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)

We reported a 64-year-old man who had malignant rheumatoid arthritis (MRA) and developed subacute myelopathy and peripheral neuropathy. He had suffered from seropositive rheumatoid arthritis for 4 years, and developed weakness of four limbs, dysuria and constipation two months before the admission. Neurological examination revealed the diffuse muscle wasting and weakness in four limbs. Deep tendon reflexes were hyperactive in four limbs, but not in jaw jerk. Babinski sign was positive bilaterally. Deep sensation was decreased in four limbs and superficial sensation was decreased below the neck. Dysuria and constipation were noted, but anal and bulbocavernosus reflexes were present. On laboratory examination, RF and RAHA increased markedly. Serum complements decreased and immune complexes were positive. Nerve conduction study demonstrated multiple entrapment neuropathy in addition to mononeuritis multiplex. Histological examination of the biopsied sural nerve disclosed the obliterating endarteritis in the epineurium, and marked decrease in number of myelinated fibers. No compressive lesions were seen in the spinal canal by spine X-ray and MRI. Assuming that inflammatory process induced cervical myelopathy, corticosteroid therapy (predonisolone 60 mg/day) was administered and alleviated neurological symptoms, in accordance with the improvement of serological abnormalities. Therefore, an inflammatory process associated with MRA was supposed to damage the spinal cord as well as peripheral nerves in the present case.
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PMID:[A case of malignant rheumatoid arthritis with corticosteroid-reactive subacute myelopathy and multiple peripheral neuropathy]. 133 27

To obtain functional studies of the cervical spine, a device has been developed which allows MRI examinations to be carried out in five different degrees of flexion. T1 and T2* weighted FFE sequences were used. Dynamic functional MRI was performed on 5 normals and 31 patients (5 disc herniation, 4 whiplash injuries, 6 spinal canal stenoses, 14 laminectomies and spinal fusions, 2 rheumatoid arthritis). The relationship of the spinal cord to the bony and ligamentous components in different degrees of flexion was particularly well shown in whiplash injury, spinal stenosis and postoperative situations.
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PMID:[Dynamic functional MRT of the cervical spine]. 139 15

A 69-year-old-female with a history of rheumatoid arthritis since 1975 had suffered from dysesthesia of extremities since October 1989. Radiating pain and weakness occurred when she tried to stand up on Dec. 25 in 1989. She was admitted to our hospital in October 1990. Physical examination showed emaciation, hypesthesia of extremities, hypesthesia over the right chest and back, impaired vibration and position sense, and hyperreflexia. Laboratory findings revealed that the erythrocyte sedimentation rate was elevated to 46mm/hr, rheumatoid factor (RF) to 83.1IU/ml and CRP to 3.7mg/dl. Her blood sugar was high and she was diagnosed as having diabetes mellitus. Cervical X ray film showed atlanto-axial subluxation. A pseudotumor around the odontoid process bulging into the spinal canal and compression of the upper cervical cord was observed by MRI. In spite of administration of bucillamine (100mg/day), the size of pseudotumor did not change. Methotrexate (MTX) at a dose of 5mg/week was started in February 1991 and the pseudotumor decreased in size with a concurrent reduction of ESR, RF and CRP. However, the high intensity lesion by T2 weighed image did not change and dysesthesia persisted. The pseudotumor was thought to be due to pannus and it was revealed that MTX was effective for reduction. The persistent dysesthesia was probably due to the degeneration of the upper cervical cord, although diabetic neuropathy may also have played a role.
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PMID:[A case of rheumatoid arthritis complicated with pseudotumor around odontoid process successfully treated by methotrexate]. 144 85

Modern diagnostic techniques for rheumatoid arthritis include x-ray examination, arthro- or myelography, CT scan, scintigraphy, thermography, ultrasonography, and MRI. X-ray is the simplest and most common method for assessing the degree of joint destruction. Arthrography provides information on intra-articular pathology. CT is particularly of value in visualizing changes in the axial skeleton. Joint scintigraphy, using 99m-technetium pertechnetate, is available in evaluating the degree of synovial inflammation. Thermography has been performed for a similar purpose. Ultrasound allows a real-time, dynamic study of soft tissues in and around the joint, including tendons, synovium and articular cartilage. MRI most clearly shows various pathological conditions such as pannus, degenerated cartilage or spinal cord compression, although the examination time should be shortened.
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PMID:[Imaging modalities of rheumatoid arthritis]. 158 35

This study is a comparison of the cervical spine MR images from 26 patients with rheumatoid arthritis of the cervical spine with those from an age and sex matched group suffering from cervical spondylosis. Erosion of bone and major atlanto-axial subluxation were confined to rheumatoid arthritis. Soft tissue changes revealed by MRI included distortion of normal ligaments and bursae around the dens, particularly in rheumatoid arthritis. Abnormal masses of soft tissue were found in both groups, but those suggesting acute inflammation were much more frequent in rheumatoid arthritis than in cervical spondylosis. Neural compression was well demonstrated, and in rheumatoid arthritis was usually caused by bony structures whereas in cervical spondylosis it was usually due to disc material. It is concluded that MRI should be used as the first investigation to follow plain films in rheumatoid arthritis of the cervical spine. Bone and soft tissue changes are clearly shown, but interpretation of the images requires the recognition that some observed abnormalities may be due to coincidental cervical spondylosis.
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PMID:MRI of the cervical spine: rheumatoid arthritis compared with cervical spondylosis. 188 88

Thirty-four selected patients were evaluated in order to define MRI capabilities in the preoperative evaluation and characterization of the pathogenetic patterns of carpal tunnel syndrome (CTS). MRI examinations were performed by means of a superconductive unit (1.0 T, Magnetom): SE T1 (500/17) and T2 (2000/90) axial images of the carpal region were obtained with a round surface coil. In 8 patients 3D GE (FLASH) pulse sequences were used to obtain 32 images of the hand; 3D reconstruction was also applied. Six patients with rheumatoid arthritis and amyloidosis were also studied after i.v. injection of Gd-DTPA (0.2 mM/kg). MRI findings were compared with both clinico-electrophysiologic and surgical results. High agreement was observed only between MRI and surgical findings. MRI allowed the direct demonstration of carpal tunnel abnormalities in 8 cases, while abnormal findings in the median nerve were observed in 18 patients. The possibility of depicting medial nerve lesions on T2-weighted images when no direct demonstration of the cause of compression is possible, could represent a guideline for the etiopathogenetic investigation of CTS. However, further experience in selected patients is necessary to define all the aspects relative to this very common syndrome.
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PMID:[Magnetic resonance in the tunnel carpal syndrome. Possibilities and perspectives of an etiopathogenetic study]. 189 78

Seven rheumatoid arthritis patients with involvement of the upper cervical spine were evaluated with a dynamic MRI study. Lateral T1 weighted images of the upper C-spine were obtained in the flexion, extension, and neutral positions. The indications for performing the dynamic MRI were radiographic instability of the upper C-spine, myelopathy, superior migration of the odontoid process, obliteration of bony landmarks on plain radiographs, and to determine the contribution of pannus on cord configuration. The dynamic MRI clearly delineated the relationship between the odontoid, foramen magnum, and cervical spinal cord as the neck was moved through a range of motion. This aided in the selection of operative candidates in four cases, and was instrumental in determining fusion levels. In three cases with suspected myelopathy secondary to cord impingement, MRI showed no significant cord compression, and aided in the decision to treat the patients conservatively. Lateral flexion-extension MRI is the diagnostic study of choice in dynamically evaluating the upper rheumatoid C-spine.
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PMID:Flexion-extension MRI of the upper rheumatoid cervical spine. 194 61

The purpose of this study was to evaluate MRI diagnostic accuracy in rheumatoid arthritis (RA), to compare MRI and radiological findings and to correlate these findings with the clinical and serological profile of the disease. The hands of 24 patients (20 females, 4 males) affected with typical RA (ARA criteria) were studied using a tomograph Magnetom 1.0 T Siemens. Two patients affected with RA refractory to conventional second-line drugs who received a bolus of methylprednisolone (1 g) were studied before and after such treatment. The hands of healthy volunteers were examined as controls. Besides MRI study all patients underwent: (1) radiological examination of the hands performed with a standard technique and (2) clinical and serological investigation aimed at characterizing diseases activity and extent. The radiographic and MRI findings were evaluated by two different observers who found 15 pathological elementary lesions and assigned a MRI and a radiological score to each patient. MRI exhibited significantly higher accuracy than radiography in evaluating rheumatoid soft-tissue changes and in detecting minimal skeletal lesions, while severe skeletal lesions were better detected by radiology. No correlation was found between pathological MRI findings, radiological results and clinical or serological data. A significant drop in soft-tissue effusion was observed after methylprednisolone pulse in two patients. This study confirms MRI potential in the study of rheumatoid joint lesions and in the early detection of minimal soft-tissue changes. Its use appears to be suitable for accurate monitoring of RA patients under specific therapy.
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PMID:[Magnetic resonance of the rheumatoid hand]. 202 29

For evaluation of the function of the upper cervical spine, especially assessment of the range of motion, functional X-rays films are useful in addition to the clinical examination. For the diagnosis of segmental instability, passive motion should be induced in order to obtain the full range. If anterior instability of the upper cervical spine is suspected, flexion-extension X-rays in the lateral view are appropriate. If a lesion of the alar ligaments is suspected, then lateral flexion X-rays films should be taken. In the normal situation, the atlas glides in the direction of bending, coupled by forced rotation of the axis. In cases with rotatory instability of the upper cervical spine, functional computed tomography should be performed. Atlantoaxial rotation of more than 52 degrees should be considered pathological as a result of a lesion of the alar ligaments. For examination of the relationship between the spinal cord and bony structures or inflammatory tissue in patients with rheumatoid arthritis, functional MRIs are helpful. Not only the exact diameter of the spinal canal can be measured during flexion and extension, but the degree of basilar impression or cranial migration of the axis can also be assessed. Optimal use of functional X-ray diagnostics, including functional the CT and MRI, is not only helpful for clinical diagnoses, but also for the planning of surgical procedures.
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PMID:[Functional roentgen diagnosis of the upper cervical spine]. 206 37

Involvement of the cervical spine by rheumatoid arthritis may have severe consequences secondary to subluxation, erosive changes, and soft-tissue inflammation. Unfortunately, the severity of radiographic findings may not directly correlate with the occurrence of cervical myelopathy. MRI has emerged as a noninvasive method of assessing the condition of the spinal cord and thecal sac as well as more precisely defining the nature of inflammatory soft-tissue changes that may result in bony erosion and cord compression. Ankylosing spondylitis is an arthropathy that classically involves the axial skeleton. Complications include acute fracture and pseudarthroses of the spine. Rarely, the development of a cauda equina syndrome has been reported. In addition to classic erosive arthropathies affecting the axial skeleton, ossification of the posterior longitudinal ligament may be associated with the development of severe myelopathy. A recently described type of amyloidosis characterized by beta-2 microglobulin deposition has been reported in patients on long-term hemodialysis. Bony erosion is seen in the spine in these patients. A causal relationship between beta-2 microglobulin and hemodialysis spondylarthropathy has yet to be definitely established.
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PMID:Complications of axial arthropathies. 211


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