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Sample records for rheumatoid finger joints

  1. Wrist and finger joint MR imaging in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Klarlund, Mette; Østergaard, Mikkel; Gideon, P

    1999-01-01

    PURPOSE: To elaborate the best MR imaging protocol for studies in rheumatoid arthritis (RA) and to evaluate the sensitivity and interobserver agreement with respect to detection of bone erosions (MR and radiography) and grading of synovial membrane hypertrophy (MR imaging only). MATERIAL...

  2. Semi-Automated Quantification of Finger Joint Space Narrowing Using Tomosynthesis in Patients with Rheumatoid Arthritis.

    Science.gov (United States)

    Ichikawa, Shota; Kamishima, Tamotsu; Sutherland, Kenneth; Kasahara, Hideki; Shimizu, Yuka; Fujimori, Motoshi; Yasojima, Nobutoshi; Ono, Yohei; Kaneda, Takahiko; Koike, Takao

    2017-06-01

    The purpose of the study is to validate the semi-automated method using tomosynthesis images for the assessment of finger joint space narrowing (JSN) in patients with rheumatoid arthritis (RA), by using the semi-quantitative scoring method as the reference standard. Twenty patients (14 females and 6 males) with RA were included in this retrospective study. All patients underwent radiography and tomosynthesis of the bilateral hand and wrist. Two rheumatologists and a radiologist independently scored JSN with two modalities according to the Sharp/van der Heijde score. Two observers independently measured joint space width on tomosynthesis images using an in-house semi-automated method. More joints with JSN were revealed with tomosynthesis score (243 joints) and the semi-automated method (215 joints) than with radiography (120 joints), and the associations between tomosynthesis scores and radiography scores were demonstrated (P tomosynthesis scores with r = -0.606 (P tomosynthesis images was in almost perfect agreement with intra-class correlation coefficient (ICC) values of 0.964 and 0.963, respectively. The semi-automated method using tomosynthesis images provided sensitive, quantitative, and reproducible measurement of finger joint space in patients with RA.

  3. The Dorsal 4-finger Technique: A Novel Method to Examine Metacarpophalangeal Joints in Patients with Rheumatoid Arthritis.

    Science.gov (United States)

    Omair, Mohammed A; Akhavan, Pooneh; Naraghi, Ali; Mittoo, Shikha; Xiong, Juan; Weber, Deborah; Lin, Daming; Weber, Melissa; Keystone, Edward C

    2018-03-01

    To describe the dorsal 4-finger technique (DFFT) in examining metacarpophalangeal (MCP) joints of patients with rheumatoid arthritis (RA) and compare it to the traditional 2-finger technique (TFT) using ultrasound (US) as a gold standard. Four rheumatologists evaluated 180 MCP joints of 18 patients with RA. All patients underwent US for greyscale (GSUS) and power Doppler US (PDUS). Agreements between rheumatologists, the 2 techniques, and US were evaluated using Cohen κ and the first-order agreement coefficient (AC1) κ methods. The population comprised 17 females (94.4%) with a mean (SD) age and disease duration of 56.8 (14.4) and 21.8 (12.9) years, respectively. Eight patients (44.4%) were taking methotrexate monotherapy, while 10 patients (55.6%) were receiving biologics. US evaluation revealed 69 (38.3%) and 30 (16.7%) joints exhibited synovitis grade 2-3 by GSUS and PDUS, respectively. Effusion was documented in 30 joints (16.7%). The mean intraobserver agreement using the DFFT and TFT were 80.5% and 86%, respectively. The mean interobserver agreements using the DFFT and TFT were 84% and 74%, respectively. κ agreement with US findings was similar for both techniques in tender joints but was higher for the DFFT in nontender joints (0.33 vs 0.07, p = 0.015 for GSUS) and (0.48 vs 0.11, p = 0.002 for PDUS). The DFFT had a higher sensitivity in detecting ballottement by GSUS (0.47 vs 0.2, p The DFFT is a novel, reproducible, and reliable method to examine MCP joints, and it has a better correlation with US than the traditional TFT.

  4. Radiosynoviorthesis in osteoarthritis of finger joints

    International Nuclear Information System (INIS)

    Moedder, G.

    2006-01-01

    This is an overview about osteoarthritis of the finger joints. The scientific publications according to the therapy of this disease by means of radiosynoviorthesis are presented, comparing the results in rheumatoid arthritis. Additionally own experience and results are reported. (orig.)

  5. Colour Doppler ultrasonography evaluation of vascularization in the wrist and finger joints in rheumatoid arthritis patients and healthy subjects

    Energy Technology Data Exchange (ETDEWEB)

    Carotti, M. [Department of Radiology, Poliytechnic University of Marche, Ancona (Italy); Salaffi, F., E-mail: fsalaff@tin.it [Department of Rheumatology, Poliytechnic University of Marche, Ospedale A. Murri - Via dei Colli 52, 60035 Jesi, Ancona (Italy); Morbiducci, J. [Department of Radiology, Poliytechnic University of Marche, Ancona (Italy); Ciapetti, A., E-mail: ciapetti.a@libero.it [Department of Rheumatology, Poliytechnic University of Marche, Ospedale A. Murri - Via dei Colli 52, 60035 Jesi, Ancona (Italy); Bartolucci, L. [Department of Radiology, Poliytechnic University of Marche, Ancona (Italy); Gasparini, S. [Department of Rheumatology, Poliytechnic University of Marche, Ospedale A. Murri - Via dei Colli 52, 60035 Jesi, Ancona (Italy); Ferraccioli, G. [Division of Rheumatology, Catholic University of the Sacred Heart, Rome (Italy); Giuseppetti, G.M. [Department of Radiology, Poliytechnic University of Marche, Ancona (Italy); Grassi, W. [Department of Rheumatology, Poliytechnic University of Marche, Ospedale A. Murri - Via dei Colli 52, 60035 Jesi, Ancona (Italy)

    2012-08-15

    Objectives: To evaluate the presence of blood flow by colour Doppler ultrasonography (CDUS) in the wrist and finger joints of rheumatoid arthritis (RA) patients and healthy subjects and to define a cut-off value of CDUS resistive index (RI). Methods: Forty-three patients with RA and 43 healthy controls were examined by CDUS. The wrists, second and third metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints were evaluated in each patient and healthy subject. Spectral Doppler analysis was performed in order to characterize the type of flow and a mean RI was measured to define a cut-off level. The area under receiver operating characteristic curve was used to evaluate the screening method's performance. Results: Flow was detected in 219 of the 430 total joints (50.9%) of RA patients (111 in the wrists, 49 in the MCP and 30 in the PIP joints). Healthy subjects had a quantifiable flow in 45 of the 430 joints (10.5%) and, in particular, 39 (86.4%) in the wrist, 5 (11.14%) in the MCP and 1 (2.2%) in the PIP joints. The intra- and inter-reader agreements for the detection of Doppler signal were very good (kappa 0.82 and 0.89, respectively). Mean RI values were 0.72 {+-} 0.06 in RA patients and 0.86 {+-} 0.06 in healthy subjects (p < 0.01). At cut-off point of RI < 0.79 the sensitivity was 89.6% and the specificity was 78.8% (positive likelihood ratio 4.22). Conclusion: DUS is a useful tool for the detection of abnormal blood flow in inflammatory joints of RA patients.

  6. Interobserver agreement in ultrasonography of the finger and toe joints in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Szkudlarek, Marcin; Court-Payen, Michel; Jacobsen, Søren

    2003-01-01

    on the same day by 2 ultrasound investigators (an experienced musculoskeletal radiologist and a rheumatologist with limited ultrasound training). Joint effusion, synovial thickening, bone erosions, and power Doppler signal were evaluated in accordance with an introduced 4-grade semiquantitative scoring system...... patients with active RA. A General Electric LOGIQ 500 ultrasound unit with a 7-13-MHz linear array transducer was used. In each patient, 5 preselected small joints (second and third metacarpophalangeal, second proximal interphalangeal, first and second metatarsophalangeal) were examined independently......, on which the investigators had reached consensus prior to the study. RESULTS: Exact agreement between the 2 observers was seen in 91% of the examinations with regard to bone erosions, in 86% with regard to synovitis, in 79% with regard to joint effusions, and in 87% with regard to power Doppler signal...

  7. Interobserver agreement in ultrasonography of the finger and toe joints in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Szkudlarek, Marcin; Court-Payen, Michel; Jacobsen, Søren

    2003-01-01

    patients with active RA. A General Electric LOGIQ 500 ultrasound unit with a 7-13-MHz linear array transducer was used. In each patient, 5 preselected small joints (second and third metacarpophalangeal, second proximal interphalangeal, first and second metatarsophalangeal) were examined independently...... on the same day by 2 ultrasound investigators (an experienced musculoskeletal radiologist and a rheumatologist with limited ultrasound training). Joint effusion, synovial thickening, bone erosions, and power Doppler signal were evaluated in accordance with an introduced 4-grade semiquantitative scoring system......, on which the investigators had reached consensus prior to the study. RESULTS: Exact agreement between the 2 observers was seen in 91% of the examinations with regard to bone erosions, in 86% with regard to synovitis, in 79% with regard to joint effusions, and in 87% with regard to power Doppler signal...

  8. High-resolution MRI of the wrist and finger joints in patients with rheumatoid arthritis: comparison of 1.5 Tesla and 3.0 Tesla

    International Nuclear Information System (INIS)

    Wieners, Gero; Detert, Jacqueline; Burmester, Gerd; Backhaus, Marina; Streitparth, Florian; Fischbach, Frank; Bruhn, Harald; Pech, Maciej; Ricke, Jens

    2007-01-01

    The goal of this study was to compare magnetic resonance (MR) image quality at different field strengths for evaluating lesions in wrist and finger joints of patients with rheumatoid arthritis (RA) in order to determine whether the higher field strength provides diagnostic gain. The hand mainly affected in 17 RA patients was examined at 1.5 Tesla (T) and 3.0 T with comparable MR imaging (MRI) protocols. MR images were reviewed twice by two experienced radiologists using the Rheumatoid Arthritis MRI Scoring System (RAMRIS) of the OMERACT (Outcome Measures in Rheumatoid Arthritis Clinical Trials) group. Image quality was rated on a five-point scale using Friedmann's test and Kendall's W-test for statistical analysis. Image comparison revealed better image quality at higher field strength. Image quality of T1-weighted images was rated 14-22% better at 3.0 T compared with 1.5 T by both readers. Moreover, the rating for the T2-weighted-images acquired at 3.0 T was one point better in the five-point scale used. Inter-reader correlation for image quality, bone erosions/defects, edema and synovitis ranged between 0.6 and 0.9 at 3.0 T and between 0.6 and 0.8 at 1.5 T. Intra-reader correlation for these parameters was high at 0.8-1.0. MRI image quality of RA hands is superior at 3.0 T, while an acceptable image quality is achieved at 1.5 T, which improves the evaluation of extent of bone edema, synovitis and identification of small bone erosions. (orig.)

  9. Cancer risk among patients with finger and hand joint and temporo-mandibular joint prostheses in Denmark.

    Science.gov (United States)

    Fryzek, J P; Mellemkjaer, L; McLaughlin, J K; Blot, W J; Olsen, J H

    1999-05-31

    The use of artificial joint implants has risen greatly over the past years. However, few investigations of the cancer risk associated with implants have been performed. We investigated cancer risk in patients with finger and hand joint and temporo-mandibular (TMJ) joint implants. A nationwide cohort in Denmark of patients with finger and hand joint prostheses (n = 858) or TMJ implants (n = 389) was followed from January 1, 1977, to December 31, 1995, to evaluate any potential cancer risks subsequent to receiving these implants. Standardized incidence ratios (SIRs) for all cancers were 1.0 (95% CI = 0.8-1.2) for the finger and hand joint cohort and 1.1 (95% CI = 0.8-1.7) for the TMJ cohort. A significant risk for non-Hodgkin's lymphoma was found in the finger and hand joint cohort (SIR = 3.8, 95% CI = 1.5-7.8). When the finger and hand joint cohort was stratified by diagnosis of rheumatoid arthritis, the excess risk was seen only in the group with rheumatoid arthritis. This is consistent with past studies, which have found an association between rheumatoid arthritis and non-Hodgkin's lymphoma. Our results provide evidence that the cancer risk for patients with finger and hand joint prostheses and TMJ implants is similar to that for the general population.

  10. 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.

  11. Joint Replacement (Finger and Wrist Joints)

    Science.gov (United States)

    ... All Topics A-Z Videos Infographics Symptom Picker Anatomy Bones Joints Muscles Nerves Vessels Tendons About Hand Surgery What is a Hand Surgeon? What is a Hand Therapist? Media Find a Hand Surgeon Home Anatomy Joint Replacement Email to a friend * required fields ...

  12. Validation of automatic joint space width measurements in hand radiographs in rheumatoid arthritis

    NARCIS (Netherlands)

    Schenk, Olga; Huo, Yinghe; Vincken, Koen L; van de Laar, Mart A; Kuper, Ina H H; Slump, Kees C H; Lafeber, Floris P J G; Bernelot Moens, Hein J

    2016-01-01

    Computerized methods promise quick, objective, and sensitive tools to quantify progression of radiological damage in rheumatoid arthritis (RA). Measurement of joint space width (JSW) in finger and wrist joints with these systems performed comparable to the Sharp-van der Heijde score (SHS). A next

  13. Validation of automatic joint space width measurements in hand radiographs in rheumatoid arthritis

    NARCIS (Netherlands)

    Schenk, Olga; Huo, Yinghe; Vincken, Koen L.; van de Laar, Mart A F J; Kuper, Ina H.H.; Slump, Cornelis H.; Lafeber, Floris P.J.G.; Bernelot Moens, Hein J.

    2016-01-01

    Computerized methods promise quick, objective, and sensitive tools to quantify progression of radiological damage in rheumatoid arthritis (RA). Measurement of joint space width (JSW) in finger and wrist joints with these systems performed comparable to the Sharp–van der Heijde score (SHS). A next

  14. Power Doppler signal calibration between ultrasound machines by use of a capillary-flow phantom for pannus vascularity in rheumatoid finger joints: a basic study.

    Science.gov (United States)

    Sakano, Ryosuke; Kamishima, Tamotsu; Nishida, Mutsumi; Horie, Tatsunori

    2015-01-01

    Ultrasound allows the detection and grading of inflammation in rheumatology. Despite these advantages of ultrasound in the management of rheumatoid patients, it is well known that there are significant machine-to-machine disagreements regarding signal quantification. In this study, we tried to calibrate the power Doppler (PD) signal of two models of ultrasound machines by using a capillary-flow phantom. After flow velocity analysis in the perfusion cartridge at various injection rates (0.1-0.5 ml/s), we measured the signal count in the perfusion cartridge at various injection rates and pulse repetition frequencies (PRFs) by using PD, perfusing an ultrasound micro-bubble contrast agent diluted with normal saline simulating human blood. By use of the data from two models of ultrasound machines, Aplio 500 (Toshiba) and Avius (Hitachi Aloka), the quantitative PD (QPD) index [the summation of the colored pixels in a 1 cm × 1 cm rectangular region of interest (ROI)] was calculated via Image J (internet free software). We found a positive correlation between the injection rate and the flow velocity. In Aplio 500 and Avius, we found negative correlations between the PRF and the QPD index when the flow velocity was constant, and a positive correlation between flow velocity and the QPD index at constant PRF. The equation for the relationship of the PRF between Aplio 500 and Avius was: y = 0.023x + 0.36 [y = PRF of Avius (kHz), x = PRF of Aplio 500 (kHz)]. Our results suggested that the signal calibration of various models of ultrasound machines is possible by adjustment of the PRF setting.

  15. MRI of the wrist and finger joints in inflammatory joint diseases at 1-year interval: MRI features to predict bone erosions

    International Nuclear Information System (INIS)

    Savnik, Anette; Malmskov, Hanne; Graff, Lykke B.; Danneskiold-Samsoee, Bente; Bliddal, Henning; Thomsen, Henrik S.; Nielsen, Henrik; Boesen, Jens

    2002-01-01

    The aim of this study was to assess the ability of MRI determined synovial volumes and bone marrow oedema to predict progressions in bone erosions after 1 year in patients with different types of inflammatory joint diseases. Eighty-four patients underwent MRI, laboratory and clinical examination at baseline and 1 year later. Magnetic resonance imaging of the wrist and finger joints was performed in 22 patients with rheumatoid arthritis less than 3 years (group 1) who fulfilled the American College of Rheumatology (ACR) criteria for rheumatoid arthritis, 18 patients with reactive arthritis or psoriatic arthritis (group 2), 22 patients with more than 3 years duration of rheumatoid arthritis, who fulfilled the ACR criteria for rheumatoid arthritis (group 3), and 20 patients with arthralgia (group 4). The volume of the synovial membrane was outlined manually before and after gadodiamide injection on the T1-weighted sequences in the finger joints. Bones with marrow oedema were summed up in the wrist and fingers on short-tau inversion recovery sequences. These MRI features was compared with the number of bone erosions 1 year later. The MR images were scored independently under masked conditions. The synovial volumes in the finger joints assessed on pre-contrast images was highly predictive of bone erosions 1 year later in patients with rheumatoid arthritis (groups 1 and 3). The strongest individual predictor of bone erosions at 1-year follow-up was bone marrow oedema, if present at the wrist at baseline. Bone erosions on baseline MRI were in few cases reversible at follow-up MRI. The total synovial volume in the finger joints, and the presence of bone oedema in the wrist bones, seems to be predictive for the number of bone erosions 1 year later and may be used in screening. The importance of very early bone changes on MRI and the importance of the reversibility of these findings remain to be clarified. (orig.)

  16. Compression and flexural properties of finger jointed mango wood sections

    OpenAIRE

    Kumar, V.S Kishan; Sharma, C.M; Gupta, Sachin

    2014-01-01

    In this paper, an attempt was made to assess the effectiveness of finger jointing in utilising mango wood sections for various end uses like furniture. The study was based on the estimation of Modulus of elasticity and Modulus of rupture under static bending and Maximum Crushing Stress and Modulus of elasticity under compression parallel to grain of finger jointed sections and comparing them with the values measured for clear wood sections from the same lot. For joining the sections, the Poly...

  17. Sacroiliac joint involvement in classical or definite rheumatoid arthritis

    International Nuclear Information System (INIS)

    Carvalho, A. de; Graudal, H.

    1980-01-01

    In 188 patients with rheumatoid arthritis 564 radiologic examinations of the sacroiliac joints were performed. Severe blurring of the joint space or ankylosis were uncommon. The involvement was related to an age > 40 years at the onset, high values of the ESR and involvement of most joint groups in the limbs and cervical spine. Sex, presence or high titres of the rheumatoid factor and antinuclear antibodies were unrelated to lesions of the sacroiliac joints. A relation to the severity of rheumatoid arthritis rather than to the immunologic condition is suggested. (Auth.)

  18. Magnetic resonance imaging, radiography, and scintigraphy of the finger joints

    DEFF Research Database (Denmark)

    Klarlund, M; Ostergaard, M; Jensen, K E

    2000-01-01

    To evaluate synovial membrane hypertrophy, tenosynovitis, and erosion development of the 2nd to 5th metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints by magnetic resonance imaging in a group of patients with rheumatoid arthritis (RA) or suspected RA followed up for one year...

  19. Painful Joints? Early Treatment for Rheumatoid Arthritis Is Key

    Science.gov (United States)

    ... Print this issue Painful Joints? Early Treatment for Rheumatoid Arthritis Is Key En español Send us your comments ... type of arthritis. It’s far more common than rheumatoid arthritis. Osteoarthritis is caused by wear and tear on ...

  20. Tensile Strength of Finger Joints at Elevated Temperatures

    DEFF Research Database (Denmark)

    Nielsen, Peter C.; Olesen, Frits Bolonius

    A series of test s aimed a t establishing the effect of temperature upon the tensile strength parallel-to-grain of finger jointed laminae for glulam has been conducted in the Fire Research Laboratory at Aalborg University Centre. The objective of this report is to present the background...

  1. The potential of young, green finger-jointed Eucalyptus grandis ...

    African Journals Online (AJOL)

    Drying will occur naturally while the lumber is fixed within the roof truss structure. The objectives of this study were (1) to investigate the strength and stiffness variation of the finger-jointed E. grandis product in both the green and dry state for different age and dimension lumber, (2) to investigate the variation in density, warp ...

  2. Heat Resistance of Glued Finger Joints in Spruce Wood Constructions

    Directory of Open Access Journals (Sweden)

    Martin Sviták

    2014-10-01

    Full Text Available The heat resistance of glued spruce wood was evaluated for different joint types and adhesives. Bending strength, modulus of elasticity, and also fracture evaluation were investigated on glued spruce samples made by the finger-jointed principle. Finger-jointed samples were glued with polyurethane (PUR and melamine-urea-formaldehyde (MUF adhesives. Heat loading was realized at temperatures 60, 80, and 110 °C and compared with wood with 20 °C. A static bending test with four-point flexural test was used. Elevated temperature and adhesive type had an important influence on the bending strength. On the other hand, adhesive type had a significant influence on the modulus of elasticity, but elevated temperature had no substantial influence.

  3. 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)

  4. Effect of radiosynovectomy in patients with inflammatory joint disorders not caused by rheumatoid arthritis

    International Nuclear Information System (INIS)

    Kroeger, S.; Klutmann, S.; Bohuslavizki, K.H.; Clausen, M.; Sawula, J.A.; Brenner, W.; Henze, E.

    1999-01-01

    Aim: Effect of radiosynovectomy (RS) should be evaluated both by subjective and objective parameters in patients with osteoarthritis and in patients with inflammatory joint disorders not caused by rheumatoid arthritis. Methods: A total of 98 joints in 61 patients were investigated. Patients were divided into two groups. The first group included 35 patients with therapy-resistant effusions caused by severe osteoarthritis (46 joints). The second group consisted of 26 patients (52 joints) with ankylosing spondylitis, reactive arthritis, undifferentiated spondylarthropathy, psoriatic arthritis, pigmented villo-nodular synovitis, and recurrent synovitis following surgery. Effect of RS was evaluated by a standardized questionnaire and quantified by T/B-ratios derived from blood pool images prior to and after RS. Results: Within the first patient group suffering from osteoarthritis, 40% showed a good or excellent improvement of clinical symptoms, 51% were unchanged, and in 9% symptoms worsened. Similar results were found in the second patient group. The majority of unchanged results were small finger joints. In contrast, wrist and knee joints showed a better improvement. Good correlation between results of bone scan and patients subjective impression was found in 38% and 67% in the first and the second patient group, respectively. Conclusion: Radiosynovectomy might be an effective treatment in osteoarthritis and inflammatory joint disorders not caused by rheumatoid arthritis. (orig.) [de

  5. Arthrodesis of the thumb interphalangeal joint and finger distal interphalangeal joints with a headless compression screw.

    Science.gov (United States)

    Cox, Christopher; Earp, Brandon E; Floyd, W Emerson; Blazar, Philip E

    2014-01-01

    To study the results of using a small, headless compression screw (AcuTwist) for thumb interphalangeal (IP) joint and finger distal interphalangeal (DIP) joint arthrodeses. Between November 2007 and January 2012, 48 primary arthrodeses of the thumb IP joint or DIP joint in the other digits were performed in 29 consecutive patients with AcuTwist devices. Indications for arthrodesis included 19 cases of osteoarthritis in 25 fingers, 3 cases of lupus in 9 fingers, 2 cases of post-traumatic osteoarthritis in 2 fingers, and 1 case and finger each of acute trauma, neuromuscular disorder, postinfectious osteoarthritis, boutonniere deformity, and Dupuytren contracture. Charts were reviewed for clinical data, and radiographs were assessed for alignment and healing. Age averaged 59 years and follow-up averaged 12 months (range, 2-50 mo). Union occurred in 43 out of 46 fingers (94%). There were no cases of nail deformity, wound complications, tip hypersensitivity, or clinically notable malalignment. Three arthrodeses failed to fuse, including 2 asymptomatic nonunions and 1 fixation loss requiring revision with autograft. The complication rate was 9%. Distal digital joint arthrodesis with the AcuTwist resulted in a fusion rate of 94% with a complication rate of 9%. Our rate of fusion compares favorably with prior series using other methods of fixation. Therapeutic IV. Copyright © 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  6. Early rheumatoid arthritis and its differentiation from other joint abnormalities

    International Nuclear Information System (INIS)

    Boutry, Nathalie; Carmo, Clarissa Canella Moraes do; Flipo, Rene-Marc; Cotten, Anne

    2009-01-01

    The introduction of disease-modifying antirheumatic drugs has created new demands on imaging to early identify patients with rheumatoid arthritis and opened new prospects in therapeutic management of patients with aggressive disease. Therefore, new imaging modalities such as magnetic resonance imaging and ultrasound have developed during the past few years in this field. In some cases, both magnetic resonance imaging and ultrasound may be also useful in making the distinction between early rheumatoid arthritis and other joints abnormalities, including early psoriatic arthritis. This article will review key aspects of important advances in imaging in rheumatoid arthritis, particularly focusing on magnetic resonance imaging and ultrasound.

  7. Radionuclide study of the joints in rheumatoid arthritis

    International Nuclear Information System (INIS)

    Ikonnikov, A.I.; Drozdovskij, B.Ya.; Ivanov, Yu.N.; Romagin, V.K.

    1985-01-01

    Diagnostic opportunities of scintigraphy with sup(113m)In- eluate in 49 rheumatoid arthritis patients with prevalent knee joint affections at the exudative-proliferative period of the disease have been studied. Selective accumulation of radionuclide in the inflammatory tissue forms the basis of the method. It is shown that the scintigraphic study (scintiscanning) with sup(113m)In allows to differentiate between the exudative ad exudative-proliferative stages of rheumatoid arthritis and to assess the results of medicamentary treatment

  8. Computer-aided joint space analysis of the metacarpal-phalangeal and proximal-interphalangeal finger joint: normative age-related and gender-specific data

    International Nuclear Information System (INIS)

    Pfeil, Alexander; Boettcher, Joachim; Seidl, Bettina E.; Heyne, Jens-Peter; Petrovitch, Alexander; Mentzel, Hans-Joachim; Kaiser, Werner A.; Eidner, Torsten; Wolf, Gunter; Hein, Gert

    2007-01-01

    The purpose of the study was to provide reference data for computer-aided joint space analysis based on a semi-automated and computer-aided diagnostic system for the measurement of metacarpal-phalangeal and proximal-interphalangeal finger joint widths; additionally, the determination of sex differences and the investigation of changes in joint width with age were evaluated. Eighty hundred and sixty-nine patients (351 female and 518 male) received radiographs of the hand for trauma and were screened for a host of conditions known to affect the joint spaces. All participants underwent measurements of joint space distances at the metacarpal-phalangeal articulation (JSD-MCP) from the thumb to the small finger and at the proximal-interphalangeal articulation (JSD-PIP) from the index finger to the small finger using computer-aided diagnosis technology with semi-automated edge detection. The study revealed an annual narrowing of the JSD of 0.6% for the JSD-MCP and for the JSD-PIP. Furthermore, the data demonstrated a notable age-related decrease in JSD, including an accentuated age-related joint space narrowing in women for both articulations. Additionally, males showed a significantly wider JSD-MCP (+11.1%) and JSD-PIP (+15.4%) compared with the female cohort in all age groups. Our data presented gender-specific and age-related normative reference values for computer-aided joint space analysis of the JSD-MCP and JSD-PIP that could be used to identify disease-related joint space narrowing, particularly in patients with osteoarthritis and rheumatoid arthritis commonly involving the peripheral small hand joints. (orig.)

  9. Early biomarkers of joint damage in rheumatoid and psoriatic arthritis.

    LENUS (Irish Health Repository)

    Mc Ardle, Angela

    2015-01-01

    Joint destruction, as evidenced by radiographic findings, is a significant problem for patients suffering from rheumatoid arthritis and psoriatic arthritis. Inherently irreversible and frequently progressive, the process of joint damage begins at and even before the clinical onset of disease. However, rheumatoid and psoriatic arthropathies are heterogeneous in nature and not all patients progress to joint damage. It is therefore important to identify patients susceptible to joint destruction in order to initiate more aggressive treatment as soon as possible and thereby potentially prevent irreversible joint damage. At the same time, the high cost and potential side effects associated with aggressive treatment mean it is also important not to over treat patients and especially those who, even if left untreated, would not progress to joint destruction. It is therefore clear that a protein biomarker signature that could predict joint damage at an early stage would support more informed clinical decisions on the most appropriate treatment regimens for individual patients. Although many candidate biomarkers for rheumatoid and psoriatic arthritis have been reported in the literature, relatively few have reached clinical use and as a consequence the number of prognostic biomarkers used in rheumatology has remained relatively static for several years. It has become evident that a significant challenge in the transition of biomarker candidates to clinical diagnostic assays lies in the development of suitably robust biomarker assays, especially multiplexed assays, and their clinical validation in appropriate patient sample cohorts. Recent developments in mass spectrometry-based targeted quantitative protein measurements have transformed our ability to rapidly develop multiplexed protein biomarker assays. These advances are likely to have a significant impact on the validation of biomarkers in the future. In this review, we have comprehensively compiled a list of candidate

  10. Roentgenographic study of the temporomandibular joint in rheumatoid arthritis

    International Nuclear Information System (INIS)

    Yun, Ho Jung; You, Dong Soo

    1984-01-01

    For the study of the temporomandibular joint in rheumatoid arthritis 30 patients were selected who were diagnosis as rheumatoid arthritis through the clinical, radiographic examination and laboratory finding. Temporoman dibular joint involvement was evaluated through the clinical, radiographic examination. The results were as follows; 1. TMJ was involved in 15 patients of 30 patients with rheumatoid arthritis. (50% involvement). 2. Duration of rheumatoid arthritis was more longer in patients with TMJ involvement than in patients without TMJ involvement. 3. Osseous changes in TMJ were in order of frequency erosion, flattening, osteophyte, sclerosis, deformity, and most common involved site was mandibular condyle. 4. Most common positional change of condyle was forward position in centric occlusion, and restricted movement of condyle in 1 inch mouth opening. 5. TMJ involvement of rheumatoid arthritis was almost bilateral. 6. Main symptoms of TMJ were pain, stiffness, tenderness, limitation of mouth opening, crepitation. 7. There was not the case of ankylosis. 8. There was statistically insignificant correlation between mandibular deviation and TMJ involvement, but some cases showed severe deviation on mouth opening.

  11. Comparison of sonography and magnetic resonance imaging for the diagnosis of partial tears of finger extensor tendons in rheumatoid arthritis

    NARCIS (Netherlands)

    Swen, W. A.; Jacobs, J. W.; Hubach, P. C.; Klasens, J. H.; Algra, P. R.; Bijlsma, J. W.

    2000-01-01

    Finger extensor tenosynovitis in rheumatoid arthritis (RA) may lead to partial and eventually to complete tendon tears. The aim of this study was to investigate the diagnostic value of sonography (SG) and/or magnetic resonance imaging (MRI) to visualize partial tendon tears. Twenty-one RA patients

  12. Finger jointing green southern yellow pine with a soy-based adhesive

    Science.gov (United States)

    Philip H. Steele; Roland E. Kreibicha; Petrus J. Steynberg; Richard W. Hemingway

    1998-01-01

    The authors present results of laboratory tests for a soy-based adhesive to bond southern yellow pine using the finger-jointing method. There was some reason to suspect that finger jointing of southern yellow pine (SYP) with the honeymoon system using soy-based adhesive might prove more difficult than for western species. The Wood Handbook classes western species in...

  13. Lower limb joint replacement in rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Clement Nicholas D

    2012-06-01

    Full Text Available Abstract Introduction There is limited literature regarding the peri-operative and surgical management of patients with rheumatoid disease undergoing lower limb arthroplasty. This review article summarises factors involved in the peri-operative management of major lower limb arthroplasty surgery for patients with rheumatoid arthritis. Methods We performed a search of the medical literature, using the PubMed search engine (http://www.pubmed.gov. We used the following terms: ‘rheumatoid’ ‘replacement’ ‘arthroplasty’ and ‘outcome’. Findings The patient should be optimised pre-operatively using a multidisciplinary approach. The continued use of methotrexate does not increase infection risk, and aids recovery. Biologic agents should be stopped pre-operatively due the increased infection rate. Patients should be made aware of the increased risk of infection and periprosthetic fracture rates associated with their disease. The surgical sequence is commonly hip, knee and then ankle. Cemented total hip replacement (THR and total knee replacement (TKR have superior survival rates over uncemented components. The evidence is not clear regarding a cruciate sacrificing versus retaining in TKR, but a cruciate sacrificing component limits the risk early instability and potential revision. Patella resurfacing as part of a TKR is associated with improved outcomes. The results of total ankle replacement remain inferior to THR and TKR. RA patients achieve equivalent pain relief, but their rehabilitation is slower and their functional outcome is not as good. However, the key to managing these complicated patients is to work as part of a multidisciplinary team to optimise their outcome.

  14. Divergent dislocation of the ring and little finger carpometacarpal joints--a rare injury pattern.

    LENUS (Irish Health Repository)

    Dillon, John

    2012-02-03

    Hand injuries due to longitudinal forces in the line of the metacarpals demonstrate unusual dislocation patterns. We describe a case of volar intra-articular fracture dislocation of the ring finger carpometacarpal joint in association with a pure dorsal dislocation of the little finger carpometacarpal joint. Open reduction supplemented with Kirschner wire fixation restored normal carpometacarpal joint anatomical relations and achieved an excellent clinical result.

  15. Neural network committees for finger joint angle estimation from surface EMG signals

    Directory of Open Access Journals (Sweden)

    Reddy Narender P

    2009-01-01

    Full Text Available Abstract Background In virtual reality (VR systems, the user's finger and hand positions are sensed and used to control the virtual environments. Direct biocontrol of VR environments using surface electromyography (SEMG signals may be more synergistic and unconstraining to the user. The purpose of the present investigation was to develop a technique to predict the finger joint angle from the surface EMG measurements of the extensor muscle using neural network models. Methodology SEMG together with the actual joint angle measurements were obtained while the subject was performing flexion-extension rotation of the index finger at three speeds. Several neural networks were trained to predict the joint angle from the parameters extracted from the SEMG signals. The best networks were selected to form six committees. The neural network committees were evaluated using data from new subjects. Results There was hysteresis in the measured SMEG signals during the flexion-extension cycle. However, neural network committees were able to predict the joint angle with reasonable accuracy. RMS errors ranged from 0.085 ± 0.036 for fast speed finger-extension to 0.147 ± 0.026 for slow speed finger extension, and from 0.098 ± 0.023 for the fast speed finger flexion to 0.163 ± 0.054 for slow speed finger flexion. Conclusion Although hysteresis was observed in the measured SEMG signals, the committees of neural networks were able to predict the finger joint angle from SEMG signals.

  16. Differences in Activation Area Within Brodmann Area 2 Caused by Pressure Stimuli on Fingers and Joints

    Science.gov (United States)

    Choi, Mi-Hyun; Kim, Hyung-Sik; Baek, Ji-Hye; Lee, Jung-Chul; Park, Sung-Jun; Jeong, Ul-Ho; Gim, Seon-Young; Kim, Sung-Phil; Lim, Dae-Woon; Chung, Soon-Cheol

    2015-01-01

    Abstract In this study, a constant pressure stimulus was applied on the 3 joints (first [p1], second [p2], and third [p3] joints) of 4 fingers (index, middle, ring, and little fingers), and the activation areas within Brodmann area 2 (BA 2) were compared for these different fingers and joints by using functional magnetic resonance imaging. Eight healthy male college students (25.4 ± 1.32 years) participated in the study. Each session was composed of 3 blocks, and each block was composed of a Control phase (30 seconds) and a Pressure phase (30 seconds). No pressure stimulus was applied in the Control phase, during which the subjects would simply lay comfortably with their eyes closed. In the Pressure phase, a pressure stimulus was applied onto one of the joints of the selected finger. For each finger and joint, BA 2 areas activated by the pressure stimulus were extracted by the region of interest method. There was a significant difference in the activation areas for the different fingers (P = .042) as well as for the different joints (P = .050). The activation area decreased in the order of the little, index, and middle fingers, as well as in the order of p1, p3, and p2. PMID:26402840

  17. Automated measurement of joint space width in small joints of patients with rheumatoid arthritis

    NARCIS (Netherlands)

    Lukas, Cédric; Sharp, John T.; Angwin, Jane; Boers, Maarten; Duryea, Jeff; Hall, James R.; Kauffman, Joost A.; Landewé, Robert; Langs, Georg; Bernelot Moens, Hein J.; Peloschek, Philipp; van der Heijde, Désirée

    2008-01-01

    Comparison of performances of 5 (semi)automated methods in measuring joint space width (JSW) in rheumatoid arthritis. Change in JSW was determined by 5 measurement methods on 4 radiographs per patient from 107 patients included in the COBRA trial (comparing sulfasalazine alone or in combination with

  18. Automated Measurement of joint space width in small joints of patients with rheumatoid arthritis

    NARCIS (Netherlands)

    Lukas, C.; Gordon, D.A.; Sharp, J.T.; Angwin, J.; Boers, M.; Duryea, J.; Hall, J.R.; Kauffman, J.A.; Landewe, R.; Langs, G.; Bernelot Moens, H.J.; Peloschek, P.; van der Heijde, D.

    2008-01-01

    Objective. Comparison of performances of 5 (semi)automated methods in measuring joint space width (JSW) in rheumatoid arthritis. Methods. Change in JSW was determined by 5 measurement methods on 4 radiographs per patient from 107 patients included in the COBRA trial (comparing sulfasalazine alone or

  19. Comparison between rheumatoid arthritis and osteoarthritis on knee joint MRI

    International Nuclear Information System (INIS)

    Wang Zhi; Meng Xianghong, Suo Yongmei; Wan Yeda

    2013-01-01

    Objective: To compare the MRI characteristics between the late stage rheumatoid arthritis (RA) and osteoarthritis (OA) in the knee joints. Materials and Methods: We collected knee joints MR data using 0.35 T MR from 40 patients with rheumatoid arthritis and 60 cases with osteoarthritis between July, 2010 and August, 2012. We compared the differences in the menisci, the articular cartilage, the subchondral bone, and synovial lesions between the two groups. We calculated the morbidity and analyzed the severity in each part in both groups, and compared the differences between the two groups. If P<0.05, the results had statistical significance. Results: The injury of all parts in the medial and lateral menisci in the RA group was more severe than in the OA group (P<0.05). The articular cartilage of lateral tibiofemoral joints in the RA group was more severe than in the OA group (Z values of the lateral femoral condyle and the lateral tibial plateau were 5.702 vs. 7.534, P<0.05). However, the injury did not significantly differ at the articular cartilage in the patellofemoral joints and in the medial tibiofemoral joints (P>0.05). The subchondral bone marrow lesions of both medial and lateral tibiofemoral joints in the RA group were more severe than in the OA group (the χ 2 values of the medial and lateral femoral condyle were 6.730 and 23.938, respectively; the χ 2 values of the medial and lateral tibial plateau were 12.033 and 41.017, respectively; P<0.05). However, there was no statistical significance in the subchondral bone marrow lesions in the patellofemoral joints (P>0.05). In the RA group, there were 97.5% (39/40) cases having diffuse synovial thickening, including 20 cases with bone destruction in the bare area. In the OA group, there were 21.7% (13/60) cases having synovial thickening with less extend compared to RA group, none of them had bone destruction in the bare area. Conclusions: There are diffuse synovial thickening, bare area destruction, diffuse

  20. Infrared laser transillumination CT imaging system using parallel fiber arrays and optical switches for finger joint imaging

    Science.gov (United States)

    Sasaki, Yoshiaki; Emori, Ryota; Inage, Hiroki; Goto, Masaki; Takahashi, Ryo; Yuasa, Tetsuya; Taniguchi, Hiroshi; Devaraj, Balasigamani; Akatsuka, Takao

    2004-05-01

    The heterodyne detection technique, on which the coherent detection imaging (CDI) method founds, can discriminate and select very weak, highly directional forward scattered, and coherence retaining photons that emerge from scattering media in spite of their complex and highly scattering nature. That property enables us to reconstruct tomographic images using the same reconstruction technique as that of X-Ray CT, i.e., the filtered backprojection method. Our group had so far developed a transillumination laser CT imaging method based on the CDI method in the visible and near-infrared regions and reconstruction from projections, and reported a variety of tomographic images both in vitro and in vivo of biological objects to demonstrate the effectiveness to biomedical use. Since the previous system was not optimized, it took several hours to obtain a single image. For a practical use, we developed a prototype CDI-based imaging system using parallel fiber array and optical switches to reduce the measurement time significantly. Here, we describe a prototype transillumination laser CT imaging system using fiber-optic based on optical heterodyne detection for early diagnosis of rheumatoid arthritis (RA), by demonstrating the tomographic imaging of acrylic phantom as well as the fundamental imaging properties. We expect that further refinements of the fiber-optic-based laser CT imaging system could lead to a novel and practical diagnostic tool for rheumatoid arthritis and other joint- and bone-related diseases in human finger.

  1. Pathological study of degenerative changes of finger joints in cadavers of aged persons

    OpenAIRE

    岩田,芳之

    1987-01-01

    In the present study, soft x-ray and light microscopic examinations were carried out on 17 interphalangeal (IP) joints and 85 distal interphalangeal (DIP) joints with Heberden's nodes from 15 cadavers. Microradiograms of the IP and DIP joints were analyzed as to the degenerative changes in the antero-posterior and lateral views according to our own criteria. Degenerative changes were more severe in females than in males. Advanced degeneration was found in the index, middle and little fingers,...

  2. Finger island flaps for treatment of dermato-desmogenic flexion contractures of proximal interphalangeal joints

    Directory of Open Access Journals (Sweden)

    T. S. Antonova

    2016-12-01

    Full Text Available Soft tissue defect will form after operative treatment of the dermato-desmogenic flexion contractures of fingers interphalangeal joints of the 2–3 grades after excision of the scar. Using the island flaps (Littler at the central vascular pedicle is one of the classical methods of plastic closure of such defects. Goal. To study the effectiveness of the surgical treatment of dermato-desmogenic flexion contractures of proximal interphalangeal joints of the fingers by using finger island flaps at the central vascular or neuro-vascular pedicle. Materials and methods. 14 operations were carried out on 13 patients for removing dermato-desmogenic flexion contractures of proximal interphalangeal (PIP joints of triphalangeal fingers over a 2-year period (2013–2015. The group included patients with a flexion contracture of the 2–3 grades PIP joints of triphalangeal fingers. Operations were performed on average 5 months after the injury (from 1.5 up to 16 months. Finger island flap in all cases was taken from adjacent finger by using the blood supply of their common finger artery. In all cases the island flap on the central pedicel was used, in 9 cases digital nerve was included in the pedicle (Littler. Closure of donor wound was made with free-skin grafts. Permanent splinting of the hand with extension of the interphalangeal joints and moderate flexion of the metacarpophalangeal joints were performed during 7–8 days after surgery, then exercise therapy was prescribed. Results. The results were estimated 6 and 12 months after surgery. All the results were regarded as excellent. In 5 cases of using the flap on a vascular pedicle flap hypoesthesia was detected, that has not led to dysfunction of the hand. Contracture recurrence during follow-up was not observed. Conclusions. Using the surgery for treatment of dermato-desmogenic flexion contractures of proximal interphalangeal joints of the fingers with the island flaps at the central vascular or neuro

  3. Temporomandibular joint involvement in rheumatoid arthritis patients: association between clinical and tomographic data

    OpenAIRE

    Cordeiro, Patrícia C. F; Guimaraes, Josemar P; de Souza, Viviane A; Dias, Isabela M; Silva, Jesca N. N; Devito, Karina L; Bonato, Leticia L

    2016-01-01

    Rheumatoid arthritis (RA) is a systemic autoimmune disease characterized by chronic inflammation and synovial hyperplasia, which usually affects multiple joints. The temporomandibular joint (TMJ) becomes susceptible to the development of changes resulting from RA. The aim of this study was to evaluate the presence of TMD and degenerative bone changes in TMJ in patients diagnosed with RA (rheumatoid arthritis). The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/ TMD) questio...

  4. Radio-synoviorthesis with yttrium 90 in the knee-joint in rheumatoid arthritis

    International Nuclear Information System (INIS)

    Hagena, F.W.; Muenchen Univ.

    1982-01-01

    The radio-synoviorthesis with yttrium 90 in the knee-joint in rheumatoid arthritis was performed and controlled in 106 knees of patients with rheumatoid arthritis over a span of time between 6 and 49 months. The results are similar to those of other authors. As compared to synovectomy radio-synoviorthesis seems less successful as far as long-term results are concerned. As local treatment radio-synoviorthesis seems a good supplementory element in the therapeutic plan of rheumatoid arthritis. The indication to alternative procedures has been considered carefully for each individual case and joint. (orig.) [de

  5. Evaluation of stresses generated in steel finger joint of bridge by X-ray stress measurement

    International Nuclear Information System (INIS)

    Kohri, Ami; Kawano, Yutaka; Nishido, Takayuki

    2017-01-01

    In a steel bridge, the evaluation of the stress generated in the finger joint without a gap to absorb temperature change can be an index when evaluating the remaining life. This study chose as the object the finger joint of a diagonal bridge, where the generated stress state is considered to be more complicated, prepared a finger joint test specimen that simulated an actual part, and performed a load test. For judgment, FEM analysis, non-destructive X-ray stress measurement, and measurement of the generated stress using strain gauge were applied. Compared with the FEM analysis results, the difference in the stress value was generated due to the difference in the contact state, but the trends of the stress distribution were equivalent. In addition, the same measurement value as the strain gauge was obtained, and the validity of the X-ray stress measurement method was confirmed. As a result, it was found that the stress measurement method by X-ray is effective for measuring the generated stress including the residual stress of the finger joint without gap at a bridge. (A.O.)

  6. Tomosynthesis can facilitate accurate measurement of joint space width under the condition of the oblique incidence of X-rays in patients with rheumatoid arthritis.

    Science.gov (United States)

    Ono, Yohei; Kashihara, Rina; Yasojima, Nobutoshi; Kasahara, Hideki; Shimizu, Yuka; Tamura, Kenichi; Tsutsumi, Kaori; Sutherland, Kenneth; Koike, Takao; Kamishima, Tamotsu

    2016-06-01

    Accurate evaluation of joint space width (JSW) is important in the assessment of rheumatoid arthritis (RA). In clinical radiography of bilateral hands, the oblique incidence of X-rays is unavoidable, which may cause perceptional or measurement error of JSW. The objective of this study was to examine whether tomosynthesis, a recently developed modality, can facilitate a more accurate evaluation of JSW than radiography under the condition of oblique incidence of X-rays. We investigated quantitative errors derived from the oblique incidence of X-rays by imaging phantoms simulating various finger joint spaces using radiographs and tomosynthesis images. We then compared the qualitative results of the modified total Sharp score of a total of 320 joints from 20 patients with RA between these modalities. A quantitative error was prominent when the location of the phantom was shifted along the JSW direction. Modified total Sharp scores of tomosynthesis images were significantly higher than those of radiography, that is to say JSW was regarded as narrower in tomosynthesis than in radiography when finger joints were located where the oblique incidence of X-rays is expected in the JSW direction. Tomosynthesis can facilitate accurate evaluation of JSW in finger joints of patients with RA, even with oblique incidence of X-rays. Accurate evaluation of JSW is necessary for the management of patients with RA. Through phantom and clinical studies, we demonstrate that tomosynthesis may achieve more accurate evaluation of JSW.

  7. Total fixation of cricoarytenoid joint of a patient with rheumatoid arthritis and Hashimoto thyroiditis.

    Science.gov (United States)

    Stojanović, Stevan P; Zivić, Ljubica; Stojanović, Jasmina; Belić, Branislav

    2010-01-01

    The incidence of cricoarytenoid joint fixation in case of rheumatoid arthritis is 17 to 33%. In later stages of rheumatoid arthritis, a gradual fixation of cricoarytenoid joint develops and both halves of the larynx become less movable which calls for endotracheal intubation; while total fixation of this joint demands surgical tracheotomy. Hashimoto thyroiditis can display symptoms which are difficult to distinguish from the ones present in total fixation of cricoarytenoid joint caused by rheumatoid arthritis. A 60-year-old woman in terminal stage of rheumatoid arthritis and Hashimoto thyroiditis, diagnosed after clinical and other examinations. She was treated for strident breathing with surgical tracheotomy. The microscopic examination of the larynx with the use of laryngoscopic pincers suggested the immovability of the right and very limited movability of the left arytenoid cartilage. A computerized endovideostroboscopy showed only passive vertical vibrating movements of the right vocal cord and irregular vibrations of the left vocal cord. Total fixation of the cricoarytenoid joint can be caused by many pathological processes, but so far references have shown no case of rheumatoid arthritis and Hashimoto thyroiditis. In differential diagnostics, one of many examinations is the microscopic examination of the larynx, but it is very important to determine the movability of the arytenoid cartilage with the use of appropriate instruments in total endotracheal anaesthesia while the patient is fully relaxed. Movements in cricoarytenoid joints in patients with Hashimoto thyroiditis and the same conditions are preserved.

  8. Automated measurement of joint space width in early rheumatoid arthritis hand radiographs

    NARCIS (Netherlands)

    Huo, YH

    2017-01-01

    Rheumatoid arthritis (RA) is a chronic inflammatory disease, affecting predominantly small joints of hands and feet. The current gold standard for assessment of radiographic progression in RA is the Sharp/van der Heijde scoring method (SvdH), scoring both bone erosions and joint space narrowing

  9. The OMERACT-RAMRIS Rheumatoid Arthritis Magnetic Resonance Imaging Joint Space Narrowing Score

    DEFF Research Database (Denmark)

    Møller Døhn, Uffe; Conaghan, Philip G; Eshed, Iris

    2014-01-01

    To test the intrareader and interreader reliability of assessment of joint space narrowing (JSN) in rheumatoid arthritis (RA) wrist and metacarpophalangeal (MCP) joints on magnetic resonance imaging (MRI) and computed tomography (CT) using the newly proposed OMERACT-RAMRIS JSN scoring method...

  10. Magnetic resonance imaging of rheumatoid arthritis in metacarpophalangeal joints

    International Nuclear Information System (INIS)

    Gasson, J.; Gandy, S.J.; Summers, I.R.; Hutton, C.W.; Jacoby, R.K.; Vennart, W.

    2000-01-01

    Objective. To report the development of high-resolution targeted magnetic-resonance imaging (MRI) techniques (not using injections of contrast media) to investigate and monitor rheumatoid arthritis (RA) in the metacarpophalangeal (MCP) joints.Design and patients. A total of 25 RA patients (age range 30-68 years) with varying degrees of disease severity ranging from early onset through active disease to the burnt-out stage, were imaged. (One patient subsequently underwent surgery and histological data was obtained.) A series of 10 control subjects were also studied - two for each 10-year age range. All the RA subjects were assessed for disease activity using standard clinical criteria and radiography as part of normal procedures. MRI was carried out using a targeted system and novel radiofrequency coil. Images of the MCP were performed at very high resolution with 1.5 mm slice thickness and in-plane resolution 130 μm. Standard gradient-echo (GE) sequences were used for anatomical imaging, multiple-echo GE sequences used to produce effective spin-spin relaxation time (T2*) maps and optimised binomial-pulse presaturation used in conjunction with a GE sequence to generate magnetization-transfer (MT) ratio maps.Results. High-quality high-resolution images of the MCP joints were obtained which highlighted normal anatomy and key features characterising the disease state (e.g. pannus, bone erosions, vascularity). Accurate measurements of T2* and MT with variations of ±4% and ±2% respectively were achieved. In active disease, variations in T2* and MT could be determined throughout areas of pannus, clearly demonstrating the heterogeneity of this erosive tissue. Pannus in MCP joints with active destruction was found to have high values of T2* varying from 25 ms to 40 ms with pockets up to 100 ms, whereas pannus present in chronic destruction, or burnt-out disease, had T2* values ranging from 21 to 29 ms. MT-active tissue was uniformly distributed in burnt-out disease

  11. Magnetic resonance imaging of rheumatoid arthritis in metacarpophalangeal joints

    Energy Technology Data Exchange (ETDEWEB)

    Gasson, J.; Gandy, S.J.; Summers, I.R. [School of Physics, Univ. of Exeter (United Kingdom); Hutton, C.W. [Mount Gould Hospital, Plymouth (United Kingdom); Jacoby, R.K. [Princess Elizabeth Orthopaedic Centre, Exeter (United Kingdom); Vennart, W. [School of Physics, Univ. of Exeter (United Kingdom); Department of ECRG, C746, Pfizer Central Research, Sandwich, Kent (United Kingdom)

    2000-06-01

    Objective. To report the development of high-resolution targeted magnetic-resonance imaging (MRI) techniques (not using injections of contrast media) to investigate and monitor rheumatoid arthritis (RA) in the metacarpophalangeal (MCP) joints.Design and patients. A total of 25 RA patients (age range 30-68 years) with varying degrees of disease severity ranging from early onset through active disease to the burnt-out stage, were imaged. (One patient subsequently underwent surgery and histological data was obtained.) A series of 10 control subjects were also studied - two for each 10-year age range. All the RA subjects were assessed for disease activity using standard clinical criteria and radiography as part of normal procedures. MRI was carried out using a targeted system and novel radiofrequency coil. Images of the MCP were performed at very high resolution with 1.5 mm slice thickness and in-plane resolution 130 {mu}m. Standard gradient-echo (GE) sequences were used for anatomical imaging, multiple-echo GE sequences used to produce effective spin-spin relaxation time (T2*) maps and optimised binomial-pulse presaturation used in conjunction with a GE sequence to generate magnetization-transfer (MT) ratio maps.Results. High-quality high-resolution images of the MCP joints were obtained which highlighted normal anatomy and key features characterising the disease state (e.g. pannus, bone erosions, vascularity). Accurate measurements of T2* and MT with variations of {+-}4% and {+-}2% respectively were achieved. In active disease, variations in T2* and MT could be determined throughout areas of pannus, clearly demonstrating the heterogeneity of this erosive tissue. Pannus in MCP joints with active destruction was found to have high values of T2* varying from 25 ms to 40 ms with pockets up to 100 ms, whereas pannus present in chronic destruction, or burnt-out disease, had T2* values ranging from 21 to 29 ms. MT-active tissue was uniformly distributed in burnt-out disease

  12. Trends in Joint Replacement Surgery in Patients with Rheumatoid Arthritis.

    Science.gov (United States)

    Young, Bradley L; Watson, Shawna L; Perez, Jorge L; McGwin, Gerald; Singh, Jasvinder A; Ponce, Brent A

    2018-02-01

    This study analyzed trends in large total joint arthroplasties (TJA) and in the proportion of these procedures performed on patients with rheumatoid arthritis (RA). The US Nationwide Inpatient Sample (2002-2012) was used to identify the incidences of total shoulder (TSA), elbow (TEA), knee (TKA), hip (THA), and ankle (TAA) arthroplasty and the proportion of these performed with coexisting RA. The prevalence of RA among patients with TJA increased 3.0%. The prevalence of RA among cases of TEA and TSA decreased by 50% (p < 0.0001) and 18% (p = 0.0016), respectively; a 38.0% decrease occurred in the prevalence of RA among TAA (p = 0.06); and nonsignificant increases were seen among THA and TKA. The average age difference between RA and non-RA patients undergoing TJA narrowed by 2 years (p < 0.0001). There was a greater reduction in the proportion of TSA, TEA, and TAA groups among women with RA than men with RA. In the TSA and TEA groups, there was a reduction in the proportion of whites with RA, but not blacks. The proportion of privately insured TSA and TAA patients with RA decreased, while patients with RA undergoing TSA, TEA, or TAA who were receiving Medicaid (government medical insurance) remained relatively stable over time. The prevalence of RA has decreased among TSA and TEA patients. A nonsignificant decline occurred among TAA patients. The average age of TJA patients with RA is beginning to mirror those without RA. Sex ratios for TSA, TEA, and TAA patients are following a similar pattern. These results may be evidence of the success of modern RA treatment strategies.

  13. Rheumatoid Arthritis Pain: Tips for Protecting Your Joints

    Science.gov (United States)

    ... so you can get out and stretch. On airplanes choose aisle seats, so you can shift your ... Education and Research; 2010. March 08, 2018 Original article: http://www.mayoclinic.org/diseases-conditions/rheumatoid-arthritis/ ...

  14. Refraction-enhanced tomosynthesis of a finger joint by X-ray dark-field imaging

    International Nuclear Information System (INIS)

    Shimao, Daisuke; Kunisada, Toshiyuki; Sugiyama, Hiroshi; Ando, Masami

    2007-01-01

    A finger joint tomogram based on X-ray dark-field imaging (XDFI) was demonstrated using the simplest shift-and-add tomosynthesis algorithm. Raw XDFI image data for tomosynthesis were acquired in a total of 11 views through 10deg, in increments of 1deg, by rotating the object and detector synchronously. Incident X-ray energy was monochromatic 36.0 keV, derived from synchrotron radiation. The total dosage in acquiring 11 views for raw image data was equivalent to that of one XDFI image. A clear tomogram was obtained of a finger joint (including articular cartilage, which is invisible by conventional tomosynthesis) without an increase in X-ray dosage. (author)

  15. Motion correction improves image quality of dGEMRIC in finger joints

    International Nuclear Information System (INIS)

    Miese, Falk; Kröpil, Patric; Ostendorf, Benedikt; Scherer, Axel; Buchbender, Christian; Quentin, Michael; Lanzman, Rotem S.; Blondin, Dirk; Schneider, Matthias; Bittersohl, Bernd; Zilkens, Christoph; Jellus, Vladimir; Mamisch, Tallal Ch.; Wittsack, Hans-Jörg

    2011-01-01

    Purpose: To assess motion artifacts in dGEMRIC of finger joints and to evaluate the effectiveness of motion correction. Materials and methods: In 40 subjects (26 patients with finger arthritis and 14 healthy volunteers) dGEMRIC of metacarpophalangeal joint II was performed. Imaging used a dual flip angle approach (TE 3.72 ms, TR 15 ms, flip angles 5° and 26°). Two sets of T1 maps were calculated for dGEMRIC analysis from the imaging data for each subject: one with and one without motion correction. To compare image quality, visual grading analysis and precision of dGEMRIC measurement of both dGEMRIC maps for each case were evaluated. Results: Motion artifacts were present in 82% (33/40) of uncorrected dGEMRIC maps. Motion artifacts were graded as severe or as rendering evaluation impossible in 43% (17/40) of uncorrected dGEMRIC maps. Motion corrected maps showed significantly less motion artifacts (P < 0.001) and were graded as evaluable in 97% (39/40) of cases. Precision was significantly higher in motion corrected images (coefficient of variation (CV = .176 ± .077), compared to uncorrected images (CV .445 ± .347) (P < .001). Motion corrected dGERMIC was different in volunteers and patients (P = .044), whereas uncorrected dGEMRIC was not (P = .234). Conclusion: Motion correction improves image quality, dGEMRIC measurement precision and diagnostic performance in dGEMRIC of finger joints.

  16. Customizing Extensor Reconstruction in Vascularized Toe Joint Transfers to Finger Proximal Interphalangeal Joints: A Strategic Approach for Correcting Extensor Lag.

    Science.gov (United States)

    Loh, Charles Yuen Yung; Hsu, Chung-Chen; Lin, Cheng-Hung; Chen, Shih-Heng; Lien, Shwu-Huei; Lin, Chih-Hung; Wei, Fu-Chan; Lin, Yu-Te

    2017-04-01

    Vascularized toe proximal interphalangeal joint transfer allows the restoration of damaged joints. However, extensor lag and poor arc of motion have been reported. The authors present their outcomes of treatment according to a novel reconstructive algorithm that addresses extensor lag and allows for consistent results postoperatively. Vascularized toe joint transfers were performed in a consecutive series of 26 digits in 25 patients. The average age was 30.5 years, with 14 right and 12 left hands. Reconstructed digits included eight index, 10 middle, and eight ring fingers. Simultaneous extensor reconstructions were performed and eight were centralization of lateral bands, five were direct extensor digitorum longus-to-extensor digitorum communis repairs, and 13 were central slip reconstructions. The average length of follow-up was 16.7 months. The average extension lag was 17.9 degrees. The arc of motion was 57.7 degrees (81.7 percent functional use of pretransfer toe proximal interphalangeal joint arc of motion). There was no significant difference in the reconstructed proximal interphalangeal joint arc of motion for the handedness (p = 0.23), recipient digits (p = 0.37), or surgical experience in vascularized toe joint transfer (p = 0.25). The outcomes of different techniques of extensor mechanism reconstruction were similar in terms of extensor lag, arc of motion, and reconstructed finger arc of motion compared with the pretransfer toe proximal interphalangeal joint arc of motion. With this treatment algorithm, consistent outcomes can be produced with minimal extensor lag and maximum use of potential toe proximal interphalangeal joint arc of motion. Therapeutic, IV.

  17. Suggested MR staging classification of early rheumatoid arthritis at the metacarpophalangeal and proximal interphalangeal joints

    International Nuclear Information System (INIS)

    Scheck, R.J.; Hoischen, S.H.; Willemsen, U.F.; Pfluger, T.; Kueffer, G.; Krueger, K.; Schattenkirchner, M.; Hahn, K.

    1997-01-01

    Purpose: MRI can demonstrate pathology of joint disease in the early course of rheumatoid arthritis prior to destructions seen on conventional radiographs. In a prospective study, we tried to develop a systematical classification of joint pathology demonstrated by MRI, which would be essential for scoring the course of the disease. Patients and method: Metacarpophalangeal and interphalangeal joints of 48 patients suffering from early rheumatoid arthritis (mean disease duration: 6.4 months) were evaluated by MRI using a high-resolution transmitter-receiver coil. Examinations included 2 mm sliced T 2 -, T 1 - and gadolinium enhanced T 1 -SE sequences in coronal and axial orientation. In consideration of pathological findings on MRI and histopathogenetical pathways of destruction in rheumatoid arthritis a MR-score (0-5) was established. Results: This allowed to score each joint examined: Score 0 (normal) in 47.8%/49.5%, score 1 in 35.5%/50.5%, score 2 in 4.2%/0%, score 3 in 10.8%/0%, score 4 in 1.5%/0% of the metacarpophalangeal/interphalangeal joints, respectively. Conclusions: Using the MR-score a relative individual destruction number can be calculated, which may be used to follow up patients in the early course of rheumatoid arthritis (e.g. drug therapy studies). The presented MR scoring system has to be evaluated further in longitudinal studies and must be correlated to radiographical and clinical findings. (orig.) [de

  18. Bone scan and joint scan of hands and feet in rheumatoid arthritis

    International Nuclear Information System (INIS)

    Carpentier, N.; Verbeke, S.; Perdrisot, R.; Grilo, R.M.; Quenesson, E.; Bonnet, C.; Vergne, P.; Treves, R.; Bertin, P.; Boutros-Toni, F.

    2000-01-01

    The aim of this study was to determine the ability of joint scan and bone scan of hands and feet, in patients with rheumatoid arthritis, to localize the altered joints. The sensitivity, the specificity, the positive predictive value (PPV) and the negative predictive value (NPV) of joint scan were determined in comparison with clinical joint assessment. Fifteen patients (780 joints) were clinically examined (pain and synovitis); during the same day, a bone scan and a joint scan were realized by oxidronate 99m Tc intravenous injection. Patients were scanned 5 minutes (tissual time, T t ) and 3 hours 1/4 (bone time, T 0 ) after the administration. The uptake of the bi-phosphonate was evaluated with a qualitative method using a grey scale. The uptake of 99m Tc oxidronate was quantitated using an extra-articular region of interest. The sensitivity, specificity, PPV and NPV of the scan at Tt were 46%, 96%, 85% et 78%. The same parameters were 75%, 66%, 53% and 84% for the scan realized at T 0 . The joint scan has showed 22% of false positive. These false positives could be a consequence of an earlier detection of joint alterations by scan. The joint scan should forecast the evolution of joints in patients with rheumatoid arthritis. (author)

  19. A fully rotational joint underactuated finger mechanism and its kinematics analysis

    Directory of Open Access Journals (Sweden)

    Wu Licheng

    2016-09-01

    Full Text Available The characteristic features of underactuated finger are compact structure, large grasping force, and simple operation. It has a wide application prospect in the fields of industrial robot, humanoid robot, human artificial limb, and space robot. A new type of fully rotating joint linkage-based underactuated mechanism is proposed, and a new method based on the law of minimum resistance is presented to realize the equivalent mechanism at different contact conditions of the finger and the kinematical analysis based on the equivalent mechanism. The kinematic equations and the limit moving position of the mechanism are derived using the proposed method. Finally, the numerical simulation is carried out by MATLAB program. The correctness and effectiveness of the proposed method are verified. The simulation results show that the proposed mechanism has a large grasp space and can achieve good grasp trajectory.

  20. Applied Joint-Space Torque and Stiffness Control of Tendon-Driven Fingers

    Science.gov (United States)

    Abdallah, Muhammad E.; Platt, Robert, Jr.; Wampler, Charles W.; Hargrave, Brian

    2010-01-01

    Existing tendon-driven fingers have applied force control through independent tension controllers on each tendon, i.e. in the tendon-space. The coupled kinematics of the tendons, however, cause such controllers to exhibit a transient coupling in their response. This problem can be resolved by alternatively framing the controllers in the joint-space of the manipulator. This work presents a joint-space torque control law that demonstrates both a decoupled and significantly faster response than an equivalent tendon-space formulation. The law also demonstrates greater speed and robustness than comparable PI controllers. In addition, a tension distribution algorithm is presented here to allocate forces from the joints to the tendons. It allocates the tensions so that they satisfy both an upper and lower bound, and it does so without requiring linear programming or open-ended iterations. The control law and tension distribution algorithm are implemented on the robotic hand of Robonaut-2.

  1. Arthroscintigraphy in diagnosis of relapses after early synovectomy of the knee joints in patients with rheumatoid arthritis

    International Nuclear Information System (INIS)

    Zubovski, G.A.; Abasov, Eh.Sh.; Smirnov, Yu.N.

    1980-01-01

    The authors studied differential diagnostic possibilities of scintigraphy with the use of sup(99m)Tc-pyrophosphate to reveal relapses after early synovectomy of the knee joints in 40 patients with rheumatoid arthritis. High informativeness of the method was established. The authors succeded in diagnosing the subclinical variant of rheumatoid synovitis in the operated joints by means of scintigraphy. The computer-arthroscintigraphy method with sup(99m)Tc-pyrophosphate is recommended for a wide use in arthrological practice to ensure an objective assessment of the condition of the operated joints in patients with rheumatoid arthritis and to conduct timely adequate therapy for the prevention of the relapses

  2. A Biomechanical Simulation of the Effect of the Extrinsic Flexor Muscles on Finger Joint Flexion

    Science.gov (United States)

    2001-10-25

    vol. 44, pp. 493-504, 1997. [8] A.B. Leger and T.E. Milner, “The effect of eccentric exercise on intrinsic and reflex stiffness in the human hand...line of action of the tendons and the effective moment arms. After a certain point, the FDP tendon became slack, while the FDS tendon remained...link chain with three revolute joints and four links was created to model the index finger. The tendons from the extrinsic flexor muscles were

  3. Simultaneous Dorsal Dislocation of the Proximal and Distal Interphalangeal Joints in the Middle Finger: A Case Report

    Directory of Open Access Journals (Sweden)

    Mohamed Ali Sbai

    2017-07-01

    Full Text Available Introduction Dorsal dislocation of a proximal or distal interphalangeal joint is a common clinical problem. However, simultaneous dislocation of both joints in the same digit is rare. Case Presentation A 32-year-old male injured his left hand third finger while biking. Examination revealed a stepladder deformity. Neurovascular examination was normal. Radiographs revealed dorsal dislocation of both the proximal and distal interphalangeal joints. The finger was reduced easily by longitudinal manual traction under the digital block. The finger was splinted in the intrinsic plus position for 3 weeks accompanied with active range of motion. After 6 months, the patient returned to normal sporting activity without limitation of motion. Conclusions In case of simultaneous dorsal dislocation of a proximal and distal interphalangeal joint, closed reduction is the treatment of choice and it could result in good and normal range of motion.

  4. United States Physical Therapists' Knowledge About Joint Hypermobility Syndrome Compared with Fibromyalgia and Rheumatoid Arthritis.

    Science.gov (United States)

    Russek, Leslie N; LaShomb, Emily A; Ware, Amy M; Wesner, Sarah M; Westcott, Vanessa

    2016-03-01

    Joint hypermobility syndrome (JHS) is one of the most common inherited connective tissue disorders. It causes significant pain and disability for all age groups, ranging from developmental delay among children to widespread chronic pain in adults. Experts in JHS assert that the condition is under-recognized and poorly managed. The aim of this study was to assess US physical therapists' knowledge about JHS compared with other causes of widespread pain and activity limitations: fibromyalgia, juvenile rheumatoid arthritis and adult rheumatoid arthritis. Cross-sectional, Internet-based survey of randomly selected members of the American Physical Therapy Association and descriptive statistics were used to explore physical therapists' knowledge about JHS, fibromyalgia, juvenile rheumatoid arthritis and adult rheumatoid arthritis, and chi square was used to compare knowledge about the different conditions. The response rate was 15.5% (496). Although 36% recognized the Beighton Scale for assessing joint hypermobility, only 26.8% of respondents were familiar with the Brighton Criteria for diagnosing JHS. Few respondents (11-19%) realized that JHS has extra-articular features such as anxiety disorder, fatigue, headache, delayed motor development, easy bruising and sleep disturbance. Physical therapists working in environments most likely to see patients with JHS underestimated the likely prevalence in their patient population. The results suggest that many physical therapists in the United States are not familiar with the diagnostic criteria, prevalence or common clinical presentation of JHS. Copyright © 2014 John Wiley & Sons, Ltd.

  5. A review of clinical and radiological aspects of rheumatoid arthritis of head joints

    International Nuclear Information System (INIS)

    Schilling, F.

    1987-01-01

    The most important inflammations--rheumatic joint diseases of the vertebral column--are chronic polyarthritis (rheumatoid arthritis) with involvement of cervical vertebral and atlanto-axial dislocation and ankylosing spondylitis (Bechterew's disease) resp. the seronegative spondylarthritis. A decisive and important difference between both forms of disease is found in the region of the cervical part of the vertebral column. In case of a spondylarthritis (ASp.) the ankylopoietica type includes the cervical vertebrae but the chronic polyarthritis (RA) is usually limited to the cervical vertebral spine. The incidence in both types (RA) is usually limited to the cervical vertebral spine. The incidence in both types (RA and ASp.) of cervical involvement is about 30%. The authors present an account of the underlying disease process. A description of rheumatoid cervical arthritis is given. The destructive and dislocating arthritis of the cranio-cervical function (arthritis of the head and neck joints) is described

  6. Distraction arthroplasty with arthroscopic microfracture in a patient with rheumatoid arthritis of the ankle joint.

    Science.gov (United States)

    Nakasa, Tomoyuki; Adachi, Nobuo; Kato, Tomohiro; Ochi, Mitsuo

    2015-01-01

    We treated a 39-year-old female who had experienced destruction of her ankle joint owing to rheumatoid arthritis. This relatively young patient wished to avoid ankle fusion and joint replacement. Therefore, distraction arthroplasty with arthroscopic microfracture was performed to improve her symptoms and preserve motion. A microfracture procedure specifically for cartilage defects of the tibial plafond and talar dome was performed with the arthroscope, after which a hinged external fixator was applied to distract the ankle joint. The ankle joint space was enlarged by the external device and joint movement allowed. After 3 months, removal of the external device and repeat arthroscopy revealed newly formed fibrocartilage on the surfaces of both the tibia and the talus. At 2 years after the surgery, a radiograph showed that the joint space enlargement of the ankle had been maintained. The American Orthopaedic Foot and Ankle Society score improved from 37 points preoperatively to 82 points at 2 years postoperatively. Our findings suggest that good clinical results can be achieved with distraction arthroplasty and arthroscopic microfracture in a relatively young patient with rheumatoid arthritis. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  7. Investigations in the scintiscanning of joints of animals with experimental and rheumatoid arthritis

    International Nuclear Information System (INIS)

    Hanheide, M.

    1982-01-01

    In 69 guinea pigs with experimental hyperergic arthritis scintiscanning was done to study the course of the inflammation and the deposition of the radionuclides used. During the first days there was an added storage in the inflamed joints of those animals on whom scintiscanning with Tc99m04 had been performed. The accumulation of Tc99m04 in the joints was due to its uptake by synovial tissue and hydrarthrosis as shown by scintiscanning after haemorrhage and perfusion, macroscopic autoradiography and measurements of radioactivity in tissue samples. In 13 animals with rheumatoid arthritis scintiscanning was done twice with Tc99m04 and three times with Tc99mMDP over a period of 13 to 21 months; concomitantly laboratory tests and X-rays were conducted. After Tc99m04 there was a fall in the scintigraphic inflammation index during treatment. That index was determined by forming the quotient from the activities established above the proximal interphalangeal joints and the tibial head. Scintiscanning with Tc99mMDP led to a fall of the inflammation index in animals with classical rheumatoid arthritis, whereas in the ones with probable rheumatoid arthritis it again rose after an initial fall. Unlike x-ray investigation, scintiscanning permits an early diagnosis and course control. (orig.) [de

  8. Comparison between three radiographic techniques for examination of the temporomandibular joints in juvenile rheumatoid arthritis

    International Nuclear Information System (INIS)

    Larheim, T.A.

    1981-01-01

    Comparison between orthopantomography, conventional radiography and lateral tomography for diagnosing arthritic lesions in the temporomandibular joints of 42 children with juvenile rheumatoid arthritis showed that each method seems to have diagnostic limitations. Concordance values of about 70 per cent were obtained. Most often destructive lesions of both the mandibular head and the fossa were observed at tomography. Secondary arthrosis, particularly sclerosis of the fossa, was most often diagnosed at conventional radiography. A combination of radiographic techniques seems to be most reliable for diagnosing arthritic joint abnormalities in children. (Auth.)

  9. Contrast-enhanced power Doppler ultrasonography of the metacarpophalangeal joints in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Szkudlarek, Marcin; Court-Payen, Michel; Strandberg, Charlotte

    2003-01-01

    The aim of this study was to examine, with dynamic contrast-enhanced MRI as the reference, if contrast-enhanced power Doppler ultrasonography (CE PDUS) of rheumatoid arthritis (RA) metacarpophalangeal (MCP) joints provides additional information for evaluation of synovial inflammation compared...... with PDUS. One MCP joint in each of 15 RA patients and 3 healthy control persons were examined with PDUS before and after intravenous bolus Levovist contrast injection. Corresponding rates of early synovial enhancement (RESE), previously shown to be closely related to histopathological synovitis, were...... calculated from dynamic contrast-enhanced MR images obtained the same day. Prior to ultrasonography, the joint was evaluated clinically. Levovist increased the flow signal in 7 of 9 joints with pre-contrast flow-signal and in 0 of 9 without pre-contrast signal. No healthy controls showed CE PDUS signal...

  10. Automatic Quantification of Radiographic Wrist Joint Space Width of Patients With Rheumatoid Arthritis.

    Science.gov (United States)

    Huo, Yinghe; Vincken, Koen L; van der Heijde, Desiree; de Hair, Maria J H; Lafeber, Floris P; Viergever, Max A

    2017-11-01

    Objective: Wrist joint space narrowing is a main radiographic outcome of rheumatoid arthritis (RA). Yet, automatic radiographic wrist joint space width (JSW) quantification for RA patients has not been widely investigated. The aim of this paper is to present an automatic method to quantify the JSW of three wrist joints that are least affected by bone overlapping and are frequently involved in RA. These joints are located around the scaphoid bone, viz. the multangular-navicular, capitate-navicular-lunate, and radiocarpal joints. Methods: The joint space around the scaphoid bone is detected by using consecutive searches of separate path segments, where each segment location aids in constraining the subsequent one. For joint margin delineation, first the boundary not affected by X-ray projection is extracted, followed by a backtrace process to obtain the actual joint margin. The accuracy of the quantified JSW is evaluated by comparison with the manually obtained ground truth. Results: Two of the 50 radiographs used for evaluation of the method did not yield a correct path through all three wrist joints. The delineated joint margins of the remaining 48 radiographs were used for JSW quantification. It was found that 90% of the joints had a JSW deviating less than 20% from the mean JSW of manual indications, with the mean JSW error less than 10%. Conclusion: The proposed method is able to automatically quantify the JSW of radiographic wrist joints reliably. The proposed method may aid clinical researchers to study the progression of wrist joint damage in RA studies. Objective: Wrist joint space narrowing is a main radiographic outcome of rheumatoid arthritis (RA). Yet, automatic radiographic wrist joint space width (JSW) quantification for RA patients has not been widely investigated. The aim of this paper is to present an automatic method to quantify the JSW of three wrist joints that are least affected by bone overlapping and are frequently involved in RA. These joints

  11. Clinical significance of dynamic magnetic resonance imaging in the evaluation of wrist joint in Rheumatoid arthritis

    International Nuclear Information System (INIS)

    Shim, Yong Woon; Suh, Jin Suck; Lee, Soo Kon; Lee, Ji Soo; Cho, Jae Hyun

    1996-01-01

    To assess the role of contrast-enhanced dynamic Magnetic Resonance Imaging in evaluation disease activity of rheumatoid arthritis. Forty-seven wrist joints with rheumatoid arthritis were examined prospectively. Coronal images of the wrist were obtained using fat-suppression Fast multi-planar spoiled gradient recalled (FMPSPGR) acquisition in the steady state ; TR/TE 102/6.4 msec, flip angle = 60, 4 slices per sequence, FOV = 8 cm, matrix 256 X 192 at 1.5 Tesla. Scans were carried out once before and five to eight times after an intravenous Gd-DPTA injection, at 30-second-intervals. The enhancement of synovium were measured, the enhancement ratio was calculated(postcontrast SNR/precontrast SNR) and time-enhancement ratio curves were plotted. Patients were divided into three groups according to the ratio of initial to peak enhancement : less than 30% ; 30-80% more than 80%. Differences among the three groups were statistically tested using clinical indices and laboratory data as variable. Comparing one group with another, there were no significant differences in clinical indices and laboratory data except for the parameter of grip strength. Enhancement pattern measured in a single wrist joint was not comparable to a clinical index in predicting disease activity in rheumatoid arthritis

  12. Effect of radiosynovectomy in patients with inflammatory joint disorders not caused by rheumatoid arthritis; Wirksamkeit der Radiosynoviorthese bei degenerativ-entzuendlichen und chronisch-entzuendlichen Gelenkerkrankungen

    Energy Technology Data Exchange (ETDEWEB)

    Kroeger, S.; Klutmann, S.; Bohuslavizki, K.H.; Clausen, M. [Universitaetskrankenhaus Eppendorf, Hamburg (Germany). Abt. fuer Nuklearmedizin; Sawula, J.A.; Brenner, W.; Henze, E. [Kiel Univ. (Germany). Klinik fuer Nuklearmedizin

    1999-07-01

    Aim: Effect of radiosynovectomy (RS) should be evaluated both by subjective and objective parameters in patients with osteoarthritis and in patients with inflammatory joint disorders not caused by rheumatoid arthritis. Methods: A total of 98 joints in 61 patients were investigated. Patients were divided into two groups. The first group included 35 patients with therapy-resistant effusions caused by severe osteoarthritis (46 joints). The second group consisted of 26 patients (52 joints) with ankylosing spondylitis, reactive arthritis, undifferentiated spondylarthropathy, psoriatic arthritis, pigmented villo-nodular synovitis, and recurrent synovitis following surgery. Effect of RS was evaluated by a standardized questionnaire and quantified by T/B-ratios derived from blood pool images prior to and after RS. Results: Within the first patient group suffering from osteoarthritis, 40% showed a good or excellent improvement of clinical symptoms, 51% were unchanged, and in 9% symptoms worsened. Similar results were found in the second patient group. The majority of unchanged results were small finger joints. In contrast, wrist and knee joints showed a better improvement. Good correlation between results of bone scan and patients subjective impression was found in 38% and 67% in the first and the second patient group, respectively. Conclusion: Radiosynovectomy might be an effective treatment in osteoarthritis and inflammatory joint disorders not caused by rheumatoid arthritis. (orig.) [German] Ziel: Der Therapieerfolg der Radiosynoviorthese (RSO) sollte bei aktivierter Arthrose und anderen chronisch-entzuendlichen Gelenkerkrankungen anhand der subjektiven Befindlichkeit und objektiver Parameter evaluiert werden. Methoden: Es wurden insgesamt 98 Gelenke bei 61 Patienten behandelt. Entsprechend der Grunderkrankung umfasste die erste Gruppe 35 Patienten mit einer therapieresistenten, aktivierten Arthrose (46 Gelenke). Die zweite Patientengruppe beinhaltete 26 Patienten (52

  13. Rheumatoid Arthritis Educational Video Series

    Medline Plus

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

  14. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Play Rheumatoid Arthritis: Symptoms and Diagnosis Rheumatoid Arthritis: What is Happening to the Joints? Rheumatoid Arthritis: Gaining Control – Working with your Rheumatologist Rheumatoid Arthritis: Additional Conditions ...

  15. The initial ultrasonographic examination of hands and feet joints in patients with early rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Monika Ponikowska

    2015-09-01

    Full Text Available Objectives : The aim was to assess of the morphology, intensity, and activity of changes in the first ultrasonographic (US examination of hands and feet in patients with early arthritis (lasting up to 12 months who were ultimately diagnosed with rheumatoid arthritis (RA. An attempt was made to demonstrate a correlation between the intensity of lesions in US and selected laboratory parameters. Material and methods : Ultrasonographic examination was performed using a LOGIC GE 500 device on a group of 60 patients with arthritis (46 women, 14 men aged 18–80, previously untreated. In total, 3120 hand and feet joints were examined. The assessment focused on the presence of joint effusion, synovial proliferation and power Doppler signals (assessed on a semi-quantitative scale. Each patient underwent laboratory tests, necessary for making a diagnosis. In order to analyze the correlations between changes in US and laboratory parameters, erythrocyte sedimentation rate (ESR, reactive protein test (CRP, rheumatoid factor (RF, and anti-citrullinated protein antibodies (ACPAs were used. Results : In the study group, the average duration of arthritis symptoms until the first US examination was 5.6 months. Among the 3120 examined hand and foot joints, deviations from the norm appeared in 1093 joints, synovial hypertrophy was found in 471 joints (grade 1 synovial hypertrophy was reported most frequently, while presence of signal in Power Doppler was revealed in 261 joints (grade 1 was observed most frequently. A statistically significant correlation was found between the intensity of changes in Power Doppler and CRP concentration. Conclusions : In patients with increased concentrations of CRP, we may expect arthritis of higher intensity, therefore, in order to prevent the progression of destructive changes, it is necessary to quickly implement effective disease-modifying antirheumatic treatment. The conducted research showed that the activity of joint

  16. Gender Peculiarities of Rheumatoid Arthritis Course

    Directory of Open Access Journals (Sweden)

    G.A. Gonchar

    2013-04-01

    Full Text Available Rheumatoid arthritis in women differs by more clinical course of pathologic process, and injury of certain joints depends on patient’s gender (changes of sacroiliac joints, development of tendovaginitis, intraarticular Hoffa bodies are more often being detected in men, whereas in women — proximal interphalangeal joints of fingers and toes, supramaxillary and knee joints. There is sexual dimorphism of the integral extraarticular (systemic manifestations of rheumatoid arthritis, is this case more frequent damage of lungs and peripheral nervous system is attributable to men, and Sjogren syndrome and changes in central nervous system are observed only in women’s group. Indicators of bone metabolism change in blood serum of patients with rheumatoid arthritis, besides patients with osteoporosis have the commonality and gender differences in concentrations of osteoassociated hormones and chemical elements.

  17. Influence of Angiotensin-Aldosterone System on Ultrasound of Joints in Patients with Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    O.B. Komarova

    2014-02-01

    Full Text Available In patients with rheumatoid arthritis and high level of angiotensin II in the blood at ultrasound of joints there are often being detected effusion in the joint cavity, hypervascularization of synovium with 2–3 points and tenosynovitis characterizing inflammatory exudative processes. In patients with high level of aldosterone, hyperplasia of synovium, presence of pannus and bone and cartilage erosions, indicating proliferative-destructive processes, were predominated. Identified correlations show that with increasing levels of angiotensin II in the blood increases the intensity of the vascularization of the synovial membrane, joint effusion, and an increase in the concentration of aldosterone in the blood affects the synovial thickness indicators, the presence of pannus and bone erosions amount.

  18. Estimation of continuous multi-DOF finger joint kinematics from surface EMG using a multi-output Gaussian Process.

    Science.gov (United States)

    Ngeo, Jimson; Tamei, Tomoya; Shibata, Tomohiro

    2014-01-01

    Surface electromyographic (EMG) signals have often been used in estimating upper and lower limb dynamics and kinematics for the purpose of controlling robotic devices such as robot prosthesis and finger exoskeletons. However, in estimating multiple and a high number of degrees-of-freedom (DOF) kinematics from EMG, output DOFs are usually estimated independently. In this study, we estimate finger joint kinematics from EMG signals using a multi-output convolved Gaussian Process (Multi-output Full GP) that considers dependencies between outputs. We show that estimation of finger joints from muscle activation inputs can be improved by using a regression model that considers inherent coupling or correlation within the hand and finger joints. We also provide a comparison of estimation performance between different regression methods, such as Artificial Neural Networks (ANN) which is used by many of the related studies. We show that using a multi-output GP gives improved estimation compared to multi-output ANN and even dedicated or independent regression models.

  19. Potential of optical spectral transmission measurements for joint inflammation measurements in rheumatoid arthritis patients

    Science.gov (United States)

    Meier, A. J. Louise; Rensen, Wouter H. J.; de Bokx, Pieter K.; de Nijs, Ron N. J.

    2012-08-01

    Frequent monitoring of rheumatoid arthritis (RA) patients enables timely treatment adjustments and improved outcomes. Currently this is not feasible due to a shortage of rheumatologists. An optical spectral transmission device is presented for objective assessment of joint inflammation in RA patients, while improving diagnostic accuracy and clinical workflow. A cross-sectional, nonrandomized observational study was performed with this device. In the study, 77 proximal interphalangeal (PIP) joints in 67 patients have been analyzed. Inflammation of these PIP joints was also assessed by a rheumatologist with a score varying from 1 (not inflamed) to 5 (severely inflamed). Out of 77 measurements, 27 were performed in moderate to strongly inflamed PIP joints. Comparison between the clinical assessment and an optical measurement showed a correlation coefficient r=0.63, p<0.001, 95% CI [0.47, 0.75], and a ROC curve (AUC=0.88) that shows a relative good specificity and sensitivity. Optical spectral transmission measurements in a single joint correlate with clinical assessment of joint inflammation, and therefore might be useful in monitoring joint inflammation in RA patients.

  20. Dichotomous versus semi-quantitative scoring of ultrasound joint inflammation in rheumatoid arthritis using novel individualized joint selection methods.

    Science.gov (United States)

    Tan, York Kiat; Allen, John C; Lye, Weng Kit; Conaghan, Philip G; Chew, Li-Ching; Thumboo, Julian

    2017-05-01

    The aim of the study is to compare the responsiveness of two joint inflammation scoring systems (dichotomous scoring (DS) versus semi-quantitative scoring (SQS)) using novel individualized ultrasound joint selection methods and existing ultrasound joint selection methods. Responsiveness measured by the standardized response means (SRMs) using the DS and the SQS system (for both the novel and existing ultrasound joint selection methods) was derived using the baseline and the 3-month total inflammatory scores from 20 rheumatoid arthritis patients. The relative SRM gain ratios (SRM-Gains) for both scoring system (DS and SQS) comparing the novel to the existing methods were computed. Both scoring systems (DS and SQS) demonstrated substantial SRM-Gains (ranged from 3.31 to 5.67 for the DS system and ranged from 1.82 to 3.26 for the SQS system). The SRMs using the novel methods ranged from 0.94 to 1.36 for the DS system and ranged from 0.89 to 1.11 for the SQS system. The SRMs using the existing methods ranged from 0.24 to 0.32 for the DS system and ranged from 0.34 to 0.49 for the SQS system. The DS system appears to achieve high responsiveness comparable to SQS for the novel individualized ultrasound joint selection methods.

  1. Blockade of PI3Kgamma suppresses joint inflammation and damage in mouse models of rheumatoid arthritis.

    Science.gov (United States)

    Camps, Montserrat; Rückle, Thomas; Ji, Hong; Ardissone, Vittoria; Rintelen, Felix; Shaw, Jeffrey; Ferrandi, Chiara; Chabert, Christian; Gillieron, Corine; Françon, Bernard; Martin, Thierry; Gretener, Denise; Perrin, Dominique; Leroy, Didier; Vitte, Pierre-Alain; Hirsch, Emilio; Wymann, Matthias P; Cirillo, Rocco; Schwarz, Matthias K; Rommel, Christian

    2005-09-01

    Phosphoinositide 3-kinases (PI3K) have long been considered promising drug targets for the treatment of inflammatory and autoimmune disorders as well as cancer and cardiovascular diseases. But the lack of specificity, isoform selectivity and poor biopharmaceutical profile of PI3K inhibitors have so far hampered rigorous disease-relevant target validation. Here we describe the identification and development of specific, selective and orally active small-molecule inhibitors of PI3Kgamma (encoded by Pik3cg). We show that Pik3cg(-/-) mice are largely protected in mouse models of rheumatoid arthritis; this protection correlates with defective neutrophil migration, further validating PI3Kgamma as a therapeutic target. We also describe that oral treatment with a PI3Kgamma inhibitor suppresses the progression of joint inflammation and damage in two distinct mouse models of rheumatoid arthritis, reproducing the protective effects shown by Pik3cg(-/-) mice. Our results identify selective PI3Kgamma inhibitors as potential therapeutic molecules for the treatment of chronic inflammatory disorders such as rheumatoid arthritis.

  2. Detection of rheumatoid arthritis in humans by fluorescence imaging

    Science.gov (United States)

    Ebert, Bernd; Dziekan, Thomas; Weissbach, Carmen; Mahler, Marianne; Schirner, Michael; Berliner, Birgitt; Bauer, Daniel; Voigt, Jan; Berliner, Michael; Bahner, Malte L.; Macdonald, Rainer

    2010-02-01

    The blood pool agent indo-cyanine green (ICG) has been investigated in a prospective clinical study for detection of rheumatoid arthritis using fluorescence imaging. Temporal behavior as well as spatial distribution of fluorescence intensity are suited to differentiate healthy and inflamed finger joints after i.v. injection of an ICG bolus.

  3. Differences in Activation Area Within Brodmann Area 2 Caused by Pressure Stimuli on Fingers and Joints: In Case of Male Subjects.

    Science.gov (United States)

    Choi, Mi-Hyun; Kim, Hyung-Sik; Baek, Ji-Hye; Lee, Jung-Chul; Park, Sung-Jun; Jeong, Ul-Ho; Gim, Seon-Young; Kim, Sung-Phil; Lim, Dae-Woon; Chung, Soon-Cheol

    2015-09-01

    In this study, a constant pressure stimulus was applied on the 3 joints (first [p1], second [p2], and third [p3] joints) of 4 fingers (index, middle, ring, and little fingers), and the activation areas within Brodmann area 2 (BA 2) were compared for these different fingers and joints by using functional magnetic resonance imaging. Eight healthy male college students (25.4 ± 1.32 years) participated in the study. Each session was composed of 3 blocks, and each block was composed of a Control phase (30 seconds) and a Pressure phase (30 seconds). No pressure stimulus was applied in the Control phase, during which the subjects would simply lay comfortably with their eyes closed. In the Pressure phase, a pressure stimulus was applied onto one of the joints of the selected finger. For each finger and joint, BA 2 areas activated by the pressure stimulus were extracted by the region of interest method. There was a significant difference in the activation areas for the different fingers (P = .042) as well as for the different joints (P = .050). The activation area decreased in the order of the little, index, and middle fingers, as well as in the order of p1, p3, and p2.

  4. Drug control of an antirheumatic in Rheumatoid arthritis via scintigraphy of joints

    International Nuclear Information System (INIS)

    Kafarnik, D.; Semmler, U.; Wiegmann, A.; Pfannenstiel, P.; Stiftung Deutsche Klinik fuer Diagnostik, Wiesbaden

    1979-01-01

    Sixteen rheumatoid arthritis patients each received diclofenac sodium or placebos in a double-blind study. The general assesment of the success of therapy on the part of the physician or the patient, can be corrected to some extent by means of a semiquantitatively evaluated sup(99m)Tc-pertechnetat joint scintigraphy used in the patients and in the controls. In particular, the comparative examinations of the wrists, which were evaluated clinically, semiquantitatively and quantitatively, showed that the sensitivity of joint scintigraphy is sufficient to demonstrate additionally the anti-inflammatory action of an antirheumatic drug even if the drug had been administered for 14 days only. (orig.) 891 AJ/orig. 892 BRE [de

  5. 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 ...

  6. Reliability of joint count assessment in rheumatoid arthritis: a systematic literature review.

    Science.gov (United States)

    Cheung, Peter P; Gossec, Laure; Mak, Anselm; March, Lyn

    2014-06-01

    Joint counts are central to the assessment of rheumatoid arthritis (RA) but reliability is an issue. To evaluate the reliability and agreement of joint counts (intra-observer and inter-observer) by health care professionals (physicians, nurses, and metrologists) and patients in RA, and the impact of training and standardization on joint count reliability through a systematic literature review. Articles reporting joint count reliability or agreement in RA in PubMed, EMBase, and the Cochrane library between 1960 and 2012 were selected. Data were extracted regarding tender joint counts (TJCs) and swollen joint counts (SJCs) derived by physicians, metrologists, or patients for intra-observer and inter-observer reliability. In addition, methods and effects of training or standardization were extracted. Statistics expressing reliability such as intraclass correlation coefficients (ICCs) were extracted. Data analysis was primarily descriptive due to high heterogeneity. Twenty-eight studies on health care professionals (HCP) and 20 studies on patients were included. Intra-observer reliability for TJCs and SJCs was good for HCPs and patients (range of ICC: 0.49-0.98). Inter-observer reliability between HCPs for TJCs was higher than for SJCs (range of ICC: 0.64-0.88 vs. 0.29-0.98). Patient inter-observer reliability with HCPs as comparators was better for TJCs (range of ICC: 0.31-0.91) compared to SJCs (0.16-0.64). Nine studies (7 with HCPs and 2 with patients) evaluated consensus or training, with improvement in reliability of TJCs but conflicting evidence for SJCs. Intra- and inter-observer reliability was high for TJCs for HCPs and patients: among all groups, reliability was better for TJCs than SJCs. Inter-observer reliability of SJCs was poorer for patients than HCPs. Data were inconclusive regarding the potential for training to improve SJC reliability. Overall, the results support further evaluation for patient-reported joint counts as an outcome measure. © 2013

  7. Presence of bacterial DNA and bacterial peptidoglycans in joints of patients with rheumatoid arthritis and other arthritides

    NARCIS (Netherlands)

    van der Heijden, I. M.; Wilbrink, B.; Tchetverikov, I.; Schrijver, I. A.; Schouls, L. M.; Hazenberg, M. P.; Breedveld, F. C.; Tak, P. P.

    2000-01-01

    The continuous presence of bacteria or their degraded antigens in the synovium may be involved in the pathogenesis of rheumatoid arthritis (RA). The aim of this study was to determine the presence of bacterial nucleic acids and bacterial cell wall constituents in the joints of patients with RA and

  8. Follow-up of volar plate interposition arthroplasty (Tupper) of the metacarpophalangeal joints in rheumatoid hands: preliminary findings

    DEFF Research Database (Denmark)

    Gøtze, J P; Jensen, Claus Hjorth

    2000-01-01

    We present the results of a three-year follow-up study of 59 interposition volar plate arthroplasties (Tupper) on metacarpophalangeal joints in 13 patients with erosive rheumatoid arthritis. The median age at the time of operation was 60 years (range 45-77). All patients reported lasting pain...

  9. Predictors of revision, prosthetic joint infection and mortality following total hip or total knee arthroplasty in patients with rheumatoid arthritis

    DEFF Research Database (Denmark)

    Cordtz, Rene Lindholm; Zobbe, Kristian; Højgaard, Pil

    2018-01-01

    OBJECTIVES: To investigate predictors of 10-year risk of revision and 1-year risk of prosthetic joint infection (PJI) and death following total hip/total knee arthroplasty (THA/TKA) in (1) patients with rheumatoid arthritis (RA) compared with patients with osteoarthritis (OA); and (2) patients...

  10. Health Professionals' Perceptions of the Effects of Exercise on Joint Health in Rheumatoid Arthritis Patients.

    Science.gov (United States)

    Halls, Serena; Law, Rebecca-Jane; Jones, Jeremy G; Markland, David A; Maddison, Peter J; Thom, Jeanette M

    2017-09-01

    Although exercise is an important factor in the management of rheumatoid arthritis (RA), research indicates that patients perceive that health professionals (HPs) are uncertain about the place of exercise in treatment and its relationship with joint damage. The present study investigated the perceptions of HPs regarding the effects of exercise on joint health in RA patients. A questionnaire investigating perceptions of exercise and joint health was distributed via professional networks and websites. Confirmatory factor analysis (CFA) was used to analyse questionnaire data and develop a focus group interview guide. Focus groups were conducted with multidisciplinary teams (MDTs) of rheumatology HPs and analysed using framework analysis. A total of 137 rheumatology HPs (95 female; 27-65 years of age) completed questionnaires. CFA showed that a four-factor model provided a marginally acceptable fit. Analysis of four focus groups (n = 24; 19 female; 30-60 years of age) identified five themes relating to HPs' perceptions of exercise and joint health in RA patients: 'Exercise is beneficial', 'Concerns about damage to joints', 'Patients have barriers to exercise', 'HP knowledge differs' and 'Patients may think service delivery is vague'. HPs were highly aware of the benefits and importance of exercise for RA patients. However, to remove the patient perception that HPs lack certainty and clarity regarding exercise it is important to ensure: (i) consistent promotion of exercise across the whole MDT; (ii) clear provision of information regarding rest, joint protection and exercise; (iii) HP education to ensure consistent, accurate knowledge, and understanding of the potential for conflicting advice when promoting exercise as part of an MDT. Copy © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  11. Structural joint damage and hand bone loss in patients with rheumatoid arthritis.

    Science.gov (United States)

    Lykke, Midtbøll Ørnbjerg

    2018-03-01

    Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by pain, swelling and progressive destruction of the joints leading to loss of function and invalidity. The bone destruction in RA is characterised by two distinct features: structural joint damage and hand bone loss, and their prevention is an important treatment goal. Inhibitors of tumour necrosis factor alpha (TNF-inhibitors) have markedly improved the treatment options in RA patients who fail treatment with conventional synthetic Disease Modifying Anti Rheumatic Drugs (sDMARDS), but their effectiveness with regards to structural joint damage and hand bone loss, predictors thereof and the association with disease activity during treatment have mainly been investigated in randomized controlled trials (RCTs) with limited generalizability due to strict in- and exclusion criteria.
 The main aim of the PhD thesis was to assess and predict structural joint damage and hand bone loss in patients with early and established RA treated with sDMARDs and TNF-inhibitors. This was investigated in two cohorts: A) The "DANBIO X-ray study": an observational, nationwide, longitudinal cohort study of established RA patients treated in clinical practice who initiated TNF-inhibitor treatment after failure of sDMARDs and B) The "OPERA study": a randomized controlled trial of sDMARD-naïve patients with early RA treated with methotrexate (MTX) and intraarticular glucocorticoid injections in combination with adalimumab or placebo-adalimumab. Structural joint damage progression was assessed with the Sharp/van der Heijde radiographic method and hand bone loss was assessed with Digital X-ray Radiogrammetry. 
From the studies presented in the PhD thesis the following was concluded:
 Structural joint damage progression and hand bone loss were significantly lower during two years of TNF-inhibitor treatment compared to the previous two years of sDMARD-treatment in the DANBIO X-ray Study. The majority of patients had

  12. Quantitative in vivo HR-pQCT imaging of 3D wrist and metacarpophalangeal joint space width in rheumatoid arthritis.

    Science.gov (United States)

    Burghardt, Andrew J; Lee, Chan Hee; Kuo, Daniel; Majumdar, Sharmila; Imboden, John B; Link, Thomas M; Li, Xiaojuan

    2013-12-01

    In this technique development study, high-resolution peripheral quantitative computed tomography (HR-pQCT) was applied to non-invasively image and quantify 3D joint space morphology of the wrist and metacarpophalangeal (MCP) joints of patients with rheumatoid arthritis (RA). HR-pQCT imaging (82 μm voxel-size) of the dominant hand was performed in patients with diagnosed rheumatoid arthritis (RA, N = 16, age: 52.6 ± 12.8) and healthy controls (CTRL, N = 7, age: 50.1 ± 15.0). An automated computer algorithm was developed to segment wrist and MCP joint spaces. The 3D distance transformation method was applied to spatially map joint space width, and summarized by the mean joint space width (JSW), minimal and maximal JSW (JSW.MIN, JSW.MAX), asymmetry (JSW.AS), and distribution (JSW.SD)-a measure of joint space heterogeneity. In vivo precision was determined for each measure by calculating the smallest detectable difference (SDD) and root mean square coefficient of variation (RMSCV%) of repeat scans. Qualitatively, HR-pQCT images and pseudo-color JSW maps showed global joint space narrowing, as well as regional and focal abnormalities in RA patients. In patients with radiographic JSN at an MCP, JSW.SD was two-fold greater vs. CTRL (p 3D joint space morphology from HR-pQCT, could improve early detection of joint damage in rheumatological diseases.

  13. Radiographic temporomandibular joint abnormality in adults with micrognathia and juvenile rheumatoid arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Larheim, T.A.; Haanaes, H.R.; Dale, K. (Oslo Univ. (Norway))

    1981-01-01

    Radiographic findings of the upper and lower jaw bone of 20 adult patients with micrognathia, bird face, and juvenile rheumatoid arthritis are reported. In all patients a symmetrically underdeveloped mandible with the chin posteriorly positioned was found at cephalometry. Arthritic lesion of the temporomandibular joint, mostly symmetric, with limitation of movement and secondary arthrosis, was observed in all patients. Complete absence of the mandibular head was frequent (75%). The fossa was generally flat, probably due to growth disturbance of the tubercle. Abnormal anterior position of the mandibular head occurred in almost half of the patients. The degree of mandibular growth disturbance seemed to be correlated to the severity of the arthritis, indicating the arthritis to be a causal mechanism of micrognathia.

  14. Talonavicular joint abnormalities and walking ability of patients with rheumatoid arthritis

    International Nuclear Information System (INIS)

    Miyamoto, Noriyoshi; Senda, Masuo; Hamada, Masanori; Katayama, Yoshimi; Kinosita, Atsushi; Uchida, Kensuke; Inoue, Hajime

    2004-01-01

    Rheumatoid arthritis (RA) is often associated with deformities of the feet, and foot pain often arises in the talonavicular joint of patients with RA. The object of this study was to assess the relationship between magnetic resonance imaging (MRI) findings of the talonavicular joint and walking ability. The subjects were 35 RA patients (10 feet in 5 males and 56 feet in 30 females) aged 34-87 years (mean: 70 years±12.1), with a disease duration from 1-54 years (mean: 14 years±12.1). MRI findings were classified as follows: Grade 1, almost normal; Grade 2, early articular destruction; Grade 3, moderate articular destruction; Grade 4, severe articular destruction; and Grade 5, bony ankylosis dislocation. Walking ability was classified into one of 9 categories ranging from normal gait to bedridden status according to the system of Fujibayashi. As the grade of MRI images became higher the walking ability decreased, and these parameters showed a correlation by Spearman's rank correlation coefficient analysis (P=0.003). Thus, in the present cohort group of patients with RA, the deterioration of walking ability increased with the severity of destruction of the talonavicular joint. (author)

  15. Body mass index and the rheumatoid arthritis swollen joint count: an observational study

    Science.gov (United States)

    Caplan, Liron; Davis, Lisa A.; Bright, Christina M.; Kerr, Gail S.; Lazaro, Deana M.; Khan, Nasim A.; Richards, J. Steuart; Johnson, Dannette S.; Cannon, Grant W.; Reimold, Andreas M.; Mikuls, Ted R.

    2012-01-01

    Objective Obesity is a prevalent condition and a serious health concern. The relationship between obesity and RA disease activity and severity has not been adequately examined, and there are concerns that periarticular adipose tissue may reduce the utility of the joint examination. Methods We used a cross-sectional study to compare the performance of swollen joint count (SJC) in subjects with rheumatoid arthritis (RA) across body mass index (BMI) strata. Specifically, regression techniques tested for associations of SJC and seven RA disease activity/severity measures (including high sensitivity c-reactive protein, radiographic changes, and multi-dimensional health assessment questionnaire scores) within BMI quartiles. We also evaluated the association of BMI with radiographic evidence of RA in multivariate analyses and the association of BMI with SJC. Clinical and laboratory data from 980 Veterans Affairs Rheumatoid Arthritis (VARA) registry participants were analyzed using linear and logistic regression. Results Associations were evident between SJC and six of the seven examined RA disease activity/severity measures. SJC predicts RA disease activity/severity at least as well in more obese subjects as in subjects with lower BMIs, and there was a trend towards better performance in higher BMI individuals. Subjects with higher BMIs were marginally less likely to be characterized by radiographic changes (O.R. 0.98, p=0.051). We found no association between BMI and SJC. Conclusions BMI does not obscure the relationship of SJC and objective disease activity measures. There is a borderline association of higher BMI and likelihood of radiographic changes characteristic of RA after controlling for clinical characteristics. PMID:22623288

  16. Intra-articular distribution pattern after ultrasound-guided injections in wrist joints of patients with rheumatoid arthritis

    DEFF Research Database (Denmark)

    Boesen, Mikael; Jensen, Karl Erik; Torp-Pedersen, Søren

    2007-01-01

    OBJECTIVE: To investigate the distribution of an ultrasound-guided intra-articular (IA) injection in the wrist joint of patients with rheumatoid arthritis (RA). METHODS: An ultrasound-guided IA drug injection into the wrist joint was performed in 17 patients with 1 ml methylprednisolone (40 mg...... with the MRI OMERACT synovitis score (r=0.60, p=0.014), but not with the erosions, bonemarrow oedema scores or any clinical parameters. CONCLUSION: The distribution of contrast on MRI showed patient specific and random patterns after IA injections in active RA wrist joints. The degree of distribution increased...

  17. The 'pre-erosive' radiologic signs of rheumatoid arthritis in soft tissue radiography of the hands

    International Nuclear Information System (INIS)

    Maekelae, P.; Virtama, P.

    1978-01-01

    Soft tissue radiography of the hands using the mammographic immersion technique was performed on 119 patients, having definite or classical rheumatoid arthritis, and on 123 controls of matching age, sex, and professional distribution. A total of 7744 finger joints and carpal borders were investigated for joint swelling, periarticular edema, pre-erosive and erosive bone changes, joint space narrowing, and osteoarthritic joint margin spurs. Slight joint swelling and pre-erosive bone changes were found in connection with osteoarthritic joint changes in elderly control patients. Periarticular edema and moderate to massive joint swelling were quite reliable signs for synovitis. The incidence of pre-erosive bone signs was significantly greater in the rheumatoid arthritis group than in the control group, especially in patients less than 60 years old. These signs can be regarded as suggestive of rheumatoid arthritis; probability diagnosis could be performed using these signs and the Bayesian approach. (orig.) [de

  18. 'pre-erosive' radiologic signs of rheumatoid arthritis in soft tissue radiography of the hands

    Energy Technology Data Exchange (ETDEWEB)

    Maekelae, P; Virtama, P [Turku Univ. (Finland). Dept. of Diagnostic Radiology

    1978-01-01

    Soft tissue radiography of the hands using the mammographic immersion technique was performed on 119 patients, having definite or classical rheumatoid arthritis, and on 123 controls of matching age, sex, and professional distribution. A total of 7744 finger joints and carpal borders were investigated for joint swelling, periarticular edema, pre-erosive and erosive bone changes, joint space narrowing, and osteoarthritic joint margin spurs. Slight joint swelling and pre-erosive bone changes were found in connection with osteoarthritic joint changes in elderly control patients. Periarticular edema and moderate to massive joint swelling were quite reliable signs for synovitis. The incidence of pre-erosive bone signs was significantly greater in the rheumatoid arthritis group than in the control group, especially in patients less than 60 years old. These signs can be regarded as suggestive of rheumatoid arthritis; probability diagnosis could be performed using these signs and the Bayesian approach.

  19. SU-E-T-171: Evaluation of the Analytical Anisotropic Algorithm in a Small Finger Joint Phantom Using Monte Carlo Simulation

    International Nuclear Information System (INIS)

    Chow, J; Owrangi, A; Jiang, R

    2014-01-01

    Purpose: This study investigated the performance of the anisotropic analytical algorithm (AAA) in dose calculation in radiotherapy concerning a small finger joint. Monte Carlo simulation (EGSnrc code) was used in this dosimetric evaluation. Methods: Heterogeneous finger joint phantom containing a vertical water layer (bone joint or cartilage) sandwiched by two bones with dimension 2 × 2 × 2 cm 3 was irradiated by the 6 MV photon beams (field size = 4 × 4 cm 2 ). The central beam axis was along the length of the bone joint and the isocenter was set to the center of the joint. The joint width and beam angle were varied from 0.5–2 mm and 0°–15°, respectively. Depth doses were calculated using the AAA and DOSXYZnrc. For dosimetric comparison and normalization, dose calculations were repeated in water phantom using the same beam geometry. Results: Our AAA and Monte Carlo results showed that the AAA underestimated the joint doses by 10%–20%, and could not predict joint dose variation with changes of joint width and beam angle. The calculated bone dose enhancement for the AAA was lower than Monte Carlo and the depth of maximum dose for the phantom was smaller than that for the water phantom. From Monte Carlo results, there was a decrease of joint dose as its width increased. This reflected the smaller the joint width, the more the bone scatter contributed to the depth dose. Moreover, the joint dose was found slightly decreased with an increase of beam angle. Conclusion: The AAA could not handle variations of joint dose well with changes of joint width and beam angle based on our finger joint phantom. Monte Carlo results showed that the joint dose decreased with increase of joint width and beam angle. This dosimetry comparison should be useful to radiation staff in radiotherapy related to small bone joint

  20. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Rheumatoid Arthritis (RA). You will learn how the diagnosis of RA is made, what happens to your ... Link Below To Play Rheumatoid Arthritis: Symptoms and Diagnosis Rheumatoid Arthritis: What is Happening to the Joints? ...

  1. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Happening to the Joints? Rheumatoid Arthritis: Gaining Control – Working with your Rheumatologist Rheumatoid Arthritis: Additional Conditions Rheumatoid Arthritis: The Immune System Don’t have ...

  2. Power Doppler ultrasonography for assessment of synovitis in the metacarpophalangeal joints of patients with rheumatoid arthritis: a comparison with dynamic magnetic resonance imaging

    DEFF Research Database (Denmark)

    Szkudlarek, Marcin; Court-Payen, M; Strandberg, C

    2001-01-01

    OBJECTIVE: To evaluate the effectiveness of power Doppler ultrasonography (PDUS) for assessing inflammatory activity in the metacarpophalangeal (MCP) joints of patients with rheumatoid arthritis (RA), using dynamic magnetic resonance imaging (MRI) as a reference method. METHODS: PDUS and dynamic ...

  3. Dual-Modality Imaging of the Human Finger Joint Systems by Using Combined Multispectral Photoacoustic Computed Tomography and Ultrasound Computed Tomography

    Directory of Open Access Journals (Sweden)

    Yubin Liu

    2016-01-01

    Full Text Available We developed a homemade dual-modality imaging system that combines multispectral photoacoustic computed tomography and ultrasound computed tomography for reconstructing the structural and functional information of human finger joint systems. The fused multispectral photoacoustic-ultrasound computed tomography (MPAUCT system was examined by the phantom and in vivo experimental tests. The imaging results indicate that the hard tissues such as the bones and the soft tissues including the blood vessels, the tendon, the skins, and the subcutaneous tissues in the finger joints systems can be effectively recovered by using our multimodality MPAUCT system. The developed MPAUCT system is able to provide us with more comprehensive information of the human finger joints, which shows its potential for characterization and diagnosis of bone or joint diseases.

  4. Novel joint selection methods can reduce sample size for rheumatoid arthritis clinical trials with ultrasound endpoints.

    Science.gov (United States)

    Allen, John C; Thumboo, Julian; Lye, Weng Kit; Conaghan, Philip G; Chew, Li-Ching; Tan, York Kiat

    2018-03-01

    To determine whether novel methods of selecting joints through (i) ultrasonography (individualized-ultrasound [IUS] method), or (ii) ultrasonography and clinical examination (individualized-composite-ultrasound [ICUS] method) translate into smaller rheumatoid arthritis (RA) clinical trial sample sizes when compared to existing methods utilizing predetermined joint sites for ultrasonography. Cohen's effect size (ES) was estimated (ES^) and a 95% CI (ES^L, ES^U) calculated on a mean change in 3-month total inflammatory score for each method. Corresponding 95% CIs [nL(ES^U), nU(ES^L)] were obtained on a post hoc sample size reflecting the uncertainty in ES^. Sample size calculations were based on a one-sample t-test as the patient numbers needed to provide 80% power at α = 0.05 to reject a null hypothesis H 0 : ES = 0 versus alternative hypotheses H 1 : ES = ES^, ES = ES^L and ES = ES^U. We aimed to provide point and interval estimates on projected sample sizes for future studies reflecting the uncertainty in our study ES^S. Twenty-four treated RA patients were followed up for 3 months. Utilizing the 12-joint approach and existing methods, the post hoc sample size (95% CI) was 22 (10-245). Corresponding sample sizes using ICUS and IUS were 11 (7-40) and 11 (6-38), respectively. Utilizing a seven-joint approach, the corresponding sample sizes using ICUS and IUS methods were nine (6-24) and 11 (6-35), respectively. Our pilot study suggests that sample size for RA clinical trials with ultrasound endpoints may be reduced using the novel methods, providing justification for larger studies to confirm these observations. © 2017 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.

  5. PERIPROSTHETIC INFECTION AFTER ENDOPROSTHETIC REPLACEMENT OF THE HIP JOINT IN PATIENTS WITH RHEUMATOID DISEASES

    Directory of Open Access Journals (Sweden)

    Vadim Petrovich Pavlov

    2013-01-01

    Full Text Available Periprosthetic infection (PI in patients with rheumatoid diseases (RD after total hip joint endoprosthesis (THJE is a relevant problem of rheumoorphopedics that has not been solved yet. The relative assessment of PI incidence rate after THJE and treatment outcomes in patients with this complication is expected to be carried out. A total of 1201 THJE performed in 1069 patients with RD are considered. The female : male ratio was 3.6 : 1; the mean age was 49.6 years (range: 16 to 83 years. 323 patients had rheumatoid arthritis (RA; 124 patients had juvenile rheumatoid arthritis (JRA; 80 patients had ankylosing spondylitis (AS; 79 patients had systemic lupus erythematosus (SLE; 11 patients had systemic sclerodermatitis (SSD; 18 patients had psoriatic arthropathy (PsA; and 353 patients had osteoarthritis (OA. Other RD were revealed in 81 patients. PI were detected in 9 (0.84% of 1069 patients with RD, including 7 (2.17% of 323 patients with RA; 1 (0.8% of 124 patients with JRA; and 1 (0.28% of 353 patients with OA. No PI were detected in 81 patients who had other RD. An eightfold (in patients with RA and a threefold (in patients with JRA increase in PI compared to that in patients with OA attests to the high risk of this complication in patients with inflammatory as compared to the patients with degenerative RD. After integrated treatment (revision surgery, sanation, continuous irrigation with antibiotics/lavasept, the graft was preserved in OA patients; the complication was prevented in RA patients. Six patients will be subjected to repeated revision surgery; one patient died of diabetes complications after the graft had been removed. A significant increase in PI incidence rate after THJE in patients with RA and JRA as compared to that in OA patients allows one to regard inflammatory RD as risk factors of this complication. The low effectiveness of the procedure for integrated therapy for PI in RD patients indicates that it needs to

  6. Comprehensive evaluation of finger flexor tendon entheseal soft tissue and bone changes by ultrasound can differentiate psoriatic arthritis and rheumatoid arthritis.

    Science.gov (United States)

    Tinazzi, Ilaria; McGonagle, Dennis; Zabotti, Alen; Chessa, Donatella; Marchetta, Antonio; Macchioni, Pierluigi

    2018-02-28

    To determine whether a detailed sonographic evaluation of the hand flexor tendon compartment could help differentiate between psoriatic arthritis (PsA) and rheumatoid arthritis (RA). Thirty-seven patients with PsA, 47 with RA and 10 healthy controls (HC) had flexor tendon (FT) compartment imaging of the dominant hand 2nd to 4th tendons using grey scale (GS) and power Doppler (PD) ultrasound (US) with evaluation for tenosynovitis, peri-tendinous lesions, soft tissue oedema and bony changes at FT insertions. 24/37 PsA and 19/47 RA cases had morning stiffness and 19/37 PsA and 10/47 RA had swollen and/or tender fingers. Tenosynovitis was more common in PsA (25/37) despite higher DAS28 scores in RA (25/37 versus 10/45; pthe insertional site was significantly more common in PsA (p=0.001). Considering a total inflammatory score per patient summing up the three modifications of the flexor tendon (tenosynovitis, peri-tendinous oedema and insertional enthesophytes) the difference between PsA and RA remained statistically significant (pthe growing body of literature that high resolution US of the hand FT compartment may help differentiate between RA and PsA, which needs assessment in the diagnostic setting.

  7. A comparative study of the value of four imaging methods for the diagnosis of rheumatoid arthritis of the shoulder joint

    International Nuclear Information System (INIS)

    Tsvetkova, S.; Semova, R.; Matalova, A.

    2008-01-01

    The shoulder joint becomes involved later than the peripheral joints of the lower and upper limb in rheumatoid arthritis. The aim of the current study is to determine the value of plain radiography (PR), ultrasonography (US), computed tomography (CT) and magnetic resonance imaging (MRI) in detecting bone erosions and soft tissue changes of the shoulder joint in patients with rheumatoid arthritis. 27 patients - 21 women and 6 men, mean age 59 years (range 39 - 78) with confirmed rheumatoid arthritis and a painful shoulder are included in the study. The mean duration of the disease is 10 years and the mean duration of the shoulder symptoms is 4 years. In every patient all the imaging modalities were performed within 30 days. PR shows depicted changes in 20 patients (74%), US - in 25 patients (93%), CT - in 23 patients (85%) and MRI - in 26 patients (96%). US and MRI are more sensitive than CT in depicting small erosions of the humeral head and soft tissue changes. MRI and CT are the best methods for the diagnosis of subchondral and intraosseous bone lesions. The traditionally used PR is less sensitive than the other methods, especially in the evaluation of the soft tissues and the small erosions. (authors)

  8. Anatomy and Biomechanics of the Finger Proximal Interphalangeal Joint.

    Science.gov (United States)

    Pang, Eric Quan; Yao, Jeffrey

    2018-05-01

    A complete understanding of the normal anatomy and biomechanics of the proximal interphalangeal joint is critical when treating pathology of the joint as well as in the design of new reconstructive treatments. The osseous anatomy dictates the principles of motion at the proximal interphalangeal joint. Subsequently, the joint is stabilized throughout its motion by the surrounding proximal collateral ligament, accessory collateral ligament, and volar plate. The goal of this article is to review the normal anatomy and biomechanics of the proximal interphalangeal joint and its associated structures, most importantly the proper collateral ligament, accessory collateral ligament, and volar plate. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Dynamic magnetic resonance imaging of the metacarpophalangeal joints in rheumatoid arthritis, early unclassified polyarthritis, and healthy controls

    DEFF Research Database (Denmark)

    Klarlund, Mette; Østergaard, Mikkel; Rostrup, Egill

    2000-01-01

    OBJECTIVE: To introduce dynamic magnetic resonance imaging (MRI) as an indicator of inflammatory activity in the metacarpophalangeal (MCP) joints of patients with rheumatoid arthritis (RA) or early unclassified polyarthritis, and to compare the results with a healthy control group. MATERIALS...... AND METHODS: We examined 42 RA and 23 early unclassified polyarthritis patients, and 12 healthy controls in a cross-sectional study. Dynamic MRI (repeated FLASH-MR images after injection of a contrast agent) was performed through the 2nd to the 5th MCP joint. Two methods for identification of the enhancing...

  10. 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 ...

  11. Detection of rheumatoid arthritis by evaluation of normalized variances of fluorescence time correlation functions

    Science.gov (United States)

    Dziekan, Thomas; Weissbach, Carmen; Voigt, Jan; Ebert, Bernd; MacDonald, Rainer; Bahner, Malte L.; Mahler, Marianne; Schirner, Michael; Berliner, Michael; Berliner, Birgitt; Osel, Jens; Osel, Ilka

    2011-07-01

    Fluorescence imaging using the dye indocyanine green as a contrast agent was investigated in a prospective clinical study for the detection of rheumatoid arthritis. Normalized variances of correlated time series of fluorescence intensities describing the bolus kinetics of the contrast agent in certain regions of interest were analyzed to differentiate healthy from inflamed finger joints. These values are determined using a robust, parameter-free algorithm. We found that the normalized variance of correlation functions improves the differentiation between healthy joints of volunteers and joints with rheumatoid arthritis of patients by about 10% compared to, e.g., ratios of areas under the curves of raw data.

  12. Magnetic resonance imaging, radiography, and scintigraphy of the finger joints: one year follow up of patients with early arthritis

    Science.gov (United States)

    Klarlund, M; Ostergaard, M; Jensen, K; Madsen, J; Skjodt, H; Lorenzen, I; the, T

    2000-01-01

    OBJECTIVES—To evaluate synovial membrane hypertrophy, tenosynovitis, and erosion development of the 2nd to 5th metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints by magnetic resonance imaging in a group of patients with rheumatoid arthritis (RA) or suspected RA followed up for one year. Additionally, to compare the results with radiography, bone scintigraphy, and clinical findings.
PATIENTS AND METHODS—Fifty five patients were examined at baseline, of whom 34 were followed up for one year. Twenty one patients already fulfilled the American College of Rheumatology (ACR) criteria for RA at baseline, five fulfilled the criteria only after one year's follow up, whereas eight maintained the original diagnosis of early unclassified polyarthritis. The following MRI variables were assessed at baseline and one year: synovial membrane hypertrophy score, number of erosions, and tenosynovitis score.
RESULTS—MRI detected progression of erosions earlier and more often than did radiography of the same joints; at baseline the MRI to radiography ratio was 28:4. Erosions were exclusively found in patients with RA at baseline or fulfilling the ACR criteria at one year. At one year follow up, scores of MR synovial membrane hypertrophy, tenosynovitis, and scintigraphic tracer accumulation had not changed significantly from baseline; in contrast, swollen and tender joint counts had declined significantly (pthe changes seen over time in clinically assessed swollen and tender joint counts. Although joint disease activity may be assessed as quiescent by conventional clinical methods, a more detailed evaluation by MRI may show that a pathological condition is still present within the synovium.

 PMID:10873961

  13. Anti-xanthine oxidase antibodies in sera and synovial fluid of patients with rheumatoid arthritis and other joint inflammations

    International Nuclear Information System (INIS)

    Arrar, L.; Hanachi, N.; Rouba, K.; Charef, N.; Khennouf, S.; Baghiani, A.

    2008-01-01

    Objective was to study anti-bovine milk xanthine oxidoreductase XOPR antibody levels in synovial fluid as well as in serum of patients suffering from rheumatoid affections to assess a possible correlation between antibody titres and severity of disease. Sera and synovial fluids were collected from volunteer donors at Setif University Hospital, Setif, Algeria from 2001-2007 with the consent of patients. Human IgG and IgM levels of free and bound anti-bovine milk XOR antibodies were determined using bovine XOR as antigen, with enzyme-linked immunosorbent assay ELISA. Serum IgG anti-bovine milk XOR titres in 30 healthy normal subjects 2.74+-2.31 microgram/mL are in agreement with that reported in the literature. Immunoglobulin G and IgM anti-bovine milk XOR antibody titres were found to be significantly higher in serum from patients with rheumatoid arthritis RA and latex positives subjects. Synovial IgM antibody titres to bovine XOR were found to be significantly higher in rheumatoid arthritis patients compared to patients with other joint inflammations. In rheumatoid arthritis patients, high concentrations of antibodies against XOR were noticed. These antibodies may play a major role in RA by inhibiting both xanthine and NADH oxidase activities of XOR. They may also play a key role in eliminating XOR from serum and synovial fluid positive role but unfortunately, immune complex formation could also activate complement and participate in self maintenance of inflammation. (author)

  14. Wear of cross-linked polyethylene against itself: a material suitable for surface replacement of the finger joint.

    Science.gov (United States)

    Sibly, T F; Unsworth, A

    1991-05-01

    Cross-linking of polyethylene (XLPE) has dramatically improved its properties in industrial applications, and it may also have some application in the field of human joint replacement. Additionally it has the advantage of permitting a lower molecular weight base material to be used, so that components may be injection moulded rather than machined. This study therefore investigates the wear resistance of medical grade cross-linked polyethylene (XLPE), cross-linked by a silane-grafting process, with a molecular weight between cross links of 5430 g mol(-1). This first report investigates the wear resistance of XLPE against itself, because for certain joints, such as the metacarpo-phalangeal joint, the material may have a high enough wear resistance to allow both bearing surfaces to be made from it. Tests were carried out both on a reciprocating pin and plate machine with pins loaded at 10 and 40 N and also on a new finger joint simulator, which simulates the loads applied to and the movements of, the metacarpo-phalangeal joint. An average wear rate of 1.8 x 10(-6) mm3 N-1 m-1 was found (range 0.9-2.75 x 10(-6) mm3 N-1 m-1). This is about six times greater than the wear rate of non-cross-linked ultra high molecular weight polyethylene (UHMWPE) against stainless steel, but for applications with low loading, such as the metacarpo-phalangeal joint, this material is shown to have adequate wear resistance. The coefficient of friction was 0.1, which is similar to that of UHMWPE on stainless steel.

  15. ASSOCIATION BETWEEN ULTRASOUND SIGNS OF JOINT INFLAMMATION AND RADIOGRAPHIC PROGRESSION IN PATIENTS WITH RHEUMATOID ARTHRITIS

    Directory of Open Access Journals (Sweden)

    O. G. Alekseeva

    2016-01-01

    Full Text Available Rheumatoid arthritis (RA is a chronic inflammatory disease causing joint destructive changes and disability.Objective: to investigate the association between the ultrasound signs of active inflammation and destruction of the joints, as evidenced by radiography, in RA patients treated with a treat-to-target strategy and to study whether ultrasound study (USS of the joints can be used to predict the occurrence of their destructive changes.Subjects and methods. The investigation included 81 patients (medium age 56 [46; 62] years with RA, who had been followed up at the V.A. Nasonova Research Institute of Rheumatology within the first Russian strategic study of pharmacotherapy for RA – REMARCA (Russian invEstigation of MethotrexAte and biologicals for eaRly aCtive Arthritis. In all the patients, methotrexate (Metoject, MEDAS, Germany as the first disease-modifying anti-rheumatic drug was subcutaneously injected at an initial dose of 10 mg/week with its rapid escalation up to 20–25 mg/week. Then the therapy was added by biologicals as the need arose. Clinical and laboratory parameters were analyzed immediately before and then after 12, 24, 36, and 48 weeks. Efficacy was assessed using the European League Against Rheumatism (EULAR criteria, CDAI, and SDAI. USS of eight articular areas (the wrist, second and third metacarpophalangeal, second and third proximal interphalangeal, second and fifth metatarsophalangeal joints in the hand and foot of the clinically dominant side was carried out in all the patients before treatment and then after 12, 24, 36, and 48 weeks. Semiquantitative gray-scale (GS assessment and power Doppler (PD were performed. Radiographic examination was done before and after 48 weeks of therapy. The Sharp method modified by van der Heijde was employed to estimate X-ray changes.Results and discussion. In the group of patients with radiographic progression, the activity of inflammation, as evidenced by PD USS, was significantly

  16. Analysis and test to predict the fatigue life of the ISX-B toroidal field coils' finger joints

    International Nuclear Information System (INIS)

    O'Toole, J.A.; Ojalvo, I.U.; Raynor, G.E.; Zatz, I.J.; Johnson, N.E.; Walls, J.C.; Nelson, B.E.; Cain, W.D.; Walstrom, P.L.; Pearce, J.W.

    1979-01-01

    A new and more rigorous structural evaluation of the ISX toroidal field (TF) coil fingers joints was undertaken to assess the effects of high-/beta/ operation of ISX-B. A new poloidal field (PF) coil set which allows high-/beta/ operation and produces larger out-of-plane loads on the TF coils was installed as part of the change to ISX-B. It was determined that the iron core significantly affects the out-of-plane load distribution and forces were calculated using the GFUN-3D code which considers 3-D iron core effects. These loads were applied to a half-symmetric finite element NASTRAN code model in which the TF coils were modeled as a string of beam elements. 8 refs

  17. Effect of adhesive stiffness and thickness on stress distributions in structural finger joints

    Science.gov (United States)

    Leslie H. Groom; Robert J. Leichti

    1994-01-01

    Environmental, political, and socioeconomic actions over the past several years have resulted in a decreased wood supply at a time when there is an increased demand for forest products. This combination of increased demand and decreased supply has forced more emphasis on engineered wood products, a varied category usually connected with adhesively-bonded end joints, of...

  18. A simplified baseline prediction model for joint damage progression in rheumatoid arthritis: a step toward personalized medicine.

    Science.gov (United States)

    de Punder, Yvonne M R; van Riel, Piet L C M; Fransen, Jaap

    2015-03-01

    To compare the performance of an extended model and a simplified prognostic model for joint damage in rheumatoid arthritis (RA) based on 3 baseline risk factors: anticyclic citrullinated peptide antibodies (anti-CCP), erosions, and acute-phase reaction. Data were used from the Nijmegen early RA cohort. An extended model and a simplified baseline prediction model were developed to predict joint damage progression between 0 and 3 years. Joint damage progression was assessed using the Ratingen score. In the extended model, prediction factors were positivity for anti-CCP and/or rheumatoid factor, the level of erythrocyte sedimentation rate, and the quantity of erosions. The prediction score was calculated as the sum of the regression coefficients. In the simplified model, the prediction factors were dichotomized and the number of risk factors was counted. Performances of both models were compared using discrimination and calibration. The models were internally validated using bootstrapping. The extended model resulted in a prediction score between 0 and 5.6 with an area under the receiver-operation characteristic (ROC) curve of 0.77 (95% CI 0.72-0.81). The simplified model resulted in a prediction score between 0 and 3. This model had an area under the ROC curve of 0.75 (95% CI 0.70-0.80). In internal validation, the 2 models showed reasonably well the agreement between observed and predicted probabilities for joint damage progression (Hosmer-Lemeshow test p > 0.05 and calibration slope near 1.0). A simple prediction model for joint damage progression in early RA, by only counting the number of risk factors, has adequate performance. This facilitates the translation of the theoretical prognostic models to daily clinical practice.

  19. Ultrasonography of the metacarpophalangeal and proximal interphalangeal joints in rheumatoid arthritis: a comparison with magnetic resonance imaging, conventional radiography and clinical examination

    DEFF Research Database (Denmark)

    Szkudlarek, Marcin; Klarlund, Mette; Narvestad, E.

    2006-01-01

    ultrasonography can provide information on signs of inflammation and destruction in RA finger joints that are not available with conventional radiography and clinical examination, and comparable to the information provided by magnetic resonance imaging (MRI). The second to fifth metacarpophalangeal and proximal...... interphalangeal joints of 40 RA patients and 20 control persons were assessed with ultrasonography, clinical examination, radiography and MRI. With MRI as the reference method, the sensitivity, specificity and accuracy of ultrasonography in detecting bone erosions in the finger joints were 0.59, 0.98 and 0...

  20. Multi-fingered robotic hand

    Science.gov (United States)

    Ruoff, Carl F. (Inventor); Salisbury, Kenneth, Jr. (Inventor)

    1990-01-01

    A robotic hand is presented having a plurality of fingers, each having a plurality of joints pivotally connected one to the other. Actuators are connected at one end to an actuating and control mechanism mounted remotely from the hand and at the other end to the joints of the fingers for manipulating the fingers and passing externally of the robot manipulating arm in between the hand and the actuating and control mechanism. The fingers include pulleys to route the actuators within the fingers. Cable tension sensing structure mounted on a portion of the hand are disclosed, as is covering of the tip of each finger with a resilient and pliable friction enhancing surface.

  1. Evaluation of the joint distribution at disease presentation of patients with rheumatoid arthritis: a large study across continents.

    Science.gov (United States)

    Bergstra, Sytske Anne; Chopra, Arvind; Saluja, Manjit; Vega-Morales, David; Govind, Nimmisha; Huizinga, Tom W J; van der Helm-van Mil, Annette

    2017-01-01

    Genetic and environmental risk factors for rheumatoid arthritis (RA) are population dependent and may affect disease expression. Therefore, we studied tender and swollen joint involvement in patients newly diagnosed with RA in four countries and performed a subanalysis within countries to assess whether the influence of autoantibody positivity affected disease expression. Patients with symptom duration <2 years fulfilling the American College of Rheumatology/European League Against Rheumatism 2010 RA classification criteria were selected from METEOR (Measurement of Efficacy of Treatment in the Era of Outcome in Rheumatology), an international observational database, and the Dutch Leiden Early Arthritis Clinic. Indian (n=947), Mexican (n=141), South African (n=164) and Dutch (n=947) autoantibody-positive and negative patients with RA, matched by symptom duration, were studied for swollen and tender joint distribution. Between countries, the reported distribution of swollen joint distribution differed, with more knee synovitis in Mexico, South Africa and India compared with the Netherlands (37%, 36%, 30% and 13%) and more elbow (29%, 23%, 7%, 7%) and shoulder synovitis (21%, 11%, 0%, 1%) in Mexico and South Africa compared with India and the Netherlands.Since the number of autoantibody-negative patients in Mexico and South Africa was limited, Indian and Dutch autoantibody-positive and negative patients with RA were compared. The number of swollen and tender joints was higher in autoantibody-negative patients, but the overall distribution of involved joints was similar. Joint involvement at diagnosis does not differ between autoantibody-positive and negative patients with RA in India and the Netherlands. However, joint involvement is reported differently across countries. More research is needed whether these differences are cultural and/or pathogenetic.

  2. Frequency of inflammatory-like MR imaging findings in asymptomatic fingers of healthy volunteers

    Energy Technology Data Exchange (ETDEWEB)

    Agten, Christoph A.; Rosskopf, Andrea B.; Jonczy, Maciej; Pfirrmann, Christian W.A.; Buck, Florian M. [University Hospital Balgrist, Radiology, Zurich (Switzerland); University of Zurich, Faculty of Medicine, Zurich (Switzerland); Brunner, Florian [University of Zurich, Faculty of Medicine, Zurich (Switzerland); University Hospital Balgrist, Department of Physical Medicine and Rheumatology, Zurich (Switzerland)

    2018-02-15

    To describe the frequency of inflammatory-like findings on MR imaging in asymptomatic volunteers and compare them with patients with known rheumatoid arthritis and psoriatic arthritis. MR images of fingers in 42 asymptomatic volunteers and 33 patients with rheumatoid/psoriatic arthritis were analyzed. The Outcome Measures in Rheumatology Clinical Trials (OMERACT) Rheumatoid/Psoriatic Arthritis MRI Scoring System (RAMRIS/PsAMRIS) and tenosynovitis scoring system were used to assess: bone marrow edema (BME), erosions, tendon sheath fluid/tenosynovitis, joint effusion, and soft-tissue edema. Findings and scores were compared between volunteers and patients. Inter-reader agreement was calculated (intraclass correlation coefficients, ICC). In volunteers, tendon sheath fluid was very common in at least one location (42/42 volunteers for reader 1, 34/42 volunteers for reader 2). BME, erosions, joint effusion, and soft-tissue edema were absent (except one BME in the 3rd proximal phalanx for reader 1). Tendon sheath fluid scores in volunteers and tenosynovitis scores in patients were high (reader 1, 7.17 and 5.39; reader 2, 2.31 and 5.45). Overall, inter-reader agreement was substantial (ICC = 0.696-0.844), except for tendon sheath fluid (ICC = 0.258). Fluid in the finger flexor tendon sheaths may be a normal finding and without gadolinium administration should not be interpreted as tenosynovitis. Bone marrow edema, erosions, joint effusion, and soft-tissue edema in the fingers most likely reflect pathology if present. (orig.)

  3. Frequency of inflammatory-like MR imaging findings in asymptomatic fingers of healthy volunteers

    International Nuclear Information System (INIS)

    Agten, Christoph A.; Rosskopf, Andrea B.; Jonczy, Maciej; Pfirrmann, Christian W.A.; Buck, Florian M.; Brunner, Florian

    2018-01-01

    To describe the frequency of inflammatory-like findings on MR imaging in asymptomatic volunteers and compare them with patients with known rheumatoid arthritis and psoriatic arthritis. MR images of fingers in 42 asymptomatic volunteers and 33 patients with rheumatoid/psoriatic arthritis were analyzed. The Outcome Measures in Rheumatology Clinical Trials (OMERACT) Rheumatoid/Psoriatic Arthritis MRI Scoring System (RAMRIS/PsAMRIS) and tenosynovitis scoring system were used to assess: bone marrow edema (BME), erosions, tendon sheath fluid/tenosynovitis, joint effusion, and soft-tissue edema. Findings and scores were compared between volunteers and patients. Inter-reader agreement was calculated (intraclass correlation coefficients, ICC). In volunteers, tendon sheath fluid was very common in at least one location (42/42 volunteers for reader 1, 34/42 volunteers for reader 2). BME, erosions, joint effusion, and soft-tissue edema were absent (except one BME in the 3rd proximal phalanx for reader 1). Tendon sheath fluid scores in volunteers and tenosynovitis scores in patients were high (reader 1, 7.17 and 5.39; reader 2, 2.31 and 5.45). Overall, inter-reader agreement was substantial (ICC = 0.696-0.844), except for tendon sheath fluid (ICC = 0.258). Fluid in the finger flexor tendon sheaths may be a normal finding and without gadolinium administration should not be interpreted as tenosynovitis. Bone marrow edema, erosions, joint effusion, and soft-tissue edema in the fingers most likely reflect pathology if present. (orig.)

  4. Correlation between knee and hindfoot alignment in patients with rheumatoid arthritis: The effects of subtalar joint destruction.

    Science.gov (United States)

    Nakada, Izumi; Nakamura, Ichiro; Juji, Takuo; Ito, Katsumi; Matsumoto, Takumi

    2015-09-01

    Compensatory hindfoot alignment for deformities at the knee level has been demonstrated in patients with knee osteoarthritis. However, this phenomenon has not been elucidated in patients with rheumatoid arthritis (RA). The aim of this study is to investigate the relationship between knee deformity and hindfoot alignment and the effect of subtalar joint destruction in patients with RA. We retrospectively investigated RA patients (110 patients, 205 limbs) using radiographs in the standing anteroposterior knee, standing lateral foot, and hindfoot alignment views. The grade of destruction at the knee and subtalar joints was assigned using Larsen's grading system. The correlation between the femorotibial and tibiocalcaneal angles and the effect of joint destruction on this correlation were analyzed using Pearson's correlation coefficients. There was moderate correlation between the femorotibial and tibiocalcaneal angles in a group of knees with a Larsen grade of ≥ 4 (r = 0.544, p = 0.0239). This correlation was stronger in a group with less damaged subtalar joints with a Larsen grade of ≤ 3 (r = 0.705, p = 0.0049). These findings emphasized the importance of examining foot and ankles in patients with RA who undergo total knee arthroplasty.

  5. [Effects of Electroacupuncture on Joint Function in Rheumatoid Arthritis Patients of Liver- and Kidney-Yin Deficiency Type].

    Science.gov (United States)

    Zhou, Yin; Zhu, Jun; Li, Lian-Bo; He, Tian-Feng; Chen, Xiao-Yi; Zheng, Yong-Yao; Chen, Yun-Fei

    2016-10-25

    To compare the effects between electroacupuncture (EA) plus western medicine and simple western medicine in improving clinical symptoms and local joint function of rheumatoid arthritis (RA) patients with yin deficiency of Liver and Kidney. A total of 68 RA patients of yin deficiency of Liver and Kidney were equally randomized into EA+medication group and medication group ( n =34 in each group). Both groups were given once-a-week methotrexate (7.5 mg/time) and once-a-day leflunomide (10 mg/time), while EA+medication group was additionally treated by EA at bilateral Ganshu (BL 18), Shenshu (BL 23), Xuanzhong (GB 39), Zusanli (ST 36), Taichong (LR 3), Hegu (LI 4) 3 times/week. The treatment lasted for 12 weeks. The visual analogue scale (VAS, for assessing rest pain), swollen joint count (SJC), tender joint count (TJC), patient's global assessment (PGA), physician's global assessment (PhGA), traditional Chinese medicine (TCM) symptom scoring, 28 joints activity index (disease activity score, DAS 28), American College of Rheumatology 20 (ACR 20, i.e. 20% of clinical improving rate), and health assessment questionnaire (HAQ) were assessed and erythrocyte sedimentation rate (ESR), serum C-reactive protein (CRP) levels were examined for comparison. Statistical differences were observed in before-after-treatment comparisons in both groups in reducing rest pain, SJC, TJC, serum CRP content, PGA and PhGA, HAQ scoring and DAS 28 ( P yin deficiency of Liver and Kidney.

  6. Reliability of the standard goniometry and diagrammatic recording of finger joint angles: a comparative study with healthy subjects and non-professional raters.

    Science.gov (United States)

    Macionis, Valdas

    2013-01-09

    Diagrammatic recording of finger joint angles by using two criss-crossed paper strips can be a quick substitute to the standard goniometry. As a preliminary step toward clinical validation of the diagrammatic technique, the current study employed healthy subjects and non-professional raters to explore whether reliability estimates of the diagrammatic goniometry are comparable with those of the standard procedure. The study included two procedurally different parts, which were replicated by assigning 24 medical students to act interchangeably as 12 subjects and 12 raters. A larger component of the study was designed to compare goniometers side-by-side in measurement of finger joint angles varying from subject to subject. In the rest of the study, the instruments were compared by parallel evaluations of joint angles similar for all subjects in a situation of simulated change of joint range of motion over time. The subjects used special guides to position the joints of their left ring finger at varying angles of flexion and extension. The obtained diagrams of joint angles were converted to numerical values by computerized measurements. The statistical approaches included calculation of appropriate intraclass correlation coefficients, standard errors of measurements, proportions of measurement differences of 5 or less degrees, and significant differences between paired observations. Reliability estimates were similar for both goniometers. Intra-rater and inter-rater intraclass correlation coefficients ranged from 0.69 to 0.93. The corresponding standard errors of measurements ranged from 2.4 to 4.9 degrees. Repeated measurements of a considerable number of raters fell within clinically non-meaningful 5 degrees of each other in proportions comparable with a criterion value of 0.95. Data collected with both instruments could be similarly interpreted in a simulated situation of change of joint range of motion over time. The paper goniometer and the standard goniometer can

  7. Rheumatoid Arthritis Educational Video Series

    Medline Plus

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

  8. Layer-by-layer assembled magnetic prednisolone microcapsules (MPC) for controlled and targeted drug release at rheumatoid arthritic joints

    Energy Technology Data Exchange (ETDEWEB)

    Prabu, Chakkarapani [Department of Pharmaceutical Technology & Centre for Excellence in Nanobio Translational Research, Anna University, Bharathidasan Institute of Technology Campus, Tiruchirappalli, Tamil Nadu (India); Latha, Subbiah, E-mail: lathasuba2010@gmail.com [Department of Pharmaceutical Technology & Centre for Excellence in Nanobio Translational Research, Anna University, Bharathidasan Institute of Technology Campus, Tiruchirappalli, Tamil Nadu (India); Selvamani, Palanisamy [Department of Pharmaceutical Technology & Centre for Excellence in Nanobio Translational Research, Anna University, Bharathidasan Institute of Technology Campus, Tiruchirappalli, Tamil Nadu (India); Ahrentorp, Fredrik; Johansson, Christer [Acreo Swedish ICT AB, Arvid Hedvalls Backe 4, Göteborg (Sweden); Takeda, Ryoji; Takemura, Yasushi [Electrical & Computer Engineering & Faculty of Engineering Division of Intelligent Systems Engineering, Yokohama National University (Japan); Ota, Satoshi [Department of Electrical and Electronic Engineering, Shizuoka University (Japan)

    2017-04-01

    We report here in about the formulation and evaluation of Magnetic Prednisolone Microcapsules (MPC) developed in order to improve the therapeutic efficacy relatively at a low dose than the conventional dosage formulations by means of magnetic drug targeting and thus enhancing bioavailability at the arthritic joints. Prednisolone was loaded to poly (sodium 4-styrenesulfonate) (PSS) doped calcium carbonate microspheres confirmed by the decrease in surface area from 97.48 m{sup 2}/g to 12.05 of m{sup 2}/g by BET analysis. Adsorption with oppositely charged polyelectrolytes incorporated with iron oxide nanoparticles was confirmed through zeta analysis. Removal of calcium carbonate core yielded MPC with particle size of ~3.48 µm, zeta potential of +29.7 mV was evaluated for its magnetic properties. Functional integrity of MPC was confirmed through FT-IR spectrum. Stability studies were performed at 25 °C±65% relative humidity for 60 days showed no considerable changes. Further the encapsulation efficiency of 63%, loading capacity of 18.2% and drug release of 88.3% for 36 h and its kinetics were also reported. The observed results justify the suitability of MPC for possible applications in the magnetic drug targeting for efficient therapy of rheumatoid arthritis. - Highlights: • Development of magnetic prednisolone microcapsules (MPC). • Physicochemical, pharmaceutical and magnetic properties of MPC were characterized. • Multiple layers of alternative polyelectrolytes prolonged prednisolone release time. • MPC is capable for targeted and sustained release rheumatoid arthritis therapy.

  9. Mesofluidic controlled robotic or prosthetic finger

    Science.gov (United States)

    Lind, Randall F; Jansen, John F; Love, Lonnie J

    2013-11-19

    A mesofluidic powered robotic and/or prosthetic finger joint includes a first finger section having at least one mesofluidic actuator in fluid communication with a first actuator, a second mesofluidic actuator in fluid communication with a second actuator and a second prosthetic finger section pivotally connected to the first finger section by a joint pivot, wherein the first actuator pivotally cooperates with the second finger to provide a first mechanical advantage relative to the joint point and wherein the second actuator pivotally cooperates with the second finger section to provide a second mechanical advantage relative to the joint point.

  10. Magnetic resonance imaging, radiography, and scintigraphy of the finger joints: one year follow up of patients with early arthritis. The TIRA Group

    DEFF Research Database (Denmark)

    Klarlund, Mette; Østergaard, Mikkel; Jensen, K E

    2000-01-01

    OBJECTIVES: To evaluate synovial membrane hypertrophy, tenosynovitis, and erosion development of the 2nd to 5th metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints by magnetic resonance imaging in a group of patients with rheumatoid arthritis (RA) or suspected RA followed up for one......, and tenosynovitis score. RESULTS: MRI detected progression of erosions earlier and more often than did radiography of the same joints; at baseline the MRI to radiography ratio was 28:4. Erosions were exclusively found in patients with RA at baseline or fulfilling the ACR criteria at one year. At one year follow up......, scores of MR synovial membrane hypertrophy, tenosynovitis, and scintigraphic tracer accumulation had not changed significantly from baseline; in contrast, swollen and tender joint counts had declined significantly (p

  11. Trigger finger

    Science.gov (United States)

    ... digit; Trigger finger release; Locked finger; Digital flexor tenosynovitis ... cut or hand Yellow or green drainage from the cut Hand pain or discomfort Fever If your trigger finger returns, call your surgeon. You may need another surgery.

  12. Thermal imaging in screening of joint inflammation and rheumatoid arthritis in children

    International Nuclear Information System (INIS)

    Lasanen, R; Julkunen, P; Töyräs, J; Piippo-Savolainen, E; Remes-Pakarinen, T; Kröger, L; Heikkilä, A; Karhu, J

    2015-01-01

    Potential of modern thermal imaging for screening and differentiation of joint inflammation has not been assessed in child and juvenile patient populations, typically demanding groups in diagnostics of musculoskeletal disorders. We hypothesize that thermal imaging can detect joint inflammation in patients with juvenile idiopathic arthritis or autoimmune disease with arthritis such as systemic lupus erythematosus. To evaluate the hypothesis, we studied 58 children exhibiting symptoms of joint inflammation. First, the patients’ joints were examined along clinical procedure supplemented with ultrasound imaging when deemed necessary by the clinician. Second, thermal images were acquired from patients’ knees and ankles. Results of thermal imaging were compared to clinical evaluations in knee and ankle. The temperatures were significantly (p max = 0.044, p mean  < 0.001) higher in inflamed ankle joints, but not in inflamed knee joints. No significant difference was found between the skin surface temperatures of medial and lateral aspects of ankle joints. In knee joints the mean temperatures of medial and lateral aspect differed significantly (p = 0.004). We have demonstrated that thermal imaging may have potential for detecting joint inflammation in ankle joints of children. For knee joints our results are inconclusive and further research is warranted. (paper)

  13. Power Doppler ultrasonography for assessment of synovitis in the metacarpophalangeal joints of patients with rheumatoid arthritis: a comparison with dynamic magnetic resonance imaging

    DEFF Research Database (Denmark)

    Szkudlarek, Marcin; Court-Payen, M; Strandberg, C

    2001-01-01

    OBJECTIVE: To evaluate the effectiveness of power Doppler ultrasonography (PDUS) for assessing inflammatory activity in the metacarpophalangeal (MCP) joints of patients with rheumatoid arthritis (RA), using dynamic magnetic resonance imaging (MRI) as a reference method. METHODS: PDUS and dynamic...... MRI were performed on 54 MCP joints of 15 patients with active RA and on 12 MCP joints of 3 healthy controls. PDUS was performed with a LOGIQ 500 unit by means of a 7-13-MHz linear array transducer. Later the same day, MRI was performed with a 1.0T MR unit. A series of 24 coronal T1-weighted images...

  14. Cartilage destruction in small joints by rheumatoid arthritis: assessment of fat-suppressed three-dimensional gradient-echo MR pulse sequences in vitro

    International Nuclear Information System (INIS)

    Uhl, M.; Allmann, K.H.; Hauer, M.P.; Langer, M.; Ihling, C.; Conca, W.

    1998-01-01

    Purpose. To assess the accuracy of different MR sequences for the detection of articular cartilage abnormalities in rheumatoid arthritis. Design and patients. Ten metacarpophalangeal joints and 10 metatarsophalangeal joints (specimens from arthritis patients undergoing ablative joint surgery) were examined with a fat-suppressed (FS) 3D FLASH, a FS 3D FISP, a FS 2D fast spin-echo T2-weighted, and a 2D FS spin-echo T1-weighted sequence. Each cartilage lesion and each cortical lesion was graded from 0 to 4 (modified Outerbridge staging system). Subsequently, the results of each sequence were compared with the macroscopic findings and statistically tested against each other. Results. The study shows that 3D gradient-echo sequences with fat suppression were best for imaging and grading of cartilage lesions in arthritis of the small joints of the hands and feet. Using 3D techniques, all grade 2, grade 3, and grade 4 lesions of cartilage or cortical bone were detected. Conclusion. FS 3D gradient-echo techniques were best for the detection and grading of hyaline cartilage and subchondral bone lesions in rheumatoid arthritis. MRI has a great potential as an objective method of evaluating cartilage damage and bone erosions in rheumatoid arthritis. (orig.)

  15. Cartilage destruction in small joints by rheumatoid arthritis: assessment of fat-suppressed three-dimensional gradient-echo MR pulse sequences in vitro

    Energy Technology Data Exchange (ETDEWEB)

    Uhl, M.; Allmann, K.H.; Hauer, M.P.; Langer, M. [Department of Diagnostic Radiology, University Hospital Freiburg (Germany); Ihling, C. [Department of Pathology, University Hospital Freiburg, Freiburg (Germany); Conca, W. [Department of Rheumatology, University Hospital Freiburg (Germany)

    1998-12-01

    Purpose. To assess the accuracy of different MR sequences for the detection of articular cartilage abnormalities in rheumatoid arthritis. Design and patients. Ten metacarpophalangeal joints and 10 metatarsophalangeal joints (specimens from arthritis patients undergoing ablative joint surgery) were examined with a fat-suppressed (FS) 3D FLASH, a FS 3D FISP, a FS 2D fast spin-echo T2-weighted, and a 2D FS spin-echo T1-weighted sequence. Each cartilage lesion and each cortical lesion was graded from 0 to 4 (modified Outerbridge staging system). Subsequently, the results of each sequence were compared with the macroscopic findings and statistically tested against each other. Results. The study shows that 3D gradient-echo sequences with fat suppression were best for imaging and grading of cartilage lesions in arthritis of the small joints of the hands and feet. Using 3D techniques, all grade 2, grade 3, and grade 4 lesions of cartilage or cortical bone were detected. Conclusion. FS 3D gradient-echo techniques were best for the detection and grading of hyaline cartilage and subchondral bone lesions in rheumatoid arthritis. MRI has a great potential as an objective method of evaluating cartilage damage and bone erosions in rheumatoid arthritis. (orig.) With 5 figs., 19 refs.

  16. Significance of clinical evaluation of the metacarpophalangeal joint in relation to synovial/bone pathology in rheumatoid and psoriatic arthritis detected by magnetic resonance imaging.

    Science.gov (United States)

    Stone, Millicent A; White, Lawrence M; Gladman, Dafna D; Inman, Robert D; Chaya, Sam; Lax, Matthew; Salonen, David; Weber, Deborah A; Guthrie, Judy A; Pomeroy, Emma; Podbielski, Dominik; Keystone, Edward C

    2009-12-01

    Rheumatologists base many clinical decisions regarding the management of inflammatory joint diseases on joint counts performed at clinic. We investigated the reliability and accuracy of physically examining the metacarpophalangeal (MCP) joints to detect inflammatory synovitis using magnetic resonance imaging (MRI) as the gold standard. MCP joints 2 to 5 in both hands of 5 patients with rheumatoid arthritis (RA) and 5 with psoriatic arthritis (PsA) were assessed by 5 independent examiners for joint-line swelling (visually and by palpation); joint-line tenderness by palpation (tender joint count, TJC) and stress pain; and by MRI (1.5 Tesla superconducting magnet). Interrater reliability was assessed using kappa statistics, and agreement between examination and corresponding MRI assessment was assessed by Fisher's exact tests (p 0.8) and positive predictive value (= 0.8). For PsA, significant associations exist between TJC and MRI synovitis scores (p < 0.01) and stress pain and MRI edema scores (p < 0.04). Assessment of swelling by palpation was not significantly associated with synovitis or edema as determined by MRI in RA or PsA (p = 0.54-1.0). In inflammatory arthritis, disease activity in MCP joints can be reliably assessed at the bedside by examining for joint-line tenderness (TJC) and visual inspection for swelling. Clinical assessment may have to be complemented by other methods for evaluating disease activity in the joint, such as MRI, particularly in patients with PsA.

  17. Magnetic resonance imaging-determined synovial membrane and joint effusion volumes in rheumatoid arthritis and osteoarthritis: comparison with the macroscopic and microscopic appearance of the synovium

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Stoltenberg, M; Løvgreen-Nielsen, P

    1997-01-01

    OBJECTIVE: To evaluate the relationship between synovial membrane and joint effusion volumes determined by magnetic resonance imaging (MRI) and macroscopic and microscopic synovial pathologic findings in patients with rheumatoid arthritis (RA) and osteoarthritis (OA). METHODS: Synovial biopsies...... were performed, and macroscopic grades of synovitis assigned, at preselected knee sites during arthroscopy or arthrotomy in 17 knees with RA and 25 with OA. Synovial inflammation and 9 separate tissue characteristics were graded histologically. Synovial membrane and joint effusion volumes were...... membrane and effusion volumes may be sensitive markers and/or predictors of disease activity and treatment outcome in RA....

  18. An evaluation of the spring finger solder joints on SA1358-10 and SA2052-4 connector assemblies (MC3617,W87)

    International Nuclear Information System (INIS)

    Kilgo, Alice C.; Vianco, Paul Thomas; Hlava, Paul Frank; Zender, Gary L.

    2006-01-01

    The SA1358-10 and SA2052-4 circular JT Type plug connectors are used on a number of nuclear weapons and Joint Test Assembly (JTA) systems. Prototype units were evaluated for the following specific defects associated with the 95Sn-5Sb (Sn-Sb, wt.%) solder joint used to attach the beryllium-copper (BeCu) spring fingers to the aluminum (Al) connector shell: (1) extended cracking within the fillet; (2) remelting of the solder joint during the follow-on, soldering step that attached the EMR adapter ring to the connector shell (and/or soldering the EMR shell to the adapter ring) that used the lower melting temperature 63Sn-37Pb (Sn-Pb) alloy; and (3) spalling of the Cd (Cr) layer overplating layer from the fillet surface. Several pedigrees of connectors were evaluated, which represented older fielded units as well as those assemblies that were recently constructed at Kansas City Plant. The solder joints were evaluated that were in place on connectors made with the current soldering process as well as an alternative induction soldering process for attaching the EMR adapter ring to the shell. Very similar observations were made, which crossed the different pedigrees of parts and processes. The extent of cracking in the top side fillets varied between the different connector samples and likely the EMR adapter ring to the shell. Very similar observations were made, which crossed the different pedigrees of parts and processes. The extent of cracking in the top side fillets varied between the different connector samples and likely reflected the different extents to which the connector was mated to its counterpart assembly. In all cases, the spring finger solder joints on the SA1358-10 connectors were remelted as a result of the subsequent EMR adapter ring attachment process. Spalling of the Cd (Cr) overplating layer was also observed for these connectors, which was a consequence of the remelting activity. On the other hand, the SA2052-4 connector did not exhibit evidence of

  19. Robotic Finger Assembly

    Science.gov (United States)

    Ihrke, Chris A. (Inventor); Bridgwater, Lyndon (Inventor); Diftler, Myron A. (Inventor); Linn, Douglas Martin (Inventor); Platt, Robert J., Jr. (Inventor); Hargrave, Brian (Inventor); Askew, Scott R. (Inventor); Valvo, Michael C. (Inventor)

    2014-01-01

    A robotic hand includes a finger with first, second, and third phalanges. A first joint rotatably connects the first phalange to a base structure. A second joint rotatably connects the first phalange to the second phalange. A third joint rotatably connects the third phalange to the second phalange. The second joint and the third joint are kinematically linked such that the position of the third phalange with respect to the second phalange is determined by the position of the second phalange with respect to the first phalange.

  20. Ultrasonography, magnetic resonance imaging, radiography, and clinical assessment of inflammatory and destructive changes in fingers and toes of patients with psoriatic arthritis

    DEFF Research Database (Denmark)

    Wiell, Charlotte; Szkudlarek, Marcin; Hasselquist, Maria

    2007-01-01

    The aim of the present study was to assess ultrasonography (US) for the detection of inflammatory and destructive changes in finger and toe joints, tendons, and entheses in patients with psoriasis-associated arthritis (PsA) by comparison with magnetic resonance imaging (MRI), projection radiography...... (x-ray), and clinical findings. Fifteen patients with PsA, 5 with rheumatoid arthritis (RA), and 5 healthy control persons were examined by means of US, contrast-enhanced MRI, x-ray, and clinical assessment. Each joint of the 2nd-5th finger (metacarpophalangeal joints, proximal interphalangeal [PIP...... tendons of the fingers were assessed for the presence of insertional changes and tenosynovitis. One hand was assessed by means of MRI for the aforementioned changes. X-rays of both hands and feet were assessed for bone erosions and proliferations. US was repeated in 8 persons by another ultrasonographer...

  1. Rosuvastatin-Induced Carotid Plaque Regression in Patients With Inflammatory Joint Diseases: The Rosuvastatin in Rheumatoid Arthritis, Ankylosing Spondylitis and Other Inflammatory Joint Diseases Study.

    Science.gov (United States)

    Rollefstad, S; Ikdahl, E; Hisdal, J; Olsen, I C; Holme, I; Hammer, H B; Smerud, K T; Kitas, G D; Pedersen, T R; Kvien, T K; Semb, A G

    2015-07-01

    Patients with rheumatoid arthritis (RA) and carotid artery plaques have an increased risk of acute coronary syndromes. Statin treatment with the goal of achieving a low-density lipoprotein (LDL) cholesterol level of ≤1.8 mmoles/liter (≤70 mg/dl) is recommended for individuals in the general population who have carotid plaques. The aim of the ROsuvastatin in Rheumatoid Arthritis, Ankylosing Spondylitis and other inflammatory joint diseases (RORA-AS) study was to evaluate the effect of 18 months of intensive lipid-lowering treatment with rosuvastatin with regard to change in carotid plaque height. Eighty-six patients (60.5% of whom were female) with carotid plaques and inflammatory joint disease (55 with RA, 21 with AS, and 10 with psoriatic arthritis) were treated with rosuvastatin to obtain the LDL cholesterol goal. Carotid plaque height was evaluated by B-mode ultrasonography. The mean ± SD age of the patients was 60.8 ± 8.5 years, and the median compliance with rosuvastatin treatment was 97.9% (interquartile range [IQR] 96.0-99.4). At baseline, the median number and height of the carotid plaques were 1.0 (range 1-8) and 1.80 mm (IQR 1.60-2.10), respectively. The mean ± SD change in carotid plaque height after 18 months of treatment with rosuvastatin was -0.19 ± 0.35 mm (P < 0.0001). The mean ± SD baseline LDL cholesterol level was 4.0 ± 0.9 mmoles/liter (154.7 ± 34.8 mg/dl), and the mean reduction in the LDL cholesterol level was -2.3 mmoles/liter (95% confidence interval [95% CI] -2.48, -2.15) (-88.9 mg/dl [95% CI -95.9, -83.1]). The mean ± SD LDL cholesterol level during the 18 months of rosuvastatin treatment was 1.7 ± 0.4 mmoles/liter (area under the curve). After adjustment for age/sex/blood pressure, no linear relationship between a reduction in carotid plaque height and the level of LDL cholesterol exposure during the study period was observed. Attainment of the LDL cholesterol goal of ≤1.8 mmoles/liter (≤70

  2. A prospective randomized study of conservative versus surgical treatment of unstable palmar plate disruption in the proximal interphalangeal finger joint

    DEFF Research Database (Denmark)

    Werlinrud, Jens Christian; Petersen, Kirstin; Lauritsen, Jens

    2013-01-01

    study in which 83 patients were randomly assigned into 2 groups: (1) conservative treatment with a rigid splint for 2 weeks, (2) surgical reattachment of the palmar plate in local anesthesia followed by 2 weeks of immobilization in a plaster cast. Both groups were thereafter treated by taping...... to the neighboring finger for 3 weeks. With regard to hyperextension instability, stiffness, and pain, there is no significant difference in outcome between patients with traumatic palmar plate lesions and hyperextension instability treated with surgical repair and patients treated conservatively with a splint. We...

  3. Trigger Finger (Stenosing Tenosynovitis)

    Science.gov (United States)

    ... All Topics A-Z Videos Infographics Symptom Picker Anatomy Bones Joints Muscles Nerves Vessels Tendons About Hand Surgery What is a Hand Surgeon? What is a Hand Therapist? Media Find a Hand Surgeon Home Anatomy Trigger Finger Email to a friend * required fields ...

  4. Open dislocation of the proximal interphalangeal joint of the little finger subsequent to chronic radial collateral ligament injury: a case report of primary ligament reconstruction with a half-slip of the flexor digitorum superficialis: Case Report.

    Science.gov (United States)

    Wada, Kazuma; Hibino, Naohito; Kondo, Kenji; Yoshioka, Shinji; Terai, Tomoya; Henmi, Tatsuhiko; Sairyo, Koichi

    2015-01-01

    Open dislocation of the proximal interphalangeal (PIP) joint is relatively rare. We report a case of a 32-year-old man who had open dislocation of the PIP joint of the little finger while playing American football. He had a history of chronic radial collateral ligament injury. We reconstructed the radial collateral ligament with a half-slip of the flexor digitorum superficialis tendon.

  5. AN ASSOCIATION OF CYTOKINE LEVELS WITH DISEASE ACTIVITY, AUTOANTIBODY LEVELS, AND JOINT DESTRUCTIVE CHANGES IN EARLY RHEUMATOID ARTHRITIS

    Directory of Open Access Journals (Sweden)

    A. S. Avdeeva

    2015-01-01

    Full Text Available Objective: to assess the association of cytokine profile measures with disease activity, autoantibody levels, and joint destructive changes in patients with early rheumatoid arthritis (RA.Subjects and methods. Forty-five patients, including 35 women, with early RA were examined. Their median age was 53.5 [46; 59.5] years; the duration of the disease – 7.0 [4.0; 11.5] months; DAS28 – 5.8 [4.9; 6.4]; 91 and 96% of the patents were positive for rheumatoid factor (RF and anticyclic citrullinated peptide antibodies, respectively. Serum cytokine concentrations were estimated using the xMAP multiplex technology. The modified Sharp method was employed to quantify radiographic changes.Results and discussion. A group of 30 patients with high disease activity (DAS28 >5.1 had higher levels of interleukin (IL-6 (62.3 [36.1; 127.5] pg/ml and IP-10 (6367.8 [3682.7; 10691.3] pg/ml than 15 patients with moderate/low disease activity (DAS28 ≤5.1 (35.8 [13.4; 64.2] and 3222.6 [1881.0; 5671.9] pg/ml, respectively, p < 0.05. The patients highly positive for IgM RF had higher levels (pg/ml of proinflammatory cytokines, such as IL-1β, IL-2, IL-6, IL-12, IL-15, interferon-γ, and tumor necrosis factor-α; the chemokine monocyte chemotactic protein-1 and the growth factors IL-7 and vascular endothelial growth factor (4.8 [2.8; 19.3], 23.0 [7.1; 55.8], 64.2 [41.6; 170.5], 52.2 [30.9; 126.9], 2.4 [0.2; 11.2], 210.8 [119.9; 584.2], 90.7 [42.7; 307/9], 57.5 [26.1; 93.8], 54.9 [37.1; 123.7], and 143.3 [70.6; 249.6] pg/ml than those who were negative/lowly positive for IgM RF (2.3 [1.9; 3.1], 4.9 [2.9; 16.8], 24.9 [20.4; 45.4], 25.6 [19.9; 57.1], 0.2 [0.01; 1.65], 94.4 [86.3; 138.9], 37.3 [23.6; 47.7], 20.9 [12.3; 33.9], 32.6 [28.1; 37.8], 74.2 [53.5; 147.6], respectively (p < 0.05.Conclusion. There are significant differences in cytokine profile measures in patients with early RA in relation to disease activity and serum autoantibody levels.

  6. Clinical registry for rheumatoid arthritis; a preliminary analysis

    International Nuclear Information System (INIS)

    Fakhr, A.; Hakim, F.; Zaidi, S.K.; Sharif, A.

    2017-01-01

    To establish a clinical registry for Rheumatoid Arthritis and delineate the most common symptoms that rheumatoid arthritis (RA) patients experience in our set up. Study Design: Cross sectional study. Place and Duration of Study: Study was carried out at Military Hospital (MH) Rawalpindi at Rheumatology Department during the period of Jan 2013 to Jun 2015. Material and Methods: A clinical registry for Rheumatoid Arthritis was developed as per criteria jointly developed by American College of Rheumatology (ACR) along with European League against Rheumatism (EULAR) (2010). Fifty-eight patients were registered after their informed consent and approval by Military Hospital (MH) Rawalpindi ethical committee. Age, gender and relevant clinical parameters of RA patients were recorded on case report forms and stored for analysis in the RA registry in Excel 2010. The figures were reported in frequencies and percentages. Results: Multiple joint pains (48.28%), fever (24.14%), morning stiffness of joints (22.41%) were the most common symptoms in RA patients. Other clinical manifestations included painful bilateral swollen joints (13.79%), pain in different parts of the body (10.34%), Raynaud's phenomenon (10.34%), malaise (8.62%), swollen body parts (8.62%), ulcers (8.62%), fatigue (6.90%), nodules on skin/elbow/interphalangeal joints (6.90%), deformities of fingers/ hand (3.45%), redness of eyes (3.45%), body rash (3.45%), inability to walk (3.45%), cervical lymphadenopathy (1.72%), stiffness of spine (1.72%) and myalgias (1.72%). Conclusion: It is concluded that multiple joint pains, fever and morning stiffness of joints are the most common symptoms of RA patients. (author)

  7. Validity and Agreement between the 28-Joint Disease Activity Score Based on C-Reactive Protein and Erythrocyte Sedimentation Rate in Patients with Rheumatoid Arthritis

    DEFF Research Database (Denmark)

    Nielung, Louise; Christensen, Robin; Danneskiold-Samsøe, Bente

    2015-01-01

    Objective. To validate the agreement between the 28-joint disease activity score based on erythrocyte sedimentation rate (DAS28-ESR) and the 28-joint disease activity score based on C-reactive protein (DAS28-CRP) in a group of Danish patients with rheumatoid arthritis (RA). Methods. Data from 109...... Danish RA patients initiating biologic treatment were analysed at baseline and following one year of treatment. Participants were retrospectively enrolled from a previous cohort study and were considered eligible for this project if CRP and ESR were measured at baseline and at the follow-up visit...... are interchangeable when assessing RA patients and the two versions of DAS28 are comparable between studies....

  8. Distinctive radiological features of small hand joints in rheumatoid arthritis and seronegative spondyloarthritis demonstrated by contrast-enhanced (Gd-DTPA) magnetic resnance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Jevtic, V. [Inst. of Radiology, Univ. Medical Centre, Ljubljana (Slovenia); Watt, I. [Dept. of Clinical Radiology, Bristol Royal Infirmary (United Kingdom); Rozman, B. [Dept. of Rheumatology, Univ. Medical Centre, Ljubljana (Slovenia); Kos-Golja, M. [Dept. of Rheumatology, Univ. Medical Centre, Ljubljana (Slovenia); Demsar, F. [Inst. Jozef Stefan, Ljubljana (Slovenia); Jarh, O. [Inst. Jozef Stefan, Ljubljana (Slovenia)

    1995-07-01

    A series of patients with clinically early inflammatory joint disease due to rheumatoid arthritis, psoriatic arthritis and Reiter`s syndrome were examined by plain film radiography and magnetic resonance imaging (MRI). The spin echo T1-weighted precontrast, T2-weighted, and, especially, T1-weighted postcontrast images demonstrated distinct differences in the distribution of inflamatory changes, both within and adjacent to involved small hand joints. Two major subtypes of inflammatory arthritis were shown, thus providing a specific differential diagnosis between rheumatoid arthritis and some patients with seronegative spondyloarthritis. In particular, all the patients with Reiter`s syndrome who were studied, and half of those with psoriatic arthritis, had a distinctive pattern of extra-articular desease involvement. The need for a new classification of clinical subsets in psoriatic arthritis has been recently suggested. The present findings suggest that magnetic resonance imaging could be useful in such a reclassification of seronegative spondyloarthritis, as well as offering considerable potential for a reappraisal of pathogenesis and therapy. In this series, it was also noted that juxta-articular osteoporosis on plain film did not correlate with bone marrow oedema on MRI. Hence the aetiology of this common radiographic finding also merits further consideration. (orig.)

  9. Distinctive radiological features of small hand joints in rheumatoid arthritis and seronegative spondyloarthritis demonstrated by contrast-enhanced (Gd-DTPA) magnetic resnance imaging

    International Nuclear Information System (INIS)

    Jevtic, V.; Watt, I.; Rozman, B.; Kos-Golja, M.; Demsar, F.; Jarh, O.

    1995-01-01

    A series of patients with clinically early inflammatory joint disease due to rheumatoid arthritis, psoriatic arthritis and Reiter's syndrome were examined by plain film radiography and magnetic resonance imaging (MRI). The spin echo T1-weighted precontrast, T2-weighted, and, especially, T1-weighted postcontrast images demonstrated distinct differences in the distribution of inflamatory changes, both within and adjacent to involved small hand joints. Two major subtypes of inflammatory arthritis were shown, thus providing a specific differential diagnosis between rheumatoid arthritis and some patients with seronegative spondyloarthritis. In particular, all the patients with Reiter's syndrome who were studied, and half of those with psoriatic arthritis, had a distinctive pattern of extra-articular desease involvement. The need for a new classification of clinical subsets in psoriatic arthritis has been recently suggested. The present findings suggest that magnetic resonance imaging could be useful in such a reclassification of seronegative spondyloarthritis, as well as offering considerable potential for a reappraisal of pathogenesis and therapy. In this series, it was also noted that juxta-articular osteoporosis on plain film did not correlate with bone marrow oedema on MRI. Hence the aetiology of this common radiographic finding also merits further consideration. (orig.)

  10. The effects of compression gloves on hand symptoms and hand function in rheumatoid arthritis and hand osteoarthritis: a systematic review.

    Science.gov (United States)

    Hammond, Alison; Jones, Vivienne; Prior, Yeliz

    2016-03-01

    to evaluate the effects of compression gloves in adults with rheumatoid arthritis and hand osteoarthritis. Systematic review of randomized controlled trials identified from MEDLINE, CINAHL, AMED, PEDro, OT Seeker, The Cochrane Library, ISI Web of Knowledge, Science Direct and PubMed from their inceptions to January 2015. Methodological quality of identified trials was evaluated using the PEDro scale by three independent assessors. Effects were summarized descriptively. Four trials (n=8-24; total n=74), comparing night wear of full-length finger compression gloves with placebo gloves, were assessed. Three were of moderate (PEDro score 4-5) and one low (score 3) methodological quality. Effect sizes or standardized mean differences could not be calculated to compare trials due to poor data reporting. In rheumatoid arthritis, finger joint swelling was significantly reduced, but results for pain and stiffness were inconclusive and no differences in grip strength and dexterity were identified. One study reported similar effects in pain, stiffness and finger joint swelling from both compression and thermal placebo gloves. Only one study evaluated gloves in hand osteoarthritis (n=5) with no differences. All the trials identified were small with a high risk of Type I and II errors. Evidence for the effectiveness of compression gloves worn at night is inconclusive in rheumatoid arthritis and hand osteoarthritis. © The Author(s) 2015.

  11. 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

  12. Trigger Finger

    Science.gov (United States)

    ... in a bent position. People whose work or hobbies require repetitive gripping actions are at higher risk ... developing trigger finger include: Repeated gripping. Occupations and hobbies that involve repetitive hand use and prolonged gripping ...

  13. Expression of the thioredoxin-thioredoxin reductase system in the inflamed joints of patients with rheumatoid arthritis

    NARCIS (Netherlands)

    Maurice, M. M.; Nakamura, H.; Gringhuis, S.; Okamoto, T.; Yoshida, S.; Kullmann, F.; Lechner, S.; van der Voort, E. A.; Leow, A.; Versendaal, J.; Muller-Ladner, U.; Yodoi, J.; Tak, P. P.; Breedveld, F. C.; Verweij, C. L.

    1999-01-01

    OBJECTIVE: To examine the expression of the thioredoxin (TRX)-thioredoxin reductase (TR) system in patients with rheumatoid arthritis (RA) and patients with other rheumatic diseases. METHODS: Levels of TRX in plasma and synovial fluid (SF) were measured using enzyme-linked immunosorbent assay.

  14. Magnetic resonance imaging-determined synovial membrane volume as a marker of disease activity and a predictor of progressive joint destruction in the wrists of patients with rheumatoid arthritis

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Hansen, M; Stoltenberg, M

    1999-01-01

    OBJECTIVE: To evaluate the synovial membrane volume, determined by magnetic resonance imaging (MRI), as a marker of joint disease activity and a predictor of progressive joint destruction in rheumatoid arthritis (RA). METHODS: Twenty-six patients with RA, randomized to receive disease-modifying a......OBJECTIVE: To evaluate the synovial membrane volume, determined by magnetic resonance imaging (MRI), as a marker of joint disease activity and a predictor of progressive joint destruction in rheumatoid arthritis (RA). METHODS: Twenty-six patients with RA, randomized to receive disease......-Pratt analysis). The rate of erosive progression on MRI was highly correlated with baseline scores and, particularly, with area under the curve (AUC) values of synovial membrane volume (Spearman's sigma = 0.69, P

  15. Correlation in the Coronal Angle between Knee and Hindfoot Was Observed in Patients with Rheumatoid Arthritis Unless Talocrural Joint Was Destroyed

    Directory of Open Access Journals (Sweden)

    Kohei Nishitani

    2017-01-01

    Full Text Available The purpose of this study is to investigate the compensatory correlation between knee and hindfoot in patients with rheumatoid arthritis (RA. This cross-sectional study included 218 patients (407 lower extremities. Radiographs of the hindfoot and full-length posteroanterior hip-to-calcaneus standing radiographs were evaluated. The destruction of the hindfoot was evaluated using the Larsen grading system. The coronal angular deformity of the knee and hindfoot was evaluated by the femorotibial angle (FTA and the angle between the tibial shaft and the entire hindfoot (tibiohindfoot angle, THFA. The correlation between FTA and THFA was determined by Pearson’s coefficient. For all patients, FTA correlated to THFA (R = 0.28, p<0.001. The correlation was observed as long as the talocrural joint was preserved (Larsen grade ≤ 2, even if the subtalar joint had been destroyed (Larsen grade ≥ 3. However, the correlation was not observed when the talocrural joint was destroyed (Larsen grade ≥ 3, R = −0.02, p=0.94. The pain in the hindfoot did not correlate with FTA or THFA. In conclusion, a compensatory deformity of the hindfoot against the deformity of the knee was observed in RA, and the correlation was lost when talocrural joint was destroyed.

  16. Case report patients diagnosed with rheumatoid arthritis

    OpenAIRE

    Váňová, Tereza

    2012-01-01

    Title of bachelors thesis: Case report patients diagnosed with rheumatoid arthritis Summary: The work is focused on diseases rheumatoid arthritis and its physiotherapy care. It consists of two parts. Part of the general anatomy of the joint contains a general, deals with the disease rheumatoid arthritis, its diagnosis, treatment and comprehensive rehabilitation treatment. Part has its own special case report physiotherapy sessions on this topic. Key words: rheumatoid arthritis, comprehensive ...

  17. 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

  18. Detection of rheumatoid arthritis using infrared imaging

    Science.gov (United States)

    Frize, Monique; Adéa, Cynthia; Payeur, Pierre; Di Primio, Gina; Karsh, Jacob; Ogungbemile, Abiola

    2011-03-01

    Rheumatoid arthritis (RA) is an inflammatory disease causing pain, swelling, stiffness, and loss of function in joints; it is difficult to diagnose in early stages. An early diagnosis and treatment can delay the onset of severe disability. Infrared (IR) imaging offers a potential approach to detect changes in degree of inflammation. In 18 normal subjects and 13 patients diagnosed with Rheumatoid Arthritis (RA), thermal images were collected from joints of hands, wrists, palms, and knees. Regions of interest (ROIs) were manually selected from all subjects and all parts imaged. For each subject, values were calculated from the temperature measurements: Mode/Max, Median/Max, Min/Max, Variance, Max-Min, (Mode-Mean), and Mean/Min. The data sets did not have a normal distribution, therefore non parametric tests (Kruskal-Wallis and Ranksum) were applied to assess if the data from the control group and the patient group were significantly different. Results indicate that: (i) thermal images can be detected on patients with the disease; (ii) the best joints to image are the metacarpophalangeal joints of the 2nd and 3rd fingers and the knees; the difference between the two groups was significant at the 0.05 level; (iii) the best calculations to differentiate between normal subjects and patients with RA are the Mode/Max, Variance, and Max-Min. We concluded that it is possible to reliably detect RA in patients using IR imaging. Future work will include a prospective study of normal subjects and patients that will compare IR results with Magnetic Resonance (MR) analysis.

  19. Detection of bone erosions in rheumatoid arthritis wrist joints with magnetic resonance imaging, computed tomography and radiography

    DEFF Research Database (Denmark)

    Døhn, Uffe Møller; Ejbjerg, Bo J; Hasselquist, Maria

    2008-01-01

    , specificity and accuracy (concordance) of MRI for detecting erosions were 61%, 93% and 77%, respectively, while the respective values were 24%, 99% and 63% for radiography. The intramodality agreements when measuring erosion volumes were high for both CT and MRI (Spearman correlation coefficients 0.92 and 0...... sensitivity and good specificity and accuracy for detection of erosions in rheumatoid arthritis and healthy wrist bones, while radiography showed very low sensitivity. The tested volumetric method was highly reproducible and correlated to scores of erosions....... measuring volumes of erosions on CT and MRI is reproducible and correlated to semiquantitative assessments (scores) of erosions on CT, MRI and radiography. METHODS: Seventeen patients with rheumatoid arthritis and four healthy control individuals underwent CT, MRI and radiography of one wrist, performed...

  20. Invasiveness of fibroblast-like synoviocytes is an individual patient characteristic associated with the rate of joint destruction in patients with rheumatoid arthritis.

    Science.gov (United States)

    Tolboom, Tanja C A; van der Helm-Van Mil, Annette H M; Nelissen, Rob G H H; Breedveld, Ferdinand C; Toes, René E M; Huizinga, Tom W J

    2005-07-01

    Rheumatoid arthritis (RA) is characterized by inflammation and destruction of synovial joints. Fibroblast-like synoviocytes (FLS) harvested from synovial tissue of patients with RA can invade normal human cartilage in severe combined immunodeficient (SCID) mice and Matrigel basement membrane matrix in vitro. This study was undertaken to investigate the association of these in vitro characteristics with disease characteristics in patients with RA. Synovial tissue samples from 72 RA and 49 osteoarthritis (OA) patients were obtained. Samples of different joints were collected from 7 patients with RA. The FLS invasiveness in Matrigel was studied, and the intraindividual and interindividual differences were compared. From the patients with FLS who exhibited the most extreme differences in in vitro ingrowth (most and least invasive FLS), radiographs of the hands and feet were collected and scored according to the Sharp/van der Heijde method to determine the relationship between in vitro invasion data and estimated yearly joint damage progression. FLS from patients with RA were more invasive than FLS from patients with OA (P patient characteristic. The mean +/- SEM Sharp score on radiographs of the hands or feet divided by the disease duration was 4.4 +/- 1.1 units per year of disease duration in patients with the least invasive FLS (n = 9), which was much lower compared with the 21.8 +/- 3.1 units per year of disease duration in patients with the most invasive FLS (n = 9) (P patient characteristic, given the much smaller intraindividual than interindividual FLS variation.

  1. The improvement of the methods of radial diagnosis and surgical treatment of patients with rheumatoid arthritis of knee and elbow joints

    International Nuclear Information System (INIS)

    Karimov, M.Yu.

    2005-05-01

    Aim of the inquiry: To improve the radial diagnosis of rheumatoid arthritis of knee and elbow joints and to work out new approaches of orthopedic-surgical treatment. Method of research: roentgenography, roentgen densitometry, magnetic resonance imaging, digital subtraction angiography, neutron activation analysis, electromyography, topographic anatomical study, arthroscopy. The results achieved and their novelty: For the first time the data about the peculiarities of blood circulation after long period corticosteroid therapy and without applying corticosteroid therapy, in patients with RA are presented according to the data of angiography. The MRI was supplemented - semiotics of knee and elbow joints affection in RA, which allowed to estimate the stage and the activity of the process more objective way. Also the RD, EMG were carried out and the estimation of condition of the patients with RA was worked out by points, that allowed to see the effectiveness of surgical treatment of RA. The results of NAA of the structure of knee joint of patients with RA allow to determine the distribution of macro- and microelements in tissues of knee. The quantitative estimation of osteoporosis by RD method gives an opportunity to evaluate objectively its degree. According to the results of topographic anatomical study of knee and elbow joints the following have been worked out: the lateral parapatellar approach to structure of knee joints and expanded intermuscular one to structures of elbow joint, which is less traumatic and promotes early rehabilitation of the patients with RA, and also promotes to radical ablation of synovial membrane of elbow joint, which is the reason of joint deformity. By the method of arthroscopy the peculiarities of steroid arthropathy of knee joint of patients with RA have been identified for the first time. Practical value:of the work contains the elaboration of the complex of radial method (roentgenographia, RD, MRI, DSA, NAA) of the diagnosis of the RA

  2. Joint pain

    Science.gov (United States)

    ... or conditions. It may be linked to arthritis , bursitis , and muscle pain . No matter what causes it, ... Autoimmune diseases such as rheumatoid arthritis and lupus Bursitis Chondromalacia patellae Crystals in the joint: Gout (especially ...

  3. Fabrication and Performance of a Glue-Pressed Engineered Honeycomb Bamboo (GPEHB Structure with Finger-jointed Ends as a Potential Substitute for Wood Lumber

    Directory of Open Access Journals (Sweden)

    Jianbo Zhou

    2015-04-01

    Full Text Available With the increasing scarcity of wood as a natural resource, bamboo has become a popular substitute for wood. The present work developed a high-strength original state multi-reorganization material (GPEHB, without the use of a hot press or traditional assembly. The original bamboo units were polygonized into outer contours and milled into finger-joints on each ending. The GPEHB was organized and assembled under an external press, using industrial adhesives. The mechanical properties and thermal insulation of GPEHB were characterized. Moreover, the overall GPEHB unit bending strength was 73.15 MPa, and the parallel-to-grain compression was 55.22 MPa (higher than that of Pinus sylvestris lumber, though less than that of glued laminated bamboo. The GPEHB unit overall density was 0.24 g/cm³, 76% lower than that of glued laminated bamboo, and 50% lower than Pinus sylvestris lumber. The compressive strength of GPEHB (7 units was 170.5 kN, while the compressive strength of GPEHB for 14 units was 493.5 kN, which meet the requirements of GB 50005 (2003. The bending strength of GPEHB 7 units was 12 kN, while that of 14 units was 37 kN. The heat conductivity coefficient for GPEHB was 0.25 W/mK, which is better than concrete and steel. The GPEHB has taken full advantage of its honeycomb-structured material, which allows it to avoid stress concentration in the regular polygonal corners.

  4. Standardisation of the MRI image evaluation in the diagnostics of rheumatoid arthritis within the wrist and metacarpophalangeal joints

    International Nuclear Information System (INIS)

    Kapuscinska, K.; Urbanik, A.; Wojciechowski, W.

    2009-01-01

    Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease of the connective tissue, which results in disability and earlier death. Thus it is very important to recognise this pathologic condition as early as possible, to lessen and delay its consequences. Currently, magnetic resonance imaging is the best imaging modality, depicting every stage of this disease and allowing for monitoring of the treatment response. The process of standardisation is needed in assessing MR pictures. The aim of this article was to present the MR protocols of hand and wrist MR examinations for rheumatologic demand and standards of results, according to worldwide OMERACT RAMRIS 2002 and supplemented by tenosynovitis system. (authors)

  5. Comparison of Photo Optical Imaging with Musculoskeletal Ultrasound and Clinical Examination in the Assessment of Inflammatory Activity in Proximal Interphalangeal Joints in Rheumatoid Arthritis and Osteoarthritis.

    Science.gov (United States)

    Amitai, Isabella; Werner, Stephanie; Schicke, Bernd; Burmester, Gerd-Rüdiger; Minet, Olaf; Zabaryło, Urszula; Backhaus, Marina; Ohrndorf, Sarah

    2015-09-01

    Lightscan is a novel, rapid, low-cost, easily operated and noninvasive imaging technology used to assess inflammatory activity in proximal interphalangeal (PIP) joints. The results are calculated automatically. To our knowledge, this is the first comparative study of photo optical imaging (POI), with clinical examination (CE), disease activity score at 28 joints (DAS28)-erythrocyte sedimentation rate (ESR), and musculoskeletal ultrasonography (US) in healthy subjects and patients with rheumatoid arthritis (RA) or osteoarthritis (OA). There were 688 PIP joints of both hands examined in 87 subjects (38 RA, 21 OA, 28 healthy) by Lightscan and compared with CE for clinically swollen and tender joints, DAS28-ESR (only RA), and US. With US as reference, POI had a sensitivity of 74% and a specificity of 93%. In the receiver-operating curve (ROC) analysis, the Lightscan showed a higher sensitivity and specificity [area under the curve (AUC) 0.879] for the distinction of healthy subjects versus patients (OA, RA) than US in greyscale (GSUS; AUC 0.797) and power Doppler (PDUS; AUC 0.67). POI correlated significantly with GSUS (r 0.473, p POI and GSUS were up to 79%, between POI and PDUS up to 92%, and between POI and CE up to 66%. POI did not correlate with DAS28-ESR. The Lightscan is a new technology offering sensitive imaging detection of inflammatory changes in subjects with RA and OA with PIP arthritis. POI was more sensitive than CE and correlated significantly to GSUS and PDUS, while presenting a higher sensitivity and specificity for the detection of healthy subjects versus patients (RA, OA) based on the ROC analysis.

  6. Early Changes of the Cortical Micro-Channel System in the Bare Area of the Joints of Patients With Rheumatoid Arthritis.

    Science.gov (United States)

    Werner, David; Simon, David; Englbrecht, Matthias; Stemmler, Fabian; Simon, Christoph; Berlin, Andreas; Haschka, Judith; Renner, Nina; Buder, Thomas; Engelke, Klaus; Hueber, Axel J; Rech, Jürgen; Schett, Georg; Kleyer, Arnd

    2017-08-01

    To characterize the specific structural properties of the erosion-prone bare area of the human joint, and to search for early microstructural changes in this region during rheumatoid arthritis (RA). In the initial part of the study, human cadaveric hand joints were examined for exact localization of the bare area of the metacarpal heads, followed by detection of cortical micro-channels (CoMiCs) in this region by high-resolution peripheral quantitative computed tomography (HR-pQCT) and, after anatomic dissection, validation of the presence of CoMiCs by micro-computed tomography (micro-CT). In the second part of the study, the number and distribution of CoMiCs were analyzed in 107 RA patients compared to 105 healthy individuals of similar age and sex distribution. Investigation by HR-pQCT combined with adaptive thresholding allowed the detection of CoMiCs in the bare area of human cadaveric joints. The existence of CoMiCs in the bare area was additionally validated by micro-CT. In healthy individuals, the number of CoMiCs increased with age. RA patients showed significantly more CoMiCs compared to healthy individuals (mean ± SD 112.9 ± 54.7/joint versus 75.2 ± 41.9/joint; P CoMiCs as observed in healthy individuals older than age 65 years. Importantly, CoMiCs were already found in RA patients very early in their disease course, with enrichment in the erosion-prone radial side of the joint. CoMiCs represent a new form of structural change in the joints of patients with RA. Although the number of CoMiCs increases with age, RA patients develop CoMiCs much earlier in life, and such changes can even occur at the onset of the disease. CoMiCs therefore represent an interesting new opportunity to assess structural changes in RA. © 2017, American College of Rheumatology.

  7. Rheumatoid arthritis

    Science.gov (United States)

    ... Firestein's Textbook of Rheumatology . 10th ed. Philadelphia, PA: Elsevier; 2017:chap 70. Garneau E. Rheumatoid arthritis. In: ... FF, ed. Ferri's Clinical Advisor 2018 . Philadelphia, PA: Elsevier; 2017:1125-1128. June RR, Moreland LW. Rheumatoid ...

  8. Evaluation of a novel photo optical imaging (Lightscan) with musculoskeletal ultrasound and clinical examination in the assessment of inflammatory activity in PIP joints in patients with rheumatoid arthritis and osteoarthritis

    OpenAIRE

    Amitai, Isabella

    2016-01-01

    Objectives: Lightscan is a novel rapid, low cost and non-invasive imaging technology to assess inflammatory activity in proximal interphalangeal (PIP) joints, which can easily be performed. The results are calculated automatically. This is the first comparative study of photo optical imaging (POI), ‘Lightscan’, with musculoskeletal ultrasonography (US), clinical examination (CE) and DAS28 (only RA) in patients with rheumatoid arthritis (RA), osteoarthritis (OA) and in healthy subjects. Me...

  9. X-Ray Exam: Finger

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español X-Ray Exam: Finger KidsHealth / For Parents / X-Ray Exam: ... Muscles, and Joints Broken Bones Getting an X-ray (Video) X-Ray (Video) View more Partner Message About Us ...

  10. Interreader agreement in the assessment of magnetic resonance images of rheumatoid arthritis wrist and finger joints--an international multicenter study

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Klarlund, Mette; Lassere, M

    2001-01-01

    and iv Gd (Techniques A and C), these rates were 86% (synovitis) and 97% (bone lesions). Corresponding intraclass correlation coefficients (quadratic weighted kappas) were 0.44-0.68, mean 0.58 (synovitis), and 0.44-0.69, mean 0.62 (bone lesion), i.e., in the moderate to good range. Unweighted kappa...

  11. Interreader agreement in the assessment of magnetic resonance images of rheumatoid arthritis wrist and finger joints--an international multicenter study

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Klarlund, Mette; Lassere, M

    2001-01-01

    and iv Gd (Techniques A and C), these rates were 86% (synovitis) and 97% (bone lesions). Corresponding intraclass correlation coefficients (quadratic weighted kappas) were 0.44-0.68, mean 0.58 (synovitis), and 0.44-0.69, mean 0.62 (bone lesion), i.e., in the moderate to good range. Unweighted kappa...... values were in the low to moderate range, generally lowest for JSN (... in assessing synovitis and bone destruction in RA multicenter studies....

  12. The prevalence of tenosynovitis of the interosseous tendons of the hand in patients with rheumatoid arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Rowbotham, Emma L. [Leeds Teaching Hospitals NHS Trust, Musculoskeletal Radiology Department, Leeds (United Kingdom); Freeston, Jane E. [Department of Rheumatology, Leeds Teaching Hospitals NHS Trust, Leeds (United Kingdom); Emery, Paul [University of Leeds, Arthritis Research UK, Leeds Musculoskeletal Biomedical Research Unit, LTHT Leeds Institute of Rheumatic Musculoskeletal Medicine, Leeds (United Kingdom); Grainger, Andrew J. [Leeds Teaching Hospitals NHS Trust, Musculoskeletal Radiology Department, Leeds (United Kingdom); Chapel Allerton Hospital, NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds (United Kingdom)

    2016-02-15

    The aim of this study was to establish the prevalence of tenosynovitis affecting the interosseous tendons of the hand in a rheumatoid arthritis (RA) population and to assess for association with metacarpophalangeal (MCP) joint synovitis, flexor tendon tenosynovitis or ulnar drift. Forty-four patients with RA underwent hand MRI along with 20 normal controls. Coronal 3D T1 VIBE sequences pre- and post-contrast were performed and reconstructed. The presence of interosseous tendon tenosynovitis was recorded alongside MCP joint synovitis, flexor tendon tenosynovitis and ulnar drift. Twenty-one (47.7 %) patients with RA showed interosseous tendon tenosynovitis. Fifty-two (14.8 %) interosseous tendons showed tenosynovitis amongst the RA patients. Interosseous tendon tenosynovitis was more commonly seen in association with adjacent MCP joint synovitis (p < 0.001), but nine MCP joints (5.1 %) showed adjacent interosseous tenosynovitis in the absence of joint synovitis. Interosseous tendon tenosynovitis was more frequently seen in fingers which also showed flexor tendon tenosynovitis (p < 0.001) and in patients with ulnar drift of the fingers (p = 0.01). Tenosynovitis of the hand interosseous tendons was found in 47.7 % of patients with RA. In the majority of cases this was adjacent to MCP joint synovitis; however, interosseous tendon tenosynovitis was also seen in isolation. (orig.)

  13. The prevalence of tenosynovitis of the interosseous tendons of the hand in patients with rheumatoid arthritis

    International Nuclear Information System (INIS)

    Rowbotham, Emma L.; Freeston, Jane E.; Emery, Paul; Grainger, Andrew J.

    2016-01-01

    The aim of this study was to establish the prevalence of tenosynovitis affecting the interosseous tendons of the hand in a rheumatoid arthritis (RA) population and to assess for association with metacarpophalangeal (MCP) joint synovitis, flexor tendon tenosynovitis or ulnar drift. Forty-four patients with RA underwent hand MRI along with 20 normal controls. Coronal 3D T1 VIBE sequences pre- and post-contrast were performed and reconstructed. The presence of interosseous tendon tenosynovitis was recorded alongside MCP joint synovitis, flexor tendon tenosynovitis and ulnar drift. Twenty-one (47.7 %) patients with RA showed interosseous tendon tenosynovitis. Fifty-two (14.8 %) interosseous tendons showed tenosynovitis amongst the RA patients. Interosseous tendon tenosynovitis was more commonly seen in association with adjacent MCP joint synovitis (p < 0.001), but nine MCP joints (5.1 %) showed adjacent interosseous tenosynovitis in the absence of joint synovitis. Interosseous tendon tenosynovitis was more frequently seen in fingers which also showed flexor tendon tenosynovitis (p < 0.001) and in patients with ulnar drift of the fingers (p = 0.01). Tenosynovitis of the hand interosseous tendons was found in 47.7 % of patients with RA. In the majority of cases this was adjacent to MCP joint synovitis; however, interosseous tendon tenosynovitis was also seen in isolation. (orig.)

  14. Radiographic changes and factors associated with subsequent progression of damage in weight-bearing joints of patients with rheumatoid arthritis under TNF-blocking therapies-three-year observational study.

    Science.gov (United States)

    Matsushita, Isao; Motomura, Hiraku; Seki, Eiko; Kimura, Tomoatsu

    2017-07-01

    The long-term effects of tumor necrosis factor (TNF)-blocking therapies on weight-bearing joints in patients with rheumatoid arthritis (RA) have not been fully characterized. The purpose of this study was to assess the radiographic changes of weight-bearing joints in patients with RA during 3-year of TNF-blocking therapies and to identify factors related to the progression of joint damage. Changes in clinical variables and radiological findings in 243 weight-bearing joints (63 hips, 54 knees, 71 ankles, and 55 subtalar joints) in 38 consecutive patients were investigated during three years of treatment with TNF-blocking agents. Multivariate logistic regression analysis was used to identify risk factors for the progression of weight-bearing joint damage. Seventeen (14.5%) of proximal weight-bearing joints (hips and knees) showed apparent radiographic progression during three years of treatment, whereas none of the proximal weight-bearing joints showed radiographic evidence of improvement or repair. In contrast, distal weight-bearing joints (ankle and subtalar joints) displayed radiographic progression and improvement in 20 (15.9%) and 8 (6.3%) joints, respectively. Multivariate logistic analysis for proximal weight-bearing joints identified the baseline Larsen grade (p bearing joints identified disease activity at one year after treatment (p bearing joints. Disease activity after treatment was an independent factor for progression of damage in proximal and distal weight-bearing joints. Early treatment with TNF-blocking agents and tight control of disease activity are necessary to prevent the progression of damage of the weight-bearing joints.

  15. Torque Control of Underactuated Tendon-driven Robotic Fingers

    Science.gov (United States)

    Abdallah, Muhammad E. (Inventor); Ihrke, Chris A. (Inventor); Reiland, Matthew J. (Inventor); Wampler, Charles W. (Inventor); Diftler, Myron A. (Inventor); Platt, Robert (Inventor); Bridgwater, Lyndon (Inventor)

    2013-01-01

    A robotic system includes a robot having a total number of degrees of freedom (DOF) equal to at least n, an underactuated tendon-driven finger driven by n tendons and n DOF, the finger having at least two joints, being characterized by an asymmetrical joint radius in one embodiment. A controller is in communication with the robot, and controls actuation of the tendon-driven finger using force control. Operating the finger with force control on the tendons, rather than position control, eliminates the unconstrained slack-space that would have otherwise existed. The controller may utilize the asymmetrical joint radii to independently command joint torques. A method of controlling the finger includes commanding either independent or parameterized joint torques to the controller to actuate the fingers via force control on the tendons.

  16. Extra-articular subcutaneous "inverted king post-truss" ligament reconstruction for severe swan neck deformity (snapping finger).

    Science.gov (United States)

    de Soras, X; de Mourgues, P; Pradel, P; Urien, J-P; Beaudoin, E

    2017-02-01

    A swan neck deformity (SND) can be well tolerated for a long time, until the appearance of a disabling "snapping finger". In its most advanced condition, the other hand is needed to initiate finger flexion. We propose a technique of extra-articular, subcutaneous ligament reconstruction with an "inverted king post-truss" configuration use in roofs and to reinforce railway bridges. An artificial ligament (MaxBraid™ polyethylene surgical suture, 5 metric, Biomet) makes a figure of eight between transosseous tunnels in the proximal and middle phalanges, crossing over top of the A3 pulley. We limited our series to severe SND cases with "snapping finger". We excluded isolated SNDs without functional disability. Eleven patients were followed for 3.4 years on average. The cause was an acute injury 8 times (7 balloon accidents), rheumatoid arthritis 2 times and overuse once (saxophone). Only one case was a poor outcome of mallet finger. The 11 patients were reassessed by a telephone survey. Two patients underwent reoperation: one for a ligament rupture, the other one for a knot that became untied. One patient had a suspected late rupture but without recurrence of the disabling snapping finger. The 11 patients considered themselves improved by the intervention. Nine patients did not notice any difference between their operated finger and the contralateral side. Return to manual activity was possible once the skin had healed. The technique is simpler than the spiral oblique retinacular ligament (SORL) reconstruction technique described by Thomson-Littler and also less demanding because it does not involve the distal interphalangeal joint. It requires only a short incision in the volar crease of the proximal interphalangeal joint. No tendon or ligament is sacrificed. Neither postoperative immobilization nor lengthy physical therapy is needed. Complications can be avoided by selecting the appropriate artificial ligament material and careful knot tying. Copyright © 2016 SFCM

  17. Robotic hand and fingers

    Science.gov (United States)

    Salisbury, Curt Michael; Dullea, Kevin J.

    2017-06-06

    Technologies pertaining to a robotic hand are described herein. The robotic hand includes one or more fingers releasably attached to a robotic hand frame. The fingers can abduct and adduct as well as flex and tense. The fingers are releasably attached to the frame by magnets that allow for the fingers to detach from the frame when excess force is applied to the fingers.

  18. Severe extra-articular manifestations of rheumatoid arthritis in absence of concomitant joint involvement following long-term spontaneous remission. A case report.

    Science.gov (United States)

    Lagrutta, Mariana; Alle, Gelsomina; Parodi, Roberto Leandro; Greca, Alcides Alejandro

    2016-01-01

    Rheumatoid arthritis (RA) is a chronic autoimmune inflammatory disease occasionally associated with severe extra-articular manifestations, mostly in cases of longstanding highly active disease. We report the case of a 56 year-old woman diagnosed with active RA at the age of 40. After 5 years of high activity, her arthritis subsides spontaneously during pregnancy despite the lack of treatment with disease-modifying anti-rheumatic drugs. She remains without articular symptoms for 7 years, and then she develops a Felty's syndrome requiring steroid treatment and splenectomy. Following steroid withdrawal she develops pericarditis with massive serohematic pericardial effusion, still in absence of articular activity, and responds to immunosuppressive therapy and colchicine. We emphasize the unusual spontaneous and sustained joint remission without specific treatment, and the development of severe extra-articular manifestations of RA in absence of concomitant articular activity, as well as the importance of controlling inflammation. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  19. Does stress affect the joints? Daily stressors, stress vulnerability, immune and HPA axis activity, and short-term disease and symptom fluctuations in rheumatoid arthritis.

    Science.gov (United States)

    Evers, Andrea W M; Verhoeven, Elisabeth W M; van Middendorp, Henriët; Sweep, Fred C G J; Kraaimaat, Floris W; Donders, A Rogier T; Eijsbouts, Agnes E; van Laarhoven, Antoinette I M; de Brouwer, Sabine J M; Wirken, Lieke; Radstake, Timothy R D J; van Riel, Piet L C M

    2014-09-01

    Both stressors and stress vulnerability factors together with immune and hypothalamus-pituitary-adrenal (HPA) axis activity components have been considered to contribute to disease fluctuations of chronic inflammatory diseases, such as rheumatoid arthritis (RA). The aim of the present study was to investigate whether daily stressors and worrying as stress vulnerability factor as well as immune and HPA axis activity markers predict short-term disease activity and symptom fluctuations in patients with RA. In a prospective design, daily stressors, worrying, HPA axis (cortisol) and immune system (interleukin (IL)-1β, IL-6, IL-8, interferon (IFN)-γ, tumour necrosis factor α) markers, clinical and self-reported disease activity (disease activity score in 28 joints, RA disease activity index), and physical symptoms of pain and fatigue were monitored monthly during 6 months in 80 RA patients. Multilevel modelling indicated that daily stressors predicted increased fatigue in the next month and that worrying predicted increased self-reported disease activity, swollen joint count and pain in the next month. In addition, specific cytokines of IL-1β and IFN-γ predicted increased fatigue 1 month later. Overall, relationships remained relatively unchanged after controlling for medication use, disease duration and demographic variables. No evidence was found for immune and HPA axis activity markers as mediators of the stress-disease relationship. Daily stressors and the stress-vulnerability factor worrying predict indicators of the short-term course of RA disease activity and fatigue and pain, while specific cytokines predict short-term fluctuations of fatigue. These stress-related variables and immune markers seem to affect different aspects of disease activity or symptom fluctuations independently in RA. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  20. 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.

  1. The severity of the articular deformities of the hands depending on the seropositivity in rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Oprea Doiniţa

    2017-11-01

    Full Text Available Background. Rheumatoid arthritis (RA, met in the literature also as chronic evolving polyarthritis, is a chronic inflammatory disease, which typically involves the small and medium joints, with a symmetric distribution. Clinical studies shown that a proportion of patients with RA, without measurable rheumatoid factors are a distinct entity from those patients with seropositive RA. Around one third of patients with RA are seronegative for those two serological markers, the rheumatoid factors (RF and anti-citrullinated peptide antibodies (Anti-CCP. Hands are the most frequently affected in both seropositive and seronegative RA and the first joints involved in the inflammatory process are the metacarpo-phalangeal joints, IFP joints and the radiocarpian joint. The big joints become later symptomatic, after the small joints are affected. Materials and methods: 66 patients files and the personal records of the patients consecutively admitted in the Rheumatology Department of the Clinical Emergency County Hospital Constanta. Patients from county Constanta were included in the study, with diagnosis of rheumatoid arthritis (diagnosis confirmed at least 2 years ago, including both forms (seropositive and seronegative of the disease. The complete clinical exam was done for the patients included in the study, following the identification of the active joint disease. The mechanical status of the joint was observed by a single evaluator for each of those 66 patients with RA, with special focus on the presence of the deformities / ankyloses of the hands joints. Therefore, there were evaluated: the mobility (the number of the joints with limited movements, deformities, ankyloses (the number of the joints without mobility. The joint mobility was assessed by counting the hand joints with limited movements and the worsening of the prehension function. The presence of the following hand deformities was followed: fingers in “swan neck”, “fusiform fingers

  2. Application physiotherapy in rehabilitation rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Angela Nogas

    2017-02-01

    National University of Water and Environmental Engineering   Abstract Background: Rheumatoid arthritis is one of the most common forms of inflammatory diseases of the joints. The disease leads to deformation, then to destruction of the diseased joint and to disability. Physiotherapy is used for the treatment and rehabilitation of rheumatoid arthritis. It is assumed that physiotherapy treatments that promote remission of the disease, improve the quality of patients’ life, create the necessary conditions for comprehensive rehabilitation programs. Objective: Systematic’s review conducting of studies that assess the effect of physiotherapy in the rehabilitation of patients with rheumatoid arthritis. Methods: Theoretical analysis of scientific and methodical literature, methods of analysis, synthesis, generalization. Results: To reduce inflammation in the joints is performed UV of affected joints weak or medium erythermal or middle erythermal doses used UHF therapy. UHF-therapy prescribed to the area of joint in I or II dose, duration 10 min., the course – 5-8 treatments. For patients with minimal activity is added electrophoresis NSAIDs. Electrophoresis aspirin is applied on the affected joints (every day, the course – 10-12 procedures, which favorably affect the course of rheumatoid arthritis. Conclusions: Physical therapy can reduce pain and stiffness in the joints, prevent deformity and restore function, improve independence and quality of life. State of the art is a major incentive to develop new activities in the treatment and rehabilitation of patients with rheumatoid arthritis to improve joint functional activity and their physical health.   Keywords: rheumatoid arthritis, physiotherapy, rehabilitation, hydrotherapy.

  3. H Nuclear magnetic resonance based metabonomics data analysis in rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Mohammad Arjmand

    2014-05-01

    Full Text Available Background: Rheumatoid arthritis (RA is a chronic, systematic inflammatory disorder that may affect many tissues and organs, but principally attacks synovial joints and it is a common rheumatic disease with many subtypes. Nuclear Magnetic resonance (1H NMR spectrometers with high sensitivity, resolution and dynamic range has permitted the rapid, simultaneous investigation of complex mixtures of endogenous or exogenous components present in biological materials. Metabonomics is the systematic study of chemical finger print resulted from cell reactions and could be used as a new biomarker for early disease diagnosis. In the present investigation, we studied serum metabolic profile in rheumatoid arthritis (RA in order to find out the metabolic finger print pattern of the disease. Materials and methods: In our metabonomics study serum samples were collected from 16 patients with active RA, and from equal number of healthy subjects. They were evaluated during a one-year follow-up with the assessment of disease activity and 1H NMR spectroscopy of sera samples. In all the cases, the presence of active rheumatoid arthritis was shown by an increase in the T1 values of the synovium of the joints. We specified and classified all metabolites using PCA, PLSDA chemometrics methods. Chenomx (Trail Version and ProMetab codes in Matlab software environments were used for our data analysis. Results were compared with the NMR metabolite data bank (www.metabolomics.ca. Anti-CCP, ANA and urea were also analyzed by ElISA and colorimetric methods respectively. Results: The most changes identified in this study were in the biosynthesis pathways of steroid hormones, biotin, fatty acids, amino acids (Leucine, Valin and isoleucine and also linoleic acid. Conclusion: In rheumatoid arthritis disease, the activation of the immune system consumes larg amounts of energy. The main donor of free energy in cells is ATP, which is generated by both glycolysis and oxidative

  4. Reducing invasiveness, duration, and cost of magnetic resonance imaging in rheumatoid arthritis by omitting intravenous contrast injection -- Does it change the assessment of inflammatory and destructive joint changes by the OMERACT RAMRIS?

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Conaghan, Philip G; O'Connor, Philip

    2009-01-01

    OBJECTIVE: Gadolinium (Gd)-enhanced magnetic resonance imaging (MRI) provides highly sensitive assessment of inflammatory and destructive changes in rheumatoid arthritis (RA) joints, but intravenous (IV) Gd injection prolongs examination time and increases cost, invasiveness, and patient discomfort...... images, whereas complete image sets were available for the second reading. RESULTS: Gd contrast injection appeared unimportant to MRI scores of bone erosions and bone edema in RA wrist and MCP joints. However, when post-Gd MRI was considered the standard reference, MRI without Gd provided only moderate......: Omitting IV contrast injection did not change scores of bone erosions and bone edema, but decreased the reliability of synovitis scores. However, this disadvantage may for some purposes be outweighed by the possibility to assess more joints and/or greater feasibility....

  5. Quantitative power Doppler ultrasound measures of peripheral joint synovitis in poor prognosis early rheumatoid arthritis predict radiographic progression.

    Science.gov (United States)

    Sreerangaiah, Dee; Grayer, Michael; Fisher, Benjamin A; Ho, Meilien; Abraham, Sonya; Taylor, Peter C

    2016-01-01

    To assess the value of quantitative vascular imaging by power Doppler US (PDUS) as a tool that can be used to stratify patient risk of joint damage in early seropositive RA while still biologic naive but on synthetic DMARD treatment. Eighty-five patients with seropositive RA of power Doppler volume and 2D vascularity scores were the most useful US predictors of deterioration. These variables were modelled in two equations that estimate structural damage over 12 months. The equations had a sensitivity of 63.2% and specificity of 80.9% for predicting radiographic structural damage and a sensitivity of 54.2% and specificity of 96.7% for predicting structural damage on ultrasonography. In seropositive early RA, quantitative vascular imaging by PDUS has clinical utility in predicting which patients will derive benefit from early use of biologic therapy. © The Author 2015. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  6. Interphalangeal Osteoarthritis Radiographic Simplified (iOARS) score: a radiographic method to detect osteoarthritis of the interphalangeal finger joints based on its histopathological alterations.

    Science.gov (United States)

    Sunk, Ilse-Gerlinde; Amoyo-Minar, Love; Stamm, Tanja; Haider, Stefanie; Niederreiter, Birgit; Supp, Gabriela; Soleiman, Afschin; Kainberger, Franz; Smolen, Josef S; Bobacz, Klaus

    2014-11-01

    To develop a radiographic score for assessment of hand osteoarthritis (OA) that is based on histopathological alterations of the distal (DIP) and proximal (PIP) interphalangeal joints. DIP and PIP joints were obtained from corpses (n=40). Plain radiographies of these joints were taken. Joint samples were prepared for histological analysis; cartilage damage was graded according to the Mankin scoring system. A 2×2 Fisher's exact test was applied to define those radiographic features most likely to be associated with histological alterations. Receiver operating characteristic curves were analysed to determine radiographic thresholds. Intraclass correlation coefficients (ICC) estimated intra- and inter-reader variability. Spearman's correlation was applied to examine the relationship between our score and histopathological changes. Differences between groups were determined by a Student's t test. The Interphalangeal Osteoarthritis Radiographic Simplified (iOARS) score is presented. The score is based on histopathological changes of DIP and PIP joints and follows a simple dichotomy whether OA is present or not. The iOARS score relies on three equally ranked radiographic features (osteophytes, joint space narrowing and subchondral sclerosis). For both DIP and PIP joints, the presence of one x-ray features reflects interphalangeal OA. Sensitivity and specificity for DIP joints were 92.3% and 90.9%, respectively, and 75% and 100% for PIP joints. All readers were able to reproduce their own readings in DIP and PIP joints after 4 weeks. The overall agreement between the three readers was good; ICCs ranged from 0.945 to 0.586. Additionally, outcomes of the iOARS score in a hand OA cohort revealed a higher prevalence of interphalangeal joint OA compared with the Kellgren and Lawrence score. The iOARS score is uniquely based on histopathological alterations of the interphalangeal joints in order to reliably determine OA of the DIP and PIP joints radiographically. Its high

  7. Radiosynovectomy of Painful Synovitis of Knee Joints Due to Rheumatoid Arthritis by Intra-Articular Administration of (177)Lu-Labeled Hydroxyapatite Particulates: First Human Study and Initial Indian Experience.

    Science.gov (United States)

    Shinto, Ajit S; Kamaleshwaran, K K; Chakraborty, Sudipta; Vyshakh, K; Thirumalaisamy, S G; Karthik, S; Nagaprabhu, V N; Vimalnath, K V; Das, Tapas; Banerjee, Sharmila

    2015-01-01

    The aim of this study is to assess the effectiveness of Radiosynovectomy (RSV) using (177)Lu-labeled hydroxyapatite ((177)Lu-HA) in the treatment of painful synovitis and recurrent joint effusion of knee joints in rheumatoid arthritis (RA). Ten patients, diagnosed with RA and suffering from chronic painful resistant synovitis of the knee joints were referred for RSV. The joints were treated with 333 ± 46 MBq of (177)Lu-HA particles administered intra-articularly. Monitoring of activity distribution was performed by static imaging of knee joint and whole-body gamma imaging. The patients were evaluated clinically before RSV and at 6 months after the treatment by considering the pain improvement from baseline values in terms of a 100-point visual analog scale (VAS), the improvement of knee flexibility and the pain remission during the night. RSV response was classified as poor (VAS body scan. Static scans of the joint at 1 month revealed complete retention of (177)Lu-HA in the joints. All patients showed decreased joint swelling and pains, resulting in increased joint motion after 6 months. The percentage of VAS improvement from baseline values was 79.5 ± 20.0% 6 months after RS and found to be significantly related to patients' age (P = 0.01) and duration of the disease (P = 0.03). Knees with Steinbrocker's Grades 0 and I responded better than those with more advanced changes (Steinbrocker's Grades III and IV) in terms of VAS improvement (75% vs. 45.8%) (P level was not different before and after RSV. RSV side-effects assessed for the whole follow-up period were minor and not significant. RSV with (177)Lu-HA was safe and effective in patients with knee joint chronic painful synovitis of rheumatoid origin. It exhibited significant therapeutic effect after 6 months follow-up period with no significant side-effects. The preliminary investigations reveal that (177)Lu-labeled HA particles hold considerable promise as a cost-effective agent for RSV. More elaborate and

  8. Rheumatoid Vasculitis

    Science.gov (United States)

    ... in any rheumatoid arthritis patient who develops new constitutional symptoms, skin ulcerations, decreased blood flow to the ... The differential diagnosis of RV includes: Cholesterol embolization syndromes, in which a piece of cholesterol breaks off ...

  9. Rheumatoid arthritis

    African Journals Online (AJOL)

    Mahmood Ally

    being implicated as possible triggers.3 Smoking has recently received much ... rheumatoid synovium and interaction with these antibodies may not only ..... with psycho-social matters and the cessation of smoking should be incorporated in the ...

  10. Hypoxia-Inducible Factor-1 as Regulator of Angiogenesis in Rheumatoid Arthritis - Therapeutic Implications

    NARCIS (Netherlands)

    Westra, J.; Molema, G.; Kallenberg, C. G. M.

    Angiogenesis plays an important role in the pathogenesis of inflammatory diseases, including rheumatoid arthritis ( RA). The site and extent of inflammation and subsequent joint destruction in the rheumatoid synovium is dependent on the development of new vasculature. Inhibition of angiogenesis,

  11. Radiographic progession of rheumatoid arthritis

    International Nuclear Information System (INIS)

    Siozos, C.D.

    1981-01-01

    The radiographic progression of rheumatoid arthritis can be graded on a 0-IV scala. For this purpose five objective criteria are used: a) destruction, b) osteoporosis, c) narrowing of joint space, d) luxation and e) ankylosis. The grading of the radiographic progression is defined by the extent and the number of the measured alterations. The radiographic progression can be registered yearly. (orig.) [de

  12. Diagnostic Delay in Rheumatoid Arthritis

    DEFF Research Database (Denmark)

    Mølbaek, Karen; Hørslev-Petersen, Kim; Primdahl, Jette

    2016-01-01

    BACKGROUND: To prevent joint damage among patients with rheumatoid arthritis (RA), there is a need to minimize delays from the onset of symptoms until the initiation of appropriate therapy. The present study explored the factors that have an impact on the time it takes for Danish patients with RA...

  13. Arthritis of the hand - Rheumatoid

    Science.gov (United States)

    ... All Topics A-Z Videos Infographics Symptom Picker Anatomy Bones Joints Muscles Nerves Vessels Tendons About Hand Surgery What is a Hand Surgeon? What is a Hand Therapist? Media Find a Hand Surgeon Home Anatomy Rheumatoid Arthritis Email to a friend * required fields ...

  14. The Reliability of Disease Activity Score in 28 Joints-C-Reactive Protein Might Be Overestimated in a Subgroup of Rheumatoid Arthritis Patients, When the Score Is Solely Based on Subjective Parameters

    DEFF Research Database (Denmark)

    Jensen Hansen, Inger Marie; Asmussen Andreasen, Rikke; Van Bui Hansen, Mark Nam

    2017-01-01

    BACKGROUND: Disease Activity Score in 28 Joints (DAS28) is a scoring system to evaluate disease activity and treatment response in rheumatoid arthritis (RA). A DAS28 score of greater than 3.2 is a well-described limit for treatment intensification; however, the reliability of DAS28 might be overe......BACKGROUND: Disease Activity Score in 28 Joints (DAS28) is a scoring system to evaluate disease activity and treatment response in rheumatoid arthritis (RA). A DAS28 score of greater than 3.2 is a well-described limit for treatment intensification; however, the reliability of DAS28 might...... be overestimated. OBJECTIVE: The aim of this study was to evaluate the reliability of DAS28 in RA, especially focusing on a subgroup of patients with a DAS28 score of greater than 3.2. METHODS: Data from RA patients registered in the local part of Danish DANBIO Registry were collected in May 2015. Patients were....... Patients with central sensitization and psychological problems and those with false-positive diagnosis of RA are at high risk of overtreatment.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where...

  15. Fingers that change color

    Science.gov (United States)

    ... gov/ency/article/003249.htm Fingers that change color To use the sharing features on this page, please enable JavaScript. Fingers or toes may change color when they are exposed to cold temperatures or ...

  16. Physiotherapy in Rheumatoid Arthritis

    Science.gov (United States)

    Kavuncu, Vural; Evcik, Deniz

    2004-01-01

    Rheumatoid arthritis (RA) is a chronic and painful clinical condition that leads to progressive joint damage, disability, deterioration in quality of life, and shortened life expectancy. Even mild inflammation may result in irreversible damage and permanent disability. The clinical course according to symptoms may be either intermittent or progressive in patients with RA. In most patients, the clinical course is progressive, and structural damage develops in the first 2 years. The aim of RA management is to achieve pain relief and prevent joint damage and functional loss. Physiotherapy and rehabilitation applications significantly augment medical therapy by improving the management of RA and reducing handicaps in daily living for patients with RA. In this review, the application of physiotherapy modalities is examined, including the use of cold/heat applications, electrical stimulation, and hydrotherapy. Rehabilitation treatment techniques for patients with RA such as joint protection strategies, massage, exercise, and patient education are also presented. PMID:15266230

  17. 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.

  18. 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.

  19. Arthrodesis of the proximal interphalangeal joint of the 4th and 5th finger using an interlocking screw device to treat severe recurrence of Dupuytren's disease.

    Science.gov (United States)

    Novoa-Parra, C D; Montaner-Alonso, D; Pérez-Correa, J I; Morales-Rodríguez, J; Rodrigo-Pérez, J L; Morales-Suarez-Varela, M

    2017-12-04

    To assess the radiological and functional outcome of arthrodesis of the 4th and 5th finger using the APEX™ (Extremity Medical, Parsippany,NJ)intermedullary interlocking screw system in patients with severe recurrence of Dupuytren's disease. The DASH questionnaire and the VAS scale were used to assess the clinical outcomes. The angle of arthrodesis, fusion time and implant fixation were evaluated on x-rays. The patients were monitored for complications during surgery and the follow-up period. The sample comprised 6 patients. Mean follow up was 19.6 months. All of the patients presented clinical and radiological evidence of fusion at 8 weeks, with fusion angles of 30° (3) and 45° (3). There were no complications and none of the implants had to be removed. The functional outcomes in these patients were poor. The system offers a reliable method for IPJ arthrodesis at a precise angle. It promotes stable fixation that does not require prolonged immobilisation. It can be used together with other procedures on the hand with severe recurrence of DD. The functional outcomes for this group of patients using this device were poor. Copyright © 2017 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

  20. Gold Finger: Metal Jewellery as a Disease Modifying Antirheumatic Therapy!

    Directory of Open Access Journals (Sweden)

    T. Hlaing

    2009-01-01

    Full Text Available Polyarticular psoriatic arthritis is a chronic, progressive and disabling auto-immune disease often affecting the small joints of the hands in a symmetrical fashion. The disease can progress rapidly causing joint swelling and damaging cartilage and bone around the joints resulting in severe deformities. We report a very unusual case of a 49-year-old woman who presented with polyarticular psoriatic arthritis affecting all proximal interphalangeal (PIP joints of both hands except the left ring finger PIP joint. On clinical examination there was no evidence of arthritis in the left ring finger PIP joint. We confirmed the paucity of joint damage in the PIP joint of the left ring finger using more modern imaging modalities such as musculoskeletal ultrasound and MRI scan of the small joints of the hands. All other PIP joints in both hands demonstrated advanced degrees of joint damage secondary to chronic psoriatic inflammatory arthritis. We postulated that wearing a gold wedding ring has helped protecting the PIP joint of the left ring finger from the damaging effect of inflammatory arthritis. The possible mechanisms by which metal jewellery (gold ring confer protection to adjacent joints was discussed.

  1. Does stress affect the joints? Daily stressors, stress vulnerability, immune and HPA axis activity, and short-term disease and symptom fluctuations in rheumatoid arthritis

    NARCIS (Netherlands)

    Evers, A.W.M.; Verhoeven, E.W.M.; Middendorp, H. van; Sweep, F.C.; Kraaimaat, F.W.; Donders, A.R.T.; Eijsbouts, A.E.; Laarhoven, A.I.M. van; Brouwer, S.J.M. de; Wirken, L.; Radstake, T.R.D.J.; Riel, P.L.C.M. van

    2014-01-01

    OBJECTIVES: Both stressors and stress vulnerability factors together with immune and hypothalamus-pituitary-adrenal (HPA) axis activity components have been considered to contribute to disease fluctuations of chronic inflammatory diseases, such as rheumatoid arthritis (RA). The aim of the present

  2. Extrinsic versus intrinsic hand muscle dominance in finger flexion.

    Science.gov (United States)

    Al-Sukaini, A; Singh, H P; Dias, J J

    2016-05-01

    This study aims to identify the patterns of dominance of extrinsic or intrinsic muscles in finger flexion during initiation of finger curl and mid-finger flexion. We recorded 82 hands of healthy individuals (18-74 years) while flexing their fingers and tracked the finger joint angles of the little finger using video motion tracking. A total of 57 hands (69.5%) were classified as extrinsic dominant, where the finger flexion was initiated and maintained at proximal interphalangeal and distal interphalangeal joints. A total of 25 (30.5%) were classified as intrinsic dominant, where the finger flexion was initiated and maintained at the metacarpophalangeal joint. The distribution of age, sex, dominance, handedness and body mass index was similar in the two groups. This knowledge may allow clinicians to develop more efficient rehabilitation regimes, since intrinsic dominant individuals would not initiate extrinsic muscle contraction till later in finger flexion, and might therefore be allowed limited early active motion. For extrinsic dominant individuals, by contrast, initial contraction of extrinsic muscles would place increased stress on the tendon repair site if early motion were permitted. © The Author(s) 2016.

  3. Speed invariance of independent control of finger movements in pianists.

    Science.gov (United States)

    Furuya, Shinichi; Soechting, John F

    2012-10-01

    Independent control of finger movements characterizes skilled motor behaviors such as tool use and musical performance. The purpose of the present study was to identify the effect of movement frequency (tempo) on individuated finger movements in piano playing. Joint motion at the digits was recorded while 5 expert pianists were playing 30 excerpts from musical pieces with different fingering and key locations either at a predetermined normal tempo or as fast as possible. Principal component analysis and cluster analysis using an expectation-maximization algorithm determined three distinct patterns of finger movement coordination for a keypress with each of the index, middle, ring, and little fingers at each of the two tempi. The finger kinematics of each coordination pattern was overall similar across the tempi. Tone sequences assigned into each cluster were also similar for both tempi. A linear regression analysis determined no apparent difference in the amount of movement covariation between the striking and nonstriking fingers at both metacarpo-phalangeal and proximal-interphalangeal joints across the two tempi, which indicated no effect of tempo on independent finger movements in piano playing. In addition, the standard deviation of interkeystroke interval across strokes did not differ between the two tempi, indicating maintenance of rhythmic accuracy of keystrokes. Strong temporal constraints on finger movements during piano playing may underlie the maintained independent control of fingers over a wider range of tempi, a feature being likely to be specific to skilled pianists.

  4. Proteome Analysis of Rheumatoid Arthritis Gut Mucosa

    DEFF Research Database (Denmark)

    Bennike, Tue Bjerg; 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...

  5. Rheumatoid Factor Positivity Is Associated with Increased Joint Destruction and Upregulation of Matrix Metalloproteinase 9 and Cathepsin K Gene Expression in the Peripheral Blood in Rheumatoid Arthritic Patients Treated with Methotrexate

    Directory of Open Access Journals (Sweden)

    Elena V. Tchetina

    2013-01-01

    Full Text Available We evaluated changes in gene expression of mTOR, p21, caspase-3, ULK1, TNFα, matrix metalloproteinase (MMP-9, and cathepsin K in the whole blood of rheumatoid arthritic (RA patients treated with methotrexate (MTX in relation to their rheumatoid factor status, clinical, immunological, and radiological parameters, and therapeutic response after a 24-month follow-up. The study group consisted of 35 control subjects and 33 RA patients without previous history of MTX treatment. Gene expression was measured using real-time RT-PCR. Decreased disease activity in patients at the end of the study was associated with significant downregulation of TNFα expression. Downregulation of mTOR was observed in seronegative patients, while no significant changes in the expression of p21, ULK1, or caspase-3 were noted in any RA patients at the end of the study. The increase in erosion numbers observed in the seropositive patients at the end of the follow-up was accompanied by upregulation of MMP-9 and cathepsin K, while seronegative patients demonstrated an absence of significant changes in MMP-9 and cathepsin K expression and no increase in the erosion score. Our results suggest that increased expression of MMP-9 and cathepsin K genes in the peripheral blood might indicate higher bone tissue destruction activity in RA patients treated with methotrexate. The clinical study registration number is 0120.0810610.

  6. Involuntary Neuromuscular Coupling between the Thumb and Finger of Stroke Survivors during Dynamic Movement.

    Science.gov (United States)

    Jones, Christopher L; Kamper, Derek G

    2018-01-01

    Finger-thumb coordination is crucial to manual dexterity but remains incompletely understood, particularly following neurological injury such as stroke. While being controlled independently, the index finger and thumb especially must work in concert to perform a variety of tasks requiring lateral or palmar pinch. The impact of stroke on this functionally critical sensorimotor control during dynamic tasks has been largely unexplored. In this study, we explored finger-thumb coupling during close-open pinching motions in stroke survivors with chronic hemiparesis. Two types of perturbations were applied randomly to the index with a novel Cable-Actuated Finger Exoskeleton: a sudden joint acceleration stretching muscle groups of the index finger and a sudden increase in impedance in selected index finger joint(s). Electromyographic signals for specific thumb and index finger muscles, thumb tip trajectory, and index finger joint angles were recorded during each trial. Joint angle perturbations invoked reflex responses in the flexor digitorum superficialis (FDS), first dorsal interossei (FDI), and extensor digitorum communis muscles of the index finger and heteronymous reflex responses in flexor pollicis brevis of the thumb ( p  index finger joint impedance was suddenly increased, thumb tip movement was substantially increased, from 2 to 10 cm ( p  index finger impacting thumb activity. The degree of coupling modulated with the phase of motion. These findings reveal a potential mechanism for direct intervention to improve poststroke hand mobility and provide insight on prospective neurologically oriented therapies.

  7. Utility of combined high-resolution bone SPECT and MRI for the identification of rheumatoid arthritis patients with high-risk for erosive progression

    Energy Technology Data Exchange (ETDEWEB)

    Buchbender, Christian, E-mail: christian.buchbender@med.uni-duesseldorf.de [Univ Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Moorenstr. 5, D-40225 Dusseldorf (Germany); Sewerin, Philipp, E-mail: philipp.sewerin@med.uni-duesseldorf.de [Univ Dusseldorf, Medical Faculty, Department of Rheumatology, Moorenstr. 5, D-40225 Dusseldorf (Germany); Mattes-György, Katalin, E-mail: katalin.mattes@med.uni-duesseldorf.de [Univ Dusseldorf, Medical Faculty, Department of Nuclear Medicine, Moorenstr. 5, D-40225 Dusseldorf (Germany); Miese, Falk, E-mail: falk.miese@med.uni-duesseldorf.de [Univ Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Moorenstr. 5, D-40225 Dusseldorf (Germany); Wittsack, Hans-Joerg, E-mail: hans-joerg.wittsack@med.uni-duesseldorf.de [Univ Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Moorenstr. 5, D-40225 Dusseldorf (Germany); Specker, Christof, E-mail: c.specker@kliniken-essen-sued.de [Department of Rheumatology and Clinical Immunology, Kliniken Essen-Sud, Propsteistrasse 2, D-45239 Essen (Germany); Antoch, Gerald, E-mail: antoch@med.uni-duesseldorf.de [Univ Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Moorenstr. 5, D-40225 Dusseldorf (Germany); Müller, Hans-Wilhelm, E-mail: HansW.Mueller@med.uni-duesseldorf.de [Univ Dusseldorf, Medical Faculty, Department of Nuclear Medicine, Moorenstr. 5, D-40225 Dusseldorf (Germany); Schneider, Matthias, E-mail: matthias.schneider@med.uni-duesseldorf.de [Univ Dusseldorf, Medical Faculty, Department of Rheumatology, Moorenstr. 5, D-40225 Dusseldorf (Germany); Scherer, Axel, E-mail: scherer@med.uni-duesseldorf.de [Univ Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Moorenstr. 5, D-40225 Dusseldorf (Germany); Ostendorf, Benedikt, E-mail: ostendorf@med.uni-duesseldorf.de [Univ Dusseldorf, Medical Faculty, Department of Rheumatology, Moorenstr. 5, D-40225 Dusseldorf (Germany)

    2013-02-15

    Objectives: To evaluate the utility of sequentially acquired, post hoc fused, magnetic resonance imaging (MRI) and multi-pinhole single photon emission computed tomography (MPH-SPECT) with technetium-99m-labeled disphosphonates (Tc99m-DPD) for the identification of finger joints with later erosive progression in early rheumatoid arthritis (ERA) patients. Methods: Ten consecutive ERA patients prospectively underwent MPH-SPECT and MRI of metacarpophalangeal (MCP) joints prior to and after 6 months methotrexate therapy. Tc99m-DPD uptake was measured at proximal and distal MCP sites using regional analysis. The course of joint pathologies was scored according to the Rheumatoid Arthritis MRI Score (RAMRIS) criteria. Results: The frequency of increased Tc99m-DPD uptake, synovitis and bone marrow edemadecreased under MTX therapy; but the number of bone erosions increased. Joints with progressive and new erosions on follow-up had a higher baseline Tc99m-DPD uptake (2.64 ± 1.23 vs. 1.43 ± 0.91) (p = 0.02). Conclusions: Joints with erosive progression are characterized by an early increased Tc99m-DPD uptake, even in absence of MRI bone pathologies. Tc99m-DPD MPH-SPECT might thus be of additional value to morphological MRI for the identification of RA patients with a high risk for erosive progression.

  8. Ultrasonography for diagnosis, monitoring and treatment of tenosynovitis in patients with rheumatoid arthritis.

    Science.gov (United States)

    Danielsen, Mads Ammitzbøll

    2018-03-01

    Rheumatod arthritis is a chronic systemic autoimmune disease, characterized by inflammation in joints and tendon sheaths, which frequently leads to permanent and serious disability due to joint destruction, but also tendon and ligament ruptures. Clinical management of rheumatoid arthritis has traditionally been supported by biochemical and radiographic findings. However, imaging modalities like ultrasound and magnetic resonance imaging (MRI) have improved the possibility for better management of rheumatoid arthritis patients, due to higher sensitivity and specificity for detecting ongoing inflammation, this thesis is focusing on tenosynovitis as recent studies have shown that inflammation in tendon sheaths, i.e. tenosynovitis, is a very common manifestation of rheumatoid arthritis and may often be mistaken for synovitis. Furthermore, presence of ultrasonographic tenosynovitis may predict clinical flare and erosive progression. 
The main aim of this PhD thesis was to further develop and validate ultrasound as a tool for diagnosis, monitoring and treatment of tenosynovitis. This was investigated in four studies: 
Study I: 3D Doppler Ultrasound findings in healthy wrist and finger tendon sheaths - Can feeding vessels lead to misinterpretation in Doppler-detected tenosynovitis? 
Study II: Image fusion of Ultrasound and MRI and B-flow evaluation of tenosynovitis - A pilot study on new imaging techniques in rheumatoid arthritis patients. 
Study III: Validity and sensitivity to change of the semi-quantitative Outcome Measures in Rheumatology Clinical Trials (OMERACT) ultrasound scoring system for tenosynovitis in patients with rheumatoid arthritis and for the quantitative scoring system, pixel index. 
Study IV: Intramuscular versus ultrasound guided intratenosynovial glucocorticoid injection for tenosynovitis in patients with rheumatoid arthritis - A randomised, double-blind, controlled study with ultrasound and clinical follow up at 4 and 12 weeks. 
From the

  9. Radiosynovectomy of Painful Synovitis of Knee Joints Due to Rheumatoid Arthritis by Intra-Articular Administration of 177Lu-Labeled Hydroxyapatite Particulates: First Human Study and Initial Indian Experience

    International Nuclear Information System (INIS)

    Shinto, Ajit S.; Kamaleshwaran, K. K.; Chakraborty, Sudipta; Vyshakh, K.; Thirumalaisamy, S. G.; Karthik, S.; Nagaprabhu, V. N.; Vimalnath, K. V.; Das, Tapas; Banerjee, Sharmila

    2015-01-01

    The aim of this study is to assess the effectiveness of Radiosynovectomy (RSV) using 177 Lu-labeled hydroxyapatite ( 177 Lu-HA) in the treatment of painful synovitis and recurrent joint effusion of knee joints in rheumatoid arthritis (RA). Ten patients, diagnosed with RA and suffering from chronic painful resistant synovitis of the knee joints were referred for RSV. The joints were treated with 333 ± 46 MBq of 177 Lu-HA particles administered intra-articularly. Monitoring of activity distribution was performed by static imaging of knee joint and whole-body gamma imaging. The patients were evaluated clinically before RSV and at 6 months after the treatment by considering the pain improvement from baseline values in terms of a 100-point visual analog scale (VAS), the improvement of knee flexibility and the pain remission during the night. RSV response was classified as poor (VAS < 25), fair (VAS ≥ 25-50), good (VAS ≥ 50-75) and excellent (VAS ≥ 75), with excellent and good results considered to be success, while fair and poor as failure and also by range of motion. Three phase bone scan (BS) was repeated after 6 months and changes in the second phase of BS3 were assessed visually, using a four-degree scale and in the third phase, semiquantitatively with J/B ratio to see the response. Biochemical analysis of C-reactive protein (CRP) and fibrinogen was repeated after 48 h, 4 and 24 weeks. In all 10 patients, no leakage of administered activity to nontarget organs was visible in the whole-body scan. Static scans of the joint at 1 month revealed complete retention of 177 Lu-HA in the joints. All patients showed decreased joint swelling and pains, resulting in increased joint motion after 6 months. The percentage of VAS improvement from baseline values was 79.5 ± 20.0% 6 months after RS and found to be significantly related to patients' age (P = 0.01) and duration of the disease (P = 0.03). Knees with Steinbrocker's Grades 0 and I responded better than

  10. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Rheumatoid Arthritis: Additional Conditions Rheumatoid Arthritis: The Immune System Don’t have ... and Health-related Quality of Life Rehabilitation Management for Rheumatoid ...

  11. [Bone structure in rheumatoid arthritis].

    Science.gov (United States)

    Ono, Kumiko; Ohashi, Satoru; Tanaka, Sakae; Matsumoto, Takuya

    2013-07-01

    In rheumatoid arthritis (RA) , the osteoclast pathway is activated by abnormal immune conditions accompanied by chronic inflammation, resulting in periarticular osteoporosis and local bone destruction around joints. In addition, multiple factors, including reduced physical activity and pharmacotherapies such as steroids, lead to systemic osteoporosis. These conditions cause decreasing bone mineral density and deterioration of bone quality, and expose patients to increased risk of fracture. Understanding the bone structures of RA and evaluating fracture risk are central to the treatment of RA.

  12. 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

  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. Multiple Fingers - One Gestalt.

    Science.gov (United States)

    Lezkan, Alexandra; Manuel, Steven G; Colgate, J Edward; Klatzky, Roberta L; Peshkin, Michael A; Drewing, Knut

    2016-01-01

    The Gestalt theory of perception offered principles by which distributed visual sensations are combined into a structured experience ("Gestalt"). We demonstrate conditions whereby haptic sensations at two fingertips are integrated in the perception of a single object. When virtual bumps were presented simultaneously to the right hand's thumb and index finger during lateral arm movements, participants reported perceiving a single bump. A discrimination task measured the bump's perceived location and perceptual reliability (assessed by differential thresholds) for four finger configurations, which varied in their adherence to the Gestalt principles of proximity (small versus large finger separation) and synchrony (virtual spring to link movements of the two fingers versus no spring). According to models of integration, reliability should increase with the degree to which multi-finger cues integrate into a unified percept. Differential thresholds were smaller in the virtual-spring condition (synchrony) than when fingers were unlinked. Additionally, in the condition with reduced synchrony, greater proximity led to lower differential thresholds. Thus, with greater adherence to Gestalt principles, thresholds approached values predicted for optimal integration. We conclude that the Gestalt principles of synchrony and proximity apply to haptic perception of surface properties and that these principles can interact to promote multi-finger integration.

  15. Torque control of underactuated tendon-driven fingers

    Directory of Open Access Journals (Sweden)

    M. E. Abdallah

    2011-02-01

    Full Text Available Given an underactuated tendon-driven finger, the finger posture is underdetermined and can move freely ("flop" in a region of slack tendons. This work shows that such an underactuated finger can be operated in tendon force control (rather than position control with effective performance. The force control eliminates the indeterminate slack while commanding a parameterized space of desired torques. The torque will either push the finger to the joint limits or wrap around an external object with variable torque – behavior that is sufficient for primarily gripping fingers. In addition, introducing asymmetric joint radii to the design allows the finger to command an expanded range of joint torques and to scan an expanded set of external surfaces. This study is motivated by the design and control of the secondary fingers of the NASA-GM R2 humanoid hand.

    This paper was presented at the IFToMM/ASME International Workshop on Underactuated Grasping (UG2010, 19 August 2010, Montréal, Canada.

  16. Effect of a treat-to-target strategy based on methotrexate and intra-articular betamethasone with or without additional cyclosporin on MRI-assessed synovitis, osteitis, tenosynovitis, bone erosion, and joint space narrowing in early rheumatoid arthritis: results from a 2-year randomized double

    DEFF Research Database (Denmark)

    Møller-Bisgaard, S.; Ejbjerg, B. J.; Eshed, I.

    2017-01-01

    Objectives: To investigate whether a treat-to-target strategy based on methotrexate (MTX) and intra-articular (IA) betamethasone suppresses magnetic resonance imaging (MRI)-determined measures of disease activity and reduces joint destruction in early rheumatoid arthritis (eRA) patients, and to i......Objectives: To investigate whether a treat-to-target strategy based on methotrexate (MTX) and intra-articular (IA) betamethasone suppresses magnetic resonance imaging (MRI)-determined measures of disease activity and reduces joint destruction in early rheumatoid arthritis (eRA) patients......, and to investigate whether concomitant cyclosporin A (CyA) provides an additional effect.Method: In the 2-year randomized, double-blind, treat-to-target trial CIMESTRA, 160 patients with eRA (intra-articular betamethasone and CyA, or placebo CyA. A total of 129 patients participated...

  17. Radiological manifestations of rheumatoid arthritis

    International Nuclear Information System (INIS)

    Kapp, H.J.

    1997-01-01

    Rheumatoid arthritis preferrably becomes manifest at the synovial joints of the limbs, especially at the small joints of the hands and feet, at bursae and synovial sheathes. The pathologic lesions are less frequently found at cartilaginous joints or entheses. The lesions very often are symmetrically distributed and are characterized by the following: 1. A periarticular, spindle-shaped opacity with a density similar to soft-tissue, induced by an inflammatory hypertrophy of the synovia, a serosynovitis, or an edematous impregnation of the periarticular tissue. 2. A juxta-articular osteoporosis, most probably caused by a neighbouring synovialitis accompanied by hyperemia. 3. A diffuse joint cavity narrowing due to a destruction of the articular cartilage by the pannus, a fibrovascular resorptive tissue. 4. Central as well as marginal erosions, caused by destruction of ossous material by the pannus. 5. Subchondral signal cysts, likewise unduced by the pannus. (Orig./AJ) [de

  18. Tetanus following replantation of an amputated finger: a case report.

    Science.gov (United States)

    Hayashida, Kenji; Murakami, Chikako; Fujioka, Masaki

    2012-10-08

    Tetanus is an infectious disease caused by tetanus toxin produced by Clostridium tetani and induces severe neurological manifestations. We treated a patient who developed tetanus during hospitalization for replantation of an amputated finger. To the best of our knowledge, this is the first published case report of such an entity. A 49-year-old Japanese man had an amputation of his right middle finger at the distal interphalangeal joint region in an accident at work. His middle finger was successfully replanted, but his fingertip was partially necrotized because of crushing and so additional reconstruction with a reverse digital arterial flap was performed 15 days after the injury. Tetanus developed 21 days after replantation of the middle finger, but symptoms remitted via rapid diagnosis and treatment. In replantation after finger trauma with exposure of nerve and blood vessel bundles, concern over injuring nerves and blood vessels may prevent irrigation and debridement from being performed sufficiently; these treatments may have been insufficiently performed in this patient. It is likely that the replanted middle finger partially adhered, and Clostridium tetani colonized the partially necrotized region. Even when there is only limited soil contamination, administration of tetanus toxoid and anti-tetanus immunoglobulin is necessary when the fingers are injured outdoors and the finger nerves and blood vessels are exposed. The drugs should be administered just after replantation if the finger has been amputated. However, if clinicians pay attention to the possibility of tetanus development, treatment can be rapidly initiated.

  19. Tetanus following replantation of an amputated finger: a case report

    Directory of Open Access Journals (Sweden)

    Hayashida Kenji

    2012-10-01

    Full Text Available Abstract Introduction Tetanus is an infectious disease caused by tetanus toxin produced by Clostridium tetani and induces severe neurological manifestations. We treated a patient who developed tetanus during hospitalization for replantation of an amputated finger. To the best of our knowledge, this is the first published case report of such an entity. Case presentation A 49-year-old Japanese man had an amputation of his right middle finger at the distal interphalangeal joint region in an accident at work. His middle finger was successfully replanted, but his fingertip was partially necrotized because of crushing and so additional reconstruction with a reverse digital arterial flap was performed 15 days after the injury. Tetanus developed 21 days after replantation of the middle finger, but symptoms remitted via rapid diagnosis and treatment. Conclusions In replantation after finger trauma with exposure of nerve and blood vessel bundles, concern over injuring nerves and blood vessels may prevent irrigation and debridement from being performed sufficiently; these treatments may have been insufficiently performed in this patient. It is likely that the replanted middle finger partially adhered, and Clostridium tetani colonized the partially necrotized region. Even when there is only limited soil contamination, administration of tetanus toxoid and anti-tetanus immunoglobulin is necessary when the fingers are injured outdoors and the finger nerves and blood vessels are exposed. The drugs should be administered just after replantation if the finger has been amputated. However, if clinicians pay attention to the possibility of tetanus development, treatment can be rapidly initiated.

  20. Fluorescence optical imaging and 3T-MRI for detection of synovitis in patients with rheumatoid arthritis in comparison to a composite standard of reference.

    Science.gov (United States)

    Thuermel, Klaus; Neumann, Jan; Jungmann, Pia M; Schäffeler, Christoph; Waldt, Simone; Heinze, Alexander; Beckmann, Alexander; Hauser, Christine; Hasenau, Anna-Lena; Wildgruber, Moritz; Clotten, Sigrun; Sievert, Matti; Haller, Bernhard; Woertler, Klaus; Harasser, Norbert; Rummeny, Ernst J; Meier, Reinhard

    2017-05-01

    To address whether Indocyanine Green (ICG) enhanced fluorescence optical imaging (FOI) is more sensitive than magnetic resonance imaging (MRI) in the detection of synovitis of the wrist and finger joints in rheumatoid arthritis and to analyze the performance of FOI depending on the grade of synovitis. Twenty patients with highly active rheumatoid arthritis (mean DAS28-ESR 5.25±1.0) and thirteen healthy volunteers underwent clinical examination, FOI and contrast-enhanced 3T-MRI. Joints were rated by three independent readers semiquantitatively (grade 0-3: no, low, moderate and high grade synovitis) and compared to a semiquantitative composite standard of reference (cSOR, grade 0-3) that incorporated clinical parameters, FOI and MRI results. 2.868 evaluations in 956 joints were performed. FOI had an overall sensitivity of 57.3% and a specificity of 92.1%, whereas MRI had a sensitivity of 89.2% and a specificity of 92.6%. The sensitivity of FOI increased with the degree of synovitis to 65.0% for moderate and severe synovitis (specificity 88.1%) and 76,3% for severe synovitis (specificity 80.5%). The performance of FOI decreased with the degree of synovitis with false negative results predominantly for mild (156/343, 45.5%) and moderate (160/343, 46.6%) synovitis and false positive FOI evaluations predominantly based on weak (grade 1) signals (133/163, 81,6%). FOI has a lower sensitivity than 3T-MRI in the detection of synovitis of the hand and finger joints. The diagnostic performance of FOI decreases with the degree of synovitis and with the strength of FOI signals. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. 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...

  2. THE CYSTIC FORM OF RHEUMATOID-ARTHRITIS

    NARCIS (Netherlands)

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

    1988-01-01

    A non-erosive 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

  3. 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...

  4. Role of ultrasound in managing rheumatoid arthritis

    DEFF Research Database (Denmark)

    Hammer, Hilde Berner; Terslev, Lene

    2012-01-01

    Ultrasound (US) is a valid and reliable imaging tool for evaluation of joint and tendon inflammation as well as cartilage and erosions in patients with rheumatoid arthritis (RA). Synovitis is usually scored semiquantitatively for both gray scale synovitis and power Doppler activity, and use...

  5. Cystic form of rheumatoid arthritis

    Energy Technology Data Exchange (ETDEWEB)

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

    1988-10-01

    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.

  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. Rheumatoid arthritis of the shoulder

    Energy Technology Data Exchange (ETDEWEB)

    Dijkstra, J.; Dijkstra, P.F.; Klundert, W. v. d.

    1985-02-01

    The course of rheumatoid arthritis in the shoulder is evaluated in 143 patients. In a period of 29 years, 630 X-rays were taken of 286 shoulders. In this series 2 or more X-rays per shoulder were taken of 89 patients (29 male, 60 female). The various changes in the glenohumeral and acromioclavicular joints were described. Gross destruction appears to be rare, compared to the more frequently seen minor cystic changes. The progress of the disease is often slow or halting. One or both of the shoulders in some of the patients (15 male and 29 female) did not have any detectable X-rays changes, although some of them were followed up for more than 20 years. During our follow-up it became apparent that the acromioclavicular and glenohumeral joints do not follow the same course neither in time nor in severity of joint destruction. Therefore, we divided the shoulder joint into the acromioclavicular and glenohumeral joint. One normal stage and 5 stages of pathology are recognised to fit into previously published schemes of the other joints. Stage 5 appears to be a new phenomenon of neojoint formation, under the previous humeral head with the inferior glenoid rim. Joint disease in the acromioclavicular joint could be divided only into 3 stages.

  8. Rheumatoid arthritis of the shoulder

    International Nuclear Information System (INIS)

    Dijkstra, J.; Dijkstra, P.F.; Jan van Breemen Inst., Amsterdam; Klundert, W. v. d.

    1985-01-01

    The course of rheumatoid arthritis in the shoulder is evaluated in 143 patients. In a period of 29 years, 630 X-rays were taken of 286 shoulders. In this series 2 or more X-rays per shoulder were taken of 89 patients (29 male, 60 female). The various changes in the glenohumeral and acromioclavicular joints were described. Gross destruction appears to be rare, compared to the more frequently seen minor cystic changes. The progress of the disease is often slow or halting. One or both of the shoulders in some of the patients (15 male and 29 female) did not have any detectable X-rays changes, although some of them were followed up for more than 20 years. During our follow-up it became apparent that the acromioclavicular and glenohumeral joints do not follow the same course neither in time nor in severity of joint destruction. Therefore, we divided the shoulder joint into the acromioclavicular and glenohumeral joint. One normal stage and 5 stages of pathology are recognised to fit into previously published schemes of the other joints. Stage 5 appears to be a new phenomenon of neojoint formation, under the previous humeral head with the inferior glenoid rim. Joint disease in the acromioclavicular joint could be divided only into 3 stages. (orig.) [de

  9. Joint diseases

    International Nuclear Information System (INIS)

    Weissman, S.D.

    1989-01-01

    The authors discuss how x-ray examination is essential in the diagnosis and evaluation of the arthritides. Most arthritides are first suspected by the clinician, and x-ray evaluation of these entities along with laboratory testing is important for confirmation of the clinical diagnosis and in staging of the disease process. Several arthritides are often diagnosed first by the podiatrist on x-ray evaluation, including pseudogout, ankylosing spondylitis, early rheumatoid arthritis, degenerative joint disease, and tuberculosis of bone. The joint responds to insult in only a limited number of ways that become apparent on x-ray. The soft tissues surrounding the joint, the articulating bones, and alignment of the joint space may all be involved by the arthritic process. On roentgenographic examination, the soft tissues must be examined for edema, masses, calcifications, and atrophy. The articulating bones must be examined for demineralization, erosions, osteophytes, periosteal reaction, cysts and sclerosis

  10. ARTHRODESIS OF THE FIRST METATARSOPHALANGEAL JOINT IN PATIENTS WITH RHEUMATOID ARTHRITIS AND HALLUX VALGUS: CHOICE OF TECHNIQUE OF ARTHRODESIS FIXATION, COMPLICATIONS AND LONG-TERM RESULTS

    Directory of Open Access Journals (Sweden)

    V. P. Pavlov

    2014-01-01

    Full Text Available Objective: to study results of arthrodesis of the first metatarsophalangeal joint (I MPT joint in patients with rheumatoidarthritis (RA and hallux valgus, assess methods of arthrodesis fixation, reveal complications and analyze longterm results.Subjects and methods. Authors observed 86 patients with RA, female : male ratio 3.2:1, mean age was 53.8±9.5 years (from 18 to 75 years; 80 from them had seropositive and 6 – seronegative RA. 72 patients had low, and 14 –moderate activity of the disease. II stage of RA was revealed in 31.4%, III – in 62.8%, IV – in 5.8%; 52.3% of  patients had I and 47.7% – II functional class. All patients  ad hallux valgus as a component of typical deformation of the forefoot – digitis V rheumaticus (DVR. Standard global reconstructive operation (SGRO and its modification (MGRO were used. Both techniques included arthrodesis of the I MTP joint where fusion of bones was fixed with Kirschner wire and compression clamps in groups A and B respectively. Results of surgical treatmentwere assessed separately for I and II–V toes. The present work provides solely the results of the I MTP joint arthrodesis.Results. Assessment of the I MTP joint with hallux valgus before and 2.3±1.5 years after operation based on AOFAS comprised 35.51±8.16/82.32±6.09 in the group A and 39.93±6.65/82.26±5,59 in the group B. Inefficiency of arthrodesis of the I MTP joint was observed in 3 patients from the group B (2.15%. Before operation, 3 from 141 feet had hallux valgus of the II stage (21–40°; III (41–60° and IV (>60° stages of hallux valgus were recorded in 90 and48 feet respectively. Following 2.3 years after arthrodesis normal I MTP joints (10–11° were observed in 131 feet whereas, that of the II stage of hallux valgus (12–20° – in 10 feet.Conclusion. High efficacy of arthrodesis of the I MTP joint in patients with RA and hallux valgus and, subsequently, low failure rate (2.15% were achieved as

  11. Characteristic Magnetic Resonance Imaging Findings in Rheumatoid Arthritis of the Temporomandibular Joint: Focus on Abnormal Bone Marrow Signal of the Mandibular Condyle, Pannus, and Lymph Node Swelling in the Parotid Glands.

    Science.gov (United States)

    Hirahara, Naohisa; Kaneda, Takashi; Muraoka, Hirotaka; Fukuda, Taiga; Ito, Kotaro; Kawashima, Yusuke

    2017-04-01

    The purpose of this study was to determine the characteristic magnetic resonance imaging (MRI) findings indicating bone and soft tissue involvement in patients with rheumatoid arthritis (RA) of the temporomandibular joints (TMJs). Twenty-one patients with RA and TMJ pain who underwent MRI examination of the TMJs at the authors' hospital from August 2006 to December 2014 were included in this study. Twenty-two patients with normal TMJs who underwent MRI examination at the authors' hospital from November to December 2014 were included as controls. MRI findings were compared between the 2 groups. MRI findings of RA in the TMJ included 1) abnormal disc position (95.2%), 2) abnormal disc morphology (83.3%), 3) joint effusion (30.9%), 4) osseous changes in the mandibular condyle (83.3%), 5) synovial proliferation (pannus; 85.7%), 6) erosion of the articular eminence and glenoid fossa (9.52%), 7) deformity of the articular eminence and glenoid fossa (16.6%), 8) abnormal bone marrow signal in the mandibular condyle (83.3%), and 9) swelling of lymph nodes in the parotid glands (78.5%). The abnormal bone marrow signal and pannus in the mandibular condyle and lymph node swelling in the parotid glands were markedly more common in patients with RA than in controls. MRI findings of RA of the TMJs were characterized by bone and soft tissue involvement, including abnormal bone marrow signal of the mandibular condyle, pannus, and swelling of lymph nodes in the parotid glands. These characteristic MRI findings could be useful in detecting RA in the TMJ in a clinical situation. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  12. PATHOMORPHOLOGICAL AND COMPUTERIZED TOMOGRAPHY STUDY OF IBUPROFEN AND COMBINATION WITH 2-PHENYL-3-CARBETHOXY-4-DIMETHYLAMINOMETHYL-5-OKSIBENZOFURAN HYDROCHLORIDE (VINBORON INFLUENCE ON THE JOINTS OF LOWER EXTREMITIES OF RATS WITH EXPERIMENTAL RHEUMATOID ARTHRITIS

    Directory of Open Access Journals (Sweden)

    F. V. Hladkykh

    2017-01-01

    Full Text Available The most frequent adverse reactions to nonsteroidal anti-inflammatory drugs are upper and lower gastrointestinal tract disorders, hepatotoxicity, nephrotoxicity, a decrease in the synthesis of proteoglycans of the cartilaginous tissue and allergic reactions. In our previous studies we have found out that Ukrainian vinboron, the antispasmodic with polytrophic pharmacological effects, can improve the safety profile of the popular non-steroidal antiphlogistics ibuprofen and can also potentiate its anti-inflammatory effect. That fact has become the background to a detailed study of the therapeutic action mechanisms of these drugs when they are used together.Aim of the study. To characterize the influence of vinboron (11 mg/kg, i.g. on the anti-inflammatory activity of ibuprofen (218 mg/kg, i.g. when combined, in a model of experimental rheumatoid arthritis according to pathomorphological, morphometric and cone-ray computerized tomography of rats’ hind limbs.Materials and methods. To reproduce the conditions for the administration of ibuprofen corresponding to its clinical use, we selected a model of experimental rheumatoid arthritis-adjuvant arthritis (AA in rats. On the 28th  day the animals were excluded from the experiment. It was followed by the amputation of the hind limbs at the level of the hocks (art. coxae and fixation of the material in 10.0% aqueous solution of neutral formalin. The ankle joints were decalcified. The drugs were prepared according to the standard procedure. Microscopy and photographing of histological preparations were carried out with the light microscope OLIMPUS BX 41 at magnifications of 40, 100, 200 and 400 times. The obtained images were processed and morphometry was carried out with the program “Quick PHOTO MICRO 2.3”. The contents of the cellular elements was determined on the basis of the equivalent unit area (1 mm2. Cone-ray computerized tomography was carried out with a digital panoramic cone

  13. Mixing methods, tasting fingers

    DEFF Research Database (Denmark)

    Mann, Anna; Mol, Annemarie; Satalkar, Priya

    2011-01-01

    This article reports on an ethnographic experiment. Four finger eating experts and three novices sat down for a hot meal and ate with their hands. Drawing on the technique of playing with the familiar and the strange, our aim was not to explain our responses, but to articulate them. As we seek...... words to do so, we are compelled to stretch the verb "to taste." Tasting, or so our ethnographic experiment suggests, need not be understood as an activity confined to the tongue. Instead, if given a chance, it may viscously spread out to the fingers and come to include appreciative reactions otherwise...

  14. A Finger Exoskeleton Robot for Finger Movement Rehabilitation

    Directory of Open Access Journals (Sweden)

    Tzu-Heng Hsu

    2017-07-01

    Full Text Available In this study, a finger exoskeleton robot has been designed and presented. The prototype device was designed to be worn on the dorsal side of the hand to assist in the movement and rehabilitation of the fingers. The finger exoskeleton is 3D-printed to be low-cost and has a transmission mechanism consisting of rigid serial links which is actuated by a stepper motor. The actuation of the robotic finger is by a sliding motion and mimics the movement of the human finger. To make it possible for the patient to use the rehabilitation device anywhere and anytime, an Arduino™ control board and a speech recognition board were used to allow voice control. As the robotic finger follows the patients voice commands the actual motion is analyzed by Tracker image analysis software. The finger exoskeleton is designed to flex and extend the fingers, and has a rotation range of motion (ROM of 44.2°.

  15. [Short-term effectiveness of Swanson artificial joint replacement in treating posttraumatic metacarpophalangeal joint stiffness].

    Science.gov (United States)

    Lu, Hui; Shen, Xiangqian; Xu, Jihua; Huang, Xin; Ye, Po; Wu, Shoucheng

    2011-11-01

    To investigate the short-term effectiveness of Swanson artificial joint replacement in treating post-traumatic metacarpophalangeal joint stiffness. Between August 2007 and May 2010, 11 cases (13 fingers) of metacarpophalangeal joint stiffness with soft tissue defects underwent Swanson artificial joint replacement. There were 7 males (9 fingers) and 4 females (4 fingers), aged 43 to 65 years with an average of 49 years. The involved fingers included 4 thumbs, 4 index fingers, 3 middle fingers, and 2 ring fingers. The types of injury included open and crush injury in 8 fingers, fracture of the metacarpophalangeal joint in 3 fingers, metacarpophalangeal joint severing in 2 fingers. The time from joint stiffness to hospitalization was 12 to 48 weeks (mean, 24 weeks). The joint activity was (136.82 +/- 28.96) degrees. According to total active motion (TAM) assessment, included good in 1 finger, fair in 6 fingers, and poor in 6 fingers before operation. The activities of daily living were assessed by Sollerman score, which was 45.64 +/- 11.04. The X-ray films and CT scan showed traumatic arthritis of the metacarpophalangeal joint. The incision healed by first intention. All patients were followed up 12 to 34 months (mean, 24.1 months). At last follow-up, the joint activity was (194.64 +/- 28.86) degrees, showing significant difference when compared with preoperative value (t = 25.214, P = 0.000). According to TAM assessment, including excellent in 1 finger, good in 4 fingers, fair in 7 fingers, and poor in 1 finger. The Sollerman score was 67.45 +/- 8.20 postoperatively, showing significant difference when compared with the preoperative score (t = -10.470, P = 0.000). X-ray examination showed no prosthesis fracture, periprosthetic fracture, or joint dislocation occurred at last follow-up. Swanson artificial joint replacement can be applied to treat post-traumatic metacarpophalangeal joint stiffness, which can improve the joint activity and has satisfactory short

  16. 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...

  17. Hallazgos clínico-radiológicos de la articulación temporomandibular en pacientes con artritis reumatoide: Clinicoradiological findings Temporomandibular joint from patients presenting with rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Gisselle M. Chávez Andrade

    2009-06-01

    Full Text Available Se realiza este estudio con el propósito de describir y evaluar los hallazgos clínico-radiológicos de la articulación temporomandibular (ATM en un grupo de pacientes con diagnóstico de artritis reumatoide (AR. La muestra fue de 61 pacientes, con una edad media de 54 años y 5 meses. Todos fueron interrogados y examinados clínicamente, luego sometidos al examen radiográfico de ambas ATMs, utilizando la técnica de proyección transcraneal, con boca cerrada y en máxima apertura. El estudio recoge los signos y síntomas de la ATM hallados, tales como dolor, tumefacción, luxación, clicking y limitada apertura bucal. El estudio de los aspectos radiográficos indicó cambios en las superficies del cóndilo y la fosa temporal, en la movilidad condilar y espacio articular. Se concluyó que en pacientes con artritis reumatoide es frecuente la presencia de hallazgos clínicos-radiológicos en la articulación temporomandibular y que tanto la edad y género del paciente como el grado de actividad y tiempo de evolución de la enfermedad (AR, son factores que influyen en el estado general de las ATMs.Aim of present paper is to describe and to assess the Clinicoradiological findings of the temporomandibular joint (TMJ in a group of patients diagnosed with rheumatoid arthritis (RA. Sample included 61 patients with a mean age of 54 years and 5 months. All of them were interrogated and clinically examined and then underwent to a radiographic examination of both TMJs, using the transcranial projection technique, with the closed mouth and in maximal opening. Study includes the TMJ syndrome founded such as pain, tumefaction, luxation, clicking, and a limited oral opening. The study of radiographic features showed the presence of changes in condyle surface and temporal fossa, in condylar motility, and articulation space. We conclude that in patients presenting with rheumatoid arthritis is frequent the presence of clinicoradiological findings in the TMJ

  18. Dynamic gadolinium-enhanced magnetic resonance imaging allows accurate assessment of the synovial inflammatory activity in rheumatoid arthritis knee joints: a comparison with synovial histology

    DEFF Research Database (Denmark)

    Axelsen, Mette Bjørndal; Stoltenberg, M.; Poggenborg, R.

    2012-01-01

    , the average grade of histological synovial inflammation was determined from four biopsies obtained during surgery. A preoperative series of T(1)-weighted dynamic fast low-angle shot (FLASH) MR images was obtained. Parameters characterizing contrast uptake dynamics, including the initial rate of enhancement...... capsule of the knee joint (Precise ROI). Intra- and interreader agreement was assessed using the intra-class correlation coefficient (ICC). Results: The IRE from the Quick ROI and the Precise ROI revealed high correlations to the grade of histological inflammation (Spearman's correlation coefficient (rho......) = 0.70, p = 0.001 and rho = 0.74, p = 0.001, respectively). Intraand inter-reader ICCs were very high (0.93-1.00). No Whole slice parameters were correlated to histology. Conclusion: DCE-MRI provides fast and accurate assessment of synovial inflammation in RA patients. Manual outlining of the joint...

  19. Mixing methods, tasting fingers

    DEFF Research Database (Denmark)

    Mann, Anna; Mol, Annemarie; Satalkar, Priya

    2011-01-01

    This article reports on an ethnographic experiment. Four finger eating experts and three novices sat down for a hot meal and ate with their hands. Drawing on the technique of playing with the familiar and the strange, our aim was not to explain our responses, but to articulate them. As we seek wo...

  20. Express-diagnostics of rheumatoid arthritis and osteoarthrosis

    Directory of Open Access Journals (Sweden)

    Zoltan M. Sigal

    2017-09-01

    Full Text Available Introduction: Diseases of bones and joints have the third greatest impact on the health of the world population. Rheumatoid arthritis and osteoarthritis are uppermost inflammatory diseases of the joints. The aim of the study is the assessment of the ultrasonography and transillumination pulsooptometry of the knee joint as the diagnostic tools for rheumatoid arthritis and osteoarthrosis. Materials and Methods: 2 266 people (29 % – rheumatoid arthritis, 62 % – osteoarthritis, 9 % – healthy, aged 19–75 years took part in the study. The ultrasonography and transillumination pulsooptometry were conducted. Measurements of hemodynamics and optical density were performed using the device and method of Z. M. Sigal (2007. Results. Various indicators were established, for example, the volume of synovial fluid in the suprapatellar bag for rheumatoid arthritis and osteoarthritis. Optical density for rheumatoid arthritis is three times less than for osteoarthritis. There are significant differences in the amplitude of pulse oscillations in rheumatoid arthritis and osteoarthritis. Results: Various indicators were established, for example, the volume of synovial fluid in the suprapatellar bag for rheumatoid arthritis and osteoarthritis. Optical density for rheumatoid arthritis is three times less than for osteoarthritis. There are significant differences in the amplitude of pulse oscillations in rheumatoid arthritis and osteoarthritis. Discussion and Conclusions: The volume of synovial fluid in the suprapatellar bag of the knee joint with rheumatoid arthritis is higher than in osteoarthritis and normal: 55.8 cm3 and above and 3,29 cm3, 1,85 cm3 and below, respectively. With osteoarthritis and normal amount of synovial fluid did not differ significantly. The optical density in the suprapatellar bag of the knee joint for rheumatoid arthritis was 0.56 ± 0.2, the amplitude of pulse oscillations was 13.45 ± 3.62 mm. In osteoarthritis, these values were 1

  1. Two cases of rheumatoid meningitis.

    Science.gov (United States)

    Magaki, Shino; Chang, Edward; Hammond, Robert R; Yang, Isaac; Mackenzie, Ian R A; Chou, Benedict T; Choi, Soo I; Jen, Joanna C; Pope, Whitney B; Bell, David A; Vinters, Harry V

    2016-02-01

    Central nervous system (CNS) involvement by rheumatoid arthritis (RA) in the form of rheumatoid meningitis (RM) is rare and most commonly occurs in the setting of longstanding severe RA. Due to a wide range of clinical presentations and nonspecific laboratory findings, it presents a diagnostic challenge often requiring brain biopsy. Only a few histopathologically confirmed cases have been described in the literature. Our aim is to describe two cases of RM and review the literature. The first case is of a previously healthy 37-year-old man who presented with severe headaches and focal neurologic deficits. Magnetic resonance imaging demonstrated abnormal leptomeningeal enhancement in the left frontal and parietal sulci. The second case is of a 62-year-old woman with a history of mild chronic joint pain who presented with confusion, personality changes and seizures. Both patients ultimately underwent brain biopsy which demonstrated RM on pathologic examination. Administration of corticosteroids resulted in significant clinical improvement in both cases. To our knowledge, our unusual case of RM in the young man is the fifth reported case of rheumatoid meningitis in a patient with no prior history of RA. Such an atypical presentation makes diagnosis even more difficult and highlights the need for awareness of this entity in the diagnostic consideration of a patient presenting with unexplained neurologic symptoms. Our literature review underscores the clinical and pathologic heterogeneity of CNS involvement in RA. © 2015 Japanese Society of Neuropathology.

  2. Kinesio Taping® of the metacarpophalangeal joints and its effect on pain and hand function in individuals with rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Sarah Roberts

    2016-10-01

    Significance of the work: Kinesio Taping® of the MCP joints of individuals with RA showed a significant decrease in pain (p = 0.00 and improved range of motion (p = 0.001 bilaterally. JP was found to significantly improve grip strength (p = 0.001 bilaterally and in the work (p = 0.01 and ADL (p = 0.01 sections of the MHQ. No significant difference was found between groups after intervention in the majority of outcomes (p = 0.24 except for grip strength where a significant difference was found (p = 0.001.

  3. Biologic interventions for fatigue in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Almeida, Celia; Choy, Ernest H S; Hewlett, Sarah

    2016-01-01

    BACKGROUND: Fatigue is a common and potentially distressing symptom for patients with rheumatoid arthritis (RA), with no accepted evidence-based management guidelines. Evidence suggests that biologic interventions improve symptoms and signs in RA as well as reducing joint damage. OBJECTIVES......: To evaluate the effect of biologic interventions on fatigue in rheumatoid arthritis. SEARCH METHODS: We searched the following electronic databases up to 1 April 2014: Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, Current Controlled Trials...... and contacted key authors. SELECTION CRITERIA: We included randomised controlled trials if they evaluated a biologic intervention in people with rheumatoid arthritis and had self reported fatigue as an outcome measure. DATA COLLECTION AND ANALYSIS: Two reviewers selected relevant trials, assessed methodological...

  4. Temporomandibular joint space in children without joint disease

    International Nuclear Information System (INIS)

    Larheim, T.A.

    1981-01-01

    Bilateral assessment of the temporomandibular joint space in children without joint disease is reported. Twenty-eight children were examined with conventional radiography and 23 with tomography. High prevalence of asymmetric joint spaces with both techniques indicated that great care should be taken when using narrowing or widening of the joint space as a diagnostic criterion in children with juvenile rheumatoid arthritis. Other signs, such as restricted translation of the mandibular head, and clinical symptoms should be evaluated. (Auth.)

  5. Rheumatoid Arthritis Educational Video Series

    Science.gov (United States)

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

  6. Genetics Home Reference: rheumatoid arthritis

    Science.gov (United States)

    ... Share: Email Facebook Twitter Home Health Conditions Rheumatoid arthritis Rheumatoid arthritis Printable PDF Open All Close All Enable ... in my area? Other Names for This Condition arthritis, rheumatoid RA Related Information How are genetic conditions and ...

  7. Talbot phase-contrast x-ray imaging for the small joints of the hand

    Energy Technology Data Exchange (ETDEWEB)

    Stutman, Dan [Department of Physics and Astronomy, Johns Hopkins University, Baltimore, MD 21218 (United States); Beck, Thomas J [Quantum Medical Metrics, 1450 South Rolling Road, Baltimore, MD 21227 (United States); Carrino, John A [Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD 21287 (United States); Bingham, Clifton O, E-mail: stutman@pha.jhu.edu [Divisions of Rheumatology and Allergy and Clinical Immunology, Johns Hopkins University, Baltimore, MD 21224 (United States)

    2011-09-07

    A high-resolution radiographic method for soft tissues in the small joints of the hand would aid in the study and treatment of rheumatoid arthritis (RA) and osteoarthritis (OA), which often attacks these joints. Of particular interest would be imaging with <100 {mu}m resolution the joint cartilage, whose integrity is a main indicator of disease. Differential phase-contrast (DPC) or refraction-based x-ray imaging with Talbot grating interferometers could provide such a method, since it enhances soft tissue contrast and can be implemented with conventional x-ray tubes. A numerical joint phantom was first developed to assess the angular sensitivity and spectrum needed for a hand DPC system. The model predicts that, due to quite similar refraction indexes for joint soft tissues, the refraction effects are very small, requiring high angular resolution. To compare our model to experiment we built a high-resolution bench-top interferometer using 10 {mu}m period gratings, a W anode tube and a CCD-based detector. Imaging experiments on animal cartilage and on a human finger support the model predictions. For instance, the estimated difference between the index of refraction of cartilage and water is of only several percent at {approx}25 keV mean energy, comparable to that between the linear attenuation coefficients. The potential advantage of DPC imaging thus comes mainly from the edge enhancement at the soft tissue interfaces. Experiments using a cadaveric human finger are also qualitatively consistent with the joint model, showing that refraction contrast is dominated by tendon embedded in muscle, with the cartilage layer difficult to observe in our conditions. Nevertheless, the model predicts that a DPC radiographic system for the small hand joints of the hand could be feasible using a low energy quasi-monochromatic source, such as a K-edge filtered Rh or Mo tube, in conjunction with a {approx}2 m long 'symmetric' interferometer operated in a high Talbot order.

  8. Short-term effect of ultrasound-guided low-molecular-weight hyaluronic acid injection on clinical outcomes and imaging changes in patients with rheumatoid arthritis of the ankle and foot joints. A randomized controlled pilot trial.

    Science.gov (United States)

    Wang, Chien-Chih; Lee, Si-Huei; Lin, Hsiao-Yi; Liu, Fu-Wei; Chiou, Hong-Jen; Chan, Rai-Chi; Chou, Chen-Liang

    2017-11-01

    To determine whether hyaluronic acid (HA) injection into rheumatoid arthritis ankles and feet can achieve improvement in foot function and reduce synovial hyper-vascularization. Forty-four patients with RA having unilateral or bilateral painful ankle and foot involvement (N = 75) were studied. All the patients were randomized to receive HA (N = 40) or lidocaine (LI) (N = 35) injection at 2-week intervals; Clinical assessments were performed using a visual analog scale (VAS) and foot function index (FFI total ) including subscales of pain (FFI pain) before injection at baseline, 4 weeks (first evaluation) and 12 weeks (secondary evaluation). Imaging evaluation based on color Doppler ultrasound (CDUS) and synovitis scores was performed simultaneously. HA injection improved the VAS score (p = .009), FFI pain (p = .041), and FFI total (p = .032) considerably more than LI injections did at the first evaluation. The CDUS values at first evaluation (p = .005) and secondary evaluation (p injections reduced the CDUS values of more than half of the joints (54%, p = .042) while the control group exhibited no change (20%, p = .56). However, HA injection did not reduce the CDUS values more than LI injection did. Regarding the evaluation of synovial hypertrophy, no significant difference was observed between or within the groups in the synovitis scores. HA injection improved short-term foot function and pain reduction. HA injection may have a modest effect in reducing synovial hyper-vascularization. Further large-scale study is warranted to confirm this result.

  9. Rheumatoid Arthritis Educational Video Series

    Medline Plus

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

  10. Rheumatoid Arthritis Educational Video Series

    Medline Plus

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

  11. Rheumatoid Arthritis Educational Video Series

    Medline Plus

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

  12. Case report physiotherapy care of a patient diagnosed with polyarthritis with early rheumatoid arthritis

    OpenAIRE

    Michálková, Kateřina

    2013-01-01

    Title of bachelor's thesis: Case report physiotherapy care of a patient diagnosed with polyarthritis with early rheumatoid arthritis. Summary: The bachelor thesis deals with polyarthritis disease with early rheumatoid arthritis and its physiotherapy care. It consists of two parts. The general part contains a general joint anatomy, deals with the major problems of disease and polyarthritis rheumatoid arthritis, its diagnosis, treatment and physiotherapy care. Special part includes a case repor...

  13. The Power of a Soccer Ball: A Traumatic Open Finger Dislocation—A Rare Case Presentation

    Directory of Open Access Journals (Sweden)

    Turan Cihan Dülgeroğlu

    2015-01-01

    Full Text Available Proximal interphalangeal joint dislocations are injuries observed frequently and caused by axial loading on the finger in the extension. In this paper we present a traumatic open finger dislocation due to a ball hitting a wrestler. It was successfully treated with reduction and the volar plate and collateral bond fixation were applied with absorbable sutures.

  14. Computational Biomechanics of the Wrist Joint

    CERN Document Server

    Nazri Bajuri, Mohd

    2013-01-01

    This book presents an analysis of the stress distribution and contact stresses in severe rheumatoid wrist after total wrist arthroplasty. It assesses and compares the load transfer throughout the joint and contact pressure at the articulations. The data obtained from this study is of importance as this provide greater evidence to the benefits of total wrist arthroplasty in rheumatoid arthritis patients.

  15. Prostaglandins and Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    Mohammad Javad Fattahi

    2012-01-01

    Full Text Available Rheumatoid arthritis (RA is a chronic, autoimmune, and complex inflammatory disease leading to bone and cartilage destruction, whose cause remains obscure. Accumulation of genetic susceptibility, environmental factors, and dysregulated immune responses are necessary for mounting this self-reacting disease. Inflamed joints are infiltrated by a heterogeneous population of cellular and soluble mediators of the immune system, such as T cells, B cells, macrophages, cytokines, and prostaglandins (PGs. Prostaglandins are lipid inflammatory mediators derived from the arachidonic acid by multienzymatic reactions. They both sustain homeostatic mechanisms and mediate pathogenic processes, including the inflammatory reaction. They play both beneficial and harmful roles during inflammation, according to their site of action and the etiology of the inflammatory response. With respect to the role of PGs in inflammation, they can be effective mediators in the pathophysiology of RA. Thus the use of agonists or antagonists of PG receptors may be considered as a new therapeutic protocol in RA. In this paper, we try to elucidate the role of PGs in the immunopathology of RA.

  16. Experimental Research on the Influence of Vibration on Fingers Mobility

    Directory of Open Access Journals (Sweden)

    Radu Panaitescu-Liess

    2013-09-01

    Full Text Available In many industrial activities the human body is exposed to vibrations transmitted through the hand-arm system. A long exposure to these vibrations can cause various health problems of blood vessels, nerves, muscles, bones, joints and upper limb [1]. This paper presents some considerations about the influence of vibration on finger joints mobility. I used a MediTouch system which consists of a motion capture device (an ergonomic glove and a dedicated software.

  17. Radiographically ossified ganglion cyst of finger in a swimmer

    Energy Technology Data Exchange (ETDEWEB)

    Tehranzadeh, J.; Anavim, A. [Department of Radiological Sciences, University of California, Orange (United States); Lin, F. [Department of Pathology, University of California, Irvine Medical Center, Orange (Canada)

    1998-12-01

    Ganglion cysts are fibrous-walled cystic lesions closely associated with joint or tendon sheaths and contain gelatinous mucinous fluid. The radiographic appearance is usually normal. Calcification or ossification in these cysts is extremely unusual. We report on an unusual appearing ganglion cyst of the little finger in a swimmer with ossification resembling myositis ossificans. (orig.) With 3 figs., 8 refs.

  18. Attempts at treating rheumatoid arthritis with radioactive yttrium

    International Nuclear Information System (INIS)

    Scott, J.T.

    1979-01-01

    Two years' observations on 33 knee joints in 33 patients with rheumatoid arthritis did not prove a therapeutic effect of Y 90 , which was tested in a randomized study against non-radioactive yttrium. It was noticable that 9 knee joints of the isotope group but only one of the control group became unstable. Independent of the yttrium treatment, significant improvement was noticed in patients where fibrin clots had been washed out of the joints in the course of arthroscopies. (orig.) [de

  19. Outcome after 40 years with rheumatoid arthritis : a prospective study of function, disease activity and mortality

    NARCIS (Netherlands)

    Minaur, Nicola J.; Jacoby, Richard K.; Cosh, John A.; Taylor, Gordon; Rasker, Johannes J.

    2004-01-01

    In an inception cohort of 100 patients with rheumatoid arthritis (RA) we studied course and outcome after 40 years, regarding function, disease activity, cause and age of death, and prognostic factors. Function, joint count, erythrocyte sedimentation rate (ESR), hemoglobin (Hb), rheumatoid factor

  20. Genetherapy with adenovirus expressing ATF-BPTI hybrid protein inhibits proteolysis by rheumatoid synovial fibroblasts

    NARCIS (Netherlands)

    Laan, W.H. van der; Grimbergen, J.M.; Verheijen, J.H.; Pha, Q.

    1998-01-01

    In rheumatoid arthritis (RA), irreversible joint damage is the result of degradation of articular structures such as cartilage, bone and tendons. The plasminogen activator (PA) system has been shown to be involved in the proteolytic degradation of cartilage matrix by rheumatoid synovial fibroblasts

  1. 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

  2. Timing and extent of finger force enslaving during a dynamic force task cannot be explained by EMG activity patterns.

    Directory of Open Access Journals (Sweden)

    Mojtaba Mirakhorlo

    Full Text Available Finger enslaving is defined as the inability of the fingers to move or to produce force independently. Such finger enslaving has predominantly been investigated for isometric force tasks. The aim of this study was to assess whether the extent of force enslaving is dependent on relative finger movements. Ten right-handed subjects (22-30 years flexed the index finger while counteracting constant resistance forces (4, 6 and 8 N orthogonal to the fingertip. The other, non-instructed fingers were held in extension. EMG activities of the mm. flexor digitorum superficialis (FDS and extensor digitorum (ED in the regions corresponding to the index, middle and ring fingers were measured. Forces exerted by the non-instructed fingers increased substantially (by 0.2 to 1.4 N with flexion of the index finger, increasing the enslaving effect with respect to the static, pre-movement phase. Such changes in force were found 260-370 ms after the initiation of index flexion. The estimated MCP joint angle of the index finger at which forces exerted by the non-instructed fingers started to increase varied between 4° and 6°. In contrast to the finger forces, no significant changes in EMG activity of the FDS regions corresponding to the non-instructed fingers upon index finger flexion were found. This mismatch between forces and EMG of the non-instructed fingers, as well as the delay in force development are in agreement with connective tissue linkages being slack when the positions of the fingers are similar, but pulled taut when one finger moves relative to the others. Although neural factors cannot be excluded, our results suggest that mechanical connections between muscle-tendon structures were (at least partly responsible for the observed increase in force enslaving during index finger flexion.

  3. Task-oriented training with computer gaming in people with rheumatoid arthritisor osteoarthritis of the hand: study protocol of a randomized controlled pilot trial.

    Science.gov (United States)

    Srikesavan, Cynthia Swarnalatha; Shay, Barbara; Robinson, David B; Szturm, Tony

    2013-03-09

    Significant restriction in the ability to participate in home, work and community life results from pain, fatigue, joint damage, stiffness and reduced joint range of motion and muscle strength in people with rheumatoid arthritis or osteoarthritis of the hand. With modest evidence on the therapeutic effectiveness of conventional hand exercises, a task-oriented training program via real life object manipulations has been developed for people with arthritis. An innovative, computer-based gaming platform that allows a broad range of common objects to be seamlessly transformed into therapeutic input devices through instrumentation with a motion-sense mouse has also been designed. Personalized objects are selected to target specific training goals such as graded finger mobility, strength, endurance or fine/gross dexterous functions. The movements and object manipulation tasks that replicate common situations in everyday living will then be used to control and play any computer game, making practice challenging and engaging. The ongoing study is a 6-week, single-center, parallel-group, equally allocated and assessor-blinded pilot randomized controlled trial. Thirty people with rheumatoid arthritis or osteoarthritis affecting the hand will be randomized to receive either conventional hand exercises or the task-oriented training. The purpose is to determine a preliminary estimation of therapeutic effectiveness and feasibility of the task-oriented training program. Performance based and self-reported hand function, and exercise compliance are the study outcomes. Changes in outcomes (pre to post intervention) within each group will be assessed by paired Student t test or Wilcoxon signed-rank test and between groups (control versus experimental) post intervention using unpaired Student t test or Mann-Whitney U test. The study findings will inform decisions on the feasibility, safety and completion rate and will also provide preliminary data on the treatment effects of the task

  4. The results of surgical and nonsurgical treatment of mallet finger

    Directory of Open Access Journals (Sweden)

    Starčević Branislav

    2006-01-01

    Full Text Available Introduction: The injury of the hand tendon classified as mallet finger presents the loss of continuity of the united lateral band of the extensor apparatus above distal interphalangeal joint, which consequently leads to specific deformity of distal interphalangeal joint which is called mallet (hammer finger. Objective Our paper had several research Objectives: presentation of the existing Results of surgical and nonsurgical treatment of mallet finger deformities and comparison of our findings and other authors’ Results. Method: The study was retro-prospective, and analyzed 62 patients treated in the Clinical Center of Serbia in Belgrade (at the Institute of Orthopedic Surgery and Traumatology, and the Emergency Center in the period 1998 to 2003. The follow up of these patients lasted at least 8 months (from 8.3 months to 71.7 months. An average follow up was 28.7 months. The Objective parameters used in the study were as follows: sex, age, dominating hand, hand injury, finger injury, mode of treatment, complications, distal interphalangeal joint flexion and total movement of the distal interphalangeal joint. Collected data were analyzed by χ2-test and Student’s t-test. The confidence interval was p=0.05. Results: A total range of motion was 51.9±6.6 for nonsurgically treated patients, and 48.2±4.2 degrees for operated patients. Mean extension deficit of the distal interphalangeal joint was 6.5±3.3 for nonsurgical and 10.0±3.2 for operated patients. Conclusion: The Results confirmed that nonsurgical mode of treatment of mallet finger deformity was much more successful than surgical Method of treating the same deformity.

  5. Hidradenocarcinoma of the finger.

    Science.gov (United States)

    Nazerali, Rahim S; Tan, Cynthia; Fung, Maxwell A; Chen, Steven L; Wong, Michael S

    2013-04-01

    Hidradenocarcinoma is a rare adnexal neoplasm representing the malignant counterpart of hidradenoma derived from eccrine sweat glands. Misdiagnosis of this disease is common due to the wide variety of histological patterns and rarity of this malignancy. We report an 87-year-old man presenting with a rare case of biopsy-proven hidradenocarcinoma of the finger. There is no standard care of treatment of hidradenocarcinoma, especially of those tumors in rare locations such as the fingers, given its rarity, variable tumor behavior and histology. Although limited treatment strategies exist, detailed data including TNM, location, histologic type and grade, and patient age should be gathered for optimal treatment strategy. The literature supports a 3-fold approach to these malignancies involving margin-free resection, sentinel lymph node biopsy to evaluate possible metastasis, and long-term follow-up given high risk of recurrence. Our treatment strategy involved a 4-fold, multidisciplinary approach involving reconstruction to optimize tumor-free remission and hand function.

  6. Subacromial bursitis with giant rice bodies as initial presentation of rheumatoid arthritis.

    Science.gov (United States)

    Subramaniam, Ramesh; Tan, Justina Wei Lyn; Chau, Cora Yuk Ping; Lee, Keng Thiam

    2012-10-01

    Rice body formation is a nonspecific response to chronic synovial inflammation associated with tuberculous arthritis, rheumatoid arthritis, juvenile rheumatoid arthritis, seronegative inflammatory arthritis, and even osteoarthritis. Such bodies were termed rice bodies because of their close resemblance to grains of polished white rice. We present a case report of a middle-aged woman with right shoulder subacromial/subdeltoid bursitis with giant rice body formation as her initial presentation of rheumatoid arthritis. Her right shoulder symptoms resolved after subacromial and subdeltoid bursectomy and removal of the rice bodies. She subsequently developed inflammatory arthritis of other joints, met the criteria for rheumatoid arthritis, and has been treated medically.

  7. Differences in finger localisation performance of patients with finger agnosia.

    Science.gov (United States)

    Anema, Helen A; Kessels, Roy P C; de Haan, Edward H F; Kappelle, L Jaap; Leijten, Frans S; van Zandvoort, Martine J E; Dijkerman, H Chris

    2008-09-17

    Several neuropsychological studies have suggested parallel processing of somatosensory input when localising a tactile stimulus on one's own by pointing towards it (body schema) and when localising this touched location by pointing to it on a map of a hand (body image). Usually these reports describe patients with impaired detection, but intact sensorimotor localisation. This study examined three patients with a lesion of the angular gyrus with intact somatosensory processing, but with selectively disturbed finger identification (finger agnosia). These patients performed normally when pointing towards the touched finger on their own hand but failed to indicate this finger on a drawing of a hand or to name it. Similar defects in the perception of other body parts were not observed. The findings provide converging evidence for the dissociation between body image and body schema and, more importantly, reveal for the first time that this distinction is also present in higher-order cognitive processes selectively for the fingers.

  8. Postural control in rheumatoid arthritis patients scheduled for total knee arthroplasty

    NARCIS (Netherlands)

    Tjon A Hen, S.S.K.; Bosch, P.V.; Laan, R.F.J.M.; Mulder, T.

    2000-01-01

    Objective: To investigate the use of compensatory visual and attentional control strategies for standing balance in patients with rheumatoid arthritis (RA) with severe knee joint impairment. Design: Experimental 2-group design. Setting: Specialized clinic for orthopedics, rheumatology, and

  9. Receptor protein tyrosine phosphatase alpha enhances rheumatoid synovial fibroblast signaling and promotes arthritis in mice

    NARCIS (Netherlands)

    Stanford, Stephanie M; Svensson, Mattias N D; Sacchetti, Cristiano; Pilo, Caila A; Wu, Dennis J; Kiosses, William B; Hellvard, Annelie; Bergum, Brith; Aleman Muench, German R; Elly, Christian; Liu, Yun-Cai; den Hertog, Jeroen; Elson, Ari; Sap, Jan; Mydel, Piotr; Boyle, David L; Corr, Maripat; Firestein, Gary S; Bottini, Nunzio

    2016-01-01

    OBJECTIVE: During rheumatoid arthritis (RA), fibroblast-like synoviocytes (FLS) critically promote disease pathogenesis by aggressively invading the joint extracellular matrix. The focal adhesion kinase (FAK) signaling pathway is emerging as a contributor to RA FLS anomalous behavior. The receptor

  10. Indium-111 leukocyte imaging in patients with rheumatoid arthritis

    International Nuclear Information System (INIS)

    Uno, K.; Matsui, N.; Nohira, K.

    1986-01-01

    This study evaluates the usefulness of labeled leukocyte imaging in patients with rheumatoid arthritis. In 33 patients, the incidence of pain and swelling in 66 wrist joints and 66 knee joints was compared with the accumulation of [ 111 In]leukocytes. No accumulation of [ 111 In]leukocytes was seen in any of the patients' wrists (0/12) or knee joints (0/14) when both pain and swelling were absent. In contrast, 93% (25/27) of wrist joints and 80% (24/30) of knee joints with both pain and swelling were positive by [ 111 In]leukocyte scintigraphy. There was little correlation between the stage of the disease, as determined by radiography, and [ 111 In]leukocyte accumulation. This study suggests that [ 111 In]leukocyte imaging may be a reliable procedure for monitoring the activity of rheumatoid arthritis, especially for confirming the lack of an ongoing inflammatory response

  11. Magnetic resonance imaging and radiographic findings of seal finger

    International Nuclear Information System (INIS)

    Marjelund, S.; Tikkakoski, T.; Isokangas, M.; Raeisaenen, S.

    2006-01-01

    Purpose: To describe the magnetic resonance imaging (MRI) and radiographic findings of five patients with seal finger. Material and Methods: The MR images and radiographs of five patients with seal finger were retrospectively evaluated. MRI was performed on four patients in the subacute phase, and follow-up imaging was done on one of them at 5 months. One patient had MRI only at a later stage 5 years after onset. Radiographs were taken three times in the subacute phase and once at a later stage. One patient had had seal finger in another finger previously. Results: Short-tau inversion-recovery (STIR) sequence showed extensive subcutaneous soft tissue edema in all four patients in the subacute phase and tenosynovitis of the flexion tendons in two cases. Three patients had edema in 2-3 phalanges, and effusion in the distal interphalangeal (DIP) joint was seen in one case. At the later stage, no signal pathology in soft tissues or bones was seen in STIR images. In the subacute phase, radiographs showed digital soft-tissue swelling in three patients, and one patient had a narrowed DIP joint, periarticular osteoporosis, and a periosteal reaction. At the later stage, flexion contracture of the finger was seen. Conclusion: In addition to soft-tissue infection, seal finger causes bone marrow edema, tenosynovitis, and effusion in the interphalangeal joints visible as increased signal intensity in STIR images. Radiographs reveal periarticular osteoporosis with loss of cartilage in the subacute phase and flexion contracture at the later stage. MRI (STIR) allows more precise delineation of the inflammatory process compared to radiography

  12. Magnetic resonance imaging and radiographic findings of seal finger

    Energy Technology Data Exchange (ETDEWEB)

    Marjelund, S.; Tikkakoski, T.; Isokangas, M.; Raeisaenen, S. [Oulu Univ. Hospital (Finland). Dept. of Radiology

    2006-12-15

    Purpose: To describe the magnetic resonance imaging (MRI) and radiographic findings of five patients with seal finger. Material and Methods: The MR images and radiographs of five patients with seal finger were retrospectively evaluated. MRI was performed on four patients in the subacute phase, and follow-up imaging was done on one of them at 5 months. One patient had MRI only at a later stage 5 years after onset. Radiographs were taken three times in the subacute phase and once at a later stage. One patient had had seal finger in another finger previously. Results: Short-tau inversion-recovery (STIR) sequence showed extensive subcutaneous soft tissue edema in all four patients in the subacute phase and tenosynovitis of the flexion tendons in two cases. Three patients had edema in 2-3 phalanges, and effusion in the distal interphalangeal (DIP) joint was seen in one case. At the later stage, no signal pathology in soft tissues or bones was seen in STIR images. In the subacute phase, radiographs showed digital soft-tissue swelling in three patients, and one patient had a narrowed DIP joint, periarticular osteoporosis, and a periosteal reaction. At the later stage, flexion contracture of the finger was seen. Conclusion: In addition to soft-tissue infection, seal finger causes bone marrow edema, tenosynovitis, and effusion in the interphalangeal joints visible as increased signal intensity in STIR images. Radiographs reveal periarticular osteoporosis with loss of cartilage in the subacute phase and flexion contracture at the later stage. MRI (STIR) allows more precise delineation of the inflammatory process compared to radiography.

  13. Rheumatoid Arthritis: Early diagnosis and treatment outcomes.

    Science.gov (United States)

    Heidari, Behzad

    2011-01-01

    Rheumatoid arthritis (RA) is an inflammatory progressive disease which in the absence of appropriate treatment can lead to joint destruction and disability. Prognosis of RA may be predicted based on the presence of some clinical and laboratory evidences. New criteria for classification of RA provide opportunity for earlier treatment. Initiation of treatment particularly by combination of DMARDs concurrent with short duration of corticosteroid is expected to prevent progressive course and even change the natural course of RA. At present any patients with clinical synovitis in at least one joint may have definite RA, requiring agressive treatment.

  14. Radiation Synovectomy: an effective alternative treatment for inflamed small joints.

    Science.gov (United States)

    Karavida, N; Notopoulos, A

    2010-01-01

    An inflamed painful joint is one of the most common indications for the patient to be referred to a rheumatologist or an orthopedician. In relation to the aetiology, the therapeutic approach might be systemic, local or a combination of them in some cases, always with the thought of balancing risk with benefit for the patient. In all cases, independently of the cause, the goal of therapy is to improve the quality of life through the reduction of pain, improvement of mobility and preservation of function. Nuclear Medicine has to offer Radiosynoviorthesis, an effective alternative procedure for treating inflamed small joints. Various radionuclides are available for radiosynoviorthesis. Their selection depends on the size of the joint to be treated. Small joints are mainly treated with [169Er] erbium under a fluoroscopic or sonographic guidance, usually with a simultaneous instillation of a corticoid. Candidates for radiosynoviorthesis should have been under a six-month systemic treatment without encouraging results or should have undergone at least one unsuccessful intra-articular injection of a long acting glucocorticoid. Since 1973, when [169Er] erbium was firstly suggested as a therapeutic agent for radiosynoviorthesis of the finger joints, there has been quite enough experience in its' application. It has been found to be cost effective in providing long term relief of pain and deformity of the inflamed joints in comparison to other therapeutic approaches. Additionally, there is no radiation risk and can be performed on an out patient basis. Therefore it can stand as an effective alternative procedure for treating early stages of chronic synovitis in RA (rheumatoid arthritis) patients, with minor damage of the cartilage and the adjacent bones, and for synovitis secondary to inflammatory arthropathies.

  15. Primary syphilis of the fingers

    OpenAIRE

    Starzycki, Z

    1983-01-01

    Six patients were seen with primary syphilitic chancres on their fingers between 1965 and 1980. Of these, two had bipolar chancres on their fingers and genitals resulting from sexual foreplay. Because syphilis is rarely suspected in such cases diagnostic errors are common.

  16. Sliding Window-Based Region of Interest Extraction for Finger Vein Images

    Science.gov (United States)

    Yang, Lu; Yang, Gongping; Yin, Yilong; Xiao, Rongyang

    2013-01-01

    Region of Interest (ROI) extraction is a crucial step in an automatic finger vein recognition system. The aim of ROI extraction is to decide which part of the image is suitable for finger vein feature extraction. This paper proposes a finger vein ROI extraction method which is robust to finger displacement and rotation. First, we determine the middle line of the finger, which will be used to correct the image skew. Then, a sliding window is used to detect the phalangeal joints and further to ascertain the height of ROI. Last, for the corrective image with certain height, we will obtain the ROI by using the internal tangents of finger edges as the left and right boundary. The experimental results show that the proposed method can extract ROI more accurately and effectively compared with other methods, and thus improve the performance of finger vein identification system. Besides, to acquire the high quality finger vein image during the capture process, we propose eight criteria for finger vein capture from different aspects and these criteria should be helpful to some extent for finger vein capture. PMID:23507824

  17. 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, ... know. Arthritis Foundation. http://www.arthritis.org/about-arthritis/types/rheumatoid-arthritis/articles/lung-disease-rheumatoid-arthritis.php. Accessed ...

  18. Emotional Communication in Finger Braille

    Directory of Open Access Journals (Sweden)

    Yasuhiro Matsuda

    2010-01-01

    Full Text Available We describe analyses of the features of emotions (neutral, joy, sadness, and anger expressed by Finger Braille interpreters and subsequently examine the effectiveness of emotional expression and emotional communication between people unskilled in Finger Braille. The goal is to develop a Finger Braille system to teach emotional expression and a system to recognize emotion. The results indicate the following features of emotional expression by interpreters. The durations of the code of joy were significantly shorter than the durations of the other emotions, the durations of the code of sadness were significantly longer, and the finger loads of anger were significantly larger. The features of emotional expression by unskilled subjects were very similar to those of the interpreters, and the coincidence ratio of emotional communication was 75.1%. Therefore, it was confirmed that people unskilled in Finger Braille can express and communicate emotions using this communication medium.

  19. Surgery for trigger finger.

    Science.gov (United States)

    Fiorini, Haroldo Junior; Tamaoki, Marcel Jun; Lenza, Mário; Gomes Dos Santos, Joao Baptista; Faloppa, Flávio; Belloti, Joao Carlos

    2018-02-20

    Trigger finger is a common clinical disorder, characterised by pain and catching as the patient flexes and extends digits because of disproportion between the diameter of flexor tendons and the A1 pulley. The treatment approach may include non-surgical or surgical treatments. Currently there is no consensus about the best surgical treatment approach (open, percutaneous or endoscopic approaches). To evaluate the effectiveness and safety of different methods of surgical treatment for trigger finger (open, percutaneous or endoscopic approaches) in adults at any stage of the disease. We searched CENTRAL, MEDLINE, Embase and LILACS up to August 2017. We included randomised or quasi-randomised controlled trials that assessed adults with trigger finger and compared any type of surgical treatment with each other or with any other non-surgical intervention. The major outcomes were the resolution of trigger finger, pain, hand function, participant-reported treatment success or satisfaction, recurrence of triggering, adverse events and neurovascular injury. Two review authors independently selected the trial reports, extracted the data and assessed the risk of bias. Measures of treatment effect for dichotomous outcomes calculated risk ratios (RRs), and mean differences (MDs) or standardised mean differences (SMD) for continuous outcomes, with 95% confidence intervals (CIs). When possible, the data were pooled into meta-analysis using the random-effects model. GRADE was used to assess the quality of evidence for each outcome. Fourteen trials were included, totalling 1260 participants, with 1361 trigger fingers. The age of participants included in the studies ranged from 16 to 88 years; and the majority of participants were women (approximately 70%). The average duration of symptoms ranged from three to 15 months, and the follow-up after the procedure ranged from eight weeks to 23 months.The studies reported nine types of comparisons: open surgery versus steroid injections (two

  20. Indirect costs of rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Filip Raciborski

    2015-12-01

    Full Text Available It is estimated that in Poland about 400,000 persons in general suffer from inflammatory joint diseases, including rheumatoid arthritis (RA. Epidemiological surveys documenting the frequency and disturbance of musculoskeletal disorders in the Polish population are few in number. Most of the estimations are based on epidemiological data from other countries (prevalence of 0.5–1%. According to the data of the National Health Fund in Poland 135,000–157,000 persons in total are treated because of rheumatoid arthritis per year [ICD10 (International Statistical Classification of Diseases and Related Health Problems: M05, M06]. In the case of this group of diseases indirect costs significantly outweigh the direct costs. Indirect costs increase together with activity level of the disease. The cost analysis of productivity loss of RA patients indicates that sickness absenteeism and informal care are the most burdensome. At the national level it amounts in total from 1.2 billion to 2.8 billion PLN per year, depending on the method of analysis. These costs could be significantly reduced through early diagnosis and introduction of effective treatment.

  1. Formation of tough composite joints

    International Nuclear Information System (INIS)

    Brun, M.K.

    1997-05-01

    Joints which exhibit tough fracture behavior were formed in a composite with a Si/SiC matrix reinforced with Textron SCS-6 fibers with either boron nitride or silicon nitride fiber coatings. In composites with BN coatings fibers were aligned uniaxially, while composites with Si 3 N 4 -coated fibers had a 0/90 degree architecture. Lapped joints (joints with overlapping fingers) were necessary to obtain tough behavior. Geometrical requirements necessary to avoid brittle joint failure have been proposed. Joints with a simple overlap geometry (only a few fingers) would have to be very long in order to prevent brittle failure. Typical failure in these joints is caused by a crack propagating along the interfaces between the joint fingers. Joints of the same overall length, but with geometry changed to be symmetric about the joint centerline and with an extra shear surface exhibited tough fractures accompanied with extensive fiber pullout. The initial matrix cracking of these joints was relatively low because cracks propagated easily through the ends of the fingers. Joints with an optimized stepped sawtooth geometry produced composite-like failures with the stress/strain curves containing an elastic region followed by a region of rising stress with an increase of strain. Increasing the fiber/matrix interfacial strength from 9 to 25 MPa, by changing the fiber coating, increased matrix cracking and ultimate strength of the composite significantly. The best joints had matrix cracking stress and ultimate strength of 138 and 240 MPa, respectively. Joint failure was preceded by multiple matrix cracking in the entire composite. The high strength of the joints will permit building of structures containing joints with only a minor reduction of design stresses

  2. [Management of rheumatoid arthritis].

    Science.gov (United States)

    Fiehn, C; Krüger, K

    2016-11-01

    Rheumatoid arthritis is the most common inflammatory rheumatic disease. Due to the destruction of joints in the course of the disease it leads to significant morbidity in affected patients. The quality of life and even life expectancy can be severely impaired. Early diagnosis and early initiation of treatment is a decisive step towards a more benign course of the disease. New classification criteria have been published in order to help in early diagnosis. Methods of imaging, such as ultrasound and magnetic resonance imaging help in the detection of synovitis, which is the major pathomorphological manifestation of arthritis and should be identified without any doubt. Treatment follows the rule of treat to target with the aim of achieving remission or if this is not realistic, at least the lowest possible level of disease activity. The first and perhaps most important step in therapy is the initiation of methotrexate or if contraindications are present, another disease-modifying antirheumatic drug (DMARD) as soon as the diagnosis is made. Initial addition of glucocorticoids is recommended, which should be reduced in dose and terminated as soon as possible. Furthermore, either the combination of different DMARDs or the start of biologic DMARDs, such as tumor necrosis factor alpha (TNF-alpha) inhibitors or second generation biologic DMARDs is possible as a treatment option. The treatment follows the rule of shared decision-making and is the standard to treat comorbidities, the use an interdisciplinary approach and to treat functional deficits by rehabilitation measures, such as physiotherapy.

  3. Design of a Reconfigurable Robotic System for Flexoextension Fitted to Hand Fingers Size

    Directory of Open Access Journals (Sweden)

    J. Felipe Aguilar-Pereyra

    2016-01-01

    Full Text Available Due to the growing demand for assistance in rehabilitation therapies for hand movements, a robotic system is proposed to mobilize the hand fingers in flexion and extension exercises. The robotic system is composed by four, type slider-crank, mechanisms that have the ability to fit the user fingers length from the index to the little finger, through the adjustment of only one link for each mechanism. The trajectory developed by each mechanism corresponds to the natural flexoextension path of each finger. The amplitude of the rotations for metacarpophalangeal joint (MCP and proximal interphalangeal joint (PIP varies from 0 to 90° and the distal interphalangeal joint (DIP varies from 0 to 60°; the joint rotations are coordinated naturally. The four R-RRT mechanisms orientation allows a 15° abduction movement for index, ring, and little fingers. The kinematic analysis of this mechanism was developed in order to assure that the displacement speed and smooth acceleration into the desired range of motion and the simulation results are presented. The reconfiguration of mechanisms covers about 95% of hand sizes of a group of Mexican adult population. Maximum trajectory tracking error is less than 3% in full range of movement and it can be compensated by the additional rotation of finger joints without injury to the user.

  4. Design of a Reconfigurable Robotic System for Flexoextension Fitted to Hand Fingers Size.

    Science.gov (United States)

    Aguilar-Pereyra, J Felipe; Castillo-Castaneda, Eduardo

    2016-01-01

    Due to the growing demand for assistance in rehabilitation therapies for hand movements, a robotic system is proposed to mobilize the hand fingers in flexion and extension exercises. The robotic system is composed by four, type slider-crank, mechanisms that have the ability to fit the user fingers length from the index to the little finger, through the adjustment of only one link for each mechanism. The trajectory developed by each mechanism corresponds to the natural flexoextension path of each finger. The amplitude of the rotations for metacarpophalangeal joint (MCP) and proximal interphalangeal joint (PIP) varies from 0 to 90° and the distal interphalangeal joint (DIP) varies from 0 to 60°; the joint rotations are coordinated naturally. The four R-RRT mechanisms orientation allows a 15° abduction movement for index, ring, and little fingers. The kinematic analysis of this mechanism was developed in order to assure that the displacement speed and smooth acceleration into the desired range of motion and the simulation results are presented. The reconfiguration of mechanisms covers about 95% of hand sizes of a group of Mexican adult population. Maximum trajectory tracking error is less than 3% in full range of movement and it can be compensated by the additional rotation of finger joints without injury to the user.

  5. Covering the Dorsal Finger Defect with Reverse Cross Finger Flap

    Directory of Open Access Journals (Sweden)

    Kaan Gurbuz

    2014-12-01

    Full Text Available Reconstruction of finger extensor zone defects with or without tendon gaps still remains a challenge for surgeons. Although surgical treatments may differ, and range from the use of local, regional, to free flaps, the outcomes for all cases are not satisfactory. In this case report, we present a case of a 3rd finger extensor side crush injury including a defect of Dd (Digit Dorsal 1, Dd2 and Dd3 defects of extensor zones with tendon gap. Tendon gap was reconstructed using m. palmaris longus tendon graft and the defect was covered with reversed cross-finger flap (random pattern with good cosmetic and excellent functional results.

  6. The effects of the Mediterranean diet on rheumatoid arthritis prevention and treatment: a systematic review of human prospective studies.

    Science.gov (United States)

    Forsyth, Casuarina; Kouvari, Matina; D'Cunha, Nathan M; Georgousopoulou, Ekavi N; Panagiotakos, Demosthenes B; Mellor, Duane D; Kellett, Jane; Naumovski, Nenad

    2018-05-01

    Rheumatoid arthritis is a progressive autoimmune disease characterised by severely swollen and painful joints. To compliment pharmacotherapy, people living with rheumatoid arthritis often turn to dietary interventions such as the Mediterranean diet. The aim of the present systematic review is to discuss the effects of the Mediterranean diet on the management and prevention of rheumatoid arthritis in human prospective studies. Four studies met the inclusion criteria, including two intervention studies reporting improvement in the pain visual analogue scale (p Mediterranean diet groups. Only one study reported a reduction in the 28 joint count disease activity score for rheumatoid arthritis for the Mediterranean diet group (p Mediterranean diet in reducing pain and increasing physical function in people living with rheumatoid arthritis. However, there is currently insufficient evidence to support widespread recommendation of the Mediterranean diet for prevention of rheumatoid arthritis.

  7. Radioimmunoassay of IgG and IgM rheumatoid factors reacting with human IgG

    International Nuclear Information System (INIS)

    Carson, D.A.; Lawrance, S.; Catalano, M.A.; Vaughan, J.H.; Abraham, G.

    1977-01-01

    Although IgG rheumatoid factor may play a central role in the pathogenesis of rheumatoid arthritis, previously there have been no precise methods for its specific measurement in serum and synovial fluid. This paper describes a solid phase radioimmunoassay for the independent quantification of IgM and IgG rheumatoid factor reacting with the Fc fragment of human IgG. As measured by this assay, serum IgG rheumatoid factor levels differed significantly between patients with seropositive and seronegative rheumatoid arthritis and normal control subjects. In addition, several sera and joint fluids from patients with seropositive rheumatoid arthritis, even without vasculitis, were shown by gel chromatography to have acid-dissociable complexes of IgG rheumatoid factor suggestive of IgG-IgG dimer or trimer formation

  8. Rheumatoid factor (RF)

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003548.htm Rheumatoid factor (RF) To use the sharing features on this ... M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health ...

  9. Finger Forces in Clarinet Playing

    Directory of Open Access Journals (Sweden)

    Alex Hofmann

    2016-08-01

    Full Text Available Clarinettists close and open multiple tone holes to alter the pitch of the tones. Their fingering technique must be fast, precise, and coordinated with the tongue articulation. In this empirical study, finger force profiles and tongue techniques of clarinet students (N = 17 and professional clarinettists (N = 6 were investigated under controlled performance conditions. First, in an expressive-performance task, eight selected excerpts from the first Weber Concerto were performed. These excerpts were chosen to fit in a 2 x 2 x 2 design (register: low--high; tempo: slow--fast, dynamics: soft--loud. There was an additional condition controlled by the experimenter, which determined the expression levels (low--high of the performers. Second, a technical-exercise task, an isochronous 23-tone melody was designed that required different effectors to produce the sequence (finger-only, tongue-only, combined tongue-finger actions. The melody was performed in three tempo conditions (slow, medium, fast in a synchronization-continuation paradigm. Participants played on a sensor-equipped Viennese clarinet, which tracked finger forces and reed oscillations simultaneously. From the data, average finger force (Fmean and peak force (Fmax were calculated. The overall finger forces were low (Fmean = 1.17 N, Fmax = 3.05 N compared to those on other musical instruments (e.g. guitar. Participants applied the largest finger forces during the high expression level performance conditions (Fmean = 1.21 N.For the technical exercise task, timing and articulation information were extracted from the reed signal. Here, the timing precision of the fingers deteriorated the timing precision of the tongue for combined tongue-finger actions, especially for faster tempi. Although individual finger force profiles were overlapping, the group of professional players applied less finger force overall (Fmean = 0.54 N. Such sensor instruments provide useful insights into player

  10. Selective recruitment of single motor units in human flexor digitorum superficialis muscle during flexion of individual fingers.

    Science.gov (United States)

    Butler, T J; Kilbreath, S L; Gorman, R B; Gandevia, S C

    2005-08-15

    Flexor digitorum superficialis (FDS) is an extrinsic multi-tendoned muscle which flexes the proximal interphalangeal joints of the four fingers. It comprises four digital components, each with a tendon that inserts onto its corresponding finger. To determine the degree to which these digital components can be selectively recruited by volition, we recorded the activity of a single motor unit in one component via an intramuscular electrode while the subject isometrically flexed each of the remaining fingers, one at a time. The finger on which the unit principally acted was defined as the 'test finger' and that which flexed isometrically was the 'active' finger. Activity in 79 units was recorded. Isometric finger flexion forces of 50% maximum voluntary contraction (MVC) activated less than 50% of single units in components of FDS acting on fingers that were not voluntarily flexed. With two exceptions, the median recruitment threshold for all active-test finger combinations involving the index, middle, ring and little finger test units was between 49 and 60% MVC (60% MVC being the value assigned to those not recruited). The exceptions were flexion of the little finger while recording from ring finger units (median: 40% MVC), and vice versa (median: 2% MVC). For all active-test finger combinations, only 35/181 units were activated when the active finger flexed at less than 20% MVC, and the fingers were adjacent for 28 of these. Functionally, to recruit FDS units during grasping and lifting, relatively heavy objects were required, although systematic variation occurred with the width of the object. In conclusion, FDS components can be selectively activated by volition and this may be especially important for grasping at high forces with one or more fingers.

  11. Development and Validation of the OMERACT Rheumatoid Arthritis Magnetic Resonance Tenosynovitis Scoring System in a Multireader Exercise.

    Science.gov (United States)

    Glinatsi, Daniel; Bird, Paul; Gandjbakhch, Frédérique; Haavardsholm, Espen A; Peterfy, Charles G; Vital, Edward M; Emery, Paul; Conaghan, Philip G; Østergaard, Mikkel

    2017-11-01

    To develop and validate a magnetic resonance imaging (MRI) tenosynovitis (TS) score for tendons at the wrist and metacarpophalangeal (MCP) joint levels in patients with rheumatoid arthritis (RA). Axial T1-weighted precontrast and postcontrast fat-saturated MR image sets of the hands of 43 patients with RA initiating rituximab therapy were obtained at baseline and after 14, 26, 38, or 52 weeks. The MR images were scored twice by 4 readers. Nine tendon compartments of the wrist and 4 flexor tendon compartments at the MCP joints were assessed. Tenosynovitis was scored as follows: 0: No; 1: The overall PEA/PCA intrareader and interreader agreements for change scores in all tendons were 73.8%/97.6% and 47.9%/85.0%, respectively. Average SRM was moderate for total scores and 60.5% of the patients had a tenosynovitis change score ≥ SDC. The TS score showed high intrareader and interreader agreement for wrist and finger tendons, with moderate responsiveness, and the majority of the patients showed a change above the SDC. This scoring system may be included as a component of the RAMRIS.

  12. 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)

  13. Total lymphoid irradiation of intractable rheumatoid arthritis

    Energy Technology Data Exchange (ETDEWEB)

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

    1986-12-01

    Eleven patients with intractable rheumatoid arthritis were treated with fractionated total lymphoid irradiation, (total dose 20 Gy). Lasting improvement in clinical symptoms was found in four patients during treatment and the remaining patients experienced similar benefit within 2 months of irradiation. There was marked reduction in exacerbations and number of joints involved. Morning stiffness, joint swelling and tenderness decreased. Complications included severe fatigue during treatment and acute bacterial arthritis in multiple joints in one patient. Four patients have since died, one of renal failure, another of cardiogenic shock following surgery 3 and 24 months after total lymphoid irradiation. Both had generalised amyloidosis. The third patient developed joint empyema and died of toxic cardiac failure. The fourth died 3 months after resection of a Kaposi's sarcoma complicated by wound infection which responded to treatment. Immunologically, total lymphoid irradiation resulted in suppression of the absolute lymphocyte count and reduction in T-helper cells, the number of T-suppressor cells remaining unchanged. These data provide evidence of T-cell involvement in the pathogenesis of rheumatoid arthritis. Total lymphoid irradiation can induce sustained improvement in clinical disease activity, but severe, possibly fatal, side-effects cannot be ignored.

  14. Systemic immune markers characterizing early stages of rheumatoid arthritis

    NARCIS (Netherlands)

    Chalan, Paulina Luiza

    2016-01-01

    Rheumatoid arthritis is a chronic autoimmune disease occurring in ~1% of the world population. The main feature of the disease is ongoing joint inflammation, caused by immune cells and their soluble factors, leading to irreversible bone erosions and cartilage damage. Early treatment can halt

  15. Dynamic exercise therapy in rheumatoid arthritis: a systematic review.

    NARCIS (Netherlands)

    Ende, C.H.M. van den; Vliet Vlieland, T.P.M.; Munneke, M.; Hazes, J.M.W.

    1998-01-01

    The aim of this systematic review was to determine the effectiveness of dynamic exercixe therapy in improving joint mobility, muscle strength, aerobic capacity and daily functioning in patients with rheumatoid arthritis (RA). In addition, possible unwanted effects such as an increase in pain,

  16. Magnetic resonance imaging in rheumatoid arthritis advances and research priorities

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; McQueen, FM; Bird, P

    2005-01-01

    Magnetic resonance imaging (MRI) has now been used extensively in cross-sectional and observational studies as well as in controlled clinical trials to assess disease activity and joint damage in rheumatoid arthritis (RA). MRI measurements or scores for erosions, bone edema, and synovitis have been...

  17. 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

  18. Effects of Oral Administration of Type II Collagen on Rheumatoid Arthritis

    Science.gov (United States)

    Trentham, David E.; Dynesius-Trentham, Roselynn A.; Orav, E. John; Combitchi, Daniel; Lorenzo, Carlos; Sewell, Kathryn Lea; Hafler, David A.; Weiner, Howard L.

    1993-09-01

    Rheumatoid arthritis is an inflammatory synovial disease thought to involve T cells reacting to an antigen within the joint. Type II collagen is the major protein in articular cartilage and is a potential autoantigen in this disease. Oral tolerization to autoantigens suppresses animal models of T cell-mediated autoimmune disease, including two models of rheumatoid arthritis. In this randomized, double-blind trial involving 60 patients with severe, active rheumatoid arthritis, a decrease in the number of swollen joints and tender joints occurred in subjects fed chicken type II collagen for 3 months but not in those that received a placebo. Four patients in the collagen group had complete remission of the disease. No side effects were evident. These data demonstrate clinical efficacy of an oral tolerization approach for rheumatoid arthritis.

  19. Viscous fingering with permeability heterogeneity

    International Nuclear Information System (INIS)

    Tan, C.; Homsy, G.M.

    1992-01-01

    Viscous fingering in miscible displacements in the presence of permeability heterogeneities is studied using two-dimensional simulations. The heterogeneities are modeled as stationary random functions of space with finite correlation scale. Both the variance and scale of the heterogeneities are varied over modest ranges. It is found that the fingered zone grows linearly in time in a fashion analogous to that found in homogeneous media by Tan and Homsy [Phys. Fluids 31, 1330 (1988)], indicating a close coupling between viscous fingering on the one hand and flow through preferentially more permeable paths on the other. The growth rate of the mixing zone increases monotonically with the variance of the heterogeneity, as expected, but shows a maximum as the correlation scale is varied. The latter is explained as a ''resonance'' between the natural scale of fingers in homogeneous media and the correlation scale

  20. 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: ...

  1. Rheumatoid Arthritis Educational Video Series

    Medline Plus

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

  2. Rheumatoid Arthritis Educational Video Series

    Medline Plus

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

  3. Polytopic dystelephalangy of the fingers

    International Nuclear Information System (INIS)

    Sugiura, Y.

    1989-01-01

    An 11-year old girl with dystelephalangy (Kirner deformity) of the right middle, ring, and little, and the left index through little fingers is reported. To the author's best knowledge, such polytopic affection with dystelephalangy has not yet been reported. The parents, one of the siblings and maternal grandfather showed dystelephalangy of the little finger. So, the patient was considered to be a homozygous state of dystelephalangy gene. (orig.)

  4. Integration of tactile input across fingers in a patient with finger agnosia.

    NARCIS (Netherlands)

    Anema, H.A.; Overvliet, K.E.; Smeets, J.B.J.; Brenner, E.; Dijkerman, H.C.

    2011-01-01

    Finger agnosia has been described as an inability to explicitly individuate between the fingers, which is possibly due to fused neural representations of these fingers. Hence, are patients with finger agnosia unable to keep tactile information perceived over several fingers separate? Here, we tested

  5. Rheumatoid Arthritis Educational Video Series

    Medline Plus

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

  6. C5a and C5aR are elevated in joints of rheumatoid and psoriatic arthritis patients, and C5aR blockade attenuates leukocyte migration to synovial fluid

    DEFF Research Database (Denmark)

    Hornum, Lars; Hansen, Anker Jon; Tornehave, Ditte

    2017-01-01

    synovial fluid was significantly inhibited by anti-C5aR. The data support that the C5a-C5aR axis may be driving the infiltration of inflammatory cells into the synovial fluid and synovium in both rheumatoid and psoriatic arthritis, and suggest that C5a or C5aR may be a promising treatment target in both...... a Boyden chamber. Appropriate statistical tests were applied for comparisons. C5aR+ cells were detected in most rheumatoid arthritis, in all psoriatic arthritis, but not in non-inflammatory control synovia. C5aR+ cells were primarily neutrophils and macrophages. C5aR+ macrophages were mainly found...

  7. Thoracic complications of rheumatoid disease

    International Nuclear Information System (INIS)

    Massey, H.; Darby, M.; Edey, A.

    2013-01-01

    Rheumatoid arthritis is a relatively common multisystem disease associated with significant mortality and morbidity. Thoracic disease, both pleural and pulmonary, is a frequent extra-articular manifestation of rheumatoid arthritis and responsible for approximately 20% of rheumatoid-associated mortality. Rheumatoid disease and its associated therapies can affect all compartments of the lung inciting a range of stereotyped pathological responses and it is not infrequent for multiple disease entities to co-exist. In some instances, development of pulmonary complications may precede typical rheumatological presentation of the disease and be the first indication of an underlying connective tissue disease. The spectrum of thoracic disease related to rheumatoid arthritis is reviewed

  8. Bone and Joint Disorders on Tristan da Cunha | Beighton | South ...

    African Journals Online (AJOL)

    The prevalence of rheumatoid arthritis and osteo-arthrosis did not differ to any great extent from that which would be expected to occur in a similar community in Europe. Classical gout was observed in one middle-aged male. Clinodactyly of the fifth finger was transmitted as an autosomal dominant trait in 12 members of the ...

  9. Productive osseous changes about the wrist in rheumatoid arthritis

    International Nuclear Information System (INIS)

    Cantor, R.M.; Braunstein, E.M.

    1987-01-01

    Radiographs of 225 consecutive patients with adult-form rheumatoid arthritis were examined for evidence of productive osseous changes about the wrist. The prevalence of new bone on the ulnar styloid was 10%. This form of new bone is probably due to overlying chronic tenosynovitis. A collar of new bone around the ulnar head is a result of degenerative change in the distal radioulnar joint. In general, productive osseous changes in theumatoid arthritis may represent inflammatory periosteal bone formation, osteophytosis, or contact remodeling. We found no evidence of an association between diffuse idiopathic skeletal hyperostosis and extensive productive osseous changes in patients with rheumatoid arthritis. (orig.)

  10. Productive osseous changes about the wrist in rheumatoid arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Cantor, R.M.; Braunstein, E.M.

    1987-07-01

    Radiographs of 225 consecutive patients with adult-form rheumatoid arthritis were examined for evidence of productive osseous changes about the wrist. The prevalence of new bone on the ulnar styloid was 10%. This form of new bone is probably due to overlying chronic tenosynovitis. A collar of new bone around the ulnar head is a result of degenerative change in the distal radioulnar joint. In general, productive osseous changes in theumatoid arthritis may represent inflammatory periosteal bone formation, osteophytosis, or contact remodeling. We found no evidence of an association between diffuse idiopathic skeletal hyperostosis and extensive productive osseous changes in patients with rheumatoid arthritis.

  11. Rheumatoid arthritis following ciguatera poisoning: A case report.

    Science.gov (United States)

    Ohta, Ryuichi; Shimabukuro, Akira; Kinjo, Mitsuyo

    2017-05-01

    Objective: To report the first case of ciguatera-associated rheumatoid arthritis in Japan. Patient: A 53-year-old man presented to our clinic with morning stiffness and pain in the fingers and wrists. Results: For six months, he had suffered from chronic pain in both hands and shoulders caused by ciguatera poisoning. He was referred to a local general hospital and diagnosed with RA. Conclusion: When synovitis becomes evident in chronic ciguatera poisoning, reevaluation is necessary, including investigation of chronic arthritis, which might be associated with the onset of RA.

  12. Treatment-specific changes in circulating adipocytokines: a comparison between tumour necrosis factor blockade and glucocorticoid treatment for rheumatoid arthritis

    NARCIS (Netherlands)

    Klaasen, R.; Herenius, M. M. J.; Wijbrandts, C. A.; de Jager, W.; van Tuyl, L. H.; Nurmohamed, M. T.; Prakken, B. J.; Gerlag, D. M.; Tak, P. P.

    2012-01-01

    Objective There is increasing evidence that adipocytokines may exert proinflammatory and destructive effects in rheumatoid arthritis (RA). Hence, the authors investigated the relationship between adipocytokines and several features associated with RA (inflammation, joint destruction and

  13. Characteristics of Rheumatoid Arthritis relative to HLA-DR in Saudi Arabia

    International Nuclear Information System (INIS)

    Al-Arfaj, Abdurhman S.

    2001-01-01

    The objective was to determine the clinical characteristics of rheumatoid arthritis in Saudi Arabia in relation to human leukocyte antigen type. A group of 91 rheumatoid arthritis patients, 72 females and 19 males were studied for the various clinical, laboratory and radiological parameters along with human leukocyte antigen-DR phenotypes. Since human leukocyte antigen-DR10 was most commonly associated with rheumatoid arthritis in our population, we compared those patients with human leukocyte antigen-DR10 to those without. The comparison yielded differences in the presence of rheumatoid nodules, erosions, corticosteroid treatment, and joint involvement at presentation, hemoglobin levels, and white cell count. Only the last 3 parameters showed a statistical significance. Human leukocyte antigen type of Saudi patients with rheumatoid arthritis influenced the course of the disease but only to a limited extent. (author)

  14. Rheumatoid arthritis and the challenge of using nanoparticles for its treatment

    Directory of Open Access Journals (Sweden)

    Chabib Lutfi

    2018-01-01

    Full Text Available Rheumatoid arthritis is the most common autoimmune disease that affects the joints. The cause of the disease is unknown, many studies proposed hypothesis about the etiology of rheumatoid arthritis. The clinical manifestations of arthritis are different in each patients. In addition, the development of the medication is still continue to achieve the most effective role with less side effect. Nanoparticles may be the answer to this problem, since they have been widely used to improve the pharmacokinetic and pharmacodynamics of rheumatoid arthritis drugs. Using nanoparticles-tagged folate or PEG to deliver rheumatoid arthritis drugs may increase the specificity of the drugs to the target and consequently, may decrease the side effects of the drugs. The purpose of this review is to summarize the etiology, clinical manifestation and highlighting the use of nanoparticles in rheumatoid arthritis treatment.

  15. Prevalence of self-reported finger deformations and occupational risk factors among professional cooks: a cross-sectional study.

    Science.gov (United States)

    Nagasu, Miwako; Sakai, Kazuhiro; Kogi, Kazutaka; Ito, Akiyoshi; Feskens, Edith J M; Tomita, Shigeru; Temmyo, Yoshiomi; Ueno, Mitsuo; Miyagi, Shigeji

    2011-05-26

    Previous studies have pointed out that the school lunch workers in Japan are suffering from work-related disorders including finger deformations. The purpose of this study was to investigate the prevalence of self-reported finger deformations and the association with job-related risk factors. A cross-sectional questionnaire study of 5,719 subjects (response rate: 81%, 982 men and 4,737 women) was undertaken during September 2003 to February 2004. Finger deformations were found among 11.7% of the men and 35.6% of the women studied, with significant differences among sex, age and sex-age groups. For both men and women the pattern of finger deformations across the hand was similar for the right and the left hand. For women, the deformations were found in about 10% of the distal interphalangeal joints of all fingers. Based on multiple logistic regression analyses, the factors female sex, age, the number of cooked lunches per cook and cooking activities were independently associated with the prevalence of finger deformations. High prevalence odds ratios were found for those frequently carrying or using tools by hands such as delivering containers, distributing meals, preparing dishes, washing equipment, cutting and stirring foods. Among the school lunch workers studied, women had a higher prevalence of finger deformations on all joints of both hands. Various cooking tasks were associated with the prevalence of finger deformations. The results suggest that improvements in working conditions are important for preventing work-related disorders such as finger deformations.

  16. Rheumatoid arthritis: Clinical, SPECT and MRI investigations

    International Nuclear Information System (INIS)

    Ascoli, G.; Cinti, P.; Nonni, M.; Rossi, B.

    2002-01-01

    Aim: To demonstrate psychometric test and neuroimaging technic capacity in subclinical conditions of cerebral affection in patients with rheumatoid arthritis; to demonstrate agreement between topographic cerebral site and morphological signs in neuroimaging study; to evaluate agreement between cognitive deficits and rheumatoid severity. Material and Method: We have enrolled 20 patients, 17 pts. (85%) showed low score evocative for executive function limitation; 6 pts. (33%) showed attention anomaly, movement organization and verbal fluency. SPECT acquisition shows frontal lobe uptake in 95% (19/20 pts.) extended to parietal lobs in 42% (8/19pts.); 1 pt. Shows normal uptake and very high score. RMN study shows a specific sign of leukoencephalopaty in 35% (7/20pts.) and liquoral spaces increased in 25% (5/20 pts.). Conclusions: Frequent cognitive functions alteration during rheumatoid arthritis; very high topographic agreement between cognitive deficits and cerebral perfusion uptake showed by SPECT study; significant correlation between severity index and disease activity and cognitive deterioration; necessity of further longitudinal study for greater number of patient; pathogenetic disconnect mechanism cortical-subcortical by vasculitic reason or deafferentation jointed to negative interaction between motor limit and cognitive deficit

  17. 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)

  18. 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.

  19. Radiographic progression of rheumatoid arthritis related to some clinical and laboratory parameters

    International Nuclear Information System (INIS)

    Carvalho, A. de; Graudal, H.

    1980-01-01

    In 188 patients followed for 3 to 12 years, the radiologic course of rheumatoid arthritis was assessed in 20 joint groups. A severe course in most joints was related to the presence of rheumatoid factor and to high values of the ESR. Granulocyte-specific antinuclear antibodies were related to a severe course in most joints. The presence of nodules, the Rose-Waaler titre and the presence of organ non-specific antinuclear antibodies were generally unrelated to the course of the disease. (Auth.)

  20. Bilateral Distal Femoral Flexion Deformity After Total Knee Arthroplasty in a Patient with Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    Jimmy Chan Chun-Ming

    2013-12-01

    Full Text Available Rheumatoid arthritis is an autoimmune systemic disease with predominant peripheral polyarthritis, often leading to severe joint destruction. This is a case report of an 81-year-old woman with long-standing severe rheumatoid arthritis requiring multiple orthopaedic operations for joint destruction since 2000. These operated joints improved her functional mobility until recently, when she found that her knees were fixed at around 70° of flexion with limited motion. There was chronic progressive flexion deformity of bilateral distal femurs, which was an extremely rare complication of total knee arthroplasty.

  1. Power Doppler sonography and ultrasound contrast agent in assessing rheumatoid synovitis

    Directory of Open Access Journals (Sweden)

    F. Salaffi

    2011-09-01

    Full Text Available Pannus formation is a fundamental event in the pathogenesis of rheumatoid arthritis and its hypervascularisation seems to be crucial to the development of joint damage. High-resolution greyscale ultrasonography is a safe, quick, and inexpensive imaging tool that allows an accurate detection of even minimal morphostructural changes in patients with rheumatoid arthritis, including joint effusion, thickening of synovial membrane and bone erosions. More recently, power Doppler sonography has proved to be a reliable tool for semiquantitative assessment of the vascularity of the synovial tissue. The contrast-enhanced power Doppler sonography seems to be a helpful adjunct in assessing synovitis and the therapeutic response to the different therapies in patients with rheumatoid arthritis. The aim of this radiological vignette was to show a representative example of use of power Doppler sonography with contrast agent in assessing rheumatoid synovitis.

  2. 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 ... Alternative Medicine http://nccam.nih.gov NIHSeniorHealth.gov—Rheumatoid Arthritis ... ...

  3. 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 the ...

  4. Effect of physiotherapy on arm functions of patients with rheumatoid arthritis

    OpenAIRE

    Kruopienė, Joana

    2006-01-01

    Rheumatoid arthritis is the inflammatory disease of web, which causes progressive inflammation of joints. Rheumatoid arthritis is on the top according to the number of patients who become invalids. The growing number of invalids in Lithuania becomes not only medical problem, but social problem as well. Everything is done to quell the activity of pathological process, its progression and to return and maintain the functions of moving device of the body with the help of prophylaxis, therapy and...

  5. EMG finger movement classification based on ANFIS

    Science.gov (United States)

    Caesarendra, W.; Tjahjowidodo, T.; Nico, Y.; Wahyudati, S.; Nurhasanah, L.

    2018-04-01

    An increase number of people suffering from stroke has impact to the rapid development of finger hand exoskeleton to enable an automatic physical therapy. Prior to the development of finger exoskeleton, a research topic yet important i.e. machine learning of finger gestures classification is conducted. This paper presents a study on EMG signal classification of 5 finger gestures as a preliminary study toward the finger exoskeleton design and development in Indonesia. The EMG signals of 5 finger gestures were acquired using Myo EMG sensor. The EMG signal features were extracted and reduced using PCA. The ANFIS based learning is used to classify reduced features of 5 finger gestures. The result shows that the classification of finger gestures is less than the classification of 7 hand gestures.

  6. Involuntary Neuromuscular Coupling between the Thumb and Finger of Stroke Survivors during Dynamic Movement

    Directory of Open Access Journals (Sweden)

    Christopher L. Jones

    2018-03-01

    Full Text Available Finger–thumb coordination is crucial to manual dexterity but remains incompletely understood, particularly following neurological injury such as stroke. While being controlled independently, the index finger and thumb especially must work in concert to perform a variety of tasks requiring lateral or palmar pinch. The impact of stroke on this functionally critical sensorimotor control during dynamic tasks has been largely unexplored. In this study, we explored finger–thumb coupling during close–open pinching motions in stroke survivors with chronic hemiparesis. Two types of perturbations were applied randomly to the index with a novel Cable-Actuated Finger Exoskeleton: a sudden joint acceleration stretching muscle groups of the index finger and a sudden increase in impedance in selected index finger joint(s. Electromyographic signals for specific thumb and index finger muscles, thumb tip trajectory, and index finger joint angles were recorded during each trial. Joint angle perturbations invoked reflex responses in the flexor digitorum superficialis (FDS, first dorsal interossei (FDI, and extensor digitorum communis muscles of the index finger and heteronymous reflex responses in flexor pollicis brevis of the thumb (p < 0.017. Phase of movement played a role as a faster peak reflex response was observed in FDI during opening than during closing (p < 0.002 and direction of perturbations resulted in shorter reflex times for FDS and FDI (p < 0.012 for extension perturbations. Surprisingly, when index finger joint impedance was suddenly increased, thumb tip movement was substantially increased, from 2 to 10 cm (p < 0.001. A greater effect was seen during the opening phase (p < 0.044. Thus, involuntary finger–thumb coupling was present during dynamic movement, with perturbation of the index finger impacting thumb activity. The degree of coupling modulated with the phase of motion. These findings reveal a potential

  7. Folate-targeted nanoparticles for rheumatoid arthritis therapy.

    Science.gov (United States)

    Nogueira, Eugénia; Gomes, Andreia C; Preto, Ana; Cavaco-Paulo, Artur

    2016-05-01

    Rheumatoid arthritis (RA) is the most common inflammatory rheumatic disease, affecting almost 1% of the world population. Although the cause of RA remains unknown, the complex interaction between immune mediators (cytokines and effector cells) is responsible for the joint damage that begins at the synovial membrane. Activated macrophages are critical in the pathogenesis of RA and showed specifically express a receptor for the vitamin folic acid (FA), folate receptor β (FRβ). This particular receptor allows internalization of FA-coupled cargo. In this review we will address the potential of nanoparticles as an effective drug delivery system for therapies that will directly target activated macrophages. Special attention will be given to stealth degree of the nanoparticles as a strategy to avoid clearance by macrophages of the mononuclear phagocytic system (MPS). This review summarizes the application of FA-target nanoparticles as drug delivery systems for RA and proposes prospective future directions. Rheumatoid arthritis is a debilitating autoimmune disease of the joints which affects many people worldwide. Up till now, there is a lack of optimal therapy against this disease. In this review article, the authors outlined in depth the current mechanism of disease for rheumatoid arthritis and described the latest research in using folic acid-targeted nanoparticles to target synovial macrophages in the fight against rheumatoid arthritis. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Rheumatoid Arthritis Educational Video Series

    Medline Plus

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

  9. [When doors slam, fingers jam!].

    Science.gov (United States)

    Claudet, I; Toubal, K; Carnet, C; Rekhroukh, H; Zelmat, B; Debuisson, C; Cahuzac, J-P

    2007-08-01

    Epidemiological analysis in a universitary paediatric emergency unit of children admitted after accidental injuries resulting from fingers crushed in a door. Prospective, descriptive cohort study from September 6th, 2004 to July 1st, 2005 included all children admitted for finger injuries crushed in a non-automatic door. included accidents due to automatic doors, toy's or refrigerator doors, families who refused to participate to the study or families who had left the waiting area before medical examination. Collected data were patient and family characteristics, accident characteristics and its management. Three hundred and forty children affected by 427 digital lesions were included. The mean age was 5.5+/-3.8 years (range 4 months - 15.5 years). Male/female ratio was equal to 1.2: 1. Fifty-eight percent of patients belonged to families composed of 3 or more siblings. Ninety-three per cent of families came to hospital within the first 2 hours after the accident (mean delay 99+/-162 min, median range 54 minutes). Location of the accident was: domestic (62%, at home (64%)), at school (17%). Locations within the home were: the bedroom (33%), bathroom and toilets (21%). An adult was present in 75% of cases and responsible for the trauma in 25% of accidents, another child in 44%. The finger or fingers were trapped on the hinge side in 57% of patients. No specific safeguard devices were used by 94% of families. Among victims, 20% had several crushed digits; left and right hand were injured with an equal frequency. The commonest involved digits were: the middle finger (29%), the ring finger (23%). The nail plate was damaged in 60% of digital lesions, associated with a wound (50%), a distal phalanx fracture (P3) (12%). Six children had a partial or complete amputation of P3, 2 children a lesion of the extensor tendon, 1 child had a rupture of the external lateral ligament. Three percent of children required an admission to the paediatric orthopaedic surgery unit. Post

  10. [10 congenital trigger fingers. Apropos of a case report].

    Science.gov (United States)

    Moutet, F; Lebrun, C; Sartorius, C

    1987-01-01

    Ten congenital triggers fingers have been treated on a 3 years old girl after correction of congenital bilateral club feet. Such a case, without any other congenital malformation seems to be unique in the French literature and only found twice in the English one. This child in spite of a normal growth and good psychomotor development, presents an unusual face, with a mouth a little bit too small, but her karyotype is normal. No trismus and no microstomia were found to enable this case to be classified in a specific syndrome. The right diagnosis may be a non evolutive arthrogryposis of the extremities. Dividing the ten proximal pulleys (A1) let 10 voluminous nodules pass through and allowed full range of motion in nine out of ten fingers. A remaining flexion deformity of the proximal interphalangeal joint needed an anterior arthrolysis, the final result was good.

  11. Hemophilic osteoarthropathy with special attention to the elbow joint

    International Nuclear Information System (INIS)

    Erlemann, R.; Adolph, J.; Peters, P.E.; Pollmann, H.

    1990-01-01

    Hemophilia is a rare disorder, whereas recurrent bleedings in the joint can result in osteoarthropathy. Radiological changes consist of osteoporosis, enlargement of the epiphyses, irregularity of the subchondral bone surface, narrowing of the joint space, cysts, erosions, joint incongruence and joint deformity. The earlier and the more frequently bleedings have occurred which have not been treated adequately, the more of the changes mentioned above are present. In children, osteoarthropathy of the elbow is present in only about 50% of cases, and in the remaining cases the degree is mostly minimal or moderate. Differential diagnosis consists of juvenile rheumatoid arthritis in children, and rheumatoid arthritis and osteoarthritis in adults. (orig.) [de

  12. Comparison of seronegative and seropositive rheumatoid arthritis with regard to some clinical characteristics.

    Science.gov (United States)

    Sahatçiu-Meka, Vjollca; Izairi, Remzi; Rexhepi, Sylejman; Manxhuka-Kerliu, Suzana

    2009-01-01

    The aim of this study is to establish a scientific comparative analysis between seronegative and seropositive rheumatoid arthritis (RA), with regard to some clinical characteristics. The studied group consisted of RA seronegative patients with titters lower then 1:64 defined by Rose-Waaler test, while the control group consisted of RA seropositive patients with titters of 1:64 or higher. Examinees all belonged to the 2nd and 3rd functional classes according to ARA criteria, were between 25-60 years of age (Xb = 49.96), with disease duration between 1-27 years (Xbox = 6.41). In the disease onset most frequently affected joints were metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joint of the hands, almost equally represented with regard to sero-status and sex. During the examination seropositive patients showed a higher presence of inflamation of peripheral joints of hand and foot, but only the presence of PIP of the hands was statistically significant (chi2 = 15.63, p < 0.01). Knees, talocrural joints and elbows were more frequently affected in seropositive patients, whereas humeroscapular, coxofemoral and sacroiliacal joints were more frequently affected in seronegative patients, but without significant statistical difference with regard to sero-status. The presence of affected PIP of the hands (chi2 = 9.96, p < 0.01) and knees (chi2 = 4.17, p < 0.05) with regard to sex was statistically significant in seropositive female patients, as well as the presence of atacked PIP of the hands (chi2 = 6.08, p < 0.05), and cervical vertebrae (chi2 = 6.00, p < 0.05) in seropositive male patients. There were some differences between groups with regard to sex in metatarsophalangealjoints (MTP), PIP of the foot, and other joints, but without any statistical significance. In both subsets statistically significant domination was found in affected second (chi2 = 20.85, p < 0.01) and third (chi2 = 15.70, p < 0.01) fingers of the PIP level of hands and third finger (chi2

  13. Tracheobronchomegaly and rheumatoid arthritis

    International Nuclear Information System (INIS)

    Rua Marin, Catalina; Diaz Betancur, James Samir; Cardona, Alejandro; Ramirez Gomez, Luis Alberto

    2008-01-01

    Tracheobronchomegaly is a rare condition of unknown etiology that has been described in association with connective tissue diseases. We present a case of tracheomegaly in a patient with a long evolution rheumatoid arthritis. This is the second case reported in the medical literature until now. Association between these pathologies is uncertain and we can not establish a clear pathophysiological link due to the rarity of its occurrence and the late onset of symptoms

  14. Factors associated with sustained remission in patients with rheumatoid arthritis.

    Science.gov (United States)

    Martire, María Victoria; Marino Claverie, Lucila; Duarte, Vanesa; Secco, Anastasia; Mammani, Marta

    2015-01-01

    To find out the factors that are associated with sustained remission measured by DAS28 and boolean ACR EULAR 2011 criteria at the time of diagnosis of rheumatoid arthritis. Medical records of patients with rheumatoid arthritis in sustained remission according to DAS28 were reviewed. They were compared with patients who did not achieved values of DAS28<2.6 in any visit during the first 3 years after diagnosis. We also evaluated if patients achieved the boolean ACR/EULAR criteria. Variables analyzed: sex, age, smoking, comorbidities, rheumatoid factor, anti-CCP, ESR, CRP, erosions, HAQ, DAS28, extra-articular manifestations, time to initiation of treatment, involvement of large joints, number of tender joints, number of swollen joints, pharmacological treatment. Forty five patients that achieved sustained remission were compared with 44 controls. The variables present at diagnosis that significantly were associated with remission by DAS28 were: lower values of DAS28, HAQ, ESR, NTJ, NSJ, negative CRP, absence of erosions, male sex and absence of involvement of large joints. Only 24.71% achieved the boolean criteria. The variables associated with sustained remission by these criteria were: lower values of DAS28, HAQ, ESR, number of tender joints and number of swollen joints, negative CRP and absence of erosions. The factors associated with sustained remission were the lower baseline disease activity, the low degree of functional disability and lower joint involvement. We consider it important to recognize these factors to optimize treatment. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  15. Impact of Finger Type in Fingerprint Authentication

    Science.gov (United States)

    Gafurov, Davrondzhon; Bours, Patrick; Yang, Bian; Busch, Christoph

    Nowadays fingerprint verification system is the most widespread and accepted biometric technology that explores various features of the human fingers for this purpose. In general, every normal person has 10 fingers with different size. Although it is claimed that recognition performance with little fingers can be less accurate compared to other finger types, to our best knowledge, this has not been investigated yet. This paper presents our study on the topic of influence of the finger type into fingerprint recognition performance. For analysis we employ two fingerprint verification software packages (one public and one commercial). We conduct test on GUC100 multi sensor fingerprint database which contains fingerprint images of all 10 fingers from 100 subjects. Our analysis indeed confirms that performance with small fingers is less accurate than performance with the others fingers of the hand. It also appears that best performance is being obtained with thumb or index fingers. For example, performance deterioration from the best finger (i.e. index or thumb) to the worst fingers (i.e. small ones) can be in the range of 184%-1352%.

  16. Optimization for Guitar Fingering on Single Notes

    Science.gov (United States)

    Itoh, Masaru; Hayashida, Takumi

    This paper presents an optimization method for guitar fingering. The fingering is to determine a unique combination of string, fret and finger corresponding to the note. The method aims to generate the best fingering pattern for guitar robots rather than beginners. Furthermore, it can be applied to any musical score on single notes. A fingering action can be decomposed into three motions, that is, a motion of press string, release string and move fretting hand. The cost for moving the hand is estimated on the basis of Manhattan distance which is the sum of distances along fret and string directions. The objective is to minimize the total fingering costs, subject to fret, string and finger constraints. As a sequence of notes on the score forms a line on time series, the optimization for guitar fingering can be resolved into a multistage decision problem. Dynamic programming is exceedingly effective to solve such a problem. A level concept is introduced into rendering states so as to make multiple DP solutions lead a unique one among the DP backward processes. For example, if two fingerings have the same value of cost at different states on a stage, then the low position would be taken precedence over the high position, and the index finger would be over the middle finger.

  17. The joint in psoriatic arthritis.

    Science.gov (United States)

    Mortezavi, Mahta; Thiele, Ralph; Ritchlin, Christopher

    2015-01-01

    Psoriatic arthritis (PsA), a chronic inflammatory joint disease associated with psoriasis, is notable for diversity in disease presentation, course and response to treatment. Equally varied are the types of musculoskeletal involvement which include peripheral and axial joint disease, dactylitis and enthesitis. In this review, we focus on the psoriatic joint and discuss pathways that underlie synovial, cartilage and bone inflammation and highlight key histopathologic features. The pivotal inflammatory mechanisms and pathobiology of PsA parallel findings in other forms of spondyloarthritis but are distinct from disease pathways described in rheumatoid synovitis and bone disease. The diagnosis of PsA from both a clinical and imaging perspective is also discussed.

  18. The clinical significance of Epitrochlear lymphadenopathy on elbow radiographs in rheumatoid arthritis

    International Nuclear Information System (INIS)

    Kwon, Bae Ju; Joo, Kyung Bin; Lee, Hak Soo; Song, Ho Taek; Park, Dong Woo; Lee, Seung Ro; Hahm, Chang Kok

    2000-01-01

    To evaluate the radiographic findings of epitrochlear lymphadenopathy with regard to the distribution and severity of the disease and clinal parameters in patients with rheumatoid arthritis. Forty six patients with rheumatoid arthritis in whom epitrochlear oval-shaped densities were seen on radiographs were involved in this study. There were 14 cases of unilateral epitrochlear lymphadenopathy in which bilateral arthritic evidence was revealed by radiographs (mixed group), and 32 of bilateral lymphadenopathy in which there was arthritic evidence (positive group). Twenty-three patients in whom lymphadenopathy was not seen on radiographs of the elbow and who were diagnosed as suffering from rheumatoid arthritis functioned as controls (negative group).For scoring the degree of arthritis using the simplified scoring method proposed by Kaye et al., joints were divided into six groups, as follows: Joint 1, elbow; Joint 2, wrist; Joint 3, radial (1st and 2nd) PIP and MCP; Joint 4, ulnar (3rd, 4th, 5th) PIP and MCP; Joint 5, Joints 1 + 2+ 3 + 4; Joint 6, Joints 1 + 4. For each joint, scores were compared with those on the contralateral side in the mixed group. Differences in clinical parameters ( disease duration, rheumatoid factor, ESR, and CRP), and scores for each joint in each arm were statistically compared between be positive and negative group. The number, mean diameter, and maximal diameter of epitrochlear lymph nodes were calculated and correlated with clinical parameters and scores for each joint. To evaluate the incidence of epitrochlear lymphadenopathy without radiographic evidence of arthritis in 46 patients (78 arms) with lymphadenopathy, the frequency of cases in which the score for the joint was zero was assessed. In the mixed group, the mean score for Joint 6 of the arm with epitrochlear lymphadenopathy was significantly higher than that for the contralateral side in the mixed group (p=3D0.022). Only CRP was significantly higher in the positive group than

  19. [Treatment of rheumatoid arthritis in 2005: prompt, agressive and customized].

    Science.gov (United States)

    Guerne, P-A; Stingelin-Guerne, S

    2005-03-09

    Treatment of rheumatoid arthritis in 2005: prompt, aggressive and customized Rheumatoid arthritis can be extremely serious (joint destruction, functional loss, decrease in life expectancy). Fortunately, our therapeutic means have recently progressed enormously (better appreciation of efficacy and ways to use DMARDs combinations and new molecules such as leflunomide and anti-TNFs, understanding of the importance of early adequate and intensive treatments when necessary). Huge progresses have also been performed with regards to evaluation and follow-up strategies (disease activity score--DAS, health assessment questionnaire--HAQ), which allows us to adapt the treatment much better. The goal now can and must be quick and total remission of the disease in all patients thus avoiding as much as possible irreversible joint damages with accompanying morbidities.

  20. Cortex Inspired Model for Inverse Kinematics Computation for a Humanoid Robotic Finger

    Science.gov (United States)

    Gentili, Rodolphe J.; Oh, Hyuk; Molina, Javier; Reggia, James A.; Contreras-Vidal, José L.

    2013-01-01

    In order to approach human hand performance levels, artificial anthropomorphic hands/fingers have increasingly incorporated human biomechanical features. However, the performance of finger reaching movements to visual targets involving the complex kinematics of multi-jointed, anthropomorphic actuators is a difficult problem. This is because the relationship between sensory and motor coordinates is highly nonlinear, and also often includes mechanical coupling of the two last joints. Recently, we developed a cortical model that learns the inverse kinematics of a simulated anthropomorphic finger. Here, we expand this previous work by assessing if this cortical model is able to learn the inverse kinematics for an actual anthropomorphic humanoid finger having its two last joints coupled and controlled by pneumatic muscles. The findings revealed that single 3D reaching movements, as well as more complex patterns of motion of the humanoid finger, were accurately and robustly performed by this cortical model while producing kinematics comparable to those of humans. This work contributes to the development of a bioinspired controller providing adaptive, robust and flexible control of dexterous robotic and prosthetic hands. PMID:23366569

  1. Integration of tactile input across fingers in a patient with finger agnosia.

    Science.gov (United States)

    Anema, Helen A; Overvliet, Krista E; Smeets, Jeroen B J; Brenner, Eli; Dijkerman, H Chris

    2011-01-01

    Finger agnosia has been described as an inability to explicitly individuate between the fingers, which is possibly due to fused neural representations of these fingers. Hence, are patients with finger agnosia unable to keep tactile information perceived over several fingers separate? Here, we tested a finger agnosic patient (GO) on two tasks that measured the ability to keep tactile information simultaneously perceived by individual fingers separate. In experiment 1 GO performed a haptic search task, in which a target (the absence of a protruded line) needed to be identified among distracters (protruded lines). The lines were presented simultaneously to the fingertips of both hands. Similarly to the controls, her reaction time decreased when her fingers were aligned as compared to when her fingers were stretched and in an unaligned position. This suggests that she can keep tactile input from different fingers separate. In experiment two, GO was required to judge the position of a target tactile stimulus to the index finger, relatively to a reference tactile stimulus to the middle finger, both in fingers uncrossed and crossed position. GO was able to indicate the relative position of the target stimulus as well as healthy controls, which indicates that she was able to keep tactile information perceived by two neighbouring fingers separate. Interestingly, GO performed better as compared to the healthy controls in the finger crossed condition. Together, these results suggest the GO is able to implicitly distinguish between tactile information perceived by multiple fingers. We therefore conclude that finger agnosia is not caused by minor disruptions of low-level somatosensory processing. These findings further underpin the idea of a selective impaired higher order body representation restricted to the fingers as underlying cause of finger agnosia. Copyright © 2010 Elsevier Ltd. All rights reserved.

  2. Short- and long-term efficacy of intra-articular injections with betamethasone as part of a treat-to-target strategy in early rheumatoid arthritis

    DEFF Research Database (Denmark)

    Hetland, Merete Lund; Østergaard, Mikkel; Ejbjerg, Bo

    2012-01-01

    To investigate the short-term and long-term efficacy of intra-articular betamethasone injections, and the impact of joint area, repeated injections, MRI pathology, anticyclic citrullinated peptide (CCP) and immunoglobulin M rheumatoid factor (IgM-RF) status in patients with early rheumatoid arthr...

  3. Efficacy of Fish Oil in Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    B. Heidari

    1998-04-01

    Full Text Available Ingestion of fish oil fatty acids (omega - 3 fatty acids inhibits the formation of arachidonic acid - derived cytokines and leads to production of compounds with diminished biological activity. Beneficial effects of dietary supplementation with fish oil in rheumatoid arthritis have been shown in many controlled trials."nMethods : 43 patients with active rheumatoid arthritis entered in a prospective, double-blind, placebo-controlled clinical trial to recieve either lOgr fish oil daily (treatment group or corn oil (placebo group. Baseline drugs and usual diet were continued without any changes. Disease variables were evaluated at baseline and after completion of study period."nThe changes in disease variables were compared by paired t-tesl in each group. Comparison of the two groups was done by t-test. Functional capacity was compared by Wilcoxon ranks test."nResults : 19 patients in treatment group and 20 patients in placebo group completed the study which lasted eight weeks . In the treatment group, joint pain index decreased from 30±11 at baseline, to 18±11 at the end of study period (P < 0.01. Joint swelling index decreased from 8 ± 4 to 2 ± 4, (P< 0.01, morning stiffness from 87 ± 41 to 24±16 minutes (P < 0.01. In the placebo group the above variable changes were from 19±14 to 25±14 ; 8±8 to 7±6 and 80±71 to 76±75 minutes respectively, which were not significant . The differences between the treatment and placebo groups were significant in joint swelling index (P < 0.05, morning stiffness (P<0.01 and functioal capacity (p< 0.005, the differences in joint pain index and grip strenght did not quite achieve statstical significance. During study period there were no adverese effects with fish oil consumption."nConclusion : Fish oil supplemention has anti-inflamatory effects in rheumatoid arthritis. Further studies are needed to recommend its long - term usage concomittant with other drugs in all patients

  4. The visualization of pannus in rheumatoid arthritis using NMR imaging. Pannusdarstellung bei rheumatoider Arthritis mittels Kernspintomographie

    Energy Technology Data Exchange (ETDEWEB)

    Schnarkowski, P. (Abt. fuer Roentgendiagnostik, Klinikum der Univ. Ulm (Germany)); Bader, C. (Abt. fuer Roentgendiagnostik, Klinikum der Univ. Ulm (Germany)); Goldmann, A. (Abt. fuer Roentgendiagnostik, Klinikum der Univ. Ulm (Germany)); Friedrich, J.M. (Abt. fuer Roentgendiagnostik, Klinikum der Univ. Ulm (Germany))

    1992-12-01

    The knee joints of 15 patients afflicted with rheumatoid arthritis were investigated using the method of nmr imaging. Parameters of investigation were the spin-echo and fast-field-echo sequences as well as the MR signal behaviour of proliferative synovial changes following intravenous administration of gadolinium dtpa. Pannus having formed on the articular surfaces or beneath the articular cartilages was distinguishable from other changes on the basis of the increased signal intensities to be observed after gadolinium dtpa had been given. (orig./GD)

  5. Viscous Fingering in Deformable Systems

    Science.gov (United States)

    Guan, Jian Hui; MacMinn, Chris

    2017-11-01

    Viscous fingering is a classical hydrodynamic instability that occurs when an invading fluid is injected into a porous medium or a Hele-Shaw cell that contains a more viscous defending fluid. Recent work has shown that viscous fingering in a Hele-Shaw cell is supressed when the flow cell is deformable. However, the mechanism of suppression relies on a net volumetric expansion of the flow area. Here, we study flow in a novel Hele-Shaw cell consisting of a rigid bottom plate and a flexible top plate that deforms in a way that is volume-conserving. In other words, fluid injection into the flow cell leads to a local expansion of the flow area (outward displacement of the flexible surface) that must be coupled to non-local contraction (inward displacement of the flexible surface). We explore the impact of this volumetric confinement on steady viscous flow and on viscous fingering. We would like to thank EPSRC for the funding for this work.

  6. Rheumatoid Arthritis-Associated Interstitial Lung Disease and Idiopathic Pulmonary Fibrosis: Shared Mechanistic and Phenotypic Traits Suggest Overlapping Disease Mechanisms.

    Science.gov (United States)

    Paulin, Francisco; Doyle, Tracy J; Fletcher, Elaine A; Ascherman, Dana P; Rosas, Ivan O

    2015-01-01

    The prevalence of clinically evident interstitial lung disease in patients with rheumatoid arthritis is approximately 10%. An additional 33% of undiagnosed patients have interstitial lung abnormalities that can be detected with high-resolution computed tomography. Rheumatoid arthritis-interstitial lung disease patients have three times the risk of death compared to those with rheumatoid arthritis occurring in the absence of interstitial lung disease, and the mortality related to interstitial lung disease is rising. Rheumatoid arthritis-interstitial lung disease is most commonly classified as the usual interstitial pneumonia pattern, overlapping mechanistically and phenotypically with idiopathic pulmonary fibrosis, but can occur in a non-usual interstitial pneumonia pattern, mainly nonspecific interstitial pneumonia. Based on this, we propose two possible pathways to explain the coexistence of rheumatoid arthritis and interstitial lung disease: (i) Rheumatoid arthritis-interstitial lung disease with a non-usual interstitial pneumonia pattern may come about when an immune response against citrullinated peptides taking place in another site (e.g. the joints) subsequently affects the lungs; (ii) Rheumatoid arthritis-interstitial lung disease with a usual interstitial pneumonia pattern may represent a disease process in which idiopathic pulmonary fibrosis-like pathology triggers an immune response against citrullinated proteins that promotes articular disease indicative of rheumatoid arthritis. More studies focused on elucidating the basic mechanisms leading to different sub-phenotypes of rheumatoid arthritis-interstitial lung disease and the overlap with idiopathic pulmonary fibrosis are necessary to improve our understanding of the disease process and to define new therapeutic targets.

  7. Tissue factor expression in rheumatoid synovium: a potential role in pannus invasion of rheumatoid arthritis.

    Science.gov (United States)

    Chen, Lujun; Lu, Yahua; Chu, Yang; Xie, Jun; Ding, Wen'ge; Wang, Fengming

    2013-09-01

    Angiogenesis, as well as pannus formation within the joint, plays an important role in the erosion of articular cartilage and bone in the pathological process of rheumatoid arthritis (RA). Tissue factor (TF), an essential initiator of the extrinsic pathway of blood coagulation, is also involved in the angiogenesis and the pannus formation of RA progression. In the present study, we used immunofluorescence and confocal scanning methods to characterize TF immunolocalization in RA synovium. We showed that positive staining of TF could be immunolocalized in synoviocytes, CD19(+) B cells and CD68(+) macrophages, whereas weak or negative staining of tissue factor could be found in CD34(+) endothelial cells of neo-vessels, CD3(+) T cells and CD14(+) monocytes in RA synovium tissues. Our study demonstrates a detailed local expression of TF in the rheumatoid synovium, and supports the notion that TF, expressed not only by the synoviocytes themselves, but also the infiltrating CD19(+) B cells and CD68(+) macrophages, is involved in the pannus invasion in the progression of rheumatoid arthritis. Copyright © 2013 Elsevier GmbH. All rights reserved.

  8. Treatment of rheumatoid arthritis with 90yttrium. Follow up studies

    International Nuclear Information System (INIS)

    Teuber, J.; Baenkler, H.W.; Regler, G.; Erlangen-Nuernberg Univ., Erlangen

    1978-01-01

    90 Yttrium-silicate was injected into 131 knee-joints from patients with rheumatoid arthritis with stadium II-IV according to Steinbrocker. The observation period lasted until two years. After three months about 80% and after 24 months still more than 50% of the patients treated showed complete or partial remission. Side-effects as formerly observed with 198 -goldpreparations did not occur. Therefore the treatment with 90 Yttrium-silicate offers an alternative to surgical synovectomy. (orig.) [de

  9. 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: ...

  10. Crescentic glomerular nephritis associated with rheumatoid arthritis: a case report.

    Science.gov (United States)

    Balendran, K; Senarathne, L D S U; Lanerolle, R D

    2017-07-21

    Rheumatoid arthritis is a systemic disorder where clinically significant renal involvement is relatively common. However, crescentic glomerular nephritis is a rarely described entity among the rheumatoid nephropathies. We report a case of a patient with rheumatoid arthritis presenting with antineutrophil cytoplasmic antibody-negative crescentic glomerular nephritis. A 54-year-old Sri Lankan woman who had recently been diagnosed with rheumatoid arthritis was being treated with methotrexate 10 mg weekly and infrequent nonsteroidal anti-inflammatory drugs. She presented to our hospital with worsening generalized body swelling and oliguria of 1 month's duration. Her physical examination revealed that she had bilateral pitting leg edema and periorbital edema. She was not pale or icteric. She had evidence of mild synovitis of the small joints of the hand bilaterally with no deformities. No evidence of systemic vasculitis was seen. Her blood pressure was 170/100 mmHg, and her jugular venous pressure was elevated to 7 cm with an undisplaced cardiac apex. Her urine full report revealed 2+ proteinuria with active sediment (dysmorphic red blood cells [17%] and granular casts). Her 24-hour urinary protein excretion was 2 g. Her serum creatinine level was 388 μmol/L. Abdominal ultrasound revealed normal-sized kidneys with acute parenchymal changes and mild ascites. Her renal biopsy showed renal parenchyma containing 20 glomeruli showing diffuse proliferative glomerular nephritis, with 14 of 20 glomeruli showing cellular crescents, and the result of Congo red staining was negative. Her rheumatoid factor was positive with a high titer (120 IU/ml), but results for antinuclear antibody, double-stranded deoxyribonucleic acid, and antineutrophil cytoplasmic antibody (perinuclear and cytoplasmic) were negative. Antistreptolysin O titer rheumatoid arthritis, awareness of which would facilitate early appropriate investigations and treatment.

  11. Current status of ultrasonography of the finger

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Seun Ah; Kim, Baek Hyun [Dept. of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan (Korea, Republic of); Kim, Seon Jeong [Dept. of Radiology, Myongji Hospital, Seonam University College of Medicine, Goyang (Korea, Republic of); Kim, Ji Na [Dept. of Radiology, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon (Korea, Republic of); Park, Sun Young [Dept. of Radiology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang (Korea, Republic of); Choi, Kyung Hee [Incheon Baek Hospital, Incheon (Korea, Republic of)

    2016-03-15

    The recent development of advanced high-resolution transducers has enabled the fast, easy, and dynamic ultrasonographic evaluation of small, superficial structures such as the finger. In order to best exploit these advances, it is important to understand the normal anatomy and the basic pathologies of the finger, as exemplified by the following conditions involving the dorsal, volar, and lateral sections of the finger: sagittal band injuries, mallet finger, and Boutonnière deformity (dorsal aspect); flexor tendon tears, trigger finger, and volar plate injuries (volar aspect); gamekeeper’s thumb (Stener lesions) and other collateral ligament tears (lateral aspect); and other lesions. This review provides a basis for understanding the ultrasonography of the finger and will therefore be useful for radiologists.

  12. Current status of ultrasonography of the finger

    Directory of Open Access Journals (Sweden)

    Seun Ah Lee

    2016-04-01

    Full Text Available The recent development of advanced high-resolution transducers has enabled the fast, easy, and dynamic ultrasonographic evaluation of small, superficial structures such as the finger. In order to best exploit these advances, it is important to understand the normal anatomy and the basic pathologies of the finger, as exemplified by the following conditions involving the dorsal, volar, and lateral sections of the finger: sagittal band injuries, mallet finger, and Boutonnière deformity (dorsal aspect; flexor tendon tears, trigger finger, and volar plate injuries (volar aspect; gamekeeper’s thumb (Stener lesions and other collateral ligament tears (lateral aspect; and other lesions. This review provides a basis for understanding the ultrasonography of the finger and will therefore be useful for radiologists.

  13. Scintigraphy with 99mTc labelled polyclonal human IgG in rheumatoid arthritis patients

    International Nuclear Information System (INIS)

    Stanchev, V.; Batalov, A.; Atanasov, A.

    1999-01-01

    The study design to assess the diagnostic relevance of scintigraphy with 99m Tc labelled polyclonal human IgG (HIG) for detecting active synovitis in rheumatoid arthritis patients. Fifteen patients presenting rheumatoid arthritis and 3 healthy volunteers are studied on digital camera (Diacam, Siemens). Following iv injection of 500 MBq 99m Tc - HIG, a 3- phase scintigraphy of the knee joints is performed and 4 hours later multiple planar views of the peripheral joint are recorded. Scintigraphic data are comparatively studied with the clinical indicators pointing to active synovitis - joint swellings and pain. Markedly expressed 99m Tc - HIG uptake is noted in joints apparently the most actively involved in the arthritis process clinically, whereas most of the joints without evidence of active synovitis revealed background activity only. The obtained scintigraphic results correlate strongly with the clinical indicator joint swelling (93.2%), and somewhat less with the presence of pain (81.5%). 13.5 per cent of the joints without clinically detectable swelling and 25.6% those free of pain are HIG-positive. 99m Tc - HIG scintigraphy is a highly sensitive noninvasive method of detecting active synovitis, promoting objective assessment of the joint inflammatory process in the course of treatment and follow-up study of rheumatoid arthritis patients

  14. In the finger it lingers

    Directory of Open Access Journals (Sweden)

    Irfan Mohamad

    2017-08-01

    Full Text Available A previously healthy 80-year-old woman presented with a history of a thorn prick injury over the distal phalange of her left finger obtained while gardening two months ago. She claimed to have a non-healing cut with a nodular lesion, which progressively increased in size, extending upwards towards the region of her left arm. There was no fever or palpable lymph nodes in the axillary region. She had been prescribed antibiotics from the local hospital but her condition did not improve.

  15. Instrumented Glove Measures Positions Of Fingers

    Science.gov (United States)

    Bozeman, Richard J., Jr.

    1993-01-01

    Glove instrumented with flat membrane potentiometers to obtain crude measurements of relative positions of fingers. Resistance of each potentiometer varies with position of associated finger; translator circuit connected to each potentiometer converts analog reading to 1 of 10 digital levels. Digitized outputs from all fingers fed to indicating, recording, and/or data-processing equipment. Gloves and circuits intended for use in biomedical research, training in critical manual tasks, and other specialized applications.

  16. Generating and analyzing synthetic finger vein images

    OpenAIRE

    Hillerström, Fieke; Kumar, Ajay; Veldhuis, Raymond N.J.

    2014-01-01

    Abstract: The finger-vein biometric offers higher degree of security, personal privacy and strong anti-spoofing capabilities than most other biometric modalities employed today. Emerging privacy concerns with the database acquisition and lack of availability of large scale finger-vein database have posed challenges in exploring this technology for large scale applications. This paper details the first such attempt to synthesize finger-vein images and presents analysis of synthesized images fo...

  17. Application of autoradiography in finger print analysis

    International Nuclear Information System (INIS)

    Stverak, B.; Kopejtko, J.; Simek, J.

    1983-01-01

    In order to broaden the possibilities of developing latent finger prints a tracer technique has been developed using sup(110m)Ag and autoradiographic imaging. This method has been tested on glass, paper and certain plastics. On paper it is possible to visualize finger prints even after previous development using Ninhydrin. It is shown that usable finger prints may be obtained also from materials from which they cannot be obtained using classical methods, e.g., polyethylene and simulated leather. (author)

  18. Ultrasound of the fingers for human identification using biometrics.

    Science.gov (United States)

    Narayanasamy, Ganesh; Fowlkes, J Brian; Kripfgans, Oliver D; Jacobson, Jon A; De Maeseneer, Michel; Schmitt, Rainer M; Carson, Paul L

    2008-03-01

    It was hypothesized that the use of internal finger structure as imaged using commercially available ultrasound (US) scanners could act as a supplement to standard methods of biometric identification, as well as a means of assessing physiological and cardiovascular status. Anatomical structures in the finger including bone contour, tendon and features along the interphalangeal joint were investigated as potential biometric identifiers. Thirty-six pairs of three-dimensional (3D) gray-scale images of second to fourth finger (index, middle and ring) data taken from 20 individuals were spatially registered using MIAMI-Fuse software developed at our institution and also visually matched by four readers. The image-based registration met the criteria for matching successfully in 14 out of 15 image pairs on the same individual and did not meet criteria for matching in any of the 12 image pairs from different subjects, providing a sensitivity and specificity of 0.93 and 1.00, respectively. Visual matching of all image pairs by four readers yielded 96% successful match. Power Doppler imaging was performed to calculate the change in color pixel density due to physical exercise as a surrogate of stress level and to provide basic physiological information. (E-mail: gnarayan@umich.edu).

  19. Patterns of magnetic resonance imaging bone erosion in rheumatoid arthritis--which bones are most frequently involved and show the most change?

    DEFF Research Database (Denmark)

    Ostergaard, Mikkel; Møller Døhn, Uffe; Duer-Jensen, Anne

    2011-01-01

    To investigate by magnetic resonance imaging (MRI) which bones in wrists and metacarpophalangeal (MCP) joints most frequently show bone erosions, and which most frequently demonstrate erosive progression, in early and established rheumatoid arthritis (RA).......To investigate by magnetic resonance imaging (MRI) which bones in wrists and metacarpophalangeal (MCP) joints most frequently show bone erosions, and which most frequently demonstrate erosive progression, in early and established rheumatoid arthritis (RA)....

  20. A Study on Brown Seaweed Therapy ( Sargassum sp. toward MDA Levels and Histological Improvement on Rat Foot Suffering Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    Fauziah Fauziah

    2013-07-01

    Full Text Available Rheumatoid arthritis (AR, an autoimun disease, is characterized by the inflammation in the joint area caused an excessive of free radicals. An excessive of free radicals in the body cause oxidative stress, that increasing levels of malondialdehyde (MDA as an indicator of lipid peroxidation and the decreasing levels of anti-oxidants. The treated with extract of brown seaweed (Sargassum sp. intended to find out the MDA levels in serum and the histological of the foot joints rheumatoid arthritis rats. Malondialdehyde levels are determined through a TBA test (Thio Barbituric acid, meanwhile the histological of the rat foot joints was determined by Hematoxylen-Eosin staining (HE. The results showed the brown seaweed extract therapy (Sargassum sp. was significantly (p <0.01 reduce levels of malondialdehyde (MDA in the serum of 21,24% and improving histological foot joints rheumatoid arthritis rats.

  1. Scintigraphy of the articular caps of a patient with rheumatoid arthritis using sup(99m)Tc-pertechnetate

    International Nuclear Information System (INIS)

    Weel, F.A. van der

    1981-01-01

    A method is presented for the diagnosis of rheumatoid arthritis, which is also used to control the effectiveness of treatment. It involves scintigraphy using sup(99m)Tc-pertechnetate. The uptake of this substance by bone joints enables full documentation of any inflammation activity in the joints. (C.F.)

  2. Cervical Myelopathy in Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    N. Mukerji

    2011-01-01

    Full Text Available Involvement of the cervical spine is common in rheumatoid arthritis. Clinical presentation can be variable, and symptoms may be due to neck pain or compressive myeloradiculopathy. We discuss the pathology, grading systems, clinical presentation, indications for surgery and surgical management of cervical myelopathy related to rheumatoid arthritis in this paper. We describe our surgical technique and results. We recommend early consultation for surgical management when involvement of the cervical spine is suspected in rheumatoid arthritis. Even patients with advanced cervical myelopathy should be discussed for surgical treatment, since in our experience improvement in function after surgery is common.

  3. 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. 

  4. A STUDY OF THE OCULAR MANIFESTATIONS OF RHEUMATOID ARTHRITIS AMONG PATIENTS PRESENTING TO A TERTIARY CENTRE

    Directory of Open Access Journals (Sweden)

    Dhanya Sukumaran

    2017-08-01

    Full Text Available BACKGROUND Rheumatoid Arthritis (RA is a chronic inflammatory disease of unknown aetiology marked by a symmetric peripheral polyarthritis. It is the most common form of chronic inflammatory arthritis and often results in joint damage and physical disability. The name is based on the term "rheumatic fever", an illness, which includes joint pain and is derived from the Greekword ῥεύμα-rheuma (nom., ῥεύματος-rheumatos (gen. ("flow, current". The suffix oid ("resembling" gives the translation as joint inflammation that resembles rheumatic fever. The first recognised description of rheumatoid arthritis was made in 1800 by Dr. Augustin Jacob Landré-Beauvais (1772-1840 of Paris. Because, it is a systemic disease, RA may result in a variety of extra-articular manifestations including fatigue, subcutaneous nodules, lung involvement, pericarditis, peripheral neuropathy, vasculitis and haematologic abnormalities. MATERIALS AND METHODS Patients who were diagnosed cases of rheumatoid arthritis attending the rheumatology clinic were referred to the Ophthalmology OPD in Government Medical College, Thrissur, for detailed eye examination. RESULTS The study was conducted in 100 patients (88 females and 12 males. Rheumatoid Factor (RF was found to be positive in 60 patients (60%, presence of dry eye did not correlate with rheumatoid positivity (Fishers exact test- the two-tailed P value = 0.4256. Through various tests, we concluded that there was aqueous deficiency in 61% and mucin deficiency in 46% of the patients. Other ocular manifestations present were- scleritis (2%, episcleritis (2% and keratomalacia (2%. CONCLUSION From the present study, we found out that extra-articular involvement of organs in rheumatoid arthritis is significant. The main ocular manifestations in rheumatoid arthritis found in our study were keratoconjunctivitis sicca, episcleritis, scleritis and keratomalacia. Though keratoconjunctivitis sicca was the most common, it did

  5. Finger crease pattern recognition using Legendre moments and principal component analysis

    Science.gov (United States)

    Luo, Rongfang; Lin, Tusheng

    2007-03-01

    The finger joint lines defined as finger creases and its distribution can identify a person. In this paper, we propose a new finger crease pattern recognition method based on Legendre moments and principal component analysis (PCA). After obtaining the region of interest (ROI) for each finger image in the pre-processing stage, Legendre moments under Radon transform are applied to construct a moment feature matrix from the ROI, which greatly decreases the dimensionality of ROI and can represent principal components of the finger creases quite well. Then, an approach to finger crease pattern recognition is designed based on Karhunen-Loeve (K-L) transform. The method applies PCA to a moment feature matrix rather than the original image matrix to achieve the feature vector. The proposed method has been tested on a database of 824 images from 103 individuals using the nearest neighbor classifier. The accuracy up to 98.584% has been obtained when using 4 samples per class for training. The experimental results demonstrate that our proposed approach is feasible and effective in biometrics.

  6. Use of preputial skin for coverage of post-burn contractures of fingers in children

    Directory of Open Access Journals (Sweden)

    Mohammed I Zaroo

    2011-01-01

    Full Text Available Objective: Hand burns are common injuries. Children frequently sustain burn injuries, especially to their hands. Contractures are a common sequel of severe burns around joints. The prepuce, or foreskin, has been used as a skin graft for a number of indications. We conducted this study to evaluate the feasibility of utilising the preputial skin for the management of post-burn contractures of fingers in uncircumcised male children. Materials and Methods: Preputial skin was used for the coverage of released contractures of fingers in 12 patients aged 2-6 years. The aetiology of burns was "Kangri" burn in eight patients and scalding in four patients. Six patients had contracture in two fingers, four patients in one finger, and two patients had contractures in three fingers. Results: None of the patients had graft loss, and all the wounds healed within 2 weeks. All patients had complete release of contractures without any recurrence. Hyperpigmentation of the grafts was observed over a period of time, which was well accepted by the parents. Conclusions: Preputial skin can be used successfully for male children with mild-to-moderate contractures of 2-3 fingers for restoration of the hand function, minimal donor site morbidity.

  7. Hybrid Photoacoustic/Ultrasound Tomograph for Real-Time Finger Imaging.

    Science.gov (United States)

    Oeri, Milan; Bost, Wolfgang; Sénégond, Nicolas; Tretbar, Steffen; Fournelle, Marc

    2017-10-01

    We report a target-enclosing, hybrid tomograph with a total of 768 elements based on capacitive micromachined ultrasound transducer technology and providing fast, high-resolution 2-D/3-D photoacoustic and ultrasound tomography tailored to finger imaging. A freely programmable ultrasound beamforming platform sampling data at 80 MHz was developed to realize plane wave transmission under multiple angles. A multiplexing unit enables the connection and control of a large number of elements. Fast image reconstruction is provided by GPU processing. The tomograph is composed of four independent and fully automated movable arc-shaped transducers, allowing imaging of all three finger joints. The system benefits from photoacoustics, yielding high optical contrast and enabling visualization of finger vascularization, and ultrasound provides morphologic information on joints and surrounding tissue. A diode-pumped, Q-switched Nd:YAG laser and an optical parametric oscillator are used to broaden the spectrum of emitted wavelengths to provide multispectral imaging. Custom-made optical fiber bundles enable illumination of the region of interest in the plane of acoustic detection. Precision in positioning of the probe in motion is ensured by use of a motor-driven guide slide. The current position of the probe is encoded by the stage and used to relate ultrasound and photoacoustic signals to the corresponding region of interest of the suspicious finger joint. The system is characterized in phantoms and a healthy human finger in vivo. The results obtained promise to provide new opportunities in finger diagnostics and establish photoacoustic/ultrasound-tomography in medical routine. Copyright © 2017 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  8.  Adiponectin in early and chronic rheumatoid arthritis and osteoarthritis

    DEFF Research Database (Denmark)

    Laurberg, Trine Bay

      Dato 31. januar 2006Title Adiponectin in early and chronic rheumatoid arthritis and osteoarthritisAuthors:Trine Bay Laurberg,Torkell Ellingsen,Jan Frystyk,Ib Hansen,Anette Jørgensen,Ulrik Tarp,Merete Lund Hetland,Kim Hørslev-Petersen,Nete Hornung,Jørgen Hjelm Poulsen,Allan Flyvbjerg,Kristian St......  Dato 31. januar 2006Title Adiponectin in early and chronic rheumatoid arthritis and osteoarthritisAuthors:Trine Bay Laurberg,Torkell Ellingsen,Jan Frystyk,Ib Hansen,Anette Jørgensen,Ulrik Tarp,Merete Lund Hetland,Kim Hørslev-Petersen,Nete Hornung,Jørgen Hjelm Poulsen,Allan Flyvbjerg......,Kristian Stengaard-PedersenBackground: Rheumatoid arthritis (RA) is a systemic, chronic, autoimmune disease, which affects the joints with inflammation leading to destruction of cartilage and bone. Osteoarthritis (OA) is a degenerative joint disease characterised by low level of chronic inflammation, slow...

  9. The rheumatoid cervical spine: Signs of instability on plain cervical radiographs

    International Nuclear Information System (INIS)

    Roche, Clare J.; Eyes, Brian E.; Whitehouse, Graham H.

    2002-01-01

    The cervical spine is a common focus of destruction from rheumatoid arthritis, second only to the metacarpophalangeal joints. Joint, bone and ligament damage in the cervical spine leads to subluxations which can cause cervical cord compression resulting in paralysis and even sudden death. Because many patients with significant subluxations are asymptomatic, the radiologist plays a key role in recognizing the clinically important clues to instability on plain radiographs of the cervical spine-often difficult in rheumatoid arthritis when the bony landmarks are osteoporotic or eroded. This review focuses on the signs of instability on plain radiographs of the cervical spine, using diagrams and clinical examples to illustrate methods of identifying significant subluxations in rheumatoid arthritis. Roche, C.J., Eyes, B.E. and Whitehouse, G.H. (2002)

  10. [Rheumatoid arthritis as a connective tissue disease].

    Science.gov (United States)

    Targońska-Stępniak, Bożena

    2018-01-01

    The available data indicate that seropositive rheumatoid arthritis (RA) develops as a result of systemic, autoimmune reaction directed against a range of "self" peptides/proteins that have undergone specific forms of post-translational modification. The development and progress of autoimmunity may be triggered by non-specific, local inflammatory processes outside the joints, for example in the oral or respiratory mucous membrane. The disease occurs in genetically susceptible individuals under the influence of environmental risk factors that promote autoimmunity and consequently the inflammatory process. Smoking is particularly linked with RA pathogenesis. Synovitis of multiple, symmetrical, peripheral joints is the most typical feature of RA which results in irreversible damage to joints structure and as a consequence in disability of patients. However, the inflammatory process in the course of RA has a systemic, constitutional nature. Therefore, extra-articular symptoms with internal organ involvement may occur additionally to synovitis, what is an unfavorable prognostic factor. Extra-articular manifestations of RA are associated with the high disease activity both inflammatory and immunological. They occur in patients with severe form of the disease and contribute to a significant lifespan reduction. This is usually associated with progressive atherosclerosis and cardiovascular complications. The systemic inhibition of an abnormal immune system activity is the mainstay of the effective RA treatment. The currently used disease modifying antirheumatic drugs affect the activity and function of different constituents of the immune system, including B and T lymphocytes and the main pro-inflammatory cytokines, and contribute to autoimmune and inflammatory processes.

  11. New agents for scintigraphy in rheumatoid arthritis

    International Nuclear Information System (INIS)

    Bois, M.H.W. de; Pauwels, E.K.J.; Breedveld, F.C.

    1995-01-01

    Radiopharmaceuticals have been used as investigative tools for the detection and treatment of arthritis activity in rheumatoid arthritis (RA) since the 1950s. Against the background of the pathophysiology of RA, the current status of joint scintigraphy and possible future developments are reviewed. Both non-specific (radiolabelled leucocytes and technetium-99m labelled human immunoglobulin) and specific targeting radiopharmaceuticals (including radiolabelled antibodies) are considered. The use of radiopharmaceuticals in the detection of arthritis activity has the advantages of allowing direct imaging of joints by means of whole-body scintigraphy and of joints that are difficult to assess clinically or radiographically. Promising results have been obtained with radiolabelled anti-CD4 and anti-E-selectin antibodies and with somatostatin receptor imaging, but more data are available regarding 99m Tc-IgG scintigraphy, which differentiates between the various degrees of arthritis activity and thus facilitates the choice of antirheumatic drug. Newer promising approaches to the imaging of RA include the use of radiolabelled J001 and cytokines, though studies on these are limited at present. (orig.)

  12. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Arthritis and Health-related Quality of Life Rehabilitation Management for Rheumatoid Arthritis Patients Rehabilitation of Older Adult ... Sheets Benefits and Risks of Opioids in Arthritis Management How to Give a Subcutaneous Injection Connect With ...

  13. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... and what other conditions are associated with RA. Learning more about your condition will allow you to ... Older Adult Patients with Arthritis Complementary and Alternative Medicine for Patients with Rheumatoid Arthritis Yoga for Arthritis ...

  14. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Arthritis Managing Your Arthritis Managing Chronic Pain and Depression in Arthritis Nutrition & Rheumatoid Arthritis Arthritis and Health- ... on this website. Copyright Johns Hopkins Arthritis Center © 2018 Patient Privacy Johns Hopkins Rheumatology

  15. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... you learn more about Rheumatoid Arthritis (RA). You will learn how the diagnosis of RA is made, ... associated with RA. Learning more about your condition will allow you to take a more active role ...

  16. 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...

  17. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Management for Rheumatoid Arthritis Patients Rehabilitation of Older Adult Patients with Arthritis Complementary and Alternative Medicine for ... Patient Update Transitioning the JRA Patient to an Adult Rheumatologist Drug Information for Patients Arthritis Drug Information ...

  18. Rheumatoid Arthritis Educational Video Series

    Medline Plus

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

  19. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... She is a critical member of our patient care team. Managing Your Arthritis Managing Your Arthritis Managing Chronic Pain and Depression in Arthritis Nutrition & Rheumatoid Arthritis Arthritis and Health- ...

  20. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... of Body Weight in Osteoarthritis Educational Videos for Patients Rheumatoid Arthritis Educational Video Series Psoriatic Arthritis 101 ... Patient to an Adult Rheumatologist Drug Information for Patients Arthritis Drug Information Sheets Benefits and Risks of ...

  1. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Arthritis and Health-related Quality of Life Rehabilitation Management for Rheumatoid Arthritis Patients Rehabilitation of Older Adult ... Sheets Benefits and Risks of Opioids in Arthritis Management How to Give a Subcutaneous Injection Rheumatology Course ...

  2. 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 ...

  3. Rheumatoid arthritis in the United Arab Emirates.

    Science.gov (United States)

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

    2008-06-01

    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, United Arab Emirates (UAE). Demographic and clinical data were collected over a 10-month period at the first visit to our clinic for patients meeting the American College of Rheumatology (ACR) criteria for RA. A total of 100 patients were seen: (average +/- SD) age 42.2 +/- 12.3 years; female 87%; Arabs 38%, Indian 36%, Caucasian and others 26%; 73% rheumatoid-factor positive; years since diagnosis: 3.9 +/- 5.7; lag time between symptom onset to diagnosis 1.2 +/- 1.3 years and lag time to first DMARD was 1.6 +/- 2.0 years. Mean tender joint count was 8.9 +/- 7.9, mean swollen joint count 9.0 +/- 7.6, mean patient's global assessment of disease activity 57.4 +/- 25.0 mm, mean ESR 33 +/- 25 mm/h, mean DAS28 5.2 +/- 1.6, physician global assessment 55.0 +/- 23.8. Only 43% were on DMARDs (25% MTX, 5% TNF blockers). Among the patients who were not on DMARD, only 28.1% had disease duration less than 1 year (p = <0.01). Erosions were present in 55.2% of patients with available X-rays, and deformities in 26% of patients. There were no racial differences in disease characteristics. The UAE has a unique population with many races residing in the country. Among the first 100 consecutive patients seen at our clinic, there were no significant differences in disease characteristics with the majority of the patients having very active disease, delayed diagnosis, and not being treated with DMARDs.

  4. Reorganization of finger coordination patterns through motor exploration in individuals after stroke.

    Science.gov (United States)

    Ranganathan, Rajiv

    2017-09-11

    Impairment of hand and finger function after stroke is common and affects the ability to perform activities of daily living. Even though many of these coordination deficits such as finger individuation have been well characterized, it is critical to understand how stroke survivors learn to explore and reorganize their finger coordination patterns for optimizing rehabilitation. In this study, I examine the use of a body-machine interface to assess how participants explore their movement repertoire, and how this changes with continued practice. Ten participants with chronic stroke wore a data glove and the finger joint angles were mapped on to the position of a cursor on a screen. The task of the participants was to move the cursor back and forth between two specified targets on a screen. Critically, the map between the finger movements and cursor motion was altered so that participants sometimes had to generate coordination patterns that required finger individuation. There were two phases to the experiment - an initial assessment phase on day 1, followed by a learning phase (days 2-5) where participants trained to reorganize their coordination patterns. Participants showed difficulty in performing tasks which had maps that required finger individuation, and the degree to which they explored their movement repertoire was directly related to clinical tests of hand function. However, over four sessions of practice, participants were able to learn to reorganize their finger movement coordination pattern and improve their performance. Moreover, training also resulted in improvements in movement repertoire outside of the context of the specific task during free exploration. Stroke survivors show deficits in movement repertoire in their paretic hand, but facilitating movement exploration during training can increase the movement repertoire. This suggests that exploration may be an important element of rehabilitation to regain optimal function.

  5. Generating and analyzing synthetic finger vein images

    NARCIS (Netherlands)

    Hillerström, Fieke; Kumar, Ajay; Veldhuis, Raymond N.J.

    2014-01-01

    Abstract: The finger-vein biometric offers higher degree of security, personal privacy and strong anti-spoofing capabilities than most other biometric modalities employed today. Emerging privacy concerns with the database acquisition and lack of availability of large scale finger-vein database have

  6. Surgical Treatment of Trigger Finger: Open Release

    Directory of Open Access Journals (Sweden)

    Firat Ozan

    2016-01-01

    Full Text Available In this study, open A1 pulley release results were evaluated in patients with a trigger finger diagnosis. 45 patients (29 females, 16 males, mean age 50.7 ± 11.9; range (24-79, 45 trigger fingers were released via open surgical technique. On the 25 of 45 cases were involved in the right hand and 16 of them were at the thumb, 2 at index, 6 at the middle and 1 at ring finger. Similarly, at the left hand, 15 of 20 cases were at the thumb, 1 at the index finger, 2 at middle finger and 2 at ring finger. Average follow-up time was 10.2 ± 2.7 (range, 6-15 months. Comorbidities in patients were; diabetes mellitus at 6 cases (13.3%, hypertension at 11 cases (24.4%, hyperthyroidism at 2 cases (4.4%, dyslipidemia at 2 cases (4.4% and lastly 2 cases had carpal tunnel syndrome operation. The mean time between the onset of symptoms to surgery was 6.9 ± 4.8 (range, 2-24 months. Patient satisfaction was very good in 34 cases (75.4% and good in 11 (24.6% patients. The distance between the pulpa of the operated finger and the palm was normal in every case postoperatively. We have not encountered any postoperative complications. We can recommend that; A1 pulley release via open incision is an effective and reliable method in trigger finger surgery.

  7. Number to finger mapping is topological.

    NARCIS (Netherlands)

    Plaisier, M.A.; Smeets, J.B.J.

    2011-01-01

    It has been shown that humans associate fingers with numbers because finger counting strategies interact with numerical judgements. At the same time, there is evidence that there is a relation between number magnitude and space as small to large numbers seem to be represented from left to right. In

  8. Rheumatoid arthritis: identifying and characterising polymorphisms using rat models

    Science.gov (United States)

    2016-01-01

    ABSTRACT Rheumatoid arthritis is a chronic inflammatory joint disorder characterised by erosive inflammation of the articular cartilage and by destruction of the synovial joints. It is regulated by both genetic and environmental factors, and, currently, there is no preventative treatment or cure for this disease. Genome-wide association studies have identified ∼100 new loci associated with rheumatoid arthritis, in addition to the already known locus within the major histocompatibility complex II region. However, together, these loci account for only a modest fraction of the genetic variance associated with this disease and very little is known about the pathogenic roles of most of the risk loci identified. Here, we discuss how rat models of rheumatoid arthritis are being used to detect quantitative trait loci that regulate different arthritic traits by genetic linkage analysis and to positionally clone the underlying causative genes using congenic strains. By isolating specific loci on a fixed genetic background, congenic strains overcome the challenges of genetic heterogeneity and environmental interactions associated with human studies. Most importantly, congenic strains allow functional experimental studies be performed to investigate the pathological consequences of natural genetic polymorphisms, as illustrated by the discovery of several major disease genes that contribute to arthritis in rats. We discuss how these advances have provided new biological insights into arthritis in humans. PMID:27736747

  9. Pseudotumoral ganglion cyst of a finger with unexpected remote origin: multimodality imaging

    International Nuclear Information System (INIS)

    Bouilleau, Loic; Malghem, Jacques; Omoumi, Patrick; Simoni, Paolo; Vande Berg, Bruno C.; Lecouvet, Frederic E.; Barbier, Olivier

    2010-01-01

    The case of a ganglion cyst in the pulp of a fifth finger in an elderly woman initially mimicking a soft tissue tumor is described. Most typical sites of ganglion cysts are well documented at the wrist and in the vicinity of inter-phalangeal and metacarpo-phalangeal joints. In this case, ultrasonography (US) and magnetic resonance imaging (MRI) demonstrated a cystic lesion within the pulp of the fifth finger and indicated carpal osteoarthritis as the distant - and unexpected - origin of the lesion. The suggested diagnosis of ganglion cyst was confirmed by computed tomography arthrography (CT arthrography) of the wrist, which showed opacification of the cyst on delayed acquisitions after intra-articular injection into the mid-carpal joint, through the fifth flexor digitorum tendon sheath. The communications between the degenerative carpal joint, the radio-ulnar bursa, the fifth flexor digitorum tendon sheath and the pedicle of the cyst were well demonstrated. (orig.)

  10. Generic Automated Multi-function Finger Design

    Science.gov (United States)

    Honarpardaz, M.; Tarkian, M.; Sirkett, D.; Ölvander, J.; Feng, X.; Elf, J.; Sjögren, R.

    2016-11-01

    Multi-function fingers that are able to handle multiple workpieces are crucial in improvement of a robot workcell. Design automation of multi-function fingers is highly demanded by robot industries to overcome the current iterative, time consuming and complex manual design process. However, the existing approaches for the multi-function finger design automation are unable to entirely meet the robot industries’ need. This paper proposes a generic approach for design automation of multi-function fingers. The proposed approach completely automates the design process and requires no expert skill. In addition, this approach executes the design process much faster than the current manual process. To validate the approach, multi-function fingers are successfully designed for two case studies. Further, the results are discussed and benchmarked with existing approaches.

  11. Electrokinetic Control of Viscous Fingering

    Science.gov (United States)

    Mirzadeh, Mohammad; Bazant, Martin Z.

    2017-10-01

    We present a theory of the interfacial stability of two immiscible electrolytes under the coupled action of pressure gradients and electric fields in a Hele-Shaw cell or porous medium. Mathematically, our theory describes a phenomenon of "vector Laplacian growth," in which the interface moves in response to the gradient of a vector-valued potential function through a generalized mobility tensor. Physically, we extend the classical Saffman-Taylor problem to electrolytes by incorporating electrokinetic (EK) phenomena. A surprising prediction is that viscous fingering can be controlled by varying the injection ratio of electric current to flow rate. Beyond a critical injection ratio, stability depends only upon the relative direction of flow and current, regardless of the viscosity ratio. Possible applications include porous materials processing, electrically enhanced oil recovery, and EK remediation of contaminated soils.

  12. 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.

  13. Prevalence of self-reported finger deformations and occupational risk factors among professional cooks: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Tomita Shigeru

    2011-05-01

    Full Text Available Abstract Background Previous studies have pointed out that the school lunch workers in Japan are suffering from work-related disorders including finger deformations. The purpose of this study was to investigate the prevalence of self-reported finger deformations and the association with job-related risk factors. Methods A cross-sectional questionnaire study of 5,719 subjects (response rate: 81%, 982 men and 4,737 women was undertaken during September 2003 to February 2004. Results Finger deformations were found among 11.7% of the men and 35.6% of the women studied, with significant differences among sex, age and sex-age groups. For both men and women the pattern of finger deformations across the hand was similar for the right and the left hand. For women, the deformations were found in about 10% of the distal interphalangeal joints of all fingers. Based on multiple logistic regression analyses, the factors female sex, age, the number of cooked lunches per cook and cooking activities were independently associated with the prevalence of finger deformations. High prevalence odds ratios were found for those frequently carrying or using tools by hands such as delivering containers, distributing meals, preparing dishes, washing equipment, cutting and stirring foods. Conclusions Among the school lunch workers studied, women had a higher prevalence of finger deformations on all joints of both hands. Various cooking tasks were associated with the prevalence of finger deformations. The results suggest that improvements in working conditions are important for preventing work-related disorders such as finger deformations.

  14. Juvenile rheumatoid arthritis

    International Nuclear Information System (INIS)

    Naz, S.; Mushtaq, A.; Bari, A.; Maqsud, A.; Khan, M. Z.; Ahmad, T. M.; Saira Rehman

    2013-01-01

    Objective: To determine the spectrum of clinical presentation, laboratory parameters and drug therapy in patients with Juvenile Rheumatoid Arthritis (JRA). Study Design: Case series. Place and Duration of Study: The Children's Hospital and The Institute of Child Health, Lahore, from October 2008 to October 2011. Methodology: All patients who fulfilled the American College of Rheumatology criteria for JRA were enrolled. Their clinical features, investigations done and treatment received for JRA were noted. Statistical analysis of data was done on SPSS version 16.0 for obtaining descriptive statistics. Results: Out of 185 patients, 50.3% (n = 93) were females; 54% (n = 100) were between 10 - 15 years of age. Polyarthritis was found in 71.9% (n = 133) followed by oligoarthritis (22.7%, n = 42) and systemic onset disease (5.4%, n = 10). Morning stiffness (78%) and fever (68%) were the most common clinical presentations. All patients with systemic onset disease had fever (n = 10) followed by skin rash, hepatosplenomegaly and lymphadenopathy. Uveitis was found in 2 patients, and both belonged to the oligoarticular group. Rheumatoid factor was found in 10.27% (n = 19) of all patients. All patients were given non-steroidal anti-inflammatory drugs (NSAIDs). Disease modifying agents (methotrexate) were given to 43.8% (n = 81). Steroids were used in 61% (n = 113) of patients either with NSAIDs alone or NSAIDs plus methotrexate. Conclusion: Disease profile of JRA at the study centre showed that polyarthritis is the commonest type. Recognition of subtypes will help in planning the management of these patients. (author)

  15. Differing Dynamics of Intrapersonal and Interpersonal Coordination: Two-finger and Four-Finger Tapping Experiments.

    Directory of Open Access Journals (Sweden)

    Kentaro Kodama

    Full Text Available Finger-tapping experiments were conducted to examine whether the dynamics of intrapersonal and interpersonal coordination systems can be described equally by the Haken-Kelso-Bunz model, which describes inter-limb coordination dynamics. This article reports the results of finger-tapping experiments conducted in both systems. Two within-subject factors were investigated: the phase mode and the number of fingers. In the intrapersonal experiment (Experiment 1, the participants were asked to tap, paced by a gradually hastening auditory metronome, looking at their fingers moving, using the index finger in the two finger condition, or the index and middle finger in the four-finger condition. In the interpersonal experiment (Experiment 2, pairs of participants performed the task while each participant used the outside hand, tapping with the index finger in the two finger condition, or the index and middle finger in the four-finger condition. Some results did not agree with the HKB model predictions. First, from Experiment 1, no significant difference was observed in the movement stability between the in-phase and anti-phase modes in the two finger condition. Second, from Experiment 2, no significant difference was found in the movement stability between the in-phase and anti-phase mode in the four-finger condition. From these findings, different coordination dynamics were inferred between intrapersonal and interpersonal coordination systems against prediction from the previous studies. Results were discussed according to differences between intrapersonal and interpersonal coordination systems in the availability of perceptual information and the complexity in the interaction between limbs derived from a nested structure.

  16. Polysymptomatic Distress in Patients With Rheumatoid Arthritis: Understanding Disproportionate Response and Its Spectrum

    NARCIS (Netherlands)

    Wolfe, Frederick; Michaud, Kaleb; Busch, Ruth E.; Katz, Robert S.; Rasker, Johannes J.; Shahouri, Shadi H.; Shaver, Timothy S.; Wang, Shirley; Walitt, Brian T.; Häuser, Winfried

    2014-01-01

    Objective Fibromyalgia (FM) in rheumatoid arthritis (RA) can cause consternation because symptoms are seen to be out of proportion to physician and laboratory assessments, and composite RA activity scores such as the 28 joint Disease Activity Score, Clinical Disease Activity Index, and Routine

  17. Patterns of radiographic changes in hands and feet of rheumatoid arthritis in Saudi Arabia

    International Nuclear Information System (INIS)

    Al-Arfaj, Abdurhman S.; Al-Boukai, Ahmad A.

    2005-01-01

    The aim of the study was to characterize the pattern of radiographic changes in the hands and feet of rheumatoid arthritis in Saudi patients. The radiographs of hands and feet of rheumatoid arthritis patients attending rheumatology outpatient clinics of King Khalid University Hospital in Riyadh, Kingdom of Saudi Arabia, over the period extending from March to June 2001, were examined and reported for the presence of osteopenia, joint space narrowing, and erosions. Fifty-six rheumatoid arthritis patients were studied. Their mean age was 50 + 1.9 years, and mean disease duration was 9.07 + 0.84 years. Generalized osteopenia was seen in 16/56 (29%) and periarticular osteopenia in 38/56 (68%). Joint space narrowing was present in 9/56 (16%) of feet and 35/56 (63%) of hand x-rays. Erosions were seen in 3/56 (6%) of feet and in 22/56 (39%) of hand x-rays. Significant correlation was seen between joints space narrowing, joint erosions, and disease duration. Radiographic changes in hands and feet of Saudi rheumatoid arthritis patients are less severe than those reported from the West, and the pattern is also different with less affection of the feet. (author)

  18. Tumour necrosis factor-α inhibitors are glucocorticoid-sparing in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Nilsson, Anna Christine; Christensen, Anne Friesgaard; Junker, Peter

    2011-01-01

    Rheumatoid arthritis (RA) is a chronic disease with autoimmune traits of unknown aetiology which primarily affects synovial joints. Glucocorticoids (GCs) are still widely used in RA treatment despite the expanding use of targeted and very efficient agents. The objective of this study was to assess...

  19. Targeting the Fas/FasL system in Rheumatoid Arthritis therapy: Promising or risky?

    NARCIS (Netherlands)

    Calmon-Hamaty, Flavia; Audo, Rachel; Combe, Bernard; Morel, Jacques; Hahne, Michael

    2015-01-01

    Rheumatoid Arthritis (RA) is a chronic inflammatory disease affecting synovial joints. Tumor necrosis factor (TNF) α is a key component of RA pathogenesis and blocking this cytokine is the most common strategy to treat the disease. Though TNFα blockers are very efficient, one third of the RA

  20. Rotator cuff degeneration in the rheumatoid shoulder : 'the issue is soft tissue'

    NARCIS (Netherlands)

    Sande, Michiel Adrianus Josephus van de

    2008-01-01

    We hypothesized that shoulder pain, caused by rheumatoid arthritis (RA), can lead to disuse of the affected shoulder joint. In addition to the structural changes caused by rotator cuff tears, tendonitis or synovitis disuse may play an important role in the aetiology of fatty degeneration (FD) of the

  1. 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.

  2. Detection of rheumatoid arthritis bone erosions by two different dedicated extremity MRI units and conventional radiography

    DEFF Research Database (Denmark)

    Duer-Jensen, A.; Vestergaard, A.; Dohn, U.M.

    2008-01-01

    Objectives: To compare the ability of two different dedicated extremity MRI (E-MRI) units and conventional radiography (CR) for identifying bone erosions in rheumatoid arthritis (RA) metacarpophalangeal (MCP) and wrist joints. Methods: CR and two MRI examinations (using 0.2 T Esaote Artoscan and 0...

  3. Detection of rheumatoid arthritis bone erosions by 2 different dedicated extremity MRI units and conventional radiography

    DEFF Research Database (Denmark)

    Duer, Anne; Vestergaard, Aage; Døhn, Uffe Møller

    2008-01-01

    OBJECTIVES: To compare the ability of 2 different dedicated extremity magnetic resonance imaging (E-MRI) units and conventional radiography (CR) for identifying bone erosions in rheumatoid arthritis (RA) metacarpophalangeal (MCP) and wrist joints. METHODS: CR and 2 MRI-examinations (on 0.2T Esaote...

  4. Pulmonary tuberculosis in a patient with rheumatoid arthritis undergoig immunosuppressive treatment: case report

    Directory of Open Access Journals (Sweden)

    Sandro Ceratti

    2014-02-01

    Full Text Available Rheumatoid arthritis is a disease which characteristically affects the joints. Because it is an autoimmune disease, immunosuppressive drugs are widely used in its treatment. The present case report illustrates the association of immunosuppressive treatment with the development of opportunistic infections in a 64-year-old patient.

  5. M-ficolin levels reflect disease activity and predict remission in early rheumatoid arthritis

    DEFF Research Database (Denmark)

    Ammitzbøll, Christian Gytz; Thiel, Steffen; Jensenius, Jens Christian

    2013-01-01

    To assess plasma M-ficolin concentrations in disease-modifying antirheumatic drug (DMARD)-naive patients with early rheumatoid arthritis (RA), to investigate the correlation of M-ficolin concentrations with disease activity markers, and to determine the predictive value of M-ficolin with respect...... to the Disease Activity Score in 28 joints (DAS28)....

  6. Gene therapy works in animal models of rheumatoid arthritis...so what!

    NARCIS (Netherlands)

    Loo, F.A.J. van de; Geurts, J.; Berg, W.B. van den

    2006-01-01

    Rheumatoid arthritis (RA) is a systemic disease with polyarticular manifestation of chronic inflammation in the knees and small joints of hand and feet. The current systemic anti-tumor necrosis factor (TNF)-alpha therapies with biologics ameliorate disease in 60% to 70% of RA patients. However,

  7. Gene therapy in animal models of rheumatoid arthritis: are we ready for the patients?

    NARCIS (Netherlands)

    Loo, F.A.J. van de; Smeets, R.L.L.; Berg, W.B. van den

    2004-01-01

    Rheumatoid arthritis (RA) is a chronic inflammatory disease of the synovial joints, with progressive destruction of cartilage and bone. Anti-tumour necrosis factor-alpha therapies (e.g. soluble tumour necrosis factor receptors) ameliorate disease in 60-70% of patients with RA. However, the need for

  8. OMERACT Rheumatoid Arthritis Magnetic Resonance Imaging Studies. Summary of OMERACT 6 MR Imaging Module

    DEFF Research Database (Denmark)

    McQueen, F; Lassere, M; Edmonds, J

    2003-01-01

    Magnetic resonance image (MRI) scanning is a new method for imaging and quantifying joint inflammation and damage in rheumatoid arthritis (RA). Over the past 4 years, the OMERACT MR Imaging Group has been developing and testing the RA-MRI scoring system (RAMRIS) for use in RA. The OMERACT filter...

  9. Gadolinium-DTPA enhanced magnetic resonance imaging of bone cysts in patients with rheumatoid arthritis

    NARCIS (Netherlands)

    Gubler, F. M.; Algra, P. R.; Maas, M.; Dijkstra, P. F.; Falke, T. H.

    1993-01-01

    To examine the contents of intraosseous cysts in patients with rheumatoid arthritis (RA) through the signal intensity characteristics on gadolinium-DTPA (Gd-DTPA) enhanced magnetic resonance imaging. The hand or foot joints of nine patients with the cystic form of RA (where the initial radiological

  10. Radiographic estimation in seropositive and seronegative rheumatoid arthritis.

    Science.gov (United States)

    Sahatçiu-Meka, Vjollca; Rexhepi, Sylejman; Manxhuka-Kërliu, Suzana; Rexhepi, Mjellma

    2011-08-01

    Long since it have been suggested that a subpopulation of patients with rheumatoid arthritis, diagnosed with negative rheumatoid factor tests, represents a clinical entity quite distinct from that of seropositive rheumatoid arthritis (RA). Our aim was to establish a scientific comparative analysis between seronegative and seropositive rheumatoid arthritis, regarding some radiological and clinical parameters, applied for the first time on patients from Kosovo. Two hundred fifty patients with rheumatoid arthritis according to the American College of Rheumatology criteria were retrospectively studied by analysis the radiographic damage and clinical parameters of the disease, using a data base. All examinees were between 25-60 years of age (Xb=49.96, SD=10.37) with disease duration between 1-27 years (Xb = 6.41, SD=6.47). All patients underwent a standardised evaluation radiographs. Baseline standardised poster anterior radiographs of hands and feet and radiographs of other joints, depending on indications, were assessed. Erythrocyte sedimentation rate values correlated with the radiological damages and statistical difference was found for seronegative subset (r=0.24, p<0.01). Longer duration of the disease resulted in the increase of radiological changes in both subsets (r=0.66, p<0.01) seronegative, (r=0.49, p<0.01) seropositive. Anatomic changes of IInd and IIIrd level were nearly equally distributed in both subsets, 76 (60.8%) seronegative, 75 (60%) seropositive. Radiological damages are nearly equal in both subsets, elevate in relation to the duration of the disease and correlate with ESR values. Regarding the sero-status, differences within sex, with some exceptions, are not relevant. Although there are some definite quantitative and qualitative differences regarding sero-status, obviously there is a great deal of overlap between the two groups.

  11. Radiographic estimation in seropositive and seronegative rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Vjollca Sahatçiu-Meka

    2011-08-01

    Full Text Available Long since it have been suggested that a subpopulation of patients with rheumatoid arthritis, diagnosed with negative rheumatoid factor tests, represents a clinical entity quite distinct from that of seropositive rheumatoid arthritis (RA. Our aim was to establish a scientific comparative analysis between seronegative and seropositive rheumatoid arthritis, regarding some radiological and clinical parameters, applied for the first time on patients from Kosovo. Two hundred fifty patients with rheumatoid arthritis according to the American College of Rheumatology criteria were retrospectively studied by analysis the radiographic damage and clinical parameters of the disease, using a data base. All examinees were between 25-60 years of age (Xb=49.96, SD=10.37 with disease duration between 1-27 years (Xb = 6.41, SD=6.47. All patients underwent a standardised evaluation radiographs. Baseline standardised poster anterior radiographs of hands and feet and radiographs of other joints, depending on indications, were assessed. Erythrocyte sedimentation rate values correlated with the radiological damages and statistical difference was found for seronegative subset (r=0.24, p<0.01. Longer duration of the disease resulted in the increase of radiological changes in both subsets (r=0.66, p<0.01 seronegative, (r=0.49, p<0.01 seropositive. Anatomic changes of IInd and IIIrd level were nearly equally distributed in both subsets, 76 (60.8% seronegative, 75 (60% seropositive. Radiological damages are nearly equal in both subsets, elevate in relation to the duration of the disease and correlate with ESR values. Regarding the sero-status, differences within sex, with some exceptions, are not relevant. Although there are some definite quantitative and qualitative differences regarding sero-status, obviously there is a great deal of overlap between the two groups.

  12. Characterization of nitrotyrosine as a biomarker for arthritis and joint injury

    DEFF Research Database (Denmark)

    Misko, T P; Radabaugh, M R; Highkin, M

    2013-01-01

    OBJECTIVES: To characterize the utility of nitrotyrosine (NT) as a biomarker for arthritis and joint injury. DESIGN: Synovial fluid, plasma, and urine from patients diagnosed with osteoarthritis (OA), rheumatoid arthritis (RA), anterior cruciate ligament (ACL) injury, meniscus injury and pseudogout...

  13. Peripheric circulation disturbance in patients with rheumatoid arthritis

    International Nuclear Information System (INIS)

    Blagodarov, V.N.; Kucher, O.M.; Morozova, L.I.; Tsygankov, A.T.

    1986-01-01

    The results of general clinical, biochemical immunologic examinations of patients suffering from rheumatoid arthritis are given. The functional state of microcircular channel vessels by the method of local clearance of radioactive xenon has been studied. 15 biopsies and 7 necropsies of skin and osteomusculocutaneous flaps of lower extremities have been studied by higtologic, histochemical and histoenzymatic methods. A hard generalized injury of microcircular tracks in skin, hypodermic tela and in muscles of lower extremities is established. Dependence of the frequency and the degree of significance of vasculitises, microthrombosises of vessel modules and sclerous changes in the circumflex connective tissue on low functional ability of joints in patients with rheumatoid arthritis with low progressing current and minimal activity of the process, when manifest vasculitises being absent, is marked

  14. 99Tcm-labelled leucocyte imaging in active rheumatoid arthritis

    International Nuclear Information System (INIS)

    Al-Janabi, M.A.; Jones, A.K.P.; Solanki, K.; Sobnack, R.; Bomanji, J.; Al-Nahhas, A.A.; Britton, K.E.; Huskisson, E.C.; Doyle, D.V.

    1988-01-01

    A simplified technique of labelling leucocytes with technetium-99m is described and applied to patients with active rheumatoid arthritis. The clinically active and less active knees in seven patients were imaged and the uptake of labelled leucocytes was measured. The measurements were repeated after local steroid injection into nine painful knees. A 50-80% reduction in leucocyte uptake localized to the region of the synovium was demonstrated in the eight knees which showed clinical responses and a rise of 8% in the non-responder. There was a variable response in the knees that were not injected. 99 Tc m leucocyte imaging in rheumatoid arthritis is able to assess objectively joint inflammation and its response to treatment. (author)

  15. Metabolomic Elucidation of the Effects of Curcumin on Fibroblast-Like Synoviocytes in Rheumatoid Arthritis

    OpenAIRE

    Ahn, Joong Kyong; Kim, Sooah; Hwang, Jiwon; Kim, Jungyeon; Lee, You Sun; Koh, Eun-Mi; Kim, Kyoung Heon; Cha, Hoon-Suk

    2015-01-01

    Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease characterized by synovial inflammation and joint disability. Curcumin is known to be effective in ameliorating joint inflammation in RA. To obtain new insights into the effect of curcumin on primary fibroblast-like synoviocytes (FLS, N = 3), which are key effector cells in RA, we employed gas chromatography/time-of-flight mass spectrometry (GC/TOF-MS)-based metabolomics. Metabolomic profiling of tumor necrosis factor (TNF)-α...

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

    Science.gov (United States)

    ... this page please turn JavaScript on. Feature: Understanding Rheumatoid Arthritis (RA) Treatment and Causes Past Issues / Summer 2014 Table of Contents How Is Rheumatoid Arthritis Treated? Doctors have many ways to treat this ...

  17. Ankle tenosynovitis in rheumatoid arthritis: clinical and ultrasonographic evaluation

    Directory of Open Access Journals (Sweden)

    Ana Luiza Naves Pereira

    2016-11-01

    Full Text Available Objective: To investigate ankle tenosynovitis in rheumatoid arthritis patients, regarding its presence, the kind of tendon involved and the concordance between clinical and ultrasound findings. Methods: Twenty patients with rheumatoid arthritis and pain or swollen ankle joint were evaluated. Tendon involvement was evaluated with ultrasound imaging. The Health Assessment Questionnaire (HAQ was performed for disability evaluation. Age, sex, disease duration, and vocational activity levels were also obtained. The statistical analysis included Fisher’s exact test. The significance level was 0.05. Results: Tenosynovitis was found in 13 of 20 (65.0% patients in 19 joints, in which 6 were bilaterally (46.1% and unilateral in 7 (53.8%. Tibialis posterior tenosynovitis was seen in nine (45.0% patients, Achilles tenosynovitis in seven (35.0%, tibialis anterior tenosynovitis in three (15.0%, and peroneal tenosynovitis in three (15.0% patients. We found concordance between symptomatic ankle and ultrasonographic findings in 92.3% of the patients with tenosynovitis. Association between severe HAQ with tendon involvement was not found (p>0.05. Disease duration was not associated with tenosynovitis. Patients were predominantly older, female, with mean age around 50.8 years. The long disease duration of patients presented a mean of 11.4 years and, most of them, with no vocational activity (65.0%. Conclusions: The results indicate that ankle tenosynovitis is very common in rheumatoid arthritis patients, both unilateral and bilateral. Tibialis posterior was the most common tendon involvement found. Finally, we found concordance between the clinical and ultrasound findings in almost all rheumatoid arthritis patients with ankle tenosynovitis.

  18. Rheumatoid arthritis clinical features and management strategies at an urban tertiary facility in Pakistan.

    Science.gov (United States)

    Rais, Rehan; Saeed, Mohammad; Haider, Rimsha; Jassani, Zahra; Riaz, Amir; Perveen, Tahira

    2014-12-01

    To determine the presentation patterns, biologically vulnerable patient groups and treatment strategies of rheumatoid arthritis. The retrospective study was conducted at the Rheumatology Clinic of Liaquat National Hospital and Medical College, Karachi, and comprised data of rheumatology patients who presented between September 2006 and September 2012. After screening all the files, rheumatoid arthritis cases were identified. Data collection was done using a questionnaire that included patient demographics, co-morbidities, clinical manifestations and drug therapy. SPSS 13 was used for statistical analysis. Of the 2300 files screened, 500(21.7%) related to patients of rheumatoid arthritis. The mean age at presentation of these 500 patients was 41±15 years. There were 367(73.4%) women and they presented at an earlier age compared to men (p<0.024). Erosions were present in 198(40%) patients on X-rays and 22(4.4%) had joint deformities. Seropositive rheumatoid arthritis was associated with higher erythrocyte sedimentation rate levels (p<0.014), but did not differ from seronegative rheumatoid arthritis in terms of Disease Activity Score-28 levels (p<0.21). The skewed gender distribution was likely an effect of rheumatoid arthritis biology rather than due to issues of healthcare accessibility. Seronegative RA is likely to present late though it is as destructive as the seropositive disease.

  19. Web-based rehabilitation interventions for people with rheumatoid arthritis: A systematic review.

    Science.gov (United States)

    Srikesavan, Cynthia; Bryer, Catherine; Ali, Usama; Williamson, Esther

    2018-01-01

    Background Rehabilitation approaches for people with rheumatoid arthritis include joint protection, exercises and self-management strategies. Health interventions delivered via the web have the potential to improve access to health services overcoming time constraints, physical limitations, and socioeconomic and geographic barriers. The objective of this review is to determine the effects of web-based rehabilitation interventions in adults with rheumatoid arthritis. Methods Randomised controlled trials that compared web-based rehabilitation interventions with usual care, waiting list, no treatment or another web-based intervention in adults with rheumatoid arthritis were included. The outcomes were pain, function, quality of life, self-efficacy, rheumatoid arthritis knowledge, physical activity and adverse effects. Methodological quality was assessed using the Cochrane Risk of Bias tool and quality of evidence with the Grading of Recommendations Assessment, Development and Evaluation approach. Results Six source documents from four trials ( n = 567) focusing on self-management, health information or physical activity were identified. The effects of web-based rehabilitation interventions on pain, function, quality of life, self-efficacy, rheumatoid arthritis knowledge and physical activity are uncertain because of the very low quality of evidence mostly from small single trials. Adverse effects were not reported. Conclusion Large, well-designed trials are needed to evaluate the clinical and cost-effectiveness of web-based rehabilitation interventions in rheumatoid arthritis.

  20. Additional diagnostic and clinical value of anti-cyclic citrullinated peptide antibodies compared with rheumatoid factor isotypes in rheumatoid arthritis.

    Science.gov (United States)

    Vallbracht, Inka; Helmke, Klaus

    2005-07-01

    In the past decade significant advantages have been made in the treatment of rheumatoid arthritis (RA) and therapeutic strategies have changed a lot. These days, highly effective disease modifying anti-rheumatic drugs enable intervention early in the disease process, in order to prevent major joint damage. For years, serological support in the diagnosis of RA has been limited to the presence of rheumatoid factors, although not very specific for RA. During the last years a variety of circulating non-RF antibodies have been discovered and reported to be of potential diagnostic value. CCP2 proved to be a very disease-specific and even sensitive marker for RA. In addition to the diagnostic properties, CCP showed to be a good prognostic marker, CCP helps to predict the erosive or nonerosive progression of the disease, and CCP is already present early in the disease. This diagnostic tool enables the clinician to choose the optimal therapeutic management for each single RA patient.

  1. Design of a wearable hand exoskeleton for exercising flexion/extension of the fingers.

    Science.gov (United States)

    Jo, Inseong; Lee, Jeongsoo; Park, Yeongyu; Bae, Joonbum

    2017-07-01

    In this paper, design of a wearable hand exoskeleton system for exercising flexion/extension of the fingers, is proposed. The exoskeleton was designed with a simple and wearable structure to aid finger motions in 1 degree of freedom (DOF). A hand grasping experiment by fully-abled people was performed to investigate general hand flexion/extension motions and the polynomial curve of general hand motions was obtained. To customize the hand exoskeleton for the user, the polynomial curve was adjusted to the joint range of motion (ROM) of the user and the optimal design of the exoskeleton structure was obtained using the optimization algorithm. A prototype divided into two parts (one part for the thumb, the other for rest fingers) was actuated by only two linear motors for compact size and light weight.

  2. Comparison of Disease Activity Score in 28 joints with ESR (DAS28), Clinical Disease Activity Index (CDAI), Health Assessment Questionnaire Disability Index (HAQ-DI) & Routine Assessment of Patient Index Data with 3 measures (RAPID3) for assessing disease activity in patients with rheumatoid arthritis at initial presentation.

    Science.gov (United States)

    Kumar, B Siddhartha; Suneetha, P; Mohan, Alladi; Kumar, D Prabath; Sarma, K V S

    2017-11-01

    In patients with rheumatoid arthritis (RA), disease severity assessment is done using Disease Activity Score in 28 joints with ESR (DAS28). Computing DAS28 is time-consuming, requires laboratory testing and an online calculator. There is a need to validate rapid methods of disease severity assessment for routine daily use. This study was conducted to compare DAS28, Clinical Disease Activity Index (CDAI), Health Assessment Questionnaire Disability Index (HAQ-DI) and Routine Assessment of Patient Index Data with 3 measures (RAPID3) to assess the disease activity in patients with RA. We prospectively studied the utility of CDAI, HAQ-DI and RAPID3 scoring in 100 consecutive newly diagnosed, disease modifying antirheumatic drugs (DMARDs) naïve adult patients with RA seen during January 2013 and June 2014 at a tertiary care teaching hospital in south India. The mean age of the patients was 42.1±11.6 yr, there were 82 females. The median [interquartile range (IQR)] symptom duration was 6 (range 4-12) months. The median (IQR) DAS28, CDAI, HAQ-DI and RAPID3 scores at presentation were 7 (6-7), 36 (28-43), 2 (1-2) and 17 (13-19), respectively. A significant positive correlation was observed between DAS28 and CDAI (r=0.568; Pfair' agreement was observed in between DAS28 and CDAI (kappa-statistic=0.296). The agreement between DAS28 and HAQ-DI (kappa-statistic=0.007) and RAPID3 (kappa-statistic=0.072) was less robust. In adult patients with RA, in the setting where illiteracy is high, CDAI emerged as the preferred choice for rapid assessment of severity of disease at the time of initial presentation.

  3. Nailfold capillaroscopy in 430 patients with rheumatoid arthritis.

    Science.gov (United States)

    Rajaei, Alireza; Dehghan, Pooneh; Amiri, Ali

    2017-01-01

    Microvascular changes are one of the first obvious steps in numerous inflammatory diseases such as rheumatoid arthritis (RA). Nailfold video capillaroscopy (NFC) is an easy, reliable and safe method for evaluating peripheral microangiopathy. The objective of this study was to examine nailfold microcirculation in RA patients, assess morphological and structural changes quantitatively and qualitatively, and recognize useful changes. A total of 430 patients diagnosed with RA were examined in a period of 4 years. NFC was performed on all fingers of both hands in each patient. Different parameters indicating microvascular changes were detected and analyzed; such as microvascular architecture, capillary distribution disturbances, capillary morphology, capillary density, efferent/afferent limb ratio, subpapillary venular plexus and morphological abnormalities. The obtained results were categorized into normal pattern, nonspecific morphological abnormality and scleroderma pattern. The mean age of participants was 51.03±14.54 (19-87 years) that consisted of 359 females and 71 males. Based on the findings, angiogenesis (74.7%) was the most pathological condition observed after tortuosity (99.5%). 7.2% and 20.9% of patients were categorized into normal and scleroderma pattern group, respectively. Among morphological abnormalities, angiogenesis, isolated enlarged loop, irregular enlarged loop and architectural derangement were significantly more frequent in scleroderma than normal pattern (p<0.001). NFC may play an important role in monitoring RA disease and patients' follow-up. Therefore, in our opinion it could be considered in the course and follow-up of rheumatoid arthritis.

  4. Finger muscle attachments for an OpenSim upper-extremity model.

    Directory of Open Access Journals (Sweden)

    Jong Hwa Lee

    Full Text Available We determined muscle attachment points for the index, middle, ring and little fingers in an OpenSim upper-extremity model. Attachment points were selected to match both experimentally measured locations and mechanical function (moment arms. Although experimental measurements of finger muscle attachments have been made, models differ from specimens in many respects such as bone segment ratio, joint kinematics and coordinate system. Likewise, moment arms are not available for all intrinsic finger muscles. Therefore, it was necessary to scale and translate muscle attachments from one experimental or model environment to another while preserving mechanical function. We used a two-step process. First, we estimated muscle function by calculating moment arms for all intrinsic and extrinsic muscles using the partial velocity method. Second, optimization using Simulated Annealing and Hooke-Jeeves algorithms found muscle-tendon paths that minimized root mean square (RMS differences between experimental and modeled moment arms. The partial velocity method resulted in variance accounted for (VAF between measured and calculated moment arms of 75.5% on average (range from 48.5% to 99.5% for intrinsic and extrinsic index finger muscles where measured data were available. RMS error between experimental and optimized values was within one standard deviation (S.D of measured moment arm (mean RMS error = 1.5 mm < measured S.D = 2.5 mm. Validation of both steps of the technique allowed for estimation of muscle attachment points for muscles whose moment arms have not been measured. Differences between modeled and experimentally measured muscle attachments, averaged over all finger joints, were less than 4.9 mm (within 7.1% of the average length of the muscle-tendon paths. The resulting non-proprietary musculoskeletal model of the human fingers could be useful for many applications, including better understanding of complex multi-touch and gestural movements.

  5. 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

  6. PERIOPERATIVE MANAGEMENT OF PATIENTS WITH RHEUMATOID ARTHRITIS

    Directory of Open Access Journals (Sweden)

    V. N. Amirdzhanova

    2014-01-01

    Full Text Available The paper considers the joint management of rheumatoid arthritis patients needing endoprosthetic replacement of the large joints of the lower extremities by rheumatologists and orthopedic traumatologists.Due to the fact that there are no conventional standards or guidelines for the perioperative management of patients with rheumatic diseases, adopted by international rheumatology associations, the authors generalize their experience in managing the patients in terms of international approaches and guidelines from different countries. The medical assessment and reduction of cardiovascular risks, the prevention of infectious complications, hemorrhages, and lower extremity deep vein thrombosis, and the specific features of management of patients with osteoporosis are under consideration. The authors' experience in managing the patients receiving antirheumatic therapy with nonsteroidal antiinflammatory and disease-modifying antirheumatic drugs, such as methotrexate, leflunomide, sulfasalazine, and hydroxychloroquine, is detailed. Recommendations for managing patients taking glucocorticoids and biologic agents (tumor necrosis factor-α inhibitors, anti-B-cell therapy, and interleukin-6 receptor inhibitors in the preoperative andpostoperative periods are given.

  7. Two-finger (TF) SPUDT cells.

    Science.gov (United States)

    Martin, Guenter; Biryukov, Sergey V; Schmidt, Hagen; Steiner, Bernd; Wall, Bert

    2011-03-01

    SPUDT cells including two fingers are only known thus far for so-called NSPUDT directions. In that case, usual solid-finger cells are used. The purpose of the present paper is to find SPUDT cell types consisting of two fingers only for pure mode directions. Two-finger (TF) cells for pure mode directions on substrates like 128°YX LiNbO(3) and YZ LiNbO(3) were found by means of an optimization procedure. The forward direction of a TF-cell SPUDT on 128°YX LiNbO(3) was determined experimentally. The properties of the new cells are compared with those of conventional SPUDT cells. The reflectivity of TF cells on 128°YX LiNbO(3) turns out to be two to three times larger than that of distributed acoustic reflection transducer (DART) and Hanma-Hunsinger cells at the same metal layer thickness.

  8. Finger prosthesis: a boon to handicapped.

    Science.gov (United States)

    Gupta, Ridhima; Kumar, Lakshya; Rao, Jitendra; Singh, Kamleshwar

    2013-08-29

    This is a clinical case report of a 52-year-old male patient with four partially missing fingers of the left hand. The article describes the clinical and laboratory procedure of making prosthesis with modern silicone material. A wax pattern was fabricated using the right hand of the patient. A special type of wax was formulated to make the pattern so that it can be easily moulded and carved. Intrinsic and extrinsic staining was also performed to match the adjacent skin colour. The patient was given the finger prosthesis and was asked to use a half glove (sports) to mask the junction between the prosthesis and the normal tissue. It also provides additional retention to the artificial fingers. The patient felt his social acceptance improved after wearing the finger prosthesis.

  9. Patient-specific prosthetic fingers by remote collaboration--a case study.

    Directory of Open Access Journals (Sweden)

    John-John Cabibihan

    Full Text Available The concealment of amputation through prosthesis usage can shield an amputee from social stigma and help improve the emotional healing process especially at the early stages of hand or finger loss. However, the traditional techniques in prosthesis fabrication defy this as the patients need numerous visits to the clinics for measurements, fitting and follow-ups. This paper presents a method for constructing a prosthetic finger through online collaboration with the designer. The main input from the amputee comes from the Computer Tomography (CT data in the region of the affected and the non-affected fingers. These data are sent over the internet and the prosthesis is constructed using visualization, computer-aided design and manufacturing tools. The finished product is then shipped to the patient. A case study with a single patient having an amputated ring finger at the proximal interphalangeal joint shows that the proposed method has a potential to address the patient's psychosocial concerns and minimize the exposure of the finger loss to the public.

  10. Investigation of an alleged mechanism of finger injury in an automobile crash.

    Science.gov (United States)

    Stacey, Stephen; Kent, Richard

    2006-07-01

    This investigation centers on the case of an adult male whose finger was allegedly amputated by the steering wheel of his car during a crash. The subject claimed to have been driving with his left index finger inserted through a hole in the spoke of his steering wheel and was subsequently involved in an offset frontal collision with a tree. The finger was found to be cleanly severed at the mid-shaft of the proximal phalanx after the crash. This injury was alleged to have been caused by inertial loading from the rotation of the steering wheel during the crash. To determine whether this injury mechanism was plausible, three laboratory tests representing distinct loading scenarios were carried out with postmortem human surrogates loaded dynamically by the subject's steering wheel. It was found that the inertial loads generated in this loading scenario are insufficient to amputate the finger. Additionally, artificially constraining the finger to force an amputation to occur revealed that a separation at the proximal interphalangeal joint occurs rather than a bony fracture of the proximal phalanx. Based on these biomechanical tests, it can be concluded that the subject's injury did not occur during the automobile crash in question. Furthermore, it can be shown that the injury was self-inflicted to fraudulently claim on an insurance policy.

  11. RHEUMATOID ARTHRITIS AND PREGNANCY

    Directory of Open Access Journals (Sweden)

    N. M. Kosheleva

    2014-01-01

    Full Text Available Rheumatoid arthritis (RA generally starts at the age when many women have already become mothers; however, it may occur in childhood or adolescence. Furthermore, there has been recently a women’s tendency to plan pregnacy for a more mature age, which necessitates a discussion about gestation in this disease. Investigation of mechanisms pregnancy can influence the development of RA both in the gestation and long-term periods is of important theoretical and practical value. The results of these investigations may be used to develop new treatments for RA and management tactics for patients during pregnancy and lactation. The  aper gives the data available in the literature on fertility in RA, impact of pregnancy on its activity and that of RA on the course and outcomes of gestation, as well as current ideas on lactation and use of oral contraceptives in RA. Particular attention is given to drug therapy in pregnant and breastfeeding women with RA: groups of anti-rheumatic drugs are considered in detail in relation to the safety of or a potential risk from their use. A therapeutic algorithm and recommendations for pregnancy planning and a follow-up of patients with RA during gestation are proposed.

  12. Leishmaniasis in rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    M. Cutolo

    2011-09-01

    Full Text Available Leishmaniasis represents a complex of diseases with an important clinical and epidemiological diversity. Visceral leishmaniasis is of higher priority than cutaneous leishmaniasis as it is a fatal disease in the absence of treatment. The clinical spectrum of leishmaniasis and control of the infection are influenced by the parasite-host relationship. The role of cellular immune responses of the Th1 type in the protection against disease in experimental and human leishmaniasis is well established. TNF-α has been implicated in cytokine-induced macrophage activation and tissue granuloma formation, two activities linked to control of intracellular visceral infection caused by Leishmania donovani. Anti- tumor necrosis factor-alpha (TNF-α strategies have had a marked and substantial impact in the treatment of rheumatoid arthritis, however the clinical use of TNF-α antagonists has been accompanied by increased reporting of infections. Here we report the first case of visceral leishmaniasis in a patient treated for a long period of time with human anti TNF-α monoclonal antibody, adalimumab. Due to the low incidence rate of Mediterranean visceral leishmaniasis, a systematic screening for leishmaniasis in all patients treated with biologics may be not recommended. However, for those patients living at high risk of leishmaniasis exposure, a periodical serological monitoring should be performed during therapy with anti-TNF monoclonal antibodies.

  13. Stainless steel quadralatch finger test report

    International Nuclear Information System (INIS)

    Deichelbohrer, P.R.

    1996-01-01

    The design of the quadralatch on the universal samplers was changed in response to flammable gas operating constraints. Additional redesign of the fingers was included to facilitate manufacturability. The new design was tested to assure satisfactory performance. It was shown that the fingers can hold a sampler in place with an upward force of at least 2200 N (500 pounds) and that the mechanical remote latch unit can release the quadralatch under this condition of maximum upward force

  14. Control System Design of the YWZ Multi-Fingered Dexterous Hand

    Directory of Open Access Journals (Sweden)

    Wenzhen Yang

    2012-07-01

    Full Text Available The manipulation abilities of a multi-fingered dexterous hand, such as motion in real-time, flexibility, grasp stability etc., are largely dependent on its control system. This paper developed a control system for the YWZ dexterous hand, which had five fingers and twenty degrees of freedom (DOFs. All of the finger joints of the YWZ dexterous handwere active joints driven by twenty micro-stepper motors respectively. The main contribution of this paper was that we were able to use stepper motor control to actuate the hand's fingers, thus, increasing the hands feasibility. Based the actuators of the YWZ dexterous hand, we firstly developed an integrated circuit board (ICB, which was the communication hardware between the personal computer (PC and the YWZ dexterous hand. The ICB included a centre controller, twenty driver chips, a USB port and other electrical parts. Then, a communication procedure between the PC and the ICB was developed to send the control commands to actuate the YWZ dexterous hand. Experiment results showed that under this control system, the motion of the YWZ dexterous hand was real-time; both the motion accuracy and the motion stability of the YWZ dexterous hand were reliable. Compared with other types of actuators related to dexterous hands, such as pneumatic servo cylinder, DC servo motor, shape memory alloy etc., experiment results verified that the stepper motors as actuators for the dexterous handswere effective, economical, controllable and stable.

  15. Magnetic resonance imaging in rheumatoid arthritis advances and research priorities

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; McQueen, FM; Bird, P

    2005-01-01

    Magnetic resonance imaging (MRI) has now been used extensively in cross-sectional and observational studies as well as in controlled clinical trials to assess disease activity and joint damage in rheumatoid arthritis (RA). MRI measurements or scores for erosions, bone edema, and synovitis have be......, and financial context of the study in question. We review the extent to which MRI assessments of joint erosion, bone edema, and synovitis fulfil these criteria, particularly as they relate to proof-of-concept RA clinical trials.......Magnetic resonance imaging (MRI) has now been used extensively in cross-sectional and observational studies as well as in controlled clinical trials to assess disease activity and joint damage in rheumatoid arthritis (RA). MRI measurements or scores for erosions, bone edema, and synovitis have been...... developed and validated by several groups. The OMERACT criteria require that outcome measures demonstrate adequate validity, discriminative power, and feasibility if they are to be useful in clinical trials. Specific performance targets for these criteria depend on the scientific, regulatory, logistical...

  16. Thyroid disorders in patients with newly diagnosed rheumatoid arthritis is associated with poor initial treatment response evaluated by disease activity score in 28 joints-C-reactive protein (DAS28-CRP)

    DEFF Research Database (Denmark)

    Emamifar, Amir; Hangaard, Jørgen; Jensen Hansen, Inger Marie

    2017-01-01

    peptide antibody (anti-CCP), and antinuclear antibody (ANA), and also disease activity score in 28 joints-C-reactive protein at the time of diagnosis and after 4 months (±1–2 months) of treatment initiation were extracted from Danish Danbio Registry. Patients’ electronic hospital records for the past 10...... years were reviewed to reveal if they had been diagnosed with thyroid disorders or they had abnormal thyroid test.In all, 439 patients were included, female 60.1%, mean age 64.6 ± 15.0 years and disease duration 2.6 ± 1.7 years. Prevalence of thyroid disorders was 69/439 (15.7%) and hypothyroidism...... treatment compared with patients with isolated RA after 4 months of treatment (P = .02). There were no associations between thyroid disorders and age, disease duration, and also IgM RF positivity.Presence of thyroid disorders in RA patients is suggestive of a more aggressive disease and poor outcome...

  17. Calcium pyrophosphate dihydrate and hydroxyapatite crystals in a patient with rheumatoid arthritis: Acase report

    Directory of Open Access Journals (Sweden)

    Shereen R Kamel

    2017-01-01

    Full Text Available The association between rheumatoid arthritis (RA and calcium pyrophosphate dihydrate (CPPD crystal deposits can now be easily identified by MSUS, which is a noninvasive technique that can be applied to patients with painful joints and enthesis that are unexplained by rheumatoid activity. In this paper, we report an Egyptian case of a 51-year-old man who had rheumatoid arthritis since 7 years and developed bilateral knee and heel pain of 1.5 months’ duration with gradual onset and progressive course. Radiography revealed features of RA in both hands, as well as features of severe osteoarthritis in both knees with no signs of chondrocalcinosis. Ultrasonography of the joints, Achilles tendon, and plantar fascia detected knee, Achilles tendon, and plantar fascia calcifications, which are characteristic of CPPD, and supraspinatus calcification, which is characteristic of hydroxyapatite (HA deposition. Further investigations revealed no evidence of metabolic disorders. CPPD and HA crystals were identified in his synovial fluid. Subclinical affection with CPPD and HA crystals in RA can be easily detected by ultrasonography, which allows early management to prevent future attacks in RA patients that could lead to exacerbation of joint symptoms that may be missed as rheumatoid disease activity. Diet control and colchicine treatment may be more effective if started early before exacerbation.

  18. Late onset rheumatoid arthritis an observational study.

    Science.gov (United States)

    Rexhepi, Sylejman; Rexhepi, Mjellma; Sahatçiu-Meka, Vjollca; Rexhepi, Blerta; Bahtiri, Elton; Mahmutaj, Vigan

    Rheumatoid arthritis (RA) may have an onset at older age. The onset of the disease at the age of 60 and over is called late-onset rheumatoid arthritis (LORA). The aim of this study was to analyze the clinical, laboratory, radiological, and treatment characteristics of patients with LORA compared to those with early-onset RA (EaORA), provided that all the patients had an approximately equal duration of the disease. This is an observational single-center study, which involved 120 patients with an established diagnosis of RA, of which 60 patients had LORA, and 60 patients EaORA. The disease activity, measured by the Disease Activity Score 28 (DAS28-ESR), was significantly higher in the LORA group compared to the EaORA group (p0.05), while the number of patients positive for anti-citrullinated protein antibody (ACPA) was signifi cantly greater in the EaORA group (p<0.05). The values of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were significantly higher in the LORA than in the EaORA group. Hemoglobin levels were lower in the LORA group (11.96±1.64 g/dL) than in the EaORA group (12.18±1.56 g/dL). The most used disease-modifying antirheumatic drugs (DMARDs) were methotrexate and sulfasalazine, while biological drugs were not used. In conclusion, based on the results of our study, LORA has some features that distinguish it from EaORA, such as higher disease activity, more frequent involvement of large joints, and more pronounced structural damage. This should be taken in account in clinical practice, especially regarding treatment choices.

  19. Finger Search in the Implicit Model

    DEFF Research Database (Denmark)

    Brodal, Gerth Stølting; Nielsen, Jesper Asbjørn Sindahl; Truelsen, Jakob

    2012-01-01

    We address the problem of creating a dictionary with the finger search property in the strict implicit model, where no information is stored between operations, except the array of elements. We show that for any implicit dictionary supporting finger searches in q(t) = Ω(logt) time, the time to move...... the finger to another element is Ω(q− 1(logn)), where t is the rank distance between the query element and the finger. We present an optimal implicit static structure matching this lower bound. We furthermore present a near optimal implicit dynamic structure supporting search, change-finger, insert......, and delete in times $\\mathcal{O}(q(t))$, $\\mathcal{O}(q^{-1}(\\log n)\\log n)$, $\\mathcal{O}(\\log n)$, and $\\mathcal{O}(\\log n)$, respectively, for any q(t) = Ω(logt). Finally we show that the search operation must take Ω(logn) time for the special case where the finger is always changed to the element...

  20. Finger replantation: surgical technique and indications.

    Science.gov (United States)

    Barbary, S; Dap, F; Dautel, G

    2013-12-01

    In this article, we discuss the surgical technique of finger replantation in detail, distinguishing particularities of technique in cases of thumb amputation, children fingertip replantation, ring finger avulsion, and very distal replantations. We emphasize the principles of bone shortening, the spare part concept, the special importance of nerve sutures and the use of vein graft in case of avulsion or crushing. However, even if finger replantation is now a routine procedure, a clear distinction should be made between revascularization and functional success. The indications for finger replantation are then detailed in the second part of this paper. The absolute indications for replantation are thumb, multiple fingers, transmetacarpal or hand, and any upper extremity amputation in a child whatever the level. Fingertip amputations distal to the insertion of the Flexor digitorum superficialis (FDS) are also a good indication. Other cases are more controversial because of the poor functional outcome, especially for the index finger, which is often functionally excluded. Copyright © 2013. Published by Elsevier SAS.

  1. Serodiagnosis and immune profile in rheumatoid arthritis.

    Science.gov (United States)

    Chakraborty, P; Bhattacharya, S; Chakraborty, M; Pal, B

    1997-11-01

    One hundred and seventy-five cases of clinically diagnosed rheumatoid arthritis, 82 non-rheumatoid cases suffering from various other diseases and 40 healthy normal controls were investigated for detection of rheumatoid factor, quantitation of serum immunoglobulin, demonstration of antinuclear antibody (ANA) and LE cell phenomenon. Microlatex agglutination test of serum for rheumatoid factor (RF) showed 64% positivity in rheumatoid group and 1.2% positivity in non-rheumatoid group. All three immunoglobulins (IgG, IgM, IgA) were found to be raised in serum of patients with rheumatoid arthritis, whereas only IgA level was elevated in serum of patients with non-rheumatoid diseases. ANA and LE cell phenomenon were observed in 3.4% and 2.8% cases respectively in cases of clinically diagnosed rheumatoid arthritis who had been suffering from severe active rheumatoid arthritis. In non-rheumatoid group RF was positive in significant titre in only one case of leprosy. Synovial fluid and synovium were found to be heavily infiltrated by plasma cells and lymphocytes. RF appears first in synovial fluid and then in serum. Hence RF titre in blood may not attain significant level for the first several months.

  2. Serology and immunoglobulin profile in rheumatoid arthritis.

    Science.gov (United States)

    Adhya, S; Chakraborty, G; Hajra, B; Bhattacharya, S; Sikdar, P K; Sinha, S; Banerjee, P P; Ghosh, E; Chakraborty, P

    1998-01-01

    One hundred and twenty cases of clinically diagnosed rheumatoid arthritis, 80 non-rheumatoid cases suffering from various other diseases and 40 healthy individuals were investigated for the presence of rheumatoid factor, quantitation of serum immunoglobulin, demonstration of ANA and LE cell phenomenon. Microlatex agglutination test of serum for rheumatoid factor showed 56.6% positivity in rheumatoid group and 3.7% positivity in non-rheumatoid group. All three serum immunoglobulins (IgG, IgM, IgA) were raised in serum in significant titre in cases of rheumatoid arthritis, whereas only IgA lever was elevated in the group of non-rheumatoid diseases. ANA and LE cell phenomenon were observed in 11.7% and 4.4% cases of rheumatoid arthritis who had severe underlying disease. In non-rheumatoid group, only one of 6 cases of systemic lupus erythematosus showed rheumatoid factor and that too in an insignificant titre (less than 1:20). Synovium and synovial fluid contained plenty of plasma cells and lymphocytes. It has been observed that RF appears first in synovial fluid and it may take several months to a year to attain detectable level in serum.

  3. New Finger Biometric Method Using Near Infrared Imaging

    Science.gov (United States)

    Lee, Eui Chul; Jung, Hyunwoo; Kim, Daeyeoul

    2011-01-01

    In this paper, we propose a new finger biometric method. Infrared finger images are first captured, and then feature extraction is performed using a modified Gaussian high-pass filter through binarization, local binary pattern (LBP), and local derivative pattern (LDP) methods. Infrared finger images include the multimodal features of finger veins and finger geometries. Instead of extracting each feature using different methods, the modified Gaussian high-pass filter is fully convolved. Therefore, the extracted binary patterns of finger images include the multimodal features of veins and finger geometries. Experimental results show that the proposed method has an error rate of 0.13%. PMID:22163741

  4. Balance between activating NKG2D, DNAM-1, NKp44 and NKp46 and inhibitory CD94/NKG2A receptors determine natural killer degranulation towards rheumatoid arthritis synovial fibroblasts

    DEFF Research Database (Denmark)

    Nielsen, Natasja; Pascal, Veronique; Fasth, Andreas E R

    2014-01-01

    Rheumatoid arthritis (RA) is an autoimmune disease characterized by chronic inflammation and synovial hyperplasia leading to progressive joint destruction. Fibroblast-like synoviocytes (FLS) are central components of the aggressive, tumour-like synovial structure termed pannus, which invades the ...

  5. Scintigraphic control of a chondro-protective therapy in osteoarthritis of fingers

    International Nuclear Information System (INIS)

    Ammer, K.

    1990-01-01

    A pilot study in patients with osteoarthritis of fingers was done to clarify the question, whether abnormal joints in bone scanning can predict degenerative changes in X-rays and if scintigraphy is of help in monitoring therapy with chondroprotective medicaments. 2 groups of 7 patients with symptomatic osteoarthritis of fingers were treated either with galvanic bath alone or in combination with Rumalon (registered trademark) -injections for 6 weeks. After therapy the number of abnormal joints in bone scan and number of tender joints was found reduced in both groups, a decrease of the mean circumference of joints was only seen in the Rumalon (registered trademark) -group. After 1 year an increase of degenerative signs in X-rays was demonstrated in both groups. But the number of tender joints was smaller in the Rumalon (registered trademark) -group than in controls. For abnormal joints in bone scanning a high positive value was calculated regarding to signs of osteoarthritis in radiographs. But no major information in monitoring the chondroprotective efficacy of the medicament was given by bone scanning. (Author)

  6. Radiological aspects of rheumatoid arthritis

    International Nuclear Information System (INIS)

    Schacherl, M.

    1985-01-01

    An introductory summary of the imaging-diagnosis will be given. The necessity of acquiring a catalogue of application to particular imaging methods is emphasized. Discussion of step by step diagnosis regarding rheumatologic questions is given on example of the hand. Technically insufficient radiographs and bad habits during diagnostic analysis are pointed out. Radiologic problems in differentiating arthritis/osteoarthrosis will be mentioned. The discussion of these points is followed by outlining the radiology of rheumatoid arthritis and the complexity of this disease. Introduction of a new stage classification. Finally twelve basic radiologic types of rheumatoid arthritis will be presented. (orig.) [de

  7. Anticardiolipin antibodies in rheumatoid arthritis.

    Science.gov (United States)

    Keane, A; Woods, R; Dowding, V; Roden, D; Barry, C

    1987-10-01

    Anticardiolipin antibody (ACA) was present in the sera of 49% of 90 consecutive patients with rheumatoid arthritis (RA). The ACA was absent in 30 control patients with osteoarthritis. C-reactive protein levels equal to or exceeding 7 mg/dl were found in 10 patients all of whom were ACA positive. ACA was present in a larger proportion of rheumatoid factor (RF) positive than of RF negative patients. Male sex and extra-articular manifestations of RA were both more common in ACA positive than ACA negative patients. In the ACA positive group the lupus anticoagulant and VDRL tests were negative. However, a small number of patients had evidence of vascular events.

  8. Finger multibiometric cryptosystems: fusion strategy and template security

    Science.gov (United States)

    Peng, Jialiang; Li, Qiong; Abd El-Latif, Ahmed A.; Niu, Xiamu

    2014-03-01

    We address two critical issues in the design of a finger multibiometric system, i.e., fusion strategy and template security. First, three fusion strategies (feature-level, score-level, and decision-level fusions) with the corresponding template protection technique are proposed as the finger multibiometric cryptosystems to protect multiple finger biometric templates of fingerprint, finger vein, finger knuckle print, and finger shape modalities. Second, we theoretically analyze different fusion strategies for finger multibiometric cryptosystems with respect to their impact on security and recognition accuracy. Finally, the performance of finger multibiometric cryptosystems at different fusion levels is investigated on a merged finger multimodal biometric database. The comparative results suggest that the proposed finger multibiometric cryptosystem at feature-level fusion outperforms other approaches in terms of verification performance and template security.

  9. Mobilidade articular dos dedos não lesados pós-reparo em lesão dos tendões flexores da mão Joint range of motion of uninjured fingers after repairs to flexor tendon injuries of the hand

    Directory of Open Access Journals (Sweden)

    RB Rabelo

    2007-10-01

    Full Text Available OBJETIVO: Verificar a amplitude de movimento (ADM em mãos que sofreram reparo tendinoso dos músculos flexores superficial e profundo dos dedos, comparando os dados de cada dedo na mão lesada e entre mãos lesadas e não lesadas. MÉTODOS: Foi realizada a goniometria ativa em 15 pacientes e 120 dedos, 60 dedos de mãos lesadas e 60 de mãos controle não lesadas. Os sujeitos foram avaliados no momento da retirada da tala gessada, tendo sido realizada a movimentação precoce pelo método de Duran modificado. A partir dos dados goniométricos, foram registrados os valores do índice TAM (Total Active Motion dos dedos nas mãos lesadas e controle. Para análise dos dados, foi acessada a fórmula de índices funcionais proposta pela American Society for Surgery of the Hand (ASSH e para cálculo estatístico, foi escolhido o Modelo de Efeitos Mistos. RESULTADOS: A fórmula da ASSH para os dedos lesados mostrou que 18,33% tiveram a classificação do movimento "bom", 18,33%, "regular" e 63,34%, "pobre". Foram comparadas as médias das medidas em graus de todos os dedos entre si dentro de cada grupo, controle ou lesado, e as médias das medidas entre os grupos, encontrando-se um p-valor significante apenas entre os grupos controle e lesado. Não houve diferença estatística entre o TAM de cada dedo na mão lesada. CONCLUSÃO: Independente de quantos dedos tenham sofrido lesão tendinosa em uma mão, os dedos não lesados também terão suas ADMs ativas diminuídas no período logo após a retirada da imobilização.OBJECTIVE: To assess the range of motion (ROM in hands that underwent tendon repair in the flexor digitorum superficialis and flexor digitorum profundus muscles of the fingers, comparing the data between the fingers on the injured hand, and between the injured and uninjured hands. METHOD: Active goniometry was performed on 15 patients, making a total of 120 fingers (60 on injured hands and 60 on noninjured control hands. The patients

  10. Degenerative Joint Diseases and Neuroinflammation.

    Science.gov (United States)

    Fusco, Mariella; Skaper, Stephen D; Coaccioli, Stefano; Varrassi, Giustino; Paladini, Antonella

    2017-04-01

    Rheumatic and joint diseases, as exemplified by osteoarthritis and rheumatoid arthritis, are among the most widespread painful and disabling pathologies across the globe. Given the continuing rise in life expectancy, their prevalence is destined to grow. Osteoarthritis, a degenerative joint disease, is, in particular, on its way to becoming the fourth leading cause of disability worldwide by 2020, with the rising incidence of obesity in addition to age being important factors. It is estimated that 25% of osteoarthritic individuals are unable to perform daily activities. Accompanying osteoarthritis is rheumatoid arthritis, which is a chronic systemic disease that often causes pain and deformity. At least 50% of those affected are unable to remain gainfully employed within 10 years of disease onset. A growing body of evidence now points to inflammation, locally and more systemically, as a promoter of damage to joints and bones, as well as joint-related functional deficits. The pathogenesis underlying joint diseases remains unclear; however, it is currently believed that cross-talk between cartilage and subchondral bone-and loss of balance between these two structures in joint diseases-is a critical element. This view is amplified by the presence of mast cells, whose dysregulation is associated with alterations of junction structures (cartilage, bone, synovia, matrix, nerve endings, and blood vessels). In addition, persistent activation of mast cells facilitates the development of spinal neuroinflammation mediated through their interaction with microglia. Unfortunately, current treatment strategies for rheumatic and articular disease are symptomatic and do little to limit disease progression. Research now should be directed at therapeutic modalities that target osteoarticular structural elements and thereby delaying disease progression and joint replacement. © 2016 World Institute of Pain.

  11. Radiographic visualisation of seropositive rheumatoid arthritis in Carriers of HLA-B27

    International Nuclear Information System (INIS)

    Jurik, A.G.; Carvalho, A. de; Graudal, H.; Aarhus Univ.

    1987-01-01

    A group of 11 B27-positive, seropositive patients with rheumatoid arthritis was compared with 11 matched B27-negative seropositive patients. The radiographs of all limb joints, the sacroiliac joints, and the cervical spine were read blindly. Ten patients in each group were radiographed 2-6 times during observation periods of 3-13 years; one patient in each group was only examined once. The prevailing picture of both groups was that of progressive erosive rheumatoid arthritis, although two small differences were found: Erosions of the apophyseal joints of the cervical spine and slight periosteal new bone formation of the shoulder, hip, and knee regions occurred more often in the B27-positive than in the B27-negative group. (orig.) [de

  12. The visualization of pannus in rheumatoid arthritis using NMR imaging

    International Nuclear Information System (INIS)

    Schnarkowski, P.; Bader, C.; Goldmann, A.; Friedrich, J.M.

    1992-01-01

    The knee joints of 15 patients afflicted with rheumatoid arthritis were investigated using the method of nmr imaging. Parameters of investigation were the spin-echo and fast-field-echo sequences as well as the MR signal behaviour of proliferative synovial changes following intravenous administration of gadolinium dtpa. Pannus having formed on the articular surfaces or beneath the articular cartilages was distinguishable from other changes on the basis of the increased signal intensities to be observed after gadolinium dtpa had been given. (orig./GD) [de

  13. Magnetic resonance imaging for early diagnosis of rheumatoid arthritis

    International Nuclear Information System (INIS)

    Uhl, M.; Allmann, K.H.; Hauer, M.P.; Laubenberger, J.; Kempis, J. v.; Langer, M.

    1997-01-01

    Nuclear magnetic resonance tomography (MRI) represents essential progress in the diagnostic means for evaluation of lesions of the muskuloskeletal system. The imaging of bone joints including material and structures like cartilage, tendons, ligaments, effusions, pannus, cortical bone and marrow offers essential advantages for diagnosis, differential diagnosis, follow-up control and detection of local complications in rheumatics radiology. The review article discusses the achievements of MRI for detection of early signs of rheumatoid arthritis and the current indications for MRI examination for early diagnosis. (Orig./AJ) [de

  14. Results of 198Au-colloid radiosynovectomy in rheumatoid arthritis

    International Nuclear Information System (INIS)

    Drozdovski, B.Ya.; Ikonnikov, A.I.

    1989-01-01

    260 patients with rheumatoid arthritis received injections of colloidal radiogold into their affected joints. The findings of radiosynoviorthesis were analysed in 210 patients. The therapeutic effect developed gradually. The best clinical results were found to occur after 12th month. At the end of the 2nd year 47% of the patients revealed a significant improvement, 38% an improvement and 15% of the patients involved showed no therapeutic effect. Good results were obtained with patients of the roentgenological stage I and II and the disease (70%). (author)

  15. Organising pneumonia - the first manifestation of rheumatoid arthritis.

    Science.gov (United States)

    Kalinova, Desislava; Kolarov, Zlatimir; Rashkov, Rasho

    2017-01-01

    Organising pneumonia (OP) is a distinct type of interstitial lung disease, because it can also be seen in association with several conditions such as infections, drugs, and connective tissue diseases. An association of OP with rheumatoid arthritis (RA) has also been described. Joint manifestations of RA usually precede lung involvements by several years; however, in less than 10% of cases of RA, interstitial lung disease may be the initial feature of RA. Organising pneumonia as the initial manifestation or developed simultaneously of RA is extremely rare, and its clinical features remain unknown. We present a 56-year-old woman with OP as the first manifestation of RA.

  16. Organising pneumonia as the first manifestation of rheumatoid arthritis

    Science.gov (United States)

    Hoshino, Chisho; Satoh, Noriyuki; Narita, Masashi; Kikuchi, Akio; Inoue, Minoru

    2011-01-01

    Organising pneumonia (OP) is an inflammatory lung disease with distinctive clinicopathological features. OP can be evident during the course of rheumatoid arthritis (RA) with increased disease activity. The authors report an OP associated with RA case in which pulmonary symptoms preceded the onset of joint symptoms. An OP patient with elevated serum anticyclic citrullinated peptide antibody is likely to manifest RA in the near future, reflecting its high disease activity. Thus, an early rheumatologic consultation should be taken into consideration to make an early decision to initiate disease-modifying antirheumatic drugs therapy. PMID:22699479

  17. Cross-finger dermal pocketing to augment venous outflow for distal fingertip replantation.

    Science.gov (United States)

    Tan, Valerie H; Murugan, Arul; Foo, Tun-Lin; Puhaindran, Mark E

    2014-09-01

    Venous anastomosis in distal fingertip replantations is not always possible, and venous congestion is recognized as a potential cause of failure. Methods previously described to address this problem include amputate deepithelization and dermal pocketing postarterial anastomosis to augment venous outflow. However, attachment of the digit to the palm or abdomen resulted in finger stiffness. We describe a modification of the previous methods by utilizing dermal flaps raised from the adjacent digit in the form of a cross-finger flap. The key differences are the partial deepithelization of the replanted fingertip and subsequent replacement of the dermal flap to the donor digit to minimize donor site morbidity. During the period where the 2 digits are attached, interphalangeal joint mobilization is permitted to maintain joint mobility.

  18. Rehabilitation of single finger amputation with customized silicone prosthesis

    OpenAIRE

    Yadav, Niharika; Chand, Pooran; Jurel, Sunit Kumar

    2016-01-01

    Finger amputations are common in accidents at home, work, and play. Apart from trauma, congenital disease and deformity also leads to finger amputation. This results in loss of function, loss of sensation as well as loss of body image. Finger prosthesis offers psychological support and social acceptance in such cases. This clinical report describes a method to fabricate ring retained silicone finger prosthesis in a patient with partial finger loss.

  19. Finger tapping ability in healthy elderly and young adults.

    Science.gov (United States)

    Aoki, Tomoko; Fukuoka, Yoshiyuki

    2010-03-01

    The maximum isometric force production capacity of the fingers decreases with age. However, little information is available on age-related changes in dynamic motor capacity of individual fingers. The purpose of this study was to compare the dynamic motor function of individual fingers between elderly and young adults using rapid single-finger and double-finger tapping. Fourteen elderly and 14 young adults performed maximum frequency tapping by the index, middle, ring, or little finger (single-finger tapping) and with alternate movements of the index-middle, middle-ring, or ring-little finger-pair (double-finger tapping). The maximum pinch force between the thumb and each finger, tactile sensitivity of each fingertip, and time taken to complete a pegboard test were also measured. Compared with young subjects, the older subjects had significantly slower tapping rates in all fingers and finger-pairs in the tapping tasks. The age-related decline was also observed in the tactile sensitivities of all fingers and in the pegboard test. However, there was no group difference in the pinch force of any finger. The tapping rate of each finger did not correlate with the pinch force or tactile sensitivity for the corresponding finger in the elderly subjects. Maximum rate of finger tapping was lower in the elderly adults compared with the young adults. The decline of finger tapping ability in elderly adults seems to be less affected by their maximum force production capacities of the fingers as well as tactile sensitivities at the tips of the fingers.

  20. Advanced imaging in rheumatoid arthritis. Part 2: Erosions

    International Nuclear Information System (INIS)

    Farrant, J.M.; O'Connor, P.J.; Grainger, A.J.

    2007-01-01

    Rheumatoid arthritis (RA) is a chronic and progressive inflammatory disorder primarily affecting the synovium. We now recognise that conventional radiographic images show changes of rheumatoid arthritis late after irreversible joint damage has occured. With the advent of powerful disease-modifying drugs there is a need for early demonstration of rheumatoid arthritis and to monitor progress of the disease and response to therapy. Advanced imaging techniques such as ultrasound and MRI have focussed on the demonstration and quanitification of synovitis and erosions and allow early diagnosis of RA. The technology to quantify synovitis and erosions is developing rapidly and now allows change in disease activity to be assessed. However, problems undoubtedly exist in quantification techniques and this review serves to highlight them. Much of the literature on advanced imaging in RA appears in rheumatological journals and may not be familiar to radiologists. This review article aims to increase the awareness of radiologists to this field and to encourage them to participate and contribute to the ongoing development of these modalities. Without this collaboration it is unlikely that these modalities will reach their full potential in the field of rheumatological imaging. This review is in two parts. This first part addresses synovitis imaging. The second part will look at advanced imaging of erosions in RA. (orig.)

  1. Laser acupuncture versus reflexology therapy in elderly with rheumatoid arthritis.

    Science.gov (United States)

    Adly, Afnan Sedky; Adly, Aya Sedky; Adly, Mahmoud Sedky; Serry, Zahra M H

    2017-07-01

    The purposes of this study are to determine and compare efficacy of laser acupuncture versus reflexology in elderly with rheumatoid arthritis. Thirty elderly patients with rheumatoid arthritis aged between 60 and 70 years were classified into two groups, 15 patients each. Group A received laser acupuncture therapy (904 nm, beam area of 1cm 2 , power 100 mW, power density 100 mW/cm 2 , energy dosage 4 J, energy density 4 J/cm 2 , irradiation time 40 s, and frequency 100,000 Hz). The acupuncture points that were exposed to laser radiation are LR3, ST25, ST36, SI3, SI4, LI4, LI11, SP6, SP9, GB25, GB34, and HT7. While group B received reflexology therapy, both offered 12 sessions over 4 weeks. The changes in RAQoL, HAQ, IL-6, MDA, ATP, and ROM at wrist and ankle joints were measured at the beginning and end of treatment. There was significant decrease in RAQoL, HAQ, IL-6, and MDA pre/posttreatment for both groups (p rheumatoid arthritis.

  2. Advanced imaging in rheumatoid arthritis. Part 1: Synovitis

    International Nuclear Information System (INIS)

    Farrant, J.M.; O'Connor, P.J.; Grainger, A.J.

    2007-01-01

    Rheumatoid arthritis (RA) is a chronic and progressive inflammatory disorder primarily affecting the synovium. We now recognise that conventional radiographic images show changes of rheumatoid arthritis long after irreversible joint damage has occured. With the advent of powerful disease-modifying drugs, there is a need for early demonstration of rheumatoid arthritis and a need to monitor progress of the disease and response to therapy. Advanced imaging techniques such as ultrasound and MRI have focussed on the demonstration and quantification of synovitis and erosions and allow early diagnosis of RA. The technology to quantify synovitis and erosions is developing rapidly and now allows change in disease activity to be assessed. However, problems undoubtedly exist in quantification techniques, and this review serves to highlight them. Much of the literature on advanced imaging in RA appears in rheumatological journals and may not be familiar to radiologists. This review article aims to increase the awareness of radiologists about this field and to encourage them to participate and contribute to the ongoing development of these modalities. Without this collaboration, it is unlikely that these modalities will reach their full potential in the field of rheumatological imaging. This review is in two parts. The first part addresses synovitis imaging. The second part will look at advanced imaging of erosions in RA. (orig.)

  3. Radiographic changes in the os calcis in rheumatoid arthritis

    International Nuclear Information System (INIS)

    Lakits, A.

    1994-01-01

    Plain films of the calcanea of 768 patients with confirmed rheumatoid arthritis were examined retrospectively with reference to inflammatory rheumatic changes. 42 patients (5.5%) showed an erosion of the posterior upper calcaneal margin related to an Achilles bursitis. In three patients there were additional plantar erosions. The Achilles bursitis was bilateral in 50% of cases, particularly in patients in stages 2 and 3 according to Steinbrocker. In the majority of bilateral cases (62%) the size or shape of the lesions was asymmetrical. Our observations indicate that involvement of the os calcis is not uncommon in rheumatoid arthritis; routine examination of this bone would appear to be indicated even in patients without symptoms. Since the defect is unilateral in half the patients, unilateral occurrence of an erosive lesion cannot be regarded as a criterion for a bacterial-inflammatory bursitis. Contrary to the symmetrical involvement of joints in the hands in rheumatoid arthritis, defects in the calcanea are often unilateral or asymmetrical. (orig.) [de

  4. A comparison of rural and urban rheumatoid arthritis populations.

    Science.gov (United States)

    Basu, N; Steven, M

    2009-02-01

    There is evidence to suggest that remote populations have poorer clinical outcomes in certain disease processes such as asthma and cancer. This study looks to identify any disparities in the management of patients with rheumatoid arthritis in the context of rurality. A retrospective observational study was performed on all 1314 patients with a diagnosis of rheumatoid arthritis who have been under the care of the principal rheumatologist at Raigmore Hospital, Inverness, between the years 1994 and 2004 inclusive. Rurality was defined according to the Scottish Household Survey. Populations were assessed in terms of age; sex; duration of diagnosis; number of years of Disease Modifying AntiRheumatic Drugs (DMARD) therapy, prednisolone use and the number of musculoskeletal practical interventions undertaken (eg joint aspiration or replacement). Two thirds of patients were considered rural dwellers. No significant difference was established between the populations with regards to management. DMARD therapy had been prescribed in 77% of rural patients vs 70% of their city counterparts for a mean 5.4 and 4.0 years respectively. The proportion of patients exposed to prednisolone therapy and who underwent musculoskeletal procedures were equivalent. Rural dwellers, with rheumatoid arthritis in the Highlands of Scotland, do not appear to be disadvantaged in regards to their disease management in comparison to the urban population.

  5. Design and preliminary evaluation of the FINGER rehabilitation robot: controlling challenge and quantifying finger individuation during musical computer game play.

    Science.gov (United States)

    Taheri, Hossein; Rowe, Justin B; Gardner, David; Chan, Vicki; Gray, Kyle; Bower, Curtis; Reinkensmeyer, David J; Wolbrecht, Eric T

    2014-02-04

    This paper describes the design and preliminary testing of FINGER (Finger Individuating Grasp Exercise Robot), a device for assisting in finger rehabilitation after neurologic injury. We developed FINGER to assist stroke patients in moving their fingers individually in a naturalistic curling motion while playing a game similar to Guitar Hero. The goal was to make FINGER capable of assisting with motions where precise timing is important. FINGER consists of a pair of stacked single degree-of-freedom 8-bar mechanisms, one for the index and one for the middle finger. Each 8-bar mechanism was designed to control the angle and position of the proximal phalanx and the position of the middle phalanx. Target positions for the mechanism optimization were determined from trajectory data collected from 7 healthy subjects using color-based motion capture. The resulting robotic device was built to accommodate multiple finger sizes and finger-to-finger widths. For initial evaluation, we asked individuals with a stroke (n = 16) and without impairment (n = 4) to play a game similar to Guitar Hero while connected to FINGER. Precision design, low friction bearings, and separate high speed linear actuators allowed FINGER to individually actuate the fingers with a high bandwidth of control (-3 dB at approximately 8 Hz). During the tests, we were able to modulate the subject's success rate at the game by automatically adjusting the controller gains of FINGER. We also used FINGER to measure subjects' effort and finger individuation while playing the game. Test results demonstrate the ability of FINGER to motivate subjects with an engaging game environment that challenges individuated control of the fingers, automatically control assistance levels, and quantify finger individuation after stroke.

  6. Admittance Control of a Multi-Finger Arm Based on Manipulability of Fingers

    Directory of Open Access Journals (Sweden)

    Jian Huang

    2011-09-01

    Full Text Available In the previous studies, admittance control and impedance control for a finger-arm robot using the manipulability of the finger were studied and methods of realizing the controls have been proposed. In this study, two 3-DOF fingers are attached to the end-effector of a 6-DOF arm to configure a multi-finger arm robot. Based on the previous methods, the authors have proposed an admittance control for a multi-finger arm robot using the manipulability of the fingers in this study. Algorithms of the averaging method and the mini-max method were introduced to establish a manipulability criterion of the two fingers in order to generate a cooperative movement of the arm. Comparison of the admittance controls combined with the top search method and local optimization method for the multi-finger arm robot was made and features of the control methods were also discussed. The stiffness control and damping control were experimentally evaluated to demonstrate the effectiveness of the proposed methods.

  7. Quantifying Parkinson's disease finger-tapping severity by extracting and synthesizing finger motion properties.

    Science.gov (United States)

    Sano, Yuko; Kandori, Akihiko; Shima, Keisuke; Yamaguchi, Yuki; Tsuji, Toshio; Noda, Masafumi; Higashikawa, Fumiko; Yokoe, Masaru; Sakoda, Saburo

    2016-06-01

    We propose a novel index of Parkinson's disease (PD) finger-tapping severity, called "PDFTsi," for quantifying the severity of symptoms related to the finger tapping of PD patients with high accuracy. To validate the efficacy of PDFTsi, the finger-tapping movements of normal controls and PD patients were measured by using magnetic sensors, and 21 characteristics were extracted from the finger-tapping waveforms. To distinguish motor deterioration due to PD from that due to aging, the aging effect on finger tapping was removed from these characteristics. Principal component analysis (PCA) was applied to the age-normalized characteristics, and principal components that represented the motion properties of finger tapping were calculated. Multiple linear regression (MLR) with stepwise variable selection was applied to the principal components, and PDFTsi was calculated. The calculated PDFTsi indicates that PDFTsi has a high estimation ability, namely a mean square error of 0.45. The estimation ability of PDFTsi is higher than that of the alternative method, MLR with stepwise regression selection without PCA, namely a mean square error of 1.30. This result suggests that PDFTsi can quantify PD finger-tapping severity accurately. Furthermore, the result of interpreting a model for calculating PDFTsi indicated that motion wideness and rhythm disorder are important for estimating PD finger-tapping severity.

  8. Robotic finger perturbation training improves finger postural steadiness and hand dexterity.

    Science.gov (United States)

    Yoshitake, Yasuhide; Ikeda, Atsutoshi; Shinohara, Minoru

    2018-02-01

    The purpose of the study was to understand the effect of robotic finger perturbation training on steadiness in finger posture and hand dexterity in healthy young adults. A mobile robotic finger training system was designed to have the functions of high-speed mechanical response, two degrees of freedom, and adjustable loading amplitude and direction. Healthy young adults were assigned to one of the three groups: random perturbation training (RPT), constant force training (CFT), and control. Subjects in RPT and CFT performed steady posture training with their index finger using the robot in different modes: random force in RPT and constant force in CFT. After the 2-week intervention period, fluctuations of the index finger posture decreased only in RPT during steady position-matching tasks with an inertial load. Purdue pegboard test score improved also in RPT only. The relative change in finger postural fluctuations was negatively correlated with the relative change in the number of completed pegs in the pegboard test in RPT. The results indicate that finger posture training with random mechanical perturbations of varying amplitudes and directions of force is effective in improving finger postural steadiness and hand dexterity in healthy young adults. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Magnetic resonance imaging of the hand in rheumatoid arthritis. New scientific insights and practical application

    International Nuclear Information System (INIS)

    Hermann, K.G.A.

    2006-01-01

    Magnetic resonance imaging (MRI) is a sensitive diagnostic modality for the detection of inflammatory changes in peripheral joints. Nevertheless, the widespread clinical use of MRI in assessing patients with early rheumatoid arthritis is still hampered by the technical complexity and higher cost of MRI compared with conventional radiography. This overview summarizes the results of recent research and gives practical tips on how to perform MRI of the hands. The authors present an MR protocol for hand imaging, discuss the pros and cons of low-field MR scanners, and outline pitfalls and artifacts. The MRI changes associated with rheumatoid arthritis such as synovitis, tenosynovitis, erosions, and bone marrow edema are described including their prognostic significance. The proven facts on the validation and grading of MR changes in rheumatoid arthritis are summarized. Finally, the role of MRI in the differential diagnosis of arthritis is critically discussed. (orig.) [de

  10. The safety of interleukin-1 receptor antagonist (anakinra in the treatment of rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    L. Riente

    2011-09-01

    Full Text Available The safety profile of interleukin-1 receptor antagonist (anakinra has been studied with randomised, placebo-controlled trials involving 2932 patients affected by rheumatoid arthritis. The most frequently reported adverse events were represented by injection site reactions (71% and headache (13.6%. No statistically significant difference in the incidence of infections was observed among the patients treated with the interleukin-1 receptor antagonist and the patients receiving placebo. In particular, the incidence of serious infections was 1,8% in rheumatoid arthritis patients on anakinra therapy and 0,7% in patients on placebo. The reported serious infections consisted of pneumonia, cellulitis, bone and joint infections, bursitis. No case of opportunistic infections or tubercolosis was observed. The results of clinical studies suggest that anakinra is a new well-tolerated drug for the treatment of patients affected by rheumatoid arthritis.

  11. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Patients from Johns Hopkins Stategies to Increase your Level of Physical Activity Role of Body Weight in Osteoarthritis Educational Videos for Patients Rheumatoid Arthritis Educational Video Series Psoriatic Arthritis 101 2010 E.S.C.A.P.E. Study Patient Update Transitioning the JRA ...

  12. 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...

  13. Glucocorticoids in early rheumatoid arthritis

    NARCIS (Netherlands)

    Everdingen, Amalia A. van

    2002-01-01

    For 50 years, glucocorticoids (GC) are used for symptomatic treatment of rheumatoid arthritis (RA). In the last decade, results from clinical studies of treatment with GC as additional therapy to long-acting antirheumatic drugs in patients with early RA suggested also disease-modifying properties of

  14. Glucocorticoid Sensitivity in Rheumatoid Arthritis

    NARCIS (Netherlands)

    R.A.M. Quax

    2013-01-01

    textabstractAccumulating observations of women with rheumatoid arthritis (RA) who ‘spontaneously’ experienced less active disease during pregnancy led to the growing belief by Philip Hench that a hormonal substance had to be involved in the improving clinical conditions of pregnant patients with RA.

  15. A radiographic classification system in juvenile rheumatoid arthritis applied to the knee

    International Nuclear Information System (INIS)

    Dale, K.; Paus, A.C.; Laires, K.

    1994-01-01

    A new radiographic grading system for evaluation of juvenile rheumatoid arthritis (JRA) for the knee is presented. The classification is based on known arthritic criteria in childhood. Joints with erosion are given a higher score than growth disturbances alone. Signs of osteoarthrosis including joint space narrowing were excluded from the classification. The femorotibial and patello-femoral joints are assessed together. Verbal definitions are used for the classification, but, regarding the erosions, standard reference films are used. The intra- and inter-observer variations of the method were low. (P < 0.01) (orig.)

  16. What People with Rheumatoid Arthritis Need to Know about Osteoporosis

    Science.gov (United States)

    ... Need to Know About Osteoporosis What Is Rheumatoid Arthritis? Rheumatoid arthritis is an autoimmune disease, a disorder in ... new habits for healthy bones. The Link Between Rheumatoid Arthritis and Osteoporosis Studies have found an increased risk ...

  17. A mechanism to compensate undesired stiffness in joints of prosthetic hands

    NARCIS (Netherlands)

    Smit, G.; Plettenbrug, D.H.; Van der Helm, F.C.T.

    2014-01-01

    Background: Cosmetic gloves that cover a prosthetic hand have a parasitic positive stiffness that counteracts the flexion of a finger joint. Objectives: Reducing the required input torque to move a finger of a prosthetic hand by compensating the parasitic stiffness of the cosmetic glove. Study

  18. Viscoelastic fingering with a pulsed pressure signal

    International Nuclear Information System (INIS)

    Corvera Poire, E; Rio, J A del

    2004-01-01

    We derive a generalized Darcy's law in the frequency domain for a linear viscoelastic fluid flowing in a Hele-Shaw cell. This leads to an analytic expression for the dynamic permeability that has maxima which are several orders of magnitude larger than the static permeability. We then follow an argument of de Gennes (1987 Europhys. Lett. 2 195) to obtain the smallest possible finger width when viscoelasticity is important. Using this and a conservation law, we obtain the lowest bound for the width of a single finger displacing a viscoelastic fluid. When the driving force consists of a constant pressure gradient plus an oscillatory signal, our results indicate that the finger width varies in time following the frequency of the incident signal. Also, the amplitude of the finger width in time depends on the value of the dynamic permeability at the imposed frequency. When the finger is driven with a frequency that maximizes the permeability, variations in the amplitude are also maximized. This gives results that are very different for Newtonian and viscoelastic fluids. For the former ones the amplitude of the oscillation decays with frequency. For the latter ones on the other hand, the amplitude has maxima at the same frequencies that maximize the dynamic permeability

  19. Saffman-Taylor fingers with kinetic undercooling

    KAUST Repository

    Gardiner, Bennett P. J.

    2015-02-23

    © 2015 American Physical Society. The mathematical model of a steadily propagating Saffman-Taylor finger in a Hele-Shaw channel has applications to two-dimensional interacting streamer discharges which are aligned in a periodic array. In the streamer context, the relevant regularization on the interface is not provided by surface tension but instead has been postulated to involve a mechanism equivalent to kinetic undercooling, which acts to penalize high velocities and prevent blow-up of the unregularized solution. Previous asymptotic results for the Hele-Shaw finger problem with kinetic undercooling suggest that for a given value of the kinetic undercooling parameter, there is a discrete set of possible finger shapes, each analytic at the nose and occupying a different fraction of the channel width. In the limit in which the kinetic undercooling parameter vanishes, the fraction for each family approaches 1/2, suggesting that this "selection" of 1/2 by kinetic undercooling is qualitatively similar to the well-known analog with surface tension. We treat the numerical problem of computing these Saffman-Taylor fingers with kinetic undercooling, which turns out to be more subtle than the analog with surface tension, since kinetic undercooling permits finger shapes which are corner-free but not analytic. We provide numerical evidence for the selection mechanism by setting up a problem with both kinetic undercooling and surface tension and numerically taking the limit that the surface tension vanishes.

  20. Saffman-Taylor fingers with kinetic undercooling

    KAUST Repository

    Gardiner, Bennett P. J.; McCue, Scott W.; Dallaston, Michael C.; Moroney, Timothy J.

    2015-01-01

    © 2015 American Physical Society. The mathematical model of a steadily propagating Saffman-Taylor finger in a Hele-Shaw channel has applications to two-dimensional interacting streamer discharges which are aligned in a periodic array. In the streamer context, the relevant regularization on the interface is not provided by surface tension but instead has been postulated to involve a mechanism equivalent to kinetic undercooling, which acts to penalize high velocities and prevent blow-up of the unregularized solution. Previous asymptotic results for the Hele-Shaw finger problem with kinetic undercooling suggest that for a given value of the kinetic undercooling parameter, there is a discrete set of possible finger shapes, each analytic at the nose and occupying a different fraction of the channel width. In the limit in which the kinetic undercooling parameter vanishes, the fraction for each family approaches 1/2, suggesting that this "selection" of 1/2 by kinetic undercooling is qualitatively similar to the well-known analog with surface tension. We treat the numerical problem of computing these Saffman-Taylor fingers with kinetic undercooling, which turns out to be more subtle than the analog with surface tension, since kinetic undercooling permits finger shapes which are corner-free but not analytic. We provide numerical evidence for the selection mechanism by setting up a problem with both kinetic undercooling and surface tension and numerically taking the limit that the surface tension vanishes.

  1. Arthrosonography as a method of assessment of xefocam efficacy in rheumatoid gonitis

    Directory of Open Access Journals (Sweden)

    E S Much

    2004-01-01

    Full Text Available Arthrosonography of 74 knee joints performed in 37 pts with rheumatoid arthritis before treatment with xefocam (Nicomed in 34 revealed signs of intra and extra-articular inflammation with presence in 100% fluid in fore part of the joint, increase B. Suprapatellaris size and thickening of synovial membrane. Fluid in lateral parts was revealed in 33 joints and in back part - in 22 joints. Semimembranosus muscle tenosynovitis was revealed at 22 joints. After xefocam administration (intra-articular injections 8 mg once a week for 3 weeks signs of intra-articular inflammation decreased in 28 and extra-articular - in 21 joints. So xefocam provides anti-inflammatory effect and can be used for treatment of synovitis.

  2. Perceiving fingers in single-digit arithmetic problems

    Directory of Open Access Journals (Sweden)

    Ilaria eBerteletti

    2015-03-01

    Full Text Available In this study, we investigate in children the neural underpinnings of finger representation and finger movement involved in single-digit arithmetic problems. Evidence suggests that finger representation and finger-based strategies play an important role in learning and understanding arithmetic. Because different operations rely on different networks, we compared activation for subtraction and multiplication problems in independently localized finger somatosensory and motor areas and tested whether activation was related to skill. Brain activations from children between 8 and 13 years of age revealed that only subtraction problems significantly activated finger motor areas, suggesting reliance on finger-based strategies. In addition, larger subtraction problems yielded greater somatosensory activation than smaller problems, suggesting a greater reliance on finger representation for larger numerical values. Interestingly, better performance in subtraction problems was associated with lower activation in the finger somatosensory area. Our results support the importance of fine-grained finger representation in arithmetical skill and are the first neurological evidence for a functional role of the somatosensory finger area in proficient arithmetical problem solving, in particular for those problems requiring quantity manipulation. From an educational perspective, these results encourage investigating whether different finger-based strategies facilitate arithmetical understanding and encourage educational practices aiming at integrating finger representation and finger-based strategies as a tool for instilling stronger numerical sense.

  3. Perceiving fingers in single-digit arithmetic problems.

    Science.gov (United States)

    Berteletti, Ilaria; Booth, James R

    2015-01-01

    In this study, we investigate in children the neural underpinnings of finger representation and finger movement involved in single-digit arithmetic problems. Evidence suggests that finger representation and finger-based strategies play an important role in learning and understanding arithmetic. Because different operations rely on different networks, we compared activation for subtraction and multiplication problems in independently localized finger somatosensory and motor areas and tested whether activation was related to skill. Brain activations from children between 8 and 13 years of age revealed that only subtraction problems significantly activated finger motor areas, suggesting reliance on finger-based strategies. In addition, larger subtraction problems yielded greater somatosensory activation than smaller problems, suggesting a greater reliance on finger representation for larger numerical values. Interestingly, better performance in subtraction problems was associated with lower activation in the finger somatosensory area. Our results support the importance of fine-grained finger representation in arithmetical skill and are the first neurological evidence for a functional role of the somatosensory finger area in proficient arithmetical problem solving, in particular for those problems requiring quantity manipulation. From an educational perspective, these results encourage investigating whether different finger-based strategies facilitate arithmetical understanding and encourage educational practices aiming at integrating finger representation and finger-based strategies as a tool for instilling stronger numerical sense.

  4. Rheumatoid disease without arthritis; clinical case of pulmonary fibrosis, rheumatoid nodulosis and positive rheumatoid factor without arthritis

    International Nuclear Information System (INIS)

    Ochoa Franco, Julian Andres; Canas Davila, Carlos Alberto

    2003-01-01

    We reported a case of a patient suffering pulmonary fibrosis rapidly progressive and a positive rheumatoid factor test with the presence of HLA DR11 y HLADR17, without arthritis, We discuss how rare is this clinical appearance, and remark the concept that rheumatoid arthritis is a systemic disease, with a wide clinical presentation, that some authors with a right criteria have called rheumatoid disease

  5. Finger millet [Eleusine coracana (L.) Gaertn].

    Science.gov (United States)

    Ceasar, Stanislaus Antony; Ignacimuthu, Savarimuthu

    2015-01-01

    Millets are the primary food source for millions of people in tropical regions of the world supplying mineral nutrition and protein. In this chapter, we describe an optimized protocol for the Agrobacterium-mediated transformation of finger millet variety GPU 45. Agrobacterium strain LBA4404 harboring plasmid pCAMBIA1301 which contains hygromycin phosphotransferase (hph) as selectable marker gene and β-glucuronidase (GUS) as reporter gene has been used. This protocol utilizes the shoot apex explants for the somatic embryogenesis and regeneration of finger millet after the transformation by Agrobacterium. Desiccation of explants during cocultivation helps for the better recovery of transgenic plants. This protocol is very useful for the efficient production of transgenic plants in finger millet through Agrobacterium-mediated transformation.

  6. Wrist ultrasound analysis of patients with early rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    J.A. Mendonça

    2011-01-01

    Full Text Available In the present study, we evaluated 42 wrists using the semi-quantitative scales power Doppler ultrasound (PDUS and gray scale ultrasound (GSUS with scores ranging from 0 to 3 and correlated the results with clinical, laboratory and radiographic data. Twenty-one patients (17 women and 4 men with rheumatoid arthritis according to criteria of the American College of Rheumatology were enrolled in the study from September 2008 to July 2009 at Universidade Estadual de Campinas (UNICAMP. The average disease duration was 14 months. The patients were 66.6% Caucasians and 33.3% non-Caucasians, with a mean age of 42 and 41 years, respectively. A dorsal longitudinal scan was performed by ultrasound on the radiocarpal and midcarpal joints using GE LOGIQ XP-linear ultrasound and a high frequency (8-10 MHz transducer. All patients were X-rayed, and the Larsen score was determined for the joints, with grades ranging from 0 to V. This study showed significant correlations between clinical, sonographic and laboratory data: GSUS and swollen right wrist (r = 0.546, GSUS of right wrist and swelling of left wrist (r = 0.511, PDUS of right wrist and pain in left wrist (r = 0.436, PDUS of right wrist and C-reactive protein (r = 0.466. Ultrasound can be considered a useful tool in the diagnosis of synovitis in early rheumatoid arthritis mainly when the anti-cyclic citrullinated peptide and rheumatoid factor are negative, and can lead to an early change in the therapeutic decision.

  7. 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

  8. 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.

  9. EFFICACY OF RECURRENT RITUXIMAB TREATMENT IN PATIENT WITH SEVERE REFRACTORY SYSTEMIC JUVENILE RHEUMATOID ARTHRITIS

    Directory of Open Access Journals (Sweden)

    E.I. Alexeeva

    2011-01-01

    Full Text Available The article contains clinical case description of a severe systemic juvenile rheumatoid arthritis, that was refractory to classic immunosuppressant therapy. The disease was characterized by such extraarticular manifestations as fever, lymphadenopathy,  hepatosplenomegaly, polyserositis, generalized joint involvement and high activity in lab tests. As a result of severe clinical course of the disease, patients develop bilateral aseptic bone necrosis in coxofemoral joints and coxarthrosis. Against the background of glucocorticosteroid treatment the patient has developed hormone-dependency and hormone resistance. Inclusion into the treatment of anti-CD20 monoclonal antibodies (rituximab has stopped systemic manifestations of the disease, inflammation in the joints, normalized lab activity rates. The positive therapeutic effect allowed to perform surgery due to bilateral coxarthrosis. These results show that rituximab is highly effective in children with systemic juvenile rheumatoid arthritis, that is resistant to classic immunosupressants and glucocorticoides. Key words: children, systemic juvenile rheumatoid arthritis, rituximab, recurrent treatment, prosthetics, hip joint. (Voprosy sovremennoi pediatrii — Current Pediatrics. — 2011; 10 (5: 157–163.

  10. The pathogenesis of rheumatoid arthritis in radiological studies. Part I: Formation of inflammatory infiltrates within the synovial membrane

    Directory of Open Access Journals (Sweden)

    Iwona Sudoł‑Szopińska

    2012-06-01

    Full Text Available Rheumatoid arthritis is a chronic inflammatory disease with a multifactorial etiology and varied course, which in the majority of patients leads to partial disability or to permanent handicap. Its characteristic trait is a persistent inflammation of the synovial membrane and the formation of an invasive synovial tissue, called the pannus, which in time leads to destruction of the cartilage, subchondral bone tissue, and the soft tissue of the affected joint(s. The pathogenesis of rheumatoid arthritis is complex and involves cells of both innate and adaptive immunity, a network of various cytokines and an immunoregulatory dysfunction. An important role in the discovery of rheumatoid arthritis pathogenesis was played by magnetic resonance imaging, which showed the disease process to extend beyond the synovium into the bone marrow. Many studies have shown a strict correlation between the vascularity of the synovium (assessed through the power Doppler ultrasound and magnetic resonance examinations, bone marrow edema and the clinical, laboratory and histopathological parameters of rheumatoid arthritis. From the current understanding of rheumatoid arthritis, bone erosions could occur from two directions: from the joint cavity and from the bone marrow. With power Doppler ultrasound, as well as in magnetic resonance imaging, it is possible to visualize the well-vascularized pannus and its destructive effects on joint structures and ligaments. In addition, the magnetic resonance study shows inflammatory and destructive changes within the bone marrow (bone marrow edema, inflammatory cysts, and erosions. Bone marrow edema occurs in 68–75% of patients with early rheumatoid arthritis and is considered to be a predictor of rapid disease progression.

  11. Bee venom acupuncture for rheumatoid arthritis: a systematic review of randomised clinical trials.

    Science.gov (United States)

    Lee, Ju Ah; Son, Mi Ju; Choi, Jiae; Jun, Ji Hee; Kim, Jong-In; Lee, Myeong Soo

    2014-11-07

    To assess the clinical evidence for bee venom acupuncture (BVA) for rheumatoid arthritis (RA). Systematic review of randomised controlled trials (RCTs). We searched 14 databases up to March 2014 without a language restriction. Patients with RA. BVA involved injecting purified, diluted BV into acupoints. We included trials on BVA used alone or in combination with a conventional therapy versus the conventional therapy alone. Morning stiffness, pain and joint swelling Erythrocyte sedimentation rate (ESR), C reactive protein (CRP), rheumatoid factor, the number of joints affected by RA and adverse effects likely related to RA. A total of 304 potentially relevant studies were identified; only one RCT met our inclusion criteria. Compared with placebo, BVA may more effectively improve joint pain, swollen joint counts, tender joint counts, ESR and CRP but was not shown to improve morning stiffness. There is low-quality evidence, based on one trial, that BVA can significantly reduce pain, morning stiffness, tender joint counts, swollen joint counts and improve the quality of life of patients with RA compared with placebo (normal saline injection) control. However, the number of trials, their quality and the total sample size were too low to draw firm conclusions. PROSPERO 2013: CRD42013005853. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  12. The therapeutic potential of plant flavonoids on rheumatoid arthritis.

    Science.gov (United States)

    Hughes, Samuel D; Ketheesan, Natkunam; Haleagrahara, Nagaraja

    2017-11-22

    Rheumatoid arthritis (RA) is an autoimmune condition that mainly affects peripheral joints. Although immunosuppressive drugs and non-steroidal anti-inflammatory drugs (NSAIDs) are used to treat this condition, these drugs have severe side effects. Flavonoids are the most abundant phenolic compounds which exhibit anti-oxidant, anti-inflammatory and immunomodulatory properties. Many bioactive flavonoids have powerful anti-inflammatory effects. However, a very few have reached clinical use. Dietary flavonoids have been reported to control joint inflammation and alleviate arthritis symptoms in both human RA and animal models of arthritis. There is little scientific evidence about their mechanism of actions in RA. We review the therapeutic effects of different groups of flavonoids belonging to the most common and abundant groups on RA. In particular, the probable mechanisms of major flavonoids on cells and chemical messengers involved in the inflammatory signaling components of RA are discussed in detail.

  13. Contrast-enhanced dynamic MR imaging in rheumatoid arthritis

    International Nuclear Information System (INIS)

    Koenig, H.; Sieper, J.; Wolf, K.J.

    1989-01-01

    This paper reports on a study for the identification of different pannus formations. Twenty patients with advanced rheumatoid arthritis of the knee joint were examined with MR imaging primary to surgery. The authors used a 1.5-T Magnetom unit, a circular surface coil for signal detection, 0.1 mmol/kg of Gd-DTPA given as a bolus injection, fast low-angle shot (FLASH) sequence (TR, 30 msec; TE, 10 msec; 128 x 128 matrix; excitation angle, 70 degrees) repeated 30 times within 120 seconds, and a T1-weighted spin-echo sequence (Tr, 500 msec; TE, 22 msec) before and 2 minutes after contrast medium injection. Enhancement of pannus and joint effusion has been measured and standardized to muscle tissue

  14. Atypical Localized Rheumatoid Nodule: Case Report

    Directory of Open Access Journals (Sweden)

    KORHAN BARIS BAYRAM

    2015-01-01

    Full Text Available Rheumatoid nodules can be seen in about 30% of patiens with rheumatoid arthritis. They are occasionally localized subcutaneous, but they can rarely seen in visceral organs. Their appearance can be confused with many clinical conditions when they have atypical localizations. To exclude the presence of a malignancy, these lesions should always be investigated. We aimed to discuss a patient with rheumatoid nodule localized in close neighborhood of hyoid bone, presumed as malignancy.

  15. Contamination by human fingers. The Midas touch

    International Nuclear Information System (INIS)

    Gwozdz, R.; Grass, F.

    2004-01-01

    Anthropogenic activity is one of the causes of contamination in the human environment: contamination of air, water, top soils, plants and food products has complex effects on human health problems. Wear and abrasion of various surfaces are constant processes in daily life, and commonly include interaction between human fingers and surfaces of every conceivable material. New methods for investigation of trace transfer processes by human fingers are described. Results of transfer for commonly used metals such as gold, silver, zinc, cadmium, tin, cobalt, nickel, chromium and iron are presented. Relationship between transfer of metals by touch and the general problem of purity in analytical activities is briefly discussed. (author)

  16. Fluctuation of biological rhythm in finger tapping

    Science.gov (United States)

    Yoshinaga, H.; Miyazima, S.; Mitake, S.

    2000-06-01

    By analyzing biological rhythms obtained from finger tapping, we have investigated the differences of two biological rhythms between healthy and handicapped persons caused by Parkinson, brain infraction, car accident and so on. In this study, we have observed the motion of handedness of all subjects and obtained a slope a which characterizes a power-law relation between frequency and amplitude of finger-tapping rhythm. From our results, we have estimated that the slope a=0.06 is a rough criterion in order to distinguish healthy and handicapped persons.

  17. Hypermobility of the first metatarsal bone in patients with Rheumatoid arthritis treated by lapidus procedure

    Directory of Open Access Journals (Sweden)

    Popelka Stanislav

    2012-08-01

    Full Text Available Abstract Background Foot deformities and related problems of the forefoot are very common in patients with rheumatoid arthritis. The laxity of the medial cuneometatarsal joint and its synovitis are important factors in the development of forefoot deformity. The impaired joint causes the first metatarsal bone to become unstable in the frontal and sagittal planes. In this retrospective study we evaluated data of patients with rheumatoid arthritis who underwent Lapidus procedure. We evaluated the role of the instability in a group of patients, focusing mainly on the clinical symptoms and X-ray signs of the instability. Methods The study group included 125 patients with rheumatoid arthritis. The indications of the Lapidus procedure were a hallux valgus deformity greater than 15 degrees and varus deformity of the first metatarsal bone with the intermetatarsal angle greater than 15 degrees on anterio-posterior weight-bearing X-ray. Results Data of 143 Lapidus procedures of 125 patients with rheumatoid arthritis, who underwent surgery between 2004 and 2010 was evaluated. Signs and symptoms of the first metatarsal bone instability was found in 92 feet (64.3% in our group. The AOFAS score was 48.6 before and 87.6 six months after the foot reconstruction. Nonunion of the medial cuneometatarsal joint arthrodesis on X-rays occurred in seven feet (4.9%. Conclusion The Lapidus procedure provides the possibility to correct the first metatarsal bone varus position and its instability, as well as providing the possibility to achieve a painless foot for walking. We recommend using the procedure as a preventive surgery in poorly symptomatic patients with rheumatoid arthritis in case of the first metatarsal bone hypermobility.

  18. Admittance Control of a Multi-Finger Arm Based on Manipulability of Fingers

    Directory of Open Access Journals (Sweden)

    Takayuki Hori

    2011-09-01

    Full Text Available In the previous studies, admittance control and impedance control for a finger‐arm robot using the manipulability of the finger were studied and methods of realizing the controls have been proposed. In this study, two 3‐DOF fingers are attached to the end‐effector of a 6‐DOF arm to configure a multi‐finger arm robot. Based on the previous methods, the authors have proposed an admittance control for a multi‐finger arm robot using the manipulability of the fingers in this study. Algorithms of the averaging method and the mini‐max method were introduced to establish a manipulability criterion of the two fingers in order to generate a cooperative movement of the arm. Comparison of the admittance controls combined with the top search method and local optimization method for the multi‐finger arm robot was made and features of the control methods were also discussed. The stiffness control and damping control were experimentally evaluated to demonstrate the effectiveness of the proposed methods.

  19. Clinical course and outcome of early rheumatoid arthritis.

    Science.gov (United States)

    Papadopoulos, I A; Katsimbri, P; Katsaraki, A; Temekonidis, T; Georgiadis, A; Drosos, A A

    2001-07-01

    We studied whether patients with seropositivity in early rheumatoid arthritis (RA) comprise a different clinical group than those with seronegativity. Four hundred seventeen patients with early RA according to the American College of Rheumatology criteria (disease duration less than 1 year) were retrospectively studied by analysis of demographic, clinical, laboratory, radiological, and therapeutic disease characteristics from the time of diagnosis until the end of the study period (1981 1999) using a data base. There were 248 seropositive patients and 169 seronegative patients with RA. No statistically significant differences were seen between the two groups before commencement of the study period in relation to age of disease onset, male:female ratio, and disease duration. However, seropositive patients showed longer medical follow-up. In addition, at disease onset, seropositive RA patients presented more frequently with symmetrical polyarthritis and small joint involvement than seronegative patients. The seropositive group also had more tender and swollen joints, weaker grip strength, and higher erythrocyte sedimentation and C-reactive protein rates during the follow-up period. In contrast, the seronegative group had less severe radiological findings and greater functional ability at the end of the study. In Greek patients with early RA, rheumatoid factor seems to be a predictor of more severe disease activity.

  20. Sustained improvement of intractable rheumatoid arthritis after total lymphoid irradiation

    International Nuclear Information System (INIS)

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

    1983-01-01

    Total lymphoid irradiation (TLI) was administered to 11 patients who had intractable rheumatoid arthritis that was unresponsive to conventional medical therapy, including aspirin, multiple nonsteroidal antiinflammatory drugs, gold salts, and D-penicillamine. Total lymphoid irradiation was given as an alternative to cytotoxic drugs such as azathioprine and cyclophosphamide. After radiotherapy, 9 of the 11 patients showed a marked improvement in clinical disease activity as measured by morning stiffness, joint tenderness, joint swelling, and overall functional abilities. The mean improvement of disease activity in all patients ranged from 40-70 percent and has persisted throughout a 13-28 month followup period. This improvement permitted the mean daily steroid dose to be reduced by 54%. Complications included severe fatigue and other constitutional symptoms during radiotherapy, development of Felty's syndrome in 1 patient, and an exacerbation of rheumatoid lung disease in another. After therapy, all patients exhibited a profound T lymphocytopenia, and a reversal in their T suppressor/cytotoxic cell to helper cell ratio. The proliferative responses of peripheral blood mononuclear cells to phytohemagglutinin, concanavalin A, and allogeneic leukocytes (mixed leukocyte reaction) were markedly reduced, as was in vitro immunoglobulin synthesis after stimulation with pokeweed mitogen. Alterations in T cell numbers and function persisted during the entire followup period, except that the mixed leukocyte reaction showed a tendency to return to normal values