ABSTRACT
This study aimed to investigate the correlation of ultrasonography (US) of synovitis with disease activity and clinical response to etanercept (ETN) in juvenile idiopathic arthritis (JIA) patients. Eighty-two JIA patients who underwent ETN treatment for 24 weeks were consecutively enrolled. US evaluations of 28 joints (shoulder, elbow, wrist, metacarpophalangeal, and proximal interphalangeal of hands and knee) at baseline were performed using grey-scale US and power doppler (PD) US, and US synovitis was defined as grey-scale abnormalities or PD abnormalities. Clinical response was assessed according to the ACRpedi 50 response criteria. In total, 2296 joints were scanned and 608 (26.5%) joints presented US synovitis, which was numerically higher than clinical synovitis (513 (22.3%)). The mean number of joints showing synovitis on US was 7.42±3.35, which was also numerically higher than that of clinical synovitis (6.26±2.70). The number of joints showing synovitis on US was positively correlated with C-reactive protein, erythrocyte sedimentation rate, number of joints with active disease, number of joints with limited range of motion, physician's global assessment of disease activity, parent/patient global assessment of overall well-being, and childhood health assessment questionnaire score. Most interestingly, the baseline number of joints showing synovitis on US was increased in ACRpedi 50 response JIA patients compared to non-response JIA patients, and it serves as an independent predictive factor for higher clinical response to ETN treatment. In conclusion, US is a more sensitive test to evaluate subclinical synovitis and disease activity in JIA patients, and US synovitis might serve as a marker for predicting increased clinical response rate to ETN treatment.
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Arthritis, Juvenile/drug therapy , Synovitis/diagnostic imaging , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Etanercept/therapeutic use , Arthritis, Juvenile/complications , Synovitis/complications , UltrasonographySubject(s)
Humans , Male , Child , Arthritis, Juvenile/diagnosis , Synovitis/diagnosis , Knee Joint/pathology , Arthritis, Juvenile/complications , Synovitis/complications , Synovitis/drug therapy , Biopsy , Magnetic Resonance Imaging , Methotrexate/therapeutic use , Ultrasonography , Antirheumatic Agents/therapeutic use , Knee Joint/diagnostic imagingABSTRACT
La ultrasonografía es una herramienta útil para la evaluación de las anormalidades del codo, especialmente aquellas relacionadas con artropatías inflamatorias, mecánicas y degenerativas, al deporte, con actividades repetitivas o con entesitis. Es una herramienta dinámica que permite evaluar tanto estructuras extraarticulares como los ligamentos, tendones, músculos, bursas, entesis, nervios y vasos, así como las estructuras intraarticulares como los recesos articulares, cartílagos y superficies óseas articuladas. El objetivo de esta revision es brindar una actualizacion del uso de este método de imagen en las patologías más frecuentes que afectan el codo.
Ultrasonography is a useful tool for evaluation of abnormalities of the elbow, especially those related to inflammatory arthritis, mechanical and degenerative diseases, sports with repetitive activities or enthesitis. It is a dynamic tool that provides an evaluation of extra-articular structures such as ligaments, tendons, muscles, bursas, enthesis, nerves and vessels, as well as intra-articular structures such as joint recess, cartilage and bone surfaces articulated. The aim of this review is to provide an update on the use of this method of image in the most common diseases that affect the elbow.
Subject(s)
Humans , Elbow/injuries , Elbow , Pain/etiology , Ultrasonography , Bursitis/complications , Bursitis , Tennis Elbow/complications , Tennis Elbow , Elbow/innervation , Collateral Ligaments/injuries , Collateral Ligaments , Cubital Tunnel Syndrome/complications , Cubital Tunnel Syndrome , Synovitis/complications , Synovitis , Tendinopathy/complications , TendinopathyABSTRACT
La consulta por cojera en un niño es frecuente, en ella el médico debe realizar una completa anamnesis y exhaustivo examen físico para el diagnóstico diferencial, pero en la mayoría de los casos este se define por los hallazgos en los estudios por imágenes. Este trabajo orienta a reconocer qué estudio solicitar de acuerdo a la patología que se sospecha como diagnóstico.
Subject(s)
Humans , Adolescent , Child, Preschool , Child , Intermittent Claudication/diagnosis , Intermittent Claudication/etiology , Arthritis, Infectious/complications , Diagnosis, Differential , Legg-Calve-Perthes Disease/complications , Lower Extremity , Osteomyelitis/complications , Synovitis/complications , Leg Injuries/complicationsABSTRACT
RS3PE syndrome, often mimicking rheumatoid arthritis (RA) or polymyalgia rheumatica (PMR), has puzzled the rheumatologists until late'80s. Though the nature of the disease still remains illusive, the outcome is excellent. This present study analyzes the clinical, radiological and immunogenetical characteristics of five patients diagnosed with RS3PE syndrome, with review of literature.
Subject(s)
Aged , Aged, 80 and over , Arthralgia/etiology , Diagnosis, Differential , Edema/complications , Female , Hand Dermatoses/complications , Humans , Male , Middle Aged , Syndrome , Synovitis/complicationsSubject(s)
Humans , Male , Female , Arthritis/diagnosis , Joints , Rheumatoid Nodule/diagnosis , Synovitis/complicationsABSTRACT
La sinovitis simétrica seronegativa remitente con edema blando (Síndorme R S3 P E por las iniciales en ingles) constituye una forma diferente de artritis que se observa en personas de edad, generalmente mayores de 60 años y se caracteriza por tener pronóstico excelente a pesar de iniciarse en forma aguda e incapacitante en la mayoría de los casos. Se presenta el resumen de dos historias que reunen los criterios clínicos establecidos para esta entidad.
Subject(s)
Humans , Male , Aged , Edema/etiology , Soft Tissue Infections , Soft Tissue Infections/complications , Soft Tissue Infections/diagnosis , Soft Tissue Infections/drug therapy , Soft Tissue Infections/epidemiology , Soft Tissue Infections/etiology , Soft Tissue Infections/pathology , Soft Tissue Infections/physiopathology , Soft Tissue Infections/therapy , Synovitis , Synovitis/complications , Synovitis/congenital , Synovitis/diagnosis , Synovitis/drug therapy , Synovitis/epidemiology , Synovitis/etiology , Synovitis/pathology , Synovitis/physiopathology , Synovitis/therapyABSTRACT
Se estudian 473 pacientes a los que se realizaron estudios artroscópicos, en los que se observa 63 con lesiones de menisco. Se presentan los diferentes hallazgos asociados a las lesiones de menisco, entre los que se destacan la sinovitis crónica (38,4% y la condromalacia (39,4%). En la discusión se destaca las principales localizaciones de la condromalacia asociada a las lesiones de menisco. Como conclusión se señala que las lesiones de menisco en pocas ocasiones se presentan solas y por lo que el examen articular sistemático revelará hallazgo importantes, recomendándose realizar artroscopía preoperatoria siempre que sea posible
Subject(s)
Humans , Menisci, Tibial/injuries , Synovitis/complications , Arthroscopy , Menisci, Tibial/surgery , Synovitis/surgeryABSTRACT
Os autores descrevem alguns pacientes portadores de SIDA que desenvolveram artropatia dos joelhos, tornozelos e pés, mencionando os achados histopatológicos encontrados na membrana sinoval desses enfermos. Comentam, ainda, as principais possíveis causas do acometimento articular e a literatura médica pertinente
Subject(s)
Humans , Joint Diseases/complications , Acquired Immunodeficiency Syndrome/complications , Synovitis/complicationsABSTRACT
Embora a disseminaçäo metastática carcinomatosa para estrutura ósseas näo possa ser considerada manifestaçäo rara, principalmente a partir de neoplasias pulmonares, o acometimento patelar associado à invasäo sinovial pode ser estabelecido como fato inusitado. Acompanhamos o caso de paciente idoso do sexo masculino que apresentou, inicialmente, monoartrite de joelho direito. Após dois meses de evoluçäo, foi internado referindo tosse persistente há 30 dias e considerável emagrecimento. A radiografia de tórax, podíamos observar presença de massa para-hilar à direita. A radiografia de joelhos evidenciou lesäo lítica no pólo inferior da patela direita; a cintilografia óssea demonstrou hipercaptaçäo isolada de joelho direito. Foi realizada punçäo sinovial, que obteve líquido hemorrágico. O estudo histológico pulmonar (através de biópsia transbrônquica) foi compatível com diagnóstico de carcinoma epidermóide pouco diferenciado; alteraçöes histológicas similares puderam ser demonstradas na membrana sinovial. A apresentaçäo dessa rara associaçäo, claramente evidenciada, permite que a carcinomatose osteossinovial participe do complexo diagnóstico diferencial das monoartrites crônicas
Subject(s)
Aged , Humans , Male , Bronchial Neoplasms , Carcinoma, Squamous Cell , Knee , Bone Neoplasms , Synovitis/complications , Joint Diseases/complications , Bone Neoplasms/complications , Synovial Membrane/pathologyABSTRACT
Os autores fazem uma revisäo da literatura sobre líquido sinovial hemorrágico, salientando sua infreqüência e relatam um caso de sinovite associado à artrose que cursou com vários derrames hemorrágicos em joelho direito