[Roentgen examinations of joints in patients with gouty arthritis]. / Die Röntgenuntersuchung der Gelenke bei Patienten mit Arthritis urica.

The radiological examination of the joints affected is necessary for the diagnosis, differential diagnosis and the assessment of the course of the chronic gout. The roentgen-morphological individual symptoms develop depending on the quantity-time-quotient of the precipitation of urates. Frequently apart from degenerative, destructive or osteoplastic symptoms only the signs of a chronic arthritis are an expression of the clinically existing chronic gout. The interpretation of the individual symptoms must be done taking into consideration the total clinical findings. In the primary attack of gout roentgen-morphological alterations at the joints are not to be expected.

[Scintigraphic examinations of sacroiliacal joints in patients with early forms of ankylosing spondylitis]. / Szintigraphische Untersuchungen der Sakroiliakalgelenke bei Patienten mit Frühformen einer Spondylarthritis ankylosans.

In contrast to the X-ray examination the scintigraphy of the sacroiliacal joints in the early phase of the ankylosing spondylarthritis allows an evidence to the local processes of bone reconstruction directly depending on their activity. Positive findings of scintigraphy have a high sensitivity and a low specifity. They demand a further differential-diagnostic clarification. In this sense, supplementing the X-ray findings, the scintigraphy brings valuable informations for the early diagnostics of ankylosing spondylarthritis. The radiation exposure of the gonads which is smaller by factor 3 in comparison to the X-ray examination of the pelvis is an essential advantage in the above all young patients. The valuation of the scintigramme must be performed in close connection between clinical rheumatologists and specialists in nuclear medicine. Our results show that longitudinal examinations let expect a further improvement of the evidence.

[Characteristics of the early phase of ankylosing spondylitis]. / Charakteristik des Frühstadiums der Spondylarthritis ankylosans.

100 patients with several clinical and suspicious radiological symptoms of Bechterev's disease (Institute of Rheumatology Moscow) and 100 patients with the clinical symptoms of Bechterev's disease without radiological symptoms of a sacroiliacal arthritis (Medico-Policlinical Institute Leipzig) have been examined within a common research programme since 1976 and analysed concerning the frequency of the complaints as well as of clinical symptoms at the beginning of the disease. The main complaints at the beginning of Bechterev's disease are nocturnal pains in the lumbosacral region, pains in the joints, in which cases 50% of the patients spoke of swellings of the joints. 42% of the patients complained of the feeling of the morning rigidity in the lumbar spinal column and 22% spoke of increased temperatures. In 9--10% of our patients an iritis was diagnosed at the beginning of the disease.

[Effects of menopause, pregnancies, breast feeding and hormonal contraceptives on the course of rheumatoid arthritis]. / Beeinflussung durch Klimakterium, Schwangerschaften, Stillperioden und Ovulationshemmer.

PIP: Of 763 patients who were treated for rheumatoid arthritis (RA), 219 went through menopause, 114 were pregnant, 92 breast-fed children, and 29 used oral contraceptives. Of the 219 menopausal women, 5% experienced an improvement and 46.1% an adverse effect on the RA. It was found that those who experienced improvement during menopause more often had had RA for longer periods and tended to have developed RA before the 45th year of age. 59 patients first developed RA during the menopause, and a general adverse effect of menopause on RA was observed. Increased seronegativity and a reduction in rheumafactor levels were observed in this group, as well as a significantly higher BSG level. In the group which developed RA during menopause, increases in morphological stage II, in grade I of functional inefficiency, and in grip strength and the BFT were observed. There was also a significant increase in the incidence of long arthralgic periods before developing RA during menopause. The relationship between RA during menopause and various other factors, e.g. occupation, weight, prior therapy, is also discussed. Among the 114 pregnant patients, 42 reported a positive effect and 30 an adverse effect on RA. Among the 92 patients who breast-fed their children, 25 reported an adverse effect and 19 reported improvement of RA. Patients who had had RA for longer periods more often reported improvement during pregnancy and breast feeding. Adverse effects of pregnancy on RA usually continued during the breast feeding period. Of the 29 patients who had used oral contraceptives, 5 reported a positive effect on RA.^ieng

[Therapy of ankylosing spondylitis]. / Therapie der Spondylitis ankylosans.

Due to the unknown etiology of the ankylosing spondylarthritis up to now a causal therapy is not possible. By complex methods of treatment, consisting of chemo- and physiotherapeutic measures we succeed in controlling the course of the disease in as far that the most severe morphological lesions may be prevented. Decisive is the use of a basis therapeutic, in which case chlorochine has been proved favourable. In the last years by optimum dispensary care of these patients with regular controls of the course and controls of the therapy as well as use of all possible rehabilitation measures the premature rate of invalidisation could be reduced from about 50% to 10%. When the disease is recognized in the prodromal phase there exists established hope of preventing severe morphological lesions.

[Results of different long term treatments of patients in the early stages of rheumatoid arthritis]. / Resultate der unterschiedlichen Langzeitbehandlung von Patienten im Frühstadium der Rheumatoid-Arthritis

In a clinical 5-year-study on 200 patients with rheumatoid arthritis with the help of the dynamics of radiological changes (radiological progressing), the joint deformation, the reduction of function and the new affection of joints (clinical progressing) as well as the medium position of activity the progressing of the disease and a good, satisfying or missing success of the long-term therapy were estimated. From the characteristics of the individual groups of therapy conclusions for the therapy in the early phase of the rheumatoid arthritis were derived.

[Longitudinal study on the locomotor function test in patients with rheumatoid arthritis]. / Längsschnittuntersuchung mit dem Bewegungsfunktionstest bei Patienten mit Rheumatoid-Arthritis

With the help of a four-year observation of the course of rheumatoed arthritis in 100 patients the evidence of the locomotor functional test after Keitel is examined for the longitudinal research. The locomotor functional test proved depending on the actual activity and in a high percentage of patients showed considerable variations from year to year which were not parallel to the clinical and radiological progression. It is not sufficiently evident as the only criterion for the establishment of the progression of the disease. The locomotor functional test is well suited for the judgement of the success of therapy in short periods and the objectivation of the actual restriction of the function especially for questionings of experts. It is proposed to include the locomotor functional test into the criteria for the establishment of the degree of function.

[Early diagnosis of spondylarthritis ankylopoietica]. / Frühdiagnostik der Spondylarthritis ankylopoetica

For the early recognition of the ankylopoietic spondylarthritis subjective and objective criteria are explained and the importance of X-ray-morphological, cytological, biochemical, immunogenetic and coagulation-physiological investigations are explained. By accentuation of two types of constellation of the course the possibility of an early diagnosis is given still before the appearance of severe irreparable X-ray-morphological changes in about half the cases of disease. Further observations and controls of courses are necessary for the confirmation of evidence.