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

Radial nerve compression palsies at the elbow and forearm result in a lower radial nerve palsy whose clinical data are generally a hardly diagnosed dissociated radial palsy, or a rough paresis in the range of epicondylalgia. Apparently spontaneous non traumatic compressions are rare. They are essentially due to lipomas, to fibromas, or sometimes to synovial cysts of the elbow. In the course of rheumatoid arthritis, palsies must be isolated. Besides, there is an actual inflammatory canal syndrome of epicondylalgias range, in which radial nerve paresis must be investigated. Traumatic compressions are essentially due to Mongeggia fractures. Radial nerve injury at the elbow is explained by a real radial canal being, in which the nerve is entrapped and where it is especially fixed on a level of its entering the supinator brevis. Any addition of a pathological element in that area (traumatic or not, tumoral or inflammatory) will be able to involve a compression and a nerve stretching, on a level of the arch of Frohse, essentially. Surgical treatment in non traumatic compressions enables to give the etiological diagnosis and to warrant healing by opening the radial canal excising the added pathological element. To achieve a total surgical operation, in epicondylalgias, the surgeons will have to open this radial canal, as well. Traumatic compressions will be explored only in cases of non spontaneous recovery, after treating the osteoarticular injury.
 ...
PMID:[Entrapment neuropathies of the posterior interosseous nerve. Clinical findings and surgical treatment (author's transl)]. 55 86

Fifteen cases of herpes zoster with lower motor neurone paresis involving the upper and lower limbs are reviewed. Five patients had an underlying disease--three had rheumatoid arthritis, two of whom were on prednisolone; one had chronic lymphatic leukaemia and one lymphosarcoma. Details are given of the time relationship between onset of pain, the appearance of the skin eruption and the later muscle weakness. Electromyographic evidence was available in 12 patients. The difficulty of assessing the muscle power in the presence of severe pain is discussed. Prognosis was generally very good; 11 patients recovered fully, three improved and one was unchanged after 5 months, when he died of lymphosarcoma. One patient was lost to follow-up at 5 months but was improving at the time.
 ...
PMID:Herpes zoster and lower motor neurone paresis. 58 57

Twenty-three elbows in 17 rheumatoid arthritis patients have undergone unconstrained Souter-Strathclyde elbow replacements since March 1984. One patient developed a deep-wound infection, and 4 others had a temporary ulnar nerve paresis. At follow-up 3 (0.5-6) years postoperatively, there was a moderate improvement in the arc of movements: 25 degrees in extension-flexion and 45 degrees in forearm rotation. Pain relief was achieved in 20 cases. Three elbows required revision, two following recurrent dislocation and the other after a humeral fracture and component loosening.
 ...
PMID:Souter-Strathclyde arthroplasty of the rheumatoid elbow. 23 cases followed for 3 years. 200 87

This study presents particular clinical manifestations in 7 patients with autoiMmune diseases: rheumatoid purpura with right crural nerve paresis (1 case), Stevens-Johnson syndrome with encephalomyeloradicular syndrome (1 case) and left Wallenberg syndrome (1 case), rheumatoid arthritis with right parieto-occipital syndrome (1 case) and Gowers local panatrophy (1 case), systemic lupus erythematosus with confusional state and meningeal syndrome (1 case) and left ictal hemiplegia (1 case). The importance of neurological clinical manifestations at the onset or during the evolution of the autoimmune diseases is emphasized.
 ...
PMID:Particular neurological aspects in vascular autoimmune diseases. I. Rheumatoid purpura, Stevens-Johnson syndrome, rheumatoid arthritis and systemic lupus erythematosus. 260 78

The clinical picture, radiological findings and treatment of 22 patients with atlantoaxial subluxation and rheumatoid arthritis are described. This lesion, untreated, may result in damage to the spinal cord, paresis or sudden death. Occipital headache, present in 13 of 22 patients, was often aggravated by working with the head in forward flexion. Paresthesias were present in six patients. The spine of the axis was often prominent. In three patients there was objective evidence of cord compression with sensory and/or pyramidal signs. In eight the lesion was asymptomatic and discovered by routine lateral radiography in flexion, the position of maximum subluxation.Conservative treatment involved the continuous use of a cervical collar to limit neck flexion. This usually relieved subjective symptoms including headaches. Successful surgical fixation was performed in two individuals. Surgical indications included acute or chronic cord compression or severe symptoms unrelieved by a collar.
 ...
PMID:Rheumatoid arthritis--atlanto-axial subluxation and its clinical presentation. 590 20

Four patients aged 41 to 73 years, who had had rheumatoid arthritis for eight to 25 years, had signs and symptoms of cervical myelopathy and radiculopathy due to either atlantoaxial dislocation with herniation of the odontoid through the foramen magnum, or subluxation of the middle to lower cervical vertebrae. Spastic paraparesis or quadriparesis, severe nuchal immobility and pain, and flaccid paresis of the upper limbs necessitated anterior medullary decompression and posterior cervical fusion. Postmortem examination disclosed old ischemic necrosis, atrophy, and gliosis in the low medulla and cervical cord. Anterior and posterior gray horns and contiguous posterior and lateral funiculi bore the brunt of the damage. Ascending and descending wallerian degeneration and atrophy of the cervical nerve root were evident. In three cases, anterior spinal or radicular arteries demonstrated intimal fibrosis with moderate stenosis; two cases depicted chronic phlebitis or subarachnoid vessels. Previous reports have infrequently provided evidence of a vasculopathy.
 ...
PMID:Cervical myelopathy due to atlantoaxial and subaxial subluxation in rheumatoid arthritis. 668 27

Cervicomedullary compression (CMC) from traumatic, infectious, or congenital processes of the atlanto-axial joint is a known cause of vocal cord immobility. Cervicomedullary compression can also occur from destructive arthritic changes and inflammatory pannus formation at the occipito-atlanto-axial joint in patients with rheumatoid arthritis (RA). We present findings suggesting that CMC in patients with RA is an unrecognized cause of vocal cord immobility. Previously, vocal cord immobility in patients with RA has been assumed to be cricoarytenoid arthritis with joint fixation. We report 3 patients with RA and radiographically demonstrated CMC with vocal cord immobility. One patient had bilateral vocal cord immobility and airway obstruction; 2 patients had unilateral cord paralysis and contralateral paresis without airway compromise. All patients had myelopathy and neck pain in addition to brain stem symptoms. All patients underwent transoral-transpharyngeal decompression of the anterior craniocervical junction with subsequent posterior fusion. These patients demonstrated full return of vocal cord function within 3 months of decompression. We propose that CMC is a cause of vocal cord paralysis in patients with RA that may go unrecognized without appropriate imaging studies of the skull base and physician awareness of symptoms of occipito-atlanto-axial subluxation and/or basilar invagination with brain stem compression. Our results demonstrate that CMC in RA is a potentially reversible cause of vocal cord paralysis.
 ...
PMID:Cervicomedullary compression: an unrecognized cause of vocal cord paralysis in rheumatoid arthritis. 963 55

Orbital myositis implies orbital inflammation confined to one or more of the extraocular muscles. The acute form responds well to high doses of oral corticosteroids tapered gradually, but it may recur or become chronic. We describe a 38 years old female who has been suffering from rheumatoid arthritis for six years. She developed diplopia as a result of a paralysis of the right and left rectus medialis muscle. MRI showed inflammatory process and thickness of the referred muscles. The patient had a total recovery with oral use of 80 mg methylprednisolone daily. Two months after the first episode she developed a bilateral ophthalmoplegy. The patient improved with oral use of steroids the second time, but a paresis of the left rectus lateralis muscle remained. From the 156 cases we reviewed only three have been related to rheumatic diseases and none has been previously related to rheumatoid arthritis.
 ...
PMID:Orbital myositis and rheumatoid arthritis: case report. 1077 Aug 85

Today, posterior stabilization of the cervical spine is most frequently performed by lateral mass screws or spinous process wiring. These techniques do not always provide sufficient stability, and anterior fusion procedures are added secondarily. Recently, transpedicular screw fixation of the cervical spine has been introduced to provide a one-stage stable posterior fixation. The aim of the present prospective study is to examine if cervical pedicle screw fixation can be done by low risk and to identify potential risk factors associated with this technique. All patients stabilized by cervical transpedicular screw fixation between 1999 and 2002 were included. Cervical disorders included multisegmental degenerative instability with cervical myelopathy in 16 patients, segmental instability caused by rheumatoid arthritis in three, trauma in five and instability caused by infection in two patients. In most cases additional decompression of the spinal cord and bone graft placement were performed. Pre-operative and post-operative CT-scans (2-mm cuts) and plain X-rays served to determine changes in alignment and the position of the screws. Clinical outcome was assessed in all cases. Ninety-four cervical pedicle screws were implanted in 26 patients, most frequently at the C3 (26 screws) and C4 levels (19 screws). Radiologically 66 screws (70%) were placed correctly (maximal breach 1 mm) whereas 20 screws (21%) were misplaced with reduction of mechanical strength, slight narrowing of the vertebral artery canal (<25%) or the lateral recess without compression of neural structures. However, these misplacements were asymptomatic in all cases. Another eight screws (9%) had a critical breach. Four of them showed a narrowing of the vertebral artery canal of more then 25%, in all cases without vascular problems. Three screws passed through the intervertebral foramen, causing temporary paresis in one case and a new sensory loss in another. In the latter patient revision surgery was performed. The screw was loosened and had to be corrected. The only statistically significant risk factor was the level of surgery: all critical breaches were seen from C3 to C5. Percutaneous application of the screws reduced the risk for misplacement, although this finding was not statistically significant. There was also a remarkable learning curve. Instrumentation with cervical transpedicular screws results in very stable fixation. However, with the use of new techniques like percutaneous screw application or computerized image guidance there remains a risk for damaging nerve roots or the vertebral artery. This technique should be reserved for highly selected patients with clear indications and to highly experienced spine surgeons.
 ...
PMID:Complications of transpedicular screw fixation in the cervical spine. 1591 52

Spontaneous vertebral artery dissection is a condition that can have lethal consequences. The condition should be considered in young male patients who present with a stroke. At presentation, headaches, cerebral ischaemic episodes and oculosympathetic paresis are the most commonly encountered manifestations. The diagnosis is confirmed with angiography. Here, we present a middle-aged male gardener with rheumatoid arthritis and signs of vertebral artery dissection to highlight the importance of diagnosis and discuss the controversies in management.
 ...
PMID:Reversible visual loss in a patient with rheumatoid arthritis and the role of vascular imaging. 1637 48


1 2 Next >>