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Tendinopathy
Published in Kohlstadt Ingrid, Cintron Kenneth, Metabolic Therapies in Orthopedics, Second Edition, 2018
Enthesopathy conditions like reactive arthritis and ankylosing spondylopathy can predispose to tendinopathy because of the enthesis inflammation in these conditions. This would be suspected with tendon pain at multiple locations with or without sacroiliac or other joint area pain. If this is suspected, a clinician should order blood work to evaluate an autoimmune inflammatory condition.
Chapter Six
Published in Eugene Fukumoto, Advanced ICD-10 for Physicians Including Worker’s Compensation and Personal Injury, 2017
Any abnormalities of the muscles, ligaments, and bones or injury can cause neck pain and stiffness. Conditions that can cause neck pain may include the following:Fibromyalgia M79.7Spondylosis with myelopathy cervical M47.12Spondylosis with radiculopathy, cervical region M47.22Cervical disc disorder with radiculopathy M50.1-Unspecified inflammatory spondylopathy, cervicothoracic M46.93Spinal stenosis, cervical region M48.02Strain of muscle, fascia and tendon at neck level S16.1-Other specified injuries of other specified part of neck S19.89-
Seronegative arthropathies
Published in Rajan Madhok, Hilary Capell, The Year in Rheumatic Disorders Volume 4, 2004
INTERPRETATION. Previous studies and those reported above have clearly shown efficacy for etanercept in AS. Two patients with HLA B27, Crohn's spondylopathy are described. One male patient with a 10-year history of Crohn's followed by onset of inflammatory spondylarthritis received etanercept 25 mg twice weekly. Ten weeks after commencing therapy, he exhibited rapid improvement in articular symptoms, but thereafter developed progressive onset of bowel disease (quiescent prior to this), accompanied by elevation of acute phase response. At 6 months, whereas musculoskeletal symptoms were settled, gastrointestinal symptomatology remained highly active. MRI scanning at outset and completion confirmed the remission of articular signs. A second male with juvenile onset AS developed iritis, psoriasis and, finally, Crohn's disease subsequent to articular disease onset. Commencement of etanercept induced prompt suppression of articular symptoms and signs with no effect noted on gastrointestinal disease up to 6 months.
Laser immunotherapy for cutaneous squamous cell carcinoma with optimal thermal effects to enhance tumour immunogenicity
Published in International Journal of Hyperthermia, 2018
Min Luo, Lei Shi, Fuhe Zhang, Feifan Zhou, Linglin Zhang, Bo Wang, Peiru Wang, Yunfeng Zhang, Haiyan Zhang, Degang Yang, Guolong Zhang, Wei R. Chen, Xiuli Wang
A 63-year-old woman presented with previously untreated bleeding ulcer on the right elbow came to our hospital. The patient suffered 30 years ago from neck pain and numbness of the right upper extremity. The patient was diagnosed as cervical spondylopathy and treated with a surgery. One year after the surgery, the numbness of right upper extremity became more serious due to damage of the nerve with cervical spondylopathy. The skin on her right upper extremity, especially her right forearm, became pale with a low skin temperature. Gradually, her right elbow developed a bleeding ulcer. In the past 30 years, the lesion grew larger and larger without any improvements on bleeding or ulceration. In April of 2014, the patient came to our hospital. Clinical investigation showed a ulcer of about 6 × 9 cm on her right elbow, accompanied with oozing, bleeding and multiple nodules covered by crust. The skin surrounding the ulcer was pale with a low skin temperature. The right elbow joint suffered from stiffness and loss of motion. A blood routine test showed her haemoglobin was only 53 g/l. A biopsy revealed the diagnosis of skin squamous cell carcinoma, grade I. The patient refused surgical excision in consideration of the large area of the ulcer. We treated the patient with laser immunotherapy after a consent form was signed in June 2014.
Clinical trial on tinnitus patients with normal to mild hearing loss: broad band noise and mixed pure tones sound therapy
Published in Acta Oto-Laryngologica, 2019
Ying Li, Guodong Feng, Haiyan Wu, Zhiqiang Gao
For the total sample, age ranged between 26 and 65 years, and one half (50%) of the patients were female. The mean age was 45 years old (49 years old in group A, range: 26–65 years old; 41 years old in group B, range: 26–64 years old). Table 1 shows the demographic and clinical characteristics for each group. Most of the patients were right-handed in all endeavors, and 64% of the patients may have had a family history of tinnitus. All patients had a long history of tinnitus. Nine patients perceived unilateral tinnitus, and 17 patients perceived bilateral tinnitus; only two patients experienced tinnitus cranii. The mean tinnitus duration was 4.75 years (range: 0.5–32 years; 2.9 years in group A, range: 0.5–20 years; 6.6 years in group B, range: 0.5–32 years). The results of an independent samples t-test about tinnitus duration show that there is no significant differences (p>.05) between groups A and B (t = 1.137, p= .266). The onset-related events of tinnitus were uncertain. A total of 82% of the patients considered their tinnitus to be a high-pitched tone, and 93% of all patients reported experiencing a continuous tone. Additionally, 14% of them had not experienced any treatment; the other 86% of them had undergone some form of therapy (e.g. medicine, acupuncture) for their tinnitus, but with no effect. When asked whether loud noise or sound made their tinnitus worse, 4% of the patients said loud noise exacerbated their tinnitus, while 89% of the patients said that loud noise could alleviate it. No patients wore hearing aids. Twenty-nine percent of the patients suffered from cervical spondylopathy. All patients underwent the pure-tone audiometry; their hearing loss ranged between 0 and 38 dB, and the mean hearing threshold at 500, 1000 and 2000 Hz was 20 dB HL. The data showed that there was no significant effect between the two groups on hearing thresholds of the pure-tone audiograms at different frequencies respectively (250 Hz, p = 1.000; 500 Hz, p = .696; 1000 Hz, p = .136; 2000 Hz, p = .305; 4000 Hz, p = .178; 8000 Hz, p = .367). All patients had normal middle ear function. The tinnitus pitch and loudness matching is provided in Figure 2.
Pharmacotherapy for juvenile spondyloarthritis: an overview of the available therapies
Published in Expert Opinion on Pharmacotherapy, 2020
Achille Marino, Mirian De Souza, Teresa Giani, Rolando Cimaz
The current criteria proposed by the International League of Associations for Rheumatology (ILAR) do not specifically classify children with juvenile onset of SpA (JSpA) [2]. Indeed, JSpA encompasses several categories of inflammatory arthritis: enthesitis-related arthritis (ERA), juvenile psoriatic arthritis (PsA) (especially the late onset), undifferentiated arthritis (UA), reactive arthritis (ReA), and the arthropathies associated with inflammatory bowel disease (IBD-A). The axial spondylopathy, therefore, is not contemplated as a distinct entity, as occurs in the classification criteria of adult spondyloarthropathies [1]. The lack of specific criteria for JSpA in the ILAR classification has led several authors to use the adult classification criteria provided by the European SpA Study Group (ESSG) [3]. In this classification, the mandatory presence of inflammatory spinal pain or synovitis (asymmetric or predominantly in the lower limbs) has to be associated with at least one of the followings: positive family history, psoriasis, inflammatory bowel disease, urethritis or acute diarrhea, alternating buttock pain, enthesopathy, or sacroiliitis as determined from radiography of the pelvic region. The ESSG classification reflects the comprehensive and polymorphic nature of SpA and may be useful also for adolescents and for young adults frequently seen by the pediatric rheumatologist; on the other hand, the inflammatory back pain, despite not strictly required, is one of the key features of ESSG classification and it is rarely seen in young patients. The EESG criteria have been demonstrated to be useful also for children with SpA and are used by some clinicians [4,5]. More recently, the Assessment of SpondyloArthritis International Society (ASAS) provided two sets of classification criteria for axial and peripheral SpA, respectively, [6,7]. The major innovations are represented by the new definition of inflammatory back pain with an age limit and the pre-radiographic identification of sacroiliitis through magnetic resonance imaging. The latter innovation of ASAS classification stresses the importance of an early diagnosis with the consequent therapeutic implications. In children with SpA the application of the peripheral rather than axial criteria should be advisable; however, the ILAR classification remains the most frequently used for inflammatory arthritis in children [8].