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)

Radiological sacroiliac (SI) changes were found in 3 patients, 2 with primary hyperparathyroidism (1 also with associated chondrocalcinosis) and 1 with osteomalacia. Osteomalacia was due to celiac disease. None of the 3 patients, all females, had a history of psoriasis, urethritis, iritis or chronic colitis. There was no renal function impairment. Peripheral joints were affected in the patient with associated condrocalcinosis. HLA B 27 was negative in all cases. Low back pain and vertebral stiffness were present in the patient with osteomalacia. A dramatic improvement in pain and stiffness ensued after vitamin D injections. These SI lesions, which may simulate ankylosing spondylitis, were attributable to subchondral bone changes related to the metabolic bone diseases. In the case of osteomalacia the SI lesions were predominantly on the right side, where there was a Looser's zone on the ischial ramus suggesting that pseudofractures could be a cause of SI changes. Metabolic osseous diseases such as osteomalacia or primary hyperparathyroidism should be investigated in cases of HLA B 27 negative radiological "sacroiliitis".
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PMID:[Sacroiliac changes, HLA-B27 negative, in primary hyperparathyroidism and osteomalacia]. 46 71

The authors present the preliminary results of an ongoing epidemiological study designed to determine the prevalence of back pain at selected worksites of Czechoslovak State Railways and Avia Letnany, an industrial plant. Examination of a total of 1,555 subjects was conducted by a field team of health-care workers of the Research Institute of Rheumatic Diseases based in Prague. The examination included a detailed medical history, physical examination and, in some probands, the results of HLA B 27 antigen determination, and x-ray examination. Overall, the prevalence of back pain in the cohort was 67%, with 63% and 76% in men and women, respectively. First complaints of back pain are most frequently reported by subjects in their 20s and 30s. The highest prevalence rate was registered in persons aged 50. The pain, as a symptom of a broad spectrum of pathological states, was most often localized in the lumbar and cervical segments of the spine -- 71% and 32%, respectively. In terms of the professions studied, the lowest prevalence was found in a group of manual workers employed at some worksites of the AVIA factory, with the highest frequency of back pain observed in an inconsistent group of diverse jobs, mostly requiring minimal training. In the Discussion section, the authors compare their results with those reported by some other studies published abroad.
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PMID:Preliminary results of an epidemiological study of back pain in a Prague population. 295 61

A 50-year-old male presented with polyarthritis and pain of the right costovertebral angle in the cervicothoracic area. Radiological findings in a sacroiliac joint, the presence of a syndesmophyte, the HLA B-27 phenotype and negative serological studies prompted the diagnosis of HLA-B27 related seronegative spondyloarthropathy. Conventional and computerized tomograms disclosed an erosive arthritis of the 1st right costovertebral joint that was responsible for the pain in the costovertebral angle. We are unaware of previous CT scan documentation of such lesions.
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PMID:Erosive arthritis of the costovertebral joint in seronegative spondyloarthropathy. 348 53

A 61-year-old man with palmoplantar pustulosis had pain and swelling persisting in his left knee for more than 3 years. The rheumatoid factor and HLA B 27 antigen were absent. Plain radiographs of the knee revealed no abnormalities despite the persistent synovitis. The bone scintigraphy showed increased uptake in the manubriosternal joint as well as in the knee. Eventually, the patient underwent arthroscopic synovectomy assisted with a holmium: YAG laser. No postoperative complications such as hemarthrosis were noted. The patient was pain free with full range of motion of the knee 22 months after surgery. Peripheral arthritis associated with palmoplantar pustulosis is usually transient. This unique case suggests that laser-assisted arthroscopic synovectomy would be a useful therapeutic option for persistent severe synovitis resistant to conservative treatment in pustulotic arthro-osteitis.
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PMID:Pustulotic arthro-osteitis report of a case successfully treated with laser-assisted arthroscopic synovectomy. 1907 45

Case 1 was a 46-year-old man who developed neck pain in addition to pain and swelling in the limb joints in 1975. The patient was diagnosed with ankylosing spondylitis (AS) in 1983 based on detection of sacroiliitis on X-ray as well as a positive result for HLA B-27. Following administration of non-steroidal anti-inflammatory drugs (NSAIDs) and sulfasalazine (SSZ), methotrexate (MTX) was substituted at doses up to 17.5 mg/week in addition to concomitant prednisolone (PSL) (7.5 mg/day). However, no favorable response was obtained. As pain and inflammatory response improved following initiation of infliximab (IFX) in April 2005, PSL was discontinued and MTX was reduced to 10 mg/week. Case 2 was a 57-year-old man who experienced limitation of neck mobility in 1975. The patient was diagnosed with AS in 1989 based on detection of cervical ankylosis and sacroiliitis on X-ray and was given NSAIDs. After developing pain and swelling in the limb joints in 1994, the patient was given PSL (10 mg/day), bucillamine, MTX (8 mg/week), and leflunomide but did not improve. Arthritis in the limbs showed short-term improvement following initiation of IFX in May 2005. These findings demonstrate that IFX is a treatment option for AS refractory to conventional treatment.
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PMID:[Two cases with ankylosing spondylitis using infliximab (case report)]. 1925 80

Inflammatory enthesitis is a hallmark of spondyloarthropathies (SSA) and may antedate other clinical manifestations. The involvement of Achilles tendon and plantar aponeurosis is common, with strong tendency toward fibrosis and calcification. We are describing imaging characteristics in a patient with positive HLA B-27 antigen with bilateral calcific achilles tendonitis who had pain in heels for 3 years.
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PMID:Bone scan in enthesopathy involving tendo Achilles. 2222 44

Introduction. Sarcoidosis is a chronic granulomatous disease, which can involve different organs and systems. Coexistence of sarcoidosis and spondyloarthritis has been reported in numerous case reports. Purpose. To determine the prevalence of sacroiliitis and spondyloarthritis in patients previously diagnosed with sarcoidosis and to investigate any possible relation with clinical findings. Materials and Methods. Forty-two patients with sarcoidosis were enrolled in the study. Any signs and symptoms in regard to spondyloarthritis (i.e., existence of inflammatory back pain, gluteal pain, uveitis, enthesitis, dactylitis, inflammatory bowel disease, and psoriasis) were questioned in detail and biochemical tests were evaluated. Sacroiliac joint imaging and lateral heel imaging were performed in all patients. Results. Sacroiliitis was found in 6 of the 42 (14.3%) sarcoidosis patients and all of these patients were female. Common features of the disease in these six patients were inflammatory back pain as the major clinical complaint, stage 2 sacroiliitis as revealed by radiological staging, and the negativity of HLA B-27 test. These six patients with sacroiliitis were diagnosed with spondyloarthritis according to the criteria of ASAS and of ESSG. Conclusion. We found spondyloarthritis in patients with sarcoidosis at a higher percentage rate than in the general population (1-1.9%). Controlled trials involving large series of patients are required for the confirmation of the data.
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PMID:The prevalence of sacroiliitis and spondyloarthritis in patients with sarcoidosis. 2489 99

[Purpose] Osteopoikilosis is a rare hereditary bone disease that is usually asymptomatic. It is generally diagnosed incidentally on plain radiography. The coexistence of osteopoikilosis with seronegative spondyloarthritis or spinal stenosis is rarely reported. Here, we report the case of a 27-year-old male patient with osteopoikilosis, seronegative spondyloarthritis, and spinal stenosis. [Subject] A 27-year-old male patient with buttock pain and back pain radiating to the legs. [Methods] A plain anteroposterior radiograph of the pelvis revealed numerous round and oval sclerotic bone areas of varying size. Investigation of the knee joints showed similar findings, and the patient was diagnosed with osteopoikilosis. Lumbar magnetic resonance images showed spinal stenosis and degenerative changes in his lumbar facet joints. Magnetic resonance images of the sacroiliac joints showed bilateral involvement with narrowing of both sacroiliac joints, nodular multiple sclerotic foci, and contrast enhancement in both joint spaces and periarticular areas. HLA B-27 test was negative. [Results] The patient was diagnosed with osteopoikilosis, seronegative spondyloarthritis, and spinal stenosis. Treatment included asemetasin twice daily and exercise therapy. [Conclusion] Symptomatic patients with osteopoikilosis should be investigated for other possible coexisting medical conditions; this will shorten the times to diagnosis and treatment.
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PMID:Coexistence of osteopoikilosis with seronegative spondyloarthritis and spinal stenosis. 2615 77