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Target Concepts:
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Query: UMLS:C0016053 (
fibromyalgia
)
4,687
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Sixty patients with palindromic rheumatism (PR) with a total follow-up time of 598 years and 295 years prospectively are presented. The study shows that PR is not a rare condition, but the syndrome is often ignored or misdiagnosed by the physician. Most cases of PR appear to evolve into chronic arthritis. PR may precede other kinds of systemic diseases, such as SLE, Wegener's granulomatosis, and
multiple myeloma
. The presence of PR in patients with
fibromyalgia
is reported in this paper. Gold appears to be the best drug for the treatment of PR. Cases of
fibromyalgia
and PR are treated successfully with antimalarial drugs. Our proposed diagnostic criteria for PR are as follows: 1) recurrent attacks of sudden-onset mono or polyarthritis or of periarticular tissue inflammation, lasting from a few hours to one week; 2) verification of at least one attack by a physician; 3) subsequent attacks in at least three different joints; 4) exclusion of other forms of arthritides.
...
PMID:Palindromic rheumatism. A clinical survey of sixty patients. 342 51
The possibility of occult hip fracture in older patients after a fall is a common problem in emergency and orthopaedic departments. Magnetic resonance imaging (MRI) scanning is the best investigation, but is expensive and may be difficult to obtain. The value of various clinical signs to determine which patients are at risk of occult hip fracture has not been reported. We reviewed all patients who had MRI scan for suspected hip fractures but had normal initial X-rays over a 6-year period. We identified 76 patients. Twelve patients were excluded. Two patients had MRI scan for suspected stress fracture and two patients had metastatic fractures. Eight patients had inadequate or untraceable clinical notes. Each patient's personal details, mobility, independence and detail clinical details were recorded. Following case review of 64 patients we excluded 5 patients with associated osteoarthritis of the hip joint, 1 patient with
fibromyalgia
and 1 patient with pre-existing
multiple myeloma
. Thirty-five patients had occult proximal femoral fractures. Of them four patients had isolated pubic ramus fractures and five patients had isolated greater trochanter fractures. Twenty-two patients had no fracture. The value of the individual tests was evaluated using Fisher exact and chi square analysis; with Bonferroni correction for multiple comparisons (10 tests) p<0.005 was deemed significant. Pain on axial loading of the limb and pre-fracture restricted patient mobility were both associated with the presence of a fracture (p<0.005). Both factors had identical positive predictive value=0.76, a negative predictive value=0.69 and post-test probability of disease given a negative test=0.30. Predictive values remained the same when both factors were considered together. Patients who were independently mobile before the fall and who do not have pain on axial compression of the limb are less likely to have a fracture, but these signs alone or in combination do not exclude a fracture. The clinical signs investigated cannot distinguish between patients with and without a hip fracture, and MRI scanning is necessary to establish whether some patients have an occult fracture.
...
PMID:Is magnetic resonance imaging (MRI) necessary to exclude occult hip fracture? 1788 Sep 73