Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Moraxella catarrhalis was isolated from blood from a 41-year-old man who had a 24-hour history of increasing pain in and swelling of the left knee. No history of trauma, arthropathy, fever, chills, cough, or chest pain was noted. What is believed to be the first case of bacteremia caused by M. catarrhalis that was associated with septic arthritis is described in this report. The case presented suggests the pathophysiology of this rare condition. One previous case of septic arthritis caused by M. catarrhalis without documented bacteremia has been reported.
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PMID:Bacteremia and septic arthritis caused by Moraxella catarrhalis. 157 59

Osteonecrosis of the hip is a well known complication in renal transplantation patients who are treated with corticosteroids for immunosuppression. In a consecutive series of 10 patients with osteonecrosis of the hip, 16 primary uncemented bipolar endoprostheses were inserted between April 1984, and February 1986. The average follow-up period after surgery was 40 months, (range, 24-48 months). All patients developed osteonecrosis of their hips and were operated on within 2 years of their renal transplant. At the time of surgery, all patients were still taking corticosteroids as well as other immunosuppressants. The average age at surgery was 34.6 years (range, 21-48 years). All hips were classified as stage 3 or 4 before operation. The average Harris score at follow-up examination was 94.2 (range, 74-101), with 13 hips rated excellent, 1 hip rated good, and 1 hip rated fair. One patient's hip prosthesis was removed after 17 months secondary to a septic arthritis. This was the only major complication in this series. Pain was improved in all patients. However, postoperative limp and abductor weakness still presented a significant problem. An extensive radiographic evaluation was made on all hips. Eleven observations and measurements were made using radiographs of the pelvis and hip. Vertical subsidence was present in 33% of the hips and averaged 2.2 mm (range, 1-4 mm). No significant radiographic loosening was evident in any hip. Acetabular protrusio was evaluated in all patients, and was found to be less than 4 mm in either the superior or axial direction. Heterotopic ossification was present in 80% of hips, but resulted in loss of motion in only one hip.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Use of the uncemented bipolar endoprosthesis for the treatment of steroid-induced osteonecrosis of the hip in renal transplantation patients. 201 3

Three cases of pyogenic sacroiliitis are described, and the English literature from 1878 to 1990 reviewed, for a total of 166 cases. In 1 patient the source of infection was identified at the site of an intravenous line; 1 patient had 2 risk factors for developing the disease (pregnancy and intravenous drug use); and a third patient had no source of infection and no associated risk factors. The diagnosis of pyogenic sacroiliitis was made in each patient by history, physical examination, and positive skeletal scintigraphy or computed tomography of the sacroiliac joint. The infectious agent causing septic arthritis was identified by fine-needle aspiration of the sacroiliac joint under fluoroscopic guidance. Two of the 3 patients also had an open biopsy of the sacroiliac joint--one to confirm the organism causing septic arthritis, and the other for surgical drainage of the infected sacroiliac joint. Cultures from all 3 patients grew organisms uncommon for this disease, and all were treated for 6 weeks with intravenous antibiotics. In all patients pain diminished after treatment. Pyogenic sacroiliitis is a relatively rare condition (1-2 cases reported/year) that may be clinically difficult to diagnose unless the clinician is familiar with the disease. A prompt diagnosis can prevent significant morbidity and reduce serious complication. Major predisposing factors include intravenous drug use, trauma, or an identifiable focus of infection elsewhere, but 44% of patients have no predisposing or associated factors identified. Most patients present with an acute febrile illness with pain in the buttocks and pain on movement that stresses the affected sacroiliac joint. There is no specific blood test which points to the diagnosis of pyogenic sacroiliitis, although the erythrocyte sedimentation rate may be greater than 100 mm/hr. The diagnostic procedure of choice is bone scan with attention to the early perfusion phase, which usually localizes the affected sacroiliac joint. Unilateral involvement is the rule. In patients whose blood cultures fail to reveal a causative organism, fluoroscopic guided fine-needle aspiration of the sacroiliac joint under general anesthesia may help to identify the organism. If all cultures are negative, open biopsy of the sacroiliac joint may be required. Open biopsy should also be done if sequestration or an abscess is formed, or if the patient fails to respond to antibiotic therapy.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Pyogenic infection of the sacroiliac joint. Case reports and review of the literature. 203 Jun 42

The indications, surgical technique, and long-term functional results for ankle arthrodesis differ between children and adults. In children, the reasons for performing a tibiotalar fusion include pain, most commonly from traumatic and septic arthritis, and instability from congenital anomalies or paralytic disorders. The most appropriate procedure is Chuinard's fusion, which achieves a tibiotalar fusion without causing a growth arrest of the distal tibial growth plate. In the long term, young patients with ankle arthrodesis function very well with minimal pain or disability. Stressful activities such as hill climbing, stair climbing, and running may be restricted or require compensatory movements.
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PMID:Ankle arthrodesis in children. 206 Feb 29

Articular complications seem to be very common in patients under chronic dialysis, where they currently constitute the main limitation to the long-term functional prognosis. Carpal tunnel syndrome is often bilateral and severe; after 8 to 10 years of haemodialysis, it is usually associated with local deposits of amyloid substance. Treatment must be undertaken early and it is surgical. Arthropathies due to microcrystalline deposits take various forms, the most frequent being acute periarticular attacks related to apatite crystals. Septic arthritis is a frequent complication, dangerous in such patients, and which must be considered in every case of acute or subacute arthritis. Chronic arthropathies affect more than one half of the patients who have been under dialysis for more than 10 years. The most common are arthralgias of the shoulders often associated with pain in other joints, restricted joint movements and synovial thickening notably in the wrists, small finger joints and knees; radiology shows subchondral cavities betraying the presence of the cervical spine, are fairly frequent in patients under long-term haemodialysis. The pathogenesis of these complications is not yet fully understood, and several factors may be involved. Anatomically, carpal tunnel syndrome and chronic arthropathies are associated with articular deposits of a very special amylose consisting of beta-2 microglobulins.
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PMID:[Rheumatologic complications and amyloidosis in dialysis patients]. 218 42

Not all children with osteomyelitis or septic arthritis will present with the characteristic findings, i.e. localized pain and swelling, fever and generalized malaise. Diagnostic problems arise in case of the following four special forms or locations of the diseases: neonatal osteomyelitis, because neonates frequently have no signs of infection; osteomyelitis of the spine and septic arthritis of the sacroiliac joint; subacute hematogenous osteomyelitis; chronic osteomyelitis. Acute bone and joint infections are diagnosed clinically. Positive blood cultures are found in only about half of all cases. Cultures of joint fluid or bone cultures are positive in 50 to 90%. The aim of therapy is to avoid destruction of bones or joints or even invalidity. Effective treatment consists of sufficient antibiotics for an adequate period of time and of immobilization. Surgical drainage is mandatory in case of abscess formation in soft tissue, of intramedullary or joint abscess, mainly hip-joint and shoulder, of persistent fever and in all chronic forms of osteomyelitis where areas of sequestra, dead tissue and abscesses may be assumed.
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PMID:[Hematogenous bone and joint infections in children]. 220 76

The 'sump syndrome' is an uncommon, late complication of a side-to-side choledochoenterostomy. Five patients with this syndrome were encountered over a 5-year period. Pain or cholangitis was the clinical presentation in four patients, whereas one patient presented with secondary septic arthritis and a hepatic abscess. Liver function tests were mildly abnormal in each patient. All patients had a stomal size of less than 1 cm as assessed by forward- or side-viewing endoscopy. Endoscopic retrograde cholangiography revealed either stones or debris in the distal common bile ducts of all patients. Four patients had a surgical clearance of their duct with concurrent closure of the choledochoduodenostomy in three patients and the creation of a Rouxen-Y end-to-side choledochojejunostomy in the fourth patient. The other patient had an endoscopic sphincterotomy performed. After 1-4 years of follow-up, four patients have had a total resolution of symptoms. The other patient with follow-up for 4 years has had one episode of cholangitis which resolved rapidly with antibiotic treatment. The pathogenesis and clinical spectrum of the sump syndrome are reviewed and current management strategies are discussed.
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PMID:Post-choledochoenterostomy 'sump syndrome'. 232 13

The Hauser operation for patellar dislocation was performed in 34 women and 20 men, median age 18 (3-55) years; one leg was amputated because of wound infection with chronic septic arthritis. At the time of follow-up, 8 (3-32) years after the operation 57 knees had normal or almost normal patellar stability, but only 26 knees were free from pain. Only 16 knees had both normal patellar stability and were without pain. Patellar arthrosis had developed in 16 knees and femorotibial arthrosis in 23 knees. Eleven patients operated on before the age of 15 years showed varying grades of axial deformity of the proximal tibia.
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PMID:The Hauser operation for patellar dislocation. 3-32-year results in 63 knees. 233 48

We report a multicenter long-term follow-up study of patients with septic arthritis of the hip during infancy or childhood. Group I ("infantile") consisted of patients with onset before age 3 months, and Group II ("childhood") consisted of patients in whom onset occurred after age 3 months. Patients were specifically examined for this review. Generally, patients at follow-up had poor anatomic appearance radiographically and scored poorly on the Harris rating system. However, pain and activity restriction were minimal. Patients who were not treated operatively tended to function better than patients who underwent operative reconstruction.
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PMID:Late sequelae of septic arthritis of the hip in infancy and childhood. 235 81

One hundred and twenty-three patients with human immunodeficiency virus infection have been referred to rheumatologists at our hospitals between October 1985 and April 1989 because of musculoskeletal symptoms. Thirty-four homosexual men presented with acute, peripheral, non-erosive arthritis (mean number of four joints affected) with the knees being involved in 23. Other features developing concurrently with arthritis included psoriasis, keratoderma blenorrhagica, plantar fasciitis, urethritis, conjunctivitis and anterior uveitis. Four of five patients investigated were HLA-B27-positive; none of 15 patients tested had raised titres of rheumatoid or antinuclear factors. Various infections were associated with the onset of arthritis and two patients with a recent history of diarrhoea had serological evidence of yersinia infection. No micro-organisms were identified within the joint except for HIV itself. At the time of onset of arthritis four of these individuals had the acquired immunodeficiency syndrome (AIDS); 11 were not known to be HIV-positive before testing which was performed following referral for arthritis. Six patients have since developed AIDS and four have died. In 15 individuals, including those who progressed to AIDS, joint symptoms have been severe, persistent and poorly responsive to non-steroidal anti-inflammatory drugs. In only five patients has the arthritis been known to resolve. Synovitis has also been seen in two women: in one of these HIV infection was thought to have been acquired through intravenous drug abuse. Other rheumatic lesions included myalgia/myositis, non-inflammatory peripheral arthritis, spinal pain, soft tissue lesions, arthralgia or myalgia of unknown cause and infective lesions including septic arthritis and bony infection due to histoplasmosis and atypical mycobacterial infection. It appears likely that HIV infection is a risk factor for the development of seronegative arthritis and other rheumatic lesions.
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PMID:Rheumatological lesions in individuals with human immunodeficiency virus infection. 261 38


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