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Query: UMLS:C0003873 (rheumatoid arthritis)
 53,068 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A look in the patient's mouth can give clues to his overall health. For instance, atrophic glossitis--or breakdown of the tongue's papillary structure--reveals that there may be incomplete absorption of vitamin B complex or some other nutritional deficiency. Tenderness and impaired motion in the jaw can mean any of a number of problems related to other joints of the body. Osteoarthritis is often to blame. Or the disablement may be due to rheumatoid arthritis or to sclerosis of joint surfaces. Atrophy of the alveolar bone, which progresses slowly during normal aging, is speeded up in persons with osteoporosis. Even after all teeth are gone, bone loss continues. It's likely to be excessive and uneven, and the resultant sharp ridges and spicules sometimes cause so much pain and irritation that the patient can't tolerate dentures.
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PMID:Oral signs of aging and their clinical significance. 100 1

Tenderness was assessed by point count and by scored palpation in 51 patients with human immunodeficiency virus (HIV) infection as well as 51 patients with rheumatoid arthritis (RA) and 50 patients with psoriatic arthritis (PsA). Fifteen of 51 (29%) patients with HIV infection met criteria for fibromyalgia, based on the presence of 10 tender (of 14) "fibrositic" points. Similar results were observed among patients with PsA (24%). The prevalence of fibromyalgia was higher among patients with RA (57%). Patients with HIV and PsA were less tender than patients with RA. Fibromyalgia in patients with HIV was significantly associated with myalgia and arthralgia, but not with age, duration of HIV infection, stage of HIV disease, or zidovudine therapy.
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PMID:Fibromyalgia in human immunodeficiency virus infection. 229 Jan 62

Determining the number of swollen joints and tender joints is a key component in the clinical assessment of rheumatoid arthritis (RA). There have been a series of investigations carried out in the last decade, which have defined the best ways to measure joint inflammation and have identified which joints should be evaluated. There is not complete agreement on the optimal joint count, but two approaches are widely used. These comprise counting either 66/68 or 28 joints. The main difference is that the 28-joint count excludes the joints in the feet. Both methods give similar information and are reproducible and valid. Tenderness and swelling should be measured separately. There are advantages and disadvantages associated with using the 28-joint count. It has the benefit of simplicity and takes less time, although some potentially relevant clinical information about the feet may be lost. There is general agreement that grading the severity of individual joint involvement is of limited advantage. Using weighted joint counts is also not widely accepted. Finally there is growing recognition of the need for training in the methods of assessing joints and the importance of international standardization. Joint counts are a component of the core clinical data set for RA and will continue to play a key role in the foreseeable future.
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PMID:Joint assessment in rheumatoid arthritis. 881 Jun 85

The aim of this study was to evaluate the ability of power Doppler sonography (PDS) with ultrasound contrast agent to assess the synovial perfusion changes induced by intra-articular steroid injection therapy in the knee joints of patients with rheumatoid arthritis (RA). Eighteen RA patients (16 women, 2 men) with a history and signs of active knee synovitis were studied. Tenderness was evaluated using Thompson's modified index of synovitis activity. All patients underwent joint aspiration followed by intra-articular injection of 40 mg of triamcinolone hexacetonide. Gray-scale ultrasonography and PDS with an intravenous ultrasound contrast agent (Levovist) examinations were carried out before and 3 weeks after the intra-articular steroid injection. The calculation of the time--intensity curves provided a quantitative estimation of the synovial perfusion. The median values of the index of synovitis activity decreased significantly from 7.0 (95% confidence interval (CI) 6.0-8.0) to 3.0 (95% CI 2.0-4.0) ( p<0.01) 3 weeks after the intra-articular steroid injection. All patients showed a reduction of PDS signal after intra-articular steroid therapy and the baseline and follow up median values of the area underlying time-intensity curves were 7.48 (95% CI 5.79-8.73) and 2.45 (95% CI 1.92-3.61), respectively. The comparison between baseline and follow-up median values of the area under the curves showed a statistically significant reduction of PDS findings ( p<0.01). At follow-up examinations the changes in the index score of the synovitis activity were significantly correlated to the changes in the values of the area underlying time-intensity curves ( r=0.785; p<0.01). A significant correlation was also observed between baseline values of the area underlying time-intensity curves and C-reactive protein (CRP) ( r=0.548; p=0.023). In conclusion, PDS with an intravenous ultrasound contrast agent has been shown to be able to detect changes in synovial perfusion after intra-articular steroid injection and may be an additional useful method in the evaluation of synovial inflammation and in the assessment of the therapeutic response.
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PMID:Contrast-enhanced power Doppler sonography of knee synovitis in rheumatoid arthritis: assessment of therapeutic response. 1529 87

Rheumatoid arthritis (RA) is a joint-destructive autoimmune disease. Three composite indices evaluating the same 28 joints are commonly used for the evaluation of RA activity. However, the relationship between, and the frequency of, the joint involvements are still not fully understood. Here, we obtained and analyzed 17,311 assessments for 28 joints in 1,314 patients with RA from 2005 to 2011 from electronic clinical chart templates stored in the KURAMA (Kyoto University Rheumatoid Arthritis Management Alliance) database. Affected rates for swelling and tenderness were assessed for each of the 28 joints and compared between two different sets of RA patients. Correlations of joint symptoms were analyzed for swellings and tenderness using kappa coefficient and eigen vectors by principal component analysis. As a result, we found that joint affected rates greatly varied from joint to joint both for tenderness and swelling for the two sets. Right wrist joint is the most affected joint of the 28 joints. Tenderness and swellings are well correlated in the same joints except for the shoulder joints. Patients with RA tended to demonstrate right-dominant joint involvement and joint destruction. We also found that RA synovitis could be classified into three categories of joints in the correlation analyses: large joints with wrist joints, PIP joints, and MCP joints. Clustering analysis based on distribution of synovitis revealed that patients with RA could be classified into six subgroups. We confirmed the symmetric joint involvement in RA. Our results suggested that RA synovitis can be classified into subgroups and that several different mechanisms may underlie the pathophysiology in RA synovitis.
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PMID:Three groups in the 28 joints for rheumatoid arthritis synovitis--analysis using more than 17,000 assessments in the KURAMA database. 2355 18