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1.
Orthop Clin North Am ; 51(2): 293-302, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32138866

RESUMO

Brazil experiences a late participation in total ankle arthroplasty, which could have positive and negative aspects. The positive view argues about the modern implants that Brazil has received in the past years, skipping the early total ankle replacement generation who present more complications and low survival rate in the literature. The negative aspects are related to gap of experience with Brazilian surgeons unable to participate in the development of the technique and implant designs during these years. This article discusses the aspects of the Brazilian experience with total ankle replacement since the earliest procedures performed.


Assuntos
Articulação do Tornozelo/cirurgia , Artrite/cirurgia , Artroplastia de Substituição do Tornozelo , Prótese Articular , Adulto , Idoso , Articulação do Tornozelo/diagnóstico por imagem , Artrite/diagnóstico por imagem , Artroplastia de Substituição do Tornozelo/efeitos adversos , Brasil , Feminino , Humanos , Prótese Articular/efeitos adversos , Masculino , Pessoa de Meia-Idade , Desenho de Prótese
3.
Ann Clin Lab Sci ; 49(5): 661-665, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31611211

RESUMO

OBJECTIVE: Gout is a type of inflammatory arthritis that can be complicated with bone erosion through several inflammatory factors. Mean platelet volume (MPV) is regarded as a marker in many inflammatory disorders, but despite this, the metric has not been used for gout. MATERIAL AND METHODS: This study evaluates the relationship between MPV and bone erosion in patients with gout. In total, 299 patients were evaluated retrospectively, and 120 patients were ultimately included based on inclusion criteria. RESULTS: Both the duration of this disease and mean platelet volume were related to bone erosion in gout and may be regarded as independent predictors of bone erosion. CONCLUSION: These results suggest that mean platelet volume can be a predictor of bone erosion in gout.


Assuntos
Artrite/sangue , Osso e Ossos/patologia , Gota/sangue , Volume Plaquetário Médio , Artrite/diagnóstico por imagem , Osso e Ossos/diagnóstico por imagem , Feminino , Gota/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Análise de Regressão
4.
J Foot Ankle Surg ; 58(5): 930-932, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31474403

RESUMO

Understanding the tibiotalar angle (TTA) is key to planning for deformity correction. The TTA is an important radiographic tool to determine alignment or malalignment of the ankle and hindfoot. Two methods of measuring the TTA have been described: the midline TTA (MTTA) and the lateral TTA (LTTA). The aim of this study was to compare the 2 angles as measured on mortise and anteroposterior (AP) radiographs in a series of normal and pathological cases. A radiographic review was performed of sequential ankle AP and mortise radiographs taken between January 2016 and September 2017 across 4 specialist orthopedic centers. Patients were categorized into a normal group, where patients had normal radiological appearances, and an arthritis group, where patients had radiographic arthritis. The MTTA and the LTTA were measured. The overall mean ± standard deviation MTTA was 88.7° ± 5.1°, and mean LTTA was 87.5° ± 5.2° (p < .01). There was no statistically significant difference between the MTTA and LTTA in the normal group or on AP radiographs alone (p = .09). There was a statistically significant difference between the MTTA and LTTA in the arthritis group (p < .01) and when measured on mortise radiographs (p = .02). The MTTA had no difference when measured on the AP and mortise radiographs. There was a statistically significant difference in the LTTA between AP and mortise radiographs (p = .04). We have shown the MTTA to be a reliable and reproducible tool in all patients, on AP and mortise radiographs. The type of radiograph does not alter the measurement of deformity. In contrast, we have shown the LTTA to be unreliable and statistically different when measured on AP and mortise radiographs.


Assuntos
Articulação do Tornozelo/diagnóstico por imagem , Artrite/diagnóstico por imagem , Radiografia , Pesos e Medidas Corporais , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Amplitude de Movimento Articular , Reprodutibilidade dos Testes
5.
Schweiz Arch Tierheilkd ; 161(9): 559-568, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31488397

RESUMO

INTRODUCTION: The clinical, ultrasonographic, radiographic, cytologic and bacteriologic findings, diagnosis and surgical treatment of two heifers with septic metacarpal physitis (type-1 osteomyelitis) and concurrent serofibrinous arthritis of the metacarpophalangeal (MCP) joint are described. Osteomyelitis likely occurred by haematogenous spread following bronchopneumonia in one heifer and developed post-traumatically in the other. In both patients, ultrasonographic examination using the 7.5 MHz linear probe showed moderate effusion of the palmar and dorsal MCP joint pouches and highly irre-gular bone contours with depression and periosteal new bone formation at the metacarpal growth plate. Radiographs showed an extensive radiolucent area with poorly defined margins at the level of the metacarpal growth plate. Surgical treatment was carried out under sedation and regional intravenous anesthesia and involved meticulous debridement of the osteomyelitic lesion of the meta-carpal growth plate combined with arthrotomy of the MCP joint and repeated lavage of the bone cavity and joint. Successful outcomes were achieved by combined use of systemic and locoregional antibiotics, NSAIDs, temporary external coaptation and adequate housing.


Assuntos
Artrite/veterinária , Doenças dos Bovinos/cirurgia , Osteomielite/veterinária , Animais , Artrite/diagnóstico por imagem , Artrite/tratamento farmacológico , Artrite/cirurgia , Bovinos , Doenças dos Bovinos/diagnóstico por imagem , Doenças dos Bovinos/tratamento farmacológico , Feminino , Osteomielite/diagnóstico por imagem , Osteomielite/tratamento farmacológico , Osteomielite/cirurgia , Resultado do Tratamento
6.
Int Orthop ; 43(11): 2529-2538, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31227853

RESUMO

PURPOSE: Incorrect positioning of components during total knee arthroplasty (TKA) increases the risk of pain, instability, and early revision. The purpose of this study was to compare 3D planning-assisted and a conventional system for TKA positioning. We hypothesized that the use of three-dimensional CT-scan planning and custom cutting guides would increase the accuracy of component positioning. METHODS: A randomized, controlled, prospective study of two groups was performed. In one group, patient-specific custom cutting guides (PSCG) were used for component positioning based on 3D CT-scan planning. In the control group, TKA was performed with a conventional ancillary system. The components' positioning angles were measured on 3D reconstructions. The main evaluation criterion was the percentage of outliers outside of a target zone of ± 3° for the coronal positioning of the femoral component. RESULTS: Eighty patients were included. The percentage of outliers for the femoral component was significantly lower in the 3D-guided group (1 patient) compared to the control group (7 patients p = 0.02). The coronal femoral angle was restored with greater accuracy in the 3D-assisted group (- 0.1° ± 1.4°) compared to the control group (1.6° ± 2.5°). Surgery was significantly shorter in the 3D group. The clinical outcomes were better in the 3D group at the two year follow-up with fewer failures and a lower standard deviation in IKS scores. CONCLUSION: The use of a 3D planning and custom guides can improve TKA component positioning by increasing the accuracy of implants alignment and reducing the percentage of outliers. The same benefit was not demonstrated for the global knee alignment and the clinical scores with no indisputable clinical advantage for the PSCG.


Assuntos
Artrite/cirurgia , Artroplastia do Joelho/instrumentação , Articulação do Joelho/cirurgia , Cirurgia Assistida por Computador/instrumentação , Tomografia Computadorizada por Raios X/métodos , Idoso , Artrite/diagnóstico por imagem , Artroplastia do Joelho/efeitos adversos , Artroplastia do Joelho/métodos , Mau Alinhamento Ósseo/diagnóstico por imagem , Mau Alinhamento Ósseo/etiologia , Mau Alinhamento Ósseo/prevenção & controle , Feminino , Humanos , Imagem Tridimensional , Articulação do Joelho/diagnóstico por imagem , Prótese do Joelho , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Cirurgia Assistida por Computador/métodos
7.
Foot Ankle Clin ; 24(2): 239-264, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31036267

RESUMO

The most common cause for end-stage ankle osteoarthritis is posttraumatic, sometimes resulting from concomitant supramalleolar deformity. Aims of the supramalleolar osteotomy include restoring the lower-leg axis to improve intraarticular load distribution and retarding degeneration of the tibiotalar joint. Preoperative planning is based on conventional weight-bearing radiographs. Often advanced imaging, including computed tomography and/or MRI, is needed for a better understanding of the underlying problem. Postoperative complications are not uncommon, including progression of tibiotalar osteoarthritis in up to 25% within 5 years of all patients who have supramalleolar osteotomies.


Assuntos
Traumatismos do Tornozelo/cirurgia , Articulação do Tornozelo/cirurgia , Artrite/prevenção & controle , Osteotomia/métodos , Traumatismos do Tornozelo/diagnóstico por imagem , Traumatismos do Tornozelo/fisiopatologia , Articulação do Tornozelo/diagnóstico por imagem , Articulação do Tornozelo/fisiopatologia , Artrite/diagnóstico por imagem , Artrite/etiologia , Articulações do Pé/diagnóstico por imagem , Articulações do Pé/fisiopatologia , Articulações do Pé/cirurgia , Humanos , Osteotomia/efeitos adversos , Cuidados Pré-Operatórios
9.
Curr Drug Saf ; 14(3): 225-229, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31132977

RESUMO

BACKGROUND: Immune checkpoint inhibitors (CPIs) are new promising anti-cancer drugs that block negative costimulation of T-cells leading to an enhanced anti-tumor immune response. Pembrolizumab, an a monoclonal antibody, targeting the programmed cell death protein 1 (PD-1) pathway. CPIs have been associated with a number of immune-related adverse events (AEs), including musculoskeletal and rheumatic disease. OBJECTIVE: To present a case with lung adenocarcinoma treated with pembrolizumab, which developed inflammatory arthritis and fasciitis. CASE REPORT: A 73-year-old male patient was referred to the rheumatology outpatient clinic with complaints of pain in the pretibial area, pain and swelling in both ankles joints and the right first metacarpophalangeal (MCP) joint. Three months ago he had diagnosed with lung adenocarcinoma and pembrolizumab was started. Locomotor system complaints were started after receiving two infusions of pembrolizumab. Physical examination revealed both ankle arthritis, mild edema in the pretibial region, tenderness in the muscles and arthritis in the right first MCP joint. Laboratory examinations showed mild acute phase reactants elevation. Lower extremity MRI showed diffuse edema in both gastrocnemius muscle and fascia, compatible with fasciitis. Pembrolizumab-related fasciitis and seronegative arthritis were diagnosed. Low dose corticosteroid was started and a significant regression was observed in the patient's complaints. CONCLUSION: Inflammatory myositis with fasciitis and inflammatory arthritis in lower extremities appears to be a new adverse effect of pembrolizumab therapy.


Assuntos
Adenocarcinoma de Pulmão , Anticorpos Monoclonais Humanizados/efeitos adversos , Artrite/induzido quimicamente , Neoplasias Pulmonares , Adenocarcinoma de Pulmão/tratamento farmacológico , Idoso , Anticorpos Monoclonais Humanizados/uso terapêutico , Artrite/diagnóstico por imagem , Humanos , Neoplasias Pulmonares/tratamento farmacológico , Masculino
10.
ACS Appl Mater Interfaces ; 11(17): 15298-15305, 2019 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-30977992

RESUMO

The difficulty of near-infrared (NIR) ratiometric detection imaging lies in the lack of high-efficiency NIR probes and the overlapping interference between two emission peaks. To achieve more accurate detection in living organisms, dual NIR-emissive luminescent nanoprobes were designed under the same excitation at 808 nm. The Er3+ ion-doped nanoparticles were employed as a reference with their fluorescence emission at 1525 nm. Meanwhile, a cyanine dye molecule (Cy925) was combined on the surface of nanoparticles as the ClO- recognition site with its NIR emission at 925 nm. The ratiometric nanoprobe relied on the ratio of aforementioned two separated NIR peaks ( I925nm/ I1525nm), featuring deeper imaging penetration depth and low autofluorescence. This nanoprobe was verified to be sensitive and highly selective to ClO- through photoluminescence titration. The in vitro detection experiment developed reasonable work curves, guaranteeing that we can detect the change in concentration of ClO- in mice limbs with arthritis through in vivo imaging experiments.


Assuntos
Corantes Fluorescentes/química , Ácido Hipocloroso/análise , Nanopartículas/química , Animais , Articulação do Tornozelo/diagnóstico por imagem , Artrite/induzido quimicamente , Artrite/diagnóstico por imagem , Carbocianinas/química , Extremidades/diagnóstico por imagem , Feminino , Fluoretos/química , Ácido Hipocloroso/química , Camundongos , Camundongos Endogâmicos BALB C , Espectroscopia de Luz Próxima ao Infravermelho , Ítrio/química
11.
Bull Hosp Jt Dis (2013) ; 77(1): 57-63, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30865866

RESUMO

The basal joint is a collection of articulations at the base of thumb that serve an important function in the overall dexterity of the hand. The unique anatomy of the basal joint provided many evolutionary advantages to the human hand, but also made this joint susceptible to arthrosis and degenerative changes. Surgical treatment of basal joint arthritis has continued to evolve since it was first described in 1949, including excisional arthroplasty, tendon interposition, ligament reconstruction, implant arthroplasty, and arthroscopy. A review of the pathoanatomy, history, and surgical treatments are assessed including a critical review of the literature.


Assuntos
Artrite/cirurgia , Articulações Carpometacarpais/cirurgia , Procedimentos Ortopédicos/métodos , Polegar/cirurgia , Artrite/diagnóstico por imagem , Artrite/história , Artrite/fisiopatologia , Fenômenos Biomecânicos , Articulações Carpometacarpais/diagnóstico por imagem , Articulações Carpometacarpais/patologia , Articulações Carpometacarpais/fisiopatologia , História do Século XX , História do Século XXI , Humanos , Procedimentos Ortopédicos/efeitos adversos , Procedimentos Ortopédicos/história , Recuperação de Função Fisiológica , Polegar/diagnóstico por imagem , Polegar/patologia , Polegar/fisiopatologia , Resultado do Tratamento
12.
J Hand Surg Am ; 44(3): 244.e1-244.e6, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30853062

RESUMO

PURPOSE: The purpose of the study was to determine the long-term results of preaxial polydactyly reconstruction through evaluating strength, range of motion, pain, arthritis, and functional outcomes. METHODS: Patients having preaxial polydactyly reconstruction 15 to 60 years ago completed the Disabilities of the Arm, Shoulder, and Hand (DASH) and the Patient-Reported Outcomes Measurement Information System (PROMIS) Upper Extremity (UE) Computer Adaptive Test (CAT). Aggregate scores were compared with those of the general population. Patients completed a clinical evaluation comprising grip strength, pinch strength, side pinch strength, and range of motion. Mean strength and range of motion were compared with the contralateral extremity. Patients had radiographs of the reconstructed thumb to evaluate for arthritis. RESULTS: Twenty-five patients, comprising 27 surgical reconstructions, completed patient-reported outcomes questionnaires, and 13 reconstructions underwent clinical and radiographic evaluation. The median follow-up was 36 years. The most common Flatt-Wassel classification was type IV. The mean DASH score was 3.7, similar to the general population mean of 10.1 (SD, 14.5). The mean PROMIS UE CAT score was 51.5, similar to the general population mean of 50 (SD, 10.0). The mean pinch strength, side pinch strength, and grip strength did not differ significantly from the contralateral extremity. There was significantly decreased range of motion at the interphalangeal joint. No patient had pain in the thumb or hand on clinical evaluation. A minority of patients developed radiographic evidence of interphalangeal joint arthritis (15.4%). Nearly half of patients, 46.2%, had angular deformity. CONCLUSIONS: Preaxial polydactyly reconstruction patients have functional outcomes similar to the general population, despite decreased range of motion at the interphalangeal joint. Patients have maintained pinch strength, side pinch strength, and grip strength. Radiographic findings of arthritis were seen in 15% of patients at follow-up but none of these patients had associated pain. Late angular deformity developed in nearly half of patients, and this highlights the importance of close follow-up until skeletal maturity. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.


Assuntos
Polidactilia/diagnóstico por imagem , Polidactilia/cirurgia , Polegar/anormalidades , Adulto , Artrite/diagnóstico por imagem , Avaliação da Deficiência , Feminino , Seguimentos , Força da Mão/fisiologia , Humanos , Masculino , Medidas de Resultados Relatados pelo Paciente , Polidactilia/fisiopatologia , Radiografia , Amplitude de Movimento Articular/fisiologia , Estudos Retrospectivos , Polegar/diagnóstico por imagem , Polegar/fisiopatologia , Polegar/cirurgia
13.
Mayo Clin Proc ; 94(4): 628-642, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30853260

RESUMO

OBJECTIVES: To determine the prevalence of intra- and extra-articular sacroiliac joint (SIJ) pain, which injection is more beneficial, and whether fluoroscopy improves outcomes. PATIENTS AND METHODS: This patient- and evaluator-blinded comparative effectiveness study randomized 125 participants with SIJ pain from April 30, 2014, through December 12, 2017, to receive fluoroscopically guided injections into the joint capsule (group 1) or "blind" injections to the point of maximum tenderness using sham radiographs (group 2). The primary outcome was average pain on a 0 to 10 scale 1 month after injection. A positive outcome was defined as at least a 2-point decrease in average pain score coupled with positive (>3) satisfaction on a Likert scale from 1 to 5. RESULTS: For the primary outcome, no significant differences were observed between groups (mean ± SD change from baseline, -2.3±2.4 points in group 1 vs -1.7±2.3 points in group 2; 95% CI, -0.33 to 1.36 points for adjusted difference; P=.23), nor was there a difference in the proportions of positive blocks (61% vs 62%) or 1-month categorical outcome (48% vs 40% in groups 1 and 2, respectively; P=.33). At 3 months, the mean ± SD reductions in average pain (-1.8±2.1 vs -0.9 ± 2.0 points; 95% CI, 0.11 to 1.58 points for adjusted difference; P=.02) and worst pain (-2.2±2.5 vs -1.4±2.0 points; 95% CI, 0.01 to 1.66 points for adjusted difference; P=.049) were greater in group 1 than 2, with other outcome differences falling shy of statistical significance. CONCLUSION: Although fluoroscopically guided injections provide greater intermediate-term benefit in some patients, these differences are modest and accompanied by large cost differences. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT02096653.


Assuntos
Anestésicos Locais/administração & dosagem , Artrite/diagnóstico por imagem , Artrite/tratamento farmacológico , Injeções Intra-Articulares/métodos , Dor Lombar/tratamento farmacológico , Dor Lombar/terapia , Articulação Sacroilíaca/patologia , Adulto , Anti-Inflamatórios/administração & dosagem , Método Duplo-Cego , Feminino , Fluoroscopia , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor/métodos , Articulação Sacroilíaca/diagnóstico por imagem , Articulação Sacroilíaca/efeitos dos fármacos
14.
J Bone Joint Surg Am ; 101(5): 446-457, 2019 Mar 06.
Artigo em Inglês | MEDLINE | ID: mdl-30845039

RESUMO

BACKGROUND: Use of 3-dimensional (3D) computed tomography (CT) preoperative planning and patient-specific instrumentation has been demonstrated to improve the accuracy of glenoid implant placement in total shoulder arthroplasty (TSA). The purpose of this study was to compare the accuracy of glenoid implant placement in primary TSA among different types of instrumentation used with the 3D CT preoperative planning. METHODS: One hundred and seventy-three patients with end-stage glenohumeral arthritis were enrolled in 3 prospective studies evaluating patient-specific instrumentation and 3D preoperative planning. All patients underwent preoperative 3D CT planning to determine optimal glenoid component and guide pin position based on surgeon preference. Patients were placed into 1 of 5 instrument groups used for intraoperative guide pin placement: (1) standard instrumentation, (2) standard instrumentation combined with use of a 3D glenoid bone model containing the guide pin, (3) use of the 3D glenoid bone model combined with single-use patient-specific instrumentation, (4) use of the 3D glenoid bone model combined with reusable patient-specific instrumentation, and (5) use of reusable patient-specific instrumentation with an adjustable, reusable base. Postoperatively, all patients underwent 3D CT to compare actual versus planned glenoid component position. Deviation from the plan (in terms of orientation and location) was compared across groups on the basis of absolute differences and outlier analysis. Univariable and multivariable comparisons were performed. As the initial analyses showed no significant differences in preoperative factors or in deviation from the plan between Groups 1 and 2 or between Groups 4 and 5 across studies, the final analysis was across 3 major treatment groups: standard instrumentation (Groups 1 and 2), single-use patient-specific instrumentation (Group 3), and reusable patient-specific instrumentation (Groups 4 and 5). RESULTS: In nearly all comparisons, there were no significant differences in the deviation from the plan (absolute differences or outlier frequency) for glenoid implant orientation or location across the 3 major treatment groups. CONCLUSIONS: This study did not demonstrate that any type of patient-specific instrumentation resulted in consistent differences in accuracy of glenoid implant placement in primary TSA with 3D CT preoperative planning. Surgeons have multiple patient-specific instrumentation options available for improving accuracy of glenoid implant placement when compared with 2D imaging without patient-specific instrumentation. LEVEL OF EVIDENCE: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.


Assuntos
Artrite/cirurgia , Artroplastia do Ombro/métodos , Prótese de Ombro , Idoso , Artrite/diagnóstico por imagem , Artroplastia do Ombro/instrumentação , Feminino , Cavidade Glenoide/diagnóstico por imagem , Humanos , Imagem Tridimensional/normas , Masculino , Pessoa de Meia-Idade , Planejamento de Assistência ao Paciente , Cuidados Pós-Operatórios/métodos , Cuidados Pré-Operatórios/métodos , Desenho de Prótese , Sensibilidade e Especificidade , Tomografia Computadorizada por Raios X/normas
15.
Zhonghua Wai Ke Za Zhi ; 57(2): 124-128, 2019 Feb 01.
Artigo em Chinês | MEDLINE | ID: mdl-30704216

RESUMO

Objective: To analyze the clinical effects of reverse shoulder arthroplasty (RSA) for the patients with the cuff tear arthritis(CTA). Methods: A retrospective analysis of 12 patients who had underwent primary RSA for treatment of CTA from January 2012 to June 2017 in Department of Orthopedic, Beijing Chaoyang Hospital, Capital Medical University. There were 8 males and 4 females, aged 69.4 years (range: 64-73 years). The operation was performed in a conventional manner, the subscapularis and biceps tendon were repaired separately.The preoperative and postoperative American shoulder elbow surgeons score and university of California at LosAngeles score of patients were recorded. The complications and the images of radiological examinations were collected. Data were analyzed by paired-samples t-test. Results: At mean follow-up of (34.7±18.1) months (range:3-66 months), the preoperative ASEA score improved from 58.2±8.2 to 92.9±2.9 (t=14.32, P=0.00) and UCLA score improved from 13.2±1.5 to 30.8±1.7(t=23.14, P=0.00). No complications like loosening of prosthesis, superficial wound infection and shoulder dislocation were noted. Conclusion: Reverse shoulder arthroplasty have satisfactory effect for the patients with the cuff tear arthritis.


Assuntos
Artrite/cirurgia , Artroplastia do Ombro/métodos , Lesões do Manguito Rotador/cirurgia , Articulação do Ombro/cirurgia , Idoso , Artrite/diagnóstico por imagem , Artrite/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Amplitude de Movimento Articular , Estudos Retrospectivos , Lesões do Manguito Rotador/complicações , Lesões do Manguito Rotador/diagnóstico por imagem , Articulação do Ombro/diagnóstico por imagem , Resultado do Tratamento
16.
Clin Rheumatol ; 38(5): 1477-1483, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30810913

RESUMO

Inflammatory arthritis is a common feature of antisynthetase syndrome. Ultrasonography is able to characterize important features of bone and tendon pathology but has not been evaluated in this setting. We review the sonographic findings in a series of patients with antisynthetase syndrome and inflammatory arthritis. A retrospective chart review was performed of patients with antisynthetase syndrome-associated inflammatory arthritis who had undergone ultrasound imaging for joint pathology. Seventeen sonographic assessments of eight patients were included. Synovial hypertrophy was seen in all eight patients, with active Doppler signal present in six patients (13 of 17 ultrasound locations). Tendon involvement was common, with tenosynovitis in seven patients (11 of 17 ultrasound locations). Erosions were present in five patients. Musculoskeletal ultrasound showed significant joint pathology including proliferative synovitis and tenosynovitis. This may be severe and associated with erosive disease. Further systematic studies are needed to better understand the articular involvement of antisynthetase syndrome. Key points • Marked inflammatory change-with proliferative synovitis, tenosynovitis, and erosions-can be seen in selected patients with antisynthetase syndrome (ASyS). • Inflammatory arthritis from ASyS can be severe and erosive in the absence of RF and ACPA and can be refractory to immunosuppressive therapy used to manage the myositis and interstitial lung disease. • Systematic sonographic evaluation of patients with ASyS is needed to further evaluate pathology and treatment response of inflammatory arthritis.


Assuntos
Artrite/diagnóstico por imagem , Inflamação/diagnóstico por imagem , Miosite/complicações , Miosite/diagnóstico por imagem , Adulto , Artrite/complicações , Artrite/patologia , Autoanticorpos/sangue , Feminino , Humanos , Inflamação/complicações , Inflamação/patologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Sinovite/complicações , Sinovite/diagnóstico por imagem , Tenossinovite/complicações , Tenossinovite/diagnóstico por imagem , Ultrassonografia Doppler
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