RESUMEN
Acute calcific periarthritis (ACP) is defined as periarticular inflammation associated with intra-articular deposits of hydroxyapatite and other basic calcium phosphate crystals. Patients with ACP present with a sudden onset of pain, together with localized swelling, as well as erythema, tenderness, and reduced range of motion. Familiarity with the clinical and radiological manifestations of ACP aids in the diagnosis and helps differentiate it from other conditions, particularly infectious or inflammatory pathologies such as septic arthritis and gout, thereby reducing the number of unnecessary diagnostic and therapeutic procedures. The objective of this pictorial essay is to illustrate the imaging findings of ACP in various joints, with an emphasis on the findings obtained by magnetic resonance imaging.
A periartrite cálcica aguda (PCA) é uma inflamação periarticular aguda associada a depósitos justa-articulares de hidroxiapatita e outros cristais básicos de fosfato de cálcio. Os pacientes apresentam início súbito de dor, edema localizado, eritema, sensibilidade e redução da amplitude de movimentos. A familiaridade com as manifestações clínicas e radiológicas da PCA facilita o diagnóstico e permite diferenciá-la de outras entidades, em particular, com doenças infecciosas ou inflamatórias, como artrite séptica e gota, reduzindo procedimentos diagnósticos e terapêuticos desnecessários. O objetivo deste ensaio iconográfico é ilustrar os achados de imagem de PCA em algumas articulações, com ênfase na ressonância magnética.
RESUMEN
Acute calcific periarthritis (ACP) in the interphalangeal joints of the hand is rare, with less than 100 cases reported. A rare case of ACP in a proximal interphalangeal (PIP) joint of the hand, in a young black woman, after acute trauma, is presented. She experienced severe pain and limited range of motion, and was medicated with an oral corticoid, which was followed by a rapid resolution of the symptoms. At six months, there were no signs of clinical or radiographic recurrence. Recognition of ACP allows for avoiding unnecessary treatments. In this case, treatment with corticoids might have played a role in a faster recovery.
La periartritis calcificada aguda (PCA) en las articulaciones interfalángicas de la mano es rara, con menos de 100 casos reportados. Se presenta un caso raro de PCA en una articulación interfalángica proximal (IFP) de la mano, en una mujer joven de raza negra, después de un traumatismo agudo. Experimentó dolor intenso y rango de movimiento limitado, y fue medicada con un corticoide oral, lo que fue seguido por una rápida resolución de los síntomas. A los seis meses no hubo signos de recurrencia clínica ni radiológica. El reconocimiento de PCA permite evitar tratamientos innecesarios. En este caso, el tratamiento con corticoides podría haber contribuido a una recuperación más rápida.
Asunto(s)
Calcinosis , Articulaciones de los Dedos , Periartritis , Humanos , Femenino , Calcinosis/etiología , Enfermedad Aguda , Traumatismos de los Dedos , AdultoRESUMEN
Abstract Acute calcific periarthritis (ACP) is defined as periarticular inflammation associated with intra-articular deposits of hydroxyapatite and other basic calcium phosphate crystals. Patients with ACP present with a sudden onset of pain, together with localized swelling, as well as erythema, tenderness, and reduced range of motion. Familiarity with the clinical and radiological manifestations of ACP aids in the diagnosis and helps differentiate it from other conditions, particularly infectious or inflammatory pathologies such as septic arthritis and gout, thereby reducing the number of unnecessary diagnostic and therapeutic procedures. The objective of this pictorial essay is to illustrate the imaging findings of ACP in various joints, with an emphasis on the findings obtained by magnetic resonance imaging.
Resumo A periartrite cálcica aguda (PCA) é uma inflamação periarticular aguda associada a depósitos justa-articulares de hidroxiapatita e outros cristais básicos de fosfato de cálcio. Os pacientes apresentam início súbito de dor, edema localizado, eritema, sensibilidade e redução da amplitude de movimentos. A familiaridade com as manifestações clínicas e radiológicas da PCA facilita o diagnóstico e permite diferenciá-la de outras entidades, em particular, com doenças infecciosas ou inflamatórias, como artrite séptica e gota, reduzindo procedimentos diagnósticos e terapêuticos desnecessários. O objetivo deste ensaio iconográfico é ilustrar os achados de imagem de PCA em algumas articulações, com ênfase na ressonância magnética.
RESUMEN
OBJECTIVE: To study the prevalence of shoulder pain and dysfunction in patients from Southern Brazil with diabetes mellitus (DM) and to evaluate the association of pain and dysfunction with diabetes control and epidemiological factors. SUBJECTS AND METHODS: We studied 150 patients with type 2 DM for pain and shoulder dysfunction with the UCLA-m (modified University of California at Los Angeles Shoulder Rating Scale); for epidemiological and treatment data, values of Hb A1C and plasma glucose were analyzed. RESULTS: Pain was present in 63.4%, and dysfunction in 53.4% of the studied sample; 26.6% of the patients rated shoulder performance as bad. No association was found between Hb A1C or plasma glucose and joint function, except for active flexion of the shoulder and fasting glucose (p = 0.026). Women had worse shoulder performance (p = 0.0043), as did elderly patients (p < 0.0001). CONCLUSIONS: Shoulder pain and dysfunction is highly prevalent in patients with type 2 diabetes; these disorders affect more women and the elderly.
OBJETIVO: Estudar a prevalência de dor e disfunção do ombro em pacientes com diabetes melito (DM) do sul do Brasil e verificar a possível associação com controle glicêmico e fatores epidemiológicos. SUJEITOS E MÉTODOS: Estudaram-se 150 pacientes com DM tipo 2 para dor e disfunção do ombro pelo instrumento UCLAm (University of California at Los Angeles Shoulder Rating Scale modificada), dados epidemiológicos e de tratamento, valores de Hb A1C e glicemia de jejum. RESULTADOS: Verificou-se que havia dor em 63,4% e disfunção em 53,4% da amostra estudada. Em 26,6% dos pacientes, o desempenho do ombro foi considerado ruim. Não se encontrou associação de Hb A1C e glicemia de jejum com dor e disfunção do ombro salvo pela associação entre flexão ativa dessa articulação com glicemia de jejum (p = 0,026). As mulheres tinham pior desempenho do ombro (p = 0,0043), assim como os mais idosos (p < 0,0001). CONCLUSÕES: Existe uma prevalência muito alta de dor e disfunção do ombro em pacientes com DM tipo 2, sendo maior em mulheres e idosos.
Asunto(s)
Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , /fisiopatología , Dimensión del Dolor/métodos , Dolor de Hombro/fisiopatología , Glucemia/análisis , Brasil/epidemiología , Estudios Transversales , /sangre , Hemoglobina Glucada/análisis , Prevalencia , Rango del Movimiento Articular/fisiología , Estadísticas no Paramétricas , Dolor de Hombro/sangre , Dolor de Hombro/epidemiología , Factores de TiempoRESUMEN
Palindromic rheumatism is characterized by multiple recurrent episodes of arthritis and periarthritis (mono or oligoarticular) that may last hours or days, disappearing without sequels. We report a 69-year-old male with a history of hypertension and a presumptive diagnosis of gout due to recurrent episodes of arthritis and periarthritis in the last thirty years. They involved at least two joints, lasted few days and were self limited. The patient was admitted due to arthritis and periarthritis of both wrists, knees, ankles, elbows and hands. He presented with fever (38-39º C), intense articular pain and anorexia. With a presumptive diagnosis of palindromic rheumatism and the lack of response to non steroidal anti infammatory drugs, methylprednisolone 20 mg/od per os was started, with an excellent response.
Asunto(s)
Anciano , Humanos , Masculino , Periartritis/patología , Artritis Reumatoide/tratamiento farmacológico , Artritis Reumatoide/patología , Diagnóstico Diferencial , Glucocorticoides/uso terapéutico , Periartritis/tratamiento farmacológico , RecurrenciaRESUMEN
El presente estudio se realizó en la clínica militar y en el hospital oncológico desde enero de 1999 hasta febrero del 2000. El universo fue de 130 pacientes que asistieron a la clínica, remitidos de su área de atención por afecciones de periartritis (bursistis en el hombro). Fueron agrupados por su sexo, y por su edad en tres grupos: de 30-39, de 40 a 55 y de 56 a 67, con el objetivo de valorarlos, reflejando además los grupos ocupacionales, de forma tal que la comparación fuera lo más homogénea posible. Los resultados indican que las maniobras aplicadas fueron efectivas en el sexo masculino desde la primera sesión, mientras que en el femenino comenzaron a sentir alivio en la segunda sesión y que para la recuperación total se necesitaron de 5 a 7 sesiones de tratamiento.
This work was performed from january1999 to february 2000 in a universe of 130 patients who attended to the clinic, with a remission from their assitance area for periarthritis affections (shoulder bursits) were grouped by sex and age in small groups (of 30 to 39), (40 to 55 and to 56 to 67), with the aim of evaluating them, reflecting also the occupational groups in such a way that comparisson would be homogeneous as possible. Results indicate that maneuvers applied are effective in the masculine sex sence the firts session than in the femenine in wich relieve was felt in the second session and for final recovering it was necessesary 5 to 7 sessions of treatment. The 87% of patients will recover of their affection. This study was carried out at the military clinic and Oncologic Hospital, using experimentation methods.
RESUMEN
Se informa sobre el uso del campo magnético discontinuo a baja frecuencia en 165 pacientes tratados en el Policlínico Integral Docente Centro de la ciudad de Camagüey entre febrero de 1994 y enero de 1995. Las afecciones tratadas fueron: osteoartritis, condromalacia, sinovitis, traumas, periartritis, fibrosis posquirúrgica, síndrome de la plica sinovial patológica y enfermedad de Hoffa. Los resultados se pueden calificar como buenos en el 97 % de los pacientes tratados.
The use of low frequency pulsed magnetic field in 165 patients treated at the Central Comprehensive Teaching Polyclinic, in the city of Camagüey, between February, 1994 and January, 1995, is reported. The affections treated were the following: osteoarthritis, chondromalacia, synovitis, traumas, periarthritis, postsurgical fibrosis, pathological synovial plica syndrome, and Hoffa disease. The results achieved may be considered as good in 97 % of the treated patients.
On rapporte l'emploi du champ magnétique discontinu à basse fréquence chez 165 patients traités dans la Policlinique Intégrale d'Enseignement Centre de la Ville de Camagüey, entre le mois de février 1994 et janvier de 1995. Les affections traitées ont été: ostéoarthrite, chondromalacie, synovite, traumes, périarthrite, fibrose post-chirurgicale, syndrome du plis synovial pathologique et maladie de Hoffa. Les résultats peuvent être classifiés comme bons chez 97 % des patients traités.