RESUMO
Psoriatic arthritis, a chronic inflammatory musculoskeletal disease that is associated with psoriasis, causes joint erosions, accompanied by loss of function and quality-of-life. The clinical presentation is variable, with extreme phenotypes that can mimic rheumatoid arthritis or ankylosing spondylitis. Because psoriasis usually presents before psoriatic arthritis, the dermatologist plays a key role in early detection of the latter. As many treatments used in psoriasis are also used in psoriatic arthritis, treatment recommendations should take into consideration the type and severity of both conditions. This consensus paper presents guidelines for the coordinated management of psoriatic arthritis by rheumatologists and dermatologists. The paper was drafted by a multidisciplinary group (6rheumatologists, 6dermatologists, and 2epidemiologists) using the Delphi method and contains recommendations, tables, and algorithms for the diagnosis, referral, and treatment of patients with psoriatic arthritis.
Assuntos
Artrite Psoriásica/diagnóstico , Artrite Psoriásica/terapia , Algoritmos , Técnica Delphi , Dermatologia , Humanos , Equipe de Assistência ao Paciente , ReumatologiaRESUMO
Osteoid osteoma is a nonmalignant tumour that rarely localizes intraarticularly. When this happens, the tumour provokes arthritis and its recognition is delayed from months to years. We report the case of a 34 year old man with a previously known HIV infection, but no evidence of immunosuppression. He develops a chronic monoarthritis of the left elbow that is initially interpreted as infectious disease. CT provides diagnostic suspicion of osteoma, that is confirmed by pathologic examination two years after the onset of the clinical complaints. CT is the radiologic technique of election in the evaluation of osteoid osteoma. Synovitis is interpreted in the literature as secondary to prostaglandin secretion by the tumour.
Assuntos
Neoplasias Ósseas/complicações , Articulação do Cotovelo , Osteoma Osteoide/complicações , Sinovite/etiologia , Ulna , Síndrome da Imunodeficiência Adquirida/complicações , Adulto , Neoplasias Ósseas/diagnóstico , Neoplasias Ósseas/cirurgia , Doença Crônica , Humanos , Masculino , Osteoma Osteoide/diagnóstico , Osteoma Osteoide/cirurgia , Abuso de Substâncias por Via Intravenosa/complicações , Ulna/cirurgiaRESUMO
The association between sclerodermia and malignant diseases is estimated around 3-7%. We present two cases of this disease concomitant to nephro-urological tumors. In one of these cases, we detected a hypernephroma in a patient with signs of florid sclerodermia, which did not disappear after nephrectomy and later showing evidence of metastasis. The other patient showed sclerodermiform signs developing quickly after transurethral resection of a vesical carcinoma. The highest incidence of associated neoplasias is observed in lung and breast cancers, hematological carcinoids and melanomas. Nephro-urological tumors are present in 0.3-0.5%.