Medical and anthropological study of a world and Olympic champion, long-distance runner, 35 years after the end his racing career.

E.Z. former world champion and holder of several gold and silver medals from Olympic Games as long-distance runner, underwent at the age of 71 comprehensive investigations. In 1993 following methods were used to establish E.Z. body build and health: Family, personal and sports history, anthropometry, somatotype, body composition posture values, sports medicine examination, ECG at rest, X-rays of the lung and heart, echocardiography at rest, systolic time intervals at rest, spirography at rest, hematology, biochemistry, X-rays of bones, exercise ECG changes and spiroergometry. Today, a typical feature of E.Z.'s bodybuild is a great amount of body fats, flabby musculature, faulty posture, restricted mobility of the spinal column and surprisingly good foot arches. The clinical findings are appropriate for his age, on his ECG at rest are signs of subendocardial ischemia above the left ventricle, atrial fibrillation and ventricular extrasystoles (Lown 1 a-b). Exercise ECG resulted in a deepening of the ischaemic changes already at a working load of 50 W. Hematology revealed normochromic macrocyt anaemia, biochemistry a borderline mineralogram, hyperuricaemia, higher S-GMT and HDL-C, T-C at the limit of normal values. X-rays of the bones were remarkable in two findings of that age. The pelvis, lumbar spine and knee joints were free of the usual pathological findings (osteoarthrosis), but presented with an exceptionally advanced osteoporosis.

[Morphological skeletal changes in juvenile chronic arthritis.]. / Morfologické zmeny na skeletu u juvenilní chronické artritidy.

The authors demonstrate morphological skeletal changes (formative, destructive and synostoses) which developed in the course of juvenile chronic arthritis. On X-rays of selected patients they draw attention to damage which impedes normal activities of the patients, and frequently because of pain or immobility, eliminates them from normal life. Because of deformities some even have to rely on assistance of another person. The purpose of the submitted paper is to stress the importance and expedience of team work of rheumatologists, radiologists and orthopaedists. These specialists evaluate the present clinical state of the patient, the severity of skeletal damage and damage of surrounding soft structures, results of previous therapy and take into account the extent of morphological skeletal changes. They decide on the indication and type of surgery and its optimal timing to prevent further deterioration of already existing deformities. The aim of this comprehensive analysis by the mentioned specialists with participation of a physiotherapist is to select treatment which will prevent progression of deformities and eliminate, or at least mitigate pain and improve the patients' mobility. Key words: juvenile chronic arthritis, skeletal deformities, X-ray changes.

[Medial and lateral shift of the femoral head epiphysis]. / Mediální a laterální posun epifýzy hlavice femuru.

The authors demonstrate a developmental anomaly of the position of the epiphysis of the hip joint, i.e. its medial shift. They assumed that it will be a pre-arthrotic condition, as other known dysplasias of the hip joint. However, the position was reversed as if the shift of the epiphysis of the head of the femur in a medial direction protected the hip joint from the development of arthrotic changes. In case of a medial shift of the epiphysis of the head of the femur--caput varum prearthrosis is not involved.

[Changes in the locomotor system in inflammatory intestinal diseases. III. Clinical aspects of seronegative spondyloarthritis]. / Zmeny pohybového ústrojí u zánetlivých strevních chorob. III. Klinika séronegativních spondartritid.

This investigation is a follow up study of our previous study (Sborn. lék., 90, 1988, 140-146). In the same group of 119 patients with inflammatory intestinal diseases (Crohn's disease - 37, ulcerative colitis - 50, celiac sprue - 32) we followed further affection of locomotor system, peripheral arthritides. Inflammatory manifestations in peripheral articulations were manifest in 11 (9.2%) patients. Among common features of enteropathic arthritides belong: asymmetrical mono-oligoarthritis, in 67% of cases in lower extremities, without X-ray structural manifestations - erosive changes in the whole course, without functional deficit, inflammatory nature of the exudate, absence of rheumatoid nodes, RF negativity, episodic course. On the contrary in 3 (27%) patients the course was chronic. Incidence, relapse, activation of arthritis depends in 18% on activity and in 17% on intestinal complications of the underlying disease. Surgical treatment of small and/or large intestines lead in 60% of cases to remission of peripheral arthritis. In 1 patient (with celiac sprue) synoviorthesis with radioactive coloid 90Y was performed.

Radiological picture of juvenile rheumatoid arthritis.

Basing on the results of radiological, clinical and laboratory examinations of 200 children with juvenile rheumatoid arthritis, we tried to obtain a comprehensive picture of radiological changes in the joints, the spine and the remaining skeleton caused by JRA. The bulk of data was obtained in the period between 1954 and 1972, but for some of the patients, our follow-up continued until 1987. Our main interest were differences in morphological changes caused by JRA and adult RA. We described initial changes and their progress in childhood, adolescence and adulthood, drawing attention to fundamental differences in radiological changes and their progress in patients with an onset of disease in the first half of childhood (up to the age of 8) and in those with an onset in the second half of childhood, where these changes were similar already to those caused by adult RA. Juvenile rheumatoid arthritis affects mainly skeletal growth by either retarding or accelerating various ossification processes. The skeleton of children has a great regenerative capacity, but this, on the other hand, supports various disturbances of growth brought forth by disease. This, apparently, account for differences of changes in the skeleton of the joints observed in JRA patients during childhood and adulthood. Whenever a case is suspected of JRA, a radiological examination of the joints involved ought to be complemented by a radiological examination of the hands because most of our radiographs showed structural changes in the hands. Particular attention should also be given to the knees and hips of children with active disease over a period of 3-6 years. Synostosis of arches and joints of the cervical spine, a typical feature of JRA, was observed in 20-25% of former JRA patients. Synostoses occurred either in the individual segments or in the whole cervical spine, but were never absent at the level of vertebral bodies C2-C3. There were neither objective nor subjective complaints.

[Osteophytes of the femur head]. / Osteofyty hlavice femuru.

The shape and size of osteophytes were studied in different parts of the head of femur (mediodistal, proximal and lateral, central). There was not found any dependence of osteophytes on the basic disease of joint which produced arthrosis. Osteophytes developed from the subchondral cortical lamella, most often at the margin of the joint cartilage. Original corticalis and joint cartilage persisted nearly always at least in remnants under mediodistal osteophyte. On the other hand, original corticalis and cartilage were found under proximal and lateral osteophytes rather exceptionally.