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Takako Miyamae, Takuma Hara, Aki Hanaya, Yumi Tani, Takayuki Kishi, Hisashi Yamanaka
A 10-year-old girl manifested persistent fever, skin rash, leg pain, fatigue, and joint pain. Based on muscle weakness, elevated muscle-derived enzymes, magnetic resonance imaging, and skin biopsy results, the diagnosis was juvenile idiopathic inflammatory myopathies (JIIM). Chest CT was normal; the anti-melanoma differentiation-associated protein-5 (anti-MDA5) autoantibody was positive. Initial manifestations subsided after prednisolone (PSL) and methotrexate treatment. After the PSL dosage was decreased, the patient presented with metacarpophalangeal (MCP) joint pain and swelling in both index fingers, synovial fluid, and signals on power Doppler ultrasound...
2018: Case Reports in Rheumatology
Mads Ammitzbøll Danielsen
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...
March 2018: Danish Medical Journal
D Stephensen, S Classey, H Harbidge, V Patel, S Taylor, A Wells
INTRODUCTION: Prevention of arthropathy is the major goal of haemophilia treatment, and early detection of the first signs of joint damage is important so that prevention strategies can be initiated to limit physical disability and improve quality of life. AIM: The aim of this study was to determine the inter-rater repeatability of the HEAD-US protocol when performed by haemophilia physiotherapists. METHODS: Sixty-three joints (21 elbows, 21 knees and 21 ankles) were examined in 21 patients (mean age; 29...
March 1, 2018: Haemophilia: the Official Journal of the World Federation of Hemophilia
Paul Emery, Gerd R Burmester, Esperanza Naredo, Yijie Zhou, Maja Hojnik, Philip G Conaghan
INTRODUCTION: The current American College of Rheumatology and European League Against Rheumatism treatment recommendations advise tapering biological disease-modifying antirheumatic drug (bDMARD) therapy in patients with rheumatoid arthritis (RA) who achieve stable clinical remission while receiving bDMARDs. However, not all patients maintain remission or low disease activity after tapering or discontinuation of bDMARDs. The aim of the Im P act of R esidual Inflammation Detected via Imaging T E chniques, D rug Levels and Patient Characteristics on the Outcome of Dose Taper I ng of Adalimumab in C linical Remission Rheumatoid Ar T hritis ( RA ) study, or PREDICTRA, is to generate data on patient and disease characteristics that may predict the clinical course of a fixed dose-tapering regimen with the bDMARD adalimumab...
February 28, 2018: BMJ Open
Linh Ngo, Eric Miller, Peter Valen, Elie Gertner
BACKGROUND: Novel immune checkpoint inhibitors have been often utilized for different types of malignancies as salvage therapy with varying success. One obstacle to immune checkpoint inhibitor use is the higher incidence of immune-mediated side effects that can prompt discontinuation of therapy. Remitting seronegative symmetrical synovitis with pitting edema has been described with immune checkpoint inhibitors only once previously. We report a case of a patient who developed remitting seronegative symmetrical synovitis with pitting edema related to immune checkpoint inhibitor therapy and stress that these symptoms can be managed without cessation of immune checkpoint inhibitor therapy...
February 26, 2018: Journal of Medical Case Reports
Tao Wang, Gang Zhao, Yong-Jun Rui, Jing-Yi Mi
RATIONALE: Primary tuberculous infection in hand and wrist is a rare disease. Few articles reported on hand primary tuberculous synovitis. PATIENT CONCERNS: A 68-year-old Chinese male, without history of tuberculosis (TB), had complained of pain and swelling in right palm and little finger for 3 months. Patient came to our hospital on 9th Oct 2016. X-ray just showed soft tissue swelling in little finger. Magnetic resonance imaging (MRI) showed synovitis around flexor tendon of little finger, volar palm, and carpal tunnel...
February 2018: Medicine (Baltimore)
Irving O Estevez-Garcia, Selma Gallegos-Nava, Erika Vera-Pérez, Luis H Silveira, Lucio Ventura-Ríos, Gonzalo Vancini, Cristina Hernández-Díaz, Fausto Sánchez-Muñoz, Martha A Ballinas-Verdugo, Marwin Gutierrez, Carlos Pineda, Pedro Rodriguez-Henriquez, Diana Castillo-Martínez, Luis M Amezcua-Guerra
OBJECTIVE: To assess potential associations among serum cytokines and microRNA (miR) levels with ultrasound (US) findings suggestive of urate deposits in chronic asymptomatic hyperuricemia and gout. METHODS: All participants underwent musculoskeletal US and measurements of serum IL-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12, IL-13, IFN-γ, TNF, MCP-1, and ENA-78, as well as miR-146a, miR-155, and miR-223 levels. RESULTS: Thirty individuals with asymptomatic hyperuricemia, 31 normouricemic controls, and 30 gouty patients were included...
February 18, 2018: Arthritis Care & Research
Orazio De Lucia, Viviana Ravagnani, Francesca Pregnolato, Arvena Hila, Irene Pontikaki, Maurizio Gattinara, Micol Romano, Valeria Gerloni, Sara Pieropan, Antonella Murgo, Maurizio Rossini, Rolando Cimaz, Pier Luigi Meroni
OBJECTIVES: To define the correlation between joint ultrasonography and clinical examination in patients with juvenile idiopathic arthritis (JIA) and to assess whether synovitis detected by ultrasonography in clinically inactive patients predicts arthritis flares. METHODS: 88 consecutive patients with JIA-46 (52%) with persistent oligoarthritis, 15 (17%) with extended oligoarthritis, 15 (17%) with rheumatoid factor-negative polyarthritis and 12 (14%) with other forms of JIA, all clinically inactive for a minimum of 3 months-underwent ultrasound (US) assessment of 44 joints...
February 6, 2018: Annals of the Rheumatic Diseases
Frances Humby, Vasco Romão, Antonio Manzo, Andrew Filer, Serena Bugatti, Elsa Vieira-Sousa, Stephen Kelly, Mihir Wechalekar, Manzoor Ahmed, Vidalba Rocher, Rebecca Hands, Carlomaurizio Montecucco, Joao Fonseca, Costantino Pitzalis
OBJECTIVES: This study aimed to evaluate whether choice of synovial biopsy technique (arthroscopic, blind needle (BN), ultrasound (US)-portal and forceps (P&F) and US-needle biopsy (NB) translates to significant variation in synovial tissue quality and quantity with the aim of informing recommendations for choice of synovial sampling technique within clinical trials. METHODS: 159 procedures were evaluated from 5 academic rheumatology centres. H&E stained paraffin embedded synovial sections were assessed in order to determine the proportion of graded synovial fragments, total area of tissue and synovitis score per procedure...
February 6, 2018: Arthritis & Rheumatology
Rositsa Karalilova, Maria Kazakova, Anastas Batalov, Victoria Sarafian
The aim of our study was to analyze the level of the glycoprotein YKL-40 in patients with active knee osteoarthritis (OA) and to search possible correlations with local inflammation and ultrasound (US) findings. MATERIAL AND METHODS: A prospective study with fifty consecutive patients with active knee OA (diagnosed based on the American College of Rheumatology criteria for OA with radiographic confirmation) was performed. Concentrations of YKL-40 in serum and synovial fluid were measured by ELISA...
February 4, 2018: Medical Ultrasonography
Hortensia De la Corte-Rodriguez, E Carlos Rodriguez-Merchan, M Teresa Alvarez-Roman, Mónica Martin-Salces, Carlo Martinoli, Víctor Jimenez-Yuste
BACKGROUND: Prevention of hemarthrosis is the key factor in the adequate management of people with hemophilia (PWH). If hemarthrosis occurs, early diagnosis of joint damage is essential to make personalized treatments. This study is aimed at gaining an understanding of the ability of point-of-care ultrasound (US) using the `Hemophilia Early Arthropathy Detection with Ultrasound´ (HEAD-US) protocol to detect abnormalities in joints without history of hemarthrosis and clinically asymptomatic joints of PWH...
February 15, 2018: Expert Review of Hematology
Anaïs Huwart, Florent Garrigues, Sandrine Jousse-Joulin, Thierry Marhadour, Dewi Guellec, Divi Cornec, Maelenn Gouillou, Alain Saraux, Valérie Devauchelle-Pensec
BACKGROUND: This study assessed inflammatory changes using ultrasound (US) and magnetic resonance imaging (MRI) in patients taking tocilizumab for polymyalgia rheumatica (PMR). METHODS: Eighteen patients were included in the prospective open-label TENOR study and received three tocilizumab infusions, without corticosteroids. B-mode and power Doppler US and MRI (T1 and T2-short time inversion recuperation weighted sequences) of the hips and shoulders were performed at weeks 0, 2, and 12...
January 25, 2018: Arthritis Research & Therapy
Kuo-Lung Lai, Der-Yuan Chen, Mei-Chin Wen, Yi-Ming Chen, Wei-Ting Hung, Yi-Hsin Chen, Hsin-Hua Chen
To clarify the nature of power Doppler (PD) signals in rheumatoid synovium and to establish the connection between PD signals and active inflammation using synovial histopathology. Ten adult patients (median age 57.0 years, 9 women and one man) with rheumatoid arthritis (RA) were enrolled and received ultrasound (US) examinations. US-guided synovial biopsies using core needle were performed in 7 knees, 2 wrists and one elbow. Each patient had one joint biopsied. In total, 11 synovial specimens were obtained for hematoxylin and eosin staining and histopathologic examinations...
January 20, 2018: Journal of the Chinese Medical Association: JCMA
Marina Carotti, Vittoria Galeazzi, Francesca Catucci, Marcello Zappia, Francesco Arrigoni, Antonio Barile, Andrea Giovagnoni
With the introduction of new biologics such as anti-TNF-alpha antibodies and other therapies in the treatment of inflammatory arthritis, capable of halting joint destruction and functional disability, there are new pressures on diagnostic and prognostic imaging. Early demonstration of pre-erosive inflammatory features and monitoring of the long-term effects of treatment are becoming increasingly important. Early detection of synovitis offers advantages in terms of allowing early instigation of therapy and may allow the identification of those patients displaying more aggressive disease who might benefit from early intervention with expensive DMARD therapy...
January 19, 2018: Acta Bio-medica: Atenei Parmensis
L Ventura-Ríos, M Hayes-Salinas, D Ferrusquia-Toriz, R I Cariño-Escobar, E Cruz-Arenas, J Gutiérrez-Martínez, L González-Ramírez, C Hernández-Díaz
Range of motion (ROM) measured objectively in nodal hand osteoarthritis (NHOA) is missing. Evaluation of collateral ligaments by ultrasound (US) is unknown in NHOA also. To compare ROM in interphalangeal joints in housewives with nodal OA, with a control group by a digital system using angle to voltage (Multielgon). The second objective was to assess correlation between collateral radial and ulnar ligaments thickness and ROM. For this cross-sectional observational study, we assessed 60 hands with symptomatic NHOA and 30 hands of healthy housewives matched for age...
January 19, 2018: Clinical Rheumatology
Mohammed A Omair, Pooneh Akhavan, Ali Naraghi, Shikha Mittoo, Juan Xiong, Deborah Weber, Daming Lin, Melissa Weber, Edward C Keystone
OBJECTIVE: 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. METHODS: 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...
January 15, 2018: Journal of Rheumatology
Pascal Zufferey, Almut Scherer, Michael J Nissen, Adrian Ciurea, Giorgio Tamborrini, Laure Brulhart, Sandra Blumhardt, Martin Toniolo, Burkhard Möller, Hans-Ruedi Ziswiler
OBJECTIVE: Several studies have suggested that patients with rheumatoid arthritis (RA) presenting with ultrasound (US) synovitis despite clinical remission have more subsequent flares than those who show both clinical and sonographic remission. The objective of our study was to investigate whether these results could be translated to a real-life setting. METHODS: We compared the time from the first US performed in clinical remission to loss of remission (defined by a DAS28 > 2...
January 15, 2018: Journal of Rheumatology
Aliya Sarmanova, Michelle Hall, Gwen S Fernandes, Archan Bhattacharya, Ana M Valdes, David A Walsh, Michael Doherty, Weiya Zhang
BACKGROUND: An important role for synovial pathology in the initiation and progression of knee osteoarthritis has been emphasised recently. This study aimed to examine whether ultrasonography-detected synovial changes associate with knee pain (KP) in a community population. METHODS: A case-control study was conducted to compare people with early KP (n = 298), established KP (n = 100) or no KP (n = 94) at baseline. Multinomial logistic regression was used to estimate the odds ratio (OR) and 95% confidence interval (CI) between groups adjusted for radiographic osteoarthritis (ROA) severity and other confounding factors...
December 19, 2017: Arthritis Research & Therapy
A Di Matteo, R De Angelis, E Cipolletta, E Filippucci, W Grassi
Background Despite being promising, the use of ultrasound (US) in the assessment of musculoskeletal manifestations of systemic lupus erythematosus (SLE) is still limited. Literature on this topic is scarce and the spectrum and clinical relevance of US abnormalities has not yet been outlined. With this paper, we aim to explore the panel of joint and tendon US findings in a group of SLE patients. Methods Twenty-five consecutive SLE patients, with current or medical history of musculoskeletal symptoms, were studied...
January 1, 2017: Lupus
Anuoluwapo R Oke, Ernest Wong, Steven Young-Min
No abstract text is available yet for this article.
December 7, 2017: Rheumatology
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