Assuntos
Humanos , Feminino , Adulto , Síndrome de Sjogren/patologia , Síndrome de Sjogren/diagnóstico por imagem , Doenças do Sistema Nervoso Periférico/patologia , Doenças do Sistema Nervoso Periférico/diagnóstico por imagem , Glândulas Salivares/patologia , Biópsia , Imageamento por Ressonância Magnética , Transtornos de Sensação/patologia , Transtornos de Sensação/diagnóstico por imagemRESUMO
The use of musculoskeletal ultrasound in rheumatology clinical practice has rapidly increased over the past decade. Ultrasound has enabled rheumatologists to diagnose, prognosticate and monitor disease outcome. Although international standardization remains a concern still, the use of ultrasound in rheumatology is expected to grow further as costs fall and the opportunity to train in the technique improves. We present a review of value of ultrasound, focusing on major applications of ultrasound in rheumatologic diseases.
Assuntos
Humanos , Imageamento por Ressonância Magnética , Sistema Musculoesquelético/diagnóstico por imagem , Osteoartrite/diagnóstico por imagem , Doenças Reumáticas/diagnóstico por imagem , Síndrome de Sjogren/diagnóstico por imagem , Espondiloartropatias/diagnóstico por imagem , Sinovite/diagnóstico por imagem , Tendinopatia/diagnóstico por imagem , Vasculite/diagnóstico por imagemRESUMO
To describe the clinical, laboratory, and radiological features of Primary Sjogren's syndrome [PSS] with central nervous system [CNS] involvement. A retrospective case series of 12 female patients with PSS and CNS involvement at King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia from 1991-2009. The diagnosis of PSS is defined by the American-European Diagnostic Criteria. We analyzed the clinical, radiological, and immunological features. The mean age was 40 years [range 16-58 years]; all patient were females and presented with active neurological symptoms. The neurological involvement preceded the classic sicca symptoms [33%]. Eight patients [66%] presented with myelopathy, 9 patients [75%] had optic neuritis, and the rest had variable neurological signs. Immunological tests [anti-Sjogren's syndrome A and anti-Sjogren's syndrome B] were high in 7 patients [58%]. Minor salivary gland biopsy revealed inflammatory cell infiltrate in 11 patients [92%]. Brain MRI showed scattered white matter changes in 7 patients [58%]. Spine MRI showed multiple foci of hyperintensity in T2-weighted image in 6 patients [50%], and long segment of hyperintensity at the cervical spinal cord in 2 patients [16%]. Our findings demonstrate that CNS involvements in PSS have great clinical variability and could precede the classic sicca symptoms by years. Primary Sjogren's syndrome can mimic multiple sclerosis [primary progressive multiple sclerosis or relapsing remitting multiple sclerosis], therefore a screening test for PSS should be considered in suspected cases. A well-defined management protocol awaits studies with larger case numbers