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Query: UMLS:C0851184 (thinning)
 11,252 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Magnetic resonance imaging (MRI) permits visualization of anatomic structures not appreciated by conventional radiographic imaging and may quantify inflammatory disease and its progression with greater sensitivity than available techniques. We therefore compared MRI with clinical evaluation and with radiographic examination of 17 patients with inflammatory arthritis of the knee. We sought to determine anatomic integrity of bone, cartilage, menisci, and ligaments, and to quantify joint effusion and synovial proliferation. Patients studied had rheumatoid arthritis (10 patients), juvenile rheumatoid arthritis (4 patients), ankylosing spondylitis (1 patient), and monoarticular arthritis (2 patients). In all patients MRI revealed clinically important abnormalities not detected by physical or conventional radiographic exams. These included proliferative synovitis (13 patients), cartilage thinning (2 patients), cartilage erosion (8 patients), bone infarction (1 patient), meniscal injury (1 patient), and synovial invagination into bone (1 patient). Also MRI indicated inflammatory disease to be quantitatively greater than had been appreciated on clinical examination or routine X-ray studies--proliferative synovitis (12 patients), erosion (7 patients), effusion (8 patients), cartilage thinning (11 patients), and ligamentous/meniscal damage (1 patient). These findings led to reassessment of anatomic staging and influenced therapeutic decision for these patients. Thus MRI provides clinically important information about joint integrity and inflammatory disease, with a sensitivity and resolution considerably beyond conventional techniques.
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PMID:Magnetic resonance imaging in patients with inflammatory arthritis of the knee. 233 54

Temporomandibular joint (TMJ) disease is uncommon in children but frequently occurs in juvenile rheumatoid arthritis (JRA). Involvement is often asymptomatic; however, it can lead to growth disturbances and facial deformity. Thirty TMJs in 15 children (11 girls and 4 boys aged 3.5-18 years) with JRA were evaluated clinically and by MRI. Plain films were reviewed when available. Magnetic resonance imaging parameters included T1-weighted and in some cases T2-weighted or gradient recall echo sequences. We assessed condylar configuration, glenoid fossa changes, presence of erosions, disk abnormality, range of motion, and presence of joint effusions or pannus. Abnormalities included cortical erosions (n = 19), disk thinning (n = 18), and perforation (n = 2). Reduction of joint movement (n = 20), joint locking (n = 3), and pannus/effusions (n = 5) were also found. Magnetic resonance imaging is a useful technique for the detection of TMJ involvement in JRA. Early detection and therapeutic intervention may lessen or prevent subsequent deformities.
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PMID:MR evaluation of the temporomandibular joint in juvenile rheumatoid arthritis. 849 10

Juvenile rheumatoid arthritis is a chronic disease, with the synovium as the target tissue. We made 594 US examinations of the knee in 240 children (mean age: 9 years) with juvenile rheumatoid arthritis. All patients underwent at least one US exam and 156 patients underwent many US examinations during 3 years' follow-up. In our series mean synovial thickness was 6 mm (range: 2.5-11 mm) while in normal subjects mean synovial thickness is 2.7 mm (range: 1-4.5 mm). The mean thickness of the suprapatellar bursa was 9 mm (range: 4-18 mm) versus 2.8 mm (range: 1-5 mm) in normal subjects. The mean length of the suprapatellar bursa was 27 mm (range: 13-44 mm) versus 14.3 mm (range: 8-23.5 mm) in normal children. Cartilage thickness was 3.3 mm (range: 1.2-5.8 mm) at the intercondylar notch, and 3 mm (range: 0.8-5.3 mm) at the femoral condyles. Cartilage thickness is 3.5 mm (range: 2-6 mm) at the intercondylar notch, and 3.2 mm (range: 1.8-5.4 mm) at the femoral condyles in normal subjects. The articular cartilage outline was blurred in 36% of patients with active knee involvement. A Baker cyst was found in 24 patients (10%). The mean volume was 3 ml (range: 1-40 ml). No tendinous alterations were observed. Changes in synovial membrane (synovial thickness), the presence of fluid in the suprapatellar bursa, and blurring of the articular cartilage outline showed statistically significant differences between juvenile rheumatoid arthritis patients with active knee involvement and subjects in clinical remission. On the contrary, articular cartilage thickening or thinning showed no statistically significant differences between juvenile rheumatoid arthritis patients with active knee involvement and subjects in clinical remission. In conclusion, US is a simple, rapid, inexpensive and accurate method for the staging and follow-up of joint inflammation in patients with juvenile rheumatoid arthritis of the knee.
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PMID:[Role of ultrasonography of the knee in the follow-up of juvenile rheumatoid arthritis]. 938 Aug 63

Common variable immunodeficiency (CVI) is characterized by a failure in B-cell differentiation and impaired immunoglobulin secretion, but with a variable clinical presentation, including the development of sarcoidal granulomas and autoimmune diseases, as well as an increased incidence of malignancies. We present a 21-year-old white man who carried a diagnosis of juvenile rheumatoid arthritis and presented 6 years later with scarring alopecia showing sarcoidal granulomas. Further work confirmed the diagnosis of CVI, and with increasing systemic symptoms, it was elected to treat the patient with a tumour necrosis factor (TNF)-alpha antagonist, a TNF-alpha receptor IgG1 fusion protein. The patient showed improvement in his systemic symptoms and some hair regrowth after 3 months of therapy, and continued improvement in his systemic disease with only mild scalp hair thinning in the areas of prior involvement after almost 1 year of therapy. CVI and sarcoid may have overlapping clinical and immunological findings. Previous therapies for CVI, including intravenous immunoglobulin, have not altered the mortality of the disease. TNF-alpha is a primary cytokine and is elevated in CVI, and specific inhibition of TNF-alpha in this patient was effective in moderating his disease, including his skin disease.
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PMID:Common variable immunodeficiency treated with a recombinant human IgG, tumour necrosis factor-alpha receptor fusion protein. 1126 23