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Annals of the Rheumatic Diseases Dec 2021Axial spondyloarthritis (axSpA) encompasses both radiographic and non-radiographic axSpA. It is a chronic inflammatory disease with a predilection for involving the... (Review)
Review
Axial spondyloarthritis (axSpA) encompasses both radiographic and non-radiographic axSpA. It is a chronic inflammatory disease with a predilection for involving the axial skeleton. The most common presenting symptoms are chronic back pain and spinal stiffness but peripheral and extra-musculoskeletal manifestations occur also frequently. The diagnosis of axSpA relies on the recognition of a clinical pattern of the disease, based on clinical, laboratory and imaging features. The Assessment in SpondyloArthritis international Society classification criteria for axSpA are valid and well implemented for research purposes. Sustained disease activity, measured by validated tools such as the Ankylosing Spondylitis Disease Activity Score, leads to irreversible structural damage and poor functioning and therefore should be abrogated. As part of the management algorithm, non-steroidal anti-inflammatory drugs remain as the first line of pharmacological treatment besides physiotherapy. As a second line, tumour necrosis factor inhibitor and interleukin-17 inhibitor are available but recently Janus kinase inhibitors have also shown efficacy in improving symptoms of the disease.
Topics: Anti-Inflammatory Agents, Non-Steroidal; Antirheumatic Agents; Axial Spondyloarthritis; Humans; Interleukin Inhibitors; Interleukin-17; Janus Kinase Inhibitors; Non-Radiographic Axial Spondyloarthritis; Physical Therapy Modalities; Tumor Necrosis Factor Inhibitors
PubMed: 34615639
DOI: 10.1136/annrheumdis-2021-221035 -
Rheumatology (Oxford, England) Mar 2019In ankylosing spondylitis (AS), structural damage that occurs as a result of syndesmophyte formation and ankylosis of the vertebral column is irreversible. Structural... (Review)
Review
In ankylosing spondylitis (AS), structural damage that occurs as a result of syndesmophyte formation and ankylosis of the vertebral column is irreversible. Structural damage is currently assessed by conventional radiography and scoring systems that reliably assess radiographic structural damage are needed to capture the differential effects of drugs on structural damage progression. The validity of the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) as a primary outcome measure in evaluating the effect of AS treatments on radiographic progression rates was assessed in this review. The mSASSS has not been used, to date, as a primary outcome measure in a prospective randomized controlled clinical trial of biologic therapy in AS. This review of the medical literature confirmed that the mSASSS is the most validated and widely used method for assessing radiographic progression in AS, correlating with worsening measures of disease signs and symptoms, spinal mobility and physical function, with a 2-year interval being required to ensure sufficient sensitivity to change.
Topics: Anti-Inflammatory Agents; Disease Progression; Humans; Radiography; Severity of Illness Index; Spondylitis, Ankylosing
PubMed: 29860356
DOI: 10.1093/rheumatology/key128 -
Vnitrni Lekarstvi 2018Axial spondyloarthritis (axSpA) is a common name for the non-radiographic form of the disease and radiographic axial spondyloarthritis, known as ankylosing spondylitis...
Axial spondyloarthritis (axSpA) is a common name for the non-radiographic form of the disease and radiographic axial spondyloarthritis, known as ankylosing spondylitis (AS). The disease is typically manifested at a young age, characterized by affection of axial skeleton, and in the most severe form can lead to complete ankylosis of the spine. Etiology of diseases have not yet been clarified, however, the genetic background, especially the binding to HLA-B27 antigen, is obvious. Clinical manifestations are dominated by chronic pain in the lower pain or buttocks that occurred in young age, in a large proportion of patients having the character of so-called inflammatory pain. In addition to the axial skeleton, axSpA there is also common affection of peripheral skeleton in the form of enthesitis, arthritis, and less often dactylitis. At present, enthesitis is considered as a hallmark of the entire spondyloarthritis group. Typical for axSpA is the frequent presence of extraskeletal manifestations in the form of uveitis, idiopathic intestinal inflammation and psoriasis. In the axSpA diagnosis, significant advances have been made in recent years in the field of imaging techniques. Magnetic resonance imaging can also identify the early stage of the disease before the development of structural lesions. Also, the newer concepts of the entire spondyloarthritis group, based on the 2009 ASAS (Assessment of SpondyloArthritis international Society) classification criteria, contributed to early diagnosis of the disease, and in particular to the underlying importance of association with HLA-B27 antigen and the presence of peripheral and non-articular manifestations. Non-steroidal anti-rheumatic drugs (NSAIDs) and TNFα blockers are effective axSpA therapy, which has been recently enhanced by interleukin 17 blockade (IL17).Key words: axial spondyloarthritis - biological treatment - enthesitis - extraarticular manifestations - magnetic resonance imaging - non-radiographic axial spondyloarthritis - sacroiliitis.
Topics: Antirheumatic Agents; HLA-B27 Antigen; Humans; Magnetic Resonance Imaging; Pain; Spondylitis, Ankylosing
PubMed: 29595276
DOI: No ID Found -
Revue de Stomatologie, de Chirurgie... Sep 2016Ankylosis of the temporomandibular joint is defined as a permanent constriction of the jaws with less than 30mm mouth opening measured between the incisors, occurring... (Review)
Review
Ankylosis of the temporomandibular joint is defined as a permanent constriction of the jaws with less than 30mm mouth opening measured between the incisors, occurring because of bony, fibrous or fibro-osseous fusion. Resulting complications such as speech, chewing, swallowing impediment and deficient oral hygiene may occur. The overall incidence is decreasing but remains significant in some developing countries. The most frequent etiology in developed countries is the post-traumatic ankylosis occurring after condylar fracture. Other causes may be found: infection (decreasing since the advent of antibiotics), inflammation (rheumatoid arthritis and ankylosing spondylitis mainly) and congenital diseases (very rare). Management relies on surgery: resection of the ankylosis block in combination with bilateral coronoidectomy… The block resection may be offset by the interposition temporal fascia flap, a costochondral graft or a TMJ prosthesis according to the loss of height and to the impact on dental occlusion. Postoperative rehabilitation is essential and has to be started early, to be intense and prolonged. Poor rehabilitation is the main cause of ankylosis recurrence.
Topics: Ankylosis; Diagnosis, Differential; Humans; Mandibular Condyle; Plastic Surgery Procedures; Temporomandibular Joint; Temporomandibular Joint Disorders
PubMed: 27481673
DOI: 10.1016/j.revsto.2016.07.001 -
Arthritis & Rheumatology (Hoboken, N.J.) Dec 2019
Topics: Ankylosis; Biological Therapy; Humans; Magnetic Resonance Imaging; Sacroiliac Joint; Spondylarthritis
PubMed: 31328427
DOI: 10.1002/art.41049 -
Oral and Maxillofacial Surgery Clinics... Feb 2018Indications and considerations for reconstruction of the temporomandibular joint (TMJ) differ between growing and skeletally mature patients. Osteoarthritis, which is... (Review)
Review
Indications and considerations for reconstruction of the temporomandibular joint (TMJ) differ between growing and skeletally mature patients. Osteoarthritis, which is the most common cause of TMJ destruction in adults, is comparatively rare in children. The most common indications in young patients are congenital deformities, pathology, ankylosis and progressive resorptive processes. Options for reconstruction include distraction osteogenesis, autologous reconstruction (ie, costochondral graft, free fibula flap), and total alloplastic joint replacement. The choice of the ideal reconstruction is based on multiple factors, which include extent and laterality of the deformity, patient age, jaw growth pattern, and potential for progressive destruction.
Topics: Adolescent; Ankylosis; Arthroplasty; Bone Transplantation; Child; Child, Preschool; Free Tissue Flaps; Humans; Infant; Joint Prosthesis; Osteogenesis, Distraction; Plastic Surgery Procedures; Temporomandibular Joint Disorders
PubMed: 29153233
DOI: 10.1016/j.coms.2017.08.006 -
Osteoporosis International : a Journal... Oct 2017Rheumatoid arthritis (RA) is associated with local and systemic inflammation that induces many changes in the skeletal health. Locally, periarticular bone loss and... (Review)
Review
Rheumatoid arthritis (RA) is associated with local and systemic inflammation that induces many changes in the skeletal health. Locally, periarticular bone loss and juxta-articular bone erosions may occur while joint ankylosis, generalized bone loss, osteoporosis, and fractures may develop secondary to inflammation. The aim of this narrative review is to summarize the clinical evidence for abnormal skeletal health in RA, the effects of disease modifying anti-rheumatic drugs (DMARDS) on bone health, and the effects of drugs for the prevention or treatment of osteoporosis in the RA population.
Topics: Ankylosis; Antirheumatic Agents; Arthritis, Rheumatoid; Bone Density Conservation Agents; Bone Diseases; Glucocorticoids; Humans; Osteoporosis; Osteoporotic Fractures; Practice Guidelines as Topic
PubMed: 28779302
DOI: 10.1007/s00198-017-4170-5 -
Otolaryngologic Clinics of North America Dec 2023Mandible fracture management has evolved dramatically. Therefore, the variety of surgical complications associated with mandibular fractures, and their incidences, have... (Review)
Review
Mandible fracture management has evolved dramatically. Therefore, the variety of surgical complications associated with mandibular fractures, and their incidences, have continued to change as well. This article aims to assess the most common and most concerning complications that can occur secondary to management of mandibular fractures by examining categories of complication types. This article also explores factors and techniques associated with reduced rates of complications as well as the management of complications.
Topics: Humans; Mandibular Fractures; Mandibular Condyle; Temporomandibular Joint Disorders; Ankylosis
PubMed: 37353369
DOI: 10.1016/j.otc.2023.05.008 -
Oral and Maxillofacial Surgery Clinics... Feb 2015Temporomandibular joint (TMJ) ankylosis is a pathologic condition where the mandible is fused to the fossa by bony or fibrotic tissues. This interferes with mastication,... (Review)
Review
Temporomandibular joint (TMJ) ankylosis is a pathologic condition where the mandible is fused to the fossa by bony or fibrotic tissues. This interferes with mastication, speech, oral hygiene, and normal life activities, and can be potentially life threatening when struggling to acquire an airway in an emergency. Trauma is the most common cause of TMJ ankylosis, followed by infection. Diagnosis of TMJ ankylosis is usually made by clinical examination and imaging studies. The management goal in TMJ ankylosis is to increase the patient's mandibular function, correct associated facial deformity, decrease pain, and prevent reankylosis.
Topics: Adipose Tissue; Ankylosis; Bone Transplantation; Diagnostic Imaging; Humans; Oral Surgical Procedures; Orthognathic Surgical Procedures; Pain Management; Prostheses and Implants; Plastic Surgery Procedures; Temporomandibular Joint Disorders
PubMed: 25483442
DOI: 10.1016/j.coms.2014.09.003 -
Emergency Radiology Jun 2021The purpose of this study is to examine the incidence, location, and magnetic resonance imaging (MRI) features of spinal epidural hematoma (SEH) and spinal subdural...
PURPOSE
The purpose of this study is to examine the incidence, location, and magnetic resonance imaging (MRI) features of spinal epidural hematoma (SEH) and spinal subdural hematoma (SSH) in post-traumatic ankylosing spondylitis (AS) patients.
METHODS
A total of 2256 consecutive referrals for urgent and emergency MRI scans of the spine over a period of eight years and nine months were manually reviewed for any mentions indicating axial ankylosis and post-traumatic spinal hematoma. We found 164 patients with ankylosed spines complicated by spinal fracture, of whom 32 had AS. Of the 132 excluded patients, 80 had diffuse idiopathic skeletal hyperostosis (DISH). The primary outcome was the presence of spinal hematoma, and the secondary outcome was spinal canal narrowing and spinal cord impingement. Two musculoskeletal radiologists and one fellow in musculoskeletal radiology reviewed the images for the presence of spinal hematoma and related signal characteristics, blinded to one another and initial reports.
RESULTS
Of 28 post-traumatic AS patients, 19 had SEHs and five had spinal SSHs. There was a statistically significant difference between Frankel grades before and after surgery in respect of neurological improvement (p = 0.008). Patients who had radiologically proven spinal cord impingement showed more severe neurological deficits (p = 0.012). Hematomas with T1 heterogeneity showed a significantly increased delay (p = 0.047) between injury and imaging, while other signal characteristics were only approximate.
CONCLUSIONS
Both SEH and SSH are common complications in post-traumatic AS patients. Patients benefit from surgery, but the relevance of spinal hematoma as a separate factor causing neurological deficit remains unclear.
Topics: Hematoma, Epidural, Spinal; Humans; Hyperostosis, Diffuse Idiopathic Skeletal; Magnetic Resonance Imaging; Spinal Fractures; Spondylitis, Ankylosing
PubMed: 33452963
DOI: 10.1007/s10140-020-01881-3