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[PMID]:29465582
[Au] Autor:Wang T; Zhao G; Rui YJ; Mi JY
[Ad] Endereço:Department of Hand Surgery, Wuxi NO.9 People's Hospital Affiliated to Soochow University, Wuxi, China.
[Ti] Título:Successfully treating hand primary tuberculous synovitis by synovectomy combined antituberculous therapy: A case report.
[So] Source:Medicine (Baltimore);97(8):e9938, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo: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. Notably, it also implied nodular images in little finger sizing 5 mm × 11 mm. Laboratory tests revealed C-reactive protein (CRP): 22 mg/L, erythrocyte sedimentation rate (ESR): 49 mm/h, and white blood cells (WBC): 11.8 × 10/L. DIAGNOSES: He was diagnosed with primary hand tuberculous synovitis. INTERVENTIONS: The patient received aspiration biopsy in right palm guided by ultrasound on 13rd Oct and pathological examination indicated Mycobacterium tuberculosis (MTB) infection. We performed radical synovetomy and collected abnormal tissue for pathological examination on 18th Oct. Finally, result showed MTB infection, which was the same with the result of first pathological examination. Then, this patient received antituberculous treatment. OUTCOMES: One year after operation, pain and swelling relieve and no recurrence of the clinical symptoms happened. LESSONS: Primary tuberculous synovitis of hand and wrist is rare, MTB infection should be considered as an infectious agent, especially in developing countries. Radical synovectomy and antituberculous treatment regain a satisfactory outcome.
[Mh] Termos MeSH primário: Antituberculosos/uso terapêutico
Articulação da Mão
Mycobacterium tuberculosis
Sinovectomia/métodos
Sinovite/terapia
Tuberculose Osteoarticular/terapia
Punho
[Mh] Termos MeSH secundário: Idoso
Terapia Combinada
Seres Humanos
Masculino
Sinovite/microbiologia
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antitubercular Agents)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180222
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009938


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[PMID]:29233086
[Au] Autor:Taipale M; Solovieva S; Leino-Arjas P; Männikkö M
[Ad] Endereço:Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Aapistie 5, 90220, Oulu, Finland.
[Ti] Título:Functional polymorphisms in asporin and CILP together with joint loading predispose to hand osteoarthritis.
[So] Source:BMC Genet;18(1):108, 2017 Dec 12.
[Is] ISSN:1471-2156
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Osteoarthritis (OA) is the most common degenerative joint disease afflicting people in the Western world and has a strong genetic influence. The aim of this study was to examine the association of two known functional polymorphisms in the TGF-ß inhibiting genes, asporin (ASPN) and cartilage intermediate layer protein (CILP), with hand OA and potential gene-occupational hand loading interaction. RESULTS: Statistically significant interaction of the CILP rs2073711 T and ASPN D15 alleles with hand OA was observed (OR = 2.48, 95% CI 1.27-4.85, p = 0.008) in a Finnish hand OA cohort of 543 women (aged 45-63). When stratified by variation in working tasks, low variation of working tasks increased the risk further (OR = 3.00, 95% CI 1.35-6.66, p = 0.007). Based on the analysis of ASPN and CILP protein-coding regions, functional studies were performed with one observed variant, rs41278695 in the ASPN gene. Analyses showed that bone morphogenetic protein 2 (BMP2) mediated expression of aggrecan (Agc1) and type II collagen (Col2a1) was significantly suppressed (p = 0.011 and p = 0.023, respectively) in a murine chondrocytic cell line (ATDC5) with cells stably expressing ASPN rs41278695. CONCLUSIONS: The carriage of either ASPN D15 or CILP rs2073711 TT is associated with increased risk of symmetrical hand OA, particularly in individuals with low variation in work tasks. ASPN rs41278695 SNP had an effect on Agc1 and Col2a1 gene expression when induced with BMP-2 suggesting an effect on the cartilage extracellular matrix composition.
[Mh] Termos MeSH primário: Proteínas da Matriz Extracelular/genética
Predisposição Genética para Doença
Articulação da Mão/fisiopatologia
Doenças Profissionais/genética
Osteoartrite/genética
Pirofosfatases/genética
[Mh] Termos MeSH secundário: Agrecanas/metabolismo
Animais
Células Cultivadas
Condrócitos/citologia
Condrócitos/metabolismo
Estudos de Coortes
Colágeno Tipo II/metabolismo
Feminino
Seres Humanos
Camundongos
Meia-Idade
Doenças Profissionais/patologia
Osteoartrite/patologia
Polimorfismo Genético
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (ASPN protein, human); 0 (Aggrecans); 0 (Collagen Type II); 0 (Extracellular Matrix Proteins); EC 3.6.1.- (CILP protein, human); EC 3.6.1.- (Pyrophosphatases)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180118
[Lr] Data última revisão:
180118
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171214
[St] Status:MEDLINE
[do] DOI:10.1186/s12863-017-0585-4


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[PMID]:29190722
[Au] Autor:Wen L; Shin MH; Kang JH; Yim YR; Kim JE; Lee JW; Lee KE; Park DJ; Kim TJ; Kweon SS; Lee YH; Yun YW; Lee SS
[Ad] Endereço:Department of Rheumatology, Chonnam National University Medical School & Hospital, Gwangju, Republic of Korea.
[Ti] Título:Association between grip strength and hand and knee radiographic osteoarthritis in Korean adults: Data from the Dong-gu study.
[So] Source:PLoS One;12(11):e0185343, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: We assessed whether grip strength was related to various types of radiographic damage in Korean adults with osteoarthritis (OA). METHODS: Data from 2,251 subjects enrolled in the Dong-gu study, who had no hand joint pain, were analyzed to investigate the relationship between grip strength and OA. Hand grip strength was measured using a hand-held dynamometer, and radiographs of the hand and knee were scored according to a semi-quantitative grading system. Multiple linear regressions were used to explore associations between grip strength and radiographic features of OA. RESULTS: Grip strength in men and women was negatively related to hand (both p < 0.001) and knee (men, p < 0.001; women, p = 0.010) OA after adjusting for confounders. Hand (men, p < 0.001; women, p = 0.001) and knee (both p < 0.001) joint space narrowing (JSN) showed the strongest associations with low grip strength, regardless of gender. Moreover, the severity of hand osteophytes in women (p = 0.001), and subchondral cysts (men, p < 0.001) was correlated with low grip strength in both genders. CONCLUSIONS: Among subjects without hand joint pain, low grip strength was associated significantly with hand and knee radiographic OA, regardless of gender. Among all types of OA radiographic damage, low grip strength showed the strongest association with JSN.
[Mh] Termos MeSH primário: Articulação da Mão/diagnóstico por imagem
Força da Mão
Osteoartrite do Joelho/diagnóstico por imagem
[Mh] Termos MeSH secundário: Idoso
Feminino
Articulação da Mão/fisiopatologia
Seres Humanos
Masculino
Meia-Idade
Osteoartrite do Joelho/fisiopatologia
República da Coreia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171226
[Lr] Data última revisão:
171226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171201
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0185343


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[PMID]:28580826
[Au] Autor:Mangnus L; van Steenbergen HW; Reijnierse M; Kälvesten J; van der Helm-Van Mil A
[Ad] Endereço:a Department of Rheumatology , Leiden University Medical Center , Leiden , the Netherlands.
[Ti] Título:Bone mineral density loss in clinically suspect arthralgia is associated with subclinical inflammation and progression to clinical arthritis.
[So] Source:Scand J Rheumatol;46(5):364-368, 2017 Sep.
[Is] ISSN:1502-7732
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Peripheral bone mineral density (BMD) may be decreased in early rheumatoid arthritis (RA) but it is unknown whether BMD loss emerges before arthritis is clinically apparent. We aimed to study whether BMD loss occurs in patients with clinically suspect arthralgia (CSA), and whether it is associated with progression to clinical arthritis and magnetic resonance imaging (MRI)-detected subclinical inflammation. METHOD: Patients with CSA had arthralgia for <1 year and were at risk of progressing to RA according to their rheumatologists. At baseline, a 1.5 T MRI was performed of unilateral metacarpophalangeal, wrist, and metatarsophalangeal joints, and scored on synovitis, bone marrow oedema, and tenosynovitis;. summing these features yielded the total MRI inflammation score. Digital X-ray radiogrammetry (DXR) was used to estimate BMD on two sequential conventional hand radiographs (mean interval between radiographs 4.4 months). The change in BMD was studied; BMD loss was defined as a decrease of ≥2.5 mg/cm /month. Patients were followed for arthritis development for a median of 18.4 months. RESULTS: In CSA patients (n = 108), change in BMD was negatively associated with age (ß = -0.03, p = 0.007). BMD loss in CSA patients was associated with arthritis development [adjusted for age hazard ratio (HR) = 6.1, 95% confidence interval (CI) 1.7 to 21.4] and was most frequently estimated in the months before clinical arthritis development. The total MRI inflammation scores were associated with the change in BMD (adjusted for age ß = -0.05, p = 0.047). The total MRI inflammation score and BMD loss were both independently associated with arthritis development (HR = 1.1, 95% CI 1.1 to 1.2, and HR = 4.6, 95% CI 1.2 to 17.2, respectively). CONCLUSION: In CSA patients, severe BMD loss is associated with MRI-detectable subclinical inflammation and with progression to clinical arthritis.
[Mh] Termos MeSH primário: Artralgia
Artrite Reumatoide
Desmineralização Patológica Óssea
Densidade Óssea
Articulação da Mão
Inflamação
[Mh] Termos MeSH secundário: Adulto
Artralgia/diagnóstico
Artralgia/fisiopatologia
Artrite Reumatoide/diagnóstico
Artrite Reumatoide/epidemiologia
Artrite Reumatoide/fisiopatologia
Desmineralização Patológica Óssea/diagnóstico por imagem
Desmineralização Patológica Óssea/fisiopatologia
Progressão da Doença
Feminino
Articulação da Mão/diagnóstico por imagem
Articulação da Mão/patologia
Seres Humanos
Inflamação/diagnóstico por imagem
Inflamação/fisiopatologia
Imagem por Ressonância Magnética/métodos
Masculino
Meia-Idade
Países Baixos/epidemiologia
Radiografia/métodos
Índice de Gravidade de Doença
Estatística como Assunto
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170927
[Lr] Data última revisão:
170927
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170606
[St] Status:MEDLINE
[do] DOI:10.1080/03009742.2017.1299217


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[PMID]:28493323
[Au] Autor:Werner D; Simon D; Englbrecht M; Stemmler F; Simon C; Berlin A; Haschka J; Renner N; Buder T; Engelke K; Hueber AJ; Rech J; Schett G; Kleyer A
[Ad] Endereço:Friedrich-Alexander University Erlangen-Nuernberg and Universitätsklinikum Erlangen, Erlangen, Germany.
[Ti] Título:Early Changes of the Cortical Micro-Channel System in the Bare Area of the Joints of Patients With Rheumatoid Arthritis.
[So] Source:Arthritis Rheumatol;69(8):1580-1587, 2017 Aug.
[Is] ISSN:2326-5205
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: 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). METHODS: 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. RESULTS: 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 < 0.001), with 20-49-year-old RA patients exhibiting similar numbers of 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. CONCLUSION: 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.
[Mh] Termos MeSH primário: Artrite Reumatoide/diagnóstico por imagem
Osso Cortical/diagnóstico por imagem
Articulação da Mão/diagnóstico por imagem
Ossos Metacarpais/diagnóstico por imagem
[Mh] Termos MeSH secundário: Adulto
Idoso
Cadáver
Estudos de Casos e Controles
Seres Humanos
Meia-Idade
Tomografia Computadorizada por Raios X
Microtomografia por Raio-X
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170821
[Lr] Data última revisão:
170821
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170512
[St] Status:MEDLINE
[do] DOI:10.1002/art.40148


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[PMID]:28431182
[Au] Autor:Husic R; Lackner A; Stradner MH; Hermann J; Dejaco C
[Ad] Endereço:Department of Rheumatology and Immunology, Medical University Graz, Graz, Austria.
[Ti] Título:Joint positions matter for ultrasound examination of RA patients-increased power Doppler signal in neutral versus flat position of hands.
[So] Source:Rheumatology (Oxford);56(8):1312-1319, 2017 Aug 01.
[Is] ISSN:1462-0332
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Objective: Position of joints might influence the result of US examination in patients with RA. The purpose of this work was to compare grey-scale (GS) and power Doppler (PWD) findings obtained in neutral vs flat position of hands. Methods: A cross-sectional study of 42 RA patients with active disease. Two dimensional and 3D sonography of wrists and MCP joints were conducted in two different joint positions: neutral position, which is a slight flexion of the fingers with relaxed extensor muscles; and flat position, where all palm and volar sides of fingers touch the Table. Two dimensional GS synovitis (GSS) and PWD signals were scored semi-quantitatively (0-3). For 3D sonography, the percentage of PWD voxels within a region of interest was calculated. GSS was not quantified using 3D sonography. Results: Compared with neutral position, 2D PWD signals disappeared in 28.3% of joints upon flattening. The median global 2D PWD score (sum of all PWD scores of an individual patient) decreased from 8 to 3 ( P < 0.001), and the global 3D PWD voxel score from 3.8 to 0.9 ( P < 0.001). The reduction of PWD scores was similar in all joints (2D: minus 50%, 3D: minus 66.4-80.1%). Inter- and intrareader agreement of PWD results was good (intraclass correlation coefficient: 0.75-0.82). Conclusion: In RA, a neutral position of the hands is linked to a higher sensitivity of 2D and 3D sonography in detecting PWD signals at wrists and MCP joints, compared with a flat position. Standardization of the scanning procedure is essential for obtaining comparable US results in RA patients in trials and clinical routines.
[Mh] Termos MeSH primário: Artrite Reumatoide/diagnóstico por imagem
Articulação da Mão/diagnóstico por imagem
Imagem Tridimensional/métodos
Posicionamento do Paciente/métodos
Ultrassonografia Doppler/métodos
[Mh] Termos MeSH secundário: Adulto
Idoso
Estudos Transversais
Feminino
Seres Humanos
Masculino
Meia-Idade
Sensibilidade e Especificidade
Sinovite/diagnóstico por imagem
Articulação do Punho/diagnóstico por imagem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170925
[Lr] Data última revisão:
170925
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170422
[St] Status:MEDLINE
[do] DOI:10.1093/rheumatology/kex153


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[PMID]:28431141
[Au] Autor:Raffeiner B; Grisan E; Botsios C; Stramare R; Rizzo G; Bernardi L; Punzi L; Ometto F; Doria A
[Ad] Endereço:Rheumatology Unit, Department of Medicine - DIMED, University of Padova, Padova.
[Ti] Título:Grade and location of power Doppler are predictive of damage progression in rheumatoid arthritis patients in clinical remission by anti-tumour necrosis factor α.
[So] Source:Rheumatology (Oxford);56(8):1320-1325, 2017 Aug 01.
[Is] ISSN:1462-0332
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Objectives: To investigate power Doppler (PD) signal, grade and location and their association with radiographic progression in RA patients in remission. Methods: A prospective observational study was conducted in 125 consecutive RA patients in stable 28-joint DAS (DAS28) remission (⩾6 months) achieved on anti-TNF-α. At baseline, patients in stable remission underwent radiographic and US examination of the wrists and MCP, PIP and MTP joints. Semi-quantitative PD scoring (0-3) was recorded. We scored PD according to two locations: capsular or within synovial tissue without bone contact (location 1) and with bone contact or penetrating bone cortex (location 2). Radiographic progression was evaluated at the 1 year follow-up and defined as a change in van der Heijde-modified total Sharp score >0. Risk ratios (RRs) of radiographic progression according to presence, grade and location of PD were calculated. Results: Four patients were excluded because of missing data. At baseline, 59/121 (48.7%) patients had a PD signal in one or more joints. PD location 2 was found in 74.6% patients (44/59). At the 1 year follow-up, 17/121 patients experienced radiographic progression: all had PD signal in one or more joints at baseline (RR 2.47, P < 0.0001). Radiographic progression was associated with the following baseline US features: PD grade 2 (RR 4.58, P < 0.01), PD grade 3 (RR 3.49, P < 0.05), total PD score ⩾2 (sum of all PD scores) (RR 3.19, P < 0.0001) and PD location 2 (RR 3.49, P < 0.0001). Conclusion: Higher PD grades and PD in contact with/or penetrating bone are associated with radiographic progression in patients in DAS28 remission.
[Mh] Termos MeSH primário: Artrite Reumatoide/diagnóstico por imagem
Progressão da Doença
Índice de Gravidade de Doença
[Mh] Termos MeSH secundário: Adulto
Idoso
Antirreumáticos/uso terapêutico
Artrite Reumatoide/tratamento farmacológico
Artrite Reumatoide/patologia
Feminino
Seguimentos
Articulação da Mão/diagnóstico por imagem
Articulação da Mão/patologia
Seres Humanos
Masculino
Meia-Idade
Estudos Prospectivos
Radiografia/métodos
Indução de Remissão/métodos
Fator de Necrose Tumoral alfa/antagonistas & inibidores
Ultrassonografia Doppler/métodos
Articulação do Punho/diagnóstico por imagem
Articulação do Punho/patologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Antirheumatic Agents); 0 (Tumor Necrosis Factor-alpha)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170925
[Lr] Data última revisão:
170925
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170422
[St] Status:MEDLINE
[do] DOI:10.1093/rheumatology/kex084


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[PMID]:28420375
[Au] Autor:Sewerin P; Vordenbaeumen S; Hoyer A; Brinks R; Buchbender C; Miese F; Schleich C; Klein S; Schneider M; Ostendorf B
[Ad] Endereço:Department of Rheumatology & Hiller Research Unit, University Hospital Düsseldorf, Moorenstreet 5, Duesseldorf, 40225, Germany. philipp.sewerin@med.uni-duesseldorf.de.
[Ti] Título:Silent progression in patients with rheumatoid arthritis: is DAS28 remission an insufficient goal in RA? Results from the German Remission-plus cohort.
[So] Source:BMC Musculoskelet Disord;18(1):163, 2017 Apr 19.
[Is] ISSN:1471-2474
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Remission is arguably the ultimate therapeutic goal in rheumatoid arthritis (RA). Applying modern strategies, clinical remission can be achieved in a substantial number of patients with early RA (ERA). Even in those patients, the number and scope of erosions can increase. We, therefore, investigated the value of MRI for the detection of radiological progression in patients with DAS28 improvement and/or clinical remission of the German Remission-plus cohort. METHODS: Data-sets of 80 RA patients (according to 2010 ACR/EULAR criteria) from the Remission-plus study cohort, who fulfilled the following criteria, were retrospectively analysed: availability of two consecutive MRI scans (low-field MRI, follow-up interval 1 year) of the clinically dominant hand and wrist, and the presence of DAS28 (CRP) scores at both time points, which was used to assess disease activity. RESULTS: Seventy-one of the 80 investigated patients presented a numerical improvement of the DAS28 (CRP) after 12 months (DAS28(CRP) T0 average (Ø) 4.96, SD 1.2; DAS28 T4 (12 month) Ø 2.6, SD 1.0), 73% of them also improved in the RAMRIS-Score, while 24% demonstrated an increase despite DAS28 improvement and 3% showed equal values. 48% of patients who improved in the DAS28 reached EULAR remission. 41% of these patients had an increase in the RAMRIS Erosion-subscore after 12 months. When considering EULAR response criteria (non-response (n = 7), moderate response (n = 19), good response (n = 45)), an increase of erosions was found in 71.4% of non-responders, 52.6% of moderate responders, and 31.1% of good responders after 12 months, all compared to baseline. CONCLUSION: Up to 40% of patients in this study demonstrated a progressive erosive disease detected by MRI despite DAS28 improvement or EULAR remission. Future studies are needed to determine the prognostic clinical impact of disease progression in MRI despite clinical remission, and to investigate if DAS28 remission may be an insufficient therapeutic goal and should be accompanied by MRI remission criteria.
[Mh] Termos MeSH primário: Antirreumáticos/uso terapêutico
Artrite Reumatoide/diagnóstico por imagem
Artrite Reumatoide/tratamento farmacológico
Progressão da Doença
Metas
Índice de Gravidade de Doença
[Mh] Termos MeSH secundário: Feminino
Alemanha
Articulação da Mão/diagnóstico por imagem
Seres Humanos
Imagem por Ressonância Magnética
Masculino
Prognóstico
Indução de Remissão
Estudos Retrospectivos
Resultado do Tratamento
Articulação do Punho/diagnóstico por imagem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antirheumatic Agents)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170713
[Lr] Data última revisão:
170713
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170420
[St] Status:MEDLINE
[do] DOI:10.1186/s12891-017-1528-y


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[PMID]:28399930
[Au] Autor:Selvaag AM; Kirkhus E; Törnqvist L; Lilleby V; Aulie HA; Flatø B
[Ad] Endereço:Department of Rheumatology, Oslo University Hospital, Rikshospitalet, Post-box 4950, Nydalen, 0424, Oslo, Norway. anselv@ous-hf.no.
[Ti] Título:Radiographic damage in hands and wrists of patients with juvenile idiopathic arthritis after 29 years of disease duration.
[So] Source:Pediatr Rheumatol Online J;15(1):20, 2017 Apr 11.
[Is] ISSN:1546-0096
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: There are few studies on radiographic outcome after long-term disease duration in juvenile idiopathic arthritis (JIA). We wanted to evaluate 29-year radiographic outcome in hands/wrists and predictors of damage in patients with long-term active JIA. METHODS: Patients diagnosed from 1980 to 1985, who had active disease at 15-, 23- or 29-year follow-up and arthritis in the wrists during the disease course, were reexamined with radiographs of hands/wrists. We used the adapted version of the Sharp van der Heijde (aSvdH) score and Carpal Height Ratio (CHR) to evaluate radiographic outcome. RESULTS: Sixty patients, mean age 38 years, were reexamined at median 29-year follow-up. 33 patients (55%) had an aSvdH score >0, median score was 4.0 (range 0-313), and 25% of the scores were high (≥53). Most patients with radiographic damage (88%) had both erosions and JSN. 52% of the patients had damage in the wrists, 43% in the MCP joints and 40% in the PIP joints. The CHR correlated strongly with the aSvdH. Both scores had high correlations with the Juvenile Arthritis Damage Index and the number of joints with limited range of motion (LROM) (r = -0.688 to 0.743, p ≤ 0.001). The aSvdH correlated weakly with measures of disease activity. The number of joints with LROM, ESR and the HAQ disability score at 15 years and HLAB27 positivity predicted the aSvdH score and the CHR at 29-year follow-up. CONCLUSIONS: The majority of patients with long-term active JIA had modest radiographic damage, but more frequently in wrists than in fingers. The radiographic scores correlated well with measures of disease damage. Restricted mobility in joints at 15 years was the most important predictor of radiographic damage at 29 years.
[Mh] Termos MeSH primário: Artrite Juvenil/diagnóstico por imagem
Articulações dos Dedos/diagnóstico por imagem
Articulação Metacarpofalângica/diagnóstico por imagem
Articulação do Punho/diagnóstico por imagem
[Mh] Termos MeSH secundário: Adulto
Artrite Juvenil/fisiopatologia
Feminino
Articulações dos Dedos/fisiopatologia
Seguimentos
Articulação da Mão/diagnóstico por imagem
Articulação da Mão/fisiopatologia
Seres Humanos
Masculino
Articulação Metacarpofalângica/fisiopatologia
Radiografia
Índice de Gravidade de Doença
Articulação do Punho/fisiopatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170816
[Lr] Data última revisão:
170816
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170413
[St] Status:MEDLINE
[do] DOI:10.1186/s12969-017-0151-7


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[PMID]:28399893
[Au] Autor:Peters SE; Laxer RM; Connolly BL; Parra DA
[Ad] Endereço:School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland.
[Ti] Título:Ultrasound-guided steroid tendon sheath injections in juvenile idiopathic arthritis: a 10-year single-center retrospective study.
[So] Source:Pediatr Rheumatol Online J;15(1):22, 2017 Apr 11.
[Is] ISSN:1546-0096
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The aims of this study were to: (a) Identify tendon sheaths most commonly treated with steroid injections in a pediatric patient population with Juvenile Idiopathic Arthritis (JIA); (b) Describe technical aspects of the procedure; (c) Characterize sonographic appearance of tenosynovitis in JIA; (d) Assess agreement between clinical request and sites injected. METHODS: This was a 10 year single-center retrospective study (May 2006-April 2016) of patients with JIA referred by Rheumatology for ultrasound-guided tendon sheath injections. Patient demographics, clinical referral information, sonographic appearance of the tendon sheaths and technical aspects of the procedure were analyzed. RESULTS: There were 308 procedures of 244 patients (75% female, mean age 9.6 years) who underwent a total of 926 tendon sheath injections. Ankle tendons were most commonly injected (84.9%), specifically the tendon sheaths of tibialis posterior (22.3%), peroneus longus (20%) and brevis (19.7%). The majority of treated sites (91.9%) showed peritendinous fluid and sheath thickening on ultrasound. There were 2 minor intra-procedure complications without sequelae. A good agreement between clinical request and sites injected was observed. CONCLUSIONS: Ultrasound-guided tendon sheath injections with steroids are used frequently to treat patients with JIA. It is a safe intervention with a high technical success rate. The ankle region, specifically the medial compartment, is the site most commonly injected in this group of patients. The most common sonographic finding is peritendinous fluid and sheath thickening. These findings might assist clinicians and radiologists to characterize and more effectively manage tenosynovitis in patients with JIA.
[Mh] Termos MeSH primário: Anti-Inflamatórios/uso terapêutico
Artrite Juvenil/tratamento farmacológico
Tendões
Tenossinovite/tratamento farmacológico
Triancinolona Acetonida/análogos & derivados
[Mh] Termos MeSH secundário: Adolescente
Articulação do Tornozelo/diagnóstico por imagem
Artrite Juvenil/diagnóstico por imagem
Criança
Pré-Escolar
Feminino
Articulações do Pé
Articulação da Mão
Seres Humanos
Lactente
Injeções
Injeções Intra-Articulares
Masculino
Estudos Retrospectivos
Tenossinovite/diagnóstico por imagem
Triancinolona Acetonida/uso terapêutico
Ultrassonografia
Articulação do Punho
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Inflammatory Agents); F446C597KA (Triamcinolone Acetonide); I7GT1U99Y9 (triamcinolone hexacetonide)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170816
[Lr] Data última revisão:
170816
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170413
[St] Status:MEDLINE
[do] DOI:10.1186/s12969-017-0155-3



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