RESUMO
ABSTRACT Sarcoidosis is a multi-system disease that involves the lung in 90% of cases. Skeletomuscular involvement of sarcoidosis may involve joints, muscles and/or bones, the latter affecting 313% of patients. Its clinical presentation is asymptomatic in half of the cases, in the other half there is pain, soft tissue edema, and decreased limb function. Radiographically it is accompanied by osteolysis, osteosclerosis, cystic lesions and pathological fractures in advanced stages. A final diagnosis is made by tissue biopsy, finding non-caseating granulomatous process accompanied by Langhans giant cells. The main indication of medical management is the control of symptoms, associated with an improvement in the functioning of the affected limb and quality of life of the patient. The case is presented of a patient with digital sarcoidosis with classic radiographic pattern with no other extra-skeletal involvement.
RESUMEN La sarcoidosis es una enfermedad multisistémica que involucra en el 90% de los casos el pulmón. El compromiso osteomuscular de la sarcoidosis puede incluir articulaciones, músculos o huesos; este último caso afecta al 3-13% de los pacientes. Su presentación clínica es asintomática en la mitad de los casos, el restante se presenta con dolor, edema de tejidos blandos y disminución en la funcionalidad de la extremidad. Radiográficamente se acompaña de osteólisis, osteoesclerosis, lesiones quísticas y fracturas patológicas en estadios avanzados. Su diagnóstico definitivo se realiza por medio de una biopsia tisular, en la que se encuentra un proceso granulomatoso no caseificante acompañado de células gigantes de Langhans. La principal indicación del manejo médico es el control de los síntomas, lo que se asocia con una mejoría en el funcionamiento de la extremidad afectada y en la calidad de vida del paciente. Se presenta el caso de un paciente con sarcoidosis digital con patrón radiográfico clásico, sin otro compromiso extraesquelético.
Assuntos
Humanos , Masculino , Adulto , Sarcoidose , Granuloma , Doenças Sanguíneas e Linfáticas , Doenças LinfáticasRESUMO
Attentional focus instructions are verbal strategies that could maximize the effects of exercise. The objective of this review was to explore and synthesize the available evidence on the incorporation of attentional focus instruction in the exercise of people with musculoskeletal disorders. A search of 11 databases was carried out until October 2020. Of 4,227 studies identified in the searches, 15 were included. The studies showed deficiencies in the conceptualization and definition of attentional focus instructions. The available evidence indicates that external focus is effective in improving motor learning and function. However, methodological limitations, clinical heterogeneity, the small number of articles included, and new experimental studies challenge the conclusions of the systematic reviews available to date. Attentional focus instructions in musculoskeletal disorders is an emerging field and requires further research. This review is a guide for future studies.