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Rheumatic Disease
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Compare affected joints or muscles with their counterparts. Passive movement is a reliable measure of range of movement. Muscle tenderness may indicate an inflammatory disorder and should be investigated. Tell the patient what is happening, particularly if it may hurt.
The Diagnosis of Inflammation: A Pathologist’s Perspective
Published in Jeremy R. Jass, Understanding Pathology, 2020
Once the distinction between a neoplastic and an inflammatory process has been made there is a tendency, if the condition is deemed to be inflammatory and apparently non-specific, for pathologists to draw a sigh of relief and take the matter no further. However, as appreciated by the Scottish anatomist and surgeon John Hunter (1728–93), inflammation is not a disease but a reaction. Whilst the tissues of the body have a limited repertoire of reactions to a vast range of noxious stimuli, it is helpful if the pathologist can find a specific cause for a ‘non-specific’ inflammatory response. In cases where the cause of an inflammatory disorder is unknown (this would apply to a large range of skin diseases) the ‘pattern’ of the inflammation will have diagnostic importance. The pattern is determined by the anatomical distribution of the inflammatory infiltrate, its severity, the cell types represented and the presence of additional features such as apoptosis, necrosis, blisters (in the case of skin) and disturbances of growth and differentiation of associated epithelial surfaces.
The Musculoskeletal System and Its Disorders
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
Psoriatic arthritis is also an inflammatory arthritis occurring in association with psoriasis, lesions on the skin. Reiter's syndrome involves arthritis of the spine, along with inflammation of the urethra and iridocyclitis (iris and ciliary body of the eye). Septic arthritis or infectious arthritis is usually acquired from the blood but may also result from the spread of osteomyelitis to the joint. Lyme disease or arthritis is an inflammatory disorder with multiple symptoms involved; transfer is by a tick.
More than a random association between chronic obstructive pulmonary disease and psoriatic arthritis: shared pathogenic features and implications for treatment
Published in Expert Review of Clinical Immunology, 2022
Luca Quartuccio, Marco Sebastiani, Francesca Romana Spinelli, Fabiano Di Marco, Rosario Peluso, Salvatore D’Angelo, Alberto Cauli, Maurizio Rossini, Fabiola Atzeni
Given that psoriatic disease and COPD appear to have a consistent association, a possible pathophysiologic link between these two diseases can be hypothesized. The most likely mechanism involves common pathways based on the imbalance of pro- and anti-inflammatory cytokines, with one disease significantly increasing the risk of the other. Indeed, patients with immune-mediated inflammatory disorders are more likely to have or develop another immune-mediated inflammatory disorder [21]. In psoriasis, the inflammatory response is characterized by the increase of a number of cytokines such as IL-1, IL-6, IL-8, IL-17, and TNF-α [25]. The same cytokines are found to be increased in both sputum and bronchoalveolar lavage of patients with COPD [26]. In addition, a wide range of molecules have been implicated in both psoriasis and COPD, as summarized in Table 1 [18]. These include additional pro-inflammatory cytokines, T cell receptors and co-stimulatory molecules, T cell cytokines, chemokines and receptors, adhesion molecules, and proteases, which have all been implicated in the pathophysiology of both COPD and psoriasis [18].
Long-term safety of adalimumab for patients with moderate-to-severe hidradenitis suppurativa
Published in Expert Opinion on Drug Safety, 2020
Vassiliki Tzanetakou, Dimitra Stergianou, Evangelos J. Giamarellos-Bourboulis
HS is a very difficult to treat chronic inflammatory disorder. Although registration of ADA was a great progress in the field, it is widely understood after 5 years of experience that ADA treatment leads to the remission of active inflammatory lesions and to a lesser extent to the decrease of draining fistulas. There is no doubt that with the current medical treatment option scars do not leave. Furthermore, ADA should be administered long term in patients. This long-term administration has two faces: the first face is the patient who enters into long-term HS remission and who is ADA dependent since stopping ADA increases substantially the risk of relapse. For this patient ADA response upon treatment re-start cannot be guaranteed as it has never been studied. The second face is the patient who presents a rather unstable course with frequent HS flare-ups. For this patient, ADA is long term continued since there is no other medical treatment option.
Diplopia after Excessive Smart Phone Usage
Published in Neuro-Ophthalmology, 2019
Savleen Kaur, Jaspreet Sukhija, Rahul Khanna, Aastha Takkar, Manpreet Singh
There was no history of head trauma, fever, neurological illness, previous such episodes, migraines/headaches, history of glasses, or patching in any of the cases. A dry refraction by an autorefractor revealed a large myopic error in all cases (Range −4.5 D to −8.5 D) in both eyes. A cycloplegic refraction, however, revealed a small hyperopia in all cases. A clinical diagnosis of accommodative spasm was made. Scheimpflug imaging of the anterior segment of the eye was done which documented movement of the anterior as well as posterior surface of the lens confirming our diagnosis. All the patients underwent a detailed Gadolinium-enhanced MRI of the brain and optic nerves which came out to be normal. Routine investigations (Hemogram, renal function, liver function tests, ESR, CRP, Chest X Ray) were carried out in all patients to rule out any evidence of infection or inflammatory disorder. However, since we were sure of spasm in these patients we did not investigate them further. Family history suggestive of migraine was not present in any of the patients included in this series. Moreover, the extraocular movements were full and hence ophthalmoplegic migraine was ruled out.