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Early arthritis clinic

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https://www.readbyqxmd.com/read/28720139/the-golmepsa-study-protocol-an-investigator-initiated-double-blind-parallel-group-randomised-controlled-trial-of-golimumab-and-methotrexate-versus-methotrexate-in-early-diagnosed-psoriatic-arthritis-using-clinical-and-whole-body-mri-outcomes
#1
Gabriele De Marco, Philip Helliwell, Dennis McGonagle, Paul Emery, Laura C Coates, Elizabeth M A Hensor, Helena Marzo-Ortega
BACKGROUND: Psoriatic arthritis (PsA) is a chronic inflammatory arthritis which impacts significantly on the quality of life and work capacity of affected individuals. Recent evidence has shown that early control of inflammation in PsA leads to improved long-term outcomes. It is postulated that prompt intervention after diagnosis using a remission-induction treatment strategy will lead to improved outcomes and optimal disease control of PsA. The aim of the present study was to compare the clinical efficacy of a treatment strategy in newly diagnosed, treatment naïve PsA subjects, using the combination of golimumab (GOL), methotrexate (MTX) and steroids versus standard care (MTX monotherapy plus steroids)...
July 18, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28705162/the-effect-of-autologous-adipose-derived-mesenchymal-stem-cell-therapy-in-the-treatment-of-a-large-osteochondral-defect-of-the-knee-following-unsuccessful-surgical-intervention-of-osteochondritis-dissecans-a-case-study
#2
Julien Freitag, Kiran Shah, James Wickham, Richard Boyd, Abi Tenen
BACKGROUND: A prospective analysis of the effect of autologous adipose derived mesenchymal stem cell (MSC) therapy in the treatment of an osteochondral defect of the knee with early progressive osteoarthritis following unsuccessful surgical intervention of osteochondritis dissecans (OCD). CASE PRESENTATION: After failed conventional management of OCD a patient undergoes intra-articular MSC therapy. Patient outcome measures included the Numeric Pain Rating Scale (NPRS), the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and the Knee Injury and Osteoarthritis Outcome Score (KOOS)...
July 14, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28692794/despite-early-improvement-patients-with-rheumatoid-arthritis-still-have-impaired-grip-force-5-years-after-diagnosis
#3
Maria Rydholm, Christina Book, Ingegerd Wikström, Lennart Jacobsson, Carl Turesson
OBJECTIVE: Objective measures of function are important in rheumatoid arthritis (RA). The objective of this study was to investigate grip strength in patients with early RA. METHODS: An inception cohort of 225 patients with early RA was followed according to a structured protocol. Average and peak grip force values (Grippit; AB Detektor, Gothenburg, Sweden) of the dominant hand were evaluated and compared to the expected, based on age- and sex-specific reference values from the literature...
July 10, 2017: Arthritis Care & Research
https://www.readbyqxmd.com/read/28690235/-diagnosis-and-treatment-for-one-case-of-elderly-diabetes-complicated-with-still-s-disease
#4
Tuanyu Fang, Kaining Chen, Eryuan Liao
Adult onset Still's disease (AOSD) is a clinical syndrome with multiple organ failure. The patients normally show intermittent high fever for a long time, a transient rash, arthritis or joint pain as the main performance, accompanied by an increase in granulocytes and enlargement in liver, spleen and lymph node. A 71-years-old female patient with type 2 diabetes admitted hospital because of high fever, skin rash, joint pain and increased granulocyte. After review of the iron protein, she was diagnosed as AOSD...
June 28, 2017: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/28688467/prediction-of-response-to-targeted-treatment-in-rheumatoid-arthritis
#5
REVIEW
C A Wijbrandts, P P Tak
Rheumatoid arthritis is an autoimmune syndrome presenting with chronic inflammation of the joints. Patients with the same diagnosis can present with different phenotypes. In some patients severe joint inflammation and early joint destruction are observed, whereas a milder phenotype can be seen in others. Conversely, patients with the same signs and symptoms may exhibit different immunological and molecular abnormalities. Since the introduction of early treatment in clinical practice, the treat to target principle, and new medicines such as biologic disease-modifying antirheumatic drugs, clinical remission can be achieved early in the disease course, albeit not in all patients...
July 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28688058/a-retrospective-study-of-joint-infections-in-patients-with-systemic-lupus-erythematosus
#6
Lin Qiao, Dong Xu, Yan Zhao, Xiaofeng Zeng, Fengchun Zhang
The aim of this study was to analyze the clinical characteristics of systemic lupus erythematosus (SLE) patients with joint infections. We retrospectively reviewed the medical records of 11,734 SLE patients admitted to Peking Union Medical College Hospital (PUMCH) from January 1990 to December 2016. Twenty patients who developed joint infections were identified. Subjects without joint infections (designated as control patients) were selected from the pool of SLE patients using a 1:4 systematic sampling method...
July 8, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28685724/role-of-contrast-enhanced-ultrasound-in-the-evaluation-of-inflammatory-arthritis
#7
REVIEW
Chen-Yang Zhao, Yu-Xin Jiang, Jian-Chu Li, Zhong-Hui Xu, Qing Zhang, Na Su, Meng Yang
OBJECTIVE: Contrast-enhanced ultrasound (CEUS) is a well-established imaging modality which has been put into clinical use in recent years with the development of second-generation contrast agent and imaging devices, and its applications in the assessment of inflammatory arthritis, such as rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis, have provoked abundant discussion and researches among radiologists and rheumatologists. To summarize the achievements of clinical studies on CEUS in the application of arthritis, and to keep up with the latest progresses of the imaging technique, we reviewed the literature in recent years, hoping to establish the role of CEUS in joint diseases...
July 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28679392/factors-associated-with-initial-or-subsequent-choice-of-biologic-disease-modifying-antirheumatic-drugs-for-treatment-of-rheumatoid-arthritis
#8
Yinzhu Jin, Rishi J Desai, Jun Liu, Nam-Kyong Choi, Seoyoung C Kim
BACKGROUND: Biologic disease-modifying antirheumatic drugs (DMARDs) are increasingly used for rheumatoid arthritis (RA) treatment. However, little is known based on contemporary data about the factors associated with DMARDs and patterns of use of biologic DMARDs for initial and subsequent RA treatment. METHODS: We conducted an observational cohort study using claims data from a commercial health plan (2004-2013) and Medicaid (2000-2010) in three study groups: patients with early untreated RA who were naïve to any type of DMARD and patients with prevalent RA with or without prior exposure to one biologic DMARD...
July 5, 2017: Arthritis Research & Therapy
https://www.readbyqxmd.com/read/28676912/clinical-characteristics-of-methotrexate-associated-lymphoproliferative-disorders-relationship-between-absolute-lymphocyte-count-recovery-and-spontaneous-regression
#9
Satoshi Takanashi, Yoshinobu Aisa, Chisako Ito, Hideki Arakaki, Yuki Osada, Yuichiro Amano, Motoharu Hirano, Tomonori Nakazato
Several reports have shown that patients with rheumatoid arthritis (RA) are at increased risk of developing lymphoproliferative disorders (LPD). Methotrexate (MTX) has been recognized as a major cause of LPD. Sometimes spontaneous regression (SR) occurs after withdrawal of MTX. Recent studies suggest that the early recovery of the absolute lymphocyte count (ALC) after withdrawal of MTX is associated with the spontaneous regression of MTX-LPD. We retrospectively analyzed 26 patients with MTX-LPD to identify predictive factors for spontaneous regression...
July 5, 2017: Rheumatology International
https://www.readbyqxmd.com/read/28672905/severe-septic-arthritis-of-the-temporomandibular-joint-with-pyogenic-orofacial-infections-a-case-report-and-review-of-the-literature
#10
Di Xiao, Xuefeng Feng, Haitao Huang, Huixin Quan
Septic arthritis of the temporomandibular joint (SATMJ) is a rare entity that has only been reported a few dozen times worldwide. However, SATMJ is an acute infectious disease and associated with a high risk for misdiagnosis, which results in severe complications for patients. The present study reported a case of an 83-year-old female patient with severe pyogenic orofacial infections caused by right-side SATMJ, which was not cured by abscess incision drainage and anti-microbial treatment. Finally, the clinical signs were resolved by condylectomy and debridement of the erosive septic TMJ, after which the function of the TMJ was completely restored...
July 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28666080/a-phase-3-study-evaluating-continuation-tapering-and-withdrawal-of-certolizumab-pegol-after-1-year-of-therapy-in-early-rheumatoid-arthritis-patients
#11
Michael E Weinblatt, Clifton O Bingham, Gerd-Rüdiger Burmester, Vivian P Bykerk, Daniel E Furst, Xavier Mariette, Désirée van der Heijde, Ronald van Vollenhoven, Brenda Van Lunen, Cécile Ecoffet, Christopher Cioffi, Paul Emery
OBJECTIVE: For DMARD-naïve, early rheumatoid arthritis patients who achieved sustained low disease activity (sLDA; DAS28[ESR]≤3.2 at both Weeks 40 and 52) after 1 year of treatment with certolizumab pegol (CZP 200mg Q2W+optimized MTX), we evaluated whether continuation of CZP as a standard (200mg Q2W+MTX) or reduced-frequency (200mg Q4W+MTX) dose was superior to stopping CZP (placebo+MTX) in maintaining LDA for 1 additional year. METHODS: 293 patients from C-EARLY Period 1 were re-randomized 2:3:2 in Period 2 to CZP standard (n=84), reduced-frequency (n=127), CZP stopped (n=82)...
June 30, 2017: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/28664284/-differential-diagnostic-spectrum-of-psoriasis-vs-psoriatic-arthritis-in-skin-and-joints
#12
REVIEW
S Gerdes, U Mrowietz, U Wagner
Psoriasis and psoriatic arthritis are common disease entities in the daily routine of dermatologists and rheumatologists. The clinical management of the diseases profits tremendously from interdisciplinary contacts and shared decision-making processes. For dermatologists, recognition of early clinical symptoms of inflammatory arthropathies is pivotal. Rheumatologists, on the other hand, are required to make an early assessment of skin and nail changes in patients, since they are important parameters in the clinical classification of inflammatory joint diseases, in particular for the diagnosis of psoriatic arthritis...
June 29, 2017: Zeitschrift Für Rheumatologie
https://www.readbyqxmd.com/read/28663038/measuring-fatigue-with-multiple-instruments-in-a-brazilian-cohort-of-early-rheumatoid-arthritis-patients
#13
Leonardo Rios Diniz, Sandor Balsamo, Talita Yokoy de Souza, Luciana Feitosa Muniz, Wagner Rodrigues Martins, Licia Maria Henrique da Mota
OBJECTIVE: To assess the prevalence of fatigue in a Brazilian population with early rheumatoid arthritis using multiple instruments, and the predictors of these instruments by differents independent variables. METHODS: Cross-sectional study with direct interview and medical records review. Fatigue, dependent variable, was assessed using eight instruments: Profile of Mood States (POMS), Multidimensional Assessment of Fatigue scale (MAF), Fatigue Severity Scale (FSS), Bristol Rheumatoid Arthritis Fatigue Multidimensional Questionnaire (BRAF-MDQ), Numerical Rating Scales (BRAF-NRS), Short-form Survey 36 (SF-36), Functional Assessment of Chronic Illness Therapy Fatigue Scale (FACIT-F) and Visual Analogic Scale for Fatigue (VASf)...
June 26, 2017: Revista Brasileira de Reumatologia
https://www.readbyqxmd.com/read/28663002/autoantibodies-in-juvenile-onset-myositis-their-diagnostic-value-and-associated-clinical-phenotype-in-a-large-uk-cohort
#14
Sarah L Tansley, Stefania Simou, Gavin Shaddick, Zoe E Betteridge, Beverley Almeida, Harsha Gunawardena, Wendy Thomson, Michael W Beresford, Angela Midgley, Francesco Muntoni, Lucy R Wedderburn, Neil J McHugh
OBJECTIVES: Juvenile myositis is a rare and heterogeneous disease. Diagnosis is often difficult but early treatment is important in reducing the risk of associated morbidity and poor outcomes. Myositis specific autoantibodies have been described in both juvenile and adult patients with myositis and can be helpful in dividing patients into clinically homogenous groups. We aimed to explore the utility of myositis specific autoantibodies as diagnostic and prognostic biomarkers in patients with juvenile-onset disease...
June 26, 2017: Journal of Autoimmunity
https://www.readbyqxmd.com/read/28655345/methotrexate-induced-hypersensitivity-pneumonitis-appearing-after-30%C3%A2-years-of-use-a-case-report
#15
Mashal Salehi, Robertha Miller, Myint Khaing
BACKGROUND: Methotrexate has been implicated in a variety of lung complications, one of which is hypersensitivity pneumonitis. Hypersensitivity pneumonitis most often occurs within the first year of starting low-dose orally administered methotrexate. We present a case of methotrexate-induced hypersensitivity pneumonitis after 30 years of methotrexate use, which is the first case to be reported so far. CASE PRESENTATION: A 77-year-old African American woman with a history of rheumatoid arthritis presented with progressively worsening shortness of breath and nonproductive cough...
June 28, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28639104/gene-mutations-and-clinical-phenotypes-in-chinese-children-with-blau-syndrome
#16
Caifeng Li, Junmei Zhang, Shipeng Li, Tongxin Han, Weiying Kuang, Yifang Zhou, Jianghong Deng, Xiaohua Tan
The mutations of CARD15 gene and clinical features of Chinese patients with Blau syndrome were analyzed. We identified 10 missense mutations, out of which five were new: R334L, E383D, R471C, C495R and D512F. The rest of them, R334W, R334Q, G481D, M513T and R587C, have been reported previously. Among all the mutations, R334W, R334Q and C495R had the highest frequency. Blau syndrome was found at early age after birth. It began with lepidic rash and symmetric polyarthritis and was phenotypically characterized by typical rash, arthritis, iridocyclitis and arteritis...
June 16, 2017: Science China. Life Sciences
https://www.readbyqxmd.com/read/28638695/pre-rheumatoid-arthritis-and-its-prevention
#17
REVIEW
Binoy J Paul, Hemanth Illath Kandy, Vinod Krishnan
Pre-rheumatoid arthritis (pre-RA) is the preclinical period of the disease that precedes the onset of clinically apparent RA. It includes the interaction between genetic and environmental risk factors and development of disease-related autoantibodies and joint symptoms and signs, which may be considered nonspecific or unclassified for RA. A better understanding of the pre-RA stage will be useful in developing screening programs for early detection of RA. Identifying and modifying risk factors such as smoking, periodontitis, obesity, viral infections, and hormonal or dietary factors will be useful in preventing RA in susceptible population...
June 2017: European Journal of Rheumatology
https://www.readbyqxmd.com/read/28631696/-ankylosing-spondylitis-and-non-radiographic-axial-spondyloarthritis-two-stages-of-disease
#18
D G Rumyantseva, T V Dubinina, A B Demina, O A Rumyantseva, E M Agafonova, A V Smirnov, Sh F Erdes
AIM: To compare the clinical manifestations of ankylosing spondylitis (AS) and non-radiographic axial spondyloarthritis (nrAxSpA). SUBJECTS AND METHODS: A Moscow early spondyloarthritis cohort has now included 132 patients with axial spondyloarthritis, of whom 69 patients who have been followed up at least 12 months are to be involved in a preliminary analysis. The mean age at the time of inclusion in the study was 28.1±5.5 years; the mean disease duration was 24...
2017: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/28631066/rheumatoid-vasculitis-a-diminishing-yet-devastating-menace
#19
REVIEW
Shweta Kishore, Lisa Maher, Vikas Majithia
PURPOSE OF REVIEW: Rheumatoid vasculitis (RV) is an unusual complication of long-standing rheumatoid arthritis, which is characterized by the development of necrotizing or leukocytoclastic vasculitis involving small or medium-sized vessels. In this review, we aim to provide an update on the epidemiology, pathogenesis, clinical presentation, and management of this challenging extra-articular manifestation. RECENT FINDINGS: RV is heterogenous in its clinical presentation depending on the organ and size of blood vessels involved...
July 2017: Current Rheumatology Reports
https://www.readbyqxmd.com/read/28630849/a-case-of-chronic-inflammation-of-the-ankle-joint-with-subtle-signs-of-inflammation-a-rare-presentation-of-tuberculosis-ankle
#20
Jeevan Pereira, S Anoop, George Joy Pettah
INTRODUCTION: Tuberculosis (TB) of the ankle is an uncommon presentation of extrapulmonary infection. The early diagnosis of TB arthritis of the ankle is difficult because of the uncommon site, the ability of TB to mimic other disorders and, all too common, lack of awareness of about this infection in ankle joint. CASE REPORT: A 30-year-old male presented with a 1-year history of right ankle pain and swelling. He denied any history of recent infection but had had recurrent ankle pain that had been treated accordingly...
January 2017: Journal of Orthopaedic Case Reports
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