infliximab treatment, SDAI and CDAI remission rates were of the same magnitude as those observed with tocilizumab treatment, and DAS28 remission rates were lower. Tocilizumab-treated patients with DAS28 remission but without CDAI remission had significantly higher swollen joint counts but lower erythrocyte sedimentation rates (ESRs) compared with patients with SDAI or CDAI remission. Disease activity in RA is reduced by tocilizumab treatment, irrespective of the type of composite measure used to evaluate disease activity. Remission rates were much higher using the DAS28 compared with the SDAI and CDAI, due to the high weight of the ESR in the DAS28 and the effect of tocilizumab on the ESR. Using the stringent SDAI and CDAI criteria, however, remission rates in patients treated with tocilizumab were in the same range as those seen in patients treated with tumor necrosis factor inhibitors. Copyright © 2011 by the American College of Rheumatology.

  1. Rheumatoid arthritis.

    Science.gov (United States)

    Vikingsson, Arnor; Graziano, Frank M

    1993-12-01

    Preview Once considered relatively benign, rheumatoid arthritis is now recognized as a disabling systemic disease that causes substantial morbidity and mortality. Early, aggressive therapy may be critical for altering the course of disease. Drs Vikings-son and Graziano describe the causes and clinical course of rheumatoid arthritis and discuss diagnostic considerations and prognostic indicators that support optimum management.

  2. Reactive arthritis associated with Mycoplasma genitalium urethritis.

    Science.gov (United States)

    Chrisment, D; Machelart, I; Wirth, G; Lazaro, E; Greib, C; Pellegrin, J-L; Bébéar, C; Peuchant, O

    2013-11-01

    Mycoplasma genitalium is an important cause of sexually transmitted infections that is gaining recognition and is an independent cause of acute and chronic nongonococcal urethritis in men. M. genitalium has been implicated as a possible causative factor in reactive arthritis. We report a case of reactive arthritis complicating M. genitalium urethritis in an HLA-B27-positive patient. © 2013.

  3. 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.

  4. 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

  5. Acute Septic Arthritis of the Knee Caused by Kingella kingae in a 5-Year-Old Cameroonian Boy

    Directory of Open Access Journals (Sweden)

    Nawal El Houmami

    2017-11-01

    Full Text Available Kingella kingae is an important cause of invasive infections in young children from Western countries. Although increasing reports indicate that this organism is the leading agent of bone and joint infections in early childhood, data on K. kingae infections from resource-limited settings are scarce, and none has yet been reported in Africa. We herein report the diagnostic and epidemiological investigations of the first case of K. kingae arthritis identified in a child from sub-Saharan Africa. A 5-year-old Cameroonian boy presented with a sudden painful limp which appeared in the course of a mild rhinopharyngitis. He lived in Cameroon where he had been vaccinated with BCG at birth and moved to France for holidays 4 days before consultation. There was no history of trauma and he did not have any underlying medical condition. Upon admission, he had a temperature of 36.7°C, and clinical examination revealed right-sided knee tenderness and effusion that was confirmed by ultrasound imaging. Laboratory results showed a white blood cell count of 5,700 cells/mm3, C-reactive protein level of 174 mg/L, and platelet count of 495,000 cells/mm3. He underwent an arthrocentesis and was immediately given intravenous amoxicillin-clavulanate. Conventional cultures from blood samples and synovial fluids were negative. Polymerase chain reaction (PCR assay targeting the broad-range 16S rRNA gene and real-time quantitative PCR assays targeting Mycobacterium species were negative. Surprisingly, real-time PCR assays targeting the cpn60, rtxA, and rtxB genes of K. kingae were positive. Multicolor fluorescence in situ hybridization specific for K. kingae identified the presence of numerous coccobacilli located within the synovial fluid. Finally, multilocus sequence typing analysis performed on deoxyribonucleic acid directly extracted from joint fluid disclosed a novel K. kingae sequence-type complex. This case report demonstrates that K. kingae may be considered

  6. Signs of forefeet joint synovitis have a limited impact on patient's perception of rheumatoid arthritis disease activity and acute-phase reactants.

    Science.gov (United States)

    Naniwa, Taio; Iwagaitsu, Shiho; Tamechika, Shinya; Maeda, Shinji; Niimi, Akio

    2016-01-01

    To determine the prevalence and distribution of signs of synovitis in the residual joints in remission defined by the American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) rheumatoid arthritis (RA) remission criteria and the role of their components in preventing misclassification due to reduced joint count. The cross-sectional observational data of RA patients including full joint counts were analyzed. Definitions of remission used were the ACR/EULAR RA remission criteria and their modifications using full joint counts with the same thresholds of the items and the calculated results. A total of 304 RA patients with 3,149 observations could be analyzed. Patients in remission according to the ACR/EULAR remission criteria can still show residual disease activity in the feet in up to 27% of the population with a 28-joint count remission. Residual disease activity has no impact on patient's global assessment for current disease activity, when signs of concomitant ankle joint synovitis were absent. RA patients in remission according to the ACR/EULAR definitions can still show signs of synovitis mostly in the forefeet joints. Acute-phase reactants and patient's global assessment for current disease activity have little impact in mitigating the limitation of reduced joint count.

  7. Evaluation of composite measures of treatment response without acute-phase reactants in patients with rheumatoid arthritis

    OpenAIRE

    Greenberg, Jeffrey D.; Harrold, Leslie R.; Bentley, Mary J.; Kremer, Joel; Reed, George; Strand, Vibeke

    2009-01-01

    Objectives. To evaluate composite measures of response without acute-phase reactants in RA patients. Specifically, Clinical Disease Activity Index (CDAI)-derived response criteria were compared with the European League Against Rheumatism (EULAR) response criteria, and the modified ACR (mACR) response criteria were compared to the ACR response criteria.

  8. Hyper-Uricemia and Gouty Access in the Adult Population of the Southeast of Gabon: Biochemical Aspects

    Directory of Open Access Journals (Sweden)

    Guy Roger Ndong Atome

    2018-03-01

    Full Text Available Gout is caused by a chronic hyperuricemia whose complications are not currently well evaluated in Africa. The aim of this study was to determine the prevalence and risk factors of hyperuricemia and gout in 85 patients recruited. A total of 26 cases of hyperuricemia, i.e., 30.6% of the study population, with 12 cases of gout and seven cases of gouty access. In this population, hyperuricemia was proportional to age (p-value < 10−4, OR = 2.6, but it was more prevalent in men, 23.5% versus 7.1% for women (p-value = 0.0047. In addition, none of these women showed signs of a gouty affection. Consumption of alcohol (OR = 13 and nucleoprotein-rich foods, obesity (BMI 30 kg/m2; OR = 6, family history of gout (OR = 6.8, as well as diseases such as high blood pressure (associated with taking diuretics; OR = 1.7, renal insufficiency (OR = 4.4 and diabetes (p < 0.049 were the main factors of the diseases associated with gout and hyperuricemia in this population. The biochemical role of these factors may increase and/or decrease the processes of synthesis and/or elimination of uric acid by acting on metabolites involved in the regulation of urate production.

  9. Hyper-Uricemia and Gouty Access in the Adult Population of the Southeast of Gabon: Biochemical Aspects.

    Science.gov (United States)

    Ndong Atome, Guy Roger; Ngoua Meye Misso, Rick-Leonid; Sima Obiang, Cédric; Onanga, Richard; Nkogue Mba, Dieudonné

    2018-03-08

    Gout is caused by a chronic hyperuricemia whose complications are not currently well evaluated in Africa. The aim of this study was to determine the prevalence and risk factors of hyperuricemia and gout in 85 patients recruited. A total of 26 cases of hyperuricemia, i.e., 30.6% of the study population, with 12 cases of gout and seven cases of gouty access. In this population, hyperuricemia was proportional to age ( p -value < 10 -4, OR = 2.6), but it was more prevalent in men, 23.5% versus 7.1% for women ( p -value = 0.0047). In addition, none of these women showed signs of a gouty affection. Consumption of alcohol (OR = 13) and nucleoprotein-rich foods, obesity (BMI 30 kg/m²; OR = 6), family history of gout (OR = 6.8), as well as diseases such as high blood pressure (associated with taking diuretics; OR = 1.7), renal insufficiency (OR = 4.4) and diabetes ( p < 0.049) were the main factors of the diseases associated with gout and hyperuricemia in this population. The biochemical role of these factors may increase and/or decrease the processes of synthesis and/or elimination of uric acid by acting on metabolites involved in the regulation of urate production.

  10. Increased serum amyloid A and its association with autoantibodies, acute phase reactants and disease activity in patients with rheumatoid arthritis.

    Science.gov (United States)

    Shen, Chen; Sun, Xu-Guo; Liu, Na; Mu, Yun; Hong, Cheng-Cheng; Wei, Wei; Zheng, Fang

    2015-02-01

    Determination of disease activity in patients with rheumatoid arthritis (RA) has become an important component for RA management. The aim of the present study was to investigate the association between circulating levels of serum amyloid A (SAA) and disease activity in RA patients. The types of disease and the respective number of patients enrolled in the present study were as follows: RA, 88; osteoarthritis (OA), 54; systemic lupus erythematosus (SLE), 43; and other autoimmune diseases, 30, as well as 50 healthy controls (HC). SAA levels were measured using an ELISA assay and western blot analysis was used to detect serum SAA levels. The correlations between SAA levels and disease activity score for 28 joints (DAS28), erythrocyte sedimentation rate (ESR) and C‑reactive protein (CRP), respectively, were evaluated; in addition, the presence and absence of rheumatoid factor (RF) and anti‑cyclic citrullinated peptide antibody (anti‑CCP) were detected in respect to SAA levels. The results of the present study demonstrated that serum levels of SAA in RA patients were significantly increased compared to those of the OA, SLE, others and HC patients (P<0.05). SAA levels were found to be positively correlated with DAS28, ESR and CRP levels (R2=0.6174, 0.4422 and 0.3919, respectively). In addition, anti‑CCP was not correlated with DAS28 (R2=0.0154). Furthermore, increased SAA levels were detected in patients with positive anti‑CCP compared with those in anti‑CCP negative subjects (P<0.01). In conclusion, the results of the present study provided further evidence for possible roles of SAA in RA, which indicated that it may be a useful biomarker for assessing disease severity and may provide additional information about disease activity.

  11. Rheumatoid Arthritis Educational Video Series

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    Full Text Available ... Osteoarthritis News Gout News Osteoporosis News Lupus News Fibromyalgia News Patient Corner Arthritis Drug Information Sheets Managing ... Managing Your Arthritis Managing Your Arthritis Managing Chronic Pain and Depression in Arthritis Nutrition & Rheumatoid Arthritis Arthritis ...

  12. Rheumatoid Arthritis Educational Video Series

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    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 ...

  13. Evaluation of composite measures of treatment response without acute-phase reactants in patients with rheumatoid arthritis.

    Science.gov (United States)

    Greenberg, Jeffrey D; Harrold, Leslie R; Bentley, Mary J; Kremer, Joel; Reed, George; Strand, Vibeke

    2009-06-01

    To evaluate composite measures of response without acute-phase reactants in RA patients. Specifically, Clinical Disease Activity Index (CDAI)-derived response criteria were compared with the European League Against Rheumatism (EULAR) response criteria, and the modified ACR (mACR) response criteria were compared to the ACR response criteria. Data from 10 108 RA patients enrolled in the Consortium of Rheumatology Researchers of North America registry were examined, including 649 patients initiating DMARD therapy. CDAI cut-off points for disease activity levels and responses were derived using receiver operating characteristic curves with the DAS28 and EULAR response criteria as gold standards. The kappa-statistics were applied to assess agreement between CDAI-derived and EULAR-defined responses, as well as ACR20 and ACR50 with mACR20- and mACR50-defined responses, respectively. For the components of the EULAR response, the derived CDAI cut-off points for DAS28 levels of 3.2 and 5.1 were 7.6 and 19.6, respectively. The derived CDAI cut-off points were 4.3 and 10.0 for DAS28 changes of 0.6 and 1.2, respectively. There were moderate to substantial agreements between CDAI-derived and EULAR responses (kappa = 0.57-0.71). Agreement of ACR20 and ACR50 with mACR20 and mACR50 responses, respectively, was excellent (kappa = 0.88-0.95). Agreement between composite measures of response without acute-phase reactants and standard measures ranged from moderate to excellent. The mACR20 and mACR50 criteria as well as CDAI-derived response criteria, can serve as composite measures of response in clinical practice and research settings without access to acute-phase reactants.

  14. Rheumatoid Arthritis Educational Video Series

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

  15. Rheumatoid Arthritis Educational Video Series

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    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 ...

  16. Rheumatoid Arthritis Educational Video Series

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

  17. A modified rheumatoid arthritis disease activity score without acute-phase reactants (mDAS28) for epidemiological research.

    Science.gov (United States)

    Bentley, Mary J; Greenberg, Jeffrey D; Reed, George W

    2010-08-01

    To develop and validate a modified version of the Disease Activity Score with 28 joint count (mDAS28), for use in epidemiological research, when acute-phase reactant values are unavailable. In a cross-sectional development cohort (5729 patients), statistically significant predictors of the logarithm of erythrocyte sedimentation rate (lnESR) were identified. After computation of the mDAS28, a cross-sectional validation cohort (5578 patients) was used to evaluate internal, criterion, and construct validities. The ability of the mDAS28 to discriminate between disease states was also assessed. A second validation cohort (longitudinal, 336 pairs of patient visits) was used to assess sensitivity to change. Significant predictors of lnESR included tender and swollen joints with 28 counts, patient's and physician's assessments of global health, and patient's assessment of pain (visual analog scale 0-100 mm) and a physical function (modified Health Assessment Questionnaire 0-3; mHAQ). Satisfactory internal validity (alpha = 0.72) and strong criterion validity compared to the DAS28, the Simplified Disease Activity Index (SDAI), and the Clinical Disease Activity Index (CDAI) (r = 0.87-0.96) were found. Predictive validity was demonstrated by good correlation with the mHAQ (r = 0.58). The mDAS28 showed substantial agreement with the DAS28, SDAI, and CDAI in discriminating between disease states (kappa = 0.70-0.77) and moderate to substantial agreement between response levels (kappa = 0.52-0.73). Both mDAS28 and DAS28 measures classified patients similarly in remission compared to the SDAI and CDAI. The mDAS28 was superior in detecting change (standardized response mean = 0.58) followed by the DAS28, CDAI, and SDAI. The mDAS28 is a valid and sensitive tool to assess disease activity in epidemiological research, as an alternative to the DAS28, when acute-phase reactant values are unavailable.

  18. Native joinPropionibacteriumseptic arthritis.

    Science.gov (United States)

    Taylor, Thomas; Coe, Marcus; Mata-Fink, Ana; Zuckerman, Richard

    2017-10-02

    Propionibacterium species are associated with normal skin flora and cultures may be dismissed as contaminants. They are increasingly recognized as a cause of septic arthritis following shoulder arthroplasty and arthrotomy. We identified three cases of Propionibacterium septic arthritis in native joints mimicking atypical osteoarthritis and review the literature, clinical course, and treatment of 18 cases. Two cases of Propionibacterium acne in native knee joints and one in a sternoclavicular joint are described. A literature search for Propionibacterium septic arthritis was performed. Clinical course, treatment, and outcome are reviewed for all cases. Our three cases were combined with 15 cases from the literature. Fourteen cases showed few signs of acute infection, slow culture growth, and delayed diagnosis. In 3 cases an early culture was dismissed as a contaminant. Six cases were reported as caused by recent arthrocentesis. Fifteen cases were cured with antibiotics, although 5 of these 15 also required surgical intervention. Two patients were diagnosed while undergoing surgery for osteoarthritis. Four patients required arthroplasty and two of our patients will require arthroplasty for good functional results. Propionibacterium as a cause of septic arthritis in native joints demonstrates few signs of acute infection, presents with prolonged course, and is often misdiagnosed or unsuspected. Anaerobic growth may be delayed or missed altogether, and outcomes are consequently poor. Consider Propionibacterium septic arthritis in atypical osteoarthritis prior to arthroplasty.

  19. Lesson of the month 1: Septic arthritis with normal acute phase reactants and white cell count in a patient receiving tocilizumab.

    Science.gov (United States)

    Conway, Richard; Orr, Carl; McCarthy, Geraldine M

    2017-06-01

    Septic arthritis represents 8-27% of cases of monoarthritis presenting to the emergency department. Tocilizumab is an interleukin-6 blocking monoclonal antibody with the mechanistic potential to interfere with the body's normal inflammatory response to an infectious insult. We present a case of septic arthritis with a normal white cell count, C-reactive protein, erythrocyte sedimentation rate and fibrinogen in a patient treated with tocilizumab. © Royal College of Physicians 2017. All rights reserved.

  20. CASE REPORT A case of extensive synovial involvement by ...

    African Journals Online (AJOL)

    symptoms, and there is no evidence to suggest that treatment is warranted for asymptomatic hyperuricaemia.2,3. Acute gouty arthritis. This is the most common manifestation of gout, as acute inflammation owing to precipitation of urate crystals within the joint. The arthritis is initially monoarticular; as the disease progresses, ...

  1. 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.

  2. Rheumatoid Arthritis Educational Video Series

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    Full Text Available ... Arthritis Managing Chronic Pain and Depression in Arthritis Nutrition & Rheumatoid Arthritis Arthritis and Health-related Quality of ... Rheumatology Arthritis Center Lupus Center Lyme Disease Clinical Research Center Myositis Center Scleroderma Center Sjogren’s Syndrome Center ...

  3. Rheumatoid Arthritis Educational Video Series

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    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 Psoriatic Arthritis News Ankylosing Spondylitis News ...

  4. 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...

  5. What Is Reactive Arthritis?

    Science.gov (United States)

    ... Initiative Breadcrumb Home Health Topics English Español Reactive Arthritis Basics In-Depth Download Download EPUB Download PDF What is it? Points To Remember About Reactive Arthritis Reactive arthritis is pain or swelling in a ...

  6. Arthritis: Conventional and Advanced Radiological Imaging

    Directory of Open Access Journals (Sweden)

    Adviye Ergun

    2014-06-01

    Full Text Available Arthritides are acute or chronic inflammation of one or more joints. The most common types of arthritis are osteoarthritis and rheumatoid arthritis, but there are more than 100 different forms. Right and early diagnosis is extremely important for the prevention of eventual structural and functional disability of the affected joint. Imaging findings, especially those of advanced level imaging, play a major role in diagnosis and monitor the progression of arthritis or its response to therapy. The objective of the review is to discuss the findings of conventional and advanced radiological imaging of most common arthritides and to present a simplified approach for their radiological evaluation.

  7. INTERRELATIONSHIP OF OUTCOME MEASURES AND PROCESS VARIABLES IN EARLY RHEUMATOID-ARTHRITIS - A COMPARISON OF RADIOLOGIC DAMAGE, PHYSICAL-DISABILITY, JOINT COUNTS, AND ACUTE-PHASE REACTANTS

    NARCIS (Netherlands)

    VANLEEUWEN, MA; VANDERHEIJDE, DMFM; VANRIJSWIJK, MH; HOUTMAN, PM; VANRIEL, PLCM; VANDEPUTTE, LBA; LIMBURG, PC

    Objective. To investigate the relationship between different outcome and process measures in early rheumatoid arthritis (RA). Methods. A 5-year prospective study of 149 patients with early RA (symptoms <1 year at entry). Results of serial measurements of process variables were transformed into time

  8. Outcome of management of non-gonococcal septic arthritis at ...

    African Journals Online (AJOL)

    Septic arthritis is an acute bacterial infection of a synovial joint. It is an orthopaedic emergency that can lead to morbidity or mortality if not properly treated. The fundamental issues in the management of septic arthritis include the duration of antibiotic therapy, the mode of joint drainage and the role of physiotherapy. There is ...

  9. Rheumatoid Arthritis Educational Video Series

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

  10. Genome-wide DNA hypomethylation and RNA:DNA hybrid accumulation in Aicardi–Goutières syndrome

    Science.gov (United States)

    Lim, Yoong Wearn; Sanz, Lionel A; Xu, Xiaoqin; Hartono, Stella R; Chédin, Frédéric

    2015-01-01

    Aicardi–Goutières syndrome (AGS) is a severe childhood inflammatory disorder that shows clinical and genetic overlap with systemic lupus erythematosus (SLE). AGS is thought to arise from the accumulation of incompletely metabolized endogenous nucleic acid species owing to mutations in nucleic acid-degrading enzymes TREX1 (AGS1), RNase H2 (AGS2, 3 and 4), and SAMHD1 (AGS5). However, the identity and source of such immunogenic nucleic acid species remain undefined. Using genome-wide approaches, we show that fibroblasts from AGS patients with AGS1-5 mutations are burdened by excessive loads of RNA:DNA hybrids. Using MethylC-seq, we show that AGS fibroblasts display pronounced and global loss of DNA methylation and demonstrate that AGS-specific RNA:DNA hybrids often occur within DNA hypomethylated regions. Altogether, our data suggest that RNA:DNA hybrids may represent a common immunogenic form of nucleic acids in AGS and provide the first evidence of epigenetic perturbations in AGS, furthering the links between AGS and SLE. DOI: http://dx.doi.org/10.7554/eLife.08007.001 PMID:26182405

  11. Genome-wide DNA hypomethylation and RNA:DNA hybrid accumulation in Aicardi-Goutières syndrome.

    Science.gov (United States)

    Lim, Yoong Wearn; Sanz, Lionel A; Xu, Xiaoqin; Hartono, Stella R; Chédin, Frédéric

    2015-07-16

    Aicardi-Goutières syndrome (AGS) is a severe childhood inflammatory disorder that shows clinical and genetic overlap with systemic lupus erythematosus (SLE). AGS is thought to arise from the accumulation of incompletely metabolized endogenous nucleic acid species owing to mutations in nucleic acid-degrading enzymes TREX1 (AGS1), RNase H2 (AGS2, 3 and 4), and SAMHD1 (AGS5). However, the identity and source of such immunogenic nucleic acid species remain undefined. Using genome-wide approaches, we show that fibroblasts from AGS patients with AGS1-5 mutations are burdened by excessive loads of RNA:DNA hybrids. Using MethylC-seq, we show that AGS fibroblasts display pronounced and global loss of DNA methylation and demonstrate that AGS-specific RNA:DNA hybrids often occur within DNA hypomethylated regions. Altogether, our data suggest that RNA:DNA hybrids may represent a common immunogenic form of nucleic acids in AGS and provide the first evidence of epigenetic perturbations in AGS, furthering the links between AGS and SLE.

  12. 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.

  13. Rheumatoid Arthritis Educational Video Series

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    Full Text Available ... is Happening to the Joints? Rheumatoid Arthritis: Gaining Control – Working with your Rheumatologist Rheumatoid Arthritis: Additional Conditions ... for Patients Arthritis Drug Information Sheets Benefits and Risks of Opioids in Arthritis Management How to Give ...

  14. Rheumatoid Arthritis Educational Video Series

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    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 ...

  15. Medicines, injections, and supplements for arthritis

    Science.gov (United States)

    Arthritis - medications; Arthritis - steroid injections; Arthritis - supplements; Arthritis - hyaluronic acid ... in your joints. These two substances come in supplement form and can be bought over-the-counter. ...

  16. Chemical characterization of a red raspberry fruit extract and evaluation of its pharmacological effects in experimental models of acute inflammation and collagen-induced arthritis.

    Science.gov (United States)

    Figueira, M E; Câmara, M B; Direito, R; Rocha, J; Serra, A T; Duarte, C M M; Fernandes, A; Freitas, M; Fernandes, E; Marques, M C; Bronze, M R; Sepodes, B

    2014-12-01

    Berries are an important dietary source of fibres, vitamins, minerals and some biologically active non-nutrients. A red raspberry fruit extract was characterized in terms of phenolic content and the anti-inflammatory properties and protective effects were evaluated in two experimental models of inflammation. The antioxidant potential of the extract, the cellular antioxidant activity and the effects over neutrophils' oxidative burst were also studied to provide a mechanistic insight for the anti-inflammatory effects observed. The extract was administered in a dose of 15 mg kg(-1), i.p. and significantly inhibited paw oedema formation in the rat. The same dose was administered via i.p. and p.o. routes in the collagen-induced arthritis model in the rat. The extract showed pharmacological activity and was able to significantly reduce the development of clinical signs of arthritis and markedly reduce the degree of bone resorption, soft tissue swelling and osteophyte formation, preventing articular destruction in treated animals.

  17. 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 ...

  18. Juvenile rheumatoid arthritis

    Science.gov (United States)

    ... joints. This form of JIA may turn into rheumatoid arthritis. It may involve 5 or more large and ... no known prevention for JIA. Alternative Names Juvenile rheumatoid arthritis (JRA); Juvenile chronic polyarthritis; Still disease; Juvenile spondyloarthritis ...

  19. 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 ...

  20. 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.

  1. Connective tissue markers of rheumatoid arthritis

    DEFF Research Database (Denmark)

    Møller, H J

    1998-01-01

    Rheumatoid arthritis (RA) is a common systemic autoimmune disorder of unknown aetiology. The most common outcome of RA is a progressive development of joint destruction and deformity. Early introduction of disease-modifying antirheumatic drugs seems important for prevention of the long term...... of rheumatoid factor contributes to the classification of arthritis as RA, and acute phase reactants are useful for quantifying and comparing the level of inflammatory activity in the course of a given patient. There is, however, a lack of sensitive and specific biochemical markers for RA, and frontline...

  2. 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.

  3. Animal Models of Rheumatoid Arthritis (I: Pristane-Induced Arthritis in the Rat.

    Directory of Open Access Journals (Sweden)

    Jonatan Tuncel

    Full Text Available To facilitate the development of therapies for rheumatoid arthritis (RA, the Innovative Medicines Initiative BTCure has combined the experience from several laboratories worldwide to establish a series of protocols for different animal models of arthritis that reflect the pathogenesis of RA. Here, we describe chronic pristane-induced arthritis (PIA model in DA rats, and provide detailed instructions to set up and evaluate the model and for reporting data.We optimized dose of pristane and immunization procedures and determined the effect of age, gender, and housing conditions. We further assessed cage-effects, reproducibility, and frequency of chronic arthritis, disease markers, and efficacy of standard and novel therapies.Out of 271 rats, 99.6% developed arthritis after pristane-administration. Mean values for day of onset, day of maximum arthritis severity and maximum clinical scores were 11.8±2.0 days, 20.3±5.1 days and 34.2±11 points on a 60-point scale, respectively. The mean frequency of chronic arthritis was 86% but approached 100% in long-term experiments over 110 days. Pristane was arthritogenic even at 5 microliters dose but needed to be administrated intradermally to induce robust disease with minimal variation. The development of arthritis was age-dependent but independent of gender and whether the rats were housed in conventional or barrier facilities. PIA correlated well with weight loss and acute phase reactants, and was ameliorated by etanercept, dexamethasone, cyclosporine A and fingolimod treatment.PIA has high incidence and excellent reproducibility. The chronic relapsing-remitting disease and limited systemic manifestations make it more suitable than adjuvant arthritis for long-term studies of joint-inflammation and screening and validation of new therapeutics.

  4. Pattern of peripheral arthritis in 15 patients with ulcerative colitis

    Directory of Open Access Journals (Sweden)

    Aref Hosseinian Amiri

    2015-01-01

    Full Text Available Background: Inflammatory bowel disease (IBD including ulcerative colitis (UC and Crohn′s disease is an immune-mediated chronic intestinal condition. The arthritis accompanying the IBDs are included in the family of spondyloarthritis. Peripheral arthritis develops in about 15-20% of IBD patients. Asymmetric oligoarthicular large joint involvements have inflammatory characteristics at these patients and occur in upper and lower extremities. Aim: The aim of the study was to analyze the pattern of joint involvement in 15 patients with UC during 2 years from January 2011 to December 2013. Subjects and Methods: This is a retrospective study of UC patients with acute and chronic arthritis during 2 years from January 2011 to December 2013 that refers to rheumatologic Clinic of Mazandaran University of Medical Sciences. Data were analyzed using the SPSS version 20. Variables analyzed include age, sex, presence of arthritis/periarthritis, the number of involved joints, kind and pattern of arthritis. Results: In these study 15 patients with UC and acute arthritis refers to BAGHBAN rheumatologic clinic. All of the patients were adults between 18 and 42-year-old with median age of 31.5 years old. Ten patients (66% were female, and five patients (33% were male. The media duration of UC was 3.9 years. Periarthrtis occurred in 7 (46% patients in association with arthritis. The most commonly involved join was ankle in 11 (73% cases. Another involved joints were knee in 5 (33%, wrist in 2 (12%, MTPs in 3 (20%, MCPs in 1 (6% and hip in 1 (6% of cases. In 4 (27% patients arthritis were monoarthicular, and eight (53% of patient′s arthritis were oligoathicular in 3 (20% cases, arthritis was polyarthicular. All of the arthritis were inflammatory. In 2 (13% of patients, arthritis were symmetric and in 9 (60% of cases were asymmetric. Conclusion: Inflammatory joint disease including arthritis and periarthrtis are important findings in UC. Asymmetric lower extremity

  5. 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.

  6. Acute septic arthritis of the temporomandibular joint derived from otitis media: a report and review of the English and Japanese literature.

    Science.gov (United States)

    Ishikawa, Shigeo; Watanabe, Tomoo; Iino, Mitsuyoshi

    2017-03-01

    Septic arthritis of the temporomandibular joint (SATMJ) is an extremely rare disease with characteristic features of preauricular pain, swelling, redness, and malocclusion. The present report describes a case of SATMJ derived from otitis media, which resulted in a good outcome. We also reviewed the English and Japanese literature with special interest in etiology. It is generally agreed that contiguous or distant infection and trauma are common etiological factors of SATMJ. So far, these etiological factors are mainly discussed based on hypotheses rather than sufficient evidence. Therefore, in many past cases, accurate causes were not identified. To our knowledge, our case is the third report of SATMJ following otitis media. In addition, this is the first case in which the pathogenic bacterium responsible for the otitis media was the definite cause of the SATMJ. Cases of SATMJ are sometimes misdiagnosed with otitis media, and SATMJ derived from otitis media is extremely rare. Dentists and otolaryngologists should collaborate for the management of this disease as needed.

  7. Acute Hepatitis E Virus infection with coincident reactivation of Epstein-Barr virus infection in an immunosuppressed patient with rheumatoid arthritis: a case report.

    Science.gov (United States)

    Schultze, Detlev; Mani, Bernhard; Dollenmaier, Günter; Sahli, Roland; Zbinden, Andrea; Krayenbühl, Pierre Alexandre

    2015-10-29

    Hepatitis E virus (HEV) is the most recently discovered of the hepatotropic viruses, and is considered an emerging pathogen in developed countries with the possibility of fulminant hepatitis in immunocompromised patients. Especially in the latter elevated transaminases should be taken as a clue to consider HEV infection, as it can be treated by discontinuation of immunosuppression and/or ribavirin therapy. To our best knowledge, this is a unique case of autochthonous HEV infection with coincident reactivation of Epstein-Barr virus (EBV) infection in an immunosuppressed patient with rheumatoid arthritis (RA). A 68-year-old Swiss woman with RA developed hepatitis initially diagnosed as methotrexate-induced liver injury, but later diagnosed as autochthonous HEV infection accompanied by reactivation of her latent EBV infection. She showed confounding serological results pointing to three hepatotropic viruses (HEV, Hepatitis B virus (HBV) and EBV) that could be resolved by detection of HEV and EBV viraemia. The patient recovered by temporary discontinuation of immunosuppressive therapy. In immunosuppressed patients with RA and signs of liver injury, HEV infection should be considered, as infection can be treated by discontinuation of immunosuppression. Although anti-HEV-IgM antibody assays can be used as first line virological tools, nucleic acid amplification tests (NAAT) for detection of HEV RNA are recommended--as in our case--if confounding serological results from other hepatotropic viruses are obtained. After discontinuation of immunosuppressive therapy, our patient recovered from both HEV infection and reactivation of latent EBV infection without sequelae.

  8. Rheumatoid Arthritis Educational Video Series

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    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 Rheumatology Course ...

  9. Rheumatoid Arthritis Educational Video Series

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    Full Text Available ... Rheumatoid Arthritis Educational Video Series Rheumatoid Arthritis Educational Video Series This series of five videos was designed ... Activity Role of Body Weight in Osteoarthritis Educational Videos for Patients Rheumatoid Arthritis Educational Video Series Psoriatic ...

  10. Rheumatoid Arthritis Educational Video Series

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    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 ...

  11. Rheumatoid Arthritis Educational Video Series

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    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. Updated: ...

  12. Rheumatoid Arthritis Educational Video Series

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    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 ...

  13. 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 was designed to help you learn more about Rheumatoid Arthritis (RA). You will learn how the diagnosis of ...

  14. Genetics Home Reference: rheumatoid arthritis

    Science.gov (United States)

    ... Email Facebook Twitter Home Health Conditions Rheumatoid arthritis Rheumatoid arthritis Printable PDF Open All Close All Enable Javascript to view the expand/collapse boxes. Description Rheumatoid arthritis is a disease that causes chronic abnormal inflammation, ...

  15. 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.

  16. CD64 as a potential biomarker in septic arthritis

    Science.gov (United States)

    2013-01-01

    Background Traditional inflammatory markers are generally unhelpful in discerning septic arthritis from inflammatory joint disease due to their lack of specificity. We wished to explore the discriminatory power of the novel inflammatory marker, Fc-gamma-receptor type 1, CD64, in patients presenting with acute arthritis. Methods Patients were recruited prospectively in the time period June 2009 to December 2011. Thirty-six patients presenting with an acute flare of chronic rheumatic arthritis, 31 with crystal-induced arthritis and 23 with septic arthritis were included. Traditional inflammatory markers, CD64 and procalcitonin (PCT) were measured and their diagnostic abilities were compared. Results CD64 and PCT both demonstrated a specificity of 98%, but poor sensitivities of 59% and 52%, respectively. White blood cell count (WBC), and erythrocyte sedimentation rate (ESR) did not have significant discriminatory power, while C-reactive protein (CRP) proved to have the best diagnostic accuracy as measured by area under the ROC curve (AUC 0.92, 95% confidence-interval 0.87-0.98). Subgroup analysis excluding patients with septic arthritis without concurrent bacteremia, and likewise exclusion of the patients with septic arthritis caused by coagulase negative staphylococci, both improved the diagnostic accuracy of CD64 and PCT, but not of WBC and CRP. Conclusions CD64 and PCT are highly specific for infectious disease, but they predominantly measure bacteremia. Their use in hospital practice has yet to be defined, and especially so in localized infections. PMID:23783182

  17. 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.

  18. [Septic arthritis in children].

    Science.gov (United States)

    Coll, M D; Ullot, R; Rigol, S; Pinyot, J; Obiols, P

    1989-01-01

    A review was made of 15 cases of septic arthritis in children. 13 of these cases corresponded to purulent arthritis, one to tuberculous arthritis and one to brucellar arthritis. All of them received diagnostic punction. Five joints received arthrotomy, by a washed-aspiration system. The antibiotic treatment was given approximately during for six weeks. We had two complications, die to a delayed diagnosis: one coxa valga and one capital femoral necrosis. It is important the insist on a early diagnosis and decompressive arthrotomy, specially in those cases in which the hip is the joint affected.

  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. Septic arthritis associated with systemic sepsis.

    Science.gov (United States)

    Jung, Sung-Weon; Kim, Dong-Hee; Shin, Sung-Jin; Kang, Byoung-Youl; Eho, Yil-Ju; Yang, Seong-Wook

    2018-01-01

    Septic arthritis presents with good joint function, but sometimes leads to poor outcomes. Concurrent systemic sepsis has been regarded as the poor outcome, and the exact cause remains unclear. This paper was performed to identify factors associated with concurrent systemic sepsis and to research results to predict poor outcomes in patients with septic arthritis. Laboratory and medical data were reviewed for 137 adults with acute septic arthritis who underwent open or arthroscopic surgical debridement at our institution between January 2005 and December 2014. The patients were divided according to whether they had septic arthritis alone (Group A) or in combination with systemic sepsis (Group B). Systemic sepsis was defined as two more systemic inflammatory signs in response to an infectious process. Patient characteristics, laboratory findings, synovial fluid findings and cultures, and surgical results were compared between two groups. Of the 137 patients, 41 (29.9%) had initial systemic sepsis at the diagnosis of septic arthritis. Independent t test revealed that duration of prodromal symptom (p = 0.012), serum neutrophil percent (p = 0.008), C-reactive protein (p = 0.001), Charlson comorbidity index (p = 0.001), positive culture in synovial fluid (p = 0.001), and methicillin-sensitive Staphylococcus aureus (MSSA) isolate in synovial fluid (p = 0.001) had significant correlations with the group B. Repeated debridement was performed for those who had recurrence of infection, and this procedure was more often in group B (23 versus 21 joints, 23.9 versus 51.2%, p = 0.012). Progression of arthritis occurred more often in group B (16 versus 17 joints, 16.7 versus 41.5%, p = 0.001). Septic arthritis combined with systemic sepsis was related to duration of prodromal symptom, serum neutrophil percent, C-reactive protein, Charlson comorbidity index, positive culture in synovial fluid, and a MSSA isolate in synovial fluid. Concurrent systemic sepsis led to

  1. 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.

  2. 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.

  3. Midcarpal and Scaphotrapeziotrapezoid Arthritis in Patients with Carpometacarpal Arthritis.

    Science.gov (United States)

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

    2016-06-01

    Carpometacarpal arthroplasty provides well-documented pain relief with preservation of thenar function in basal joint arthritis treatment. Nevertheless, some patients continue to have pain following surgery. The authors hypothesize that unrecognized midcarpal (capitolunate) arthritis is a contributor to persistent pain after carpometacarpal arthroplasty. The prevalence of midcarpal arthritis in patients with basal joint arthritis is unknown. This article establishes the radiographic prevalence of midcarpal arthritis in patients with carpometacarpal arthritis. Patients with basal joint arthritis were identified from a search using International Classification of Diseases, Ninth Revision code 716.94. Hand radiographs were reviewed and graded using the Eaton classification and Sodha classification for carpometacarpal arthritis. Scaphotrapeziotrapezoid arthritis and midcarpal arthritis were graded using the Sodha classification for arthritis as follows: grade 1, no or nearly no arthrosis; grade 2, definite arthrosis but not severe; and grade 3, severe arthrosis. Eight hundred ninety-six radiographs were reviewed. The prevalence of scaphotrapeziotrapezoid arthritis in this population was 64 percent. The prevalence of midcarpal arthritis in this population was 23.5 percent. The prevalence of midcarpal arthritis in patients with radiologic evidence of carpometacarpal arthritis was 25.4 percent. The prevalence of severe midcarpal arthritis was 7 percent. The prevalence of midcarpal arthritis in patients with basal joint arthritis is 24 percent. The presence of two locations of arthritis may explain persistent hand and wrist pain in this population despite carpometacarpal arthroplasty. Clinically, these data will allow hand surgeons to better educate patients with basal joint arthritis regarding the possibility of incomplete pain relief following carpometacarpal arthroplasty.

  4. Unusual radiographic changes of a gout patient

    International Nuclear Information System (INIS)

    Markota, J.

    2004-01-01

    Background. Gout is a metabolic disorder that results in hyperuricemia and accumulation of uric acid crystals (urats) in tissues, especially joint cartilage. The gouty arthritis presents as acute attacks of arthritis leading eventually to chronic gouty arthritis. In 80% of cases it first occurs in the matatarsophalangeal (MTP) joint of the great toe and is more frequent in male population. Case report. We present a case of unusual radiographic changes accompanying gouty arthritis. A 63 year old female complained about swelling of the first MTP joint on the right, right knee, about stiffness of feet and hands' digits and about backache. First symptoms started to appear 30 years ago. In the time of examination radiographs displayed degenerative changes of the majority of presented joints, bilateral sacroiliitis and osseous ankylosis of both insteps. Microscopic examination showed urate crystals in the samples of the synovial fluid aspirated from the knee. The histological findings of the synovial tissue after the synovectomy were also in favour of gouty arthritis. Conclusions. Radiographs are the most important imaging modality in the diagnostic process of gout. However, radiographic differential diagnosis can be difficult, since the findings overlap with other conditions which cause arthritis and osteoarthritis especially in longstanding gout, elderly patients and females. The diagnosis must be often confirmed with the help of laboratory and histological findings. (author)

  5. Forms of Arthritis

    Science.gov (United States)

    ... Today, Linda Saisselin takes joy in holding her new grandson—pain free. Photo courtesy of Linda Saisselin Osteoarthritis (OA) — the form of arthritis typically occurring during middle or old age, this is a joint disease that mostly affects ...

  6. Arthritis: Frequently Asked Questions

    Science.gov (United States)

    ... SME Issue Briefs Compendium of Interventions ASMP/CDSMP Meta-Analysis Executive Summary Communication Campaigns Physical Activity. The Arthritis Pain Reliever. FAQs Campaign Materials Download General Campaign Materials Buenos días, artritis FAQs ...

  7. HLA-DRB1 shared epitope genotyping using the revised classification and its association with circulating autoantibodies, acute phase reactants, cytokines and clinical indices of disease activity in a cohort of South African rheumatoid arthritis patients.

    Science.gov (United States)

    Meyer, Pieter W A; Hodkinson, Bridget; Ally, Mahmood; Musenge, Eustasius; Wadee, Ahmed A; Fickl, Heidi; Tikly, Mohammed; Anderson, Ronald

    2011-01-01

    The revised shared epitope (SE) concept in rheumatoid arthritis (RA) is based on the presence (S) or absence (X) of the SE RAA amino acid motif at positions 72 to 74 of the third hypervariable region of the various human leucocyte antigen (HLA)-DRB1 alleles. The purpose of this study was to investigate SE subtypes on the basis of the American College of Rheumatology 1987 revised criteria for the classification of RA in a cohort of South African RA patients (n = 143) and their association with clinical and circulating biomarkers of disease activity (autoantibodies, acute phase reactants and cytokines). Genomic DNA was analysed using high-resolution recombinant sequence-specific oligonucleotide PCR typing of the HLA-DRB1 allele. Subtypes of the SE were classified according to the amino acids at positions 72 to 74 for the RAA sequence, and further sub-divided according to the amino acids at positions 70 and 71, which either contribute to (S2, S3P), or negate (S1, S3D) RA susceptibility. Disease activity was assessed on the basis of (1) Disease Activity Score in 28 joints using C-reactive protein (CRP), (2) rheumatoid factor (RF), (3) CRP and (4) serum amyloid A by nephelometry, anticyclic citrullinated peptide antibodies (aCCP) by an immunofluorometric procedure, and cytokines by multiplex bead array technology. Of the 143 RA patients, 81 (57%) were homozygous (SS) and 50 (35%) were heterozygous (SX) for the SE alleles with significant overexpression of S2 and S3P (respective odds ratios (ORs) 5.3 and 5.8; P < 0.0001), and 12 (8%) were classified as no SE allele (XX). Both the SS and SX groups showed a strong association with aCCP positivity (OR = 10.2 and P = 0.0010, OR = 9.2 and P = 0.0028, respectively) relative to the XX group. Clinical scores and concentrations of the other biomarkers of disease activity (RF, CRP and T helper cell type 1 (Th1), Th2, macrophage and fibroblast cytokines) were also generally higher in the SS group than in the SX and XX groups. RA

  8. 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.

  9. Safety and efficacy of uric acid in patients with acute stroke (URICO-ICTUS): a randomised, double-blind phase 2b/3 trial.

    Science.gov (United States)

    Chamorro, Angel; Amaro, Sergio; Castellanos, Mar; Segura, Tomás; Arenillas, Juan; Martí-Fábregas, Joan; Gállego, Jaime; Krupinski, Jurek; Gomis, Meritxell; Cánovas, David; Carné, Xavier; Deulofeu, Ramón; Román, Luis San; Oleaga, Laura; Torres, Ferran; Planas, Anna M

    2014-05-01

    Uric acid is an antioxidant with neuroprotective effects in experimental models of stroke. We assessed whether uric acid therapy would improve functional outcomes at 90 days in patients with acute ischaemic stroke. URICO-ICTUS was a randomised, double-blind, placebo-controlled, phase 2b/3 trial that recruited patients with acute ischaemic stroke admitted to ten Spanish stroke centres. Patients were included if they were aged 18 years or older, had received alteplase within 4·5 h of symptom onset, and had an eligible National Institutes of Health Stroke Scale (NIHSS) score (>6 and ≤25) and premorbid (assessed by anamnesis) modified Rankin Scale (mRS) score (≤2). Patients were randomly allocated (1:1) to receive uric acid 1000 mg or placebo (both infused intravenously in 90 min during the infusion of alteplase), stratified by centre and baseline stroke severity. The primary outcome was the proportion of patients with excellent outcome (ie, an mRS score of 0-1, or 2 if premorbid score was 2) at 90 days, analysed in the target population (all randomly assigned patients who had been correctly diagnosed with ischaemic stroke and had begun study medication). The study is registered with ClinicalTrials.gov, number NCT00860366. Between July 1, 2011, and April 30, 2013, we randomly assigned 421 patients, of whom 411 (98%) were included in the target population (211 received uric acid and 200 received placebo). 83 (39%) patients who received uric acid and 66 (33%) patients who received placebo had an excellent outcome (adjusted risk ratio 1·23 [95% CI 0·96-1·56]; p=0·099). No clinically relevant or statistically significant differences were reported between groups with respect to death (28 [13%] patients who received uric acid vs 31 [16%] who received placebo), symptomatic intracerebral haemorrhage (nine [4%] vs six [3%]), and gouty arthritis (one [acid group and 532 in the placebo group, of which 61 (12%) and 67 (13%), respectively, were serious adverse events (p=0

  10. 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. Updated: ...

  11. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... to take a more active role in your care. The information in these videos should not take ... She is a critical member of our patient care team. Managing Your Arthritis Managing Your Arthritis Managing ...

  12. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Studies The Camille Julia Morgan Arthritis Research and Education Fund About Us Appointment Information Contact Us Our Faculty Our Staff Rheumatology Specialty Centers You are here: Home / Patient Corner / Patient Webcasts / Rheumatoid Arthritis Educational Video ...

  13. Occupational therapy for rheumatoid arthritis.

    NARCIS (Netherlands)

    Steultjens, E. M.; Dekker, J.; Bouter, L. M.; van Schaardenburg, D.; van Kuyk, M. A.; van den Ende, C. H.

    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

  14. 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

  15. Arthritis of the hand - Rheumatoid

    Science.gov (United States)

    ... Therapist? Media Find a Hand Surgeon Home Anatomy Rheumatoid Arthritis Email to a friend * required fields From * To * ... debilitating when it affects the hands and fingers. Rheumatoid arthritis is one of the most common forms of ...

  16. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... more about Rheumatoid Arthritis (RA). You will learn how the diagnosis of RA is made, what happens ... Benefits and Risks of Opioids in Arthritis Management How to Give a Subcutaneous Injection Rheumatology Course Connect ...

  17. 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 ...

  18. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Osteoarthritis News Gout News Osteoporosis News Lupus News Fibromyalgia News Patient Corner Arthritis Drug Information Sheets Managing ... Rheumatoid Arthritis (RA). You will learn how the diagnosis of RA is made, what happens to your ...

  19. 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 Rheumatology Course ...

  20. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Conditions Rheumatoid Arthritis: The Immune System Don’t have SilverLight? Get it here. Updated: July 9, 2012 ... in seeking it because of something they may have read on this website. Copyright Johns Hopkins Arthritis ...

  1. 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 ...

  2. Qigong Exercise and Arthritis

    Directory of Open Access Journals (Sweden)

    Ray Marks

    2017-09-01

    Full Text Available Background: Arthritis is a chronic condition resulting in considerable disability, particularly in later life. Aims: The first aim of this review was to summarize and synthesize the research base concerning the use of Qigong exercises as a possible adjunctive strategy for promoting well-being among adults with arthritis. A second was to provide related intervention directives for health professionals working or who are likely to work with this population in the future. Methods: Material specifically focusing on examining the nature of Qigong for minimizing arthritis disability, pain and dependence and for improving life quality was sought. Results: Collectively, despite almost no attention to this topic, available data reveal that while more research is indicated, Qigong exercises—practiced widely in China for many centuries as an exercise form, mind-body and relaxation technique—may be very useful as an intervention strategy for adults with different forms of painful disabling arthritis. Conclusion: Health professionals working with people who have chronic arthritis can safely recommend these exercises to most adults with this condition with the expectation they will heighten the life quality of the individual, while reducing pain and depression in adults with this condition.

  3. Qigong Exercise and Arthritis.

    Science.gov (United States)

    Marks, Ray

    2017-09-27

    Background: Arthritis is a chronic condition resulting in considerable disability, particularly in later life. Aims: The first aim of this review was to summarize and synthesize the research base concerning the use of Qigong exercises as a possible adjunctive strategy for promoting well-being among adults with arthritis. A second was to provide related intervention directives for health professionals working or who are likely to work with this population in the future. Methods: Material specifically focusing on examining the nature of Qigong for minimizing arthritis disability, pain and dependence and for improving life quality was sought. Results: Collectively, despite almost no attention to this topic, available data reveal that while more research is indicated, Qigong exercises-practiced widely in China for many centuries as an exercise form, mind-body and relaxation technique-may be very useful as an intervention strategy for adults with different forms of painful disabling arthritis. Conclusion: Health professionals working with people who have chronic arthritis can safely recommend these exercises to most adults with this condition with the expectation they will heighten the life quality of the individual, while reducing pain and depression in adults with this condition.

  4. Pasteurella multocida infectious arthritis.

    Science.gov (United States)

    Spagnuolo, P J

    1978-01-01

    Pasteurella multocida, a small gram-negative rod, is a domestic animal saprophyte that occasionally causes disease in humans. Infectious arthritis may develop from a superficial animal bite or scratch. Nine previous cases of infectious arthritis due to this organism have been documented in the literature, and a tenth case is reported here. Most patients had recent animal exposure, and half the patients had underlying chronic rheumatoid arthritis. Clinical signs of inflammation were consistently present; however, systemic infection was infrequent. The lack of positive synovial fluid gram-stain smears may make differentiation from other forms of infectious arthritis difficult. Penicillin in moderate doses is effective therapy, with osteomyelitis developing in only two patients. The tendency for this syndrome to affect patients with rheumatoid arthritis may reflect deficient local defense mechanisms, chronic steroid therapy, or increased ownership of pets. The mechanism of spread of infection to the joint space appears to be through contiguous spread from a skin site rather than by the hematogenous route in most cases.

  5. 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.

  6. Sarcopaenia and rheumatoid arthritis.

    Science.gov (United States)

    Targowski, Tomasz

    2017-01-01

    In October 2016 a new independent disease called sarcopaenia (according to ICD-10 classification) appeared. According to the recommendation of the European Working Group on Sarcopenia in Older People (EWGSOP), sarcopaenia is defined as abnormally low muscle mass plus low skeletal muscle strength or low physical performance. Sarcopaenia, as a primary disease, is mainly observed in older people, but it can also appear in younger adults in the course of many clinical chronic conditions. One of the most frequent chronic diseases associated with chronic inflammation and functional limitation of skeletal system is rheumatoid arthritis. In the present article, current knowledge on the epidemiology of sarcopaenia and its association with rheumatoid arthritis is presented.

  7. 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.

  8. 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...... resonance imaging (MRI); other modalities such as computed tomography are not used routinely. Imaging is an integral part of management of PsA. In this article, we provide an overview of the status, virtues, and limitations of imaging modalities in PsA, focusing on radiography, US, and MRI....

  9. Epidemiology of septic arthritis of the knee at Hospital das Clínicas, Universidade de São Paulo

    Directory of Open Access Journals (Sweden)

    Camilo Partezani Helito

    2014-01-01

    Conclusion: S. aureus is still the most common pathogen in acute knee infections in our environment. Gram staining, absence of fever and normal leukocyte count cannot be used to rule out septic arthritis.

  10. Total lymphoid irradiation of intractable rheumatoid arthritis

    International Nuclear Information System (INIS)

    Herbst, M.; Fritz, H.; Sauer, R.

    1986-01-01

    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. (author)

  11. Efficacy and safety of febuxostat in 73 gouty patients with stage 4/5 chronic kidney disease: A retrospective study of 10 centers.

    Science.gov (United States)

    Juge, Pierre-Antoine; Truchetet, Marie-Elise; Pillebout, Evangeline; Ottaviani, Sébastien; Vigneau, Cécile; Loustau, Clotilde; Cornec, Divi; Pascart, Tristan; Snanoudj, Renaud; Bailly, Florian; Cornec-Le Gall, Emilie; Schaeverbeke, Thierry; Saraux, Alain; Dieudé, Philippe; Flipo, René-Marc; Richette, Pascal; Lioté, Frédéric; Bardin, Thomas; Chalès, Gérard; Ea, Hang-Korng

    2017-10-01

    The allopurinol dose is limited in chronic kidney disease, particularly stage 4/5 chronic kidney disease. Febuxostat has a hepatic metabolism and has been approved without dose adaptation in gouty patients with stage 1-3 chronic kidney disease. We aimed to study the safety and efficacy of febuxostat for stage 4/5 chronic kidney disease. In this retrospective study, we included patients with (1) a diagnosis of gout, (2) febuxostat treatment, (3) estimated glomerular filtration rate≤30mL/min/1.73m 2 (Modification of Diet in Renal Disease formula) at febuxostat initiation and (4) follow-up for at least 3 months after febuxostat initiation. Efficacy, safety and variation in estimated glomerular filtration rate were analyzed. We included 73 patients (mean age 70.2±11.8, 61 men, 31 with vascular chronic kidney disease and 18 renal transplantation) with gout (baseline serum uric acid level=9.86±2.85mg/dL, mean gout duration 6.2±7.0 years) from 10 academic centers. Comorbidities included cardiac failure (17.8%), hypertension (98.6%), diabetes mellitus (30.1%), dyslipidemia (64.8%) and history of cardiovascular events (38.4%). At the last visit (mean follow-up 68.5±64.8 weeks), the daily dose of febuxostat was 40mg for 7 patients (10.5%), 80mg for 50 (74.6%) and 120mg for 10 (14.9%). Serum uric acid level waschronic kidney disease. However, safety data were not clear regarding renal function. Larger studies are needed to assess safety. Copyright © 2016 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

  12. 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.

  13. 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

  14. Rheumatoid arthritis. Radiological aspects

    International Nuclear Information System (INIS)

    Restrepo Suarez, Jose Felix; Pena Cortes, Mario; Rondon Herrera, Federico; Iglesias Gamarra, Antonio

    2000-01-01

    We reviewed in this paper the radiographic characteristics of rheumatoid arthritis, making emphasis in the more common involved joints. We present a select but complete set of film as a result of our practice for many years in the Universidad Nacional de Colombia, HSJD, Bogota

  15. rheumatoid arthritis health outcome

    African Journals Online (AJOL)

    2004-12-04

    Dec 4, 2004 ... School of Psychology, University of KwaZulu-Natal,. Pietermaritzburg. Girish M Mody, MB ChB, MRCP, FCP, MD, FRCP. Department of Rheumatology, Nelson R Mandela School of Health Sciences, University of KwaZulu-Natal, Durban. Rheumatoid arthritis (RA) is a systemic autoimmune disorder.

  16. 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

  17. Rheumatoid Arthritis: Can It Affect the Eyes?

    Science.gov (United States)

    Rheumatoid 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: Can It Affect the Lungs?

    Science.gov (United States)

    Rheumatoid 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 ...

  19. 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 ...

  20. EXPERIENCE OF TREATMENT WITH RITUXIMAB IN PATIENT WITH SYSTEMIC TYPE OF JUVENILE RHEUMATOID ARTHRITIS

    Directory of Open Access Journals (Sweden)

    K.B. Isaeva

    2009-01-01

    Full Text Available The article gives a case report on patient with severe systemic type of juvenile arthritis, refractory to treatment with classical immuno suppressants and blocker of tumor necrotizing factor Successive application of biological agent — rituximab was described. In 9 weeks, extra articular symptoms of disease and acute inflammatory lesions in joints were stopped, and functional activity of child increased. Presented case report demonstrates high effectiveness of rituximab: patient with severe systemic type of juvenile arthritis has clinical and laboratory remission of disease during 12 months.Key words: children, juvenile rheumatoid arthritis, rituximab.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(3:132-138

  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. Identification of Anaerobic Bacteria in Iranian patients with Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    Shahb Shafeian

    2013-11-01

    Full Text Available Please cite this article as: Shafeian SH, Bandehpour M, Mirzaahmadi S, Tofighi A. Identification of Anaerobic Bacteria in patients with Rheumatoid Arthritis. . Novel Biomed 2013;1(2:39-42.Background: There is a report about the 2-5% prevalence for septic arthritis by anaerobic bacteria. The relevance between synivitis and intestinal microbial flora has been a hypothesis for ten years. The PCR with sensitivity and specificity 99% for microorganism detection in acute, chronic and relapse form of septic arthritis is helpful.Methods: In this research we designed to diagnosis intestinal anaerobic bacteria which are able to occur bacteremia or septicemia. So amplification of the 16srRNA and narG genes in this type of bacteria is the best way for detection of them and followed by the treatment of the patients.Results: 100 patients with septic arthritis incidences were studied here. From these numbers 61% were bacterial arthritis and 18% were infected by anaerobic bacteria. Conclusion: On the base of coding of nitrate reductase, the positive samples were identified Enterobacter cloacae and Methylovorus sp. O157   Escherichia coli and Borrelia garinii.

  3. 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.

  4. Rheumatoid arthritis: vocational rehabilitation.

    Science.gov (United States)

    Cochrane, G M

    1982-01-01

    The consequences of inflation and accelerating introduction of automation and microprocessors into industry are a shift from unskilled to skilled work, the lessening of opportunities for the unskilled worker, and growing unemployment. If disabled people are competing for employment they must take every opportunity to extend education and acquire skills. Juvenile chronic arthritis presents one set of problems in vocational rehabilitation at the beginning of a working career and adult rheumatoid arthritis another, commonly in those over 45 years old and previously established in work. The prevalence of severe disability in juvenile chronic arthritis is about 1 in 20 000 of the population, females are affected twice as often as males and 1 in 10 has defective vision or blindness due to chronic iridocyclitis. At school, besides education, there must be emphasis on encouraging independence, self-confidence, mobility and determination. A School Leavers' Conference early in the last year at school gives the adolescent the best chance of choosing a career. Rheumatoid arthritis is three times more common in women and increasingly, over the last 40 years, women are working besides home-making. Morning stiffness, fatigue, immobility and pain are the common symptoms of widespread involvement of joints and systemic disturbance. The principal determinant in the success of vocational rehabilitation is personality, and the social and environmental factors are more significant than the degree of disability. The Disablement Resettlement Officer can assure continuity of rehabilitation between the health and employment services: a favourable outcome is work, self-derived income independence and freedom of movement using whatever technical aids are required to achieve this.

  5. Psoriasis and psoriasic arthritis

    International Nuclear Information System (INIS)

    Cortes Vera, Sandra Liliana; Iglesias Gamarra, Antonio; Restrepo Suarez, Jose Felix

    2003-01-01

    The psoriasis is an skin inflammatory disease characterized by chronic and recurrent red skin covered with silver scales. In their pathogenesis, immunogenetic and environmental factors are conjugated. Psoriatic arthritis. That is a seronegative arthropathy. In the greater part of cases follow to a chronic course of cutaneous psoriasis. In this paper, we analyzed the most frequent forms of presentation of cutaneous psoriasis and we revised the psoriatic arthropathy, with some indications about its treatment

  6. [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.

  7. Evidence-based Diagnostics: Adult Septic Arthritis

    Science.gov (United States)

    Carpenter, Christopher R.; Schuur, Jeremiah D.; Everett, Worth W.; Pines, Jesse M.

    2011-01-01

    Background Acutely swollen or painful joints are common complaints in the emergency department (ED). Septic arthritis in adults is a challenging diagnosis, but prompt differentiation of a bacterial etiology is crucial to minimize morbidity and mortality. Objectives The objective was to perform a systematic review describing the diagnostic characteristics of history, physical examination, and bedside laboratory tests for nongonococcal septic arthritis. A secondary objective was to quantify test and treatment thresholds using derived estimates of sensitivity and specificity, as well as best-evidence diagnostic and treatment risks and anticipated benefits from appropriate therapy. Methods Two electronic search engines (PUBMED and EMBASE) were used in conjunction with a selected bibliography and scientific abstract hand search. Inclusion criteria included adult trials of patients presenting with monoarticular complaints if they reported sufficient detail to reconstruct partial or complete 2 × 2 contingency tables for experimental diagnostic test characteristics using an acceptable criterion standard. Evidence was rated by two investigators using the Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS). When more than one similarly designed trial existed for a diagnostic test, meta-analysis was conducted using a random effects model. Interval likelihood ratios (LRs) were computed when possible. To illustrate one method to quantify theoretical points in the probability of disease whereby clinicians might cease testing altogether and either withhold treatment (test threshold) or initiate definitive therapy in lieu of further diagnostics (treatment threshold), an interactive spreadsheet was designed and sample calculations were provided based on research estimates of diagnostic accuracy, diagnostic risk, and therapeutic risk/benefits. Results The prevalence of nongonococcal septic arthritis in ED patients with a single acutely painful joint is approximately 27

  8. Neonatal detection of Aicardi Goutières Syndrome by increased C26:0 lysophosphatidylcholine and interferon signature on newborn screening blood spots.

    Science.gov (United States)

    Armangue, Thais; Orsini, Joseph J; Takanohashi, Asako; Gavazzi, Francesco; Conant, Alex; Ulrick, Nicole; Morrissey, Mark A; Nahhas, Norah; Helman, Guy; Gordish-Dressman, Heather; Orcesi, Simona; Tonduti, Davide; Stutterd, Chloe; van Haren, Keith; Toro, Camilo; Iglesias, Alejandro D; van der Knaap, Marjo S; Goldbach Mansky, Raphaela; Moser, Anne B; Jones, Richard O; Vanderver, Adeline

    2017-11-01

    Aicardi Goutières Syndrome (AGS) is a heritable interferonopathy associated with systemic autoinflammation causing interferon (IFN) elevation, central nervous system calcifications, leukodystrophy and severe neurologic sequelae. An infant with TREX1 mutations was recently found to have abnormal C26:0 lysophosphatidylcholine (C26:0 Lyso-PC) in a newborn screening platform for X-linked adrenoleukodystrophy, prompting analysis of this analyte in retrospectively collected samples from individuals affected by AGS. In this study, we explored C26:0 Lyso-PC levels and IFN signatures in newborn blood spots and post-natal blood samples in 19 children with a molecular and clinical diagnosis of AGS and in the blood spots of 22 healthy newborns. We used Nanostring nCounter™ for IFN-induced gene analysis and a high-performance liquid chromatography with tandem mass spectrometry (HPLC MS/MS) newborn screening platform for C26:0 Lyso-PC analysis. Newborn screening cards from patients across six AGS associated genes were collected, with a median disease presentation of 2months. Thirteen out of 19 (68%) children with AGS had elevations of first tier C26:0 Lyso-PC (>0.4μM), that would have resulted in a second screen being performed in a two tier screening system for X-linked adrenoleukodystrophy (X-ALD). The median (95%CI) of first tier C26:0 Lyso-PC values in AGS individuals (0.43μM [0.37-0.48]) was higher than that seen in controls (0.21μM [0.21-0.21]), but lower than X-ALD individuals (0.72μM [0.59-0.84])(p<0.001). Fourteen of 19 children had elevated expression of IFN signaling on blood cards relative to controls (Sensitivity 73.7%, 95%CI 51-88%, Specificity 95%, 95% CI 78-99%) including an individual with delayed disease presentation (36months of age). All five AGS patients with negative IFN signature at birth had RNASEH2B mutations. Consistency of agreement between IFN signature in neonatal and post-natal samples was high (0.85). This suggests that inflammatory markers

  9. 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.

  10. HLA-DRB1 shared epitope genotyping using the revised classification and its association with circulating autoantibodies, acute phase reactants, cytokines and clinical indices of disease activity in a cohort of South African rheumatoid arthritis patients

    OpenAIRE

    Meyer, Pieter WA; Hodkinson, Bridget; Ally, Mahmood; Musenge, Eustasius; Wadee, Ahmed A; Fickl, Heidi; Tikly, Mohammed; Anderson, Ronald

    2011-01-01

    Introduction The revised shared epitope (SE) concept in rheumatoid arthritis (RA) is based on the presence (S) or absence (X) of the SE RAA amino acid motif at positions 72 to 74 of the third hypervariable region of the various human leucocyte antigen (HLA)-DRB1 alleles. The purpose of this study was to investigate SE subtypes on the basis of the American College of Rheumatology 1987 revised criteria for the classification of RA in a cohort of South African RA patients (n = 143) and their ass...

  11. 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. © The Author(s) 2015.

  12. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... treatments are available, what is happening in the immune system and what other conditions are associated with RA. ... Rheumatologist Rheumatoid Arthritis: Additional Conditions Rheumatoid Arthritis: The Immune System Don’t have SilverLight? Get it here. Updated: ...

  13. 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.

  14. Collagen-Induced Arthritis: A model for Murine Autoimmune Arthritis.

    Science.gov (United States)

    Pietrosimone, K M; Jin, M; Poston, B; Liu, P

    2015-10-20

    Collagen-induced arthritis (CIA) is a common autoimmune animal model used to study rheumatoid arthritis (RA). The development of CIA involves infiltration of macrophages and neutrophils into the joint, as well as T and B cell responses to type II collagen. In murine CIA, genetically susceptible mice (DBA/1J) are immunized with a type II bovine collagen emulsion in complete Freund's adjuvant (CFA), and receive a boost of type II bovine collagen in incomplete Freund's adjuvant (IFA) 21 days after the first injection. These mice typically develop disease 26 to 35 days after the initial injection. C57BL/6J mice are resistant to arthritis induced by type II bovine collagen, but can develop arthritis when immunized with type II chicken collagen in CFA, and receive a boost of type II chicken collagen in IFA 21 days after the first injection. The concentration of heat-killed Mycobacterium tuberculosis H37RA (MT) in CFA also differs for each strain. DBA/1J mice develop arthritis with 1 mg/ml MT, while C57BL/6J mice require and 3-4 mg/ml MT in order to develop arthritis. CIA develops slowly in C57BL/6J mice and cases of arthritis are mild when compared to DBA/1J mice. This protocol describes immunization of DBA/1J mice with type II bovine collagen and the immunization of C57BL/6J mice with type II chicken collagen.

  15. Skin Manifestations of Rheumatoid Arthritis, Juvenile Idiopathic Arthritis, and Spondyloarthritides.

    Science.gov (United States)

    Chua-Aguilera, Carolyn Jean; Möller, Burkhard; Yawalkar, Nikhil

    2017-12-01

    Extra-articular manifestations of rheumatoid arthritis, juvenile idiopathic arthritis, and various spondyloarthritides including psoriatic arthritis, ankylosing spondylitis, reactive arthritis, and inflammatory bowel disease-associated spondyloarthritis often involve the skin and may occur before or after diagnosis of these rheumatic diseases. Cutaneous manifestations encompass a wide range of reactions that may have a notable negative impact not only on the physical but especially on the emotional and psychosocial well-being of these patients. Several cutaneous manifestations have been related to rheumatoid arthritis such as subcutaneous nodules including classical rheumatoid nodules, accelerated rheumatoid nodulosis, and rheumatoid nodulosis; vascular disorders like rheumatoid vasculitis, livedo racemosa, and Raynaud's phenomenon; and neutrophilic and/or granulomatous diseases like pyoderma gangrenosum, Sweet's syndrome, rheumatoid neutrophilic dermatitis, interstitial granulomatous dermatitis with arthritis, as well as palisaded neutrophilic and granulomatous dermatitis. In juvenile idiopathic arthritis, the main cutaneous manifestations include an evanescent rash, rheumatoid nodules, as well as plaque and guttate psoriasis. Plaque psoriasis is also the main skin disease involved in spondyloarthritides. Furthermore, other forms of psoriasis including guttate, inverse, erythrodermic, pustular, and particularly nail psoriasis may also occur. In addition, a variety of drug-induced skin reactions may also appear in these diseases. Early recognition and understanding of these different dermatologic manifestations together with an interdisciplinary approach are often needed to optimize management of these diseases.

  16. 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.

  17. Mycoplasma hyosynoviae arthritis in grower-finisher pigs

    DEFF Research Database (Denmark)

    Nielsen, E.O.; Nielsen, N.C.; Friis, N.F.

    2001-01-01

    The actiology of acute lameness in pigs, 3-5 months of age in nine Danish herds with high incidences of lameness was investigated. Eighty-seven acutely lame pigs, that exhibited lameness of varying degree in the hind legs, were selected. Non-lame pigs were matched on pen, sex and weight. The lame...... history of lameness. The cubital joints were most frequently affected and a history of hind leg lameness was not statistically associated with osteochondrotic lesions at slaughter (OR, 1.69; 95% CI, 0.94-3.05), or joint infection with M hyosynoviae at slaughter (OR, 0.88; 95% CI, 0.31-2.40). Arthritis due...

  18. The effect of X-rays on the experimental arthritis in rats

    International Nuclear Information System (INIS)

    Trott, K.R.; Parker, R.; Seed, M.P.

    1995-01-01

    We investigated the therapeutic efficacy of low doses of X-rays on different in-vivo models of monoarticular arthritis which have been developed for the investigation of anti-inflammatory drugs. Zymosan or heat-inactivated mycobacterium tuberculosis was injected into 1 knee joint of Wistar rats to produce, via different pathogenetic mechanisms, an acute monoarticular arthritis. Five days later, the amount of joint swelling, bone destruction and cartilage catabolism were measured. Immediately after arthritis induction, the knees were irradiated with a single dose of 5 Gy or with 4 daily fractions of 1 Gy. X-irradiation with daily doses of 1 Gy significantly reduced bone loss and cartilage degradation in Zymosan-induced arthritis and joint swelling in mycobacterium tuberculosis induced arthritis. However, a single high radiation dose significantly increased bone loss in mycobacterium tuberculosis induced arthritis. These data confirm the hypothesis of an anti-inflammatory effect of low radiation doses which so far has been based only on clinical experience. By using an established model of monoarticular arthritis we have now the opportunity to study the mechanism of the anti-inflammatory radiation effect in comparison to that of anti-inflammatory drugs. This way, we hope to provide a scientific basis for the use of radiotherapy in various painful degenerative joint disorders. (orig.) [de

  19. 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

  20. 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.

  1. [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. Copyright © 2014 Elsevier Editora Ltda. All rights reserved.

  2. Septic arthritis in children: diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Pääkkönen M

    2017-05-01

    Full Text Available Markus Pääkkönen1,2 1Department of Pediatric Orthopaedic Surgery, 2Department of Hand Surgery, Turku University Hospital and the University of Turku, Turku, Finland Abstract: Acute septic arthritis in children is usually hematogenous. It is more common in boys, and it most often affects the large joints of the lower limb. Diagnosis is based on cultures obtained from the infected joint and is supported by C-reactive protein blood test or ultrasound imaging. Staphylococcus aureus is the most common causative agent and is the primary target for empiric treatment. First-generation cephalosporins and clindamycin are suitable antibiotics. Vancomycin is utilized in areas with high rates of clindamycin- and methicillin-resistant S. aureus. After a short intravenous administration of 2–4 days, a total course of 2 weeks is sufficient in uncomplicated cases. Early antibiotic treatment has significantly improved the prognosis in high-income settings, but uncomplicated recovery is compromised if the treatment is delayed. Complications such as symptomatic osteoarthritis or avascular necrosis of the femoral head develop slowly. A long follow-up of 1–2 years is required to detect all possible sequelae. Keywords: child, septic arthritis, sepsis, Staphylococcus aureus

  3. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Studies The Camille Julia Morgan Arthritis Research and Education Fund About Us Appointment Information Contact Us Our Faculty Our Staff Rheumatology Specialty Centers You are here: Home / Patient ...

  4. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Our Staff Rheumatology Specialty Centers You are here: Home / Patient Corner / Patient Webcasts / Rheumatoid Arthritis Educational Video ... to take a more active role in your care. The information in these videos should not take ...

  5. 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 ...

  6. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... a more active role in your care. The information in these videos should not take the place of any advice you ... Management for Rheumatoid Arthritis Patients Rehabilitation of Older Adult ...

  7. Genetics Home Reference: psoriatic arthritis

    Science.gov (United States)

    ... 2 links) American Society for Surgery of the Hand Johns Hopkins Arthritis Center General Information from MedlinePlus (5 links) Diagnostic Tests Drug Therapy Genetic Counseling Palliative Care Surgery and Rehabilitation Related Information How are genetic conditions diagnosed? How ...

  8. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Rounds Pathophysiology of the Rheumatic Diseases Our Research Patient-Centered Outcomes Research Research Studies The Camille Julia Morgan Arthritis Research and Education Fund About Us Appointment Information Contact Us Our ...

  9. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Contact Us Our Faculty Our Staff Rheumatology Specialty Centers You are here: Home / Patient Corner / Patient Webcasts / ... Ruffing has been a member of the Arthritis Center since 2000, currently serving as the Nurse Manager. ...

  10. Rheumatoid arthritis and hand surgery

    DEFF Research Database (Denmark)

    Peretz, Anne Sofie Rosenborg; Madsen, Ole Rintek; Brogren, Elisabeth

    2017-01-01

    Rheumatoid arthritis results in characteristic deformities of the hand. Medical treatment has undergone a remarkable development. However, not all patients achieve remission or tolerate the treatment. Patients who suffer from deformities and persistent synovitis may be candidates for hand surgery...

  11. Treatment of severe rheumatoid arthritis

    International Nuclear Information System (INIS)

    Wright, V.

    1986-01-01

    Current practices in treating severe rheumatoid arthritis are reviewed, including remarks on controlled trials of methotrexate, total lymphatic irradiation trials at Stanford and Harvard, and total body irradiation trials. U.K

  12. Fetal Programming in Rheumatoid Arthritis

    NARCIS (Netherlands)

    F.D.O. de Steenwinkel (Florentien)

    2013-01-01

    markdownabstract__Abstract__ Rheumatoid arthritis (RA) is a chronic, systemic, inflammatory, autoimmune disease mainly affecting synovial tissues, which can lead to severe morbidity and progressive joint destruction resulting in deformations and disability. Other important outcomes include

  13. Arthritis in America PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2017-03-07

    This 60 second public service announcement is based on the March 2017 CDC Vital Signs report. Many adults in the United States have arthritis. Learn how to reduce the pain of arthritis, as well as manage the condition.  Created: 3/7/2017 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 3/7/2017.

  14. Smoking and Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    Kathleen Chang

    2014-12-01

    Full Text Available Rheumatoid arthritis (RA is a chronic inflammatory disease caused by both genetic and environmental factors. Smoking has been implicated as one of the most important extrinsic risk factors for its development and severity. Recent developments have shed light on the pathophysiology of RA in smokers, including oxidative stress, inflammation, autoantibody formation and epigenetic changes. The association of smoking and the development of RA have been demonstrated through epidemiologic studies, as well as through in vivo and animal models of RA. With increased use of biological agents in addition to standard disease-modifying antirheumatic drugs (DMARDs, there has been interest in how smoking affects drug response in RA treatment. Recent evidence suggests the response and drug survival in people treated with anti-tumour necrosis factor (anti-TNF therapy is poorer in heavy smokers, and possible immunological mechanisms for this effect are presented in the current paper.

  15. Hepatitis C-associated arthritis.

    Science.gov (United States)

    Buskila, D

    2000-07-01

    Rheumatologic complications of hepatitis C virus (HCV) infection are common and include mixed cryoglobulinemia, vasculitis, sicca symptoms, myalgia, arthritis, and fibromyalgia. The prevalence of cryoglobulinemia in Sweden and Germany is much lower compared with data from southern Europe. Viral, genetic, or environmental factors may be responsible for such a difference in prevalence. There is no single clinical picture of arthritis in patients with HCV infection. There is a well-defined picture of arthritis associated with the presence of mixed cryoglobulinemia that consists of an intermittent mono- or oligoarticular, nondestructive arthritis affecting large and medium-size joints. Involvement of salivary and lacrimal glands is common in HCV-infected subjects, but HCV antigens are not detected in affected glands. HCV-infected subjects express a high prevalence of a variety of autoantibodies, usually in low titers. The clinical significance of most of these autoantibodies is not clear. The prevalence and titer of these autoantibodies are unaffected by interferon-alpha therapy. Several studies have attempted to assess whether HCV infection may be involved in the etiopathogenesis of rheumatic and autoimmune diseases. The results of most of these studies do not support the idea that HCV infection may play a pathogenic role in the development of systemic lupus erythematosus, antiphospholipid syndrome, or leukocytoclastic vasculitis. Experience treating patients with HCV-associated arthritis is limited and treatment remains controversial. No major therapeutic trials in HCV-associated arthritis were reported in the past 2 years.

  16. Biologic therapy of rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Damjanov Nemanja

    2009-01-01

    Full Text Available Rheumatoid arthritis (RA and juvenile idiopathic/rheumatoid arthritis (JIA are chronic, inflammatory, systemic, auto-immune diseases characterized by chronic arthritis leading to progressive joint erosions. The individual functional and social impact of rheumatoid arthritis is of great importance. Disability and joint damage occur rapidly and early in the course of the disease. The remarkably improved outcomes have been achieved initiating biologic therapy with close monitoring of disease progression. Biologic agents are drugs, usually proteins, which can influence chronic immune dysregulation resulting in chronic arthritis. According to the mechanism of action these drugs include: 1 anti-TNF drugs (etanercept, infiximab, adalimumab; 2 IL-1 blocking drugs (anakinra; 3 IL-6 blocking drugs (tocilizumab; 4 agents blocking selective co-stimulation modulation (abatacept; 5 CD 20 blocking drugs (rituximab. Biologics targeting TNF-alpha with methotrexate have revolutionized the treatment of RA, producing significant improvement in clinical, radiographic, and functional outcomes not seen previously. The new concept of rheumatoid arthritis treatment defines early diagnosis, early aggressive therapy with optimal doses of disease modifying antirheumatic drugs (DMARDs and, if no improvement has been achieved during six months, early introduction of biologic drugs. The three-year experience of biologic therapy in Serbia has shown a positive effect on disease outcome.

  17. Septic arthritis in children: frequency of coexisting unsuspected osteomyelitis and implications on imaging work-up and management.

    Science.gov (United States)

    Monsalve, Johanna; Kan, J Herman; Schallert, Erica K; Bisset, George S; Zhang, Wei; Rosenfeld, Scott B

    2015-06-01

    Osteomyelitis and septic arthritis clinically present at any age with overlapping signs and symptoms. The purposes of this study were to evaluate the demographic distribution of septic arthritis and osteomyelitis in children and to explore optimal imaging guidelines for these patients. We performed a retrospective study of children up to 18 years old who were treated for osteomyelitis or septic arthritis between January 2011 and September 2013. All patients underwent MRI without previous intervention. Studies were reviewed to determine the incidence of septic arthritis or superimposed osteomyelitis. The reference diagnosis was based on the combined review by the orthopedic surgeon and infectious disease notes, discharge summary, operative report, and MRI examination. One hundred sixty-two children who underwent 177 MRI examinations were diagnosed with acute musculoskeletal infection. One hundred three patients were included in the septic arthritis category, of whom 70 (68%) had septic arthritis with osteomyelitis. Seventy-four (42.1%) patients had isolated osteomyelitis without septic arthritis. Children under 2 years old were more likely to have septic arthritis (either isolated or with osteomyelitis) than isolated osteomyelitis compared with older children (p = 0.0003). In children who underwent MRI for suspected musculoskeletal infection, septic arthritis was more prevalent in children under the age of 2 years than in older children. However, both septic arthritis and osteomyelitis were found frequently in older children. Musculoskeletal infection imaging workup guidelines for children of all ages should address the frequent association of osteomyelitis and septic arthritis. We recommend that MRI should be used in the evaluation of suspected musculoskeletal infections in children, and the nearest joint should always be included to evaluate the extent of articular disease.

  18. Early Subchondral Bone Loss at Arthritis Onset Predicted Late Arthritis Severity in a Rat Arthritis Model.

    Science.gov (United States)

    Courbon, Guillaume; Cleret, Damien; Linossier, Marie-Thérèse; Vico, Laurence; Marotte, Hubert

    2017-06-01

    Synovitis is usually observed before loss of articular function in rheumatoid arthritis (RA). In addition to the synovium and according to the "Inside-Outside" theory, bone compartment is also involved in RA pathogenesis. Then, we investigated time dependent articular bone loss and prediction of early bone loss to late arthritis severity on the rat adjuvant-induced arthritis (AIA) model. Lewis female rats were longitudinally monitored from arthritis induction (day 0), with early (day 10) and late (day 17) steps. Trabecular and cortical microarchitecture parameters of four ankle bones were assessed by microcomputed tomography. Gene expression was determined at sacrifice. Arthritis occurred at day 10 in AIA rats. At this time, bone erosions were detected on four ankle bones, with cortical porosity increase (+67%) and trabecular alterations including bone volume fraction (BV/TV: -13%), and trabecular thickness decrease. Navicular bone assessment was the most reproducible and sensitive. Furthermore, strong correlations were observed between bone alterations at day 10 and arthritis severity or bone loss at day 17, including predictability of day 10 BV/TV to day 17 articular index (R 2  = 0.76). Finally, gene expression at day 17 confirmed massive osteoclast activation and interestingly provided insights on strong activation of bone formation inhibitor markers at the joint level. In rat AIA, bone loss was already observed at synovitis onset and was predicted late arthritis severity. Our results reinforced the key role of subchondral bone in arthritis pathogenesis, in favour to the "Inside-Outside" theory. Mechanisms of bone loss in rat AIA involved resorption activation and formation inhibition changes. J. Cell. Physiol. 232: 1318-1325, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  19. Severe leukopenia in a rheumatoid arthritis patient treated with a methotrexate/leflunomide combination.

    Science.gov (United States)

    Toth, Paola; Bernd, Roberto

    2014-01-01

    A rheumatoid arthritis patient was treated for two years with methotrexate and leflunomide combination therapy. The evolution was uneventful until she had clopidogrel, simvastatin, isosorbide, aspirin and omeprazole added to medication due to acute myocardial infarction. Four weeks after this, she was hospitalized with severe leukopenia.

  20. Tophaceous Gout simulating infected Ankle Implants

    Directory of Open Access Journals (Sweden)

    Ioannis K

    2016-11-01

    Full Text Available Gout is a well known metabolic disorder characterized by the formation of urate crystals in joints resulting in recurrent attacks of acute inflammatory arthritis following which tophi can occur in joints or subcutaneous tissues. We report a rare localization of gouty tophi in a 52 years old male. The tophi had formed over the stainless steel implant used for the fixation of a lateral malleolus fracture 20 years ago.

  1. Rheumatoid arthritis: Skeletal manifestations observed on portable chest roentgenograms

    International Nuclear Information System (INIS)

    Levine, R.B.; Sullivan, K.L.

    1985-01-01

    This report describes the thoracic skeletal radiographic findings of rheumatoid arthritis, observed on portable chest examinations of 21 patients. Their pathophysiology is reviewed and additional examples of a recently described finding are illustrated: erosion of the medial surface of the proximal humerus with subsequent pathologic fracture, associated with superior and medial migration of the humeral head [11]. It has been proposed that erosion of the medial aspect of the proximal humerus is due to impingement wear, and that pathologic fracture results from the fulcrum effect of the inferior lip of the glenoid on the humerus. Rheumatoid arthritis is often diagnosed by the clinician rather than the radiologist. However, in acutely ill patients receiving portable chest radiographs, complete history and laboratory findings are often unavailable. Attention to the thoracic skeleton may clarify pleural and/or parenchymal lung disease in these patients. (orig.)

  2. Arthritis Genetics Analysis Aids Drug Discovery

    Science.gov (United States)

    ... NIH Research Matters January 13, 2014 Arthritis Genetics Analysis Aids Drug Discovery An international research team identified 42 new ... Edition Distracted Driving Raises Crash Risk Arthritis Genetics Analysis Aids Drug Discovery Oxytocin Affects Facial Recognition Connect with Us ...

  3. Gut Microbes Linked to Rheumatoid Arthritis

    Science.gov (United States)

    ... Matters November 25, 2013 Gut Microbes Linked to Rheumatoid Arthritis The presence of a specific type of gut bacteria correlates with rheumatoid arthritis in newly diagnosed, untreated people. The finding suggests ...

  4. Arthritis Mechanisms May Vary by Joint

    Science.gov (United States)

    ... Issues Subscribe August 2016 Print this issue Arthritis Mechanisms May Vary by Joint En español Send us ... joints have unique patterns of chemical tags—called epigenetic markers—that differ between rheumatoid arthritis and osteoarthritis. ...

  5. Arthritis Pain: Do's and Don'ts

    Science.gov (United States)

    ... depression symptoms but also arthritis pain. It's no surprise that arthritis pain has a negative effect on ... Clinic does not endorse any of the third party products and services advertised. Advertising and sponsorship policy ...

  6. Accommodation and Compliance Series: Employees with Arthritis

    Science.gov (United States)

    ... Clinic identifies the following risk factors: family history, age, sex, previous join injury, and obesity (Mayo Clinic, 2011). How is arthritis treated? Treatments for arthritis vary; exercising, medication, natural remedies, nutrition, ...

  7. Collagen-induced arthritis in mice

    NARCIS (Netherlands)

    Bevaart, Lisette; Vervoordeldonk, Margriet J.; Tak, Paul P.

    2010-01-01

    Collagen-induced arthritis (CIA) in mice is an animal model for rheumatoid arthritis (RA) and can be induced in DBA/1 and C57BL/6 mice using different protocols. The CIA model can be used to unravel mechanisms involved in the development of arthritis and is frequently used to study the effect of new

  8. Exercise therapy in juvenile idiopathic arthritis

    NARCIS (Netherlands)

    Takken, T.; van Brussel, M.; Engelbert, R. H. H.; van der Net, J.; Kuis, W.; Helders, P. J. M.

    2008-01-01

    Exercise therapy is considered an important component of the treatment of arthritis. The efficacy of exercise therapy has been reviewed in adults with rheumatoid arthritis but not in children with juvenile idiopathic arthritis (JIA). To assess the effects of exercise therapy on functional ability,

  9. Rheumatoid Arthritis: "You Are Not Alone."

    Science.gov (United States)

    ... page please turn JavaScript on. Feature: Understanding Rheumatoid Arthritis (RA) Rheumatoid Arthritis: "You Are Not Alone." Past Issues / Summer 2014 ... Contents Members of the America 2 Anywhere 4 Arthritis (A2A4A) running group after finishing a marathon. Through ...

  10. 9 CFR 311.7 - Arthritis.

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Arthritis. 311.7 Section 311.7 Animals... CERTIFICATION DISPOSAL OF DISEASED OR OTHERWISE ADULTERATED CARCASSES AND PARTS § 311.7 Arthritis. (a) Carcasses affected with arthritis which is localized and not associated with systemic change may be passed for human...

  11. Pelvic radiotherapy in the setting of rheumatoid arthritis: Refining the paradigm.

    Science.gov (United States)

    Felefly, T; Mazeron, R; Huertas, A; Canova, C H; Maroun, P; Kordahi, M; Morice, P; Deutsch, É; Haie-Méder, C; Chargari, C

    2017-04-01

    Conflicting results concerning the toxicity of radiotherapy in the setting of rheumatoid arthritis were reported in literature. This work describes the toxicity profiles of patients with rheumatoid arthritis undergoing pelvic radiotherapy for gynecologic malignancies at our institution. Charts of patients with rheumatoid arthritis who underwent pelvic radiotherapy for cervical or endometrial cancer in a curative intent at the Gustave-Roussy Cancer Campus between 1990 and 2015 were reviewed for treatment-related toxicities. Acute and late effects were graded as per the Common Terminology Criteria for Adverse Events version 4.0 scoring system. Eight patients with cervical cancer and three with endometrial cancer were identified. Median follow-up was 56 months. Median external beam radiotherapy dose was 45Gy. All patients received a brachytherapy boost using either pulse- or low-dose rate technique. Concomitant chemotherapy was used in seven cases. Median time from rheumatoid arthritis diagnosis to external beam radiation therapy was 5 years. No severe acute gastrointestinal or genitourinary toxicity was reported. One patient had grade 3 dermatitis. Any late toxicity occurred in 7 /11 patients, and one patient experienced severe late toxicities. One patient with overt systemic rheumatoid arthritis symptoms at the time of external beam radiation therapy experienced late grade 3 ureteral stenosis, enterocolitis and lumbar myelitis. Pelvic radiotherapy, in the setting of rheumatoid arthritis, appears to be feasible, with potentially slight increase in low grade late events compared to other anatomic sites. Patients with overt systemic rheumatoid arthritis manifestation at the time of radiotherapy might be at risk of potential severe toxicities. Copyright © 2017 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

  12. Temporomandibular Joint Septic Arthritis

    Directory of Open Access Journals (Sweden)

    Gianfranco Frojo, MD

    2018-01-01

    Full Text Available Summary:. Infection of the temporomandibular joint (TMJ is a rare pediatric condition resulting from the introduction of pathogens into the joint by hematogenous seeding, local extension, or trauma. Early recognition of the typical signs and symptoms including fever, trismus, preauricular swelling, and TMJ region tenderness are critical in order to initiate further evaluation and prevent feared complications of fibrosis, ankylosis, abnormal facial structure, or persistence of symptoms. Contrast-enhanced computed tomography with ancillary laboratory analysis including erythrocyte sedimentation rate, C-reactive protein, and white blood cell count are beneficial in confirming the suspected diagnosis and monitoring response to therapy. Initial intervention should include empiric parenteral antibiotics, early mandibular mobilization, and joint decompression to provide synovial fluid for analysis including cultures. This report describes a case of TMJ bacterial arthritis in a healthy 6-year-old male who was promptly treated nonsurgically with intravenous antibiotics and localized needle joint decompression with return to normal function after completion of oral antibiotics and physical therapy.

  13. Avaliação de provas de fase aguda em crianças e adolescentes com artrite idiopática juvenil e sua correlação com atividade da doença Acute phase reactants evaluation in children and adolescents with juvenile idiopathic arthritis and its correlation with disease activity

    Directory of Open Access Journals (Sweden)

    Aline Alencar M. F. Nicácio

    2009-06-01

    Full Text Available OBJETIVO:Analisar a relação entre as provas de fase aguda e a atividade clínica da artrite idiopática juvenil e avaliar a concordância entre velocidade de hemossedimentação e proteína C reativa (VHS e PCR na fase aguda da doença. MÉTODOS: Foi realizado estudo retrospectivo tipo coorte a partir da análise de prontuários de 30 crianças e adolescentes que preenchiam os critérios diagnósticos para artrite idiopática juvenil, estavam em atendimento em ambulatório de Reumatologia Pediátrica e haviam realizado as provas de fase aguda (VHS e PCR. RESULTADOS: Dos 30 pacientes, 21 (70% eram do sexo feminino e 19 (63,3% apresentavam o subtipo oligoarticular da doença. A média de idade de início dos sintomas foi 65,6 meses, a idade de diagnóstico de 85,3 e o tempo de evolução, 57,2 meses. As provas de fase aguda mostraram associação positiva com a atividade de doença. A anemia não teve relação com a atividade de doença. A concordância entre as duas provas de fase aguda foi superior a 80%. CONCLUSÕES: As provas de fase aguda mantêm relação positiva com a atividade da doença e o seu uso concomitante aumenta a especificidade.OBJECTIVE:To analyze the relationship between the acute phase reactants and the disease activity of Juvenile Idiopathic Arthritis (JIA and to evaluate the agreement between erythrocyte sedimentation rate and C-reactive protein during the acute phase of the disease. METHODS: a cohort retrospective study has been conducted based on the analysis of 30 children and adolescents who fulfilled the diagnostic criteria of JIA. All of them were in current follow-up at the pediatric rheumatology outpatient clinic and had acute phase reactants blood tests performed. RESULTS: Studied population comprised 30 patients: 21 (70% of them were females and 19 (63.3% presented oligoarticular subtype. The mean age at disease onset was 65.6 months; the age at diagnosis was 85.3 months and the follow-up had 57.2 months of

  14. Collagen-Induced Arthritis: A model for Murine Autoimmune Arthritis

    OpenAIRE

    Pietrosimone, K. M.; Jin, M.; Poston, B.; Liu, P.

    2015-01-01

    Collagen-induced arthritis (CIA) is a common autoimmune animal model used to study rheumatoid arthritis (RA). The development of CIA involves infiltration of macrophages and neutrophils into the joint, as well as T and B cell responses to type II collagen. In murine CIA, genetically susceptible mice (DBA/1J) are immunized with a type II bovine collagen emulsion in complete Freund’s adjuvant (CFA), and receive a boost of type II bovine collagen in incomplete Freund’s adjuvant (IFA) 21 days aft...

  15. Septic arthritis of the temporomandibular joint: case reports and review of the literature.

    Science.gov (United States)

    Gayle, Eryka A; Young, Sean M; McKenna, Samuel J; McNaughton, Candace D

    2013-11-01

    Septic arthritis of the temporomandibular (TM) joint is rare, but it is associated with high risk for significant morbidity. We reviewed the available literature regarding the presentation, evaluation, treatment, and clinical course of TM joint septic arthritis, focusing on elements relevant to emergency physicians. In the first case, a healthy 6-year-old boy presented with fever and trismus; computed tomography with contrast revealed a TM joint effusion. After empiric intravenous antibiotics, intraoperative arthrocentesis of the TM joint returned 1 mL of flocculent fluid, which was cultured and grew pan-sensitive Streptococcus pyogenes. He was discharged home with amoxicillin/clavulanate and experienced complete resolution of his symptoms. In the second case, more than 3 weeks after extraction of her third molars, an 18-year-old woman presented with facial pain, swelling, and trismus and was found to have a loculated abscess involving the left masseteric and pterygomandibular spaces with extension to the left deep temporal region and the skull base. She experienced a complicated postoperative course and required multiple procedures and intravenous antibiotics for growth of multiple bacteria. More than a month later she underwent TM joint arthrotomy for TM joint septic arthritis, and she was found to have acute osteomyelitis. She continued to require multiple treatment modalities; 20 months after her initial presentation, she underwent left total TM joint arthroplasty for fibrous ankylosis of the TM joint. Septic arthritis of the TM joint may be caused by hematogenous spread of distant infection or local spread of deep masticator space infections. Patients may present with TM joint septic arthritis acutely or sub-acutely. Septic arthritis of the TM joint should be considered in the differential diagnosis of patients who present with trismus and pain or fever. Copyright © 2013. Published by Elsevier Inc.

  16. Septic Arthritis of Native Joints.

    Science.gov (United States)

    Ross, John J

    2017-06-01

    Septic arthritis is a rheumatologic emergency that may lead to disability or death. Prompt evacuation of the joint, either by arthrocentesis at the bedside, open or arthroscopic drainage in the operating room, or imaging-guided drainage in the radiology suite, is mandatory. Methicillin-resistant Staphylococcus aureus (MRSA) has become a major cause of septic arthritis in the United States. MRSA joint infection seems to be associated with worse outcomes. Antibiotic courses of 3 to 4 weeks in duration are usually adequate for uncomplicated bacterial arthritis. Treatment duration should be extended to 6 weeks if there is imaging evidence of accompanying osteomyelitis. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. CLINICAL HETEROGENEITY OF EARLY PSORIATIC ARTHRITIS

    Directory of Open Access Journals (Sweden)

    V. V. Badokin

    2016-01-01

    Full Text Available Objective: to reveal the characteristic symptoms and syndromes of early-stage psoriatic arthritis (ePsA, which are pivotal to its early diagnosis.Patients and methods. Fifty-one patients with a PsA duration of less than 2 years (mean 12 months were examined. The diagnosis of PsA was established on the basis of the conventional CASPAR criteria and the Russian criteria developed by the expert method. The conventional current criteria, including the number of tender and swollen joints, DAS28, values of acute-phase indicators, were used to detect inflammatory activity. Skin syndrome was evaluated using the Psoriasis Area and Severity Index (PASI. X-ray study of the hands, distal and proximal feet, pelvis, and other involved joints and MRI of the distal hands/feet were performed. The Maastricht Ankylosing Spondylitis Enthesitis Score (MASES and reduced GUESS were used to assess enthesopathy.Results. The types of articular syndrome in ePsA were identified in accordance of the duration of the disease. The authors determined the characteristic features of arthritis, spondylitis, enthesitis, and dactylitis, their diagnostic value and associations with other manifestations in the first 2 years of PsA. There was a relationship of dermatitis and psoriatic onychopathy to the clinical picture of articular syndrome.Conclusion. ePsA is characterized by marked heterogeneity of articular syndrome with predominantly mono/oligoarthritic and polyarthritic articular syndrome. The significant signs are enthesitis and dactylitis, which serve as risk factors for the unfavorable course of the disease. 

  18. Dietetic recommendations in rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    María Rosa Alhambra-Expósito

    2013-12-01

    Full Text Available Rheumatoid arthritis (RA is a chronic autoimmune disease that has a significant effect on patients’ physical, emotional, and social functioning. For decades, patients have used different diets to try to improve the symptoms of RA. The possible benefits of dietary therapy for rheumatoid arthritis are reviewed in this article. Nutritional objectives for RA, are to halt the loss of bone mass, promote healing of bone fractures and improving bone-associated inflammatory disorders and joints. In general, diets low in saturated fat, rich in polyunsaturated fats: omega 3 and omega 6, rich in complex carbohydrates and fiber are recommended.

  19. Insufficiency fractures in rheumatoid arthritis

    International Nuclear Information System (INIS)

    Vidal, L.; Ausejo de Pomar, E.; Cruzalegui, L.; Cano, R.; Morales, R.; Ara, P.

    1992-01-01

    The occurrence of insufficiency fractures in patients with long-standing rheumatoid arthritis has not been sufficiently emphasized. Osteoporosis due to rheumatoid arthritis, corticosteroid therapy, contracture and angular deformity of the extremity, combine to predispose to the occurrence of the insufficiency fractures in these patients. Additionally, the pain and disability caused by the fracture is often attributed to rheumatoid joint involvement, masking the diagnosis of insufficiency fracture. The fracture may not be visible on radiographs near the onset of symptoms and the bone scanning can help in making an early diagnosis. (Author). 18 refs., 2 fig

  20. Identifying flares in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Bykerk, Vivian P; Bingham, Clifton O; Choy, Ernest H

    2016-01-01

    to flare, with escalation planned in 61%. CONCLUSIONS: Flares are common in rheumatoid arthritis (RA) and are often preceded by treatment reductions. Patient/MD/DAS agreement of flare status is highest in patients worsening from R/LDA. OMERACT RA flare questions can discriminate between patients with...... Set. METHODS: Candidate flare questions and legacy measures were administered at consecutive visits to Canadian Early Arthritis Cohort (CATCH) patients between November 2011 and November 2014. The American College of Rheumatology (ACR) core set indicators were recorded. Concordance to identify flares...

  1. Arthritis associated with calcium oxalate crystals in an anephric patient treated with peritoneal dialysis

    Energy Technology Data Exchange (ETDEWEB)

    Rosenthal, A.; Ryan, L.M.; McCarty, D.J.

    1988-09-02

    The authors report a case of calcium oxalate arthropathy in a woman undergoing intermittent peritoneal dialysis who was not receiving pharmacologic doses of ascorbic acid. She developed acute arthritis, with calcium oxalate crystals in Heberden's and Bouchard's nodes, a phenomenon previously described in gout. Intermittent peritoneal dialysis may be less efficient than hemodialysis in clearing oxalate, and physicians should now consider calcium oxalate-associated arthritis in patients undergoing peritoneal dialysis who are not receiving large doses of ascorbic acid.

  2. THE HYDROGEN ION CONCENTRATION OF JOINT EXUDATES IN RHEUMATIC FEVER AND OTHER FORMS OF ARTHRITIS.

    Science.gov (United States)

    Boots, R H; Cullen, G E

    1922-09-30

    1. The hydrogen ion concentration of joint exudates aspirated from patients ill with acute rheumatic fever, arthritis of undetermined origin, and bacterial arthritis was determined. The hydrogen ion concentrations of the joint exudates from patients with acute rheumatic fever approximated the normal reaction of blood, varying from pH 7.27 to 7.42. Exudates from patients with arthritis of undetermined origin varied in pH from 7.33 to 7.47. The pH of a joint effusion occurring in a patient with myocardial insufficiency was 7.34. Bacteriologically, all of these fluids were sterile by ordinary means of cultivation. An exudate aspirated from a knee infected with Staphylococcus aureus had a pH of 6.69, while that from a patient having an arthritis due to Streptococcus hoemolyticus was also acid, having a pH of 6.19. 2. Since a definitely acid medium is necessary for the liberation of free salicylic acid and since all of the joint fluids from patients with acute rheumatic fever were slightly alkaline, no free salicylic acid could possibly exist in such joint fluids following the administration of salicylates.

  3. Acute Lymphoblastic Leukaemia presenting as Juvenile Idiopathic ...

    African Journals Online (AJOL)

    Background: Acute Lymphoblastic Leukaemia in children commonly presents with osteo articular manifestations that may mimic Juvenile Idiopathic Arthritis. This may create considerable diagnostic difficulty and lead to delay in commencing appropriate treatment. Case: An eight year old boy who presented with multiple ...

  4. [The temporomandibular joint in juvenile idiopathic arthritis: what radiologists need to look for on magnetic resonance imaging].

    Science.gov (United States)

    De La Hoz Polo, M; Navallas, M

    2014-01-01

    The term "juvenile idiopathic arthritis" (JIA) encompasses a group of arthritis of unknown cause with onset before the age of 16 years that last for at least 6 weeks. The prevalence of temporomandibular joint involvement in published series ranges from 17% to 87%. Temporomandibular joint involvement is difficult to detect clinically, so imaging plays a key role in diagnosis and monitoring treatment. MRI is the technique of choice for the study of arthritis of the temporomandibular joint because it is the most sensitive technique for detecting acute synovitis and bone edema. Power Doppler ultrasonography can also detect active synovitis by showing the hypervascularization of the inflamed synovial membrane, but it cannot identify bone edema. This article describes the MRI technique for evaluating the temporomandibular joint in patients with juvenile idiopathic arthritis, defines the parameters to look for, and illustrates the main findings. Copyright © 2013 SERAM. Published by Elsevier Espana. All rights reserved.

  5. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... of five videos was designed to help you learn more about Rheumatoid Arthritis (RA). You will learn how the diagnosis of RA is made, what ... and what other conditions are associated with RA. Learning more about your condition will allow you to ...

  6. Treating rheumatoid arthritis to target

    DEFF Research Database (Denmark)

    Smolen, Josef S; Breedveld, Ferdinand C; Burmester, Gerd R

    2016-01-01

    BACKGROUND: Reaching the therapeutic target of remission or low-disease activity has improved outcomes in patients with rheumatoid arthritis (RA) significantly. The treat-to-target recommendations, formulated in 2010, have provided a basis for implementation of a strategic approach towards this t...

  7. Treating rheumatoid arthritis to target

    DEFF Research Database (Denmark)

    Smolen, Josef S; Aletaha, Daniel; Bijlsma, Johannes W J

    2010-01-01

    BACKGROUND: Aiming at therapeutic targets has reduced the risk of organ failure in many diseases such as diabetes or hypertension. Such targets have not been defined for rheumatoid arthritis (RA). OBJECTIVE: /st> To develop recommendations for achieving optimal therapeutic outcomes in RA. METHODS...

  8. COMORBIDITY IN RHEUMATOID ARTHRITIS

    Directory of Open Access Journals (Sweden)

    T. A. Panafidina

    2014-01-01

    Full Text Available The peak onset of rheumatoid arthritis (RA is at 30-55 years of age. At this age, the patients have also other concomi- tant diseases (comorbidities that affect the course and prognosis of RA, the choice of its treatment policy, quality of life of the patients. Objective: to identify the most important and common comorbidities in patients with RA. Subjects and methods. Two hundred patients (median age 55 [46; 61] years were enrolled; there was a preponderance of women (82.5% with median disease duration 5 [1; 10] years, seropositive for IgM rheumatoid factor (83.0% and anti-cyclic citrullinated peptide antibodies (81.6% with moderate and high disease activity (median DAS28 value 3.9 [3.1; 4.9]. Varying degrees of destructive changes in hand and foot joints were radiologically detected in 71.2% of the patients; 64.5% of the patients had Functional Class II. Methotrexate was given to 69.5% of the patients; therapy with biological agents was used in 21.0% of the cases. 15.5% of the patients did not receive DMARD or biologics. 43.0% of the patients with RA received glucocorticoids. Results. Comorbidities were present in 72.0% of the patients with RA. The most common diseases were hypertension (60.0%, dyslipidemia (45.0%, fractures at various sites (29.5%, and coronary heart disease (21.0%. Myocardial infarction and stroke were observed in 1.5 and 1.0% of cases, respectively. There was diabetes mellitus (DM in 7.5% of the cases and osteoporosis in 15.5% of the patients. 81.7% of the patients with RA and hypertension and 80.0% of those with RA and DM received antihypertensive and sugar-lowering therapy, respectively. At the same time the RA patients with dyslipidemia and osteoporosis received specific drugs far less frequently (30.0 and 29.0%, respectively. Conclusion. Comorbidities are frequently encountered in RA. By taking into account the fact that cardiovascular dis- eases are a main cause of death in RA; it is necessary to adequately and timely

  9. Septic arthritis of the knee following anterior cruciate ligament reconstruction

    Directory of Open Access Journals (Sweden)

    Matjaz Sajovic

    2009-04-01

    Full Text Available Septic arthritis of the knee is a rare complication after arthroscopic anterior cruciate ligament reconstruction, and the most appropriate treatment is unclear. All case series reported so far have been retrospective, and case numbers of septic arthritis have ranged from 4 to 11. From a consecutive case series of 1,283 patients who underwent arthroscopic anterior cruciate ligament reconstruction between January 1997 and May 2008, we report on 3 patients (0.23% with post-operative septic arthritis. All patients had acute infection (≤ 2 weeks, bacterial cultures showed Staphylococcus species in 2 patients, while the bacterial culture was negative in the third. All of them underwent immediate arthroscopic debridement and lavage with continuous irrigation, as well as antibiotic treatment. The results were evaluated with physical and radiographic examination, functional testing, KT-2000, Lysholm and Tegner scales. The infection was successfully eradicated without further surgical treatment and the ligament graft was retained in all patients. Follow-up, at an average of 33 months, revealed that the patients had full symmetric knee range of motion and no effusion. The average Lysholm score was 91 points. In the patient with a lower subjective score, radiographs demonstrated patellofemoral joint-space narrowing, which is most probably in correlation with his anterior knee pain problems and lower activity level. The 134 N KT-2000 arthrometer side-to-side differences averaged 13 mm. Their performance in the single-legged hop test gave excellent results. The goals of treatment for septic arthritis after anterior cruciate ligament reconstruction are, primarily, to protect the articular cartilage and, secondly, to protect the graft. Through early diagnosis and prompt treatment, the infection can be successfully eradicated, with stability of the knee and full range of motion achieved.

  10. Clostridium difficile Enterocolitis and Reactive Arthritis: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Michela Cappella

    2016-01-01

    Full Text Available Reactive arthritis is a rare complication of Clostridium difficile enterocolitis, especially in children. We review the 6 pediatric cases published in the English and non-English literature and discuss their clinical presentation, outcome, treatment, and pathophysiology. We also report the seventh case of Clostridium difficile reactive arthritis in a 6-year-old boy who was treated with amoxicillin-clavulanate for 10 days because of an upper respiratory infection. After the antibiotic course, the child developed at the same time diarrhea with positive stool culture for Clostridium difficile and an asymmetric polyarthritis. Nonsteroidal anti-inflammatory drugs and metronidazole completely resolved the pain, joint swelling, and diarrhea. After twelve months of follow-up there has been no recurrence. This report confirms the self-limiting course of Clostridium difficile reactive arthritis. Clostridium difficile testing in children with gastrointestinal symptoms and acute onset of joint pain should be always considered.

  11. Arthritis and cognitive impairment in older adults.

    Science.gov (United States)

    Baker, Nancy A; Barbour, Kamil E; Helmick, Charles G; Zack, Matthew; Al Snih, Soham

    2017-06-01

    Adults aged 65 or older with arthritis may be at increased risk for cognitive impairment [cognitive impairment but not dementia (CIND) or dementia]. Studies have found associations between arthritis and cognition impairments; however, none have examined whether persons with arthritis develop cognitive impairments at higher rates than those without arthritis. Using data from the Health and Retirement Study, we estimated the prevalence of cognitive impairments in older adults with and without arthritis, and examined associations between arthritis status and cognitive impairments. We calculated incidence density ratios (IDRs) using generalized estimating equations to estimate associations between arthritis and cognitive impairments adjusting for age, sex, race/ethnicity, marital status, education, income, depression, obesity, smoking, the number of chronic conditions, physical activity, and birth cohort. The prevalence of CIND and dementia did not significantly differ between those with and without arthritis (CIND: 20.8%, 95% CI 19.7-21.9 vs. 18.3%, 95% CI 16.8-19.8; dementia: 5.2% 95% CI 4.6-5.8 vs. 5.1% 95% CI 4.3-5.9). After covariate control, older adults with arthritis did not differ significantly from those without arthritis for either cognitive outcome (CIND IDR: 1.6, 95% CI = 0.9-2.9; dementia IDR: 1.1, 95% CI = 0.4-3.3) and developed cognitive impairments at a similar rate to those without arthritis. Older adults with arthritis were not significantly more at risk to develop cognitive impairments and developed cognitive impairments at a similar rate as older adults without arthritis over 6 years.

  12. Combining cytology and microcrystal detection in nonpurulent joint fluid benefits the diagnosis of septic arthritis.

    Science.gov (United States)

    Ferreyra, Marine; Coiffier, Guillaume; Albert, Jean-David; David, Claire; Perdriger, Aleth; Guggenbuhl, Pascal

    2017-01-01

    To evaluate the performance of combined cytology and microcrystal detection in joint fluid for diagnosing septic arthritis. Retrospective single-center study of joint fluid samples from patients with manifestations suggesting acute or chronic arthritis. The absolute leukocyte count (/mm 3 ) was recorded; as well as the differential counts, particularly of neutrophils (%). Microcrystals were sought and bacteriological cultures performed. Septic arthritis was defined as positive cultures of joint fluid or blood samples. Diagnostic performance was assessed based on sensitivity, specificity, the receiver-operating characteristics (ROC) curve with the area under the curve (AUC), and the positive and negative likelihood ratios (LR+ and LR-). Two hundred and eight joint fluid samples were included. The diagnoses were septic arthritis (n=28), chondrocalcinosis (n=41), gout (n=28), rheumatoid arthritis (n=33), spondyloarthritis (n=31), osteoarthritis (n=18), and undifferentiated arthritis (n=29). Among cytological parameters, those having the best diagnostic performance were the neutrophil count (cutoff, >50,000/mm 3 ), the leukocyte count (cutoff, >50,000/mm 3 ), and the percentage of neutrophils (cutoff, >95%); corresponding LR+ values were 8.93, 5.76, and 4.55, respectively. Neutrophil percentages lower than 80% had an LR- value of 0.07. Combining these cytological variables with the absence of crystals improved the diagnostic performance, yielding LR+ values of 11.36, 10.94, and 10.82 for neutrophils >95%, neutrophils >50,000/mm 3 , and leukocytes >50,000/mm 3 , respectively. Combining cytological characteristics of joint fluid with the absence of crystals benefits the diagnosis of septic arthritis. Copyright © 2016. Published by Elsevier SAS.

  13. Genome Engineering for Personalized Arthritis Therapeutics.

    Science.gov (United States)

    Adkar, Shaunak S; Brunger, Jonathan M; Willard, Vincent P; Wu, Chia-Lung; Gersbach, Charles A; Guilak, Farshid

    2017-10-01

    Arthritis represents a family of complex joint pathologies responsible for the majority of musculoskeletal conditions. Nearly all diseases within this family, including osteoarthritis, rheumatoid arthritis, and juvenile idiopathic arthritis, are chronic conditions with few or no disease-modifying therapeutics available. Advances in genome engineering technology, most recently with CRISPR-Cas9, have revolutionized our ability to interrogate and validate genetic and epigenetic elements associated with chronic diseases such as arthritis. These technologies, together with cell reprogramming methods, including the use of induced pluripotent stem cells, provide a platform for human disease modeling. We summarize new evidence from genome-wide association studies and genomics that substantiates a genetic basis for arthritis pathogenesis. We also review the potential contributions of genome engineering in the development of new arthritis therapeutics. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Technetium scintigraphy in experimental hyperergic arthritis and by rheumatoid arthritis

    International Nuclear Information System (INIS)

    Hanheide, M.; Dreher, R.; Grebe, S.F.; Virian, M.; Federlin, K.; Sattler, E.L.; Altaras, J.; Mueller, H.; Giessen Univ.; Giessen Univ.; Giessen Univ.

    1980-01-01

    Guinea pigs showed an increased uptake of 99m-TC-04 in the inflamed joints during the first days of experimental arthritis. Tc-04 was found in the joint fluid and inflamed synovia. The uptake of Tc-04 and Tc-MDP was reduced by therapy in 13 patients with RA. Classical RA showed an increased uptake of Tc-MDP compared with probable RA. Scintigraphy offers the possibility of early diagnosis and study of progression. (orig.) [de

  15. Acute encephalomyelitis with multiple herpes viral reactivations during abatacept therapy.

    Science.gov (United States)

    Nakajima, Hideto; Takayama, Ayami; Ito, Takumi; Yoshikawa, Tetsushi

    2013-05-09

    To describe the case of a patient who had been receiving abatacept, a T-cell costimulatory molecule blocker for rheumatoid arthritis, and developed an acute encephalomyelitis associated with reactivation of the varicella zoster virus (VZV), Epstein-Barr virus (EBV) and cytomegalovirus (CMV). A 61-year-old woman receiving abatacept therapy for rheumatoid arthritis developed a disturbance of consciousness. MRI indicated multifocal parenchymal lesions in the brainstem, supratentorial areas and cervical spinal cord. Although steroid therapy significantly improved the neurological symptoms and MRI findings, the patient died of sepsis aggravated by coinfection with a fungal infection. Retrospectively, a PCR assay revealed continued systemic reactivation of VZV, EBV and CMV. Acute encephalomyelitis may be associated with VZV EBV and CMV reactivation during abatacept therapy. Clinicians must be aware of the possibility of acute encephalomyelitis associated with herpes virus reactivation during abatacept therapy for rheumatoid arthritis.

  16. Periodontal and hematological characteristics associated with aggressive periodontitis, juvenile idiopathic arthritis, and rheumatoid arthritis

    DEFF Research Database (Denmark)

    Poulsen, Anne Havemose; Westergaard, Jytte; Stoltze, Kaj

    2006-01-01

    Periodontitis shares several clinical and pathogenic characteristics with chronic arthritis, and there is some degree of coexistence. The aims of this study were to elucidate whether patients with localized aggressive periodontitis (LAgP), generalized aggressive periodontitis (GAgP), juvenile idi...... idiopathic arthritis (JIA), and rheumatoid arthritis (RA) share periodontal and hematological characteristics distinguishing them from individuals free of diseases....

  17. How to diagnose rheumatoid arthritis early: a prediction model for persistent (erosive) arthritis

    NARCIS (Netherlands)

    Visser, Henk; le Cessie, Saskia; Vos, Koen; Breedveld, Ferdinand C.; Hazes, Johanna M. W.

    2002-01-01

    To develop a clinical model for the prediction, at the first visit, of 3 forms of arthritis outcome: self-limiting, persistent nonerosive, and persistent erosive arthritis. A standardized diagnostic evaluation was performed on 524 consecutive, newly referred patients with early arthritis.

  18. Measuring synovial fluid procalcitonin levels in distinguishing cases of septic arthritis, including prosthetic joints, from other causes of arthritis and aseptic loosening.

    Science.gov (United States)

    Saeed, K; Dryden, M; Sitjar, A; White, G

    2013-08-01

    Differentiating septic arthritis from non-septic arthritis can be challenging as the clinical pictures are similar and an efficacious diagnostic test is not yet available. Our objectives in this study were to establish if procalcitonin (PCT) could be reproducibly measured from synovial fluid, if there is a difference in synovial procalcitonin values between patients with septic and non-septic arthritis, respectively, including those with implants and to determine cut-off levels that could be used as a practical tool in the management of these conditions. Using a standard serum assay, synovial fluid PCT levels were measured retrospectively in 26 septic and 50 non-septic predefined arthritis cases. The reproducibility of synovial PCT was also assessed at various concentrations. Synovial PCT can be measured and is reproducible. In this cohort, statistically significant higher synovial PCT levels were found in cases of septic arthritis than in non-septic arthritis. Sensitivities, specificities and positive and negative predictive values varied at different cut-off levels. The test could be added to other microbiological and biochemical tests and may be used to supplement other clinical, radiological and laboratory findings in the assessment of patients with acute painful joints. In our cohort, findings of very high synovial PCT levels supported an infection process, including in prosthesis-related infections. The high negative predictive value of low synovial PCT levels could exclude infection in both native and prosthetic joints. Larger prospective studies are needed to further validate these results and to examine the cost effectiveness of synovial PCT.

  19. Can magnetic resonance imaging differentiate undifferentiated arthritis?

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Duer, Anne; Hørslev-Petersen, K

    2005-01-01

    A high sensitivity for the detection of inflammatory and destructive changes in inflammatory joint diseases makes magnetic resonance imaging potentially useful for assigning specific diagnoses, such as rheumatoid arthritis and psoriatic arthritis in arthritides, that remain undifferentiated after...... conventional clinical, biochemical and radiographic examinations. With recent data as the starting point, the present paper describes the current knowledge on magnetic resonance imaging in the differential diagnosis of undifferentiated arthritis....

  20. Rehabilitation in patients with Rheumatoid Arthritis

    OpenAIRE

    Evaggelos Giavasopoulos; Paraskevi Gourni

    2008-01-01

    Rehabilitation of patients with rheumatoid arthritis aims to the management of the consequences of disease. It is widely accepted that, no drug therapy at present leads to long‐term orremission f everyone with rheumatoid arthritis (R.A.). Consequently, patients experience physical, psychological, functional, social and role negative effects of the disease. AIM : The am of the present article was to evaluate the role of rehabilitation to patients with rheumatoid arthritis sMethod and material:...

  1. Oral buprenorphine is anti-inflammatory and modulates the pathogenesis of streptococcal cell wall polymer-induced arthritis in the Lew/SSN rat.

    Science.gov (United States)

    Volker, D; Bate, M; Gentle, R; Garg, M

    2000-10-01

    This study was carried out to determine an effective regimen for pain management in streptococcal cell wall (SCW)-induced arthritis in female Lew/SSN rats. Forty weanling rats lin 2 groups) were trained to accept disks of jelly as part of their dietary regimen. At 8 weeks of age weighing 150 g, SCW arthritis was induced and sublingual buprenorphine tablets were incorporated into the jelly disks to alleviate the pain of acute arthritis, which developed 24 h post-induction. Group A rats received buprenorphine at a rate of 1 mg/kg 12 hourly. Group B rats received buprenorphine at a rate of 2 mg/kg 12 hourly. Both groups of rats were monitored for symptoms of distress using an adaptation of the Morton and Griffin scale of adverse reactions. Group A rats with severe arthritis required additional subcutaneous (s.c.) injections of buprenorphine to alleviate the adverse effects of arthritis. Group B rats, with twice the dose of buprenorphine did not require additional s.c. injections of buprenorphine. Histological sections of rat hocks indicated that the inflammation was suppressed in Group B rats. We concluded that oral administration of buprenorphine is an effective method of pain management in the pathogenesis of SCW-induced arthritis in Lew/SSN rats. In this model of arthritis, oral buprenorphine has a significant anti-inflammatory effect and appears to modulate the destructive arthritic phase in joints in this animal model of arthritis.

  2. Ho-166 Hydroxyapatite (Ha) as a potential therapeutic agent in the treatment of rheumatoid arthritis

    International Nuclear Information System (INIS)

    Chandia, M.; Errazu, X.; Pinto, L.; Troncoso, F.; Mendoza, P.; Jofre, J.

    2004-01-01

    Radiation synovectomy is a procedure which is aimed at ablation of the inflamed synovium in rheumatoid arthritis through intraarticular injection of a chemical substance labeled with a beta-emitting radioisotope. The objective of this study was to evaluate Ho-166 Hydoxyapatite (Ho-166 HA) particle as potential therapeutic agent for the treatment of acute and chronic arthritis. Ho-166 was obtained by irradiation of 165 Ho 2 O 3 in the 5 MW Research Reactors (RECH1) at the Nuclear Centre La Reina (Chilean Nuclear Energy Commission). The HA synthesis, Ho-166 HA labeling and quality control procedures were performed in the laboratories of Chilean Atomic Energy Commission. Two groups of arthritic (acute and chronic) rabbits with antigen-induced arthritis were administered Ho-166 HA intra-articularly following two different protocols; single dose protocol and double dose protocol. The therapeutic efficacy of Ho-166 HA was assessed by clinical follow-up and evaluation, as well as by serial radionuclide imaging of the inflamed joints with Ga-67 Citrate, before and after treatment. The average radionuclide purity of administered Ho-166 HA in our study was 99%. All animals were followed up by clinical examination. Grades of inflammation, general physical conditions as well as the level of appetite were recorded following treatment. The localization and distribution of the Ho-166 HA were studied by gamma camera imaging at 4 and 24 hrs after-injections. The scans were examined meticulously to look for any evidence of leakage of radiopharmaceutical from the joint space. The group of animals with acute arthritis showed evidence of significant clinical improvement following radionuclide therapy. The animals which received higher doses (double dose) demonstrated better therapeutic response. Based on the preliminary reports from this pilot study it was concluded that Ho-166 HA is a useful radiopharmaceutical for the treatment of rheumatoid arthritis. (author)

  3. Diagnosis and treatment of Lyme arthritis.

    Science.gov (United States)

    Arvikar, Sheila L; Steere, Allen C

    2015-06-01

    In the United States, Lyme arthritis is the most common feature of late-stage Borrelia burgdorferi infection, usually beginning months after the initial bite. In some, earlier phases are asymptomatic and arthritis is the presenting manifestation. Patients with Lyme arthritis have intermittent or persistent attacks of joint swelling and pain in 1 or a few large joints. Serologic testing is the mainstay of diagnosis. Synovial fluid polymerase chain reaction for B burgdorferi DNA is often positive before treatment, but is not a reliable marker of spirochetal eradication after therapy. This article reviews the clinical manifestations, diagnosis, and management of Lyme arthritis. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. [Cutaneous panarteritis nodosa with destructive arthritis].

    Science.gov (United States)

    Alonso Ruiz, A; Calabozo Raluy, M; Manrique Martínez, P; Rossell Cerro, M; Múgica Sanperio, C; Goicoechea Marcaida, A

    1990-01-27

    The existence of arthritis in cutaneous panarteritis nodosa (CPAN) is controversial. We report a 52-year-old male with chronic destructive arthritis of both knees and palpable purpura in the feet, where the underlying histological finding was necrotizing arteritis. Systemic involvement was not demonstrated. AntiHBc and antiHBs antibodies were positive. Four of the 11 cases of CPAN with arthritis that we have found reported in the literature were well documented, and only one developed erosions of the joints. Our patient is the first reported case of CPAN with destructive arthritis and evidence of previous hepatitis B virus infection.

  5. Efek Anti Radang dan Toksisitas Akut Ekstrak Daun Jintan (Plectranthus amboinicus pada Tikus yang Diinduksi Arthritis

    Directory of Open Access Journals (Sweden)

    Lailatul Muniroh

    2013-06-01

    Full Text Available Abstrak Tanaman Jintan (Plectranthus amboinicus dikenal sebagai tanaman bangun-bangun, dikenal sebagai salah satu tanaman berkhasiat obat bagi masyarakat Indonesia. Penelitian ini bertujuan menganalisis aktivitas ekstrak daun jintan dan mengetahui efek toksisitas akut pada tikus putih yang diinduksi arthritis. Ekstrak dari daun jintan segar disarikan dengan metode maserasi ethanol 96%, dan diencerkan dengan larutan CMC-Na. Tikus putih Wistar jantan dan betina, umur 2-3 bulan dibagi 5 kelompok: Kontrol, induksi arthritis (P1, induksi artritis dan ekstrak daun jintan dosis 19 g/kgBB (P2, induksi artritis dan ekstrak daun jintan dosis 38 g/kgBB (P3 dan kelompok obat allopurinol 2,5 mg/kgBB (P4. Seluruh kelompok tikus diinduksi arthritis menggunakan uric acid2% dan oxonic acid1,5% per oralselama 15 hari berturut-turut. Setelah terbentuk lesi arthritis, diberikan ekstrak daun jintan secara intra peritoneal selama 7 hari. Sampel serum darah diambil sebelum dan sesudah perlakuan untuk mengukur konsentrasi monosodium urea (MSU. Uji toksisitas akut menggunakan 4 kelompok tikus putih Wistar jantan dan betina yang diberi ekstrak daun jintan mulai dosis 1900 mg/kg BB, 3800 mg/kgBB dan 5000 mg/kgBB.Hasil penelitian menunjukkan ekstrak daun jintan secara kualitatif mempunyai kandungan senyawa Flavonoid, Saponin, Polifenol, Terpen dan Antrakuinon. Uji aktivitas ekstrak daun jintan memperlihatkan penurunan konsentrasi MSU (p 0,05 sebelum dan sesudah perlakuan. Uji toksisitas akut ekstrak daun jintan tidak menimbulkan kematian 50% (LD50 dan tidak menimbulkan gejala toksik, gangguan syarafi dan penurunan aktivitas pada semua kelompok perlakuan sehingga ekstrak daun jintan dapat digolongkan sebagai bahan yang “praktis tidak toksik”. Abstract Anti Inflammation Effects and Acute Toxicity of Jintan Leaves (Plectranthus amboinicus Extract on Arthritis Induced Rats.Jintan plant (Plectranthus amboinicus is known as bangun-bangun plant and known as one of medicinal

  6. Tyrosine kinases in rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Kobayashi Akiko

    2011-08-01

    Full Text Available Abstract Rheumatoid arthritis (RA is an inflammatory, polyarticular joint disease. A number of cellular responses are involved in the pathogenesis of rheumatoid arthritis, including activation of inflammatory cells and cytokine expression. The cellular responses involved in each of these processes depends on the specific signaling pathways that are activated; many of which include protein tyrosine kinases. These pathways include the mitogen-activated protein kinase pathway, Janus kinases/signal transducers and activators transcription pathway, spleen tyrosine kinase signaling, and the nuclear factor κ-light-chain-enhancer of activated B cells pathway. Many drugs are in development to target tyrosine kinases for the treatment of RA. Based on the number of recently published studies, this manuscript reviews the role of tyrosine kinases in the pathogenesis of RA and the potential role of kinase inhibitors as new therapeutic strategies of RA.

  7. Clinimetric criteria of rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Domenico Galasso

    2012-10-01

    Full Text Available Rheumatoid arthritis is a systemic autoimmune disease, mainly poli-artycular, among wide-spread chronic inflammatory diseases, that cause pain, functional limitation, damage and joints deformations, and disability. It is characterized by turns of active inflammation and remission phases. Inflammation degree and persistence are associated to a bad functional prognosis and progressive joint disability. These patients management require a continuous valuation of inflammatory activity index of disease both therapeutic management and to prevent disablement process. We focus on many valuation index of joint disability and functional damage. Very important are both the scales of auto-values concerning the pain and the joint swelling and clinical data get by physician to valuate activity index of disease as defined by DAS28. Significant data come by health-related quality of life, disability and by AIMS2 (Arthritis Impact Measurement Scale.

  8. Arthritis dermatitis syndrome in children

    International Nuclear Information System (INIS)

    Velasquez Mendez, Monica Patricia; Ramirez Gomez, Luis Alberto

    2004-01-01

    The pediatric rheumatology is a medical specialization with many areas under developed. The prevalence, pathophysiology and form of presentation of the pediatric rheumatic disease are different of adults. The skin compromise in many pediatric rheumatic diseases is a helping sing for diagnosis. The arthritis-dermatitis syndrome can be the first manifestation of many diseases as infections, tumors and endocrine diseases, but in pediatric age the immunologic and infections diseases are really important. Among infections diseases, virus (parvovirus, rubella, HIV) and bacteria (gonococcus, meningoccus) are the most Important. Within the group of autoimmune diseases the vasculitis such as Henoch-Schonlein purpura and Kawasaki disease are among the more prevalent autoimmune disease. This is a general review about arthritis-dermatitis syndrome in pediatric age

  9. Emerging immunotherapies for rheumatoid arthritis

    Science.gov (United States)

    Reynolds, Gary; Cooles, Faye AH; Isaacs, John D; Hilkens, Catharien MU

    2014-01-01

    Novel treatments in development for rheumatoid arthritis target 3 broad areas: cytokines, cells, and signaling pathways. Therapies from each domain share common advantages (for example previously demonstrated efficacy, potential long-term immunomodulation, and oral administration respectively) that have stimulated research in each area but also common obstacles to their development. In this review recent progress in each area will be discussed alongside the factors that have impeded their path to clinical use. PMID:24535556

  10. Rheumatoid arthritis of the wrist

    International Nuclear Information System (INIS)

    Naegele, M.; Kunze, V.; Koch, W.; Bruening, R.; Seelos, K.; Stroehmann, I.; Woell, B.; Reiser, M.

    1993-01-01

    21 patients with rheumatoid arthritis of the wrist diagnosed according to the criteria of the American Rheumatism Association were examined by dynamic MRT before and after the i.v. injection of Gd-DTPA (0.1 mmol/kg). The results were correlated with the clinical and radiological findings. The increased signal intensity of the pannus was 1.17±0.45%/sec and this differed significantly (p [de

  11. Nail involvement in psoriatic arthritis.

    Science.gov (United States)

    Sobolewski, Piotr; Walecka, Irena; Dopytalska, Klaudia

    2017-01-01

    Nail psoriasis is considered a significant psychological and social problem causing functional impairment in affected patients. Nail changes hamper their daily and occupational activities and contribute to a worse quality of life. Almost 50% of patients with psoriasis vulgaris and up to 80% of patients with psoriatic arthritis are afflicted with nail lesions. The important correlation between psoriatic arthritis and nail changes is well established - the presence of the latter is a strong predictor of the development of arthritis. There is a broad spectrum of nail dystrophies associated with psoriasis, ranging from the common pitting, subungual hyperkeratosis and loosening of the nail plate to less frequent discolouration and splinter haemorrhages. Some of these symptoms are also observed in other nail diseases, and further diagnostics should be performed. The assessment tools NAPSI (Nail Psoriasis Severity Index), mNAPSI (Modified Nail Psoriasis Severity Index), and PNSS (Psoriasis Nail Severity Score) are most commonly used to grade the severity of nail involvement in psoriasis and enable the evaluation of therapy effectiveness. The treatment of nail psoriasis is a major clinical challenge. It should be adjusted to the extent of dermal, articular and ungual lesions. Systemic therapies of psoriasis, especially biological agents, are most likely to be effective in treating nail psoriasis. However, as their use is limited in scope and safety, topical therapy remains a mainstay, and the combination of corticosteroids and vitamin D 3 analogues is considered to be most helpful.

  12. Rheumatoid arthritis as psychic problem

    Directory of Open Access Journals (Sweden)

    Jiří Kaas

    2014-12-01

    Full Text Available The article deals with the issue of psychic problems of rheumatoid arthritis patients. Rheumatoid arthritis is a chronic, inflammatory motor system disease with comprehensive impact on the patient's life. The disease is often considered an exclusively physical disease. But such approach is insufficient because the disease is accompanied by motor limitations of different intensities, by pain and by fatigue that cause considerable exhaustion to the patient. The patients often must give up their hobbies and in some cases even their jobs. In most serious cases, even common daily activities including self-servicing actions become an obstacle to the patient. It is therefore logical that the psyche of a patient with such disease is considerably strained. One of the partial goals of the study consisted in mapping the subjectively perceived quality of life of rheumatoid arthritis patients in facet 8, "negative feelings", and in ascertaining whether there is statistically significant relation to facets 1, "pain and discomfort", and 2, "energy and fatigue". Another goal consisted in comparing the subjectively perceived quality of life between men and women with rheumatoid arthritis, as well as between population of rheumatoid arthritis patients and control healthy population. The study was implemented within the research project of the Grant Agency of the University of South Bohemia in České Budějovice number 120/2012/S, "Reflection of quality of life in nursing", under use of two standardized questionnaires, WHOQOL-100 and HAQ. This article presents exclusively the data acquired based on the WHOQOL-100 questionnaire. The research set consisted of patients suffering from rheumatoid arthritis from all over the Czech Republic. The size of the set was determined by a statistician at 200 individuals suffering from the disease, in a ratio of 150 women and 50 men. The selection set was derived from the basic set of rheumatoid arthritis patients and can

  13. Rheumatoid arthritis as psychic problem

    Directory of Open Access Journals (Sweden)

    Jiří Kaas

    2014-01-01

    Full Text Available The article deals with the issue of psychic problems of rheumatoid arthritis patients. Rheumatoid arthritis is a chronic, inflammatory motor system disease with comprehensive impact on the patient's life. The disease is often considered an exclusively physical disease. But such approach is insufficient because the disease is accompanied by motor limitations of different intensities, by pain and by fatigue that cause considerable exhaustion to the patient. The patients often must give up their hobbies and in some cases even their jobs. In most serious cases, even common daily activities including self–servicing actions become an obstacle to the patient. It is therefore logical that the psyche of a patient with such disease is considerably strained. One of the partial goals of the study consisted in mapping the subjectively perceived quality of life of rheumatoid arthritis patients in facet 8, "negative feelings", and in ascertaining whether there is statistically significant relation to facets 1, "pain and discomfort", and 2, "energy and fatigue". Another goal consisted in comparing the subjectively perceived quality of life between men and women with rheumatoid arthritis, as well as between population of rheumatoid arthritis patients and control healthy population. The study was implemented within the research project of the Grant Agency of the University of South Bohemia in České Budějovice number 120/2012/S, „Reflection of quality of life in nursing", under use of two standardized questionnaires, WHOQOL–100 and HAQ. This article presents exclusively the data acquired based on the WHOQOL–100 questionnaire. The research set consisted of patients suffering from rheumatoid arthritis from all over the Czech Republic. The size of the set was determined by a statistician at 200 individuals suffering from the disease, in a ratio of 150 women and 50 men. The selection set was derived from the basic set of rheumatoid arthritis patients and

  14. Septic arthritis due to Clostridium ramosum.

    Science.gov (United States)

    García-Jiménez, Antonio; Prim, Núria; Crusi, Xavier; Benito, Natividad

    2016-04-01

    Clostridium species are anaerobic bacilli that are rarely reported as etiologic agents of infectious arthritis. Previous cases of arthritis caused by Clostridium ramosum have not been reported. We describe the first 2 cases of C. ramosum arthritis. We reviewed the etiology of arthritis in our hospital during the previous 15 years. Both patients had underlying immunocompromising conditions and their infections involved a joint with preexisting disease: patient 1 had rheumatic arthritis and a prosthetic joint; patient 2, chronic renal failure on dialysis and hip osteoarthritis. The infection was hematogenously acquired and the course was indolent but destructive in both the cases. Management included open arthrotomy and resection arthroplasty. The infection had a persisting and relapsing course, and prolonged antibiotic treatment was required. In the literature review, we found 55 previous cases of arthritis caused by Clostridium species between 1966 and 2014; Clostridium perfringens was the most common infecting species; the infection was traumatically acquired in most of the cases. A total of 15 patients have been described with infections caused by C. ramosum; none had septic arthritis. The majority were elderly or immunocompromised adults. Proper collection, transportation and processing of clinical specimens is essential for diagnosing clostridial infections. More information about the best management of clostridial arthritis are needed. We describe the first 2 cases of septic arthritis caused by C. ramosum. They shared several pathogenic and clinical features. The possibility of anaerobic arthritis should always be considered when collecting diagnostic specimens. An increasing number of clostridial arthritis cases are likely to be diagnosed in future years. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Gross and histopathological findings in synovial membranes of pigs with experimentally induced Mycoplasma hyosynoviae arthritis

    DEFF Research Database (Denmark)

    Hagedorn-Olsen, T.; Basse, A.; Jensen, Tim Kåre

    1999-01-01

    or contact exposure with M. hyosynoviae induced arthritis in 13- to 17-week-old pigs. The acute to subacute arthritis was characterized by increased amounts of serohaemorrhagic, serofibrinous or mahogany coloured synovial fluid combined with edema and hyperaemia, followed by yellow to brownish discoloration...... and moderate villous proliferation of the synovial membrane. In the chronic phase moderate fibrosis was seen, but no periarticular or articular cartilage involvement. The acute to subacute histopathological characteristics were edema, hyperaemia, variable hyperplasia of synovial lining cells, increased density...... of subsynovial cell populations, diffuse and perivascular infiltration with lymphocytes, plasma cells and macrophage-like cells, fibrinous material, mild to moderate villous hypertrophy and mild to moderate fibrosis in chronic cases. The morphogenetic changes during the course of the infection may be described...

  16. Epidemiology of septic arthritis of the knee at Hospital das Clínicas, Universidade de São Paulo.

    Science.gov (United States)

    Helito, Camilo Partezani; Noffs, Guilherme Guelfi; Pecora, Jose Ricardo; Gobbi, Riccardo Gomes; Tirico, Luis Eduardo Passarelli; Lima, Ana Lucia Munhoz; de Oliveira, Priscila Rosalba; Camanho, Gilberto Luis

    2014-01-01

    Septic arthritis is an infrequent disease although very important due to the possibility of disastrous outcomes if treatment is not adequately established. Adequate information concerning the epidemiology of septic arthritis is still lacking due to the uncommon nature of the disease as well as the struggle to establish a correct case-definition. To epidemiologically characterize the population seen at Hospital das Clínicas, University of São Paulo with a diagnosis of septic arthritis between 2006 and 2011. Sixty-one patients diagnosed with septic arthritis of the knee between 2006 and 2011 were retrospectively evaluated. The patients' clinical and epidemiological characteristics, the microorganisms that caused the infection and the patients' treatment and evolution were analyzed. Septic arthritis of the knee was more common among men, with distribution across a variety of age ranges. Most diagnoses were made through positive synovial fluid cultures. The most prevalent clinical comorbidities were systemic arterial hypertension and diabetes mellitus, and the most commonly reported joint disease was osteoarthritis. Staphylococcus aureus was the prevailing pathogen. Fever was present in 36% of the cases. All patients presented elevation in inflammatory tests. Gram staining was positive in only 50.8% of the synovial fluid samples analyzed. Six patients presented complications and unfavorable evolution of their condition. S. aureus is still the most common pathogen in acute knee infections in our environment. Gram staining, absence of fever and normal leukocyte count cannot be used to rule out septic arthritis. Copyright © 2013 Elsevier Editora Ltda. All rights reserved.

  17. Acute pancreatitis

    Science.gov (United States)

    ... its blood vessels. This problem is called acute pancreatitis. Acute pancreatitis affects men more often than women. Certain ... well it can be treated. Complications of acute pancreatitis may include: Acute kidney failure Long-term lung damage (ARDS) Buildup ...

  18. Socioeconomic status and risk of rheumatoid arthritis

    DEFF Research Database (Denmark)

    Pedersen, Line Merete Blak; Jacobsen, Søren; Klarlund, Mette

    2006-01-01

    To examine whether markers of socioeconomic status (SES) are associated with risk of rheumatoid arthritis (RA), and if so, whether selected lifestyle-related factors could explain this association.......To examine whether markers of socioeconomic status (SES) are associated with risk of rheumatoid arthritis (RA), and if so, whether selected lifestyle-related factors could explain this association....

  19. Pseudomonas Septic Arthritis | Thanni | Nigerian Journal of ...

    African Journals Online (AJOL)

    BACKGROUND: Septic arthritis due to pseudomonas species is unusual and when it occurs, there is often an underlying cause like immune depression, intravenous drug abuse or a penetrating injury. PATIENT AND METHOD: We report a case of pseudomonas septic arthritis complicating cannulation of a leg vein following ...

  20. Arthritis and X-linked agammaglobulinemia.

    Science.gov (United States)

    Machado, Pedro; Santos, Alexandra; Faria, Emília; Silva, Jorge; Malcata, Armando; Chieira, Celso

    2008-01-01

    Primary immunodeficiencies are defined as genetically determined functional and/or quantitative abnormalities in one or more of the components of the immune system. Immunodeficiency and arthritis can be related, although the mechanisms are not always clear. Different causes for immunodeficiency can secondarily be found in patients with arthritis; on the other hand, arthritis can be a manifestation of primary immunodeficiency. Arthritis occurs chiefly in humoral primary immunodeficiencies, namely in X-linked agammaglobulinemia and common variable immunodeficiency, and may be one of the warning signs for primary immunodeficiency. We report a case of arthritis as the presenting feature of X-linked agammaglobulinemia. In X-linked agammaglobulinemia, arthritis may be a consequence of infection, most notably by Mycoplasma, or of immune dysfunction itself. In children, and occasionally in young adults, a combination of arthritis and hypogammaglobulinemia should suggest primary immunodeficiency, although other causes of hypogammaglobulinemia must be excluded. Physicians evaluating patients with arthritis should be aware of this fact so that an early diagnosis can be pursued as it is of extreme importance in the optimal management and prognosis of these patients.

  1. Rheumatoid arthritis in the hand. Chapter 9

    International Nuclear Information System (INIS)

    Weston, W.J.

    1979-01-01

    Rheumatoid arthritis is primarily a disease of the synovial membrane. To demonstrate synovial changes it is necessary to show adequate detail of the soft tissue. This is best obtained by using industrial film and by hand-processing. The anatomy of the hand and the radiological appearance of rheumatoid arthritis are described. (author)

  2. Microbiota and arthritis: correlations or cause?

    Science.gov (United States)

    Bravo-Blas, Alberto; Wessel, Hannah; Milling, Simon

    2016-03-01

    The microorganisms that colonise our bodies, the commensal 'microbiota', respond to changes in our behaviour and environment, and can also profoundly affect our health. We can now investigate these organisms with unprecedented depth and precision, revealing that they may contribute to the pathogenesis of diseases including arthritis. Here we discuss the changes occurring in the microbiota in people with arthritis, and how manipulation of the microbiota may provide an additional pathway for therapy. We highlight two important aspects of the recent literature. First we describe changes in the microbiota identified in people with arthritis; these correlations give insights into the microbial changes that may contribute to symptoms of arthritis. We then discuss attempts to ameliorate arthritis by manipulating the microbiota. This is a rapidly developing area of research. There are tantalising hints that interventions targeting the microbiota may become therapeutically viable for some types of inflammatory arthritis. Our commensal microbial communities respond to changes in our health, and are altered in people with arthritis. Understanding the complex relationships between the microbiota and the body may enable us to deliberately manipulate these organisms and provide additional therapeutic options for people with arthritis.

  3. Immune modulation by vaccination in chronic arthritis

    NARCIS (Netherlands)

    Zonneveld - Huijssoon, E.

    2012-01-01

    Vaccination in autoimmunity can have beneficial, but also detrimental effects. In this thesis, we tried to identify factors that contribute to a favourable or an unfavourable outcome of vaccination in Juvenile Idiopathic Arthritis (JIA) and experimental arthritis. In the first part, we focused on

  4. LIPID PROFILE IN CHILDREN WITH RHEUMATOID ARTHRITIS

    Directory of Open Access Journals (Sweden)

    E.Yu. Gudkova

    2008-01-01

    Full Text Available Lipid composition in children with different types of juvenile arthritis was investigated in this trial. Significant decrease of plasma concentration of cholesterol in high density lipoproteins in patients with high activity of rheumatoid arthritis was discovered. «Atherogenic» shift of lipid composition and increase of atherogenity index was shown in most of pediatric patients with different types of juvenile arthritis. The number of children with increased atherogenity index grows according to the increase of disease activity. pediatric patients with high activity of juvenile arthritis and juvenile ankylosing spondylitis are the risk group of early atherosclerosis development.Key words: juvenile arthritis, atherosclerosis, high density lipoproteins, triglyceride, atherogenity index.

  5. Photoacoustic tomography to identify inflammatory arthritis

    Science.gov (United States)

    Rajian, Justin Rajesh; Girish, Gandikota; Wang, Xueding

    2012-09-01

    Identifying neovascularity (angiogenesis) as an early feature of inflammatory arthritis can help in early accurate diagnosis and treatment monitoring of this disease. Photoacoustic tomography (PAT) is a hybrid imaging modality which relies on intrinsic differences in the optical absorption among the tissues being imaged. Since blood has highly absorbing chromophores including both oxygenated and deoxygenated hemoglobin, PAT holds potential in identifying early angiogenesis associated with inflammatory joint diseases. PAT is used to identify changes in the development of inflammatory arthritis in a rat model. Imaging at two different wavelengths, 1064 nm and 532 nm, on rats revealed that there is a significant signal enhancement in the ankle joints of the arthritis affected rats when compared to the normal control group. Histology images obtained from both the normal and the arthritis affected rats correlated well with the PAT findings. Results support the fact that the emerging PAT could become a new tool for clinical management of inflammatory arthritis.

  6. Hearing status in patients with rheumatoid arthritis.

    Science.gov (United States)

    Ahmadzadeh, A; Daraei, M; Jalessi, M; Peyvandi, A A; Amini, E; Ranjbar, L A; Daneshi, A

    2017-10-01

    Rheumatoid arthritis is thought to induce conductive hearing loss and/or sensorineural hearing loss. This study evaluated the function of the middle ear and cochlea, and the related factors. Pure tone audiometry, speech reception thresholds, speech discrimination scores, tympanometry, acoustic reflexes, and distortion product otoacoustic emissions were assessed in rheumatoid arthritis patients and healthy volunteers. Pure tone audiometry results revealed a higher bone conduction threshold in the rheumatoid arthritis group, but there was no significant difference when evaluated according to the sensorineural hearing loss definition. Distortion product otoacoustic emissions related prevalence of conductive or mixed hearing loss, tympanometry values, acoustic reflexes, and speech discrimination scores were not significantly different between the two groups. Sensorineural hearing loss was significantly more prevalent in patients who used azathioprine, cyclosporine and etanercept. Higher bone conduction thresholds in some frequencies were detected in rheumatoid arthritis patients that were not clinically significant. Sensorineural hearing loss is significantly more prevalent in refractory rheumatoid arthritis patients.

  7. Psoriatic arthritis: from pathogenesis to therapy.

    LENUS (Irish Health Repository)

    Fitzgerald, Oliver

    2012-02-01

    Psoriatic arthritis is a multigenic autoimmune disease that involves synovial tissue, entheseal sites and skin, and that may result in significant joint damage. Although there are no diagnostic tests for psoriatic arthritis, research has identified consistent features that help to distinguish the condition from other common rheumatic diseases. Comparison of HLA-B and HLA-C regions in psoriatic arthritis with those in psoriasis without joint involvement demonstrates significant differences, such that psoriatic arthritis cannot be viewed simply as a subset of genetically homogeneous psoriasis. T-cell receptor phenotypic studies have failed to identify antigen-driven clones, and an alternative hypothesis for CD8 stimulation involving innate immune signals is proposed. Finally, imaging studies have highlighted entheseal involvement in psoriatic arthritis, and it is possible that entheseal-derived antigens may trigger an immune response that is critically involved in disease pathogenesis.

  8. Arthroscopic Treatment for Primary Septic Arthritis of the Hip in Adults

    Directory of Open Access Journals (Sweden)

    Jörg Hartmut Schröder

    2016-01-01

    Full Text Available Purpose. Primary septic arthritis is a rare differential diagnosis of acute hip pain in adults. Inspired by the success of all-arthroscopic treatment in pediatric patients, we developed a diagnostic and surgical pathway for our adult patients. Methods. Seven patients, average age 44±13.7 years with acute hip pain since 4.4±2.9 days in the average, were included. Septic arthritis was confirmed by joint aspiration and dissemination was excluded by MRI and standard radiographs. Surgical treatment consisted of immediate arthroscopic lavage using 4 portals for debridement, high-volume irrigation, partial synovectomy, and drainage. Results. Patients were treated in hospital for 12.4±3.1 days (range 7–16 days. WBC and CRP returned to physiological levels. During the mean follow-up of 26.4±19.4 months (range 13–66 months no patient showed recurrence of infection. The 5 patients with an unimpaired hip joint prior to the infection had a mean modified Harris Hip Score of 94±5.6 points (range 91–100 at final follow-up. Conclusions. Arthroscopic therapy using a minimally invasive approach with low perioperative morbidity for the treatment of primary septic arthritis of the adult hip is able to restore normal hip function in acute cases without dissemination of the infection. Level of Evidence. IV.

  9. Evaluation of the activity of synovitis in patients with rheumatoid arthritis: Value of power Doppler ultrasonography

    International Nuclear Information System (INIS)

    Ahn, Joong Mo; Lim, Hyo Keun; Kim, Seung Hoon; Kim, Sung Hyun; Koh, Eun Mi; Kim, Jin Seok; Cha, Hoon Suk

    2001-01-01

    To correlate the grades on power Doppler ultrasonography with clinical disease activity indices and acute phase reactant values for assessing the activity of synovitis in patients with rheumatoid arthritis. Twenty patients with rheumatoid arthritis diagnosed on the basis of American College of power Doppler ultrasonography. Two experienced radiologists evaluated, in consensus, the power Doppler signals as follows: grade I=no flow or minimal flow, grade 2=mild flow, grade 3=moderate flow and grade 4= marked flow. The clinical disease activity indices consisted of the counts of tender joints and swollen joints, patient's assessment of pain, patient's global assessment of disease activity, physician's globe assessment of disease activity and patient's assessment of physical function. Acute-phase reactants included CRP and ESR. The grades on power Doppler ultrasonography were correlated with clinical disease activity indices as well as acute-phases reactant values by a use of Spearman rank correlation coefficient. The grades on power Doppler ultrasonography showed a statistically significant correlation with tender joint count (rs=.835; p<.05), swollen joint count (rs=.833; p<.05), physician's global assessment of disease activity (rs=.857; p<.05), CRP (rs=.838; P<.05) and ESR (rs=.838; p<.05). The power Doppler ultrasonography is an useful diagnostic modality for assessing the activity of synovitis in patients with rheumatoid arthritis.

  10. Prevalence of ischemic heart disease and associated factors in patients with rheumatoid arthritis in Southern Brazil

    Directory of Open Access Journals (Sweden)

    Rafael Kmiliauskis Santos Gomes

    Full Text Available Abstract Objective: To estimate the prevalence of ischemic heart disease and associated factors in patients with rheumatoid arthritis. Methods: A cross-sectional study using the American College of Rheumatology diagnostic criteria in order to select patients seen at primary or secondary health care units in Blumenau, Santa Catarina, Southern Brazil, in 2014. The presence of ischemic heart disease was defined as an acute myocardial infarction with percutaneous coronary intervention or coronary artery bypass graft surgery that has occurred after diagnosis. Fischer's exact test, Wald's linear trend test, and multivariate logistic regression analysis were used to test the associations. Results: Among 296 patients (83.1% female with a mean age of 56.6 years and a mean rheumatoid arthritis duration of 11.3 years, 13 reported having acute myocardial infarction requiring a percutaneous or surgical reperfusion procedure, a prevalence of 4.4% (95% CI 2.0-6.7. Diabetes Mellitus (odds ratio [OR] 4.9 [95% CI 1.6-13.8] and disease duration >10 years (OR 8.2 [95% CI 1.8-39.7] were the only factors associated with an ischemic disease that remained in the final model, after the multivariate analysis. Conclusion: The prevalence of acute myocardial infarction was similar to that observed in other studies. Among the traditional risk factors, Diabetes Mellitus, and among the factors related to rheumatoid arthritis, disease duration, were the variables associated with comorbidity.

  11. Prevalence of ischemic heart disease and associated factors in patients with rheumatoid arthritis in Southern Brazil.

    Science.gov (United States)

    Gomes, Rafael Kmiliauskis Santos; Albers, Ana Carolina; Salussoglia, Ana Isadora Pianowski; Bazzan, Ana Maria; Schreiner, Luana Cristina; Vieira, Mateus Oliveira; Silva, Patrícia Giovana da; Machado, Patrícia Helena; Silva, Cynthia Mara da; Mattos, Mauro Marcelo; Nobre, Moacyr Roberto Cuce

    To estimate the prevalence of ischemic heart disease and associated factors in patients with rheumatoid arthritis. A cross-sectional study using the American College of Rheumatology diagnostic criteria in order to select patients seen at primary or secondary health care units in Blumenau, Santa Catarina, Southern Brazil, in 2014. The presence of ischemic heart disease was defined as an acute myocardial infarction with percutaneous coronary intervention or coronary artery bypass graft surgery that has occurred after diagnosis. Fischer's exact test, Wald's linear trend test, and multivariate logistic regression analysis were used to test the associations. Among 296 patients (83.1% female) with a mean age of 56.6 years and a mean rheumatoid arthritis duration of 11.3 years, 13 reported having acute myocardial infarction requiring a percutaneous or surgical reperfusion procedure, a prevalence of 4.4% (95% CI 2.0-6.7). Diabetes Mellitus (odds ratio [OR] 4.9 [95% CI 1.6-13.8]) and disease duration >10 years (OR 8.2 [95% CI 1.8-39.7]) were the only factors associated with an ischemic disease that remained in the final model, after the multivariate analysis. The prevalence of acute myocardial infarction was similar to that observed in other studies. Among the traditional risk factors, Diabetes Mellitus, and among the factors related to rheumatoid arthritis, disease duration, were the variables associated with comorbidity. Copyright © 2017 Elsevier Editora Ltda. All rights reserved.

  12. Periodontal Disease as a Risk Factor for Rheumatoid Arthritis: A Systematic Review.

    Science.gov (United States)

    Kaur, Sushil; White, Sarahlouise; Bartold, Mark

    2012-01-01

    The objective of this systematic review is to identify and synthesise the best available evidence to examine whether periodontal disease is a risk factor for rheumatoid arthritis. Rheumatoid arthritis (RA) is a chronic inflammatory disease of unknown aetiology and has a complex multifactorial pathogenesis affecting joints and other tissues. The natural history of rheumatoid arthritis is poorly defined; its clinical course fluctuates and the prognosis unpredictable. Rheumatoid arthritis affects up to 1-3% of the population, with a 3:1 female preponderance disappearing in older age. There is also evidence of a genetic predisposition to the disease. Rheumatoid arthritis is characterised by progressive and irreversible damage of the synovial-lined joints causing loss of joint space, bone and function, leading to deformity. Extracellular matrix degradation is a hallmark of rheumatoid arthritis which is responsible for the typical destruction of cartilage, ligaments, tendons, and bone.Rheumatoid arthritis is characteristically a symmetric arthritis (symmetrical swelling of the joints). Articular and periarticular manifestations include joint swelling and tenderness to palpation, with morning stiffness and severe motion impairment in the involved joints. Extra-articular signs can involve pulmonary, cardiovascular, nervous, and reticuloendothelial systems. The clinical presentation of rheumatoid arthritis rheumatoid arthritis varies, but an insidious onset of pain with symmetric swelling of the small joints is the most frequent finding. Rheumatoid arthritis onset is acute or subacute in about 25% of patients. Early rheumatoid arthritis is characterised by symmetric polyarthritis involving the small joints of the hands and feet with no radiologic changes. Rheumatoid arthritis most frequently affects the metacarpophalangeal, proximal interphalangeal and wrist joints. Although any joint, including the cricoarytenoid joint, can be affected, the distal interphalangeal, the

  13. Double blind, randomized, placebo-controlled study of dexamethasone therapy for hematogenous septic arthritis in children.

    Science.gov (United States)

    Odio, Carla M; Ramirez, Tobias; Arias, Gloria; Abdelnour, Arturo; Hidalgo, Isabel; Herrera, Marco L; Bolaños, Willy; Alpízar, Jorge; Alvarez, Patricio

    2003-10-01

    Septic arthritis is associated with residual dysfunction in 10 to 25% of affected children. Concentrations of cytokines detected in synovial fluid of children with bacterial arthritis correlate with the severity of inflammation. Treatment with dexamethasone decreased cartilage degradation in experimental Haemophilus influenzae b and Staphylococcus aureus arthritis. To decrease the number of patients with residual dysfunction of the affected joint at the end of therapy and at 6 and 12 months and to speed clinical recovery by the administration of dexamethasone. In a double blind manner we randomly selected 123 children with suspected hematogenous bacterial arthritis to receive dexamethasone or saline for 4 days. Antibiotic therapy was tailored according to age and the recovered pathogen. Of the 123 children enrolled, 61 were assigned to the dexamethasone group and 62 to the placebo group. Only 50 and 50 patients in each group were evaluable. The 2 groups of patients were comparable with respect to age, sex, duration of symptoms, pathogen, affected joint and therapeutic and diagnostic procedures. Staphylococcus aureus accounted for 67% of the isolates, Haemophilus influenzae type b for 13% and Streptococcus pneumoniae for 9%. Dexamethasone therapy reduced residual dysfunction at the end of therapy, P = 0.000068; at 6 months, P = 0.00007; and at 12 months, P = 0.00053 of follow-up and shortened the duration of symptoms (P = 0.001) during the acute phase. The 26% incidence of residual dysfunction in the control patients was similar to the 25% found in other series. A short course of dexamethasone reduced residual joint dysfunction and shortened significantly the duration of symptoms in children with documented hematogenous septic arthritis. These results suggest that a 4-day course of low dose dexamethasone given early benefits children with hematogenous septic arthritis.

  14. Bone edema on magnetic resonance imaging is an independent predictor of rheumatoid arthritis development in patients with early undifferentiated arthritis

    DEFF Research Database (Denmark)

    Duer-Jensen, Anne; Hørslev-Petersen, Kim; Hetland, Merete Lund

    2011-01-01

    To study magnetic resonance imaging (MRI) as a tool for early diagnosis of rheumatoid arthritis (RA) in patients with early undifferentiated arthritis (UA).......To study magnetic resonance imaging (MRI) as a tool for early diagnosis of rheumatoid arthritis (RA) in patients with early undifferentiated arthritis (UA)....

  15. Therapeutical approach to rheumatoid arthritis

    OpenAIRE

    Paraskevi Gourni; Evaggelos Giavasopoulos

    2008-01-01

    Rheumatoid arthritis (RA) is a chronic disease characterized by inflammation of the synovial joints, and loss of the function leading to disability. The ultimate goal in managing RA is to prevent joint damage and to maintain functional ability. Although, οver the past decade, major advances have been made in our understanding of the factors that are crucial in regulating this disease, still the managment of the disease remains difficult.Aim : Τhe aim of the present study was the evaluation ...

  16. Shoulder arthography in rheumatoid arthritis

    International Nuclear Information System (INIS)

    Reinbold, W.D.; Hehne, H.J.; Rau, W.S.; Freiburg Univ.

    1983-01-01

    Shoulder arthrography in a patient with rheumatoid arthritis is performed to differentiate between a rheumatoid flare and limitation of motion secondary to tear in the rotator cuff. Accurate diagnosis is important because of the therapeutic implications. The arthrographic findings characteristic of rheumatoid involvement of the shoulder joint are nodular filling defects of the joint, the subacromial and subdeltoideal bursa in case of rotator cuff tear, irregular capsular attachment, contracted joint space and visualized lymphatic drainage. A dilatation of the biceps tendon sheath has not been shown. (orig.) [de

  17. Significance of bone marrow edema in pathogenesis of rheumatoid arthritis

    International Nuclear Information System (INIS)

    Sudoł-Szopińska, Iwona; Kontny, Ewa; Maśliński, Włodzimierz; Prochorec-Sobieszek, Monika; Warczyńska, Agnieszka; Kwiatkowska, Brygida

    2013-01-01

    Assessing the pathology of the synovium, its thickening and increased vascularity through ultrasound and magnetic resonance examinations (more often an ultrasound study alone) is still considered a sensitive parameter in the diagnosis of rheumatoid arthritis and in monitoring of treatment efficacy. Magnetic resonance studies showed that, aside from the joint pannus, the subchondral bone tissue constitutes an essential element in the development of rheumatoid arthritis. Bone marrow edema correlates with inflammation severity, joint destruction, clinical signs and symptoms of rheumatoid arthritis, and thus is considered a predictor of rapid radiological progression of the disease. The newest studies reveal that bone marrow edema may be a more sensitive indicator of the response to therapy than appearance of the synovium. Bone marrow edema presents with increased signal in T2-weighted images, being most visible in fat saturation or IR sequences (STIR, TIRM). On the other hand, it is hypointense and less evident in T1-weighted images. It becomes enhanced (hyperintense) after contrast administration. Histopathological studies confirmed that it is a result of bone inflammation (osteitis/osteomyelitis), i.e. replacememt of bone marrow fat by inflammatory infiltrates containing macrophages, T lymphocytes, B lymphocytes, plasma cells and osteoclasts. Bone marrow edema appears after a few weeks from occurrence of symptoms and therefore is considered an early marker of inflammation. It correlates with clinical assessment of disease activity and elevated markers of acute inflammatory phase, i.e. ESR and CRP. It is a reversible phenomenon and may become attenuated due to biological treatment. It is considered a “herald” of erosions, as the risk of their formation is 6-fold higher in sites where BME was previously noted

  18. Radiographic manifestations of arthritis in AIDS patients

    International Nuclear Information System (INIS)

    Rosenberg, Z.S.; Norman, A.; Solomon, G.

    1988-01-01

    The purpose of this study is to familiarize the radiologist with a newly discovered association between arthritis and acquired immunodeficiency syndrome (AIDS). The authors retrospectively reviewed the clinical and radiographic findings in 31 patients with human immunodeficiency virus (HIV) infection referred to their rheumatology clinic with musculoskeletal complaints. The patients carried a wide range of clinical diagnosis including Reiter syndrome, psoriatic arthritis, undifferentiated seronegative arthritis, isolated enthesopathies, rheumatoid arthritis and osteonecrosis. Radiographs were available in 24 of the 31 patients, and in 20 they showed radiographic features of arthritis, which included soft-tissue swelling periarticular osteoporosis, synovial effusions, sacroiliitis, periosteal reaction, joint space narrowing, marginal erosions, and osteonecrosis. Although the radiographic abnormalities were frequently mild, they were significant, given the short duration of disease in many of their patients (weeks to months) at the time radiographs were obtained. The range of radiographic findings in their series was varied and paralleled the wide range of clinical diagnoses. No findings were pathognomonic for HIV-associated arthritis. Nevertheless, HIV infection needs to be considered in any patient belonging to a recognized risk group who presents with musculoskeletal disease. This is particularly important since immunosupressive drugs used for the treatment of arthritis can be detrimental to patients with HIV infection

  19. Ankle arthritis predicts polyarticular disease course and unfavourable outcome in children with juvenile idiopathic arthritis

    DEFF Research Database (Denmark)

    Esbjörnsson, Anna-Clara; Aalto, Kristiina; Broström, Eva W

    2015-01-01

    OBJECTIVES: To evaluate the occurrence, clinical characteristics and prognostic factors associated with ankle arthritis in children with juvenile idiopathic arthritis (JIA). METHODS: 440 children with JIA were followed for eight years in a prospective Nordic population-based cohort study. Data...... on remission was available for 427 of these children. Occurrence of clinically assessed ankle arthritis was analysed in relation to JIA category, clinical characteristics and remission data eight years after disease onset. RESULTS: In 440 children with JIA, 251 (57%) experienced ankle arthritis during...... the first eight years of disease. Ankle arthritis was least common in the persistent oligoarticular category (25%) and most common in children with extended oligoarticular (83%) and polyarticular RF-negative (85%) JIA. Children who developed ankle arthritis during the first year of disease were younger...

  20. Thumb troubles in rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    G. Garofalo

    2011-09-01

    Full Text Available Thumb involvement may play a relevant role in inducing a severe functional impairment in rheumatoid arthritis. The aim of this sonographic vignette is to show the value of sonography in detailing anatomic changes involving the thumb during a phase of active synovitis. The patient was a 50-year old man who presented with a 3-year history of rheumatoid arthritis. He complained of a 4-week history of a marked recrudescence inflammatory thumb involvement associated with clinical signs of carpal tunnel syndrome. Sonographic images were obtained with a real-time ultrasound system equipped with a 13 MHz linear transducer. Sonographic examination on longitudinal dorsal scan of the metacarpophalangeal joint of the thumb showed a moderate joint cavity widening with two evident bone erosions, one at the metacarpal head and the other one at the basis of the proximal phalanx. The longitudinal volar scan of the first metacarpophalangeal joint confirmed the presence of synovitis detecting a marked joint cavity widening, with aspect of synovial proliferation. The flexor pollicis longus tendon was severely involved (marked tendon sheath widening, synovial proliferation, loss of the normal homogeneous fibrillar echotexture, and a large intratendinous tear. Sonography allowed the depiction of a wide range of otherwise undetectable pathologic changes in the standard clinical setting.

  1. [Reiter disease or reactive arthritis?].

    Science.gov (United States)

    Eppinger, S; Schmitt, J; Meurer, M

    2006-04-01

    There is an ongoing international discussion on whether the condition reactive arthritis should be named after a former Nazi functionary. The German dermatological community should participate in this debate. In 1916, Hans Reiter described a disease with the symptoms urethritis, conjunctivitis, and arthritis, which was later named after him. After becoming titular professor in May 1918, Reiter was appointed director of the regional public health department Mecklenburg-Schwerin in 1926. At the same time he taught social hygiene at the University of Rostock, where he was appointed full professor in 1928. In 1931, Hans Reiter became a member of the National Socialist German Workers Party (NSDAP). In July 1932 he was elected representative of the NSDAP to the seventh assembly of Mecklenburg-Schwerin. After becoming its acting director in July 1933, Reiter was appointed president of the Reich public health department in Berlin on October 1, 1933. Both his excellent professional qualifications, as well as his National Socialist attitudes, were considered key criteria for taking over this important position. As the president of the Reich public health department, Reiter was said to have known about the conduct of experiments with typhus-fever at the concentration camp Buchenwald in which 250 humans died. From the end of the Second World War until 1947, Reiter was imprisoned in the Nuremberg Prison for War Criminals, but never convicted of a crime.

  2. Complementary medicine in rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    F. Atzeni

    2011-09-01

    Full Text Available Use of complementary and alternative medicine (CAM for chronic conditions has increased in recent years. CAM is immensely popular for musculoskeletal conditions and patients suffering from rheumatoid arthritis (RA frequently try CAM. This review summarises the trial data for or against CAM as a symptomatic treatment for rheumatoid arthritis. Collectively the evidence demonstrates that some CAM modalities show significant promise, e.g. acupuncture, diets, herbal medicine, homoeopathy, massage, supplements. However, for the great majority of these therapies no evidencebased (clinical randomized trials results are available. CAM is usually used in addition to, and not as a substitute for conventional therapies. The motivation of patients to try CAM is complex; the willingness to take control of their healthcare, the desire to try everything available, the mass-media pressure and the erroneous notion that CAM is without risks. In fact, none of these treatments is totally devoid of risks. While the use of complementary and alternative modalities for the treatment of RA continues to increase, rigorous clinical trials examining their efficacy are needed before definitive recommendations regarding the application of these modalities can be made.

  3. Temporomandibular joint abnormalities in rheumatoid arthritis

    International Nuclear Information System (INIS)

    Larheim, T.A.; Tveito, L.; Dale, K.; Ruud, A.F.

    1981-01-01

    Transantral (infraorbital, transmaxillary) examination of the temporomandibular joint was compared with conventional transcranial examination and lateral tomography of patients with rheumatoid arthritis aged 23 to 83. Abnormalities were most frequently found at tomography, and equally frequent at transantral and transcranial examinations. The various examinations appeared to be rather supplementary. Bone erosion was frequently observed at transantral examination, which appeared to be the preferable radiographic method for detecting arthritis of this joint. Combined with transcranial examination, the method is recommended for the evaluation of temporomandibular joint abnormalities in rheumatoid arthritis if tomographic equipment is not available. (Auth.)

  4. Tumor Necrosis Factor-Alpha Targeting Can Protect against Arthritis with Low Sensitization to Infection

    Directory of Open Access Journals (Sweden)

    Nadia Belmellat

    2017-11-01

    Full Text Available Tumor necrosis factor-alpha (TNF-α blockade is an effective treatment for rheumatoid arthritis (RA and other inflammatory diseases, but in patients, it is associated with reduced resistance to the infectious agents Mycobacterium tuberculosis and Listeria monocytogenes, among others. Our goal was to model infection and arthritis in mice and to compare etanercept, a currently used anti-TNF-α inhibitor, to an anti-TNF-α vaccine. We developed a murine surrogate of the TNF-α kinoid and produced an anti-murine TNF-α vaccine (TNFKi composed of keyhole limpet hemocyanin conjugated to TNF-α, which resulted in anti-TNF-α antibody production in mice. We also used etanercept (a soluble receptor of TNF commonly used to treat RA as a control of TNF neutralization. In a mouse model of collagen-induced arthritis, TNFKi protected against inflammation similar to etanercept. In a mouse model of acute L. monocytogenes infection, all TNFKi-treated mice showed cleared bacterial infection and survived, whereas etanercept-treated mice showed large liver granulomas and quickly died. Moreover, TNFKi mice infected with the virulent H37Rv M. tuberculosis showed resistance to infection, in contrast with etanercept-treated mice or controls. Depending on the TNF-α blockade strategy, treating arthritis with a TNF-α inhibitor could result in a different profile of infection suceptibility. Our TNFKi vaccine allowed for a better remaining host defense than did etanercept.

  5. A novel de novo PSTPIP1 mutation in a boy with pyogenic arthritis, pyoderma gangrenosum, acne (PAPA) syndrome.

    Science.gov (United States)

    Fathalla, Basil M; Al-Wahadneh, Adel M; Al-Mutawa, Mariam; Kambouris, Marios; El-Shanti, Hatem

    2014-01-01

    Autoinflammatory disorders are a group of Mendelian disorders characterized by seemingly unprovoked inflammatory bouts without high-titer autoantibodies or antigen-specific T-cells and are probably due to defects in the innate immunity. We here report on a 4-year-old Arabic boy with the clinical presentation of an autoinflammatory disorder, namely Pyogenic Arthritis, Pyoderma Gangrenosum and Acne (PAPA) syndrome. The presentation includes abscess formation after immunization and recurrent mono-articular acute arthritis in various joints that responded favourably to systemic glucocorticosteroids, albeit without acne or pyoderma gangrenosum. The mutation analysis of the boy identified a novel de novo mutation in PSTPIP1, the gene responsible for PAPA syndrome. We recommend that the diagnosis of PAPA syndrome should be entertained in the differential diagnosis of patients with recurrent sterile pyogenic arthritis prior to the development of pyoderma gangrenosum or acne in order to initiate a timely management of the disorder.

  6. [Tropical pyomyositis simulating septic arthritis in AIDS patients. Two cases].

    Science.gov (United States)

    Abouzahir, A; Bouchama, R; Azennag, M; Garcin, J M

    2004-01-01

    Tropical pyomyositis (TP) is an acute bacterial infection of skeletal muscles characterized by rapid formation of abscesses. Since the beginning of the AIDS epidemic, interest in TP has increased because of its rising incidence in association with HIV infection and of the problems that it poses for differential diagnosis. Occurrence of TP is a criterion for classification of HIV infected patients in WHO disease stage III. The purpose of this report is to describe two HIV-infected patients who presented TP simulating septic arthritis of the hip and knee respectively. Medical imaging was particularly useful in establishing accurate topographic diagnosis and needle drainage in decreasing the duration of hospitalization and avoiding the need for surgical debridement. Needle puncture must be guided by ultrasound or scan imaging.

  7. Non-steroidal anti-inflammatory drugs for acute gout

    NARCIS (Netherlands)

    van Durme, Caroline M. P. G.; Wechalekar, Mihir D.; Buchbinder, Rachelle; Schlesinger, Naomi; van der Heijde, Désirée; Landewé, Robert B. M.

    2014-01-01

    Background Gout is an inflammatory arthritis that is characterised by the deposition of monosodium urate crystals in synovial fluid and other tissues. The natural history of articular gout is generally characterised by three periods: asymptomatic hyperuricaemia, episodes of acute gout and chronic

  8. Acute pericarditis: diagnosis and management.

    Science.gov (United States)

    Snyder, Matthew J; Bepko, Jennifer; White, Merima

    2014-04-01

    Acute pericarditis, inflammation of the pericardium, is found in approximately 5% of patients admitted to the emergency department for chest pain unrelated to acute myocardial infarction. It occurs most often in men 20 to 50 years of age. Acute pericarditis has a number of potential etiologies including infection, acute myocardial infarction, medication use, trauma to the thoracic cavity, and systemic diseases, such as rheumatoid arthritis. However, most etiologic evaluations are inconclusive. Patients with acute pericarditis commonly present with acute, sharp, retrosternal chest pain that is relieved by sitting or leaning forward. A pericardial friction rub is found in up to 85% of patients. Classic electrocardiographic changes include widespread concave upward ST-segment elevation without reciprocal T-wave inversions or Q waves. First-line treatment includes nonsteroidal anti-inflammatory drugs and colchicine. Glucocorticoids are traditionally reserved for severe or refractory cases, or in cases when the cause of pericarditis is likely connective tissue disease, autoreactivity, or uremia. Cardiology consultation is recommended for patients with severe disease, those with pericarditis refractory to empiric treatment, and those with unclear etiologies.

  9. Exercise Helps Ease Arthritis Pain and Stiffness

    Science.gov (United States)

    ... mowing the lawn, raking leaves and walking the dog count. Body awareness exercises, such as gentle forms ... www.uptodate.com/home. Accessed Nov. 16, 2015. Benefits of exercise for osteoarthritis. Arthritis Foundation. http://www. ...

  10. Role of Gut Microbiota in Rheumatoid Arthritis.

    Science.gov (United States)

    Maeda, Yuichi; Takeda, Kiyoshi

    2017-06-09

    Rheumatoid arthritis (RA) is a systemic autoimmune disease, caused by both genetic and environmental factors. Recently, investigators have focused on the gut microbiota, which is thought to be an environmental agent affecting the development of RA. Here we review the evidence from animal and human studies that supports the role of the gut microbiota in RA. We and others have demonstrated that the abundance of Prevotella copri is increased in some early RA. We have also used gnotobiotic experiments to show that dysbiosis in RA patients contributed to the development of Th17 cell-dependent arthritis in intestinal microbiota-humanized SKG mice. On the other hand, Prevotella histicola from human gut microbiota suppressed the development of arthritis. In summary, Prevotella species are involved in the pathogenesis of arthritis.

  11. Role of Gut Microbiota in Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    Yuichi Maeda

    2017-06-01

    Full Text Available Rheumatoid arthritis (RA is a systemic autoimmune disease, caused by both genetic and environmental factors. Recently, investigators have focused on the gut microbiota, which is thought to be an environmental agent affecting the development of RA. Here we review the evidence from animal and human studies that supports the role of the gut microbiota in RA. We and others have demonstrated that the abundance of Prevotella copri is increased in some early RA. We have also used gnotobiotic experiments to show that dysbiosis in RA patients contributed to the development of Th17 cell-dependent arthritis in intestinal microbiota-humanized SKG mice. On the other hand, Prevotella histicola from human gut microbiota suppressed the development of arthritis. In summary, Prevotella species are involved in the pathogenesis of arthritis.

  12. Rheumatoid Arthritis | Ally | South African Family Practice

    African Journals Online (AJOL)

    Immune-mediated inflammatory disorders include a clinically diverse group of conditions sharing similar pathogenic mechanisms. Conditions such as rheumatoid arthritis, psoriasis, spondyloarthropathy, inflammatory bowel disease and connective tissue diseases are characterised by immune dysregulation and chronic ...

  13. Marine oil supplements for arthritis pain

    DEFF Research Database (Denmark)

    Senftleber, Ninna K.; Nielsen, Sabrina M.; Andersen, Jens Rikardt

    2017-01-01

    Arthritis patients often take fish oil supplements to alleviate symptoms, but limited evidence exists regarding their efficacy. The objective was to evaluate whether marine oil supplements reduce pain and/or improve other clinical outcomes in patients with arthritis. Six databases were searched......-regression analysis. Grading of Recommendations Assessment, Development and Evaluation (GRADE) was used to rate the overall quality of the evidence. Forty-two trials were included; 30 trials reported complete data on pain. The standardized mean difference (SMD) suggested a favorable effect (-0.24; 95% confidence.......57–0.24). The evidence for using marine oil to alleviate pain in arthritis patients was overall of low quality, but of moderate quality in rheumatoid arthritis patients....

  14. Atlantooccipital septic arthritis complicating recurrent otitis media.

    Science.gov (United States)

    Asher, Zoe; Cranswick, Noel; Rao, Padma; Steer, Andrew C

    2013-01-01

    Otitis media is known to have a number of complications. We present the first reported case of atlantooccipital septic arthritis as a complication of Streptococcus pneumoniae otitis media in an 8-month-old boy.

  15. Septic arthritis: immunopathogenesis, experimental models and therapy

    Science.gov (United States)

    2014-01-01

    Septic arthritis is an inflammatory disease of the joints that is started by an infection whose most common agent is Staphylococcus aureus. In this review we discuss some of the most arthritogenic bacterial factors and the contribution of innate and specific immune mechanisms to joint destruction. Special emphasis is given to the induction of experimental arthritis by S. aureus in mice. The improvement of therapy by association of antibiotics with down-modulation of immunity is also included. PMID:24822058

  16. Asymptomatic atlantoaxial subluxation in rheumatoid arthritis.

    OpenAIRE

    Mohammadali Nazarinia; Reza Jalli; Eskandar Kamali Sarvestani; Siamak Farahangiz; Maryam Ataollahi

    2014-01-01

    This cross-sectional study is conducted to determine the prevalence of asymptomatic cervical spine subluxation in rheumatoid arthritis patients by plain radiographs and its relation to demographic and clinical characteristics, disease activity measures and medications. 100 rheumatoid arthritis patients (18 male and 82 female) were selected randomly, according to the American college of Rheumatology Criteria, who were under follow up in the rheumatology clinic. A complete history was taken, an...

  17. [Cartilage degradation in rheumatoid arthritis].

    Science.gov (United States)

    Ishiguro, Naoki

    2009-03-01

    Rheumatoid arthritis (RA) is a polyarticular joint disease. The inflammatory process is characterized by infiltration of inflammatory cells into the joints, leading to proliferation of synoviocytes and destruction of cartilage and bone. The Matrix metalloproteinases (MMPs) are a family of zinc-dependent proteinases. It had been well recognized that MMP play major roles in the cartilage breakdown in RA and OA. Moreover ADAM-TS-1, -4, -5 have aggrecanase activity, and also involve the cartilage degradation in RA and OA. Of course they contribute the cartilage homeostasis in healthy subjects. Failure to regulate the synthesis, activation and inhibition of the proteinases finally leads to cartilage destruction. Aggrecan and type II collagen are major components in cartilage matrix. Cleavage of aggrecan by aggrecanase and that of collagen by collagenase are critical steps for degradation of articular cartilage in RA. To prevent the cartilage damage, inflammatory synovitis should be suppressed in early stage.

  18. [New therapies for rheumatoid arthritis].

    Science.gov (United States)

    Salgado, Eva; Maneiro, José Ramón

    2014-11-18

    Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease characterized by inflammation of the synovial membrane and progressive destruction of the articular cartilage and bone. Advances in the knowledge of disease pathogenesis allowed the identification of novel therapeutic targets such as tumor necrosis factor (TNF), interleukin (IL)-1, IL-6 or the system JAK/STAT phosphorylation. At present there are 5 TNF antagonists approved for RA. Tocilizumab blocks the pathway of IL-6 and is the only biological with proven efficacy in monotherapy. Rituximab modulates B cell response in RA. Abatacept provided new data on T cell involvement in the pathogenesis of RA. Tofacitinib is the first kinase inhibitor approved for this disease. Biologic drugs have proven efficacy, almost always in combination with methotrexate, and even halt radiographic progression. Monitoring infection is the main precaution in handling these patients. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

  19. Temporomandibular joint in rheumatoid arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Syrjaenen, S.M.

    The temporomandibular joint (TMJ) was investigated clinically and by orthopantomography in 110 patients with rheumatoid arthritis (RA) and in 73 control subjects. Clinical symptoms in the TMJ were established in 34% of the RA patients and in 18% of the controls. Radiographic abnormalities were found in 60% of the RA patients compared with 15% in the controls. No single radiographic abnormality was characteristic of joint involvement by RA. The most common radiologic features in RA patients were changes in the morphology of the condylar head and articular eminentia, marginal irregularities, reduced mobility, and an anterior position of the condylar head. No abnormalities were encountered in the early stage of the disease, which at least in part could be attributed to the inherent limitations of orthopantomography. The incidence of joint lesions increased with duration of the RA. (orig.).

  20. Rheumatoid arthritis affecting temporomandibular joint

    Directory of Open Access Journals (Sweden)

    Amandeep Sodhi

    2015-01-01

    Full Text Available Rheumatoid arthritis (RA is a chronic, systemic, autoimmune inflammatory disorder that is characterized by joint inflammation, erosive properties and symmetric multiple joint involvement. Temporomandibular joint (TMJ is very rare to be affected in the early phase of the disease, thus posing diagnostic challenges for the dentist. Conventional radiographs fail to show the early lesions due to its limitations. More recently cone-beam computed tomography (CBCT has been found to diagnose the early degenerative changes of TMJ and hence aid in the diagnosis of the lesions more accurately. Our case highlights the involvement of TMJ in RA and the role of advanced imaging (CBCT in diagnosing the bony changes in the early phase of the disease.

  1. Link between rheumatoid arthritis and chronic periodontitis

    Directory of Open Access Journals (Sweden)

    Tomasz Kaczyński

    2018-03-01

    Full Text Available Chronic periodontitis is an infectious disease associated with the progressive destruction of periodontal tissues. In recent years, more and more data indicate an existing relationship between periodontal disease and rheumatoid arthritis. The link between both diseases has been confirmed in multiple studies. Despite the fact that this association might be based on shared environmental and genetic risk factors, a possible causal relation was advocated by experimental, epidemiological and interventional studies, with the leading role of Porphyromonas gingivalis. Individuals with chronic periodontitis are at an increased risk of developing rheumatoid arthritis, as well as rheumatoid arthritis patients are at an increased risk of chronic periodontitis and more severe forms of periodontitis. Furthermore, there is a correlation between the activity in both diseases – patients with more severe periodontitis suffer from more active rheumatoid arthritis. Intervention attempts were also performed, which demonstrated that eliminating periodontal infection and inflammation can affect the severity of rheumatoid arthritis. In this paper, we review the current knowledge about the link between both diseases, focusing on its clinical implications. Will periodontal treatment become a part of standard therapy for rheumatoid arthritis?

  2. Burden of childhood-onset arthritis

    Directory of Open Access Journals (Sweden)

    Hassett Afton L

    2010-07-01

    Full Text Available Abstract Juvenile arthritis comprises a variety of chronic inflammatory diseases causing erosive arthritis in children, often progressing to disability. These children experience functional impairment due to joint and back pain, heel pain, swelling of joints and morning stiffness, contractures, pain, and anterior uveitis leading to blindness. As children who have juvenile arthritis reach adulthood, they face possible continuing disease activity, medication-associated morbidity, and life-long disability and risk for emotional and social dysfunction. In this article we will review the burden of juvenile arthritis for the patient and society and focus on the following areas: patient disability; visual outcome; other medical complications; physical activity; impact on HRQOL; emotional impact; pain and coping; ambulatory visits, hospitalizations and mortality; economic impact; burden on caregivers; transition issues; educational occupational outcomes, and sexuality. The extent of impact on the various aspects of the patients', families' and society's functioning is clear from the existing literature. Juvenile arthritis imposes a significant burden on different spheres of the patients', caregivers' and family's life. In addition, it imposes a societal burden of significant health care costs and utilization. Juvenile arthritis affects health-related quality of life, physical function and visual outcome of children and impacts functioning in school and home. Effective, well-designed and appropriately tailored interventions are required to improve transitioning to adult care, encourage future vocation/occupation, enhance school function and minimize burden on costs.

  3. Plasma osteopontin in acute liver failure

    DEFF Research Database (Denmark)

    Srungaram, Praveen; Rule, Jody A; Yuan, He Jun

    2015-01-01

    BACKGROUND: Osteopontin (OPN) is a novel phosphoglycoprotein expressed in Kupffer cells that plays a pivotal role in activating natural killer cells, neutrophils and macrophages. Measuring plasma OPN levels in patients with acute liver failure (ALF) might provide insights into OPN function...... in the setting of massive hepatocyte injury. METHODS: OPN levels were measured using a Quantikine® ELISA assay on plasma from 105 consecutive ALF patients enrolled by the US Acute Liver Failure Study Group, as well as controls including 40 with rheumatoid arthritis (RA) and 35 healthy subjects both before, and 1...

  4. Why golimumab in the treatment of psoriatic arthritis, ankylosing spondylitis and rheumatoid arthritis?

    Directory of Open Access Journals (Sweden)

    M. Rossini

    2015-03-01

    Full Text Available Golimumab is an anti-TNF monoclonal antibody administred subcutaneously once a month and produced with an innovative technology that minimizes immunogenicity. This paper reviews and updates the main studies on the efficacy, safety and pharmacoeconomic aspects of treatment with golimumab of psoriatic arthritis, ankylosing spondylitis and rheumatoid arthritis.

  5. Comprehensive assessment of rheumatoid arthritis susceptibility loci in a large psoriatic arthritis cohort.

    LENUS (Irish Health Repository)

    Bowes, John

    2012-08-01

    A number of rheumatoid arthritis (RA) susceptibility genes have been identified in recent years. Given the overlap in phenotypic expression of synovial joint inflammation between RA and psoriatic arthritis (PsA), the authors explored whether RA susceptibility genes are also associated with PsA.

  6. Late hemorrhagic pseudoseptic arthritis encountered during total knee arthroplasty due to hyaluronic acid viscosupplementation

    Directory of Open Access Journals (Sweden)

    Jeremy M. Korsh, MD

    2016-12-01

    Full Text Available Osteoarthritis (OA is the most common form of arthritis and affects approximately one-third of people in the United Sates aged 65 years and older. Since 2013, the American Academy of Orthopaedic Surgeons has not been able to recommended using hyaluronic acid for patients with symptomatic OA of the knee. Subsequent publications have also cautioned against the use of viscosupplementation based on lack of efficacy and the potential for harm. We present a case of late hemorrhagic pseudoseptic arthritis encountered during TKA due to hyaluronic acid viscosupplementation. Our triad of findings includes (1 acute and chronic inflammatory cells on frozen section, (2 synovitis with hemosiderin deposition, and (3 blackened cartilage with iron deposition on permanent histopathology. Our case is unique in that it shows a previously undescribed late complication of viscosupplementation.

  7. Acute Bronchitis

    Science.gov (United States)

    ... Table of Contents1. Overview2. Symptoms3. Diagnosis4. Prevention5. Treatment6. Everyday Life7. Questions8. Resources What is acute bronchitis? Acute ... heartburn, you can get acute bronchitis when stomach acid gets into the bronchial tree. How is acute ...

  8. 166Ho-HA evaluation as therapeutic agent for rheumatoid arthritis treatment

    International Nuclear Information System (INIS)

    Chandia, M.C.; Errazu, X.C.; Pinto, L.N.; Godoy, N.O.; Avila, M.J.; Mendoza, P.; Mendoza, J.; Jofre, J.; Sirraalta, P.

    2002-01-01

    Aim: Rheumatoid arthritis is a limiting disease having, among its pathological features, the inflammation of synovial tissue with progressive and later destruction of the articulation. This leads to joint deformation and loss of its function, generating pain and reducing the mobility of the affected articulation. The aim was to evaluate 166 Ho-Hydroxyapatite ( 166 Ho-HA) as potential radiopharmaceutical for the symptomatic treatment of chronic and acute arthritis. Materials and Methods: Holmiun-166 was produced by irradiation of Ho 2 O 3 at La Reina Research Reactor, Nuclear Chilean Energy Commission. Hydroxyapatite was in-house synthesized. Its labelling and quality controls follows the internationally accepted procedures. An antigen's arthritis was induced to eight New Zealand rabbits with the 166 Ho-HA radiochemical being administered thereafter in two dosage modalities (single and double). The compound therapeutic efficiency was evaluated based upon clinical improvement and images from the inflamated articulation using 67 Ga citrate before and after 166 Ho-HA injection. Results: The radiochemical purity of the inoculated compound was greater than 98% as measured under sterility conditions. Clinically, an inflammation reduction (2 cm), appetite improvement and general well being was observed. The 166 Ho-HA distribution and localization was monitored using gamma camera images taken at 4 and 24 h. There was no evidence of extra articular leakage. From the 67 Ga citrate imaging, the acute group shows an overall improvement of well being corresponding to a lesser uptake at the inflamated articulation, regarding to the chronic group. The 166 Ho-HA double doses, compared to the single doses, suggest a reduced uptake of 67 Ga citrate at the inflamated tissue, meaning an increased therapeutic effect. Conclusions: 166 Ho-HA is useful as therapeutic agent for the symptomatic treatment of rheumatoid arthritis as shown by imaging and clinical examination

  9. Septic arthritis in the central part of Denmark

    DEFF Research Database (Denmark)

    Asmussen Andreasen, Rikke; Andersen, Nanna Skaarup; Just, Søren Andreas

    Septic arthritis in the central part of Denmark, Annals of the Rheumatic Diseases, volume 73, supplement 2, p. 287......Septic arthritis in the central part of Denmark, Annals of the Rheumatic Diseases, volume 73, supplement 2, p. 287...

  10. Aiming for a simpler early arthritis MRI protocol

    DEFF Research Database (Denmark)

    Stomp, Wouter; Krabben, Annemarie; van der Heijde, Désirée

    2015-01-01

    PURPOSE: To evaluate whether intravenous gadolinium (Gd) contrast administration can be eliminated when evaluating synovitis and tenosynovitis in early arthritis patients, thereby decreasing imaging time, cost, and invasiveness. MATERIALS AND METHODS: Wrist MRIs of 93 early arthritis patients wer...

  11. What Are Osteoporosis and Arthritis and How Are They Different?

    Science.gov (United States)

    ... Are Osteoporosis and Arthritis and How Are They Different? Fast Facts: An Easy-to-Read Series of ... swelling, and stiffness. How Are Osteoporosis and Arthritis Different? Osteoporosis and osteoarthritis are sometimes confused because their ...

  12. Psoriatic arthritis mutilans (PAM) in the Nordic countries

    DEFF Research Database (Denmark)

    Gudbjornsson, B; Ejstrup, L; Gran, J T

    2013-01-01

    To determine the prevalence and clinical characteristics of psoriatic arthritis mutilans (PAM) in the Nordic countries.......To determine the prevalence and clinical characteristics of psoriatic arthritis mutilans (PAM) in the Nordic countries....

  13. Elevated rheumatoid factor and long term risk of rheumatoid arthritis

    DEFF Research Database (Denmark)

    Nielsen, Sune F; Bojesen, Stig E; Schnohr, Peter

    2012-01-01

    To test whether elevated concentration of rheumatoid factor is associated with long term development of rheumatoid arthritis.......To test whether elevated concentration of rheumatoid factor is associated with long term development of rheumatoid arthritis....

  14. Risk of atrial fibrillation and stroke in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Lindhardsen, Jesper; Ahlehoff, Ole; Gislason, Gunnar Hilmar

    2012-01-01

    To determine if patients with rheumatoid arthritis have increased risk of atrial fibrillation and stroke.......To determine if patients with rheumatoid arthritis have increased risk of atrial fibrillation and stroke....

  15. Rheumatoid Arthritis Pain: Tips for Protecting Your Joints

    Science.gov (United States)

    Rheumatoid arthritis pain: Tips for protecting your joints Use these joint protection techniques to help you stay in control of your rheumatoid arthritis pain. By Mayo Clinic Staff Joint protection is ...

  16. Rheumatoid Arthritis Diet: Can Certain Foods Reduce Symptoms?

    Science.gov (United States)

    ... saturated fats, sodium and processed foods might help reduce symptoms associated with rheumatoid arthritis. But the research ... often results in weight loss, which can independently reduce stress on joints and improve arthritis symptoms. Some ...

  17. Degenerative Changes in the Spine: Is This Arthritis?

    Science.gov (United States)

    ... in my spine. Does this mean I have arthritis? Answers from April Chang-Miller, M.D. Yes. ... spine. Osteoarthritis is the most common form of arthritis. Doctors may also refer to it as degenerative ...

  18. Cytokine profiles in peripheral blood and whole blood cell cultures associated with aggressive periodontitis, juvenile idiopathic arthritis, and rheumatoid arthritis

    DEFF Research Database (Denmark)

    Poulsen, Anne Havemose; Sørensen, Lars Korsbaek; Stoltze, Kaj

    2005-01-01

    Cytokines play a key role in the pathogenesis of inflammatory diseases. An obvious question is whether patients with aggressive periodontitis, juvenile idiopathic arthritis, or rheumatoid arthritis share blood cytokine profiles distinguishing them from individuals free of disease....

  19. Managing Arthritis (A Minute of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2017-10-19

    Arthritis is a common chronic condition among Americans. Early diagnosis and management of arthritis is critical for maintaining quality of life. This podcast discusses importance of early diagnosis and management of arthritis.  Created: 10/19/2017 by MMWR.   Date Released: 10/19/2017.

  20. Cardio-pulmonary manifestations of rheumatoid arthritis among ...

    African Journals Online (AJOL)

    Background: Rheumatoid arthritis is a chronic systemic inflammatory disease, characterized by polyarthritis and extraarticular manifestations. The cardiopulmonary manifestations of rheumatoid arthritis were studied retrospectively in a cohort of rheumatoid arthritis patients. Methods: This was a retrospective study of all ...

  1. Arthritis mutilans due to chronic tophaceous gout | Akintayo | African ...

    African Journals Online (AJOL)

    Background: Arthritis mutilans is a form of destructive arthritis which is often characterized with severe osteolysis. It is more commonly described in association with the most severe forms of psoriatic and rheumatoid arthritis. Case presentation: A 69-year old man presented with a fifteen-year history of recurrent inflammatory ...

  2. Pleural and pulmonary alterations caused by rheumatoid arthritis

    International Nuclear Information System (INIS)

    Bankier, A.A.; Fleischmann, D.; Kiener, H.P.; Wiesmayr, M.N.; Herold, C.J.

    1996-01-01

    Pulmonary complications caused by rheumatoid arthritis are a clinically relevant aspect of this chronic arthropathy. This article reviews pulmonary abnormalities induced by rheumatoid arthritis and their clinical and radiological findings. In addition, the role of different imaging modalities in the diagnostic work-up of pulmonary complications caused by rheumatoid arthritis is discussed. (orig./MG) [de

  3. Exercise therapy in juvenile idiopathic arthritis: a Cochrane Review

    NARCIS (Netherlands)

    Takken, T.; van Brussel, M.; Engelbert, R. H. H.; van der Net, J.; Kuis, W.; Helders, P. J. M.

    2008-01-01

    Exercise therapy is considered an important component of the treatment of arthritis. The efficacy of exercise therapy has been reviewed in adults with rheumatoid arthritis but not in children with juvenile idiopathic arthritis (JIA). To assess the effects of exercise therapy on functional ability,

  4. 76 FR 29767 - Arthritis Advisory Committee; Notice of Meeting

    Science.gov (United States)

    2011-05-23

    ... HUMAN SERVICES Food and Drug Administration Arthritis Advisory Committee; Notice of Meeting AGENCY: Food... of Committee: Arthritis Advisory Committee. General Function of the Committee: To provide advice and... arthritis attacks. ILARIS has also been shown to extend the time to the next attack and reduce the frequency...

  5. 77 FR 14529 - Arthritis Advisory Committee; Notice of Meeting

    Science.gov (United States)

    2012-03-12

    ... HUMAN SERVICES Food and Drug Administration Arthritis Advisory Committee; Notice of Meeting AGENCY: Food... of Committee: Arthritis Advisory Committee. General Function of the Committee: To provide advice and... moderately to severely active rheumatoid arthritis who have had an inadequate response to one or more disease...

  6. 78 FR 32403 - Arthritis Advisory Committee; Notice of Meeting

    Science.gov (United States)

    2013-05-30

    ... HUMAN SERVICES Food and Drug Administration Arthritis Advisory Committee; Notice of Meeting AGENCY: Food... of Committee: Arthritis Advisory Committee. General Function of the Committee: To provide advice and... meeting. Agenda: On July 22, 2013, the committee will discuss the Assessment of SpondyloArthritis...

  7. Management of Children with Juvenile Idiopathic Arthritis.

    Science.gov (United States)

    Viswanathan, Vijay; Murray, Kevin J

    2016-01-01

    Juvenile idiopathic arthritis (JIA) comprises a group of heterogeneous disorders of chronic arthritis in childhood and remains the commonest pediatric rheumatic disease associated with significant long-term morbidity. Advances in understanding of the pathogenesis, better definition of disease control/remission measures, and the arrival of biological agents have improved the outcomes remarkably. Methotrexate (Mtx) remains the first-line disease modifying (DMARD) therapy for most children with JIA due to its proven efficacy and safety. Sulphosalazine (SSz) (especially for enthesitis) and leflunomide may also have a secondary role. Tumor necrosis factor inhibitors (TNF-I), alone or in combination with Mtx have shown tremendous benefit in children with polyarticular JIA, enthesitis related arthritis (ERA) and psoriatic arthritis. Tocilizumab appears very efficacious in systemic arthritis and abatacept and tocilizumab also appear to benefit polyarticular JIA; the role of rituximab remains unclear, though clearly beneficial in adult RA. TNF-I with Mtx is also effective in uveitis associated with JIA. Biologicals have demonstrated an impressive safety record in children with JIA, although close monitoring for rare but potentially dangerous adverse events, such as tuberculosis and other infections; paradoxical development of additional autoimmune diseases; and possibly an increased risk of cancers is warranted.

  8. Pemetrexed ameliorates experimental arthritis in rats.

    Science.gov (United States)

    Karatas, Ahmet; Koca, Suleyman Serdar; Ozgen, Metin; Dagli, Adile Ferda; Erman, Fazilet; Sahin, Nuran; Sahin, Kazim; Isik, Ahmet

    2015-02-01

    Pemetrexed (PMTX) is an anti-folate drug as methotrexate. The purpose of this study was to assess the efficacy of PMTX on collagen-induced arthritis (CIA). Forty Wistar albino rats were randomized into four groups. Arthritis was induced by intradermal injection of chicken type II collagen combined with incomplete Freund's adjuvant. Animals were sacrificed at the 15th day after the onset of arthritis. Tumor necrosis factor alpha (TNF-α), interleukin (IL)-17, and malondialdehyde (MDA) levels were increased, and superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) activities and the expressions of nuclear factor erythroid 2-related factor 2 (Nrf2) and heme oxygenase-1 (HO-1) were decreased in the arthritis group. In the PMTX-treated (0.2 and 1 mg/kg/week i.p.) groups, the levels of TNF-α, IL-17, and MDA were decreased; the activities of SOD, CAT, and GPx and the expressions of Nrf2 and HO-1 were restored, and perisynovial inflammation and cartilage-bone destruction were decreased. PMTX has anti-arthritic potential in the CIA model and may be a therapeutic agent for rheumatoid arthritis.

  9. INFLIXIMAB IN TREATMENT OF REFRACTORY JUVENILE ARTHRITIS

    Directory of Open Access Journals (Sweden)

    I.P. Nikishina

    2010-01-01

    Full Text Available Inclusion to the clinical practice of genetically engineered biological medications opens new opportunities in treatment of juvenile arthritis. The article summarizes an experience of treatment of juvenile arthritis with infliximab in children’s department of Scientific Center of Rheumatology, Russian Academy of Medical Sciences. The analysis included 55 patients (16 children had systemic type, 23 — polyarticular type of juvenile arthritis, and 16 patients had juvenile spondylarthritis, treated with infliximab in 2002–2009 years. Infliximab was administrated in patients with high activity of the disease refractory to the modern basic therapy. Patients received intravenous infliximab 3–5 mg/kg daily according to the standard scheme (on 0, 2, 6 weeks and further every 8 weeks. Therapy with this drug was estimated as effective (improvement on 30% and more according ACRpedi in 80% of patients: 16% achieved ACR30, 29% — ACR50, 26% — ACR70, and 9% — ACR90. Unfavorable effects (infusion reactions were detected in 16% of cases. Infections, including one case of disseminated tuberculosis, developed in 20% of patients. Thus, treatment with infliximab is effective and has good «risk–benefit» ratio in treatment of patients with refractory juvenile arthritis. Key words: children, juvenile arthritis, infliximab, treatment.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2010;9(1:142-149

  10. Cardiovascular risk in rheumatoid arthritis.

    Science.gov (United States)

    Soubrier, Martin; Barber Chamoux, Nicolas; Tatar, Zuzana; Couderc, Marion; Dubost, Jean-Jacques; Mathieu, Sylvain

    2014-07-01

    The objectives of this review are to discuss data on the cardiovascular risk increase associated with rheumatoid arthritis (RA), the effects of RA treatments on the cardiovascular risk level, and the management of cardiovascular risk factors in patients with RA. Overall, the risk of cardiovascular disease is increased 2-fold in RA patients compared to the general population, due to the combined effects of RA and conventional risk factors. There is some evidence that the cardiovascular risk increase associated with nonsteroidal anti-inflammatory drug therapy may be smaller in RA patients than in the general population. Glucocorticoid therapy increases the cardiovascular risk in proportion to both the current dose and the cumulative dose. Methotrexate and TNFα antagonists diminish cardiovascular morbidity and mortality rates. The management of dyslipidemia remains suboptimal. Risk equations may perform poorly in RA patients even when corrected using the multiplication factors suggested by the EUropean League Against Rheumatism (EULAR) (multiply the score by 1.5 when two of the following three criteria are met: disease duration longer than 10 years, presence of rheumatoid factor or anti-cyclic citrullinated peptide (CCP) antibodies, and extraarticular manifestations). Doppler ultrasonography of the carotid arteries in patients at moderate cardiovascular risk may allow a more aggressive approach to dyslipidemia management via reclassification into the high-risk category of patients with an intima-media thickness greater than 0.9 mm or atheroma plaque. Copyright © 2014. Published by Elsevier SAS.

  11. Rheumatoid arthritis and sleep quality.

    Science.gov (United States)

    Goes, Ana Claudia Janiszewski; Reis, Larissa Aparecida Busatto; Silva, Marilia Barreto G; Kahlow, Barbara Stadler; Skare, Thelma L

    Sleep disturbances are common in rheumatoid arthritis (RA) patients and contribute to loss of life quality. To study associations of sleep quality with pain, depression and disease activity in RA. This is a transversal observational study of 112 RA patients submitted to measurement of DAS-28, Epworth scale for daily sleepiness, index of sleep quality by Pittsburg index, risk of sleep apnea by the Berlin questionnaire and degree of depression by the CES-D (Center for Epidemiologic Studies Depression scale) questionnaire. We also collected epidemiological, clinical, serological and treatment data. Only 18.5% of RA patients had sleep of good quality. In univariate analysis a bad sleep measured by Pittsburg index was associated with daily doses of prednisone (p=0.03), DAS-28 (p=0.01), CES-D (p=0.0005) and showed a tendency to be associated with Berlin sleep apnea questionnaire (p=0.06). In multivariate analysis only depression (p=0.008) and Berlin sleep apnea questionnaire (p=0.004) kept this association. Most of RA patients do not have a good sleep quality. Depression and risk of sleep apnea are independently associated with sleep impairment. Copyright © 2016 Elsevier Editora Ltda. All rights reserved.

  12. Acute Pancreatitis and Pregnancy

    Science.gov (United States)

    ... Information Acute Pancreatitis Acute Pancreatitis and Pregnancy Acute Pancreatitis and Pregnancy Timothy Gardner, MD Acute pancreatitis is ... of acute pancreatitis in pregnancy. Reasons for Acute Pancreatitis and Pregnancy While acute pancreatitis is responsible for ...

  13. Interleukin-21 receptor deficiency increases the initial toll-like receptor 2 response but protects against joint pathology by reducing Th1 and Th17 cells during streptococcal cell wall arthritis.

    Science.gov (United States)

    Marijnissen, Renoud J; Roeleveld, Debbie M; Young, Deborah; Nickerson-Nutter, Cheryl; Abdollahi-Roodsaz, Shahla; Garcia de Aquino, Sabrina; van de Loo, Fons A J; van Spriel, Annemiek B; Boots, Annemieke M H; van den Berg, Wim B; Koenders, Marije I

    2014-04-01

    The cytokine interleukin-21 (IL-21) can have both proinflammatory and immunosuppressive effects. The purpose of this study was to investigate the potential dual role of IL-21 in experimental arthritis in relation to Th17 cells. Antigen-induced arthritis (AIA) and chronic streptococcal cell wall (SCW) arthritis were induced in IL-21 receptor-deficient (IL-21R(-/-) ) and wild-type mice. Knee joints, synovial tissue, and serum were analyzed for arthritis pathology and inflammatory markers. During AIA and chronic SCW arthritis, IL-21R deficiency protected against severe inflammation and joint destruction. This was accompanied by suppressed serum IgG1 levels and antigen-specific T cell responses. Levels of IL-17 were reduced during AIA, and synovial lymphocytes isolated during SCW arthritis for flow cytometry demonstrated that mainly IL-17+ interferon-γ (IFNγ)-positive T cells were reduced in IL-21R(-/-) mice. However, during the acute phases of SCW arthritis, significantly higher joint swelling scores were observed, consistent with enhanced tumor necrosis factor and IL-6 expression. Interestingly, IL-21R(-/-) mice were significantly less capable of up-regulating suppressor of cytokine signaling 1 (SOCS-1) and SOCS-3 messenger RNA. IL-21 stimulation also affected the Toll-like receptor 2 (TLR-2)/caspase recruitment domain 15 response to SCW fragments in vitro, indicating that impaired SOCS regulation in the absence of IL-21 signaling might contribute to the increased local activation during SCW arthritis. In contrast to the proinflammatory role of IL-21 in adaptive immunity, which drives IL-17+IFN+ cells and joint pathology during chronic experimental arthritis, IL-21 also has an important immunosuppressive role, presumably by inhibiting TLR signaling via SOCS-1 and SOCS-3. If this dual role of IL-21 in various immune processes is present in human disease, it could make IL-21 a difficult therapeutic target in rheumatoid arthritis. Copyright © 2014 by the American

  14. Fatigue - an underestimated symptom in psoriatic arthritis.

    Science.gov (United States)

    Krajewska-Włodarczyk, Magdalena; Owczarczyk-Saczonek, Agnieszka; Placek, Waldemar

    2017-01-01

    The nature of fatigue is very complex and involves physiological, psychological and social phenomena at the same time, and the mechanisms leading to occurrence and severity of fatigue are still poorly understood. The condition of chronic inflammation associated with psoriatic arthritis can be regarded as a potential factor affecting development of fatigue. Only a few studies so far have focused on the occurrence of fatigue in psoriatic arthritis. The problem of chronic fatigue is underestimated in everyday clinical practice. Identification and analysis of subjective fatigue components in each patient can provide an objective basis for optimal fatigue treatment in daily practice. This review presents a definition of chronic fatigue and describes mechanisms that may be associated with development of fatigue, highlighting the role of chronic inflammation, selected fatigue measurement methods and relations of fatigue occurrence with clinical aspects of psoriatic arthritis.

  15. Radiosynovectomy in the Therapeutic Management of Arthritis

    International Nuclear Information System (INIS)

    Knut, Liepe

    2015-01-01

    Radiosynovectomy is a well-established therapy in arthritis and involves an intra-articular injection of small radioactive particles to treat a synovitis. In Europe, frequent indications are rheumatoid and poly-arthritis. Especially in Germany radiosynovectomy is the second common therapy in Nuclear Medicine with about 40,000–60,000 treated joints per year. In Spain, USA, Turkey, Argentines and Philippines the therapy is more use in hemophilic arthritis with excellent results. Especially in developing countries with low availability of clotting factors, the radiosynovectomy represent a cost effective therapeutic option for repeated bleedings in hemophilic arthropathy. The special focus in these countries is maintaining of mobility and work ability. Often only the knee and medium joints (ankle, elbow and shoulder) are treated using yttrium-90, rhenium-186 or phosphorus-32. However, in rheumatoid arthritis most common affected joints are the fingers. For the treatment in these small joints, erbium-169 is necessary. Unfortunately, erbium-169 is only available in Europe. Further indications for radiosynovectomy are osteoarthritis and the articular effusion after joint replacement. The reported response rates in rheumatoid and poly-arthritis range from 60% to 80% depends from the stage of previous arthrosis. The best effectiveness of therapy was observed in hemophilic arthritis with response rate of 90% and significant reducing of bleeding frequency. The therapy is well-tolerated with low rate of side effects. In respect of the specific uptake of particles in the synovia and short range of beta radiation, the radiation exposure outside the joint is very low. The radiosynovectomy has efforts in comparison to surgical synovectomy: it's a minor intervention with low costs; and simultaneous treatments of multiple joints or treatment in short intervals are possible. The presented paper summarized the published papers and reports our own experiences in >15,000 treated

  16. Septic arthritis caused by Peptostreptococcus asaccharolyticus

    Directory of Open Access Journals (Sweden)

    Carlos Costa

    2016-07-01

    Full Text Available Peptostreptococcus spp are commensal organisms, usually involved in periodontal disease. Peptostreptococcus asaccharolyticus is an anaerobic gram-negative cocci, difficult to isolate due to its slow growth. Septic arthritis by this microorganism is a rare entity, but it can occur by hematogenous dissemination from a distant focus. Colonization and growth are more likely to occur in an already damaged articulation. We report the case of a 57 year-old woman with peripheral spondyloarthritis who developed knee septic arthritis by Peptostreptococcus asaccharolyticus.

  17. Penicillamin-induced neuropathy in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Pedersen, P B; Hogenhaven, H

    1990-01-01

    A case of penicillamin-induced severe polyradiculopathy in rheumatoid arthritis is presented. The neuropathy was of demyelinating type, purely motor, proximal and clinically fully reversible when the drug ceased. In case of a progressive neuropathy, during penicillamin treatment, this adverse eff...... effect should be born in mind, and discontinuation of the drug considered.......A case of penicillamin-induced severe polyradiculopathy in rheumatoid arthritis is presented. The neuropathy was of demyelinating type, purely motor, proximal and clinically fully reversible when the drug ceased. In case of a progressive neuropathy, during penicillamin treatment, this adverse...

  18. Septic arthritis caused by Enterobacter agglomerans.

    Science.gov (United States)

    Flatauer, F E; Khan, M A

    1978-05-01

    A case of septic arthritis was caused by Enterobacter agglomerans, an association that to our knowledge has not been described previously. The right knee joint of a previously healthy 11-year-old boy became infected when the organism was introduced through the overlying skin by a contaminated wooden splinter. Conservative management with antibiotic therapy and repeated arthrocenteses was successful. Enterobacter agglomerans is a known plant pathogen, and a relationship between human infections caused by this organism and contact with plants is well recognized. The patient described here demonstrates that, when given a suitable set of environmental circumstances, E agglomerans can cause infection in man, including septic arthritis.

  19. Therapy of rheumatoid arthritis by radiosynovectomy

    International Nuclear Information System (INIS)

    Mruck, S.; Feistel, H.; Kat, S.; Kuwert, T.

    2001-01-01

    Radiosynovectomy is a therapeutic modality for local treatment of inflammatory point diseases. It is performed by intraarticular instillation of beta-emitting radionuclides. Its effectiveness is based upon the anti-inflammatory action of beta-radiation. Accordingly, the indication of radiosynovectomy is based upon the evidence of the inflammatory etiology of disease. The principle of its therapeutic action makes radiosynovectomy a valuable device for successful treatment of florid rheumatoid arthritis. It can be performed as an alternative to surgical synovectomy or in combination with it. The following article describes the therapeutic management of rheumatoid arthritis by radiosynovectomy including patient preparation, performance, and follow-up. (orig.) [de

  20. Ultrasound in Rheumatologic Interstitial Lung Disease: A Case Report of Nonspecific Interstitial Pneumonia in Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    A. Laria

    2015-01-01

    Full Text Available According to the American Thoracic Society (ATS/European Respiratory Society consensus classification, idiopathic interstitial pneumonias (IIPs include several clinic-radiologic-pathologic entities: idiopathic pulmonary fibrosis (IPF, usual interstitial pneumonia (UIP, nonspecific interstitial pneumonia (NSIP, cryptogenic organizing pneumonia, acute interstitial pneumonia, respiratory bronchiolitis-associated ILD, desquamative interstitial pneumonia, and lymphoid interstitial pneumonia. Ultrasound Lung Comets (ULCs are an echographic chest-sonography hallmark of pulmonary interstitial fibrosis. We describe the ultrasound (US findings in the follow-up of a NSIP’s case in rheumatoid arthritis (RA.

  1. Long-term followup of rheumatoid arthritis patients treated with total lymphoid irradiation

    International Nuclear Information System (INIS)

    Tanay, A.; Field, E.H.; Hoppe, R.T.; Strober, S.

    1987-01-01

    Total lymphoid irradiation was administered to 32 patients with intractable rheumatoid arthritis. Twenty-four patients showed at least a 25% improvement in 3 of 4 disease activity parameters, which persisted during the followup period of up to 48 months. Eight of the 32 patients required adjunctive immunosuppressive drug therapy to maintain improvement. Four patients died after total lymphoid irradiation; the causes of death were acute myocardial infarction (1 patient), pulmonary embolism (1 patient), and rheumatoid lung disease complicated by respiratory infection (2 patients). After therapy, patients exhibited a prolonged reduction in the number and function of circulating T helper cells

  2. SECONDARY OSTEOARTHRITIS IN RHEUMATOID ARTHRITIS

    Directory of Open Access Journals (Sweden)

    I. A. Starodubtseva

    2015-01-01

    Full Text Available The paper considers the problems of comorbidities in patients with rheumatoid arthritis (RA. Two or more RA-related conditions were diagnosed according to the results of the QUEST-RA program implemented in 34 countries. Osteoarthritis along with hypertension, hyperlipidemia, and osteoporosis was detected among the most commonly diseases. Owing to expanded diagnostic capabilities, the recognition and treatment of the comorbidities have recently received much attention, as embodied in the draft Association of Rheumatologists of Russia Guidelines for RA management (2014; Part 1. The concept and major characteristics of secondary osteoarthritis in RA are analyzed. It is precisely the inflammatory process and underlying disease-related risk factors, including treatment, that have impact on the development of secondary osteoarthritis and patients’ quality of life as a whole. All this allows an inference about the mechanisms closely intertwined with the underlying disease for the development of secondary osteoarthritis, which initiates cartilage damage and further remodeling. Primary and secondary osteoarthritis was comparatively analyzed. Particular emphasis is placed on current cartilage biomarkers, their diagnostic value and role in monitoring the efficiency of treatment in clinical trials. The paper provides a comparative analysis of detectable serum and urine biomarkers according to the results of the complex analysis made by the National Institutes of Health. Particular attention is given to cartilage oligomeric matrix protein (COMP. Foreign authors’ investigations suggest that there is a relationship between serum COMP levels and disease severity and joint X-ray changes. There is evidence for the efficacy of hyaluronic acid used in the treatment of secondary osteoarthritis in patients with RA. 

  3. X-linked agammaglobulinemia combined with juvenile idiopathic arthritis and invasive Klebsiella pneumoniae polyarticular septic arthritis.

    Science.gov (United States)

    Zhu, Zaihua; Kang, Yuli; Lin, Zhenlang; Huang, Yanjing; Lv, Huoyang; Li, Yasong

    2015-02-01

    X-linked agammaglobulinemia (XLA) is a primary immunodeficiency disease caused by mutations in the Bruton's tyrosine kinase (BTK) gene. XLA can also present in combination with juvenile idiopathic arthritis (JIA), the major chronic rheumatologic disease in children. We report herein the first known case of a juvenile patient diagnosed with XLA combined with JIA that later developed into invasive Klebsiella pneumoniae polyarticular septic polyarthritis. An additional comprehensive review of XLA combined with JIA and invasive K. pneumoniae septic arthritis is also presented. XLA was identified by the detection of BTK mutations while the diagnosis of JIA was established by clinical and laboratory assessments. Septic arthritis caused by invasive K. pneumoniae was confirmed by culturing of the synovia and gene detection of the isolates. Invasive K. pneumoniae infections can not only result in liver abscesses but also septic arthritis, although this is rare. XLA combined with JIA may contribute to invasive K. pneumoniae infection.

  4. Radiosynovectomy in the treatment of arthritis

    International Nuclear Information System (INIS)

    Liepe, Knut

    2005-01-01

    Full text: Radiosynovectomy is a useful therapeutic option that involves radiopharmaceutical injections into joints, especially to treat rheumatoid arthritis. The indications included different kinds of arthritis, such as rheumatoid arthritis, psoriatic arthritis, Bechterew's disease, hemophiliac arthritis, osteoarthritis, but also patients with joint prosthesis and synovial effusion. There are three commercial available radiopharmaceuticals for the treatment: yttrium-90 for the knee (185 to 250 MBq), rhenium-186 for larger joints (shoulder and hip with 111 MBq; elbow, wrist, ankle joint with can also rederbium-169 for smaller joints (acromioclavicular joint with 37 MBq, thumb base and MTP I with 30 MBq, MCP and MTP II-V with 22 MBq, PIP with 18.5 MBq, and DIP with 15 MBq, respectively). Decisive for the treatment is a positive sign for arthritis in the two-phase bone scan with 99mTc-HMDP (high uptake in the blood pool phase). Only for radiosynovecotmy in the knee an ultrasound with an evidence of effusion is sufficient. Side effects by the treatment are rare, such as temporary radiation or crystal synovitis, tissue necrosis (extra articular fraction or intra-articular), joint infection (1 of 35,000 joints) or effects due to the immobilisation (thrombosis, pulmonary embolism (immobilization of the knee), lymphoedema or loss of motion. In the treatment of the knee a prophylaxis with heparin is necessary to protect the patients for a pulmonary embolism. The clinical outcome is depending from the primary disease and the stage of arthrosis. Kresnik at al reported in 2190 treated joints an overall response rate of 73 ± 17%. A higher response rate was observed in patients with early stage of arthrosis (73 ± 12%) to patients with advance stage (52 ± 24%). The best results had patients with hemophiliac arthritis (91 ± 4%). In our hospital were treated up to 10.000 joints with a mean response rate of 70-80%. There was a higher response rate in larger joints with 81 ± 5

  5. Incidence and management of infusion reactions to infliximab in 186 italian patient’s with rheumatoid arthritis: the Padua experience

    Directory of Open Access Journals (Sweden)

    S. Todesco

    2011-09-01

    Full Text Available Objective: We report the incidence and treatment of infusion reactions to infliximab, a chimeric monoclonal IgG1 antibody against tumor necrosis factor a, in a large cohort of patients with rheumatoid arthritis. Patients and methods: One hundred eighty six patients with rheumatoid arthritis treated with infliximab for a total of 216.6 patient years were retrospectively evaluated. Patients received 2160 infliximab infusions at the Division of Rheumatology at the University Hospital of Padua from May, 2000 to April, 2004. Specific treatment protocols for initial and subsequent acute infusion reactions were followed and the outcomes documented. Results: The overall incidence of infusion reactions to infliximab was 0.8% (19 out of 2160 of infusions, affecting 10.2% of patients (19 out of 186. Mild, moderate, or severe acute reactions occurred in 0.1% (3 of 2160, 0.6% (13 of 2160, and 0.04% (1 of 2160 of infliximab infusions, respectively. Delayed infusion reactions occurred in 0.09% (2 of 2160 of infusions. Use of specific treatment protocols resulted in rapid resolution of all acute reactions to infliximab. With a prophylaxis protocol, all patients who experienced an initial mild acute reaction were able to receive additional infusions. Conclusions: Using appropriate treatment protocols, infliximab infusion reactions were effectively treated and prevented in patients with mild acute reactions upon retreatment. In the case of moderate to severe infusion reactions, the risks and the benefits of the continuation of infliximab therapy need to be carefully considered.

  6. Biochemical Evaluation of Withania somnifera Root Powder on Adjuvant-Induced Arthritis in Rats

    Directory of Open Access Journals (Sweden)

    Mahaboobkhan Rasool

    2015-04-01

    Full Text Available The present investigation was carried out to evaluate the biochemical effect of Withania somnifera Linn. Solanaceae, commonly known as ashwagandha on adjuvant induced arthritic rats. Results were compared to Indomethacin, a non steroidal anti-inflammatory drug. Arthritis was induced by an intra dermal injection of Complete Freund’s Adjuvant (0.1 ml into the right hind paw of Wistar albino rats. Withania somnifera root powder (1000 mg/kg/day and Indomethacin (3 mg/kg/day were orally administered for 8 days (from 11th to 18th day after adjuvant injection. After the experimental period, all the animals were sacrificed and serum, liver and spleen samples were collected for further biochemical analysis. A significant increase in the activities of gluconeogenic enzymes, tissue marker enzymes, blood glucose level, WBC, platelet count, erythrocyte sedimentation rate, and acute phase proteins (hyaluronic acid, fibrinogen and ceruloplasmin was observed in adjuvant-induced arthritic rats, whereas the activities of glycolytic enzymes, body weight, levels of hemoglobin, RBC count, and packed cell volume were found to be decreased. These biochemical alterations observed in arthritic animals were ameliorated significantly after the administration of Withania somnifera root powder (1000 mg/kg/b.wt and Indomethacin (3 mg/kg/b.wt. Our results suggest that Withania somnifera root powder is capable of rectifying the above biochemical changes in adjuvant arthritis and it may prove to be useful in treating rheumatoid arthritis.

  7. Rheumatoid arthritis in the United Arab Emirates

    NARCIS (Netherlands)

    Badsha, Humeira; Kong, Kok Ooi; Tak, Paul P.

    2008-01-01

    Studies have shown that patients with rheumatoid arthritis (RA) in the Middle East have delayed diagnosis and low disease-modifying anti-rheumatic drug (DMARD) utilization. We describe the characteristics and treatments of consecutive RA patients presenting to a new musculoskeletal clinic in Dubai,

  8. IJMBR ARTHRITIS edited 4.3.1

    African Journals Online (AJOL)

    MJP

    2015-10-28

    Oct 28, 2015 ... various pathogens most commonly caused by a variety of bacteria. However, viruses, mycobacteria, ... [3] Salmonella typhi and Klebsiella spp are also implicated especially in sickle cell disease. ... The signs and symptoms of septic arthritis include joint pain, swelling and soreness with joint immobility; fever ...

  9. Management of melioidosis osteomyelitis and septic arthritis.

    Science.gov (United States)

    Shetty, R P; Mathew, M; Smith, J; Morse, L P; Mehta, J A; Currie, B J

    2015-02-01

    Little information is available about several important aspects of the treatment of melioidosis osteomyelitis and septic arthritis. We undertook a retrospective review of 50 patients with these conditions in an attempt to determine the effect of location of the disease, type of surgical intervention and duration of antibiotic treatment on outcome, particularly complications and relapse. We found that there was a 27.5% risk of osteomyelitis of the adjacent bone in patients with septic arthritis in the lower limb. Patients with septic arthritis and osteomyelitis of an adjacent bone were in hospital significantly longer (p = 0.001), needed more operations (p = 0.031) and had a significantly higher rate of complications and re-presentation (p = 0.048). More than half the patients (61%), most particularly those with multifocal bone and joint involvement, and those with septic arthritis and osteomyelitis of an adjacent bone who were treated operatively, needed more visits to theatre. ©2015 The British Editorial Society of Bone & Joint Surgery.

  10. Wrist Septic Arthritis: An 11 Year Review.

    Science.gov (United States)

    Yap, Robert Tze Jin; Tay, Shian Chao

    2015-10-01

    This report utilizes 11 years (2003-2013) of clinical records of patients for a retrospective evaluation of the effectiveness of various combinations of diagnostic methods, treatment options and surgical procedures to try to determine the optimal combinations to improve the rate of success for the treatment of septic wrist arthritis. Analysis of records of 40 patients treated for septic wrist arthritis in our hospital involving records of physical examination, full blood analysis, biochemical, microbial profiles, type of surgical intervention, length of stay, number of surgical interventions to resolution and the rate of morbidity and mortality. The patients were subdivided into 2 groups, consisting of 6 (mortality) in one group and 34 (non-mortality) in the other. The various parameters as listed above were compared for differences. The patient records included those from immunocompromised elderly patients, with other existing medical complications such as gout, pseudogout, cellulitis and arthritic flare that made accurate diagnosis of septic wrist arthritis challenging. There is a trend showing better success in the treatment of septic wrist arthritis among patients without co-morbid medical problems. Due to the unavoidable delays in microbial identification, it was noted that escalation of antibiotics should be adopted especially for the immunocompromised patients. Staphylococcus aureus, the most common microbial pathogen in our findings, point to the need to adopt a lower threshold for escalation of antibiotics for immunocompromised patients with slow reversal of infection in order to reduce morbidity, mortality, number of surgeries and length of post-operative stay.

  11. [The golden age of rheumatoid arthritis treatment].

    Science.gov (United States)

    Mercado, Ulises

    2014-01-01

    Today, we enjoy the golden age of rheumatology. In the 1970s, the paradigm for treating rheumatoid arthritis consisted in a pyramid. In the decade of the 1980s, and shortly after began a revolution in the understanding and treatment of rheumatic diseases. Methotrexate and tumor necrosis factor-blockers came on the scene.

  12. Fecal microbiota in early rheumatoid arthritis.

    Science.gov (United States)

    Vaahtovuo, Jussi; Munukka, Eveliina; Korkeamäki, Mika; Luukkainen, Reijo; Toivanen, Paavo

    2008-08-01

    To compare the composition of intestinal microbiota of patients with early rheumatoid arthritis (RA) or fibromyalgia (FM), fecal samples were collected from 51 patients with RA and 50 with FM. RA patients fulfilled the RA criteria of the American College of Rheumatology, and duration of their disease was etiopathogenesis of RA.

  13. Rheumatoid arthritis | Ally | South African Family Practice

    African Journals Online (AJOL)

    Conditions such as rheumatoid arthritis (RA), psoriasis, spondyloarthropathy, inflammatory bowel disease and connective-tissue disease are characterised by immune dysregulation and chronic inflammation. This review will focus on immunopathogenic mechanisms, aspects of early disease, co-morbidity and therapy in RA ...

  14. Retrocalcaneal bursitis in juvenile chronic arthritis.

    OpenAIRE

    Goldenstein-Schainberg, C; Homsi, C; Rodrigues Pereira, R M; Cossermelli, W

    1992-01-01

    Retrocalcaneal bursitis has been described in various adult rheumatic diseases and septic bursitis unrelated to previous bursal disease has been reported in children. The case is reported here of a girl with juvenile chronic arthritis who developed non-septic retrocalcaneal bursitis; the diagnosis was suggested by a combination of clinical and radiographic studies and was confirmed by ultrasonography.

  15. Retrocalcaneal bursitis in juvenile chronic arthritis.

    Science.gov (United States)

    Goldenstein-Schainberg, C; Homsi, C; Rodrigues Pereira, R M; Cossermelli, W

    1992-01-01

    Retrocalcaneal bursitis has been described in various adult rheumatic diseases and septic bursitis unrelated to previous bursal disease has been reported in children. The case is reported here of a girl with juvenile chronic arthritis who developed non-septic retrocalcaneal bursitis; the diagnosis was suggested by a combination of clinical and radiographic studies and was confirmed by ultrasonography. Images PMID:1444631

  16. immunological arthritis Prevalence of biochemical and abnormalities ...

    African Journals Online (AJOL)

    1991-02-02

    Feb 2, 1991 ... Tile prevalence of biochemical and immunological abnormali- ties was studied in a group of 256 patients with rheumatoid arthritis (104 coloureds, 100 whites and 52 blacks). The most common biochemical abnormalities detected were a reduction in the serum creatinine value (43,4%), raised globulins (39 ...

  17. Total shoulder replacement in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Sneppen, O; Fruensgaard, S; Johannsen, Hans Viggo

    1996-01-01

    A prospective study of 62 Neer mark II total shoulder arthroplasties performed during the period from 1981 to 1990 on 51 patients with rheumatoid arthritis was undertaken to evaluate factors associated with component loosening and proximal humeral migration. Thirty-two (51%) showed proximal migra...

  18. Septic arthritis due to Streptococcus sanguis.

    Science.gov (United States)

    Mandac, Inga; Prkacin, Ingrid; Matovinović, Mirjana Sabljar; Sustercić, Dunja

    2010-06-01

    Septic arthritis may represent a direct invasion of joint space by various microorganisms, including bacteria, viruses and fungi. Although any infectious agent may cause bacterial arthritis, bacterial pathogens are the most significant because of their rapidly destructive nature. We present a case of septic arthritis in a 56-year old male patient due to Streptococcus viridans which is member of the viridans group streptococci. Patient was admitted to Our Hospital presented as fever of unknown origin, losing more than 30 kg of body weight during couple of months, and anemia of chronic disease as paraneoplastic process. He had long history of arterial hypertension and stroke. There was swelling and pain of the right sternoclavicular joint and precordial systolic murmur in physical status. A large diagnostic panel has been made, computerized tomography (CT) of right sternoclavicular joint showed widening of periarticular soft tissue and loss of clavicular corticalis. Cytologic analysis of synovial fluid showed more than 90% of polymorphonuclear leukocytes. There were no crystals on microscopic examination and Gram stain of fluid was negative. Blood cultures were positive for S. sanguis and there was a consideration about possible periodontal disease. Stomatologic examination verified periapical ostitis and extraction of potential cause of infection has been done. Therapy with benzilpenicilline was followed by the gradual improvement of clinical and laboratory parameters. Although viridans group streptococci and Streptococcus sanguis in particular are rare causes of septic arthritis in native joints, they should be considered in the differential diagnosis of periodontal disease.

  19. Management of arthritis patients after functional deterioration

    NARCIS (Netherlands)

    Bulthuis, Y.

    2010-01-01

    Hospitalization in arthritis patients is indicated when the disease flares or when joint replacements are to be placed. Conservative treatment aims to control disease activity and to reduce pain. Joint replacement is indicated when pain or functional limitations due to a destroyed joint impair the

  20. Rheumatoid Arthritis, infiltrated pulmonary, and sharp dyspnoea

    International Nuclear Information System (INIS)

    Giraldo Estrada, Horacio

    2002-01-01

    A study of a patient (50 year-old) feminine sex, is made with antecedents of rheumatoid arthritis (RA) the last 10 years in treatment with steroids, hypothyroidism and arterial hypertension who consults for square of dyspnoea of small efforts, dry cough and fever. An evolution of the illness is made and the topic is analyzed

  1. Bone metabolism in patients with rheumatoid arthritis

    NARCIS (Netherlands)

    Bijlsma, J. W.

    1988-01-01

    Bone metabolism in patients with rheumatoid arthritis is reviewed. Two different entities are recognised: 1) a localised periarticular bone loss, due to inflammatory processes and 2) a generalised increased bone turnover, ultimately leading to a loss of axial bone mass. The mechanism of this loss of

  2. Computed tomographic feature of tuberculous arthritis

    International Nuclear Information System (INIS)

    Kim, Hak Hee; Lee, Hae Giu; Cha, Eun Suk; Kang, Kyung Jin; Jeon, Jeong Su; Park, Young Ha; Yim, Jung Ik; Bahk, Yong Whee

    1992-01-01

    The sparsity of publication concerning CT findings of tuberculous arthritis prompted authors to retrospectively evaluate 12 patients with tuberculous arthritis for characteristic CT findings. In each patients, the diagnosis of tuberculous arthritis was confirmed by surgery or biopsy. The CT examinations were evaluated by two radiologists retrospectively. Involved joints were the hip joint in seven patients, the sacroiliac joint in three patients, and the shoulder and ankle joint in one patient each. CT features included subchondral bony erosion(12 patients), soft tissue mass in the joint space(nine), widening of the joint space(eight), ipsilateral music atrophy(eight), thickening of the joint capsule(seven), intra-articular effusion(six), soft tissue abscess(five), and bony sclerosis(four). In seven patients with the duration of symptoms less than 1 year, thickening of joint capsule and intra-articular effusion were the predominant findings, while bony sclerosis, gross bone destruction, and soft tissue mass in joint space were seen in five patients with the duration of symptoms longer than 1 year. Our results indicate that CT is useful in the diagnosis of tuberculous arthritis by demonstrating characteristic pathologic changes of the joint space, soft tissue abnormality and bony involvement

  3. Integrated care for patients with rheumatoid arthritis

    NARCIS (Netherlands)

    Verhoef, John

    2007-01-01

    This thesis describes an example of optimization of the traditional multidisciplinary team care model and evolving arthritis care models with emphasis on the question how theoretical models of the system theory and communication can be used to analyse, evaluate, and optimize care delivery. With

  4. Penicillamin-induced neuropathy in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Pedersen, P B; Hogenhaven, H

    1990-01-01

    A case of penicillamin-induced severe polyradiculopathy in rheumatoid arthritis is presented. The neuropathy was of demyelinating type, purely motor, proximal and clinically fully reversible when the drug ceased. In case of a progressive neuropathy, during penicillamin treatment, this adverse...

  5. Parental rheumatoid arthritis and childhood epilepsy

    DEFF Research Database (Denmark)

    Rom, Ane Lilleøre; Wu, Chun Sen; Olsen, Jørn

    2016-01-01

    Objective: To assess the influence of parental rheumatoid arthritis (RA) on risk of epilepsy. Methods: We performed a nationwide cohort study including all singletons born in Denmark from 1977 to 2008 (n = 1,917,723) through individual linkage to nationwide Danish registries. The children were...

  6. Established rheumatoid arthritis - new imaging modalities

    DEFF Research Database (Denmark)

    McQueen, Fiona M; Østergaard, Mikkel

    2007-01-01

    New imaging modalities are assuming an increasingly important role in the investigation and management of rheumatoid arthritis. It is now possible to obtain information about all tissues within the joint in three dimensions using tomographic techniques such as magnetic resonance imaging (MRI...

  7. Proteome Analysis of Rheumatoid Arthritis Gut Mucosa

    DEFF Research Database (Denmark)

    Bjerg Bennike, Tue; Ellingsen, Torkell; Glerup, Henning

    2017-01-01

    Rheumatoid arthritis (RA) is an inflammatory joint disease leading to cartilage damage and ultimately impaired joint function. To gain new insight into the systemic immune manifestations of RA, we characterized the colon mucosa proteome from 11 RA-patients and 10 healthy controls. The biopsies were...

  8. Scoring ultrasound synovitis in rheumatoid arthritis

    DEFF Research Database (Denmark)

    D'Agostino, Maria-Antonietta; Terslev, Lene; Aegerter, Philippe

    2017-01-01

    OBJECTIVES: To develop a consensus-based ultrasound (US) definition and quantification system for synovitis in rheumatoid arthritis (RA). METHODS: A multistep, iterative approach was used to: (1) evaluate the baseline agreement on defining and scoring synovitis according to the usual practice...

  9. On the origin of rheumatoid arthritis

    DEFF Research Database (Denmark)

    Svendsen, Anders J; Kyvik, Kirsten O; Houen, Gunnar

    2013-01-01

    Rheumatoid arthritis (RA) is an autoimmune disease with a complex origin. Previous studies have reported heritability estimates on RA at about 60%. Only 16% of the genetic background of the disease has been disclosed so far. The purpose of the present investigation was to provide an optimized...

  10. Mitochondrial haplogroups in patients with rheumatoid arthritis

    DEFF Research Database (Denmark)

    Duhn, Pernille Hurup; Sode, Jacob; Hagen, Christian Munch

    2017-01-01

    Objective To describe the distribution of specific mitochondrial DNA (mtDNA) haplogroups (hgs) in a cohort of patients with rheumatoid arthritis (RA). Methods Two-hundred nineteen consecutive patients with RA had mtDNA isolated from their blood, sequenced and haplotyped. Patients were diagnosed...

  11. Diagnosing Rheumatoid Arthritis | Gotlieb | South African Family ...

    African Journals Online (AJOL)

    South African Family Practice. Journal Home · ABOUT · Advanced Search · Current Issue · Archives · Journal Home > Vol 45, No 4 (2003) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. Diagnosing Rheumatoid Arthritis. D Gotlieb. Abstract. No Abstract. Full Text:.

  12. Diagnosing Rheumatoid Arthritis | Gotlieb | South African Family ...

    African Journals Online (AJOL)

    South African Family Practice. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 45, No 4 (2003) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. Diagnosing Rheumatoid Arthritis. D Gotlieb. Abstract.

  13. Adherence to methotrexate in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Bliddal, Henning; Eriksen, Stine A; Christensen, Robin

    2015-01-01

    Objectives. To study adherence to methotrexate (MTX) and factors of importance thereof in patients with rheumatoid arthritis (RA). Methods. Patients with a hospital diagnosis of RA (ICD10 codes M05.X or M06.X) after January 1, 1997, and aged ≥18 years at the date of first diagnosis...

  14. Linkage Between Periodontal Disease and Rheumatoid Arthritis

    DEFF Research Database (Denmark)

    Holmstrup, Palle; Nielsen, Claus Henrik

    2016-01-01

    and the presence of bacteria in the periodontal pockets, which, as the result of daily procedures, may spread after penetration of the vasculature, are possible mediators of systemic consequences. The present chapter deals with the possible association of periodontitis with rheumatoid arthritis, which may possess...

  15. Scoring ultrasound synovitis in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Terslev, Lene; Naredo, Esperanza; Aegerter, Philippe

    2017-01-01

    OBJECTIVES: To test the reliability of new ultrasound (US) definitions and quantification of synovial hypertrophy (SH) and power Doppler (PD) signal, separately and in combination, in a range of joints in patients with rheumatoid arthritis (RA) using the European League Against Rheumatisms...

  16. Corticosteroid pulse therapy in active rheumatoid arthritis

    NARCIS (Netherlands)

    Weusten, B. L.; Jacobs, J. W.; Bijlsma, J. W.

    1993-01-01

    The infusion of high doses of corticosteroids (corticosteroid pulse therapy, CPT) is used to treat refractory rheumatoid arthritis (RA). In the first part of this article, literature on the efficacy of CPT is reviewed, and different CPT regimens (high-dose, low-dose, oral CPT) are compared. Several

  17. Temporomandibular joint involvement in psoriatic arthritis | Okkesim ...

    African Journals Online (AJOL)

    Psoriasis is a chronic, papulosquamous, and an inflammatory skin disease. It has been found that between 5% and 24% of patients develop psoriatic arthritis (PA) at the same time after or even prior to skin findings. The involvement of temporomandibular joint (TMJ) is a rare condition. In this report, a-46-year-old male ...

  18. Voltaren in the Treatment of Rheumatoid Arthritis

    African Journals Online (AJOL)

    hours the excretion is almost complete.-. A short pilot study by one of us (L.S.) showed that the drug was effective in patients with rheumatoid arthritis. (RA), and suggested that a full clinical trial was warranted. Department of Orthopaedic Surgery, Medical School,. University of the Witwatersrand, Johannesburg. L. SOLOMO.

  19. Established rheumatoid arthritis - new imaging modalities

    DEFF Research Database (Denmark)

    McQueen, Fiona M; Østergaard, Mikkel

    2007-01-01

    New imaging modalities are assuming an increasingly important role in the investigation and management of rheumatoid arthritis. It is now possible to obtain information about all tissues within the joint in three dimensions using tomographic techniques such as magnetic resonance imaging (MRI) and...

  20. Juvenile idiopathic arthritis and the temporomandibular joint ...

    African Journals Online (AJOL)

    Background: The temporomandibular joint (TMJ) is one of the most underdiagnosed and undertreated conditions of juvenile idiopathic arthritis (JIA) because its involvement is often asymptomatic and the joint is difficult to examine. Objectives: The aim of this study was to investigate clinical as well as magnetic resonance ...

  1. [Biopharmaceuticals in the treatment of rheumatoid arthritis

    DEFF Research Database (Denmark)

    Baslund, B.; Bendtzen, K.

    2008-01-01

    The current status on the use of biopharmaceuticals in the treatment of rheumatoid arthritis is reviewed. Blocking of TNF-alpha, co-stimulation of CD28+ T-cells and depletion of CD20+ B-cells are all effective ways to diminish inflammation and joint damage. However, not all patients react...

  2. Management of osteoporosis in rheumatoid arthritis patients

    NARCIS (Netherlands)

    Hoes, J.N.; Bultink, I.E.; Lems, W.F.

    2015-01-01

    Introduction: In rheumatoid arthritis (RA) patients, the risk of both vertebral and non-vertebral fractures is roughly doubled, which is for an important part caused by inflammation-mediated amplification of bone loss and by immobilization. New treatments have become available in the last two

  3. [Cystic Rheumatoid Arthritis--case report].

    Science.gov (United States)

    Mourão, Ana Filipa; Santos, Fernando Pimentel; Falcão, Sandra; Pinto, Teresa Laura; Barros, Rita; de Matos, António Alves; Branco, Jaime Cunha

    2007-01-01

    Among the many radiological findings seen in Rheumatoid Arthritis RA small subchondral geodes and erosions are typical. Large geodes are far less common abnormalities and their presence may indicate diagnostic and therapeutic difficulties. We present a case report of a 55-year old woman with seronegative RA that developed a large geode in the knee with extensive joint destruction.

  4. Understanding Rheumatoid Arthritis (RA): Treatment and Causes

    Science.gov (United States)

    ... help my RA? What You Can Do: The Importance of Self-Care Although healthcare professionals can prescribe or recommend treatments to help patients manage their rheumatoid arthritis, the real key to living well with the disease lies with the patients ...

  5. Relation Between Rheumatoid Arthritis and Hearing Disorders

    Directory of Open Access Journals (Sweden)

    A Doosti

    2007-07-01

    Full Text Available Introduction: Some of the studies have shown that RA (Rheumatoid Arthritis may cause hearing disorders. These disorders can result in problems later in life, so survey of correlation between rheumatoid arthritis and hearing disorders is important . Methods: This was a case-control study which has done from December 2004 to August 2006 at Shaheed Sadoughi hospital in Yazd. In this study, 50 Rheumatoid arthritis patients as case group (100 ears with 50 persons as control group who were of the same age, sex and job (100 ears were compared. Results: Patients were 21-67 years old and the mean age was 47.58 years(It was the same as the control group.From 50 cases (controls 42 were women and 8 were men . Audiometric tests in different frequencies showed that hearing loss in high frequencies, especially in 8000 Hz was significantly different in the two groups. Also, acoustic reflex was absent in case group and this too was significantly different.The evaluation of sensory neural hearing loss showed that this hearing loss was sensory, not neural . Conclusion: In Rheumatoid arthritis, middle and inner ear disorders have been shown. But some patients aren't aware of their hearing loss and they have no clinical complains, so frequent evaluation of audiometric tests is recommended. Hearing disorders can be controlled by therapeutic and rehabilitation procedures in these patients.

  6. Thermotherapy for treating rheumatoid arthritis.

    Science.gov (United States)

    Robinson, V; Brosseau, L; Casimiro, L; Judd, M; Shea, B; Wells, G; Tugwell, P

    2002-01-01

    Thermotherapy is often used as adjunct in the treatment of rheumatoid arthritis (RA) by rehabilitation specialists. To evaluate the effectiveness of different thermotherapy applications on objective and subjective measures of disease activity in patients with RA. We searched Medline, EMBASE, Pedro, Current Contents, Sports Discus and CINAHL up to and including September 2001. The Cochrane Field of Rehabilitation and related therapies and the Cochrane Musculoskeletal Review Group were also contacted for a search of their specialized registers. Hand searching was conducted on all retrieved articles for additional articles. Comparative controlled studies, such as randomized controlled trials, controlled clinical trials, cohort studies or case/control studies, of thermotherapy compared to control or active interventions in patients with RA were eligible. No language restrictions were applied. Abstracts were accepted. Two independent reviewers identified potential articles from the literature search (VR, LB). These reviewers extracted data using pre-defined extraction forms. Consensus was reached on all data extraction. Quality was assessed by two reviewers using a 5 point scale that measured the quality of randomization, double-blinding and description of withdrawals. Seven studies (n=328 subjects) met the inclusion criteria. The results of this systematic review of thermotherapy for RA found that there was no significant effect of hot and ice packs applications (Ivey 1994), cryotherapy (Rembe 1970) and faradic baths (Hawkes 1986) on objective measures of disease activity including joint swelling, pain, medication intake, range of motion (ROM), grip strength, hand function compared to a control (no treatment) or active therapy. There is no significant difference between wax and therapeutic ultrasound as well as between wax and faradic bath combined to ultrasound for all the outcomes measured after 1, 2 or 3 week(s) of treatment (Hawkes 1986). There was no difference in

  7. Bone density in rheumatoid arthritis

    International Nuclear Information System (INIS)

    Noorwali, Abdulsalam A.

    2004-01-01

    The aim of this study is to examine the bone mineral density (B/d) in rheumatoid arthritis (RA) patients and to study the effect of disease activity and steroid therapy on BMD. Thirty Saudi female patients with RA and 10 Saudi healthy females matched for age as controls were the material of this work. Patients were attending the out-patient clinic of Makkah Rheumatology and Rehabilitation Center, Al-Noor Specialist Hospital, Makkah, Kingdom of Saudi Arabia between November 2002 and July 2003. All patients were subjected to clinical assessment and laboratory investigations. Bone mineral density was measured by dual-energy x-ray (DXA) in the lumbar spine at L2-4 and in the femoral bone (femoral neck, wards triangle and trochanteric). The results of our study showed a significant decrease in BMD in RA patients compared with healthy controls (spine = 0.863 +/-2.29 versus 1.289 +/- 0.54 g/cm2, p<0.05; total femoral = 0.755 +/-0.27 versus 1.06 +/-0.49 g/cm2, p<0.05; femoral neck = 0.725 +/-0.25 versus 1.008 +/-0.482 g/cm2, p<0.05; ward s triangle = 0.586 +/-0.21 versus 0.909 +/-0.43 g/cm2, p<0.05 and trochanteric = 0.607 +/-0.225 versus 0.898 +/-0.419 g/cm2, p<0.05). The decreased BMD correlated significantly with the impairment of functional activity, increased disease activity and with the use of steroids. There was no correlation between the decreased BMD and the body weight, height, age and the duration of the disease. We conclude that the impairment functional activity, increased disease activity and the use of steroids for long periods are the major determinants of BMD of both spinal and femoral bone in rheumatoid patients. (author)

  8. [Epidemiology and bacteriological diagnosis of paediatric acute osteoarticular infections].

    Science.gov (United States)

    Ferroni, A

    2007-10-01

    Acute paediatric osteo-articular infections require a fast and sensitive diagnosis allowing a treatment directed to the causative pathogen. Many micro-organisms can be incriminated, but Staphylococcus aureus and Kingella kingae markedly prevail. K. kingae became the first bacterial species responsible for septic arthritis in children osteo-articular infections is still low in France. The microbiological diagnosis of septic arthritis relies upon analysis of articular fluid, which requires systematic inoculation of a blood culture vial to increase the recovery rate of K. kingae. If the culture is negative, it is recommended to carry out a universal PCR or a PCR targeted to the main germs responsible for septic arthritis. Indeed, PCR represents an undeniable benefice for the diagnosis of paediatric septic arthritis, particularly for the DNA detection of K. kingae. The diagnosis of acute osteomyelitis relies primarily upon blood cultures, since the bone puncture is not a systematic procedure in this setting. Their efficiency is low, and there is still a need to look for other arguments of diagnosis such as search of possible portals of entry or specific serologies.

  9. Autoimmune Arthritides, Rheumatoid Arthritis, Psoriatic Arthritis, or Peripheral Spondyloarthropathy, Following Lyme Disease

    Science.gov (United States)

    Arvikar, Sheila L.; Crowley, Jameson T.; Sulka, Katherine B.; Steere, Allen C.

    2016-01-01

    Objective To describe systemic autoimmune joint diseases following Lyme disease and to compare their clinical features with Lyme arthritis. Methods Records of all adult patients referred to our Lyme arthritis clinic over a 13-year period in whom we diagnosed a systemic autoimmune joint disease following Lyme disease were reviewed. For comparison, records of patients enrolled in our Lyme arthritis (LA) cohort over the most recent 2-year period were analyzed. IgG antibodies to Borrelia burgdorferi and to 3 Lyme disease-associated autoantigens were measured. Results We identified 30 patients who developed a new-onset systemic autoimmune joint disorder a median of 4 months after Lyme disease, usually erythema migrans (EM). Fifteen had rheumatoid arthritis (RA), 13 had psoriatic arthritis (PsA), and 2 had peripheral spondyloarthropathy (SpA). The 30 patients typically had polyarthritis; and those with PsA/SpA often had previous psoriasis, axial involvement, or enthesitis. In the comparison group of 43 LA patients, monoarticular knee arthritis, without prior EM, was the usual clinical picture. Most systemic autoimmune patients had positive tests for B. burgdorferi IgG antibodies by ELISA, but they had significantly lower titers and lower frequencies of Lyme-associated autoantibodies than LA patients. Prior to our evaluation, the patients often received additional antibiotics for presumed Lyme arthritis without benefit. We prescribed anti-inflammatory therapies, most commonly disease modifying anti-rheumatic drugs (DMARDs), resulting in improvement. Conclusion Systemic autoimmune joint diseases, RA, PsA/SpA, may follow Lyme disease. Development of polyarthritis after antibiotic-treated erythema migrans, previous psoriasis, or low-titer B. burgdorferi antibodies are clues to the correct diagnosis. PMID:27636905

  10. Tocilizumab, a humanized anti-interleukin-6 receptor antibody, for treatment of rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Masahiko Mihara

    2011-02-01

    Full Text Available Masahiko Mihara1, Yoshiyuki Ohsugi2, Tadamitsu Kishimoto31Product Research Department, Chugai Pharmaceutical Co Ltd, Fuji-Gotemba Research Laboratories, Shizuoka, Japan; 2Chugai Pharmaceutical Co Ltd, Tokyo, Japan; 3Laboratory of Immunoregulation, Graduate School of Frontier Biosciences, Osaka University, Osaka, JapanAbstract: Interleukin (IL-6 has a variety of biological functions. For example, it stimulates the production of acute-phase reactants (C-reactive protein and serum amyloid A and hepcidin which interferes with iron recycling and absorption, causing iron-deficient anemia, and augments expression of vascular endothelial growth factor and receptor activator of nuclear factor-κB ligand in synovial cells, leading to neovascularization and osteoclast formation. IL-6 also acts on lymphocytes, not only on B cells to stimulate autoantibody production, but also on naïve T helper cells to promote Th17 cell differentiation. Thus, an imbalance between T cell subsets possibly contributes to development of rheumatoid arthritis. Several clinical studies have demonstrated that a humanized anti-IL-6 receptor antibody, tocilizumab, improves clinical symptoms in rheumatoid arthritis. Tocilizumab prevented radiographic progression of joint destruction by inhibiting cartilage/bone resorption. Tocilizumab also improved hematological abnormalities, including hypergammaglobulinemia, high levels of autoantibodies, and elevation of erythrocyte sedimentation rate and acute-phase proteins. Importantly, tocilizumab improved quality of life by reducing systemic symptoms, including fatigue, anemia, anorexia, and fever. These findings have confirmed that hyperproduction of IL-6 is responsible for the above clinical symptoms, including joint destruction. Many patients treated with tocilizumab achieved clinical remission associated with decreased serum IL-6, suggesting that IL-6 enhances autoimmunity. Tocilizumab is a new therapeutic option for rheumatoid arthritis

  11. Bilateral acute lupus pneumonitis in a case of rhupus syndrome

    Directory of Open Access Journals (Sweden)

    Supriya Sarkar

    2012-01-01

    Full Text Available Rhupus syndrome, the overlap of rheumatoid arthritis (RA and systemic lupus erythematosus (SLE, is an extremely uncommon condition. Organ damages found due to SLE are usually mild in rhupus. Lupus pneumonitis in rhupus syndrome has not been reported worldwide. We are reporting a 23-year-old female with bilateral symmetric erosive arthritis, oral ulcer, alopecia, polyserositis, anemia, leucopenia, positive RA-factor, anti nuclear antibody (ANA and anti ds-DNA. She presented with acute onset dyspnea, high fever, chest pain, tachycardia, tachypnea, hypoxia and respiratory alkalosis. High resolution computed tomography (HRCT-thorax showed bilateral, basal consolidation with air bronchogram. Repeated sputum and single broncho alveolar lavage (BAL fluid examination revealed no organism or Hemosiderin-laden macrophage. The diagnosis of rhupus was confirmed by combined manifestations of RA and SLE, and the diagnosis of acute lupus pneumonitis was established by clinico-radiological picture and by excluding other possibilities.

  12. The role of eicosanoids in experimental Lyme arthritis

    Directory of Open Access Journals (Sweden)

    Charles Robert Brown

    2014-05-01

    Full Text Available Experimental Lyme arthritis is an inflammatory arthritis caused by infection of mice with the spirochete, Borrelia burgdorferi. It recapitulates many of the disease parameters seen in human patients with Lyme arthritis, and thus serves as a model system for the investigation of disease pathogenesis. While much progress has been made in defining components of the immune response to Borrelia infection, an overall understanding of the host response leading to arthritis resistance or susceptibility remains elusive. In this review, we will focus on recent advancements of our understanding of the roles of eicosanoids as inflammatory mediators in the regulation of experimental Lyme arthritis. Eicosanoids, such as PGE2 and LTB4, are powerful regulators of inflammatory responses and thus may be important mediators of Lyme arthritis.

  13. Clinical evaluation of joint scintigraphy in rheumatoid arthritis

    International Nuclear Information System (INIS)

    Shimabukuro, Kunisada; Sakata, Hiromichi; Shirono, Kazuo; Nakajo, Masataka; Shinohara, Shinji

    1983-01-01

    Pertechnetate (sup(99m)TcO 4 - ) joint scintigraphy was performed on 45 patients with rheumatoid arthritis, 3 with nonspecific arthritis and 6 normal subjects. 1) The sites of radioisotopic accumulation were generally in agreement with those of clinical involvement in rheumatoid arthritis. 2) By analysis of build-up curves in the wrist joint, tracer was found to be concentrated more rapidly in rheumatoid arthritis (T 1/2 = 0.67 min.) than in nonspecific arthritis (T 1/2 = 2.66 min.) 3) The degree of radioisotopic accumulation correlated well with the value of CRP and erythrocyte sedimentation rate. It could be cosidered that pertechnetate joint scintigraphy is useful for clinical evaluation of rheumatoid arthritis. (author)

  14. Value of contrast-enhanced ultrasound in rheumatoid arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Zordo, Tobias de; Mlekusch, Sabine P.; Feuchtner, Gudrun M. [Department of Radiology II, Medical University Innsbruck, Anichstrasse 35, 6020 Innsbruck (Austria); Mur, Erich [Department of Internal Medicine, Medical University Innsbruck, Anichstrasse 35, 6020 Innsbruck (Austria); Schirmer, Michael [Department of Internal Medicine, Hospital of the Elisabethines Klagenfurt, Voelkermarkter Strasse 15-19, 9020 Klagenfurt (Austria); Klauser, Andrea S. [Department of Radiology II, Medical University Innsbruck, Anichstrasse 35, 6020 Innsbruck (Austria)], E-mail: andrea.klauser@i-med.ac.at

    2007-11-15

    The purpose of this review is to describe the spectrum of sonographic findings in rheumatic diseases with respect to the diagnostic potential using US contrast media which prove activity or inactivity in synovial tissue where new treatment regimes target. Synovial activity can be found in non-erosive and erosive forms of primary and secondary osteoarthritis, and in inflammatory forms of joint diseases like rheumatoid arthritis and peripheral manifestations of spondyloarthritis including, ankylosing spondylitis, Reiter's syndrome, psoriatic arthritis and enteropathic arthritis. It can also be present in metabolic and endocrine forms of arthritis, in connective tissue arthropathies like systemic lupus erythematosus or scleroderma and in infectious arthritis. Ultrasound should be used as first-line imaging modality in suspected early cases of RA and other forms of arthritis, whereas contrast-enhanced ultrasound (CEUS) can further enable for sensitive assessment of vascularity which correlates with disease activity.

  15. Reactive arthritis induced by recurrent Clostridium difficile colitis

    Directory of Open Access Journals (Sweden)

    Allison Marr

    2012-01-01

    Full Text Available Clostridium difficile colitis is a common infection that can be difficult to resolve and may result in recurrent infections. Reactive arthritis is a rare presentation of this disease and its treatment is not well differentiated in the literature. We describe a case of reactive arthritis occurring in a patient with a history of recurrent Clostridium difficile colitis while currently receiving a taper of oral vancomycin. His arthritis symptoms resolved with corticosteroids and continued treatment with anticlostridial antibiotics.

  16. Is yoga a suitable treatment for rheumatoid arthritis: current opinion

    OpenAIRE

    Telles, Shirley; Singh, Nilkamal

    2012-01-01

    Shirley Telles, Nilkamal SinghPatanjali Research Foundation, Haridwar, IndiaAbstract: We reviewed published literature regarding the use of yoga for managing rheumatoid arthritis to determine whether adequate evidence exists to suggest its usefulness as a therapy. A search for previous studies involving yoga and rheumatoid arthritis in PubMed yielded eight reports. These studies reported the benefits of yoga in the physical and mental health of patients with rheumatoid arthritis (RA), suggest...

  17. Rheumatoid arthritis associated interstitial lung disease: a review

    Directory of Open Access Journals (Sweden)

    Deborah Assayag

    2014-04-01

    Full Text Available Rheumatoid arthritis is a common inflammatory disease affecting about 1% of the population. Interstitial lung disease is a serious and frequent complication of rheumatoid arthritis. Rheumatoid arthritis associated interstitial lung disease (RA-ILD is characterized by several histopathologic subtypes. This article reviews the proposed pathogenesis and risk factors for RA-ILD. We also outline the important steps involved in the work-up of RA-ILD and review the evidence for treatment and prognosis.

  18. Probenecid

    Science.gov (United States)

    Probenecid is used to treat chronic gout and gouty arthritis. It is used to prevent attacks related ... kidneys to help the body eliminate uric acid. Probenecid is also used to make certain antibiotics more ...

  19. Anti-inflammatory Activity of Matricaria recutita L. against Acute and ...

    African Journals Online (AJOL)

    We investigated the effects of Matricaria recutita L. (MR) in acute and chronic inflammatory conditions. The anti-inflammatory activity of Matricaria recutita was studied against carrageenan induced hind paw, arachidonic acid, acetic acid and complete Freund's adjuvant (CFA)-induced arthritis in rats. The methanol extract of ...

  20. Case Comparison of Response To Aquatic Exercise: Acute versus Chronic Conditions.

    Science.gov (United States)

    Mobily, Kenneth E.; Mobily, Paula R.; Lessard, Kerry A.; Berkenpas, Molly S.

    2000-01-01

    Describes the effects of individualized aquatic exercise programs on people with knee impairments. An adolescent athlete with an acute injury demonstrated significant functional improvement. A 33-year-old with arthritis demonstrated only marginal progress. Comparison of cases relative to valid data collection methods and response to aquatic…

  1. Photopenia of the femoral head on 3 phase bone scan using Tc-99m MDP with acute irritable hip in the preschool children: comparison with MR findings

    International Nuclear Information System (INIS)

    Ryu, Young Hoon; Lee, Jong Doo; Yoon, Choon Sik; Suh, Jin Suck; Jeon, Tae Joo

    1998-01-01

    The child with acute irritable hip is always a diagnostic challenge. Photopenia of femur head is described in Legg-Calve-Perthes disease (LCP). However, it can be seen in cases of septic arthritis (SA) with interruption of vascular supply. Despites being uncommon, recognition of SA as a cause of photopenia is important and requires urgent referral to decompression and drainage. This study was to evaluate causes and scintigraphic features of photopenia of femur head in patients with acute irritable hip and to correlate them with MR findings. 15 patients with acute irritable hip showed photopenia of femur head on bone scan were included. Mean age was 5.3 yrs ( 9 months to 8 yrs). There were 9 patients with LCP and 3 with septic arthritis combined with osteomyelitis. All parents underwent 3 phase bone scan and hip MRI within 2 days interval. Patterns of photopenia of femur head was divided into partial, complete and extending to the metaphysis. All patients with LCP showed partial photopenia confined to femur epiphysis. Whereas, 1 with septic arthritis demonstrated complete photopenia of femur head and in 2 with septic arthritis and 3 with septic arthritis combined with osteomyelitis revealed complete photopenia of femur head extending to the metaphyseal area. In cases with septic arthritis, increased uptake affecting both sides of hip joint except for photopenic area is also noted. On MRI, all patients with LCP showed abnormalities confined to the epiphysis. In cases with septic arthritis, abnormalities are not confined to the epiphysis and marrow edema and joint effusion were also noted. In evaluating photopenia of the femur head, it would be helpful to distinguish between the photopenia localized to the femoral epiphysis as seen in cases of LCP and complete photopenia of femur head with extension to the metaphysis as seen in cases of septic arthritis. Recognition of complete with extension to the metaphysis help guide urgent proper management of septic arthritis

  2. The effect of rheumatoid arthritis-associated autoantibodies on the incidence of cardiovascular events in a large inception cohort of early inflammatory arthritis.

    Science.gov (United States)

    Barra, Lillian J; Pope, Janet E; Hitchon, Carol; Boire, Gilles; Schieir, Orit; Lin, Daming; Thorne, Carter J; Tin, Diane; Keystone, Edward C; Haraoui, Boulos; Jamal, Shahin; Bykerk, Vivian P

    2017-05-01

    . RA is associated with an increased risk of cardiovascular events (CVEs). The objective was to estimate independent effects of RA autoantibodies on the incident CVEs in patients with early RA. Patients were enrolled in the Canadian Early Inflammatory Arthritis Cohort, a prospective multicentre inception cohort. Incident CVEs, including acute coronary syndromes and cerebrovascular events, were self-reported by the patient and partially validated by medical chart review. Seropositive status was defined as either RF or ACPA positive. Multivariable Cox proportional hazards survival analysis was used to estimate the effects of seropositive status on incident CVEs, controlling for RA clinical variables and traditional cardiovascular risk factors. . A total of 2626 patients were included: the mean symptom duration at diagnosis was 6.3 months ( s . d . 4.6), the mean age was 53 years ( s . d . 15), 72% were female and 86% met classification criteria for RA. Forty-six incident CVEs occurred over 6483 person-years [incidence rate 7.1/1000 person-years (95% confidence interval 5.3, 9.4)]. The CVE rate did not differ in seropositive vs seronegative subjects and seropositivity was not associated with incident CVEs in multivariable Cox regression models. Baseline covariates independently associated with incident CVEs were older age, a history of hypertension and a longer duration of RA symptoms prior to diagnosis. The rate of CVEs early in the course of inflammatory arthritis was low; however, delays in the diagnosis of arthritis increased the rate of CVEs. Hypertension was the strongest independent risk factor for CVEs. Results support early aggressive management of RA disease activity and co-morbidities to prevent severe complications. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  3. Clinical characteristics and outcomes in polyarticular septic arthritis.

    Science.gov (United States)

    Lieber, Sarah B; Fowler, Mary Louise; Zhu, Clara; Moore, Andrew; Shmerling, Robert H; Paz, Ziv

    2017-09-14

    Septic polyarthritis is rarer than septic monoarthritis, but associated with higher mortality. Septic polyarthritis may be difficult to distinguish clinically from noninfectious inflammatory arthritis. We describe one of the largest samples of septic polyarthritis with the aim of distinguishing septic monoarthritis from polyarthritis. We conducted a retrospective study of adults admitted to tertiary care with septic monoarthritis and polyarthritis. Baseline characteristics, microbial profiles, joint involvement, length of stay, and 60-day readmission rates were determined. We identified 464 and 42 cases of septic monoarthritis and polyarthritis, respectively, including 7 cases of septic polyarthritis with comorbid rheumatoid arthritis. Compared to those with septic monoarthritis, patients with septic polyarthritis were more likely to have rheumatoid arthritis (Pseptic arthritis (Pseptic polyarthritis with/without underlying rheumatoid arthritis were similar in terms of presenting features and outcomes, except for more frequent immunosuppressive therapy in rheumatoid arthritis (Pseptic arthritis, patients with septic polyarthritis were more likely to have systemic infection at presentation than those with septic monoarthritis. Despite this difference, patients with septic monoarthritis and polyarthritis tended to have similar outcomes. While rheumatoid arthritis was observed more frequently among patients with septic polyarthritis, those with/without underlying rheumatoid arthritis had similar presenting features and outcomes. Copyright © 2017 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

  4. Radiosynoviorthese in the treatment of patients with rheumatoid arthritis

    International Nuclear Information System (INIS)

    Drozdovskij, B.Ya.; Ikonnikov, A.I.; Krylov, V.V.

    1991-01-01

    Radiosynoviorthese, a new method for the treatment of patients with rheumatoid arthritis, was developed. Altogether 260 patients with rheumatoid arthritis were treated. The therapeutic activity of radioactive colloid Au was administered intraarticularly to all the patients. Indications and contraindications for radiation therapy of rheumatoid arthritis were developed. Good short- and long-term results were noted in most of the patients after radiation therapy. Radiosynoviorthese as a method of local active therapy of affected joints with colloid Au in the multiple modality treatment of rheumatoid arthritis is effective; its prolonged stable therapeutic effect in patients is observed

  5. A Case Control Study of Incident Rheumatological Conditions Following Acute Gastroenteritis During Military Deployment

    Science.gov (United States)

    2013-01-01

    A case–control study of incident rheumatological conditions following acute gastroenteritis during military deployment Kathryn H DeYoung,1,2 Mark S...following acute gastroenteritis during military deployment. BMJ Open 2013;3:e003801. doi:10.1136/bmjopen-2013- 003801 ▸ Prepublication history for this...population may include individuals with reactive arthritis (ReA) from deployment-related infectious gastroenteritis . Design: This case–control

  6. Suffering in people with rheumatoid arthritis.

    Science.gov (United States)

    Dildy, S P

    1996-11-01

    Knowledge of the nature, meaning, and impact of suffering from the perspective of people with rheumatoid arthritis is needed to determine what nursing interventions are most helpful in reducing suffering. Grounded theory was used to identify the nature of suffering in 14 people with rheumatoid arthritis. Suffering was found to be a process directed toward regaining normalcy and consisted of three phases: disintegration of self; the shattered self; and reconstruction of self. Experiencing suffering resulted in struggling, lose of dreams, restructuring a future orientation, and withdrawing. Finding meaning through positive life changes was an outcome of suffering. The informants' differentiation between pain and suffering also was examined. The provision of comfort measures along with a caring and empathetic attitude were identified as helpful nursing interventions in reducing suffering.

  7. The cystic form of rheumatoid arthritis

    International Nuclear Information System (INIS)

    Dijkstra, P.F.; Gubler, F.M.; Maas, A.

    1988-01-01

    A nonerosive form of rheumatoid arthritis (R.A.) was found in 62 patients out of 660 patients with R.A.. These 62 patients exhibit slowly progressive cystic changes in about the same joints in which usually erosions develop in classic R.A.. The E.S.R. is often low, half of the patients remained seronegative and there are 35 males and 27 females in the group. A smaller group of 15 out of these patients could be followed from a stage wherein the radiographs were normal to a stage of extensive cystic changes, over a period of at least 6 years. An attempt is made to delineate this group within the rheumatoid arthritis disease entity. (orig.) [de

  8. Nanomedicine delivers promising treatments for rheumatoid arthritis.

    Science.gov (United States)

    Prasad, Leena Kumari; O'Mary, Hannah; Cui, Zhengrong

    2015-01-01

    An increased understanding in the pathophysiology of chronic inflammatory diseases, such as rheumatoid arthritis, reveals that the diseased tissue and the increased presence of macrophages and other overexpressed molecules within the tissue can be exploited to enhance the delivery of nanomedicine. Nanomedicine can passively accumulate into chronic inflammatory tissues via the enhanced permeability and retention phenomenon, or be surface conjugated with a ligand to actively bind to receptors overexpressed by cells within chronic inflammatory tissues, leading to increased efficacy and reduced systemic side-effects. This review highlights the research conducted over the past decade on using nanomedicine for potential treatment of rheumatoid arthritis and summarizes some of the major findings and promising opportunities on using nanomedicine to treat this prevalent and chronic disease.

  9. Reactive Arthritis Caused by Yersinia enterocolitica Enteritis.

    Science.gov (United States)

    Honda, Kazuya; Iwanaga, Nozomi; Izumi, Yasumori; Tsuji, Yoshika; Kawahara, Chieko; Michitsuji, Toru; Higashi, Shuntaro; Kawakami, Atsushi; Migita, Kiyoshi

    2017-01-01

    We report a case of reactive arthritis (ReA) triggered by Yersinia enterocolitica enteritis. A 24-year-old Japanese man developed polyarthritis in the lower limbs. Two weeks prior to these symptoms, he noted diarrhea, right lower abdominal pain and a fever. Y. enterocolitica was not isolated from a stool culture; however, he was diagnosed with ReA based on the colonoscopic findings of a high anti-Y. enterocolitica antibody titer and HLA-B27 antigen positivity. Following treatment with methotrexate and steroids, his arthritis improved. This is the first reported Japanese case of ReA in the English literature after a gastrointestinal infection caused by Y. enterocolitica.

  10. [Side effects of COX-2 selective inhibitors. Critic related with its administration in patients with rheumatoid arthritis and osteoarthritis].

    Science.gov (United States)

    Carrillo Gutiérrez, Ofmara Y; Pérez Sánchez, Adriana G; Medina Serriteño, Nicolás; Rodríguez Orozco, Alain R

    2007-01-01

    At the end of 2000 the new age of AINEs was introduced, specially the selective inhibitors of the COX-2, whose main function is to block the production of the prostaglandins and the acute tissue inflammation. These inhibitors have analgesic, antithermal and antiinflammatory effects similar to traditional AINEs; they are prescribed specifically to diminish pain and inflammation in patients with rheumatoid arthritis and osteoarthritis. After them introduction, it was reported that they can produce cardiovascular effects, mainly infarcts. This revision exposes the adverse effects that selective inhibitors of the COX-2 produce when elevated doses are administered, during prolonged time, in patients with rheumatoid arthritis and osteoarthritis; in addition, it comments present recommendations for them prescription.

  11. Paraparesis in a patient with Crohn disease resulting from septic arthritis of the hip and psoas abscess.

    Science.gov (United States)

    Femminineo, A F; LaBan, M M

    1988-03-01

    A psoas abscess is a recognized complication of Crohn disease. Less commonly, septic arthritis has been described with this entity. The occurrence of both these complications together in Crohn disease is quite rare. A 56-year-old patient with Crohn disease presented with weakness and pain in both lower extremities. Computerized body tomograms demonstrated a large psoas abscess with fistulous connections to the bowel as well as extending into the capsule of the left hip joint. X-ray examination revealed evidence of acute septic arthritis. Electromyographic studies demonstrated lumbosacral plexus involvement bilaterally. The patient subsequently underwent ileocolectomy with drainage of the left psoas abscess, followed by extensive inpatient rehabilitation. Some immediate strength improvement was noted bilaterally. At discharge, the patient remained paraparetic. In patients with known history of Crohn disease, a psoas abscess should be considered when there are symptoms of lower extremity pain, hip flexion contractures, and progressive weakness.

  12. Clinical significance of changes of serum NO, NOS and TNF-α levels in patients with rheumatoid arthritis

    International Nuclear Information System (INIS)

    Tang Qiling

    2008-01-01

    Objective: To study the clinical significance of changes of serum NO, NOS and TNF-α levels in patients with rheumatoid arthritis. Methods: The serum concentration of TNF-α was determined with radioimmunoassay (RIA) and NO, NOS contents were determined with chemical methods in 36 eases of rheumatoid arthitis as well as 35 controls. Results: Serum concentration of NO, NOS and TNF-α during acute attack in patients with rheumatoid arthritis were significantly higher than those in controls (P<0.01). After treatment for one week, serum NO, NOS and TNF-α levels were markedly decreased but still remained significantly higher than those in controls (P<0.05). Conclusion: Detection of serum NO, NOS and TNF-α levels were useful for assessment of therapeutic efficacy and were of important clinicals value. (authors)

  13. Effects of Trichilia monadelpha (Meliaceae extracts on bone histomorphology in complete Freund’s adjuvant-induced arthritis

    Directory of Open Access Journals (Sweden)

    INEMESIT OKON BEN

    2017-06-01

    Full Text Available Aim: To assess the effect of petroleum ether extract (PEE, ethyl acetate extract (EthE, and ethanol extract (EAE of Trichilia monadelpha stem bark on bone histomorphology in arthritis. Methods: Percentage inhibition of edema and arthritic scores in complete Freund’s adjuvant-induced (0.1 ml of 5 mgml-1 of heat killed Mycobacterium tuberculosis in paraffin oil injected sub-plantar into the right hind paw arthritic Sprague-Dawley rats treated with PEE, EthE, or EAE (10, 30, and 100 mgkg-1, dexamethasone (0.3-3.0 mgkg-1 or methotrexate (0.1–1.0 mgkg-1 over a 28-day period were estimated. Rat paws were radiographed and scored. Body weights were taken and paw tissues harvested for histopathological studies. Results: The extracts significantly (P≤0.01-0.0001 and dose-dependently reduced the polyarthritic phase of arthritis. EAE and PEE significantly (P≤0.01-0.0001 minimized edema spread from acute arthritic phase (day 0-10 to polyarthritic phase (day 10-28. EthE improved deteriorated body weight in arthritis. All extracts significantly (P≤0.05-0.01 improved arthritic score; reducing erythema, swelling and joint rigidity, and also significantly (P≤0.05-0.01 reduced hyperplasia, pannus formation, and exudation of inflammatory cells into synovial spaces. Conclusion: The stem bark extracts of Trichilia monadelpha reduce bone tissue damage and resorption associated with adjuvant-induced arthritis, hence could be useful in managing arthritis in humans. [J Complement Med Res 2017; 6(2.000: 177-185

  14. Prevalence of Arthritis and Arthritis-Attributable Activity Limitation by Urban-Rural County Classification - United States, 2015.

    Science.gov (United States)

    Boring, Michael A; Hootman, Jennifer M; Liu, Yong; Theis, Kristina A; Murphy, Louise B; Barbour, Kamil E; Helmick, Charles G; Brady, Terry J; Croft, Janet B

    2017-05-26

    Rural populations in the United States have well documented health disparities, including higher prevalences of chronic health conditions (1,2). Doctor-diagnosed arthritis is one of the most prevalent health conditions (22.7%) in the United States, affecting approximately 54.4 million adults (3). The impact of arthritis is considerable: an estimated 23.7 million adults have arthritis-attributable activity limitation (AAAL). The age-standardized prevalence of AAAL increased nearly 20% from 2002 to 2015 (3). Arthritis prevalence varies widely by state (range = 19%-36%) and county (range = 16%-39%) (4). Despite what is known about arthritis prevalence at the national, state, and county levels and the substantial impact of arthritis, little is known about the prevalence of arthritis and AAAL across urban-rural areas overall and among selected subgroups. To estimate the prevalence of arthritis and AAAL by urban-rural categories CDC analyzed data from the 2015 Behavioral Risk Factor Surveillance System (BRFSS). The unadjusted prevalence of arthritis in the most rural areas was 31.8% (95% confidence intervals [CI] = 31.0%-32.5%) and in the most urban, was 20.5% (95% CI = 20.1%-21.0%). The unadjusted AAAL prevalence among adults with arthritis was 55.3% in the most rural areas and 49.7% in the most urban. Approximately 1 in 3 adults in the most rural areas have arthritis and over half of these adults have AAAL. Wider use of evidence-based interventions including physical activity and self-management education in rural areas might help reduce the impact of arthritis and AAAL.

  15. Efficacy of roentgenotherapy in rheumatoid arthritis

    International Nuclear Information System (INIS)

    Ivanova, R.L.; Andreyashchenko, N.F.; Benenson, E.B.

    1981-01-01

    The clinical efficacy of radiotherapeutic small doses in rheumatoid arthritis (single doses - 0.266-0.4435 Gy, summary - 2.66-4.435 Gy) has been analyzed. An analysis has been made of isolated radiotherapy with the ALG effect, and concomitant ALG therapy plus radiotherapy. A conclusion has been made as to the comparability of a radiotherapeutic effect with an ALG anti-inflammatory effect, nonsteroid drugs, and with the intraarticular administration of hydrocortisone [ru

  16. Arthroscopic Synovectomy of Wrist in Rheumatoid Arthritis.

    Science.gov (United States)

    Shim, Jae Woo; Park, Min Jong

    2017-11-01

    Rheumatoid arthritis (RA) is a systemic inflammatory disorder affecting multiple joints. Wrist involvement is common. Patients with persistent symptoms despite medical management are candidates for surgery. Synovectomy can provide pain relief and functional improvement for rheumatoid wrist. Arthroscopic synovectomy is a safe and reliable method, with minimal postoperative morbidity. This article reviews the role, technique, and results of arthroscopic synovectomy in the rheumatoid wrist. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Antibiotics for the treatment of rheumatoid arthritis

    OpenAIRE

    Ogrendik, Mesut

    2013-01-01

    Mesut OgrendikDivision Physical Therapy and Rheumatology, Nazilli State Hospital, Nazilli, TurkeyAbstract: Antibiotic treatment for rheumatoid arthritis (RA) commenced in the 1930s with the use of sulfasalazine. Later, tetracyclines were successfully used for the treatment of RA. In double-blind and randomized studies, levofloxacin and macrolide antibiotics (including clarithromycin and roxithromycin) were also shown to be effective in the treatment of RA. There have been several reports in t...

  18. Role of Gut Microbiota in Rheumatoid Arthritis

    OpenAIRE

    Yuichi Maeda; Kiyoshi Takeda

    2017-01-01

    Rheumatoid arthritis (RA) is a systemic autoimmune disease, caused by both genetic and environmental factors. Recently, investigators have focused on the gut microbiota, which is thought to be an environmental agent affecting the development of RA. Here we review the evidence from animal and human studies that supports the role of the gut microbiota in RA. We and others have demonstrated that the abundance of Prevotella copri is increased in some early RA. We have also used gnotobiotic experi...

  19. Intestinal Dysbiosis and Rheumatoid Arthritis: A Link between Gut Microbiota and the Pathogenesis of Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    Gabriel Horta-Baas

    2017-01-01

    Full Text Available Characterization and understanding of gut microbiota has recently increased representing a wide research field, especially in autoimmune diseases. Gut microbiota is the major source of microbes which might exert beneficial as well as pathogenic effects on human health. Intestinal microbiome’s role as mediator of inflammation has only recently emerged. Microbiota has been observed to differ in subjects with early rheumatoid arthritis compared to controls, and this finding has commanded this study as a possible autoimmune process. Studies with intestinal microbiota have shown that rheumatoid arthritis is characterized by an expansion and/or decrease of bacterial groups as compared to controls. In this review, we present evidence linking intestinal dysbiosis with the autoimmune mechanisms involved in the development of rheumatoid arthritis.

  20. Canine rheumatoid arthritis characterized by hyperprolactinemia

    Directory of Open Access Journals (Sweden)

    Tohru Kimura

    2017-04-01

    Full Text Available The senile female dog suffering from rheumatoid arthritis was clinically and clinicopathologically examined. The articular lesions localized in the elbows, stifles, and the carpal and tarsal joints. The dog with clinical signs of arthritis developed draining nodular lesions in the involved joints. The affected joints became swollen, and then serous exudates were observed in their ulcerative lesions. In addition, the dog developed leaks of milk (lactorrhea in response to suckling stimuli. There were no abnormal values in hematological and blood coagulation profiles. Serum biochemical examinations showed an increase in total protein concentrations. Serum protein electrophoresis confirmed a prominent decrease in albumin and moderate increases in β1, β2 and γ-globurin. The serum prolactin concentration was apparently higher than that of normal dogs. This affected dog had raised rheumatoid factors and immune complexes. Both antinuclear antibodies and direct Coombs test were positive and serum complement titers and anti DNA antibodies were increased in this dog. In conclusion, the present results revealed that lactorrhea characterized by hyperprolactinemia and autoimmunological profiles was one of important clinical predictors associated with an increased risk of rheumatoid arthritis.

  1. Fibromyalgia Complicating Disease Management in Rheumatoid Arthritis

    International Nuclear Information System (INIS)

    Abbasi, L.; Haidri, F. R.

    2014-01-01

    Objective: To evaluate frequency of fibromyalgia in rheumatoid arthritis and its effect on disease activity score. Study Design: Cross-sectional study. Place and Duration of Study: The Indus Hospital, Karachi, from December 2010 to May 2011. Methodology: All adult patients of either gender diagnosed as rheumatoid arthritis on the basis of clinical, laboratory and X-ray criteria were included in the study. The sample data was separated into two groups depending on presence or absence of fibromyalgia and 28 joint disease activity score (DAS-28) value was evaluated. Results: There were 31 (25.83%) patients with rheumatoid arthritis and fibromyalgia (RAFM) out of the total 120. The median (IQR) age of patients was 40 (32 - 51) years. All were females. The overall female frequency was 79 (88.8%). The median (IQR) DAS-28 score in RA group was 4.9 (3.66 - 5.71), while the median (IQR) DAS-28 score in RAFM was 7.04 (6.62 - 7.64) [p < 0.0001]. The number of patient getting combination therapy of DMARD in RAFM group was 61.3% while in RA group was 42.7%. Conclusion: DAS-28 was found to be significantly higher in RAFM patients probably because of higher perception of pain. (author)

  2. Asymptomatic atlantoaxial subluxation in rheumatoid arthritis.

    Directory of Open Access Journals (Sweden)

    Mohammadali Nazarinia

    2014-06-01

    Full Text Available This cross-sectional study is conducted to determine the prevalence of asymptomatic cervical spine subluxation in rheumatoid arthritis patients by plain radiographs and its relation to demographic and clinical characteristics, disease activity measures and medications. 100 rheumatoid arthritis patients (18 male and 82 female were selected randomly, according to the American college of Rheumatology Criteria, who were under follow up in the rheumatology clinic. A complete history was taken, and physical examination has been done with focus on the cervical spine to determine their demographic data, disease duration, age of disease onset, drug history, swollen and tender joint counts, and ESR, Hb, CRP, RF levels. The disease activity of patients with rheumatoid arthritis was measured using the disease activity score 28. Radiographs of the cervical spine included lateral views taken in flexion, extension, neutral position of the neck and anterioposterior and odontoid projection view. Asymptomatic cervical spine subluxation was found in 17 of the 100 patients (17%. The prevalence of, anterior atlantoaxial subluxation, atlantoaxial impaction and subaxial subluxation was 10(10%, 5(5% and 6(6%, respectively. Posterior subluxation was not detected. The only characteristic that showed meaningful relationship with cervical spine subluxation was CRP (P=0.036. Our results showed that patients with RA, who have cervical spine subluxation cannot be distinguished on the basis of symptoms. Cervical spine involvement is common and may be asymptomatic, indicating routine cervical spine imaging is needed in patients with RA.

  3. Asymptomatic atlantoaxial subluxation in rheumatoid arthritis.

    Science.gov (United States)

    Nazarinia, Mohammadali; Jalli, Reza; Kamali Sarvestani, Eskandar; Farahangiz, Siamak; Ataollahi, Maryam

    2014-01-01

    This cross-sectional study is conducted to determine the prevalence of asymptomatic cervical spine subluxation in rheumatoid arthritis patients by plain radiographs and its relation to demographic and clinical characteristics, disease activity measures and medications. 100 rheumatoid arthritis patients (18 male and 82 female) were selected randomly, according to the American college of Rheumatology Criteria, who were under follow up in the rheumatology clinic. A complete history was taken, and physical examination has been done with focus on the cervical spine to determine their demographic data, disease duration, age of disease onset, drug history, swollen and tender joint counts, and ESR, Hb, CRP, RF levels. The disease activity of patients with rheumatoid arthritis was measured using the disease activity score 28. Radiographs of the cervical spine included lateral views taken in flexion, extension, neutral position of the neck and anterioposterior and odontoid projection view. Asymptomatic cervical spine subluxation was found in 17 of the 100 patients (17%). The prevalence of, anterior atlantoaxial subluxation, atlantoaxial impaction and subaxial subluxation was 10(10%), 5(5%) and 6(6%), respectively. Posterior subluxation was not detected. The only characteristic that showed meaningful relationship with cervical spine subluxation was CRP (P=0.036). Our results showed that patients with RA, who have cervical spine subluxation cannot be distinguished on the basis of symptoms. Cervical spine involvement is common and may be asymptomatic, indicating routine cervical spine imaging is needed in patients with RA.

  4. Physiologic characterization of inflammatory arthritis in a rabbit model with BOLD and DCE MRI at 1.5 Tesla.

    Science.gov (United States)

    Nasui, Otilia C; Chan, Michael W; Nathanael, George; Crawley, Adrian; Miller, Elka; Belik, Jaques; Cheng, Hai-Ling; Kassner, Andrea; Rayner, Tammy; Weiss, Ruth; Detzler, Garry; Zhong, Anguo; Moineddin, Rahim; Jong, Roland; Rogers, Marianne; Doria, Andrea S

    2014-11-01

    Our aim was to test the feasibility of blood oxygen level dependent magnetic resonance imaging (BOLD MRI) and dynamic contrast-enhanced (DCE) MRI to monitor periarticular hypoxic/inflammatory changes over time in a juvenile rabbit model of arthritis. We examined arthritic and contralateral nonarthritic knees of 21 juvenile rabbits at baseline and days 1,14, and 28 after induction of arthritis by unilateral intra-articular injection of carrageenin with BOLD and DCE MRI at 1.5 Tesla (T). Nine noninjected rabbits served as controls. Associations between BOLD and DCE-MRI and corresponding intra-articular oxygen pressure (PO2) and blood flow [blood perfusion units (BPU)] (polarographic probes, reference standards) or clinical-histological data were measured by correlation coefficients. Percentage BOLD MRI change obtained in contralateral knees correlated moderately with BPU on day 0 (r = -0.51, p = 0.02) and excellently on day 28 (r = -0.84, p = 0.03). A moderate correlation was observed between peak enhancement DCE MRI (day 1) and BPU measurements in arthritic knees (r = 0.49, p = 0.04). In acute arthritis, BOLD and DCE MRI highly correlated (r = 0.89, p = 0.04; r = 1.0, p < 0.0001) with histological scores in arthritic knees. The proposed techniques are feasible to perform at 1.5 T, and they hold potential as surrogate measures to monitor hypoxic and inflammatory changes over time in arthritis at higher-strength MRI fields. • BOLD and DCE MRI detect interval perisynovial changes in a rabbit knee • BOLD and DCE MRI act as surrogate markers of physiologic changes in arthritis • BOLD MRI signal represents oxygen extraction compared with intra-articular PO 2 • DCE MRI measurements estimate physiologic periarticular vascular properties • In rabbit knees with acute arthritis, BOLD/DCE MRI highly correlated with histological scores.

  5. K/BxN serum transfer arthritis as a model for human inflammatory arthritis

    Directory of Open Access Journals (Sweden)

    Anne Deen Christensen

    2016-06-01

    Full Text Available The K/BxN serum-transfer arthritis (STA model is a murine model in which the immunological mechanisms occurring in rheumatoid arthritis (RA and other arthritides can be studied. To induce K/BxN STA, serum from arthritic transgenic K/BxN mice is transferred to naive mice and manifestations of arthritis occur a few days later. The inflammatory response in the model is driven by autoantibodies against the ubiquitously expressed self-antigen, glucose-6-phosphate isomerase (G6PI, leading to the formation of immune complexes that drive the activation of different innate immune cells such as neutrophils, macrophages and possibly mast cells. The pathogenesis further involves a range of immune mediators including cytokines, chemokines, complement factors, Toll-like receptors, Fc receptors, and integrins, as well as factors involved in pain and bone erosion. Hence, even though the K/BxN STA model mimics only the effector phase of RA, it still involves a wide range of relevant disease mediators. Additionally, as a murine model for arthritis, the K/BxN STA model has some obvious advantages. Firstly, it has a rapid and robust onset of arthritis with 100% incidence in genetically identical animals. Secondly, it can be induced in a wide range of strain backgrounds and can therefore also be induced in gene-deficient strains to study the specific importance of disease mediators. Even though G6PI might not be an essential autoantigen, for example, in RA, the K/BxN STA model is a useful tool to understand how autoantibodies in general drive the progression of arthritis by interacting with downstream components of the innate immune system. Finally, the model has also proven useful as a model wherein arthritic pain can be studied. Taken together, these features make the K/BxN STA model a relevant one for RA and it is a potentially valuable tool especially for the pre-clinical screening of new therapeutic targets for RA and perhaps other forms of inflammatory

  6. Sirt2 suppresses inflammatory responses in collagen-induced arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Jiangtao [Department of Orthopaedics, Qilu Hospital, Shandong University, 44 Wenhua Xi Road, Jinan, Shandong 250012 (China); Department of Orthopaedics, Yantaishan Hospital, 91 Jiefang Road, Yantai, Shandong 264001 (China); Sun, Bing; Jiang, Chuanqiang; Hong, Huanyu [Department of Orthopaedics, Yantaishan Hospital, 91 Jiefang Road, Yantai, Shandong 264001 (China); Zheng, Yanping, E-mail: yanpingzheng@yahoo.com [Department of Orthopaedics, Qilu Hospital, Shandong University, 44 Wenhua Xi Road, Jinan, Shandong 250012 (China)

    2013-11-29

    Highlights: •Sirt2 expression decreases in collagen-induced arthritis (CIA). •Sirt2 knockout aggravates severity of arthritis in mice with CIA. •Sirt2 knockout increases levels of pro-inflammatory factors in the serum. •Sirt2 deacetylates p65 and inhibits pro-inflammatory factors expression. •Sirt2 rescue abates severity of arthritis in mice with CIA. -- Abstract: Arthritis is a common autoimmune disease that is associated with progressive disability, systemic complications and early death. However, the underling mechanisms of arthritis are still unclear. Sirtuins are a NAD{sup +}-dependent class III deacetylase family, and regulate cellular stress, inflammation, genomic stability, carcinogenesis, and energy metabolism. Among the sirtuin family members, Sirt1 and Sirt6 are critically involved in the development of arthritis. It remains unknown whether other sirtuin family members participate in arthritis. Here in this study, we demonstrate that Sirt2 inhibits collagen-induced arthritis (CIA) using in vivo and in vitro evidence. The protein and mRNA levels of Sirt2 significantly decreased in joint tissues of mice with CIA. When immunized with collagen, Sirt2-KO mice showed aggravated severity of arthritis based on clinical scores, hind paw thickness, and radiological and molecular findings. Mechanically, Sirt2 deacetylated p65 subunit of nuclear factor-kappa B (NF-κB) at lysine 310, resulting in reduced expression of NF-κB-dependent genes, including interleukin 1β (IL-1β), IL-6, monocyte chemoattractant protein 1(MCP-1), RANTES, matrix metalloproteinase 9 (MMP-9) and MMP-13. Importantly, our rescue experiment showed that Sirt2 re-expression abated the severity of arthritis in Sirt2-KO mice. Those findings strongly indicate Sirt2 as a considerably inhibitor of the development of arthritis.

  7. Occult renal cell carcinoma with acrometastasis and ipsilateral juxta-articular knee lesions mimicking acute inflammation

    Directory of Open Access Journals (Sweden)

    Bhaskar Borgohain

    2012-01-01

    Full Text Available Generally, skeletal peripheral metastases below the elbow and the knee are rare. Skeletal metastases to the hand or foot are very rare; but when they do it may be a revealing clinical finding. Purely lytic lesions are commonly seen in metastases from lung, renal, and thyroid tumors, but they are also known to occur in primary myeloma, brown tumor and lymphomas. A 70-year-old man was brought to the emergency department with acute painful swelling involving his right hand and the right knee. Due to significant accompanying soft tissue swellings cellulitis, acute osteomyelitis and gouty arthropathy were included in the initial differential diagnosis. Radiographs showed pure lytic bony lesion with complete disappearance of lower two third of the second metacarpal, trapezium and trapezoid bones of the right hand along with a lytic subarticular lesion of medial condyle of ipsilateral femur. Chest X-ray (CXR was normal but sonography of the abdomen readily demonstrated a large renal mass, later confirmed at biopsy as renal cell carcinoma (RCC. Clinicians should be cognizant of the strong association between digital acrometastases and renal cell carcinoma in male patients with normal CXR findings. In suspected hand acrometastasis associated with a soft tissue component outside the contours of normal bone, screening the abdomen by sonography should be done prior to bone biopsy and before costly or time-consuming investigations are offered. Metastatic RCC should be included in the differential diagnosis of all unilateral expansile bony lesions of the digit. It is particularly important if such lesion/lesions are accompanied by local inflammation. Screening the abdomen by sonography may be of particular value in such elderly male patient when Chest X-ray shows no abnormality.

  8. Indomethacin and naproxen suppositories in the treatment of rheumatoid arthritis.

    Science.gov (United States)

    Berry, H; Swinson, D; Jones, J; Hamilton, E B

    1978-01-01

    A double-blind cross-over study of 35 out-patients with rheumatoid arthritis showed that Naproxen and Indomethacin suppositories were both effective forms of treatment in rheumatoid arthritis, both being significantly superior to placebo in terms of relief of morning stiffness. PMID:356764

  9. The lungs in rheumatoid arthritis - a clinical, radiographic and ...

    African Journals Online (AJOL)

    The lungs in rheumatoid arthritis - a clinical, radiographic and pulmonary function study. Stephen C. Morrison, Girish M. Mody, Sally R. Benatar, Orlando L Meyers. Abstract. Objective. To detennine the prevalence and spectrum of pulmonary abnormalities in patients with rheumatoid arthritis (RA) in a developing country.

  10. Understanding Arthritis Promoting Healthy Lifestyles for Older Adults

    Science.gov (United States)

    Tremethick, Mary Jane; Hogan, Patricia I.; Coleman, Barb; Adams, Kady

    2010-01-01

    One of the goals of "Healthy People 2010" is to decrease the incidence of limitation in physical activity due to arthritis. Physical education, recreation, and dance professionals can play an important role in meeting this objective by addressing barriers to physical activity and exercise in older adults with arthritis, and by successfully…

  11. Which patients improve the most from arthritis rehabilitation?

    DEFF Research Database (Denmark)

    Hagel, Sofia; Lindqvist, Elisabet; Petersson, Ingemar F

    2014-01-01

    Objective: To study health-related quality of life (HRQoL) in arthritis rehabilitation performed by multidisciplinary teams in patients with chronic inflammatory arthritis. Predictors of change in health-related quality of life and the proportion of patients with clinical improvement were investi...

  12. Arthritis Awareness (A Minute of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2016-05-19

    Roughly 52.5 million adults in the United States have arthritis. This podcast discusses the importance of physical activity and maintaining a healthy weight in order to prevent arthritis and/or lessen symptoms.  Created: 5/19/2016 by MMWR.   Date Released: 5/19/2016.

  13. CDC Vital Signs–Arthritis in America

    Centers for Disease Control (CDC) Podcasts

    2017-03-07

    This podcast is based on the March 2017 CDC Vital Signs report. Many adults in the United States have arthritis. Learn how to reduce the pain of arthritis, as well as manage the condition.  Created: 3/7/2017 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 3/7/2017.

  14. Managing Arthritis (A Cup of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2017-10-19

    Arthritis is a common chronic condition among Americans. As the population ages, the number of people with this condition is expected to increase dramatically. In this podcast, Dr. Jennifer Hootman discusses the importance of early diagnosis and management of arthritis.  Created: 10/19/2017 by MMWR.   Date Released: 10/19/2017.

  15. Rheumatoid arthritis: diagnosis and treatment with a particular ...

    African Journals Online (AJOL)

    limited, recognition and aggressive management of patients with rheumatoid arthritis ... individual, and chronic periodontal disease [4]. Extra-articular ... European League Against Rheumatism (EULAR) criteria for the diagnosis of rheumatoid is summarized in Box 1. Although a clinical diagnosis of rheumatoid arthritis may.

  16. 38 CFR 4.58 - Arthritis due to strain.

    Science.gov (United States)

    2010-07-01

    ... arthritis in the joints directly subject to strain. Amputation, or injury to an upper extremity, is not.... With service incurred lower extremity amputation or shortening, a disabling arthritis, developing in the same extremity, or in both lower extremities, with indications of earlier, or more severe...

  17. Pantoea agglomerans foreign body-induced septic arthritis.

    Science.gov (United States)

    Rave, Omer; Assous, Marc Victor; Hashkes, Philip J; Lebel, Ehud; Hadas-Halpern, Irit; Megged, Orli

    2012-12-01

    A 4-year-old boy was admitted because of left knee arthritis. Synovial fluid culture yielded Pantoea agglomerans identified by 16S rDNA polymerase chain reaction. Ultrasound examination revealed a foreign body in the synovial fluid. The patient underwent arthroscopy with removal of a thorn. This article highlights the need to search for a foreign body in Pantoea septic arthritis.

  18. Neuroradiologic picture of cerebral vasculitis in rheumatoid arthritis

    International Nuclear Information System (INIS)

    Paci, R.; Giuffrida, C.M.; Marangolo, M.; Ventura, F.; Di Paola, F.

    1983-01-01

    The central nervous system is rarely involved in rheumatoid arthritis. In this paper the authors report a case of a 50-year-old woman who had rheumatoid arthritis for about 6 years. A month before admission she presented a symptomatology resembling an expansive intracranial process. Angiography revealed cerebral arteritis and CT showed areas of hypodensity with marked contrast enhancement. (orig.)

  19. Rheumatoid Arthritis Associated with Pulmonary Fibrosis in Nigerians

    African Journals Online (AJOL)

    Rheumatoid arthritis may sometimes present with extra-articular involvement, pulmonary involvement is not common. Rheumatoid arthritis has been reported among Nigerians and extra-articular manifestations are rarely seen. One of the patients was misdiagnosed and mismanaged as a patient with pulmonary tuberculosis ...

  20. Home Care Guide on Juvenile Rheumatoid Arthritis (For Parents).

    Science.gov (United States)

    Giesecke, Linda L.; And Others

    The booklet, written by the medical staff of a children's hospital, provides information for parents of children with juvenile rheumatoid arthritis (JRA). Arthritis is a swelling of the joint(s) in children and lasts for over 6 weeks (sometimes many years). Aspirin is the main medicine given for JRA, and it works not only to control pain but also,…