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Background: Ankylosing spondylitis (AS) is characterised as a chronic inflammatory disease of the axial skeleton. The force platform is an option for performing the postural assessment of these individuals. Objectives: To review and evaluate the behaviour of the centre of pressure (CoP) variables during the postural control examination in patients with AS compared to a control group. Method: A systematic review, registered in PROSPERO, that followed the PRISMA Statement. A search was carried out in the following databases: Medline, Web of Science, Embase, Scopus, and Scielo, from 1945 to 2023. Studies were selected that aimed to understand the use of the force platform for the assessment of postural control. The risk of bias assessment was performed using the AXIS tool. Results: Five studies were included, with a total of 247 participants. The assessment of risk of bias presented high scores in the AXIS tool. Patients with a diagnosis of AS presented increased thoracic kyphosis in most of the studies, as well as large displacements in the anteroposterior (AP) and mediolateral (ML) directions, and altered total mean velocity (TMV) and frequency, indicating worse postural stability. Regarding the functional status, the most used questionnaires were the Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Metrology Index (BASMI) and Bath Ankylosing Disease Activity Index (BASDAI). Conclusion: Patients with ankylosing spondylitis present postural instability, verified by means of higher values of centre of posture variables. Clinical implications: Individuals with ankylosing spondylitis presented postural instability and balance deficit. Therefore, exercises for balance training and postural control are essential in the clinical management of these patients.
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BACKGROUND: Juvenile idiopathic arthritis (JIA) comprises a whole spectrum of chronic arthritis starting before 16 years of age. The study aims to explore the clinical and demographic descriptors, treatment, and disease progression of enthesitis-related arthritis (ERA) in comparison with juvenile-onset spondyloarthritis (SpA). METHODS: Cross-sectional analysis of consecutive patients in two dedicated clinics, with a single visit and retrospective case-notes review. Arthritis, enthesitis and sacroiliitis were evaluated by scoring disease activity and damage. Continuous variables were reported by median, interquartile range; categorical variables were reported by the frequency comparison of the two groups. RESULTS: Thirty-three cases were included, being 23 (69.7%) with ERA. The median age at diagnosis was 12.5 y (SpA) vs. 9 y (ERA) (p < 0.01); the time from symptom onset to diagnosis was 5.5 y (SpA) vs. 1.5 y (ERA) (p < 0.03). In both groups, the predominant presentation was a single joint or < 5 lower limb joints and asymmetric involvement, with a high frequency of enthesitis. There was a higher frequency of mid-tarsal and ankle synovitis in the ERA group and hip involvement in those with SpA. The comparison of the frequency of spine symptoms at presentation, 30% SpA vs. 21.7% ERA (p = 0.7), was not significant, and radiographic progression to spinal involvement occurred in 43.5% of ERA patients. The median time for spinal progression and age at onset was 2.2 and 12 y for ERA, and 4 and 16.5 y for SpA, respectively. Activity and damage scores were not significantly different between the groups. Treatment comparison resulted in 91.3% of ERA and 100% SpA being treated, predominantly with NSAIDs in both groups, followed by DMARDs and biologics, with a higher frequency of biologics in SpA. CONCLUSION: The main differences were the late diagnoses of SpA, and the hip and spine involvement, with higher frequency of biologic treatment in juvenile-onset SpA compared to ERA.
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Antirreumáticos , Artrite Juvenil , Progressão da Doença , Espondilartrite , Humanos , Estudos Transversais , Artrite Juvenil/complicações , Artrite Juvenil/tratamento farmacológico , Artrite Juvenil/diagnóstico , Criança , Adolescente , Feminino , Masculino , Estudos Retrospectivos , Espondilartrite/complicações , Espondilartrite/tratamento farmacológico , Espondilartrite/diagnóstico , Antirreumáticos/uso terapêutico , Entesopatia/etiologia , Entesopatia/diagnóstico por imagem , Sacroileíte/diagnóstico por imagem , Idade de Início , AdultoRESUMO
INTRODUCTION: In chronic arthropathies, there are several mechanisms of joint destruction. In recent years, studies have reported the implication of receptor activator of nuclear factor kappa-B ligand (RANKL) and osteoprotegerin (OPG) in the process of activation and differentiation of osteoclasts, a key cell in the development of bone erosion. The RANKL/OPG ratio is increased in the serum of patients with malignant diseases and lytic bone disease, as well as rheumatoid arthritis (RA). The objective of this study was to measure and compare the concentrations of OPG and RANKL in the synovial fluid (SF) of patients with rheumatoid arthritis, spondyloarthritis (SpA) and osteoarthritis (OA). METHODS: This was an observational and cross-sectional study with 83 patients, 33 with RA, 32 with SpA and 18 with OA, followed up regularly in the outpatient clinics of the Rheumatology Department of the Clinics Hospital of the Ribeirão Preto Medical School-USP. All patients were assessed for indications for arthrocentesis by the attending physicians at the time of SF collection and were evaluated for demographic variables and medication use. Disease activity was assessed in individuals with RA and SpA. The quantification of SF OPG and RANKL levels was performed by ELISA, and the correlations of the results with clinical, laboratory and radiological parameters were assessed. RESULTS: We found no statistically significant difference in the RANKL and OPG levels among the groups. Patients with RA showed a positive correlation between the SF cell count and RANKL level (r = 0.59; p < 0.05) and the RANKL/OPG ratio (r = 0.55; p < 0.05). Patients with OA showed a strong correlation between C-reactive protein (CRP) and the RANKL/OPG ratio (r = 0.82; p < 0.05). There was no correlation between the OPG and RANKL levels and markers of inflammatory activity or the disease activity index in patients with RA or SpA. CONCLUSION: Within this patient cohort, the RANKL/OPG ratio was correlated with the SF cell count in patients with RA and with serum CRP in patients with OA, which may suggest a relationship with active inflammation and more destructive joint disease.
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Artrite Reumatoide , Osteoartrite , Espondilartrite , Humanos , Osteoprotegerina/metabolismo , NF-kappa B , Estudos Transversais , LigantesRESUMO
Abstract Introduction In chronic arthropathies, there are several mechanisms of joint destruction. In recent years, studies have reported the implication of receptor activator of nuclear factor kappa-B ligand (RANKL) and osteoprotegerin (OPG) in the process of activation and differentiation of osteoclasts, a key cell in the development of bone erosion. The RANKL/OPG ratio is increased in the serum of patients with malignant diseases and lytic bone disease, as well as rheumatoid arthritis (RA). The objective of this study was to measure and compare the concentrations of OPG and RANKL in the synovial fluid (SF) of patients with rheumatoid arthritis, spondyloarthritis (SpA) and osteoarthritis (OA). Methods This was an observational and cross-sectional study with 83 patients, 33 with RA, 32 with SpA and 18 with OA, followed up regularly in the outpatient clinics of the Rheumatology Department of the Clinics Hospital of the Ribeirão Preto Medical School-USP. All patients were assessed for indications for arthrocentesis by the attending physicians at the time of SF collection and were evaluated for demographic variables and medication use. Disease activity was assessed in individuals with RA and SpA. The quantification of SF OPG and RANKL levels was performed by ELISA, and the correlations of the results with clinical, laboratory and radiological parameters were assessed. Results We found no statistically significant difference in the RANKL and OPG levels among the groups. Patients with RA showed a positive correlation between the SF cell count and RANKL level (r = 0.59; p < 0.05) and the RANKL/ OPG ratio (r = 0.55; p < 0.05). Patients with OA showed a strong correlation between C-reactive protein (CRP) and the RANKL/OPG ratio (r = 0.82; p < 0.05). There was no correlation between the OPG and RANKL levels and markers of inflammatory activity or the disease activity index in patients with RA or SpA. Conclusion Within this patient cohort, the RANKL/OPG ratio was correlated with the SF cell count in patients with RA and with serum CRP in patients with OA, which may suggest a relationship with active inflammation and more destructive joint disease.
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Introducción: Las espondiloartropatías son enfermedades caracterizadas por la inflamación del esqueleto axial, de las articulaciones periféricas y de las inversiones tendinosas. Muchas de las alteraciones en pacientes asintomáticos con sinovitis y entesitis subclínica han sido reveladas mediante ultrasonido, técnica adecuada para evaluar este padecimiento. Objetivo: Evaluar las características ecográficas sobre el daño en la articulación de la rodilla en pacientes con diagnóstico de espondiloartropatías y su relación con la exploración clínico-analítica. Métodos: Se realizó un estudio descriptivo, transversal en pacientes con diagnóstico de EspA atendidos en el Hospital Clínico Quirúrgico Hermanos Ameijeiras en los servicios de Reumatología e Imagenología en el período entre enero de 2018 y agosto de 2020. Se estudiaron 53 pacientes con espondiloartropatías; 26 mujeres y 27 hombres; se examinaron 106 rodillas. Resultados: Predominaron pacientes con espondilitis anquilosante; 73,6 por ciento de los pacientes estudiados. De toda la muestra, el 43,4 por ciento tuvo actividad inflamatoria en la rodilla derecha y 37,7 por ciento fue bilateral. El 58,5 por ciento tuvo derrame articular; el 84 por ciento fue transparente. El 61,3 por ciento de los casos estudiados mostró engrosamiento sinovial y el 81,5 por ciento fue avascular. En la membrana vascularizada predominó el vaso recto, (12 por ciento). El 23,6 por ciento de la muestra tuvo quiste poplíteo. Conclusiones: El ultrasonido de alta resolución en la espondiloartropatía de la rodilla resultó una técnica útil para detectar engrosamiento de la membrana sinovial, derrame y el aumento de la vascularización. También se demostró que no existió relación entre los reactantes de fase aguda y la actividad inflamatoria, así como con la actividad Doppler en las espondiloartropatías en la rodilla en esta serie(AU)
Introduction: Spondyloarthropathies are diseases characterized by inflammation of the axial skeleton, peripheral joints and tendon inversions. Many of the alterations in asymptomatic patients with synovitis and subclinical enthesitis have been revealed by ultrasound, an adequate technique to evaluate this condition. Objective: To evaluate the ultrasound characteristics of knee joint damage in patients diagnosed with spondyloarthropathies and their relationship with clinical-analytical examination. Methods: An observational, descriptive and cross-sectional study was carried out in 53 patients with spondyloarthropathies; 26 women and 27 men; 106 knees were examined. Results: Patients with ankylosing spondylitis predominated; 73.6 percent of the patients studied. Out of the entire sample, 43.4 percent had inflammatory activity in the right knee and 37.7 percent was bilateral. 58.5 percent had joint effusion; 84 percent were transparent. 61.3 percent of the cases studied showed synovial thickening and 81.5 percent was avascular. In the vascularized membrane, the vasa recto predominated (12 percent). 23.6 percent of the sample had a popliteal cyst. Conclusions: High resolution ultrasound in knee spondyloarthropathy was a useful technique to detect thickening of the synovial membrane, effusion and increased vascularization. It was also shown that there was no relationship between acute phase reactants and inflammatory activity, as well as Doppler activity in knee spondyloarthropathies in this series(AU)
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Humanos , Masculino , Feminino , Ultrassonografia/métodos , Espondiloartropatias/epidemiologia , Traumatismos do Joelho/epidemiologia , Epidemiologia Descritiva , Estudos TransversaisRESUMO
Resumen La espondiloartropatía destructiva es una patología osteoarticular presente en algunos pacientes con enfermedad crónica que puede afectar varios niveles de la columna vertebral y puede ser asintomática, generar dolor o causar complicaciones que ponen en peligro la integridad de la médula espinal y/o la vida. Presentamos el caso de un hombre de 70 años con enfermedad renal crónica terminal en hemodiálisis quien consultó por dolor dorsal y paraplejia, en quien se diagnosticó espondiloartropatía destructiva no infecciosa por imágenes y estudio histopatológico. Este caso nos muestra la importancia de pensar en esta patología y la necesidad de un enfoque multidisciplinario en el diagnóstico y manejo. (Acta Med Colomb 2022; 47. DOI:https://doi.org/10.36104/amc.2022.2193).
Abstract Destructive spondyloarthropathy is a bone and joint disease which presents in some patients with chronic illnesses and may affect various levels of the spinal column. It may be asymptomatic, cause pain, or produce spinal cord and/or life-endangering complications. We present the case of a 70-year-old man with end-stage renal disease on hemodialysis who consulted due to back pain and paraplegia. He was diagnosed with destructive noninfectious spondyloarthropathy through imaging and histopathological studies. This case shows us the importance of considering this disease and the need for a multidisciplinary approach in its diagnosis and management. (Acta Med Colomb 2022; 47. DOI:https://doi.org/10.36104/amc.2022.2193).
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Large epidemiologic and clinical estimates of spondyloarthritis (SpA) in Latin America are not available. In this narrative review, our goal was to descriptively summarize the prevalence and features of SpA in Latin America, based on available small studies. A review of peer-reviewed literature identified 41 relevant publications. Of these, 11 (mostly based on Mexican data) estimated the prevalence of SpA and its subtypes, which varied from 0.28 to 0.9% (SpA), 0.02 to 0.8% (ankylosing spondylitis), 0.2 to 0.9% (axial SpA), and 0.004 to 0.08% (psoriatic arthritis). Demographic and/or clinical characteristics were reported in 31 of the 41 publications, deriving data from 3 multinational studies, as well as individual studies from Argentina, Brazil, Chile, Colombia, Costa Rica, Mexico, Peru, Uruguay, and Venezuela. Data relating to treatment, disease manifestations (articular and extra-articular), and comorbidities were summarized across the countries. Available data suggest that there is a variability in prevalence, manifestations, and comorbidities of SpA across Latin America. Basic epidemiologic and clinical data are required from several countries not currently represented. Data relating to current treatment approaches, patient outcomes, and socioeconomic impact within this large geographic region are also needed.
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Espondilartrite/epidemiologia , Adulto , Artrite Psoriásica/epidemiologia , Comorbidade , Feminino , Humanos , América Latina/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Espondilartrite/complicações , Espondilartrite/tratamento farmacológico , Espondilite Anquilosante/epidemiologiaRESUMO
Abstract Large epidemiologic and clinical estimates of spondyloarthritis (SpA) in Latin America are not available. In this narrative review, our goal was to descriptively summarize the prevalence and features of SpA in Latin America, based on available small studies. A review of peer-reviewed literature identified 41 relevant publications. Of these, 11 (mostly based on Mexican data) estimated the prevalence of SpA and its subtypes, which varied from 0.28 to 0.9% (SpA), 0.02 to 0.8% (ankylosing spondylitis), 0.2 to 0.9% (axial SpA), and 0.004 to 0.08% (psoriatic arthritis). Demographic and/or clinical characteristics were reported in 31 of the 41 publications, deriving data from 3 multinational studies, as well as individual studies from Argentina, Brazil, Chile, Colombia, Costa Rica, Mexico, Peru, Uruguay, and Venezuela. Data relating to treatment, disease manifestations (articular and extra-articular), and comorbidities were summarized across the countries. Available data suggest that there is a variability in prevalence, manifestations, and comorbidities of SpA across Latin America. Basic epidemiologic and clinical data are required from several countries not currently represented. Data relating to current treatment approaches, patient outcomes, and socioeconomic impact within this large geographic region are also needed.(AU)
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Humanos , Espondilartrite/epidemiologia , Prognóstico , Espondilite Anquilosante/epidemiologia , Artrite Psoriásica/epidemiologia , Demografia , Prevalência , Fatores de Risco , América Latina/epidemiologiaRESUMO
Abstract Background: Familial Mediterranean fever (FMF) is an autoinflammatory disease characterized by recurrent episodes of fever and serositis. Sacroiliitis can be observed in some FMF patients. This study aimed to compare the demographic, clinical, and laboratory findings, and treatment in children with FMF and sacroiliitis, and children with juvenile spondyloarthropathy (JSpA). Methods: In total, 1687 pediatric FMF patients that were followed-up between May 2010 and June 2020 were evaluated retrospectively. Among them, those with sacroiliitis ( n = 63) were included in the study and compared to patients with JSpA ( n = 102). Results: The study included 63 FMF patients with sacroiliitis (38 males [60.3%] and 25 females [39.7%]) with a mean age of 15.2 ± 4.1 years. Mean age at symptom onset was 7.2 ± 5.05 years and mean age at diagnosis was 9.74 ± 4.67 years. The most common mutation in the FMF patients was M694V/M694V ( n = 22). Patients were diagnosed with sacroiliitis with a mean of 12 months (range: 6-36 months) after the diagnosis of FMF. Among the FMF patients, 28 (44.4%) had enthesitis, 23 (36.5%) had heel pain, and 11 (17.4%) had low back pain. The study also included 102 JSpA patients (90 males [88.2%] and 12 females [11.8%]). Mean age of patients with JSpA was 16.1 ± 2.8 years. As compared to 102 JSpA patients, patients with FMF and sacroiliitis had higher acute phase reactants, whereas HLA- B27 positivity rate was lower. In addition, axial involvement rate was higher in the JSpA patients. Conclusion: Sacroiliitis is a common co-morbidity in FMF patients. The phenotypic features of these patients are different from patients with JSpA.
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Spondyloarthropathies are a group of chronic inflammatory disorders that involve the joints of the axial skeleton, peripheral joints and have extra-articular manifestations. Treatment includes inhibitors of tumor necrosis factor α. Currently there are five approved inhibitors: a soluble receptor, Etanercept and four monoclonal. Etanercept has very low toxicity with pulmonary adverse reactions being very rare. We present the case of a patient who developed respiratory symptoms and pulmonary infiltrates of rapid evolution after the third dose of treatment with Etanercept.
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OBJECTIVE: Re-evaluate the pathological lesions found on a gomphothere recovered from Quebrada Quereo (Late Pleistocene), Coquimbo region, Chile (31º55'41" S, 71º34'43" W, 20â¯masl). MATERIALS: 227 axial and appendicular specimens from a young adult male individual (SGO.PV.267). METHODS: Macroscopic and radiographic analysis. RESULTS: Pathological conditions identified included asymmetries of a cervical vertebra and of thoracic vertebra 16, degenerative joint disease in thoracic and lumbar vertebrae, possible evidence of neoplastic lesions within the bodies of three thoracic vertebrae (possibly hemangiomas), and fusion at thoracic vertebrae 15 and 16, suggesting the presence of spondyloarthropathy. CONCLUSIONS: The original diagnosis of traumatic lesions on this specimen is unsupported. The re-evaluation identified the presence of developmental defects, degenerative joint disease, possible neoplastic lesions, and spondyloartropathy. SIGNIFICANCE: The present analysis adds data to the sparse paleopathological record of South American gomphotheres. LIMITATIONS: Taphonomic alteration of some skeletal elements, as well as the presence of an incomplete individual, limits the ability to determine the etiology of some of the lesions identified. SUGGESTIONS FOR FURTHER RESEARCH: Researchers are encouraged to re-examine specimens curated in museums in order to identify pathological conditions that might have been overlooked or might benefit from re-evaluation.
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Doenças Ósseas/história , Doenças Ósseas/veterinária , Mamífero Proboscídeo , Animais , Chile , História Antiga , PaleopatologiaRESUMO
Inflammatory arthritis is documented for the first time in snakes. Ossification of the intervertebral capsule and zygapophyseal joints resulting in segmental vertebral fusion was observed in the aquatic Cretaceous snake Lunaophis aquaticus. Such pathologic alterations are pathognomonic for the spondyloarthropathy form of inflammatory arthritis. A survey of 2144 snakes in recent collections, performed to identify Holocene prevalence, revealed only two occurrences in extant snakes. The findings in Bitis gabonica and Elaphe taeniura were indistinguishable from those noted in Lunaophis aquaticus and identical to those previously recognized in modern varanids. The pathology likely represents a form of reactive arthritis related to enteropathic infection. While the disease probably did not affect general locomotion, its vertebral column position may have compromised mating.
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Fósseis , Serpentes/anatomia & histologia , Coluna Vertebral/patologia , Espondiloartropatias/patologia , Animais , Evolução Biológica , Coluna Vertebral/anatomia & histologiaRESUMO
The objective of the study is to determine the risk factors for the development of reactive arthritis (ReA) and examine the factors associated with the persistence of symptoms. Patients with a new diagnosis of ReA and controls with a gastrointestinal (GI), urogenital, or sexually transmitted infection in the 3-6 months prior to study entry were prospectively enrolled in Guatemala City. ReA patients fulfilled the Assessment in Spondyloarthritis International Society criteria for peripheral spondyloarthropathy (SpA). Patients underwent history, examination, Achilles tendon ultrasound, and blood draw. Human leukocyte antigen (HLA) type and serum biomarkers were measured. t tests and nonparametric equivalents were used to examine the association of clinical, laboratory, and imaging factors with ReA. Patients were contacted 2 years later to assess for persistence of symptoms. Study subjects included patients with ReA (N = 32) and controls (N = 32). ReA patients were most frequently infected in April whereas controls were most frequently infected in August. Two ReA patients and two controls were HLA-B27-positive. Serum cathepsin K and C-reactive protein were higher in ReA patients compared to controls (p = 0.03 for both), while total cholesterol and low-density lipoprotein were lower (p = 0.008 and 0.045, respectively). Among those with ReA, 15 (47%) patients had continued symptoms at 2 years. These patients had a lower matrix metalloproteinase-3 level at diagnosis than patients for whom ReA resolved (p = 0.004). HLA-B27 was not associated with development of ReA in Guatemala; however, the month of infection was associated with ReA. The most striking finding was the persistence of arthritis at 2 years in nearly half of the patients.
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Artrite Reativa/diagnóstico , Adolescente , Adulto , Artrite Reativa/etiologia , Artrite Reativa/imunologia , Biomarcadores/sangue , Estudos de Casos e Controles , Feminino , Seguimentos , Antígeno HLA-B27/imunologia , Humanos , Masculino , Pessoa de Meia-Idade , Proibitinas , Fatores de Risco , Avaliação de Sintomas , Adulto JovemRESUMO
Abstract Candida arthritis is an unusual manifestation that usually affects the knees. A 35-year-old man presented with a 2-month history of pain and swelling in the right knee. Swelling persisted after anti-inflammatory treatment. Peripheric spondyloarthritis was considered, but methotrexate, sulfasalazine, and methylprednisolone did not reduce the swelling. Direct examination of synovial fluid and a culture were positive for Candida albicans. Intravenous and intra-articular amphotericin-B were administered. The arthritis regressed and a culture and direct staining showed negative results. Candida arthritis should be considered in patients with arthritis that is resistant to treatment and prolonged, even if risk factors are absent.
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Humanos , Masculino , Adulto , Candida albicans/isolamento & purificação , Candidíase/complicações , Artrite Infecciosa/microbiologia , Articulação do Tornozelo/microbiologia , Candidíase/diagnóstico , Artrite Infecciosa/diagnóstico , Espondilartrite/diagnóstico , Diagnóstico DiferencialRESUMO
La espondiloartropatía juvenil (EAPj) representa un grupo de artropatías crónicas que se inician en la infancia y que corresponden a entidades cuyas clasificaciones se han modificado en el transcurso de las décadas. Las clasificaciones actuales las incluyen sólo parcialmente. Las manifestaciones clínicas incluyen compromiso articular periférico asimétrico, entesis, sacroilíaco y menos frecuentemente de columna han permitido agruparlas en cinco categorías entre el que se encuentra la forma anquilosante juvenil relacionada con HLA B27 (+), el prototipo de EAPj y que podría representar a la forma de inicio de espondiloartropatía anquilosante del adulto. Los recientes avances en los estudios genéticos, en la patogenia, el desarrollo de mejores técnicas de imagenología tales como la ecografía musculo-esquelética y resonancia magnética aplicada a la Reumatología pediátrica podrían contribuir a generar criterios de clasificación de manera tal que faciliten la comunicación científica con los Reumatólogos de adultos. Un diagnóstico precoz, la aplicación de medidas de actividad de la enfermedad validadas y el oportuno manejo terapéutico obtendrán un pronóstico más favorable. Los resultados terapéuticos en EAPj presentan evidencia limitada aún requiriéndose mayor tiempo de evolución para obtener resultados a largo plazo.
Juvenile spondyloarthropathy (EAPj) represents a heterogeneous group of juvenile articular inflammatory entities and their classification have been changed during the last decades. The current classifications include only partially. The clinical manifestations of diseases involves peripheral joints, enthesis, sacroiliac and less frequently spine and they are classified in five specific subgroups among which is the juvenile ankylosing HLA B27 (+); the EAPjs prototype and that may represent one of ankylosing spondyloarthropathy adult diseases. Recently, novel insights into the epidemiology, pathogenesis, and development of the imaging techniques such as muscle-skeletal ultrasound and magnetic resonance applied to pediatric rheumatology could be contributing to new classification criteria in order to facilitate the scientific communication with Rheumatologist of adult patients. An early diagnosis a validated measures of disease activity and treatment can change the course and outcome of disease.
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Humanos , Adolescente , Feminino , Espondiloartropatias/classificação , Espondiloartropatias/diagnóstico , Espondiloartropatias/terapia , Espondiloartropatias/etiologiaRESUMO
Seronegative arthropathies or spondyloarthropathy belong to a group of diseases that share clinical and genetic characteristics associated strongly with major histocompatibility complex class I HLA-B27. We report a case of a female patient of 39 years old with nightly back pain, morning stiffness and diffuse lumbar pain in the right buttock. In the immunological study observed negative rheumatoid factor and radiographic study observed right sacroiliitis. The final diagnosis is an enteric spondyloarthropathy...
Las artropatías seronegativas o espondiloartropatías corresponden a un grupo de enfermedades que comparten características clínicas y genéticas, asociadas fuertemente con el complejo mayor de histocompatibilidad clase I HLA-B27. Se presenta el caso de una paciente de 39 años con dolor lumbar nocturno, rigidez matutina lumbar y dolor difuso en la región glútea derecha.En el estudio inmunológico se observa factor reumatoídeo negativo, y al estudio radiológico se constata sacroileítis derecha. El diagnóstico final es una espondiloartropatía entérica...
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Humanos , Adulto , Feminino , Espondiloartropatias/complicações , Espondiloartropatias/diagnóstico , Artrite Reativa , Enterite , Espondiloartropatias/terapia , Espondilite AnquilosanteRESUMO
Presentamos, en esta primera parte de la historia de la artritis psoriática, los eventos que llevaron al conocimiento de esta enfermedad, de cómo se separó de las otras y cómo se generaron los primeros criterios clasificatorios de esta patología.Palabras clave: historia, espondioartropatía, psoriasis, artritis psoriática.
In this first part of the history of psoriatic arthritis, we present the most important events that led to the knowledge of this disease, how it was separated from other inflammatory arthropathies, as well as how the first classificatory criteria in this disease were developed.Key words: history, spondyloarthropathy, psoriasis, psoriatic arthritis.
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Artrite Psoriásica/história , História , PsoríaseRESUMO
La Artritis Idiopática Juvenil (AIJ), es un término que describe a un grupo heterogéneo de artritis inflamatoria crónica, que ocurre en personas menores de 16 años de edad, tiene una duración de 6 semanas o más, y donde otras patologías han sido excluidas. El propósito de esta revisión es presentar los cambios en la clasificación y diagnóstico, y mencionar algunos aspectos en el tratamiento de la Artritis Idiopática Juvenil, a fin de lograr un mayor conocimiento de esta patología, en cuyo seguimiento intervienen de manera multidisciplinaria el pediatra, el reumatólogo infantil, el fisiatra, el traumatólogo, el psicólogo y los especialistas de sistemas afectados.
Juvenile idiopathic arthritis (JIA) is a term that describes a heterogeneous group of chronic inflammatory arthritic conditions occurring in persons under age 16 and which last 6 weeks or more, when other diseases have been excluded. The purpose of this review is to report on changes that have been made in classification and diagnosis of the condition, and to mention some aspects of its treatment to promote better understanding of these conditions, in which roles exist for practitioners from a number of disciplines, including pediatricians, pediatric rheumatologists, physiatrists, traumatologists, psychologists, and others from specialties related to specific affected systems.