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Thermal Imaging for Inflammatory Arthritis Evaluation
Published in U. Snekhalatha, K. Palani Thanaraj, Kurt Ammer, Artificial Intelligence-Based Infrared Thermal Image Processing and Its Applications, 2023
U. Snekhalatha, K. Palani Thanaraj, Kurt Ammer
RA is an inflammatory multi-factorial systemic disorder that affects around 1–2% of Indians, especially women in the age group of 50-year-olds (Mittal and Dubey, 2013). It causes pain, disability, and loss of function. Earlier screening or diagnosis of RA allows better treatment and prevention. Unfortunately, there is no specific test to detect the presence of RA. RA is traditionally diagnosed by combining symptoms such as morning stiffness with clinical signs such as a number of swollen and tender joints and laboratory tests such as ESR, CRP, rheumatoid factor, and anti-cyclic citrullinated peptide (anti-CCP) antibodies. For the diagnosis of RA, clinical signs and symptoms must have been present for at least 6 weeks (Arnett et al., 1988). The severity of disease can be further assessed by imaging modalities such as X-ray, ultrasound, and MRI. However, the sensitivity of these tests is limited in the diagnosis of RA at the earlier stage (Heidari, 2011). In 2010, the American College of Rheumatology/European League against Rheumatism Collaborative Initiative published revised rheumatoid arthritis classification criteria aimed at earliest identification of patients who might benefit from treatment with disease-modifying anti-rheumatic drugs (DMARD). The presence of obvious “clinical” synovitis in at least one joint is central to this classification (Aletaha et al., 2010). Imaging techniques such as MRI or sonography can confirm clinically suspected synovitis.
Temporomandibular Joint Disorders
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Rheumatoid disease can occur in the child, adolescent, or adult. It usually presents with signs and symptoms of synovitis, namely pain, swelling, heat, and restriction of movement. Progression can lead to joint collapse, resulting in malocclusion with anterior open bite and retrusive contact. Diagnosis is made in coordination with the rheumatology team and is guided by the presence of other affected joints.
Immunosuppressants, rheumatic and gastrointestinal topics
Published in Evelyne Jacqz-Aigrain, Imti Choonara, Paediatric Clinical Pharmacology, 2021
Evelyne Jacqz-Aigrain, Imti Choonara
In JIA intra-articular corticosteroid injections are now considered in many centres as first-line therapy in the oligoarticular sub-type, or adjunctive therapy before DMARDs have become effective in polyarthritis. It is often possible to induce rapid, early control of synovitis, relief of symptoms and rapid rehabilitation. Complications, such as leg length discrepancy, may be avoided [4]. The mechanisms of action of corticosteroids are discussed below.
Identifying the response process validity of clinical vignette-type multiple choice questions: An eye-tracking study
Published in Medical Teacher, 2023
Francisco Carlos Specian Junior, Thiago Martins Santos, John Sandars, Eliana Martorano Amaral, Dario Cecilio-Fernandes
Boy, three-year-old, was brought to the Emergency Room with pain in the right lower limb and difficulty in walking for one day. Family history: brother with an upper respiratory tract infection for 10 days. Physical examination: T = 36.8 °C; RR = 16 breaths per minute; HR = 90 beats per minute; Limbs: limitation of internal and external rotation of the right hip; does not perform complete extension of the right lower limb. The most likely diagnosis is:Rheumatic fever.Legg-Calve-Perthes disease.Transient synovitis.Juvenile idiopathic arthritis.
Favorable clinical response and drug retention of anti-IL-6 receptor inhibitor in rheumatoid arthritis with high CRP levels: the ANSWER cohort study
Published in Scandinavian Journal of Rheumatology, 2022
Y Nakayama, M Hashimoto, R Watanabe, K Murakami, K Murata, M Tanaka, H Ito, W Yamamoto, K Ebina, K Hata, Y Hiramatsu, M Katayama, Y Son, H Amuro, K Akashi, A Onishi, R Hara, K Yamamoto, K Ohmura, S Matsuda, A Morinobu
Rheumatoid arthritis (RA) is a chronic autoimmune condition with synovitis. The treatment strategy for RA has radically changed since biological disease-modifying anti-rheumatic drugs (bDMARDs) were introduced into clinical practice. To date, eight bDMARDs have been approved for RA treatment. These bDMARDs can be classified into three categories according to their mechanisms of action. Tumour necrosis factor inhibitors (TNFi) include infliximab (IFX), adalimumab (ADA), etanercept (ETN), golimumab (GLM), and certolizumab-pegol (CZP). Anti-interleukin-6 receptor monoclonal antibodies (IL-6Ri) include tocilizumab (TCZ) and sarilumab (SAR). The immunoglobulin fused with cytotoxic T-lymphocyte antigen-4 (CTLA4-Ig) is called abatacept (ABT), which acts via selective inhibition of T-cell costimulation. Although these bDMARDs have different mechanisms of action, remission rates were found to be similar in clinical trials (1). Therefore, the American College of Rheumatology (ACR) and European League Against Rheumatism (EULAR) give the same recommendations for all bDMARDs (2, 3).
Hemophilic arthropathy: a teaching approach devoted to hemophilia treaters in under-development countries
Published in Expert Review of Hematology, 2021
Hemophilic hemarthroses should be prevented by employing primary prophylaxis combined with good physical care (with the assistance of PRM physicians). Ideally, this treatment should be available globally. If articular hemorrhage occurs, it needs to be managed with aggressive hematological treatment and arthrocentesis until its full resolution (defined by POC-US). If the articular hemorrhage is recurrent, chronic synovitis will appear, which will make the articulation predisposed to re-bleeding. Synovitis can be restricted by radiosynovectomy, which can be redone many times throughout the lives of patients with hemophilia. If synovitis is persistent, osteochondral damage to the joint will worsen, which will ultimately cause severe pain and considerable functional disability. Then, surgery will be inevitable to mitigate the problem.