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masquerading rheumatoid arthritis

Thangalakshmi Sivathapandi, Jaykanth Amalachandran, Shelley Simon, Indirani Elangovan
The primary hypertrophic osteoarthropathy (PHOA) (pachydermoperiostosis) is a rare genetic/hereditary disease characterized by skin changes (pachydermia), clubbing of fingers and periosteal thickening (periostitis) with sub-periosteal new bone formation. Here we describe a case of an adolescent male who presented with clubbing and polyarthralgia. On evaluation with scintigraphy and SPECT-CT, he was diagnosed to have incomplete form of PHOA(skeletal manifestations without skin changes). The identification of incomplete form of primary hypertrophic osteoarthropathy which can be easily misdiagnosed as rheumatoid arthritis is discussed here...
April 2018: Indian Journal of Nuclear Medicine: IJNM: the Official Journal of the Society of Nuclear Medicine, India
Shun Yamashita, Naoko E Furukawa, Tomoyo Matsunaga, Yuka Hirakawa, Masaki Tago, Shu-Ichi Yamashita
BACKGROUND Adult-onset Still's disease (AOSD) is a rare multi-systemic inflammatory disorder of unknown etiology characterized by spiking fever, characteristic rash, and arthritis. It often associates with high serum ferritin levels. CASE REPORT An 88-year-old woman had fever of over 39°C without response to extended-spectrum antibiotics for 6 days. She had non-specific erythema with infiltration on her trunk. She had leukocytosis with neutrophilia of 80%, mild hepatic dysfunction, normal level of rheumatoid factor and antinuclear antibody, thrombocytopenia, elevated d-dimer and soluble interleukin2 receptor, extremely high serum ferritin (78 662 ng/mL), and splenomegaly...
December 6, 2017: American Journal of Case Reports
Manuel John, M Raman, Keith Ryan
Ticks are tiny crawling bugs in the spider family that feed by sucking blood from animals. They are second only to mosquitoes as vectors of human disease, both infectious and toxic. Infected ticks spread over a hundred diseases, some of which are fatal if undetected. They spread the spirochete (which multiplies in the insect's gut) with a subsequent bite to the next host. We describe the only reported cases of peri ocular tick bite from India that presented to us within a span of 3 days and its management. Due suspicion and magnification of the lesions revealed the ticks which otherwise masqueraded as small skin tags/moles on gross examination...
November 2017: Indian Journal of Ophthalmology
Muhammad Armughan Ali, Marium Rehman, Mohammad Saeed
Symptoms of inflammatory arthritis such as rheumatoid arthritis (RA) can overlap with fibromyalgia syndrome (FMS). Moreover, FMS and RAcan coexist. Hence, the diagnosis of low intensity, antibody-negative RAmay present a challenge. Here, we present the case of a middle-aged woman thought to have FMS, osteoarthritis and osteoporosis for 4 years prior to being diagnosed as seronegative RAon musculoskeletal ultrasound (MSKUS). Targeted therapy with etanercept led to a complete clinical response and normalization of previously elevated C-reactive protein...
September 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Sukesh Edavalath, Abhra C Chowdhury, Sanat Phatak, Durga P Misra, Ritu Verma, Able Lawrence
Multiple myeloma can rarely mimic seronegative rheumatoid arthritis (RA). We report a 55-year-old woman who presented with longstanding deforming polyarthritis with extensive subcutaneous nodules, tenosynovitis, anti-cyclic citrullinated peptide positivity and mononeuritis multiplex. Even though the clinical picture was consistent with seropositive RA, the absence of bone erosion or joint space narrowing on hand and knee radiographs led us to question the diagnosis of RA. Further investigation revealed a diagnosis of multiple myeloma with cutaneous amyloid deposits, based on serum immunofixation, bone marrow aspiration and biopsy of a subcutaneous nodule...
August 12, 2016: International Journal of Rheumatic Diseases
Masoumeh Salari, Robab Bigom Aboutorabi, Zahra Rezaieyazdi
Hyperparathyroidism is a complex clinical syndrome characterized by dysfunction in the metabolism of bone, calcium and phosphorus. Rheumatologic manifestations are common amongst patients with hyperparathyroidism. We report a 50-year-old woman with hypercalcemia, lytic bone lesions and inflammatory arthritis of both hands that were not resolved after parathyroidectomy. Laboratory evidence of elevated erythrocyte sedimentation rate, positive C-reactive protein (CRP) and high titers of anti-CCP and rheumatoid factor was diagnostic of rheumatoid arthritis (RA) according to European League Against Rheumatism criteria...
October 2015: Archives of Iranian Medicine
Pradeep Venkatesh, Varun Gogia, Bhavin Shah, Shikha Gupta, Pradeep Sagar, Satpal Garg
The purpose of the study was to identify the clinical and etiological profile of uveitis at the apex institute for eye care in India. This is a prospective, prevalence study. 980 consecutive patients with uveitis referred to uvea clinic, Dr. RP Centre for Ophthalmic Sciences (Ophthalmology division, All India Institute of Medical Sciences). Demographic data of each patient were noted and a thorough ocular examination including slit lamp examination and dilated fundus evaluation was carried out. OCT and fluorescein angiography were undertaken whenever indicated...
June 2016: International Ophthalmology
Tina Rendini, William Levis
No abstract text is available yet for this article.
May 2015: Journal of Drugs in Dermatology: JDD
Conor N Gruber, Kathleen Finzel, Barry L Gruber
We report a 40-year-old woman with onset of oligoarthritis shortly after initiating treatment with methimazole for Graves disease. Over the course of 7 years, her arthritis became progressively severe, leading to a diagnosis of seronegative rheumatoid arthritis. Treatment with disease-modifying antirheumatic agents and surgical intervention was contemplated. Ultrasound and magnetic resonance imaging revealed exuberant synovitis, involving right elbow and knees. Upon withdrawal of methimazole, prompt resolution of all signs and symptoms of arthritis was observed within several weeks...
June 2014: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
Konstantinos Filis, George Galyfos, Andreas Larentzakis, Evridiki Karanikola, Constantinos Zarmakoupis
Pseudoaneurysms of the brachial artery are common following a percutaneous cardiac catheterization. Synovial cysts are a commonly identified entity in patients with rheumatic diseases as well. We present a rare case of a synovial cyst in the elbow masquerading as an iatrogenic pseudoaneurysm of the brachial artery. A 51-year-old female patient presented with a pulsatile and painful mass in the right antecubital fossa. The medical history revealed a recent diagnostic cardiac catheterization at the same site and rheumatoid arthritis under oral treatment...
July 2014: Annals of Vascular Surgery
G R Mohyuddin, F Sultan, K Zhang, G Khaleeq
A commonly prescribed drug for Rheumatoid Arthritis (R.A) and Inflammatory Bowel Disease (IBD) treatment, Sulfasalazine can occasionally cause lung toxicity such as interstitial pneumonitis and eosinophilic pneumonias. We report a case of a 46 year old female being treated with Sulfasalazine for Ulcerative Colitis, who developed shortness of breath and a radiographic pattern of hilar adenopathy. Biopsy showed granulomas that resembled Sarcoidosis. We review different presentations of Sulfasalazine induced lung disease and describe the first known case of Sulfasalazine lung toxicity mimicking Sarcoidosis...
October 2013: Sarcoidosis, Vasculitis, and Diffuse Lung Diseases: Official Journal of WASOG
Lawrence B Afrin
Acquired agranulocytosis is a rare, life-threatening disorder. The few known causes/associations usually are readily identifiable (e.g., drug reaction, Felty syndrome, megaloblastosis, large granular lymphocytic leukemia, etc.). We report a novel association with mast cell disease. A 61-year-old morbidly obese man developed rheumatoid arthritis unresponsive to several medications. Agranulocytosis developed shortly after sulfasalazine was started but did not improve when the drug was soon stopped. Other symptoms across many systems developed including hives and presyncope...
January 2012: Military Medicine
Chellam Kirubakaran, Julius Xavier Scott, Sam Ebenezer
Arthritis could be a presenting feature of acute lymphoblastic leukaemia (ALL) and could be wrongly diagnosed as juvenile rheumatoid arthritis (JRA). Clinical and laboratory parameters might differentiate ALL and JRA in children who present with arthritis. Out of a total of 250 children of ALL, 10 were referred to the department of child health and paediatric haemato-oncology of Christian Medical College, Vellore during 1990-2002. They were compared with 10 age-matched children who had systematic onset of JRA...
August 2011: Journal of the Indian Medical Association
F Seidensticker, P I Foerster, E M Messmer, A Kampik, S R Thurau
This report describes a 12-year-old girl with diffuse infiltrating retinoblastoma. This inflammatory condition belongs to the uveitis masquerade syndromes, which comprise a group of various ocular diseases such as chronic intraocular inflammation and ocular tumors.
December 2010: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
D L Sommerfield, P McDonagh, A M Heffernan, P Hu, C K Power
BACKGROUND: Epidural anaesthesia generally provides safe postoperative pain control, but does carry a small risk of nerve damage. CASE DESCRIPTION: A 30-year-old woman with long standing rheumatoid arthritis underwent a primary total knee replacement under general anaesthetic. Postoperatively, a continuous epidural infusion was used for pain relief. On discontinuation of the epidural, she was confirmed to have a foot drop. Her subsequent investigation and management for neuropathic pain was coordinated by the acute pain service...
March 2012: Irish Journal of Medical Science
Yusuf Aydın, Hülya Coşkun, Seher Kır, Selma Yazici, Özlem Kudaş, Adem Güngör
Acromegaly is a chronic endocrinopathy characterized by hypersecretion of growth hormone (GH) and consequently of insulin-like growth factor-1 (IGF-1). The arthropathy in acromegaly is the most frequent and important cause of morbidity and functional disability in acromegaly. Rheumatoid arthritis (RA) is a rarely reported clinical situation in patients with acromegalic. We herein report 57- and 45-year-old two women, who complained bilateral, symmetric pain, swelling and morning stiffness in the joints of hands after optimal acromegaly treatment resembling acromegaly arthropathy...
September 2012: Rheumatology International
Ram Kumar Marwaha, Ketan Prasad Kulkarni, Deepak Bansal, Amita Trehan
Acute lymphoblastic leukemia (ALL) often presents with osteoarthritic manifestations which may lead to misdiagnosis with juvenile rheumatoid arthritis (JRA). This study was designed to identify ALL patients with initial diagnosis of JRA, compare their clinicolaboratory characteristics and outcome with other ALL patients treated at our center. Case records of 762 patients with ALL were analyzed. Information regarding the clinical-demographic profile, therapy and outcome were recorded. Of the children, 49 (6...
March 2010: Annals of Hematology
Sumeer Thinda, James S Tomlinson
BACKGROUND: Rheumatoid nodules are the most common extra-articular findings in patients with rheumatoid arthritis. They occur most commonly at pressure points such as the extensor surfaces of the forearms, fingers, and occiput, but have also been reported to occur in unusual locations including the central nervous system, pericardium, pleura, and sclera. We present the unusual case of rheumatoid nodules in the small bowel mesentery masquerading as an intra-abdominal malignancy. CASE PRESENTATION: A 65-year-old-male with a known history of longstanding erosive, nodular, seropositive rheumatoid arthritis was incidentally found to have a mesenteric mass on computed tomography (CT) exam of the abdomen...
2009: World Journal of Surgical Oncology
K S Kanik, D P Greenwald
Mycobacterium avium/Mycobacterium intracellulare[cf1] complex (MAC) is a rare cause of tenosynovitis. We describe a case in which a previously healthy patient developed bilaterally symmetric synovitis and was treated with disease modifying anti rheumatic drugs (DMARDs); the synovitis progressed into a bilaterally symmetric chronic granulomatous tenosynovitis that was uncontrollable despite a synovectomy and DMARD therapy. Three years after developing symptoms, and 2 1/2 years after her diagnosis of rheumatoid arthritis, MAC was cultured from synovial fluid...
June 2000: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
Fabio Jennings, Elaine Lambert, Michael Fredericson
Most individuals seeking consultation at sports medicine clinics are young, healthy athletes with injuries related to a specific activity. However, these athletes may have other systemic pathologies, such as rheumatic diseases, that may initially mimic sports-related injuries. As rheumatic diseases often affect the musculoskeletal system, they may masquerade as traumatic or mechanical conditions. A systematic review of the literature found numerous case reports of athletes who presented with apparent mechanical low back pain, sciatica pain, hip pain, meniscal tear, ankle sprain, rotator cuff syndrome and stress fractures and who, on further investigation, were found to have manifestations of rheumatic diseases...
2008: Sports Medicine
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