Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0003873 (rheumatoid arthritis)
 53,068 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Flexor tenosynovitis (FT) is a common manifestation of rheumatoid arthritis (RA), contributing to hand deformity and manual dysfunction. The efficacy of intratendon sheath corticosteroids was assessed by reviewing the results of such treatment in 173 episodes of FT documented in 46 patients with definite or classic RA. Ninety-three percent of initial episodes resolved completely for 3 or more months (median: 25 months); tenosynovitis did not recur in 59%. The likelihood of a favorable response did not diminish with treatment of recurrent FT in a given digit. Comparable results were found in 52 FT episodes observed in 38 non-RA patients. No tendon sheath or soft tissue infection or tendon rupture ensued in either treatment group. The response was influenced by the specific corticosteroid preparation selected. Based on this experience, a trial of intratendon sheath corticosteroid injections prior to surgical intervention is recommended for RA patients with FT.
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PMID:Intratendon sheath corticosteroid treatment of rheumatoid arthritis-associated and idiopathic hand flexor tenosynovitis. 7 13

A 63-year-old man developed symmetrical polyarthritis, subcutaneous nodules at the elbows, olecranon bursitis, and recurrent tenosynovitis. He was later discovered to have idiopathic hemochromatosis. Staining of the subcutaneous nodule revealed iron deposits. These manifestations which are common to rheumatoid arthritis may be seen in hemochromatotic arthropathy.
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PMID:Hemochromatotic arthropathy mimicking rheumatoid arthritis. A case with subcutaneous nodules, tenosynovitis, and bursitis. 69 54

Tenosynovitis of one or more flexor tendons of the hand (mean 3.1 tendons per patient) was noted in 55% of 100 patients with rheumatoid arthritis (RA) examined periodically during a mean period of 5 years. The third flexor tendon was involved most frequently (71% of patients), followed by the second (62%), fourth (53%), fifth (27%), and first (13%). Patients with flexor tendonitis (FT) had a significantly higher prevalence of rheumatoid nodules (56% vs 33%), carpal tunnel syndrome (47% vs 13%), wrist extensor tenosynovitis (47% vs 9%), and elbow epicondylitis (22% vs 7%) than patients without FT. Dupuytren's contracture, DeQuervain's tenovaginitis, flexor carpi radialis and ulnaris tendonitis, and Achilles tendonitis were found exclusively in patients with FT. A control group of 50 non-RA patients with FT had statistically fewer diseased tendons per patient (mean 1.5) and a different digital distribution, the thumb being affected more frequently (P less than 0.05) than in RA patients.
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PMID:Hand flexor tenosynovitis in rheumatoid arthritis. Prevalence, distribution, and associated rheumatic features. 87 1

In a 42-year-old male with a 15-year history of rheumatoid arthritis, bilateral rupture of the flexor pollicis longus was associated with subluxation with radial deviation of the carpus and increased angulation of the tendon in relation to the navicular. Flexor tenosynovitis in the rheumatoid hand may present as carpal tunnel syndrome or ruptured flexor tendons. The condition is associated with invasive rheumatoid granulation tissue, vasculitis, ischemic necrosis due to compartment compression, and attrition rupture due to navicular bony protuberance.
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PMID:Flexor tendon ruptures in the rheumatoid hand: bilateral flexor pollicis longus rupture. 91 77

A follow-up study of 201 flexor tendon synovectomies of the hand in patients with rheumatoid arthritis is presented. The operations were performed from 1/2-49 years after onset of the disease, and the patients were between 16 and 76 years of age. The follow-up study is based on questionnaires and, in addition, 78% of the patients also had a physical re-examination. The follow-up time spanned 12-78 months. Nearly 70% of the operated hands were subjectively improved; the others were unchanged or worse. The poor results were often caused by progression of arthritis in finger joints. Recurrence of the tenosynovitis was observed in about 37% of the hands, but in very few to such an extent that reoperation has been necessary.
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PMID:Flexor tendon synovectomy of the hand in rheumatoid arthritis. A follow-up study of 201 operated hands. 93 21

In nineteen hands (seventy-four fingers) of eleven women and one man with rheumatoid arthritis there was restriction of active and passive motion of the proximal interphalangeal joints, with signs of flexor tenosynovitis but no clinical or roentgenographic evidence of involvement of the joint. The nineteen hands were treated by flexor tenosynovectomy (palm only in nine, palm and carpal tunnel in five, both palm and digits in four, and digit, palm, and wrist in one) combined with manipulation of the joint under regional anesthesia. After an average follow-up of twenty-one months (range, six to thirty-six months), the average range of active motion had increased from 40 to 84 degrees and the average range of passive motions, from 57 to 87 degrees. Only three patients had unsatisfactory results, one because of persistent unexplained swelling and two because of recurrence of the tenosynovitis.
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PMID:Stiffness of the proximal interphalangeal joints in rheumatoid arthritis. The role of flexor tenosynovitis. 95 26

A series of 314 wrist operations performed on 227 patients with rheumatoid arthritis is presented. In 266 hands various wrist operations were undertaken with the object of synovial debridement and in 48 hands the wrist was also arthrodesed. The mean age at the time of surgical treatment was 51 years and the mean period of observation 4.2 years. This study shows that the main benefits of synovectomy are related to a constant and marked pain relief and prevention of tendon ruptures. The hope that synovectomy might arrest or prevent skeletal destruction was not realized and progression of X-ray changes was found in 74%. The very low recurrence rate in the present series as judged by clinical signs is probably not very significant and it is concluded that the X-ray findings are the most reliable criteria reflecting the real activity in a rheumatoid joint. In several wrists where prophylactic ulnar head resection had been performed through a small ulnar incision, an active dorsal tenosynovitis with tendon invasion developed later. These and other findings at the operation indicate that the erosive effect of the distal end of the ulna is certainly not the sole cause of tendon rupture in this area and that a complete exposure and decompression of the tendons should regularly be performed. Finally, arthrodesis of the wrist was so successful that it can be highly recommended.
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PMID:Assessment of surgery of the rheumatoid wrist. 121 92

IL-1 can participate in the perpetuation of arthritis through direct stimulation of synoviocytes and augmentation of matrix degradation. Hence, local production of the IL-1R antagonist protein (IRAP) might be an important negative feedback signal that regulates synovitis. We assessed synovial IRAP production in synovia from 30 individuals, by using a specific mAb and the immunoperoxidase staining method. IRAP was detected in 11 of 12 rheumatoid arthritis (RA) synovial tissues (ST) and was located primarily in the sublining, particularly in perivascular regions enriched for macrophages. Some staining was observed in the intimal lining of the synovium, although this was significantly less than in the sublining (p less than 0.05). Nine of 12 osteoarthritis (OA) tissues were positive for IRAP. In contrast to RA, the staining was observed primarily in the synovial lining in OA, with only minimal sublining IRAP being detected. Synovia from four patients without arthritis were negative (three autopsy specimens and one post-traumatic sample). Of the other two patients with miscellaneous diagnoses, one sample was negative (tenosynovitis) and one was positive (seronegative inflammatory arthritis) (sublining). Studies of serial sections and double-immunostaining experiments indicated that macrophages are the major cells containing immunoreactive IRAP. IRAP gene expression in vivo was determined by performing in situ hybridization on ST from 17 arthritis patients. RNA sense IRAP probes did not hybridize to any tissues. Anti-sense IRAP probes bound to two of nine RA tissues, two of six OA tissues, one of one seronegative inflammatory arthropathy tissue, and none of one flexor tenosynovitis tissue. As with immunoreactive protein, IRAP mRNA was primarily localized to cells in the synovial lining in OA but was more prominent in perivascular lymphoid aggregates in RA and seronegative inflammatory arthropathy. Northern blot analysis was performed on RNA isolated from nine ST. The appropriately sized IRAP band was identified in six of nine samples (five of six RA and one of three OA). Supernatants from cultured RA and OA ST cells contained immunoreactive and biologically active IRAP. Hence, IRAP gene expression and protein production occur in RA and OA synovium, albeit in different distributions.
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PMID:IL-1 receptor antagonist protein production and gene expression in rheumatoid arthritis and osteoarthritis synovium. 138 92

Pain in the foot and ankle is most frequently secondary to static and degenerative changes, eg, corns, hammer toes, bunions, anterior metatarsalgia, and heel pain. A second common group consists of rheumatologic disorders that encompass immune and hereditary factors. This group includes rheumatoid arthritis, the often underdiagnosed seronegative spondyloarthropathies, and, less commonly, crystalline deposit disorders and diffuse connective tissue diseases. Both the physician and the public need a heightened awareness of the existence and presence of these disorders, which may be devastating, eg, psoriatic arthritis and tenosynovitis. To these groups, we now must add Lyme disease and acquired immunodeficiency syndrome. The advances in testing, including immunologic and nuclear imaging (eg, magnetic resonance imaging), have permitted more rapid and specific diagnosis with earlier treatment.
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PMID:Foot and ankle pain resulting from rheumatic conditions. 158 Nov 52

The basic principles of the determination of crystals in synovial fluid by means of the polarisation microscope are described. The presence of crystals in synovial fluid was determined in 48 patients with the following clinical diagnoses: rheumatoid arthritis, gout, pseudogout, reactive arthritis, in patients with a diagnosis of extraarticular rheumatism: peritendinitis, in patients with reactive arthritis and in 2 patients with injured knee joint. Crystals of Na urate, Ca-pyrophosphate dihydrate and cholesterol were found. The analysis of synovial fluid for the presence of crystals in an important diagnostic procedure contributing greatly to the quick and correct diagnosis of arthritis.
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PMID:[Identification of crystals in synovial fluid]. 196 21


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