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Rheumatology (Oxford, England) Jan 2021Ankle arthritis is a useful clinical signpost to differential diagnosis in rheumatic disease. Biomechanical features and differences in cartilage physiology compared... (Review)
Review
Ankle arthritis is a useful clinical signpost to differential diagnosis in rheumatic disease. Biomechanical features and differences in cartilage physiology compared with the knee may confer protection of the ankle joint from factors predisposing to certain arthritides. The prevalence of ankle OA is low, and usually secondary to trauma. Primary OA of the ankle should be investigated for underlying causes, especially haemochromatosis. New presentations of inflammatory mono/oligo arthritis involving the ankle are more likely due to undifferentiated arthritis or spondyloarthritis than RA, and gout over CPPD. The ankle is often involved in bacterial and viral causes of septic arthritis, especially bacterial, chikungunya and HIV infection, but rarely tuberculosis. Periarticular hind foot swelling can be confused with ankle arthritis, exemplified by Lofgren's syndrome and hypertrophic osteoarthropathy where swelling is due to subcutaneous oedema and osteitis respectively, and the ankle joint is rarely involved.
Topics: Ankle Joint; Arthritis; Diagnosis, Differential; Humans
PubMed: 33097958
DOI: 10.1093/rheumatology/keaa531 -
British Medical Journal (Clinical... Sep 1981
Topics: Antibodies, Antinuclear; Arthritis; Arthritis, Rheumatoid; Humans; Rheumatoid Factor; Spondylitis, Ankylosing
PubMed: 6790107
DOI: No ID Found -
The American Journal of Medicine Mar 2020Chikungunya virus (CHIKV) is a single-stranded RNA virus belonging to the family Togaviridae and genus Alphavirus that causes an acute febrile illness, chikungunya... (Comparative Study)
Comparative Study Review
Chikungunya virus (CHIKV) is a single-stranded RNA virus belonging to the family Togaviridae and genus Alphavirus that causes an acute febrile illness, chikungunya fever, which is transmitted to humans by Aedes species mosquitoes. During acute illness, patients have high fever, polyarthralgias or polyarthritis, maculopapular rash, headache, and myalgia that lasts for days to weeks. Following resolution of acute infection, a significant proportion of patients develop chronic chikungunya arthritis that can resemble rheumatoid arthritis. In this review, we first consider the historical background of infectious causes of inflammatory arthritis, and then the pathogenic and clinical manifestations of chronic chikungunya arthritis as a rheumatoid arthritis mimic. We believe that chronic chikungunya arthritis may be a postinfectious inflammatory process, and that an understanding of the parallels and differences between chronic chikungunya arthritis and rheumatoid arthritis may offer insights into better diagnosis and treatment of both diseases.
Topics: Arthritis, Rheumatoid; Chikungunya Fever; Humans
PubMed: 31705850
DOI: 10.1016/j.amjmed.2019.10.005 -
Journal of Medical Case Reports Apr 2022Granulomatous mastitis is a rare inflammatory disease of the breast, typically seen in woman of child-bearing age. No definitive etiology has been described. In rare...
BACKGROUND
Granulomatous mastitis is a rare inflammatory disease of the breast, typically seen in woman of child-bearing age. No definitive etiology has been described. In rare instances, this condition has been reported to be associated with extramammary manifestations such as erythema nodosum and arthritis. We describe this rare condition in an adolescent female.
CASE PRESENTATION
A 16-year-old, Hispanic female presented with right-sided painful breast swelling, polyarthritis, and erythema nodosum on bilateral shins and lower thighs. Physical examination was negative for lymphadenopathy and pulmonary, gastrointestinal, and cardiovascular findings. Ophthalmologic examination for uveitis and serologic tests for autoimmune diseases were negative. Diagnosis of idiopathic granulomatous mastitis was made by exclusion of other etiologies and conditions. Confirmation was made by histopathologic examination demonstrating noncaseating granuloma within breast lobules with neutrophils and microabscess formation. After wide local excision and a short course of trimethoprim-sulfamethoxazole, our patient was placed on naproxen and prednisone, the latter being tapered off over 3 months, with steady and complete resolution of all symptoms.
CONCLUSION
This is the first reported case of idiopathic granulomatous mastitis in a pediatric patient who also had extramammary manifestations, including erythema nodosum and polyarthritis. In this case-based review, we summarize the phenotype, risk factors, prognosis, and treatment options of this rare condition, chiefly to make the readers cognizant of such a diagnostic possibility in similar clinical presentation in the future.
Topics: Adolescent; Arthritis; Child; Erythema Nodosum; Female; Granuloma; Granulomatous Mastitis; Humans; Prednisone
PubMed: 35382864
DOI: 10.1186/s13256-022-03327-5 -
Tidsskrift For Den Norske Laegeforening... May 2000Palindromic rheumatism is an inflammatory rheumatic disease characterised by recurrent attacks of arthritis confined to one or more peripheral joints. Each episode of...
BACKGROUND
Palindromic rheumatism is an inflammatory rheumatic disease characterised by recurrent attacks of arthritis confined to one or more peripheral joints. Each episode of arthritis rarely lasts more than 14 days, and subsides without leaving any residues.
MATERIAL AND METHODS
Three patients with palindromic arthritis are presented, and the literature reviewed.
RESULTS
The clinical and laboratory characteristics of the three patients were similar to those generally described for palindromic rheumatism. Two patients developed seropositive rheumatoid arthritis and one patient developed chronic seronegative polyarthritis.
INTERPRETATION
Palindromic rheumatism may evolve into chronic polyarthritis.
Topics: Arthritis; Arthritis, Rheumatoid; Diagnosis, Differential; Female; Humans; Middle Aged; Recurrence
PubMed: 10916474
DOI: No ID Found -
The American Journal of Case Reports Apr 2019BACKGROUND Clopidogrel is an antiplatelet medication that plays an important role in primary management and secondary prevention of thrombotic vascular events in...
BACKGROUND Clopidogrel is an antiplatelet medication that plays an important role in primary management and secondary prevention of thrombotic vascular events in patients with acute coronary syndrome. It is generally well tolerated by most patients, but rare adverse effects such as inflammatory arthritis has been noted. A very few cases of migratory polyarthritis secondary to clopidogrel have been reported in the literature. CASE REPORT We describe 2 cases of acute migratory polyarthritis associated with clopidogrel that resolved with discontinuation of clopidogrel and did not recur after prasugrel initiation. In the first case, the patient presented with migratory polyarthritis approximately 2-3 days after initiating clopidogrel, and the symptoms lasted in each joint for 1-2 days. In the second case, the migratory polyarthritis started 1 week after initiating clopidogrel, and the symptoms lasted in each joint for approximately 2-3 days. The symptoms completely resolved after discontinuing clopidogrel in both the cases, which is typical of an immune-mediated drug reaction. A diagnosis of acute migratory inflammatory polyarthritis related to clopidogrel was determined in both cases by excluding other conditions causing inflammatory arthritis. In both cases, the eosinophil count was within normal limits, thereby differentiating the disease process from an acute allergic reaction. CONCLUSIONS Identifying the etiology of inflammatory arthritis in a patient on clopidogrel needs extensive evaluation. The diagnosis of clopidogrel-related inflammatory arthritis is often missed due to lack of awareness. Early diagnosis and timely intervention are essential, as the symptoms completely resolve after discontinuing clopidogrel.
Topics: Aged; Arthritis; Clopidogrel; Humans; Male; Middle Aged; Platelet Aggregation Inhibitors
PubMed: 30967523
DOI: 10.12659/AJCR.911598 -
Clinical Rheumatology Oct 2013Leprosy can manifest arthritis both as a complication and a comorbid disorder and can be a challenging differential diagnosis in rheumatology practice due to several... (Review)
Review
Leprosy can manifest arthritis both as a complication and a comorbid disorder and can be a challenging differential diagnosis in rheumatology practice due to several common features. Uncommonly, it may present as acute severe polyarthritis with skin lesions and neurological deficit or a digital vasculitis and gangrene. We demonstrate this profile in a retrospective case series analysis of 33 patients (13 females, median age 55 years) in a community-based clinic setting over the period 1998-2012; an electronic search of case records of 41,000 patients was carried out. Rheumatoid arthritis (RA) coexisted in seven patients (three lepromatous, two tuberculoid, and two polyneuritic). Serological rheumatoid factor and antinuclear antibody were often false positive. Several patients of RA were on long-term supervised methotrexate. Rheumatologists should be aware of this clinical mimic to avoid errors in diagnosis and management.
Topics: Adult; Aged; Antibodies, Antinuclear; Antirheumatic Agents; Arthritis; Arthritis, Rheumatoid; Diagnosis, Differential; Diagnostic Errors; False Positive Reactions; Female; Humans; Leprosy; Male; Methotrexate; Middle Aged; Retrospective Studies; Rheumatoid Factor; Rheumatology; Symptom Assessment
PubMed: 23645094
DOI: 10.1007/s10067-013-2276-5 -
Acta Odontologica Scandinavica Mar 2024To evaluate the association of different forms of inflammatory polyarthritis with clinical signs of temporomandibular disorders (TMD) and radiological findings in...
OBJECTIVE
To evaluate the association of different forms of inflammatory polyarthritis with clinical signs of temporomandibular disorders (TMD) and radiological findings in temporomandibular joint (TMJ), based on a nationwide health survey in Finland. The aim was also to assess the presence of clinical and radiological TMD findings in subjects with increased risk for developing rheumatoid arthritis (RA).
MATERIAL AND METHODS
Anationally representative sample included 6331 Finnish adults who participated in the Health 2000 Survey (BRIF8901). Subjects were examined for signs of TMD, findings in panoramic radiograph of TMJ, musculoskeletal health and serology (rheumatoid factor, RF, and anti-cyclic citrullinated peptide, aCCP).
RESULTS
Sixty-four percent of seronegative RAand 60% of seropositive RAsubjects had at least one sign of TMD. While adjusting for confounding factors (gender, age, dentures and smoking history), RAwas significantly associated with crepitation and abnormal radiological findings in TMJ. Seronegative RAwas also associated with restricted mouth opening. Systemic autoimmunity associated with RA("at risk of RA") was not associated with clinical or radiological TMD findings.
CONCLUSIONS
Clinical and radiological findings of TMD are more prevalent among subjects with inflammatory polyarthritis than among the population in general in the Finnish adult population.
Topics: Humans; Temporomandibular Joint Disorders; Male; Female; Adult; Middle Aged; Finland; Arthritis; Rheumatoid Factor; Arthritis, Rheumatoid; Radiography, Panoramic; Aged
PubMed: 37812570
DOI: 10.1080/00016357.2023.2267118 -
BMJ Case Reports Jul 2021A 52-year-old male patient with polyarthritis nodosa (PAN) was referred to our neurology outpatient clinic. His main symptom was paroxysmal alternating bilateral...
A 52-year-old male patient with polyarthritis nodosa (PAN) was referred to our neurology outpatient clinic. His main symptom was paroxysmal alternating bilateral blindness. Subsequently, he developed retro-orbital pain. Neurological examination including funduscopy was normal and laboratory tests showed no relevant abnormalities. MRI orbits showed remarkable perineural thickening and contrast enhancement of the optic nerve sheaths with sparing of the central optic nerve. These findings are pathognomonic for the clinical-radiological diagnosis of optic perineuritis (OPN). The patient was treated with high-dose immunosuppressants and had a good clinical outcome. Rapid diagnosis of OPN is important because early treatment is associated with a better outcome.
Topics: Arthritis; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Optic Nerve; Optic Neuritis; Vision Disorders
PubMed: 34289998
DOI: 10.1136/bcr-2020-237988 -
Folia Biologica 2023Collagen-induced arthritis is the most com-mon in vivo model of rheumatoid arthritis used for investigation of new potential therapies in preclinical research.... (Review)
Review
Collagen-induced arthritis is the most com-mon in vivo model of rheumatoid arthritis used for investigation of new potential therapies in preclinical research. Rheumatoid arthritis is a systemic inflammatory and autoimmune disease affecting joints, accompanied by significant extra-articular symptoms. The pathogenesis of rheumatoid arthritis and collagen-induced arthritis involves a so far properly unexplored network of immune cells, cytokines, antibodies and other factors. These agents trigger the autoimmune response leading to polyarthritis with cell infiltration, bone and cartilage degeneration and synovial cell proliferation. Our review covers the knowledge about cytokines present in the rat collagen-induced arthritis model and the factors affecting them. In addition, we provide a comparison with rheumatoid arthritis and a description of their important effects on the development of both diseases. We discuss the crucial roles of various immune cells (subtypes of T and B lymphocytes, dendritic cells, monocytes, macrophages), fibroblast-like synoviocy-tes, and their related cytokines (TNF-α, IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12, IL-17, IL-23, GM-CSF, TGF-β). Finally, we also focus on key antibodies (rheu-matoid factor, anti-citrullinated protein antibodies, anti-collagen II antibodies) and tissue-degrading enzymes (matrix metalloproteinases).
Topics: Rats; Animals; Cytokines; Arthritis, Experimental; Arthritis, Rheumatoid; Antibodies; Tumor Necrosis Factor-alpha; Collagen
PubMed: 38063000
DOI: 10.14712/fb2023069020041