RESUMO
Arthritis in systemic sclerosis (PSS) can be prominent and an overlap with rheumatoid arthritis (RA) has sometimes been queried. We therefore analysed the pattern of joint involvement of hands and wrists in 34 patients (1 male) with PSS and compared it with that of 9 patients with mixed connective tissue disease (MCTD), a condition with distinct overlap features. Although MCTD patients were younger, disease duration was similar in both groups. Extra-articular radiological findings such as calcinosis, pulp atrophy and tuft resorption were present in over half the patients with PSS but were less frequent in MCTD. Marginal erosions occurred in over 50% and ulnar styloid erosions in 35% of the PSS patients. Erosions of the 1st CMC joint were seen in one-third of them and were unrelated to age. Erosions did not correlate with clinical synovitis, the presence of rheumatoid factor which was present in 26% of PSS patients or the presence of anti-centromere or anti-Scl-70 antibodies. Erosions in MCTD patients occurred frequently and were more destructive and rapidly progressive. Correlation between erosions, rheumatoid factor and clinical arthritis was high. We conclude that erosions in PSS are frequent. Their pattern is varied but usually discrete and seldom destructive. They are not related to arthritis or serological abnormalities and may be due to several mechanisms aside from synovitis. In contrast, erosions in MCTD are more frequently destructive and related to arthritis and rheumatoid factor, suggesting a true overlap.
Assuntos
Artrite/diagnóstico por imagem , Doença Mista do Tecido Conjuntivo/diagnóstico por imagem , Escleroderma Sistêmico/diagnóstico por imagem , Adulto , Idoso , Anticorpos Antinucleares/análise , Feminino , Mãos/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Radiografia , Doença de Raynaud/diagnóstico , Fator Reumatoide/análise , Articulação do Punho/diagnóstico por imagemRESUMO
One hundred and sixty normal sacral sacs at myelography have been studied and the results analysed statistically. The features which may have clinical relevance are discussed.
Assuntos
Mielografia , Sacro/diagnóstico por imagem , Adolescente , Adulto , Envelhecimento , Antropometria , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Fatores SexuaisRESUMO
An air oesophagogram, defined as a column of air involving the entire oesophagus, seen on a lateral chest X-ray was observed in 6 (20%) of 30 consecutive patients with systemic sclerosis (SSc) but in none of the controls. The presence of this sign was unrelated to the clinical subset of SSc and to age but was associated with the symptom of regurgitation.
Assuntos
Ar , Esôfago/diagnóstico por imagem , Radiografia Torácica , Escleroderma Sistêmico/diagnóstico por imagem , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valores de Referência , Escleroderma Sistêmico/fisiopatologiaAssuntos
Duodeno/anormalidades , Ar , Duodeno/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , RadiografiaAssuntos
Doenças Ósseas/diagnóstico por imagem , Mieloma Múltiplo/complicações , Mieloma Múltiplo/diagnóstico por imagem , Adulto , Idoso , Doenças do Sistema Nervoso Central/complicações , Vértebras Cervicais/diagnóstico por imagem , Feminino , Humanos , Ísquio/diagnóstico por imagem , Vértebras Lombares/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Mieloma Múltiplo/patologia , Doenças do Sistema Nervoso Periférico/complicações , Radiografia , Costelas/diagnóstico por imagem , Escápula/diagnóstico por imagemAssuntos
Exostose/diagnóstico , Dedos , Unhas , Dedos do Pé , Adolescente , Adulto , Idoso , Feminino , Humanos , Técnicas In Vitro , Masculino , Pessoa de Meia-Idade , RadiografiaAssuntos
Colo/transplante , Neoplasias Esofágicas/cirurgia , Laringectomia , Neoplasias Faríngeas/cirurgia , Fala , Neoplasias da Glândula Tireoide/cirurgia , Adulto , Idoso , Neoplasias Esofágicas/radioterapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Faríngeas/radioterapia , Faringectomia , Capacitação Espermática , Neoplasias da Glândula Tireoide/radioterapia , TireoidectomiaRESUMO
Twenty-four cases of carcinoma of the urinary bladder, involving bone, have been reviewed. Eighteen of these were distant metastases beyond the pelvis. The lesions were predominantly osteolytic. Ossification in the soft tissues adjacent to the bone metastasis was observed in three cases, all involving the left tibia. The reason for this site of predilection remains obscure.
Assuntos
Neoplasias Ósseas/secundário , Carcinoma de Células de Transição/secundário , Ossificação Heterotópica/etiologia , Neoplasias da Bexiga Urinária , Adulto , Idoso , Neoplasias Ósseas/complicações , Neoplasias Ósseas/diagnóstico por imagem , Carcinoma de Células de Transição/complicações , Carcinoma de Células de Transição/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ossificação Heterotópica/diagnóstico por imagem , Osteólise/diagnóstico por imagem , Osteólise/etiologia , Osteosclerose/diagnóstico por imagem , Osteosclerose/etiologia , Radiografia , Estudos RetrospectivosRESUMO
Excretion urography in 18 patients with procidentia confirmed the presence of a significant incidence of urinary tract obstruction and its relief following corrective surgery.
Assuntos
Urografia/métodos , Prolapso Uterino/diagnóstico por imagem , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Transtornos Urinários/etiologia , Prolapso Uterino/complicações , Prolapso Uterino/cirurgiaRESUMO
A 46-year-old man with arthritis mutilans and hand radiographic appearance suggestive of previous surgery is described. We propose the term 'pseudoarthroplastic' hand for this radiological finding.
Assuntos
Artrite Reumatoide/diagnóstico por imagem , Mãos/diagnóstico por imagem , Adulto , Artrite Psoriásica/complicações , Artrite Reumatoide/patologia , Mãos/patologia , Humanos , Masculino , Articulação Metacarpofalângica/diagnóstico por imagem , Articulação Metacarpofalângica/patologia , Radiografia , Terminologia como AssuntoRESUMO
One hundred consecutive admissions to an acute geriatric unit were examined for clinical and radiographic evidence of osteoarthritis (OA) and articular chondrocalcinosis (ACC). Thirty-four patients had ACC. This was age related, the prevalence rising from 15% in patients aged 65-74 years to 44% in patients over 84 years. The commonly involved joints were the knee (25%), public symphysis (15%), and wrist (9%). No other aetiological factors predisposing to ACC were found. Of the 25 patients with ACC in the knee 7 had no symptoms or signs and no radiographic evidence of OA at that site. However, the combination of ACC and radiographic OA was characterised by an increase in clinical joint disease. Features of inflammation (joint swelling and joint line tenderness) involving the knee, wrist, and elbow were particularly common in ACC. It is concluded that ACC is common in the elderly and is associated with an increased incidence of joint disease.
Assuntos
Condrocalcinose/epidemiologia , Osteoartrite/epidemiologia , Idoso , Condrocalcinose/complicações , Inglaterra , Humanos , Técnicas In Vitro , Masculino , Osteoartrite/complicaçõesRESUMO
Hand and foot radiographs of 51 patients with systemic lupus erythematosus (SLE) were examined prospectively and correlations made between radiological, clinical and serological data. At least one abnormality was present in the hands of 53% and in the feet of 66.7% of patients. Jaccoud's type arthropathy affected the hands of 12% and the feet of 8% of patients. Erosions of the ulnar styloids were common (27.5%) but their presence did not correlate with any clinical or laboratory feature of SLE. Antibodies to U1 RNP correlated with hand deformity, while severity of radiological damage related mainly to disease duration.
Assuntos
Infecções por Coxsackievirus/complicações , Doenças do Pé/complicações , Artropatias/complicações , Lúpus Eritematoso Sistêmico/complicações , Adolescente , Adulto , Idoso , Criança , Feminino , Pé/diagnóstico por imagem , Pé/patologia , Doenças do Pé/diagnóstico , Doenças do Pé/epidemiologia , Mãos/diagnóstico por imagem , Mãos/patologia , Humanos , Artropatias/diagnóstico , Artropatias/epidemiologia , Lúpus Eritematoso Sistêmico/patologia , Masculino , Pessoa de Meia-Idade , Prevalência , RadiografiaRESUMO
A 71 year old woman suffering from ankylosing spondylitis with aggressive peripheral joint disease for 46 years developed unusual radiographic features in the hips and knees. The pathogenic processes responsible are uncertain, and no histology is yet available. Although she had been treated with radiotherapy to the knees, there was no similar history to explain the hitherto unreported appearance of the hips.
Assuntos
Articulação do Quadril/diagnóstico por imagem , Articulação do Joelho/diagnóstico por imagem , Espondilite Anquilosante/diagnóstico por imagem , Idoso , Feminino , Mãos/diagnóstico por imagem , Humanos , Ossos Pélvicos/diagnóstico por imagem , RadiografiaRESUMO
Cervical spondylitis has been reported in 35-75% of patients with PsA. The clinical and radiological changes of the cervical spine were evaluated in 75 patients with PsA. Cervical spine involvement was found in 45% of those examined and 36% of patients X-rayed. The pattern of disease was ankylosing in 85% of patients, characterized by ankylosis, syndesmophytes and ligamentous ossification. Twelve per cent had radiological evidence of cervical spondylitis without clinical evidence of disease. The major predictor of cervical spine disease was the duration of psoriatic arthropathy. Cervical spondylitis was not related to disease severity, extent of skin or nail involvement and neither did it reflect any homogeneous pattern of disease.
Assuntos
Artrite Psoriásica/complicações , Vértebras Cervicais , Espondilite/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Artrite Psoriásica/diagnóstico por imagem , Vértebras Cervicais/diagnóstico por imagem , Humanos , Pessoa de Meia-Idade , Prevalência , Radiografia , Espondilite/diagnóstico por imagem , Espondilite/epidemiologiaRESUMO
OBJECTIVE: To undertake 2 independent studies of shoulder involvement in patients with ankylosing spondylitis (AS) and assess the frequency of shoulder pain, stiffness, and loss of movement and function. To evaluate and correlate shoulder symptoms, function, range of movement, and radiology. METHODS: A cross sectional design was used in both studies. In Study A, a self-administered questionnaire was sent to members of the National Ankylosing Spondylitis Society of the UK and patients attending the Royal National Hospital for Rheumatic Diseases. In Study B, a clinical assessment of 88 patients with AS was undertaken that included a radiological assessment of 26 consecutive patients. RESULTS: In Study A, 15.2% and 13.8% of subjects had severe/very severe shoulder pain or stiffness, respectively. In Study B the corresponding findings were 9.6% and 17.6%. Patient reported disability associated with shoulder involvement was uncommon. Study A revealed that patients with severe/very severe shoulder pain were more likely to have significant hip and knee involvement. Significant shoulder involvement appears to be as common as involvement of the hip joint. In Study B radiological changes were common, being present in 31% of patients, but were often minor. There was a significant correlation between the sum of the stiffness, abduction, and flexion scores for both shoulders and the total radiological score (r = 0.87; p<0.001). CONCLUSION: The results suggest that shoulder symptoms and loss of shoulder mobility are common in patients with AS, and correlate with higher pain scores and influence of AS on their lives as assessed by the Arthritis Impact Measurement Scale, but are rarely disabling. Involvement of the shoulder joint in AS correlates with involvement of other peripheral joints as well as the extent of radiographic change on shoulder radiographs.