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Query: UMLS:C0003090 (arthrodesis)
 8,374 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Juvenile rheumatoid arthritis or, more correctly, juvenile chronic polyarthritis with its many clinical manifestations can be separated into the Still-syndrome with acute beginning, high fever and a high percentage of extra-articulalar, i.e. visceral symptoms, and the chronic polyarthritis in the more strict sense with non-visceral symptoms. The subsepsis allergica should be regarded as a subseptic first stage of the Still syndrome. The Still-syndrome implies a systemic disease mainly of the reticulo-endothelial system, with carditis, nephropathy, recurrent erythemas, and a progressing polyarthritis. Later symptoms are amyloidosis, chronic nephritis, myo- and pericarditis, and artheriitis necroticans. Predominanly the involvement of the kidneys is the reasons for the high mortality rate of 13%. Chronic polyarthritis in the strict sense is similar in children and adults, though in children rheumatic factors are rarely detected. The exsudative form of arthritis tends to cause early deterioration. Joint symptoms are distributed asymmetrically and show locally inflammed growth otherwise less common in Still-syndrome. Spondylitis cervicalis rapidly causes ankylosis. Atlanto-axial-arthritis with consequent atlanto-axial dislocation can be the reason for neurological disturbances. Juvenile mono- or oligo-arthritis often turns into polyarthritis; but for joints the prognosis is more favourable. In contrast, rheumatoid iridocyclitis as found in 22% of the cases causes unfavourable complications because symptoms are not noticed in time so that treatment is often too late. Juvenile spondylitis ankylosans begins with a peripheral arthritic stage which is not easily distinguished from chronic polyarthritis. The male sex, mono- or oligoarthritis of the outer extremities, pain in the heel, atlanto-axial-arthritis, iridocyclitis, and a positive HLA of 27 give a diagnostic clue. -- Characteristics of the therapy will be discussed.
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PMID:[Juvenile rheumatoid arthritis and related collagen diseases. Clinical aspects (author's transl)]. 1 66

The technique and instruments of PAP, Krompecher and Jaros allow a precise preparation of the femoral head, acetabulum, femoral condyles and tibial plateau in the donor and recipient for the application of homograft transplants of joint articular surfaces of 5 millimetre thickness. In the present series, specimens were preserved by freezing at 30 degrees below zero to prevent immunologic reactions in the recipient. Immunogenic control tests in 12 patients have shown that freezing at 30 degrees below zero does not eliminate antigens in the transplant. In future, therefore, it is intended to transplant only cartilage with living cells in relation to the HLA system. The problem of prevention of infection has been solved by a special antibiotic preparation of the specimen. Radiographic examination 4 years after operation shows that only two of 12 patients had an unsatisfactory result. Function in these two hip joints is, however, better than before operation although the transplant has been partly resorbed. The technique of homograft transplantation of the hip and knee joints is suitable for young or middle-aged individuals in whom the only alternative would be an arthrodesis. For older persons a joint prosthesis is preferable.
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PMID:[Homografts allogeneic of the knee and hip joints]. 13 66

Tomography of the sacroiliac joints (SIJ) was performed in 72 patients with rheumatoid arthritis (RA) and in 50 controls. Twenty-seven rheumatoid patients (38%) showed typical sacroilitis with predominantly severe intraarticular ankylosis and subchondral erosions. Fourteen patients (19%) had a probable sacroilitis with mild erosions and intraarticular ankylosis and concomitant degenerative changes. Fifteen patients (21%) showed predominantly degenerative changes and 16 RA patients (22%) had no radiological manifestation of the SIJ. There was no relation between typical sacroilitis and age of patients, duration of disease, rheumatoid factor, Steinbrocker's stage and frequency of HLA B27.
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PMID:Tomographic examinations of sacroiliac joints in adult patients with rheumatoid arthritis. 16 Apr 56

Seronegative spondyloarthritides (Reiter's syndrome, ankylosing spondylitis, or psoriatic arthritis) was diagnosed in 24 of 30 patients with severe heel pain. Most of the patients were carriers of the antigen HLA B27. Talalgia was frequently the first symptom of disease. Heel surgery is contra-indicated during the inflammation phase, since it may cause local aggravation and risk of ankylosis of the talocalcaneal articulation. Other causes of heel pain include tendon chondrocalcinosis, local tuberculous infection, and nodular tendinitis caused by a partial rupture of the tendon. On the other hand, severe talagia was rarely found in rheumatoid arthritis, and no case was related to the presence of tophi or xanthomas of the Achilles tendon.
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PMID:Talalgia. A review of 30 severe cases. 67 39

The study concerns the clinical, haematological, serological, radiological and histocompatibility antigenic status of eleven in-patients suffering from long-standing sero-positive rheumatoid arthritis at the Royal Hospital and Home for Incurables in London. The study revealed a striking degree of widespread bony ankylosis affecting the peripheral joints and cervical spine. In large part, this bony ankylosis accounted for the disability but it is considered that the cervical spine ankylosis may protect the spinal cord from damage. The absence of the histocompatability antigen HLA 27 is a useful pointer in the exclusion of Ankylosing Spondylitis. Despite the clinical impression that the disease was inactive, the elevated sedimentation rate (23-66, mean 41 mm) suggests that the rheumatoid process remains active.
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PMID:Ankylosing rheumatoid arthritis. 112 35

Rheumatoid arthritis and ankylosing spondylitis were detected in the same patient after a long period of observation of the disease. X-ray studies demonstrated the characteristic rheumatoid arthritis changes in peripheral joints. By contrast, few X-ray changes of ankylosing spondylitis were detected, during follow-up. Diagnostic approach through scintigraphic studies disclosed a symmetric uptake of the radionuclide in sacroiliac joints, and computed tomography revealed bilateral ankylosis. The combination of these tests was useful to define the presence of axial disease. This patient was both HLA B27 and DR4 positive. Rheumatoid arthritis occurred before ankylosing spondylitis, that interestingly was defined as a late onset disease.
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PMID:Rheumatoid arthritis associated with ankylosing spondylitis defined by scintigraphic and CT abnormalities. 148 55

In the seronegative spondyloarthropathies the hip lesions can be subdivided into a concentric type progressing to ankylosis and an eccentric type leading to joint destruction. Radiologic examination of the hips was performed in 177 of 211 patients suffering from seronegative spondyloarthropathies on whom ileocolonoscopy with biopsies of ileum and colon was performed; in 27 of these 177 patients, hip lesions were demonstrated. The concentric form seems to be radiologically, clinically and genetically more related to axial involvement; moreover, the frequency of subclinical gut inflammation was the same as in the group of patients with ankylosing spondylitis (AS) without peripheral arthritis, and thus significantly lower than in patients with AS with peripheral arthritis. Eccentric, destructive hip lesions seem to be unrelated to axial involvement, but they are associated with the presence of HLA-Bw62 and gut inflammation (100%), mainly of the chronic, Crohn disease-like type.
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PMID:Destructive hip lesions in seronegative spondyloarthropathies: relation to gut inflammation. 233 55

The authors report 4 cases of "Sheathing Panarthritis" (S.P.): two female patients with a positive rheumatoid serology, presented a complete ankylosis of the articular system, including the temporo-mandibular joint and the spine; two male patients presented a complete articular ankylosis of the lower extremities and a more or less total spine ankylosis, by only a slight involvement of the upper extremities. The study of the HLA system, carried out in ten cases--3 in this series--showed the presence of B27 in six cases, and the presence of A2 in five cases out of eight. A single study of locus DR revealed the presence of DR 1. On the nosological point of view, this radio-clinical picture, individualized by Forestier, was successively considered as an autonomous affection, a rheumatoid polyarthritis (P.R.), an ankylosing spondylarthritis (AS). The author's opinion is dual since, from the analysis of the cases, they do not feel that it is possible to classify all cases either with P.R. or with A.S. After studying the various radio-clinical aspects of P.R., they believe that, in patients with S.P., it exists an ankylosing "factor X" which exacerbates the ability of P.R. and A.S. to manufacture sclerosis, transforming these diseases into S.P.
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PMID:[Ankylosing panarthritis]. 358 52

Seventeen patients with Reiter's disease who were included in an earlier prospective study, were reviewed 21 years after their initial episode. Two patients had active synovitis and this correlated with the duration of the initial episode, the extent of the initial synovitis and the peak ESR. In contrast the risk of developing ankylosing spondylitis, present in five patients, was unrelated to the duration of the initial episode or the extent of the initial peripheral synovitis but was greatest in those with a higher peak ESR. A comparison of radiological features at the onset and later showed that five patients had developed bilateral sacroiliac joint fusion although two of these had some sclerosis around the sacroiliac joints at the onset. Eight patients had multifocal marginal syndesmophytes which, in four, occurred without sacroiliac changes. Plantar spur formation and hip and shoulder disease were associated with spondylitis while destructive small joint changes were a feature of Reiter's disease itself. Ten patients were HLA B27 positive. The clinical features at onset were unrelated to the B27 type. Sacroiliitis, osteitis pubis, pelvic whiskering and vertebral squaring were only present in B27 positive patients but syndesmophyte formation was unrelated to B27 type.
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PMID:The natural history of Reiter's disease--21 years of observations. 376 19

One hundred and twenty-two hospitalized patients, 35 years or more of age with confirmed bilateral sacro-iliitis and 239 first-degree relatives, 25 years or more of age, were examined. All but 3 of the patients had confirmed ankylosing spondylitis (AS) in accordance with established criteria. The sacro-iliac joints were scored by a recently developed grading system. The prevalence of grade V sacro-iliits--extensive ankylosis--was greater in HLA B27-positive than in HLA B27-negative patients, and ankylosis of apophyseal joints, ossification of the interspinous ligament, or block vertebrae were not seen in HLA B27-negative patients. Shining corners and/or squared vertebrae were the most frequent findings of the dorsolumbar spine in patients with a disease course of less than 10 years. Mixed osteophytes were rare in patients below 40 years of age. All radiographic inflammatory changes scored in the spine-except for shining corners--were most often seen in patients with a disease history exceeding 20 years. Syndesmophytes and/or ankylosed apophyseal joints were less extensive in female than in male patients. No differences in the severity of radiographic changes in sacro-iliac joints or in frequency, severity or localization of different radiographic changes of the dorsolumbar spine were observed between HLA B27-positive patients with and those without psoriasis or acute anterior uveitis. Definite sacro-iliitis was restricted to HLA B27-positive relatives of HLA B27-positive probands and demonstrated in one-fifth of them. Shining corners and/or squared vertebrae were frequent findings in relatives with sacro-iliitis (45%), whereas apophyseal joint ankylosis, ossification of the interspinous ligament, block vertebrae and bridging syndesmophytes were not seen. Our results support the view that AS is not a defined disease entity and should be regarded as a syndrome. AS is an improper name for all patients fulfilling the Rome and/or New York criteria for definite AS, since many of them will probably never develop ankylosis of the spine or sacro-iliac joints.
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PMID:Radiographic evaluation of patients with Bechterew's syndrome (ankylosing spondylitis) and their first-degree relatives. Findings in the spine and sacro-iliac joints and relations to non-radiographic findings. 387 98


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