ABSTRACT
BACKGROUND AND AIMS: Digital tomosynthesis has proven useful in the evaluation of damage to joints. This study aims to describe the most common digital tomosynthesis findings for four rheumatological entities and to compare the usefulness of this technique with that of other imaging techniques. MATERIALS AND METHODS: Following the PRISMA guidelines, we systematically searched the literature for articles about the use of digital tomosynthesis in rheumatoid arthritis, osteoarthritis, spondyloarthritis, and gout. We used the QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies) criteria to evaluate the quality of the articles included. RESULTS: We included 13 articles. For rheumatoid arthritis, osteoarthritis, and spondyloarthritis, digital tomosynthesis detected bone abnormalities better than plain-film X-rays; however, for gout, the results were variable. CONCLUSIONS: Digital tomosynthesis can play an important role in the evaluation of skeletal abnormalities in rheumatological disease, especially compared to plain-film X-rays.
ABSTRACT
RESUMEN La enfermedad de Behcet es una entidad clínica autoinflamatoria, de etiología desconocida, generalmente con compromiso sistémico, con un patrón de exacerbación y remisión frecuente que se asocia a retraso en el diagnóstico. El diagnóstico de esta enfermedad es complejo, por esta razón presentamos 4 casos de pacientes con enfermedad de Behcet, que durante el abordaje clínico fueron consideradas otras enfermedades de naturaleza autoinmune. La revisión integrada de la historia clínica, la aparición de úlceras orales y genitales, así como el estudio de tipificación del complejo mayor de histocompatibilidad (HLA) permitieron diagnosticar la enfermedad de Behcet.
ABSTRACT Behcet disease is a rare autoinflammatory disorder of unknown aetiology and is characterised by systemic manifestations with an exacerbation-remission pattern, often associated with diagnostic delay. The diagnostic approach to this disease is complex. A report is given on four cases of patients fulfilling the diagnostic criteria for Behcet disease. Other autoimmune rheumatic diseases were considered in the clinical approach. A meticulous clinical evaluation, taking into consideration relapsing aphthous ulcers in oral mucosa and genitalia, and HLA typing allowed a proper diagnosis of Behcet disease to be made.
Subject(s)
Humans , Male , Female , Adult , Rheumatology , Behcet Syndrome , Oral Ulcer , Rare Diseases , DiagnosisABSTRACT
The objective of the study is to find predictors of remission, radiographic progression (RP), and erosive disease in a cohort of patients with early onset rheumatoid arthritis (EORA) that followed a therapeutic protocol aiming at remission, in a real world tight-control setting. EORA patients were enrolled in a 3-year follow-up study. Clinical, biological, immunogenetic, and radiographical data were analyzed. Radiographs were scored according to Sharp-van der Heijde (SvdH) method. RP was defined by an increase of 3 units in 36 months. Remission was defined as DAS28 <2.6. A stepwise multiple logistic regression model was used to identify independent predictors of the three target outcomes. One hundred twenty-nine patients were included. Baseline disease activity was high. Significant overall improvement was observed, but only 33.3 % achieved remission. At 36 month, 50.4 % (65) of patients showed erosions. RP was observed in 62.7 % (81) of cases. Statistical analysis showed that baseline SvdH score was the only predictive factor associated with the three outcomes evaluated. Lower HAQ-DI and absence of autoantibodies were predictive of remission. Higher levels of ESR and presence of erosions at entry were predictive of RP. Independent baseline predictors of incident erosive disease were anti-CCP and RF positivity, symptom duration at baseline >3 months, and presence of HLA-DRB1 shared epitope. Radiographic damage at baseline was the main predictor of outcomes. Autoantibodies, HAQ and ESR at baseline, symptom duration before diagnosis, and HLA-DRB1 status had influence on clinical course and development of structural joint damage in Colombian RA patients.
Subject(s)
Arthritis, Rheumatoid/diagnostic imaging , Arthritis, Rheumatoid/pathology , Adult , Antirheumatic Agents/administration & dosage , Arthritis, Rheumatoid/drug therapy , Autoantibodies/blood , Colombia , Disease Progression , Female , Follow-Up Studies , HLA-DRB1 Chains/genetics , Humans , Logistic Models , Male , Methotrexate/administration & dosage , Middle Aged , Peptides, Cyclic/immunology , Prospective Studies , Radiography , Remission Induction , Rheumatoid Factor/immunology , Severity of Illness IndexABSTRACT
La osteopoiquilia y osteopatía condensante diseminada es una rara entidad, de carácter hereditaria-familiar, que afecta especialmente al sexo masculino y de curso asintomático, caracterizada por el hallazgo radiológico de pequeños focos ovoides o lenticulares entre 2 mm y 2 cm, paralelos al eje longitudinal del hueso. Se ha descrito asociada a la dermatofibrosis conocida como síndrome de Buschke-Ollendorff. Se describe una serie de 12 pacientes, con diagnóstico de osteopoiquilia de acuerdo a los criterios diagnósticos establecidos, observando en todos ellos adecuado modelado óseo, razón por la que se propone clasificar esta entidad en un grupo diferente al de las llamadas enfermedades displásicas de hueso. Se describe la primera asociación en la literatura mundial entre osteopoiquilia, dermatofibrosis lenticular y condrocalcinosis (AU)
Subject(s)
Adolescent , Adult , Female , Male , Middle Aged , Humans , Osteopoikilosis/diagnosis , Prospective Studies , Osteopoikilosis/complications , Chondrocalcinosis/complicationsABSTRACT
En este artículo presentamos el caso de una niña de 4 años de edad con hiperfosfatasia, una enfermedad caracterizada por elevación de la fosfatasa alcalina por un defecto enzimático, con alteraciones en la formación de hueso membranoso dando lugar a macrohuesos en el cráneo, huesos largos, costilla y columna. La paciente que se revisa presentaba además una hipercalcemia, hallazgo para el cual no encontraron una explicación clara, pero que sin embargo, constituye una asociación que no ha sido descrita en la literatura. Presentamos finalmente una revisión de los casos de hiperfosfatasia informados hasta ahora en la literatura y planteamos la necesidad de clasificar mejor las enfermedades óseas e incluirla como una enfermedad metabólica ósea y no una displasia (AU)
Subject(s)
Female , Child, Preschool , Humans , Alkaline Phosphatase/blood , Bone Diseases, Metabolic/diagnosis , Hypercalcemia/complications , Diagnosis, DifferentialABSTRACT
No disponible
Subject(s)
Female , Male , Humans , Rickets/history , Osteomalacia/history , Colombia/epidemiology , Vitamin D Deficiency/history , Protein-Energy Malnutrition/history , Cod Liver Oil/therapeutic use , Densitometry/trends , Alkaline Phosphatase/blood , Osteomalacia/epidemiology , Rickets/epidemiology , Bone Demineralization, Pathologic/physiopathology , Parathyroid Hormone/bloodABSTRACT
Se presenta un caso de sobreposición de una distrofia mixta no esclerosante de paquidermoperiostosis y una displasia diafisaria tipo Engelmann-Camurati. Se realiza una revisión extensa de la literatura, destacando los aspectos históricos sobre las características clínicas radiológicas y el posible origen de esta sobreposición no descrita en la literatura (AU)
