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1.
Ann Anat ; 239: 151812, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34384858

RESUMO

This study aimed to evaluate the effects of omega-3 (ω3) polyunsaturated fatty acids, in association with aspirin (AA), on the morphology of cytokine release in the temporomandibular joint (TMJ) of rats induced with rheumatoid arthritis (IR) by injecting 100 µL of complete Freund's adjuvant with bovine type II collagen at the tail base. Thirty-two adult male rats were divided into treatment groups: Sham, treated with 0.9% sodium chloride (NaCl) p.o.; IR-control, treated with 0.9% NaCl p.o.; IR-ω3 treated with ω3 PUFAS (85 mg/kg/day p.o.); and IR-ω3 + AA treated with ω3 (85 mg/kg/day p.o.) + AA (20 mg/kg/day i.p.). After maintained treatment for seven days, the animals were euthanized. Bilateral TMJs from each rat were removed and one was subjected to histological immunoassays and enzyme-linked immunosorbent assays to assess interleukin (IL)-1ß, tumor necrosis factor-α, and IL-10 levels. Data analysis was performed using the Kruskal-Wallis and Dunn tests. In the IR-ω3 and IR-ω3 + AA groups, the TMJ was greater than in the IR-control group (P < 0.0001). The addition of AA did not improve the effects of ω3 (P = 0.0698). Similarly, the addition of AA conferred no additional effects on the cytokine levels (P > 0.05); however, it increased the proteoglycan density, compared with ω3 alone. We found that ω3 exhibited anti-inflammatory activity in arthritic rats, and the addition of AA increased proteoglycan density, but did not affect cytokine expression.


Assuntos
Artrite , Aspirina , Animais , Bovinos , Citocinas , Adjuvante de Freund , Masculino , Ratos , Articulação Temporomandibular
2.
Clin Podiatr Med Surg ; 39(1): 113-127, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34809790

RESUMO

Limb length inequality or discrepancy (LLD) occurs when there is a difference in length between 2 limbs or when deviation exists from a normally expected length for a given age. The magnitude of the discrepancy is defined as the difference between the 2 extremities. Aside from congenital etiologies, LLD can also arise from infection, paralysis, tumors/neoplasm, and surgery. Approximately 70% to 90% of the world's population has some elements of LLD with compensation allowing for tolerance and potentially masking the extent to which one limb could be significantly shorter either functionally or structurally. Components of functional LLD could include congenital shortening of soft tissues, joint contractures, axial skeleton malalignment, and abnormal pedal biomechanics (ie, posterior tibial tendonitis or equinovarus). In accordance with literature reports, most individuals can tolerate upwards of a 2 cm discrepancy. Although a constellation of symptoms such as joint pain, arthritis, alterations in oxygen consumption/heart rate, and low back pathology can occur later on in adulthood, the focus in this review will be with early diagnosis and management in the pediatric population.


Assuntos
Artrite , Pé Torto Equinovaro , Adulto , Fenômenos Biomecânicos , Criança , , Humanos , Desigualdade de Membros Inferiores
3.
Georgian Med News ; (319): 100-102, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34749331

RESUMO

Reactive arthritis is an acute, sterile, non-suppurative and inflammatory arthropathy that usually follows infection process. Gastrointestinal, genitourinary and respiratory tract infections generally provoke reactive arthritis. Also, reactive arthritis can be seen after vaccination. Reactive arthritis cases have been reported after tetanus, combined diphteria-poliomyelitis-tetanus toxoid, hepatitis B or influenza vaccination. Although reactive arthritis is more common in youngs, healthcare workers should be aware of the development of post inactivated COVID-19 vaccine reactive arthritis in older patients. We present two cases with ReA induced by inactivated coronavirus 2019 (COVID-19) vaccination (CoronaVac, Sinovac). Both patients in our study were over 70 years old and presented with polyarthritis that developed after vaccination. Rheumatoid factor and anti-nucleer antibody were negative and patients responded well to short-term steroid therapy, arthritis were not resistant.


Assuntos
Artrite , COVID-19 , Idoso , Artrite/induzido quimicamente , Vacinas contra COVID-19 , Humanos , SARS-CoV-2 , Vacinação/efeitos adversos , Vacinas de Produtos Inativados
4.
J Assoc Physicians India ; 69(10): 11-12, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34781658

RESUMO

BACKGROUND: In the current era of effective Anti retroviral therapy (ART), and Human Immunodeficiency Virus (HIV) infection becoming a chronic illness, there has been a gradual rise in the prevalence of rheumatic manifestations associated with this disease. These are characterized by a modified clinical course and widened spectrum of a few emerging rheumatic manifestations seen with HIV infection. AIMS AND OBJECTIVES: To assess the type, frequency, prevalence and clinical spectrum of rheumatic manifestations among &male patients followed at an HIV clinic of a tertiary care defence hospital. MATERIALS AND METHODS: All male patients with confirmed HIV infection at the study centre were studied after obtaining informed consent. A detailed history was taken including the date of seropositivity, symptoms of rheumatic disease, family history of rheumatic illness, and treatment history with ART. A detailed general and systemic examination was performed and rheumatic symptoms guided appropriate investigations were carried out on as required basis. RESULTS: 879 confirmed HIV cases were evaluated for rheumatic manifestations during the study period. Of these 499 cases were newly detected HIV cases and the rest 380 were old cases on follow up. Rheumatic disorders were diagnosed in 16 cases (1.82%). Spondyloarthropathy was the commonest presentation i.e. 5 out of 16 cases (31.25 % of the rheumatic disorders). Mean age was 37 years (range 27-52 yrs). 2 patients of the study group had the rheumatic illness prior to detection of HIV. Psoriatic Arthritis (0.114 %) was seen in 1 patient who was HLA B-27 negative. Reactive arthritis (0.227 %) was noted in 2 patients. 1 patient had cutaneous small vessel vasculitis (0.114 %), whereas 1 of the patient developed DLE (0.114 %) over neck. HIV related non specific polyarthritis (0.114 %) of the large joints was noted in 1 patient who was RF negative, while polyarthralgia (0.340 %) was noted in 3 patients. 10 patients (60 %) had CD 4 count < 200 cells/ µL, whereas 6 patients had a CD 4 count between 200 and 500 cells/µL. 13 out of 16 patients detected to have rheumatic illnesses were on ART. CONCLUSION: With the advent of ART, the clinical spectrum of HIV infection is changing as a chronic treatable disease. Present study consisting mainly adult males, showed only 1.82 % prevalence of rheumatic disorders in HIV infection. Early diagnosis, availability of ART and prompt treatment of opportunistic infections have changed the clinical profile of HIV patients. Impact of ART in producing and affecting the clinical spectrum of rheumatic disease has to be kept in mind while treating HIV-infected patients.


Assuntos
Artrite , Infecções por HIV , Doenças Reumáticas , Adulto , Infecções por HIV/complicações , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Doenças Reumáticas/epidemiologia , Centros de Atenção Terciária
5.
Curr Sports Med Rep ; 20(11): 577-583, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34752430

RESUMO

ABSTRACT: Elite athletes commonly present with joint pains that are attributed to overuse injuries though on occasion it can be due to an inflammatory arthropathy. The diagnostic challenge is that presenting symptoms of benign injuries are similar to inflammatory arthropathies. A holistic review of the athlete can provide clues suggestive of inflammatory arthropathy, before requesting further investigations to confirm the diagnosis. Current imaging modalities are not specific in differentiating inflammatory arthritis with other causes of joint inflammation. Prompt treatment is required to restore the athlete to an optimum level of activity and prevent career ending disability, all in adherence to the regulations of the sporting governing bodies. This review aims to highlight the importance of inflammatory arthropathy in the differentials for an athlete presenting with joint pains.


Assuntos
Artrite , Traumatismos em Atletas , Esportes , Artralgia , Atletas , Traumatismos em Atletas/diagnóstico por imagem , Traumatismos em Atletas/terapia , Humanos
6.
Bone Joint J ; 103-B(11): 1717-1724, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34719266

RESUMO

AIMS: The main objective of this study was to examine whether the Oxford Shoulder Score (OSS) demonstrated floor or ceiling effects when used to measure outcomes following shoulder arthroplasty in a large national cohort. Secondary objectives were to assess its pain and function subscales, and to identify independent predictors for patients achieving a postoperative ceiling score following shoulder arthroplasty. METHODS: Secondary database analysis of the National Joint Registry (NJR), which included 48,270 patients undergoing shoulder arthroplasty, was conducted. The primary outcome measure was the OSS. Secondary outcome measures were the OSS-Function Component Subscale and OSS-Pain Component Subscale. Floor and ceiling effects were considered to be present if > 15% of patients scored either the lowest or highest possible score. Logistic regression analysis was used to identify independent predictors for scoring the highest possible OSS score postoperatively. RESULTS: Preoperatively, 1% of patients achieved the lowest possible OSS score (0) and 0.4% of patients achieved the highest possible score (48). Postoperatively, < 1% of patients achieved the lowest score at all timepoints, but the percentage achieving the highest score at six months was 8.3%, at three years 16.9%, and at five years 17%. Male patients, those aged between 60 and 89 years, and those undergoing an anatomical total shoulder arthroplasty (ATSA) were more likely to contribute to the ceiling effect seen in the OSS questionnaire. Pain and function subscales exhibited greater ceiling effects at three years and five years when compared with the overall OSS questionnaire. Logistic regression analysis showed that sex, procedure type, and preoperative OSS score were independent predictors for scoring the highest possible OSS at years. CONCLUSION: Based on NJR patient-reported outcome measures data, the OSS does not exhibit a ceiling effect at six months, but does at three years and five years, in part due to outcome scores of ATSA. Preoperative OSS, age, male sex, and ATSA are independent predictors of achieving a ceiling score. Cite this article: Bone Joint J 2021;103-B(11):1717-1724.


Assuntos
Artrite/cirurgia , Artroplastia do Ombro , Articulação do Ombro/lesões , Articulação do Ombro/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sistema de Registros , Autorrelato , Resultado do Tratamento , Reino Unido
8.
MMWR Morb Mortal Wkly Rep ; 70(40): 1408-1414, 2021 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-34618794

RESUMO

The numerous health benefits of physical activity include reduced risk for chronic disease and improved mental health and quality of life (1). Physical activity can improve physical function and reduce pain and fall risk among adults with arthritis, a group of approximately 100 conditions affecting joints and surrounding tissues (most commonly osteoarthritis, fibromyalgia, gout, rheumatoid arthritis, and lupus) (1). Despite these benefits, the 54.6 million U.S. adults currently living with arthritis are generally less active than adults without arthritis, and only 36.2% of adults with arthritis are aerobically active (i.e., meet aerobic physical activity guidelines*) (2). Little is known about which physical activities adults with arthritis engage in. CDC analyzed 2019 Behavioral Risk Factor Surveillance System (BRFSS) data to examine the most common nonwork-related physical activities among adults with arthritis who reported any physical activity during the past month, nationally and by state. In 2019, 67.2% of adults with arthritis reported engaging in physical activity in the past month; among these persons, the most commonly reported activities were walking (70.8%), gardening (13.3%), and weightlifting (7.3%). In 45 U.S. states, at least two thirds of adults with arthritis who engaged in physical activity reported walking. Health care providers can help inactive adults with arthritis become active and, by encouraging physical activity and referring these persons to evidence-based physical activity programs, improve their health and quality of life.


Assuntos
Artrite/epidemiologia , Exercício Físico , Caminhada/estatística & dados numéricos , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos/epidemiologia , Adulto Jovem
9.
MMWR Morb Mortal Wkly Rep ; 70(40): 1401-1407, 2021 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-34618800

RESUMO

Arthritis has been the most frequently reported main cause of disability among U.S. adults for >15 years (1), was responsible for >$300 billion in arthritis-attributable direct and indirect annual costs in the U.S. during 2013 (2), is linked to disproportionately high levels of anxiety and depression (3), and is projected to increase 49% in prevalence from 2010-2012 to 2040 (4). To update national prevalence estimates for arthritis and arthritis-attributable activity limitation (AAAL) among U.S. adults, CDC analyzed combined National Health Interview Survey (NHIS) data from 2016-2018. An estimated 58.5 million adults aged ≥18 years (23.7%) reported arthritis; 25.7 million (10.4% overall; 43.9% among those with arthritis) reported AAAL. Prevalence of both arthritis and AAAL was highest among adults with physical limitations, few economic opportunities, and poor overall health. Arthritis was reported by more than one half of respondents aged ≥65 years (50.4%), adults who were unable to work or disabled* (52.3%), or adults with fair/poor self-rated health (51.2%), joint symptoms in the past 30 days (52.2%), activities of daily living (ADL)† disability (54.8%), or instrumental activities of daily living (IADL)§ disability (55.9%). More widespread dissemination of existing, evidence-based, community-delivered interventions, along with clinical coordination and attention to social determinants of health (e.g., improved social, economic, and mental health opportunities), can help reduce widespread arthritis prevalence and its adverse effects.


Assuntos
Artrite/epidemiologia , Artrite/fisiopatologia , Limitação da Mobilidade , Adolescente , Adulto , Idoso , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estados Unidos/epidemiologia , Adulto Jovem
10.
MMWR Morb Mortal Wkly Rep ; 70(42): 1466-1471, 2021 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-34673750

RESUMO

Arthritis is a highly prevalent and disabling condition among U.S. adults (1); arthritis-attributable functional limitations and severe joint pain affect many aspects of health and quality of life (2). Self-management education (self-management) and physical activity can reduce pain and improve the health status and quality of life of adults with arthritis; however, in 2014, only 11.4% and 61.0% of arthritis patients reported engaging in each, respectively. To assess self-reported self-management class attendance and health care provider physical activity counseling among adults with doctor-diagnosed arthritis, CDC analyzed 2019 Behavioral Risk Factor Surveillance System (BRFSS) data. In 2019, an age-standardized state median of one in six (16.2%) adults with arthritis reported ever attending a self-management class, and 69.3% reported ever receiving health care provider counselling to be physically active. Prevalences of both differed by state and sociodemographic characteristics; decreased with lower educational attainment, joint pain severity, and urbanicity; and were lower in men than in women. Health care providers can play an important role in promoting self-management class attendance and physical activity by counseling arthritis patients about their benefits and referring patients to evidence-based programs (3).


Assuntos
Artrite/terapia , Aconselhamento/estatística & dados numéricos , Exercício Físico , Pessoal de Saúde/psicologia , Educação de Pacientes como Assunto/estatística & dados numéricos , Relações Médico-Paciente , Autogestão/educação , Adolescente , Adulto , Idoso , Artrite/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos/epidemiologia , Adulto Jovem
11.
Praxis (Bern 1994) ; 110(14): 778-784, 2021.
Artigo em Alemão | MEDLINE | ID: mdl-34702056

RESUMO

CME Rheumatology 24: DISH of the Hand and Undifferentiated Polyarthritis Abstract. We present a case with undifferentiated, unclassified polyarthritis and with peripheral diffuse idiopathic skeletal hyperostosis (DISH). We discuss the differential diagnoses of "seronegative" polyarthritis and explain the radiographic findings of the little-known peripheral aspects of DISH.


Assuntos
Artrite , Hiperostose Esquelética Difusa Idiopática , Reumatologia , Artrite/diagnóstico por imagem , Diagnóstico Diferencial , Humanos , Hiperostose Esquelética Difusa Idiopática/diagnóstico
12.
Acta Reumatol Port ; 46(3): 281-282, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34663777

RESUMO

This is the first detailed description of an erosive seronegative polyarthritis in the Vogt-Koyanagi-Harada Syndrome in Portugal.


Assuntos
Artrite , Síndrome Uveomeningoencefálica , Artrite/etiologia , Humanos , Portugal , Síndrome Uveomeningoencefálica/diagnóstico
13.
Nutrients ; 13(10)2021 Sep 24.
Artigo em Inglês | MEDLINE | ID: mdl-34684351

RESUMO

Ginsenosides are active compounds that are beneficial to bone metabolism and have anti-osteoporosis properties. However, very few clinical investigations have investigated the effect of ginseng extract (GE) on bone metabolism. This study aims to determine the effect of GE on improving bone metabolism and arthritis symptoms in postmenopausal women with osteopenia. A 12-week randomized, double-blind, placebo-controlled clinical trial was conducted. A total of 90 subjects were randomly divided into a placebo group, GE 1 g group, and GE 3 g group for 12 weeks based on the random 1:1:1 assignment to these three groups. The primary outcome is represented by bone metabolism indices consisting of serum osteocalcin (OC), urine deoxypyridinoline (DPD), and DPD/OC measurements. Secondary outcomes were serum CTX, NTX, Ca, P, BsALP, P1NP, OC/CTX ratio, and WOMAC index. The GE 3 g group had a significantly increased serum OC concentration. Similarly, the GE 3 g group showed a significant decrease in the DPD/OC ratio, representing bone resorption and bone formation. Moreover, among all the groups, the GE 3 g group demonstrated appreciable improvements in the WOMAC index scores. In women with osteopenia, intake of 3 g of GE per day over 12 weeks notably improved the knee arthritis symptoms with improvements in the OC concentration and ratios of bone formation indices like DPD/OC.


Assuntos
Artrite/tratamento farmacológico , Doenças Ósseas Metabólicas/tratamento farmacológico , Panax/química , Extratos Vegetais/uso terapêutico , Artrite/sangue , Artrite/complicações , Artrite/fisiopatologia , Biomarcadores/sangue , Doenças Ósseas Metabólicas/sangue , Doenças Ósseas Metabólicas/complicações , Doenças Ósseas Metabólicas/fisiopatologia , Remodelação Óssea , Método Duplo-Cego , Ingestão de Alimentos , Exercício Físico , Feminino , Humanos , Pessoa de Meia-Idade , Osteocalcina/sangue , Fenilenodiaminas/sangue , Placebos , Extratos Vegetais/efeitos adversos , Extratos Vegetais/farmacologia , Resultado do Tratamento
14.
Arthroscopy ; 37(10): 3138-3139, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34602153

RESUMO

Multimodal therapies may optimize treatments if individual treatments are potentiated. In an attempt to obtain the elusive cure for cartilage degeneration, combined biologic injectable therapy might improve results. Due to the multipotent mesenchymal stem cells in adipose tissue, microfat containing adipose-derived stem cells may assist in cartilage repair. Platelet-rich plasma (PRP) has been similarly shown to be an effective biologic therapy through the release of growth factors affecting chondrocyte metabolism and decreasing inflammation. These 2 different products might be synergistic. Recent study, however, shows no significant differences when evaluating microfat with or without PRP, and importantly also shows that PRP with microfat does provide improvement in knee arthritic pain. This improvement may not correlate with the development of new cartilage, but it does improve function. Each biologic has beneficial effects on knee joint function through different mechanisms.


Assuntos
Artrite , Células-Tronco Mesenquimais , Plasma Rico em Plaquetas , Cartilagem , Condrócitos , Humanos
16.
Nat Rev Rheumatol ; 17(11): 651-664, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34599320

RESUMO

Fatigue is a complex phenomenon and an important health concern for many people with chronic inflammatory rheumatic diseases, such as rheumatoid arthritis, psoriatic arthritis, primary Sjögren syndrome and systemic lupus erythematosus. Although some clinical trials have shown the benefits of cognitive behavioural therapy in fatigue management, the effect of this approach is relatively modest, and no curative treatment has been identified. The pathogenesis of fatigue remains unclear. Despite many challenges and limitations, a growing body of research points to roles for the immune system, the central and autonomic nervous systems and the neuroendocrine system in the induction and maintenance of fatigue in chronic diseases. New insights indicate that sleep, genetic susceptibility, metabolic disturbances and other biological and physiological mechanisms contribute to fatigue. Furthermore, understanding of the relationships between psychosocial factors and fatigue is increasing. However, the interrelationships between these diverse mechanisms and fatigue remain poorly defined. In this Review, we outline various biological, physiological and psychosocial determinants of fatigue in inflammatory rheumatic diseases, and propose mechanistic and conceptual models of fatigue to summarize current understanding, stimulate debate and develop further research ideas.


Assuntos
Artrite , Doenças do Tecido Conjuntivo , Fadiga , Doenças Reumáticas , Vasculite , Artrite/imunologia , Pesquisa Biomédica , Doença Crônica , Doenças do Tecido Conjuntivo/imunologia , Fadiga/diagnóstico , Fadiga/etiologia , Fadiga/fisiopatologia , Fadiga/terapia , Previsões , Humanos , Inflamação/imunologia , Doenças Reumáticas/complicações , Doenças Reumáticas/imunologia , Vasculite/imunologia
17.
Nanomedicine (Lond) ; 16(23): 2117-2132, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34525845

RESUMO

Arthritis has been a heavy burden on the economy and society at large. Recently, nanomaterials that can convert near-infrared light into localized heat have demonstrated better targeting to arthritic joints, fewer side effects, ease of combined application with current therapeutics and enhanced efficacy for arthritis treatment. In this review, the authors summarize traditional thermal therapies for arthritis treatment and their molecular mechanisms and discuss the advantages and applications of nanotechnology-based thermal therapies for arthritis treatment. In conclusion, nanotechnology-based thermal therapies are effective alternatives or adjuvant strategies to the current pharmacological treatment of arthritis. Future clinical translation of thermal therapies could benefit from research elucidating their mechanisms and standardizing their parameters to optimize efficacy.


Assuntos
Artrite , Nanoestruturas , Artrite/terapia , Humanos , Raios Infravermelhos , Nanotecnologia , Fototerapia
18.
JNMA J Nepal Med Assoc ; 59(233): 81-83, 2021 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-34508451

RESUMO

The systemic lupus erythematosus (SLE) is a connective tissue disorder with variable presentations in children. The usual presentation includes arthritis, malar rash, nephritis, hemolytic anemia, and fever. Isolated hematologic abnormality as the only presentation of SLE is rare. Here is a case report of a female child presented to us with superficial and mucosal bleeding with isolated low platelet count and anemia in proportion to blood loss. When platelet count did not go up despite appropriate treatment in lines of ITP, further investigations were done, diagnosis of SLE was established, and management was done accordingly.


Assuntos
Anemia , Artrite , Lúpus Eritematoso Sistêmico , Púrpura Trombocitopênica Idiopática , Criança , Feminino , Humanos , Lúpus Eritematoso Sistêmico/complicações , Lúpus Eritematoso Sistêmico/diagnóstico , Lúpus Eritematoso Sistêmico/tratamento farmacológico , Contagem de Plaquetas , Púrpura Trombocitopênica Idiopática/complicações , Púrpura Trombocitopênica Idiopática/diagnóstico
19.
Acta Dermatovenerol Croat ; 291(1): 46-50, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34477064

RESUMO

The pancreatitis, panniculitis, polyarthritis (PPP) syndrome is a rare skin, joint, and pancreatic disorder, also known as subcutaneous nodular fat necrosis. It results from obstruction of pancreatic ducts with direct secretion of pancreatic enzymes into the bloodstream, causing extra pancreatic fat necrosis with subcutaneous tissue and joint inflammation. It is usually a cutaneous sign of pancreatic cancer or pancreatitis. To our knowledge, this is the first case associated with a pancreatic pseudotumor. We describe a 59-year-old man initially presenting with numerous painful erythematous subcutaneous nodules due to a fibrous pancreatic pseudotumor and its extreme dermatologic disease, resulting in necrosis of the shin and foot so severe that an amputation of the lower leg above the knee was required, a complication not previously described, to our knowledge. We emphasize that PPP syndrome is a cutaneous marker of internal malignancy, most often of pancreatic cancer or pancreatitis, but in this case of a rare pancreatic pseudotumor.


Assuntos
Artrite , Necrose Gordurosa , Neoplasias Pancreáticas , Pancreatite , Paniculite , Artrite/diagnóstico , Artrite/etiologia , Necrose Gordurosa/complicações , Necrose Gordurosa/diagnóstico , Humanos , Inflamação , Masculino , Pessoa de Meia-Idade , Necrose , Neoplasias Pancreáticas/complicações , Neoplasias Pancreáticas/diagnóstico , Pancreatite/complicações , Pancreatite/diagnóstico , Paniculite/diagnóstico , Paniculite/etiologia
20.
Bone Joint J ; 103-B(9): 1457-1461, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34465150

RESUMO

AIMS: The aim of this study was to identify the origin and development of the threshold for surgical intervention, highlight the consequences of residual displacement, and justify the importance of accurate measurement. METHODS: A systematic review of three databases was performed to establish the origin and adaptations of the threshold, with papers screened and relevant citations reviewed. This search identified papers investigating functional outcome, including presence of arthritis, following injury. Orthopaedic textbooks were reviewed to ensure no earlier mention of the threshold was present. RESULTS: Knirk and Jupiter (1986) were the first to quantify a threshold, with all their patients developing arthritis with > 2 mm displacement. Some papers have discussed using 1 mm, although 2 mm is most widely reported. Current guidance from the British Society for Surgery of the Hand and a Delphi panel support 2 mm as an appropriate value. Although this paper is still widely cited, the authors published a re-examination of the data showing methodological flaws which is not as widely reported. They claim their conclusions are still relevant today; however, radiological arthritis does not correlate with the clinical presentation. Function following injury has been shown to be equivalent to an uninjured population, with arthritis progressing slowly or not at all. Joint space narrowing has also been shown to often be benign. CONCLUSION: Knirk and Jupiter originated the threshold value of 2 mm. The lack of correlation between the radiological and clinical presentations warrants further modern investigation. Measurement often varies between observers, calling a threshold concept into question and showing the need for further development in this area. The principle of treatment remains restoration of normal anatomical position. Cite this article: Bone Joint J 2021;103-B(9):1457-1461.


Assuntos
Fixação Interna de Fraturas/métodos , Fraturas Intra-Articulares/cirurgia , Fraturas do Rádio/cirurgia , Artrite/prevenção & controle , Humanos , Fraturas Intra-Articulares/diagnóstico por imagem , Complicações Pós-Operatórias/prevenção & controle , Fraturas do Rádio/diagnóstico por imagem
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