ABSTRACT
OBJECTIVES: Subclinical synovitis is often detected by musculoskeletal ultrasound (MSUS) in juvenile idiopathic arthritis (JIA) patients in clinical remission. The main objective of this prospective, observational, longitudinal, multicentre study was to evaluate the predictive value of MSUS-detected subclinical synovitis in relation to flares at 12 months following TNFi tapering in a JIA population in stable clinical remission. METHODS: We included 56 JIA patients in stable remission undergoing TNFi therapy tapered at baseline and in some cases at 6 months. We performed baseline and 6-month MSUS assessment on B-mode (BM) and power Doppler (PD) mode of 22 joints and 8 tendons. RESULTS: Eighteen patients (32.1%) experienced a flare during the 12-month study period. BM synovitis was frequent (83.9%) but PD synovitis was scarcely found (8.9%). There were no significant differences in MSUS findings between patients who experienced a flare and those who remained in remission. Only 5 patients had positive for PD synovitis, in joints with BM synovitis grades 2 or 3, and none experienced a flare. Concomitant methotrexate (MTX) was more frequent in patients who were successfully tapered (71.1% vs. 27.8%; p=0.002) and patients older than 12 experienced a greater number of flares and earlier onset. CONCLUSIONS: Subclinical synovitis, as detected by MSUS, proved not to be a predictor of flares. Those patients on a TNFi-tapered concomitant methotrexate regimen experienced the fewest flares although flare risk increased with age.
Subject(s)
Arthritis, Juvenile/diagnostic imaging , Synovitis/diagnostic imaging , Ultrasonography/methods , Arthritis, Juvenile/drug therapy , Arthritis, Juvenile/pathology , Biological Products/therapeutic use , Disease Progression , Humans , Methotrexate , Prospective Studies , Recurrence , Remission Induction , Synovial Membrane/diagnostic imaging , Tumor Necrosis Factor-alpha/antagonists & inhibitorsABSTRACT
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Subject(s)
Humans , Male , Adolescent , Osteoma, Osteoid/complications , Osteoma, Osteoid , Arthritis, Juvenile/complications , Arthritis, Psoriatic/complications , Arthritis, Psoriatic , Knee/pathology , Knee , Osteoma, Osteoid/drug therapy , Glucocorticoids/therapeutic use , Muscular Atrophy/drug therapy , Muscular Atrophy/pathology , Muscular AtrophySubject(s)
Arthritis, Juvenile , Osteoma, Osteoid , Bone Neoplasms , Diagnosis, Differential , Humans , Knee Joint , Tomography, X-Ray ComputedABSTRACT
No disponible
Subject(s)
Humans , Female , Child , Meningitis, Listeria/complications , Meningitis, Listeria/diagnosis , Meningitis, Listeria/drug therapy , Listeria monocytogenes , Listeria monocytogenes/isolation & purification , Lupus Erythematosus, Systemic/complications , Lupus Erythematosus, Systemic/diagnosis , Antibodies, Monoclonal/therapeutic use , Nephritis/complications , Hydroxychloroquine/therapeutic use , Cyclophosphamide/therapeutic use , Bacteremia/complications , Methylprednisolone/therapeutic use , Leukocytosis/complicationsSubject(s)
Immunocompromised Host , Immunosuppressive Agents/adverse effects , Listeriosis/immunology , Lupus Erythematosus, Systemic/drug therapy , Meningoencephalitis/immunology , Mycophenolic Acid/adverse effects , Rituximab/adverse effects , Child , Drug Therapy, Combination , Female , Humans , Immunosuppressive Agents/therapeutic use , Listeriosis/diagnosis , Lupus Erythematosus, Systemic/immunology , Meningoencephalitis/diagnosis , Mycophenolic Acid/therapeutic use , Rituximab/therapeutic useABSTRACT
No disponible
Subject(s)
Humans , Male , Adult , Lipomatosis, Multiple Symmetrical/complications , Arthritis, Juvenile/complications , Rheumatoid Factor/analysisABSTRACT
No disponible
Subject(s)
Humans , Male , Adult , Arthritis, Juvenile/complications , Focal Nodular Hyperplasia/etiology , Hypertension, Portal/etiology , Risk FactorsSubject(s)
Arthritis, Juvenile/complications , Growth Disorders/etiology , Osteochondrodysplasias/etiology , Adult , Humans , MaleSubject(s)
Arthritis, Juvenile/complications , Liver/pathology , Adult , Humans , Hyperplasia/etiology , Male , Time FactorsABSTRACT
La osteoartropatía hipertrófica es una entidad caracterizada por la tríada de periostitis de huesos largos, acropaquias y artritis. Radiológicamente se distinguen 2 patrones; uno caracterizado por neoformación ósea que predomina en pacientes con patología pulmonar, y otro por acro-osteolisis que se asocia más frecuentemente con cardiopatías congénitas. Presentamos el caso de un varón de 30 años diagnosticado de hipertensión arterial pulmonar primaria desde los 2 años, que desarrolló una osteoartropatía hipertrófica con un patrón radiológico mixto (AU)
Hypertrophic osteoarthropathy is an entity characterized by a triad of periostitis of long bones, clubbing and arthritis. Radiologically there are two patterns, one characterized by new bone formation which predominates in patients with pulmonary disease, and another by acro-osteolysis that is most frequently associated with congenital heart disease. We report the case of a 30-year-old man diagnosed with primary pulmonary hypertension for two years, developing hypertrophic osteoarthropathy with a mixed radiological pattern (AU)
Subject(s)
Humans , Male , Adult , Osteoarthropathy, Primary Hypertrophic/complications , Osteoarthropathy, Primary Hypertrophic/diagnosis , Acro-Osteolysis/complications , Acro-Osteolysis/diagnosis , Hypertension, Pulmonary/complications , Periostitis/complications , Hand , Foot , Osteoarthropathy, Primary Hypertrophic/physiopathology , Osteoarthropathy, Primary Hypertrophic , Osteolysis , Acro-Osteolysis , Periostitis/physiopathology , PeriostitisABSTRACT
Hypertrophic osteoarthropathy is an entity characterized by a triad of periostitis of long bones, clubbing and arthritis. Radiologically there are two patterns, one characterized by new bone formation which predominates in patients with pulmonary disease, and another by acro-osteolysis that is most frequently associated with congenital heart disease. We report the case of a 30-year-old man diagnosed with primary pulmonary hypertension for two years, developing hypertrophic osteoarthropathy with a mixed radiological pattern.
Subject(s)
Hypertension, Pulmonary/complications , Osteoarthropathy, Secondary Hypertrophic/etiology , Adult , Autoantibodies/blood , Autoantigens/immunology , Calcium/therapeutic use , Citrulline/analysis , Diphosphonates/therapeutic use , Hand Bones/diagnostic imaging , Humans , Imidazoles/therapeutic use , Male , Osteoarthropathy, Secondary Hypertrophic/diagnostic imaging , Osteoarthropathy, Secondary Hypertrophic/drug therapy , Osteolysis/diagnostic imaging , Osteolysis/etiology , Peptides/chemistry , Peptides/immunology , Pregnenediones/therapeutic use , Radiography , Radius/diagnostic imaging , Vitamin D/therapeutic use , Wrist Joint/diagnostic imaging , Zoledronic AcidABSTRACT
No disponible
