ABSTRACT
INTRODUCTION: Imaging of heel enthesopathy in spondyloarthritis (SpA) could potentially be useful for diagnosis and monitoring. The aim of this study was to assess the diagnostic capacities of MRI and power Doppler ultrasonography (PDUS) of the heel to distinguish patients with SpA from controls and to distinguish between patients with SpA with and without enthesopathy. METHODS: A cross-sectional single-centre study was performed in 51 patients (102 heels) with definite SpA according to Amor's criteria. Patients with degenerative non-inflammatory low back pain (n=24, 48 heels) were included as controls. Bilateral heel MRI and PDUS were performed by two senior musculoskeletal radiologists blinded to the clinical and biological data on the same day as the clinical evaluation. The data were analysed by patient and by heel. RESULTS: Neither MRI nor PDUS could discriminate between patients with SpA and controls; bone oedema on MRI was the only abnormality specific to SpA (94%), but with a poor sensitivity (22%). However, among patients with SpA, painful heels had more inflammatory abnormalities (81% by MRI, 58% by PDUS) than heels with no pain (56% at MRI, 17% at PDUS). CONCLUSION: Heel MRI and PDUS frequently show inflammatory lesions in SpA, particularly in painful heels. However, they were also often abnormal in controls. These results suggest that heel MRI and PDUS cannot be used for the diagnosis of SpA. However, PDUS and MRI may be useful for the depiction and assessment of enthesis inflammatory lesions in patients with SpA with heel pain.
Subject(s)
Heel/pathology , Magnetic Resonance Imaging/methods , Spondylarthritis/diagnosis , Ultrasonography, Doppler/methods , Achilles Tendon/pathology , Adult , Bone Marrow Diseases/diagnosis , Bone Marrow Diseases/etiology , Case-Control Studies , Cross-Sectional Studies , Edema/diagnosis , Edema/etiology , Female , Heel/diagnostic imaging , Humans , Male , Middle Aged , Pain/etiology , Spondylarthritis/complications , Spondylarthritis/diagnostic imagingABSTRACT
We report two cases of symptomatic neurocysticercosis in two migrants whose negative serology delayed appropriate treatment for 9 and 6 months, respectively. Seroconversion occurred after treatment, which was associated with paradoxical reaction in one patient. Long-term outcome was good in both patients.
Subject(s)
Albendazole/administration & dosage , Antibody Formation/drug effects , Antigens, Helminth/immunology , Neurocysticercosis , Taenia , Adult , Animals , Anticestodal Agents/administration & dosage , Blotting, Western/methods , Emigrants and Immigrants , Enzyme-Linked Immunosorbent Assay/methods , Humans , Magnetic Resonance Imaging/methods , Male , Neurocysticercosis/diagnosis , Neurocysticercosis/drug therapy , Neurocysticercosis/immunology , Neurocysticercosis/physiopathology , Taenia/drug effects , Taenia/immunology , Tomography, X-Ray Computed/methods , Treatment OutcomeABSTRACT
INTRODUCTION: Churg-Strauss syndrome (CSS) is characterized by asthma, hypereosinophilia, and vasculitis involving at least two extrapulmonary organs. CASE: We report a case of a patient with antineutrophilic cytoplasmic antibody-negative CSS who developed pulmonary interstitial fibrosis (PIF). DISCUSSION: The possible relations between CSS and PIF are discussed. Because this case report is the first to describe features of pulmonary fibrosis in a patient with CSS, we cannot know whether this association is causal or fortuitous.
