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Rheumatic Disease
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Joint pain may arise from the joint itself, or from adjacent bone or surrounding soft tissue, or be referred from other systems (e.g. cardiac pain may be referred to the arm). Joint swelling always indicates disease.
How much is too much for venous malformation management?
Published in Byung-Boong Lee, Peter Gloviczki, Francine Blei, Jovan N. Markovic, Vascular Malformations, 2019
They usually present at childhood or early adulthood with functional or cosmetic symptoms related to their size and location, including pain, reduced joint mobility, and skeletal deformity.3–6 On examination, they are soft and compressible masses with blue discolorations of the skin. They characteristically decompress with elevation and local compression and enlarge on Valsalva maneuver. Palpable phleboliths and thrombi may also be present. They can cross tissue planes and invade adjacent tissues, including fat, muscle, tendon, and even bone. Joint swelling can be caused by venous engorgement, localized thrombosis/thrombophlebitis, mass effect, or local hemorrhage. Any connection to the deeper limb venous system can also precipitate the risk of deep vein thrombosis.3–5
Red and yellow flags
Published in Caroline J Rodgers, Richard Harrington, Helping Hands: An Introduction to Diagnostic Strategy and Clinical Reasoning, 2019
Caroline J Rodgers, Richard Harrington
Several questions can be asked to help consider a possible diagnosis of osteoarthritis: Is there a history of trauma?Have they noticed any other joint swelling? (Look for Heberden’s and Bouchard’s nodes.)Have they had pain, swelling and stiffness at the base of the thumb?If they have hip pain, do they have any factors that predispose to hip osteoarthritis (previous Perthe’s disease, leg length discrepancy, previous hip trauma)?
Predictive role of laboratory markers and clinical features for recurrent Henoch-Schönlein Purpura in childhood: A study from Turkey
Published in Modern Rheumatology, 2020
Şule Gökçe, Zafer Kurugöl, Güldane Koturoğlu, Aslı Aslan
The epidemiological and demographic data including age, gender, seasonal contact time were analyzed. Previous infections, vaccinations, and insect bites were all recorded as provided they were within two weeks prior to the first symptom. Fever was considered to be present if the temperature was >37.7 °C. Renal involvement was defined as follows: Microscopic hematuria was defined when the urine test result was > 5 erythrocytes/mm3; gross hematuria was defined when blood in the urine could be seen with the naked eye. Severe nephropathy was considered to be present when the patient had 1 of the following findings: nephrotic syndrome: defined as plasma albumin level under 25g/L and either 1g of proteinuria/d per m2 of body surface area in children, with or without the presence of edema; or acute nephritic syndrome that was defined as hematuria with at least 2 of the following features; hypertension, elevated plasma urea or creatinine serum levels, and oliguria. Rash location means purpura mainly concentrated in parts of the body. The joint involvement was described as the presence of joint swelling and/or limitation of joint movement. Gastrointestinal involvement was defined as bowel angina (characterized by the presence of diffuse abdominal pain), gastrointestinal bleeding (melena or hematochezia or the child had a positive stool Guaiac test), and nausea and vomiting in the context of the clinical duration of vasculitis. Stomachache and hematemesis also support gastrointestinal involvement.
Anti-citrullinated protein antibodies and arthritis in Sjögren’s syndrome: a systematic review and meta-analysis
Published in Scandinavian Journal of Rheumatology, 2019
N Molano-González, E Olivares-Martínez, JM Anaya, G Hernández-Molina
The characteristics of the studies (4–8, 13–17) are summarized in Tables 1 and 2. All the patients included in these studies fulfilled the American–European Consensus Group (AECG) classification criteria for pSS and none of the studies evaluated children. All the studies were performed in rheumatological referral centres, and six were from Europe (4–6, 8, 14) and four from Asia (7, 15–17). Four studies did not report the disease duration (7, 13, 14, 17); in the rest of them, it ranged from 2.4 years to 8.8 years. Half of the studies had a transversal design (4–6, 14, 15) and the rest were longitudinal (7, 8, 16, 17). Among these studies, the median time of follow-up was not mentioned, except in Iwamoto’s study (16) which had a follow-up of 1.83 ± 0.88 years. Most of the studies defined arthritis as non-erosive joint swelling (4–8, 13, 15–17); in two studies, the presence of arthritis was also evaluated by ultrasound findings in all the patients (7) or in the case of doubt after the clinical and X-ray evaluation (8).
Syringomyelia with left knee charcot arthropathy: a case report
Published in British Journal of Neurosurgery, 2020
Guihong Li, Yaonan Ding, Chaochao Zhang, Haiyan Huang
Charcot arthropathy is a chronic form of degenerative arthropathy, caused by diabetes mellitus, syringomyelia, tabes dorsalis, and other neuropathies. Painless joint swelling and limited joint mobility are the main manifestations. The joints most frequently involved are the ankles and feet in diabetes mellitus, the hips and knees in tabes dorsalis, and the shoulders and elbows in syringomyelia. Charcot arthropathy secondary to syringomyelia involving knee joint is extremely rare, with only one previous case report identified in the literature.1 Herein, we describe a case of syringomyelia with left knee Charcot arthropathy in a 35-year-old male, who presented with a dissociative sensory disorder, muscle atrophy, painless knee joint swelling and limited joint mobility.