Bone erosions and joint damage caused by chikungunya virus: a systematic review

ABSTRACT Background: Chikungunya fever is an emerging global infection transmitted by Aedes mosquitoes that manifests as an acute febrile illness with joint pain and can lead to chronic arthritis. The mechanism underlying chronic joint damage remains unclear; however, chronic chikungunya arthritis shares similarities with rheumatoid arthritis. Disease-modifying antirheumatic drugs have revolutionized rheumatoid arthritis treatment by preventing joint damage. However, the role of these therapies in chronic chikungunya arthritis has not been determined. We conducted a systematic review to evaluate the burden of joint structural damage in chronic chikungunya arthritis to help to define the role of disease-modifying therapy in this disease. Methods: This systematic review included retrospective and prospective studies, trials, and case reports evaluating joint damage caused by chikungunya virus. Various databases were searched without any date or language restrictions. Study selection was conducted independently by two researchers, and data were extracted from the articles selected. Results: A total of 108 studies were initially evaluated, with 8 meeting the inclusion criteria. Longitudinal studies have reported persistent joint pain from chikungunya infection and the progression of radiographic joint damage up to 13 years post-infection. Joint imaging revealed synovial inflammation, bone erosion, and cartilage destruction in patients with chronic chikungunya arthritis. Conclusions: Few studies have addressed chikungunya-induced joint damage, limiting our understanding of chronic chikungunya arthritis. Nevertheless, chronic chikungunya arthritis has similarities to rheumatoid arthritis. The success of early disease-modifying antirheumatic drug therapy in rheumatoid arthritis underscores the need for comprehensive research on its role in chikungunya arthritis.

The therapeutic effect of bone peptide combined with rifapentin and levofloxacin in the treatment of bone and joint damage caused by brucellosis / 中华地方病学杂志

Objective:To study the therapeutic effect of bone peptide combined with rifapentin and levofloxacin on bone and joint damage caused by brucellosis.Methods:A prospective study was conducted to select 64 patients with brucellosis bone and joint damage admitted to Shanxi Provincial People's Hospital from January 2017 to June 2021. They were randomly divided into a control group (32 cases) and an observation group (32 cases) using a random number table method. The control group was treated with rifapentin and levofloxacin, while the observation group was treated with bone peptide on the basis of the control group, with a treatment period of 8 weeks, and the peripheral venous blood sample was collected before and after treatment. The visual analogue scale (VAS), activity of daily living (ADL) score, serum C-reactive protein (CRP), procalcitonin (PCT), erythrocyte sedimentation rate (ESR), and cytokines [tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6)] levels were compared before and after treatment.Results:The total effective rates of treatment in the observation group and the control group were 90.62% (29/32) and 65.62% (21/32), respectively, with statistically significant differences between the groups (χ 2 = 5.85, P = 0.016). After treatment, the VAS score of the observation group was lower than that of the control group ( t = 8.29, P < 0.001), and the ADL score was higher than that of the control group ( t = 6.77, P < 0.001). Both groups had lower VAS scores after treatment than before treatment in the same group ( t = 21.72, 15.09, P < 0.001), and higher ADL scores than before treatment in the same group ( t = 22.49, 12.54, P < 0.001). After treatment, the levels of CRP, PCT, ESR, TNF-α, and IL-6 of the observation group were lower than those of the control group ( t = 8.11, 10.75, 4.64, 5.11, 4.55, P < 0.001); the levels of CRP, PCT, ESR, TNF-α, and IL-6 in the two group were lower than these before treatment in the same group ( t = 14.21, 21.47, 11.21, 15.07, 9.73, 15.50, 21.30, 7.52, 6.78, 4.93, P < 0.001). Conclusion:The bone peptide combinated with rifapentin and levofloxacin has a good therapeutic effect on bone and joint damage caused by brucellosis, which can significantly reduce pain and cellular inflammatory reactions in patients, and improve their quality of life.

Health-related quality of life in adults with juvenile idiopathic arthritis / Calidad de vida relacionada con la salud en pacientes adultos con artritis idiopática juvenil

ABSTRACT Background: Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in the paediatric age. It is estimated that between 30-60% of adults patients persist with active disease, which leads to sequelae and complications as well as a decrease functional capacity and reduced quality of life. Objectives: To evaluate the health-related quality of life in adult patients diagnosed with juvenile idiopathic arthritis. Methodology: A cross-sectional study was performed, using a search for adult patients diagnosed with JIA between 1996 and 2018. Clinical records were reviewed during the paediatric age, and clinical parameters were evaluated for activity (JADASc-71), and joint (JADI-A) and extra-articular (JADI-E) damage, functional capacity (HAQ), and quality of life (SF-36). Relationships were determined by non-conditional logistic regression. Results: A total of 69 patients were included. The most frequent subtype of JIA was enthesitis-related arthritis (ERA) (33%). Active disease was observed in 33%. Polyarticular JIA RF (+) was associated with active disease (P = .007), high values of JADASc-71 (P = .003), and HAQ (P = .001). Age of onset after 5 years reduced risk of joint damage (OR = 0.16) and extra-articular damage (OR = 0.03). Poor therapeutic adherence was associated with joint damage (P = .00) and JADASc-71 (P = .004). A high score of JADI-E was associated with functional dis-ability (OR = 5.75). Joint damage (P = .003) and extra-articular damage (P = .024), and functional disability (OR = 7.05) were associated with low values in the SF-36. Conclusions: JIA is not a disease limited to the paediatric age. Persistence of active disease, joint, and extra-articular damage are associated with functional disability and a decrease in H-RQoL.

RESUMEN Introducción: La artritis idiopática juvenil (AIJ) permanece activa en el 30-60% de los pacientes adultos, conduciendo a complicaciones articulares, extraarticulares, disminución en la capacidad funcional y reducción en la calidad de vida. Objetivos: Evaluar la calidad de vida relacionada con la salud en pacientes adultos con diagnóstico de AIJ. Metodología: Estudio corte transversal; se realizó una búsqueda de pacientes adultos con diagnóstico de AIJ entre 1996 y 2018. Se revisaron historias clínicas durante la edad pediátrica y se evaluaron parámetros clínicos para actividad (JADASc-71), daño articular (JADI-A) y extraarticular (JADI-E), capacidad funcional (HAQ) y calidad de vida (SF-36). Asociaciones determinadas por regresión logística no condicional. Resultados: Se incluyó a 69 pacientes. El subtipo de AIJ más frecuente fue la artritis relacionada con la entesitis (ARE) (33%). El 33% de los pacientes tenían enfermedad activa. La AIJ poliarticular FR positivo se asoció a enfermedad persistentemente activa (p = 0,007), altos valores del JADASc-71 (p = 0,003) y HAQ (p = 0,001). La edad de inicio posterior a 5 años redujo el riesgo de daño articular (OR = 0,16) y extraarticular (OR = 0,03). La mala adherencia terapéutica se asoció a daño articular (p = 0,00) y JADASc-71 (p = 0,004). La alta puntuación del JADI-E se asoció a discapacidad funcional (OR = 5,75). El daño articular (p = 0,003) y extraarticular (p = 0,024) y discapacidad funcional (OR = 7,05) se asociaron a bajos valores en SF-36. Conclusiones: La AIJ no es una enfermedad limitada a edad pediátrica. La persistencia de enfermedad activa y el daño articular y extraarticular se asocian a discapacidad funcional y disminución en la calidad de vida relacionada con la salud.

Anquilosis de la articulación temporomandibular / Ankylosis of the temporomandibular joint

Introducción: resulta de interés para médicos y especialistas el conocimiento sobre la incapacidad de la apertura de la cavidad oral debido a coaliciones entre los elementos óseos y fibrosos en la región glenoidea. Objetivo: revisar la literatura sobre las características de esta patología. Desarrollo: en el primer trimestre del año 2006, a fin de realizar una revisión bibliográfica no exhaustiva para localizar la información disponible sobre la anquilosis de la articulación temporomandibular, se realizó una búsqueda bibliográfica en Scielo, Medline, Isi Web of Knowlegde y Dialnet, buscando como palabras clave: anquilosis (ankylosis) y articulación temporomandibular (temporomandibular joint). Además de la búsqueda computarizada se realizó una búsqueda manual entre las referencias de los estudios seleccionados. Conclusiones: la anquilosis temporomandibular resulta una entidad clínica compleja, usualmente molesta para los pacientes dada la imposibilidad de alimentarse y nutrirse adecuadamente, además de las deformidades que desde el punto de vista estético afecta la esfera psicológica de las personas aquejadas. Su tratamiento es difícil, no obstante, una atención adecuada minimiza las consecuencias de las complicaciones que pueden aparecer como resultado de la técnica quirúrgica u otros factores no relacionados con ella. Se reconoce que una identificación y tratamiento oportuno del problema puede favorecer los buenos resultados de la conducta médica y la rápida integración del paciente a la sociedad(AU)

Introduction: it is of interest for physicians and specialist's knowledge about the inability of the opening of the oral cavity due to coalitions between the bone and fibrous elements in the glenoid region. Objective: to review the literature on the characteristics of this pathology. Development: in the first quarter of 2006, in order to perform a non-exhaustive literature review to locate the available information on ankylosis of the temporomandibular joint, a literature search was carried out in Scielo, Medline, Isi Web of Knowlegde and Dialnet, searching as key words: ankylosis (ankylosis) and temporomandibular joint (temporomandibular joint). In addition to the computerized search, a manual search was made among the references of the selected studies. Conclusions: the temporomandibular ankylosis is a complex clinical entity, usually annoying for patients given the impossibility of feeding and nourishing adequately, in addition to the deformities that from the aesthetic point of view affects the psychological sphere of the people afflicted. Its treatment is difficult, nevertheless, an adequate attention minimizes the consequences of the complications that can appear as a result of the surgical technique or other factors not related to it. It is recognized that an identification and timely treatment of the problem can favor the good results of medical behavior and the rapid integration of the patient into society(AU)

Afectación articular en un paciente joven con enfermedad de Still del adulto: a propósito de un caso / Joint involvement in a young patient with adult Still's disease: in relation to a case

Introducción: La enfermedad de Still del adulto es una enfermedad reumática, inflamatoria, sistémica y crónica que generalmente comienza sobre los 40 años de edad, pero puede aparecer en edades más tempranas. Se caracteriza por gran variedad de manifestaciones generales, articulares, fiebre y rash principalmente. Etiopatogénicamente, el proceso inflamatorio crónico que se genera durante el curso de la enfermedad es el responsable de las manifestaciones clínicas y del daño articular que se produce. Objetivo: dar a conocer los elementos básicos para el diagnóstico de la enfermedad de Still del adulto. Caso clínico: se presenta el caso de un paciente masculino, de 21 años de edad, que acude a consulta con manifestaciones clínicas que permiten realizar el diagnóstico de una Enfermedad de Still del Adulto. Conclusiones: La enfermedad de Still del Adulto, a pesar de no tener un patrón de deformidades tan amplio como la artritis reumatoide, también produce daño articular que puede comprometer la función de la articulación afectada. Resulta importante identificar precozmente las manifestaciones clínicas que hacen sospechar su diagnóstico para minimizar, retrasar o prevenir la afectación de las articulaciones(AU)

Introduction: adult Still's disease is a rheumatic, inflammatory, systemic and chronic disease that usually begins around 40 years of age, but may appear at younger ages. It is characterized by a great variety of general, joint, fever and rash manifestations. Etiopathogenically, the chronic inflammatory process that is generated during the course of the disease is responsible for the clinical manifestations and joint damage that occurs. Objective: to present the basic elements for the diagnosis of adult Still's disease. Clinical case: the case of a male patient, 21 years of age, who comes to the clinic with clinical manifestations that allow the diagnosis of an Adult Still's Disease. Conclusions: adult Still's disease, despite not having a pattern of deformities as extensive as rheumatoid arthritis, also produces joint damage that can compromise the function of the affected joint. It is important to identify early clinical manifestations that make your diagnosis suspect to minimize, delay or prevent the involvement of the joints(AU)

Clinical and imaging characteristics of bone and joint damage derived from brucellosis / 中华地方病学杂志

Objective To provide data evidence for early diagnosis of bone and joint damage derived from brucellosis by analyzing its clinical and imaging characteristics.Methods Patients with brucellosis accepted in Ji'nan Infectious Disease Hospital form December 2013 to December 2014 were selected.Patients with bone and joint damage confirmed through imaging were further studied,their epidemiological and clinical characters,CT and MRI characteristics,treatment and outcome were summarized.Results Total of 97.8％ (45/46) patients had a clear contact history,most of them worked in poultry farming,taking up to 67.4％ (31/46).July to October was its peak time for attacking,taking up to 58.7％ (27/46).The clinical manifestations of patients were joint pain,swelling and activities obstacles.In the CT images,there was obvious bony destruction,characterized by multiple round or large areas of low density insect damage sample spots.There was osteosclerotic bone lesions or osteophyte formatted in edge.The paravertebral soft tissue was swelling,and the vertebral body deformation was not obvious,and there was vertebra small joint damage occasionally.In the MRI images,there was vertebral ligaments damage,or soft tissue damage,or osteoproliferation at the edge of the vertebral bodies.There was abnormal signal T1W1 or T2W1 signal,and FS-T1W1 showed high signal,while FS-T2W1 showed slightly high signal.The diagnosis rate of CT,MRI and CT combined MRI for bone and joint damage derived from brucellosis was 76.1％ (35/46),84.8％ (39/46) and 91.3％ (42/46),respectively.The main therapeutic drugs were doxycycline and rifampicin,and the clinical effective rate was 91.3％ (42/46).Conclusion The epidemiological characters,CT and MRI characteristics of bone and joint damage derived from brucellosis have certain representativeness,and the comprehensive investigation is beneficial for clinical diagnosis.