ABSTRACT
Objective To analyze the clinical features and outcome of remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome,and enhance the understanding of it.Methods Fourteen cases of RS3PE syndrome treated in the Department of Rheumatology and Immunology were analyzed retrospec-tively,including the clinical characteristics,laboratory data.Data were presented as -x±s.Results Fourteen patients(nine man,five women) with RS3PE were enrolled.Their age was (68±9) (range:52-78)years.The main clinical features were acute onset symmetrical edema in both hands and feet and polyarthritis.Polyarthritis were involved in hand joints in 14 patients,wrists in 13 patients,knees in 10 patients,ankles in 9 patients,and shoulders in 8.In laboratory examinations,the average value of erythrocyte sedimentation rate was (68±26) mm/l h and C-reactive protein was (49±41) mg/L.Mild anemia of normocytic-normochromic type and mild low level of serum albumin were frequent findings.Antinuclear antibody was present only in one patient at low titer (1∶20).Rheumatoid factor and other auto antibodies were all negative in patients.Before corticosteroid treatment,the MRI test was performed in 8 patients and revealed prominent synovitis and articular effusion.Two cases had bone erosions on MRI; five patients were fuond to have malignant tumors,three of them initially presented with RS3PE.Polyarthritis and edema were relieved after treated with low dose corticosteroids and DMARDs drugs.But those patients with cancer were easily to recurr.Conclusion RS3PE syndrome is relatively uncommon.It occurs predominantly in elderly men and is characterized by rapid-onset symmetrical polyarthritis,presence of pitting edema of both hands and feet.Erosive changes can be seen on MRI.Patients usually have dramatic response to low dose corticosteroids and DMARDs drugs.Patients should be closely followed as RS3PE is closely related to cancer.
ABSTRACT
Objective:To dynamically observe the change of intra-articular pressure of the hip by means of injecting 2‰Noradrenaline(NA)into the hip joint cavity,to study the effects of intra-articular pressure change on transient synovitis of hip(TSH).Methods:Fourty-eight dogs aged 2~3 months had been randomly divided into 12 groups,with four in each group All were injected 2‰NA into the hip joint an four assessments had been done.①The intra-articular pressure of hip was determined at different times.②99m TC-MDP triphasic imaging was used to observe the local blood supply of femoral head.③Pathological changes were observed to understand the disease course.④X-ray was adopted to exmine the hip.Result:Noradrenaline induced transient synovitis of hip,and synovitis resulted in the increase of intra-articular pressure of hip which was over 20mmHg and lowered to be normal with the inflammation fading away.Transient blood insufficiency was observed in femoral head,but with no putrescence.Conclusion:In transient synovitis of hip,synovitis resulted in the change of intra-articular pressure hip,which changed to be normal as the inflammation faded away;and the intra-articular pressure change would influence the blood supply in femoral head,and could canse transient blood insufficiency.