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Thermography by Specialty
Published in James Stewart Campbell, M. Nathaniel Mead, Human Medical Thermography, 2023
James Stewart Campbell, M. Nathaniel Mead
Ankylosing Spondylitis is a systemic disease that causes inflammatory arthritis, eye inflammation (uveitis), and cardiac problems. Sacroiliitis is often the major symptom, but other joints may be involved, especially the hips, spine, and joints of the hand. Achilles and patellar tendinitis may also occur in AS.61 Many of these sites of inflammation can be detected thermographically, thus aiding in the detection, staging, and treatment of AS.62 As the sacroiliac joints are fairly deep anatomically, thermographic signs over the lumbosacral spine are rarely seen in early cases. Thermographic signs over the sacroiliac area are more likely in advanced cases.63
Clinical Aspects of Ankylosing Spondylitis
Published in Barend J. van Royen, Ben A. C. Dijkmans, Ankylosing Spondylitis Diagnosis and Management, 2006
Irene E. van der Horst-Bruinsma
Psoriatic arthritis occurs in 5% to 7% of the people with psoriasis. The psoriatic arthritis can present as a mono- or oligoarthritis, resembling the reactive arthritis pattern, or as a symmetrical polyarthritis, resembling RA, but with involvement of the DIP joints (instead of the PIP joints in RA) and without a positive rheumatoid factor. Axial disease occurs in about 5% of the psoriasis patients. Axial involvement may occur independent from peripheral arthritis and is often asymptomatic, but symptoms of inflammatory back pain or chest wall pain may be present. Sacroiliitis is observed in one-third of the patients and frequently asymmetric. Spondylitis may occur without sacroiliitis and may result in fusion of the spine. Enthesitis is common, especially in the oligoarticular form of the disease. The radiographic features of the spine in case of psoriatic spondylitis show more or less random syndesmophyte formation, whereas in AS, syndesmophytes form in a more ascending fashion (133).
Can it be osteoarticular involvement in the brucellosis?
Published in The Aging Male, 2023
Hasan Tahsin Gozdas, Tayibe Bal
As a famous zoonosis, brucellosis may affect every organ and system in the body. The most common involvement of the brucellosis is osteoarticular involvement [2]. Sacroiliitis and lumbar spondilodiscitis are the most common forms of osteoarticular involvement which usually present as lower back pain [3]. Their patient suffered from low back pain and arthralgia. In clinical examination, he also had local tenderness at the low lumbar region. Brucellosis was diagnosed in this patient, however it is not clear in the manuscript whether osteoarticular involvement was available or not. We think that this point is important, because triple antibiotics for at least 12 weeks were found to be more effective in the treatment of osteoarticular brucellosis as per the recommendations of WHO [4]. However, their patient was treated with dual antibiotics for 6 weeks.
Bilateral sacroiliitis following group C streptococcal sepsis
Published in Baylor University Medical Center Proceedings, 2022
Sanjeev Shrestha, Eva Rottmann, Prakash Kharel, Francis Lim, David Henry Bulbin
She presented the following month to the emergency department with back pain and polyarthritis in the setting of fever (38°C); no obvious effusion was found on the exam or in bedside ultrasound, and no new signs of cellulitis were seen on skin exam. Her laboratory work was significant for a leucocyte count of 12.91 K/μL; C-reactive protein of 108 mg/L; alanine transaminase of 56 U/L with otherwise normal liver function; erythrocyte sedimentation rate of 72 mm/h; blood cultures without any growth; urinalysis with moderate bacteriuria without any symptoms; and urine cultures without any growth. Chest x-ray showed increased interstitial markings without any focal signs of infection. X-ray of the back showed possible findings of sacroiliitis. Differentials were reconsidered for reactive arthritis, psoriatic arthritis, and ankylosing spondylitis. Magnetic resonance imaging (Figure 1b) showed erosive changes along the anteroinferior aspect of the sacroiliac joints with evidence of synovitis bilaterally, consistent with sacroiliitis. She was started on a methylprednisolone taper and infliximab infusion. At 3-month follow-up in the outpatient rheumatology clinic, her symptoms were well controlled. Methotrexate was added to prevent chimeric antibody development.
Choosing the most appropriate biologic therapy for Crohn’s disease according to concomitant extra-intestinal manifestations, comorbidities, or physiologic conditions
Published in Expert Opinion on Biological Therapy, 2020
Ciro Romano, Sergio Esposito, Roberta Ferrara, Giovanna Cuomo
Axial involvement, suggested by persistent inflammatory back pain, is underlain by sacroiliitis. Five to 20% of CD patients may suffer from axial spondylarthritis. Magnetic resonance imaging is the diagnostic tool of choice to reveal inflammation of one or both sacroiliac joints, even before sequelae of sacroiliitis become apparent on conventional radiology. Like polyarticular peripheral arthritis, axial involvement runs an independent course from that of CD, thus possibly predating CD and needing exclusive treatment. Finally, axial and peripheral joint involvement may coexist in 3–6% of CD patients [2,7]. The correct recognition of the pattern of articular involvement, along with the assessment of CD activity, is paramount in order to implement the most appropriate biologic treatment [8]. Since guidelines for treatment of CD and spondylarthritis are separately available [9–11], close collaboration between gastroenterologists and rheumatologists is crucial in order to ensure optimal management of combined conditions. In general, judicious application of guidelines, based on recognition of the prevalently active disease and the type of biologic agents suitable for treatment of both conditions, is usually advised.