Subject(s)
COVID-19 , Telerehabilitation , Humans , Pandemics , Physical Therapy Modalities , ShoulderSubject(s)
Arthritis, Rheumatoid , Osteochondrodysplasias , Tracheal Diseases , Arthritis, Rheumatoid/complications , Arthritis, Rheumatoid/diagnostic imaging , Cervical Vertebrae/diagnostic imaging , Humans , Osteochondrodysplasias/complications , Osteochondrodysplasias/diagnostic imaging , Tracheal Diseases/complications , Tracheal Diseases/diagnostic imagingABSTRACT
Stress fractures are overuse injuries of the bone characterized by a magnetic resonance imaging (MRI) finding of the fracture line with bone marrow edema. Clinical findings are tenderness and persistent pain. It is usually related to repetitive stresses. A 25-year-old woman was admitted with bilateral severe knee pain. She was in the postpartum period and the complaints started three days after the beginning of 2-h daily walk. The initial plain radiograph showed no abnormality, while MRI demonstrated bilateral incomplete fracture line at the proximal tibia. The patient had accompanying vitamin D deficiency and osteopenia, diagnosed with pregnancy-related osteopenia and stress fracture of bilateral proximal tibia. We advised cessation of weight bearing, resting, and supplementation of calcium and vitamin D. This report highlights that, in the postpartum period, persistent pain may indicate bone lesions such as stress fractures, particularly developing shortly after a vigorous physical activity. Detailed physical examination and further investigations are necessary to detect these fractures and risk factors.
Subject(s)
Spinal Muscular Atrophies of Childhood/complications , Adolescent , Cervical Cord/abnormalities , Cervical Cord/diagnostic imaging , Humans , Magnetic Resonance Imaging/methods , Male , Muscle Weakness/etiology , Muscle Weakness/physiopathology , Spinal Cord Compression/complications , Spinal Cord Compression/diagnostic imaging , Spinal Muscular Atrophies of Childhood/diagnostic imagingABSTRACT
Tumor necrosis factor (TNF)-α is a cytokine that plays a well-established, key role as a central mediator of inflammation and immune regulation. TNF-α and its receptors are suggested to play a critical role in a number of chronic inflammatory diseases, including rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis (AS), juvenile chronic arthritis, and inflammatory bowel disease (IBD). TNF-α inhibitors are currently used in the treatment of these diseases. We report a 29-year-old male with AS who developed Crohn's disease while taking etanercept. Etanercept treatment was interrupted and a switch to a monoclonal antibody-based anti-TNF treatment using adalimumab was started, which induced a prompt improvement of the gastrointestinal symptoms. We indicate the immunodysregulatory and proinflammatory effects of etanercept and discuss the potential pathogenic mechanisms of the paradoxical effect of TNF-α inhibitors. We also review the related literature on new-onset IBD following anti-TNF treatment for AS.