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Rheumatic Disease
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Joint pain is a feature of most rheumatic diseases, but these disorders may present in different guises with other symptoms to a variety of specialist clinics ranging from dermatology to genitourinary medicine. The last two decades have seen a revolution with the discovery and application of monoclonal antibodies. All patients with inflammatory arthritis can now expect that treatment will put their disease into remission.
Induction and Regulation of Arthritis by T Cell-Derived Collagen Binding Proteins
Published in Thomas F. Kresina, Monoclonal Antibodies, Cytokines, and Arthritis, 2020
The intent of this chapter is not simply to provide coverage of totally accepted areas but to delineate recent information, much of which is preliminary and require further scientific scrutiny. Thus, the goal of this review is to pinpoint promising new insights for which additional investigative work could lead to major therapeutic breakthroughs for patients with inflammatory arthritis. Only a highly condensed reference list is included since reviews of TABM (1,2) and autoimmunity to collagen (3–6) have recently appeared.
Musculoskeletal system
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
Bone or joint pain without trauma may have many causes and initial clinical (and if appropriate serological) assessment should direct the need for imaging. If there are no clues, plain radiography of the affected area may reveal pathology that will then drive further investigation. For example, if the patient presents with pain in a long bone, radiographs of the area may reveal a stress fracture that can be treated accordingly, or might reveal a bone tumour requiring MRI and possibly CT or technetium bone scan for full characterisation and staging. If plain X-ray images of painful joints show degenerative disease no further tests may be needed, unless CT is required for surgical planning of an arthroplasty (see above). If inflammatory arthritis is suggested on plain radiographs, further blood tests may be indicated and further imaging could include ultrasound and/or MRI to assess the articular cartilage and synovium. As stated, the imaging strategy must be dictated by clinical features.
The increased risk of atrial fibrillation in inflammatory arthritis: a systematic review and meta-analysis of cohort studies
Published in Immunological Investigations, 2022
Yubo Ma, Zhipeng Pan, Dazhi Fan, Shanshan Xu, Faming Pan
Joint inflammation is found in several diseases, with the most common being rheumatoid arthritis (RA) and spondyloarthritis (SpA), including ankylosing spondylitis (AS), psoriatic arthritis (PsA), reactive arthritis, and undifferentiated spondyloarthritis (uSpA). Although the clinical manifestations of these diseases differ, they share systematic inflammatory pathology that affects multi-organs. In addition to the joint destruction, active inflammation also leads to the release of inflammatory cytokines into the circulation. The concentrated cytokines and immune cells could induce systematic immune and inflammation responses in numerous tissues and organs. In patients with inflammatory arthritis, the concentrations of inflammation biomarkers like C-reactive protein are associated with increased risk of cardiovascular events. Recently, studies indicate that patients with inflammatory arthritis are associated with an increased risk of AF and contributed to the morbidity and mortality (Baek et al. 2016; Bengtsson et al. 2018; Lazzerini et al. 2017; Lindhardsen et al. 2012). For instance, one meta-analysis including three cohorts has reported the increased risk of AF in patients with RA (Ungprasert et al. 2017). However, systematic review and meta-analysis focusing on the AF risk in patients with inflammatory arthritis, including SpA and RA, is still devoid. Therefore, we conducted this study to estimate the risk of AF in patients with inflammatory arthritis.
The role of dietary antioxidant index and index of nutritional quality in MS onset: finding from an Iranian population-based incident case–control study
Published in Nutritional Neuroscience, 2022
Ibrahim Abdollahpour, Saharnaz Nedjat, Yahya Salimi, Mohammad Ali Mansournia, Farhad Vahid, Bianca Weinstock-Guttman
Evidence suggests a promising treatment role for antioxidants in prevention and treatment of a number of diseases including cancer and cardio vascular diseases (CVD) [38]. Dietary antioxidants could play a role in decreasing the oxidative stress related to inflammatory arthritis [39]. It also might reverse a number of age-related immune deficiencies [40]. Moreover, a substantial role has been demonstrated for the oxidative stress in the pathogenesis of autoimmune rheumatic diseases [41] and autoimmune skin disease [42]. In a matched case–control study, an antioxidant deficiency as well as a significant increase in oxidative stress measures was demonstrated in blood of MS patients [43]. Socha et al. demonstrated that total antioxidant status in patients with relapsing-remitting MS was significantly lower compared with healthy volunteer [44]. In contrast, dietary intake of antioxidants was not significantly different between MS patients and controls in another matched case–control study [45].
HR-pQCT in vivo imaging of periarticular bone changes in chronic inflammatory diseases: Data from acquisition to impact on treatment indications
Published in Modern Rheumatology, 2021
Camille P. Figueiredo, Mariana O. Perez, Lucas Peixoto Sales, Georg Schett, Rosa M. R. Pereira
Chronic inflammatory arthritis is associated with substantial bone damage. For instance, RA is characterized by chronic inflammation of the synovial membrane that leads to destruction of periarticular bone and impaired joint function [48–50], as evidenced by bone erosions, periarticular osteopenia, and generalized osteoporosis [51]. RA is also appreciated as an independent risk factor of secondary osteoporosis [52,53]. In RA, there is substantial interest in using sensitive imaging tools to diagnose structural bone damage and monitor the progression of structural bone damage during anti-rheumatic treatment [54,55]. Conventional radiographs are considered the gold standard for detection of bone erosions in daily clinic practice, but they have limitations in detecting small erosions, as well as to characterize the nature and extent of bone damage in RA [56,57]. Other imaging methods, such as ultrasound and magnetic resonance imaging are used in RA, however mainly emphasizing on the detection of inflammatory lesions [58] while having limitations to visualize bone [59,60]. Stach et al. first applied HR-pQCT in RA patients [30] and visualized bone erosions in metacarpophalangeal (MCP) joints with great accuracy and in three dimensions. Shortly thereafter, Fouque-Aubert et al. assessed hand bone loss by HR-pQCT in RA patients, evaluating vBMD and microarchitecture [33].