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Ultrasound of rheumatology

Matteo Piga, Luca Saba, Alessandra Gabba, Mattia Congia, Antonella Balestrieri, Alessandro Mathieu, Alberto Cauli
BACKGROUND: The aim was to determine the accuracy of high-resolution ultrasonography (US) for detecting erosion in the metacarpophalangeal (MCP) and wrist joints of patients with different subtypes of systemic lupus erythematosus (SLE) arthritis, using computed tomography (CT) as the gold-standard reference method. METHOD: The ulnar head, radiocarpal and second to fifth MCP joints in 26 patients with SLE - 9 classified as having rhupus syndrome, 10 as having Jaccoud's arthropathy (JA) and 7 as having non-deforming non-erosive (NDNE) arthritis - were subdivided into areas and bilaterally evaluated for the presence of bone erosion by CT and US...
October 4, 2016: Arthritis Research & Therapy
I K Haugen
Hand osteoarthritis (OA) is a prevalent disease that can lead to substantial pain and physical disability. Currently, no disease-modifying drugs exist for the treatment of OA. Most OA research has been conducted on knee OA and we have limited knowledge about disease mechanisms in hand OA. During her research career, Ida K Haugen (IKH) has focused on the epidemiology of hand OA and imaging techniques. She has established a large international network, providing the opportunity to study the epidemiology of hand OA in large international OA cohorts...
August 2016: Scandinavian Journal of Rheumatology
Francisca Sivera, Sofia Ramiro, Nada Cikes, Maurizio Cutolo, Maxime Dougados, Laure Gossec, Tore K Kvien, Ingrid E Lundberg, Peter Mandl, Arumugam Moorthy, Sonia Panchal, José A P da Silva, Johannes W Bijlsma
BACKGROUND: The aim of this project was to analyze and compare the educational experience in rheumatology specialty training programs across European countries, with a focus on self-reported ability. METHOD: An electronic survey was designed to assess the training experience in terms of self-reported ability, existence of formal education, number of patients managed and assessments performed during rheumatology training in 21 core competences including managing specific diseases, generic competences and procedures...
2016: Arthritis Research & Therapy
Paul R Fortin, Nathalie Cloutier, Vincent Bissonnette, Ellie Aghdassi, Lihi Eder, David Simonyan, Nathalie Laflamme, Eric Boilard
OBJECTIVE: Microparticles (MP) are small extracellular vesicles present in body fluids. MP originate from different cellular lineages, principally from platelets in blood, and may expose phosphatidylserine (PS). In systemic lupus erythematosus (SLE), MP harbor immunoglobulin G (IgG), thereby forming MP-containing immune complexes (mpIC). We aimed to verify an association between SLE disease activity, damage, and surrogate markers of atherosclerosis and MP harboring IgG, taking into account the platelet origin and PS exposure of MP...
September 1, 2016: Journal of Rheumatology
Marwin Gutierrez, Cristina Hernandez-Diaz, Lucio Ventura-Rios, Lina María Saldarriaga-Rivera, Santiago Ruta, Magaly Alva, Claudia Mora -Trujillo, Wilkerson Pérez, Henry Terrazas, Rodolfo Del Carmen Arape Toyo, Maritza Quintero, Carla Solano, Oscar Sedano Santiago, Janet Grisel Huamán Sotomayor, Cesar Cefferino, Guillermo E Py, Marcelo J Audisio, Walter Javier Spindler, Horacio Berman, Carla Airoldi, Rómulo Wong, Ana Laura Álvarez Del Castillo Araujo, Mario E Díaz, Carmen Cerón Villaquiran, Rubén Darío Mantilla, José Alexandre Mendonça, Inês Guimarães da Silveira, Aline Defaveri do Prado, Melissa Cláudia Bisi, Violeta Rosario, Jeannette Medrano-Sánchez, Roberto Muñoz-Louis, Ana Cecilia Lozada-Navarro, Araceli Bernal, Maribel Lozano, Carlos Pineda
This study aimed to perform an overview of how ultrasound (US) is being used, implemented, and applied in rheumatologic centers in Latin America (LA). A retrospective, multicenter 1-year experience study was undertaken. Eighteen centers from eight countries were involved. The following information were collected: demographic data, indication to perform an US examination, physician that required the examination, and the anatomical region required for the examination. A total of 7167 patients underwent an US examination...
August 30, 2016: Clinical Rheumatology
Sevdalina N Lambova
Micro- and macrovascular pathology is a frequent finding in a number of common rheumatic diseases. Secondary Raynaud's phenomenon (RP) is among the most common symptoms in systemic sclerosis and several other systemic autoimmune diseases including a broad differential diagnosis. It should be also differential from other peripheral vascular syndromes such as embolism, thrombosis, etc., some of which lead to clinical manifestation of the blue toe syndrome. The current review discusses the instrumental methods for vascular assessments...
April 2016: Folia Medica
Espen A Haavardsholm, Anna-Birgitte Aga, Inge Christoffer Olsen, Siri Lillegraven, Hilde B Hammer, Till Uhlig, Hallvard Fremstad, Tor Magne Madland, Åse Stavland Lexberg, Hilde Haukeland, Erik Rødevand, Christian Høili, Hilde Stray, Anne Noraas, Inger Johanne Widding Hansen, Gunnstein Bakland, Lena Bugge Nordberg, Désirée van der Heijde, Tore K Kvien
OBJECTIVE:  To determine whether a treatment strategy based on structured ultrasound assessment would lead to improved outcomes in rheumatoid arthritis, compared with a conventional strategy. DESIGN:  Multicentre, open label, two arm, parallel group, randomised controlled strategy trial. SETTING:  Ten rheumatology departments and one specialist centre in Norway, from September 2010 to September 2015. PARTICIPANTS:  238 patients were recruited between September 2010 and April 2013, of which 230 (141 (61%) female) received the allocated intervention and were analysed for the primary outcome...
2016: BMJ: British Medical Journal
Nemanja Damjanov, Vera Milic, Juan Carlos Nieto-González, Iustina Janta, Lina Martínez-Estupiñan, Belén Serrano, Carmen Mata, María Montoro, Denisa Stanciu, Jelena Marinković-Erić, Francisco Javier López-Longo, Luis Carreño, Esperanza Naredo
OBJECTIVE: To evaluate the multiobserver reliability of salivary gland ultrasonography (SGUS) for scoring greyscale (GS) parenchymal inhomogeneity and parenchymal color Doppler (CD) signal in patients with established primary Sjögren syndrome (pSS). METHODS: The study comprised 2 multiobserver reliability assessments in patients with pSS in 2 European centers. The first reliability exercise was performed on 24 patients with pSS and 8 controls who were independently evaluated with GS and CD US by 5 observers at the Institute of Rheumatology, Belgrade, Serbia...
October 2016: Journal of Rheumatology
Carlos Acebes, John P Harvie, Alison Wilson, Janet Duthie, Fran Bowen, Malcolm Steven
There is no agreement among the rheumatology community in how to implement the musculoskeletal ultrasound (MSUS) technique in the Rheumatology Divisions. To test the perceived usefulness of the MSUS, under consensus indications, for referring colleagues for the clinical management of their patients with inflammatory arthritis (IA) and to score the satisfaction level of the patients with different aspects of the ultrasound (US) examination, after attend to the MSUS clinic. A written questionnaire-based survey regarding the usefulness and satisfaction with the implementation of a pilot MSUS clinic in a Rheumatology Unit...
August 11, 2016: Rheumatology International
Christian Beyer, Sofia Ramiro, Francisca Sivera, Peter Mandl, Pedro M Machado, Caroline Ospelt, Anna Moltó, Helga Radner, Annamaria Iagnocco, Johannes W Bijlsma, Ingrid E Lundberg
OBJECTIVES: To understand the educational needs and preferences of young clinicians and physician researchers in the field of rheumatology in Europe. METHODS: An international online survey was performed as a joint venture of ESCET and EMEUNET. The survey assessed the acceptance of and the access to the current European League Against Rheumatism (EULAR) educational portfolio, as well as the unmet educational needs and learning preferences among individuals below the age of 40 years working in rheumatology in Europe...
2016: RMD Open
Mohamed Mortada, Ayman Zeid, Mirvat Abd El-Hamid Al-Toukhy, Nillie Ezzeldin, M Elgawish
OBJECTIVES: The objective of this study was to examine the concordance of a grading scale (0-4) of medial femoral osteophytes in knee joint detected by ultrasound (US) compared with the corresponding grades (0-4) of Kellgren-Lawrence (K&L) scale of conventional radiography and clinical joint examination. PATIENTS AND METHODS: A cross-sectional observational study included 160 patients with knee pain who fulfilled the American College of Rheumatology (ACR) criteria for knee osteoarthritis (KOA) and 20 patients with knee pain who have not fulfilled the ACR criteria for KOA...
2016: Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders
Christoph F Dietrich, Adrian Goudie, Liliana Chiorean, Xin Wu Cui, Odd Helge Gilja, Yi Dong, Jacques S Abramowicz, Sudhir Vinayak, Susan Campbell Westerway, Christian Pállson Nolsøe, Yi-Hong Chou, Michael Blaivas
Over the last decade, the use of portable ultrasound scanners has enhanced the concept of point of care ultrasound (PoC-US), namely, "ultrasound performed at the bedside and interpreted directly by the treating clinician." PoC-US is not a replacement for comprehensive ultrasound, but rather allows physicians immediate access to clinical imaging for rapid and direct solutions. PoC-US has already revolutionized everyday clinical practice, and it is believed that it will dramatically change how ultrasound is applied in daily practice...
July 26, 2016: Ultrasound in Medicine & Biology
Paula Väre, Elena Nikiphorou, Pekka Hannonen, Tuulikki Sokka
OBJECTIVE: To describe a one-stop, integrated rheumatology service and assess patient satisfaction. METHODS: A descriptive report and patient satisfaction survey of a rheumatology clinic model first developed in 1996 to enhance the patient "journey" through rheumatology services. A patient-satisfaction survey over a 3-week period assessed several aspects of care including quality of services, consultations, and patient education. RESULTS: All referrals are screened by a rheumatologist to pre-schedule laboratory/radiology/other tests for the visit...
2016: SAGE Open Medicine
Daniel Windschall, Ralf Trauzeddel, Maria Haller, Manuela Krumrey-Langkammerer, Antje Nimtz-Talaska, Rainer Berendes, Gerd Ganser, Christine Nirschl, Philipp Schoof, Ralf Felix Trauzeddel, Katharina Palm-Beden, Hartwig Lehmann
Musculoskeletal ultrasound (MSUS) is an important tool for evaluating disease activity, therapeutic progress, and remission status of rheumatic diseases in children. Knowledge of age-related normal findings is essential when interpreting pathological findings such as those seen in juvenile idiopathic arthritis. To evaluate normal findings of the knee joint, we recorded age-related stages of musculoskeletal development in the knee of 435 healthy children between 1 and 18 years of age using high-resolution B-mode MSUS...
November 2016: Rheumatology International
Lucio Ventura-Ríos, Cristina Hernández-Díaz, Guadalupe Sanchez-Bringas, Eduardo Madrigal-Santillán, José Antonio Morales-González, Carlos Pineda
The aim of this study is to characterize bone erosions in metatarsal heads (MTH) in rheumatoid arthritis (RA) and gout by grayscale ultrasound. In a descriptive, cross-sectional study, we evaluated 40 patients with RA and 40 with gout, both diagnosed according to the American College of Rheumatology/European League Against Rheumatism criteria, respectively. All patients had bone erosion demonstrated by ultrasound, which was used, following OMERACT criteria, to describe the shape, size, number, border definition, overhanging margin, topography (intra- or extra-articular), and distribution (over dorsal, medial, lateral, or plantar aspect) of the lesions in the MTH...
September 2016: Clinical Rheumatology
Mariano Andrés, Francisca Sivera, Sabina Pérez-Vicente, Loreto Carmona, Paloma Vela
The aim of this study was to explore the variability in hospital admissions of patients with spondyloarthritis (SpA) in Spain, and the centre factors that may influence that variability. Descriptive cross-sectional study, part of the emAR II study, performed in Spain (2009-2010). Health records of patients with a diagnosis of SpA and at least one visit to the rheumatology units within the previous 2 years were reviewed. Variables related to hospital admissions, to the SpA, and to the patient and centre were collected...
September 2016: Rheumatology International
Emanuela Bellis, Carlo Alberto Scirè, Greta Carrara, Antonella Adinolfi, Alberto Batticciotto, Alessandra Bortoluzzi, Giovanni Cagnotto, Marta Caprioli, Marco Canzoni, Francesco Paolo Cavatorta, Orazio De Lucia, Valentina Di Sabatino, Antonella Draghessi, Georgios Filippou, Ilaria Farina, Maria Cristina Focherini, Alessandra Gabba, Marwin Gutierrez, Luca Idolazzi, Filippo Luccioli, Pierluigi Macchioni, Marco Sergio Massarotti, Claudio Mastaglio, Luana Menza, Maurizio Muratore, Simone Parisi, Valentina Picerno, Matteo Piga, Roberta Ramonda, Bernd Raffeiner, Daniela Rossi, Silvia Rossi, Paola Rossini, Garifallia Sakellariou, Crescenzio Scioscia, Carlo Venditti, Alessandro Volpe, Marco Matucci-Cerinic, Annamaria Iagnocco
OBJECTIVES: This study aimed to estimate the prevalence of US-detected tenosynovitis in RA patients in clinical remission and to explore its clinical correlates. METHODS: A total of 427 RA patients in clinical remission were consecutively enrolled from 25 Italian rheumatology centres. Tenosynovitis and synovitis were scored by US grey scale (GS) and power Doppler (PD) semi-quantitative scoring systems at wrist and hand joints. Complete clinical assessment was performed by rheumatologists blinded to the US results...
October 2016: Rheumatology
Laura C Cappelli, Anna Kristina Gutierrez, Alan N Baer, Jemima Albayda, Rebecca L Manno, Uzma Haque, Evan J Lipson, Karen B Bleich, Ami A Shah, Jarushka Naidoo, Julie R Brahmer, Dung Le, Clifton O Bingham
OBJECTIVES: Immune checkpoint inhibitors (ICIs) targeting the cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) and programmed cell death protein 1 (PD-1) pathways have demonstrated survival improvements in multiple advanced cancers, but also cause immune-related adverse events (IRAEs). IRAEs with clinical features similar to rheumatic diseases have not been well described. We report patients with inflammatory arthritis and sicca syndrome secondary to ICIs. METHODS: We report patients evaluated in the Johns Hopkins Rheumatology clinics from 2012 to 2016 identified as having new rheumatological symptoms in the context of treatment with ipilimumab (anti-CTLA-4) and/or nivolumab (anti-PD-1) for solid tumours...
June 15, 2016: Annals of the Rheumatic Diseases
Mickaël Chouk, Claire Vidon, Elise Deveza, Frank Verhoeven, Fabien Pelletier, Clément Prati, Daniel Wendling
Intravenous drug addiction is responsible for many complications, especially cutaneous and infectious. There is a syndrome, rarely observed in rheumatology, resulting in "puffy hands": the puffy hand syndrome. We report two cases of this condition from our rheumatologic consultation. Our two patients had intravenous drug addiction. They presented with an edema of the hands, bilateral, painless, no pitting, occurring in one of our patient during heroin intoxication, and in the other 2 years after stopping injections...
June 3, 2016: Joint, Bone, Spine: Revue du Rhumatisme
Lucio Ventura-Ríos, Guadalupe Sánchez-Bringas, Carlos Pineda, Cristina Hernández-Díaz, Anthony Reginato, Magaly Alva, Marcelo Audisio, Ana Bertoli, Tomas Cazenave, Marwin Gutiérrez, Claudia Mora, Guillermo Py, Oscar Sedano, Carla Solano, Eugenio de Miguel
The objective of the present study is to evaluate, by ultrasonography (US), the prevalence in the quadriceps, patellar, and Achilles tendon involvement of gout compared to that of patients with osteoarthritis and asymptomatic marathon runners. This is a multicenter, multinational, transverse cross-sectional, and comparative study comprising 80 patients with the diagnosis of gout according to the American College of Rheumatology (ACR) criteria, compared with two control groups: 35 patients with generalized osteoarthritis according to the ACR criteria and 35 subjects who were healthy marathon runners...
August 2016: Clinical Rheumatology
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