Rheumatology and Orthopedic Medicine最新文献

Aseptic femur head necrosis revealing cushing's disease: a rare presentation 无菌性股骨头坏死显示库欣病:罕见的表现

Rheumatology and Orthopedic Medicine Pub Date : 2020-12-29 DOI: 10.15761/ROM.1000175

Z. Alaya, Mouna Braham, E. Bouajina

{"title":"Aseptic femur head necrosis revealing cushing's disease: a rare presentation","authors":"Z. Alaya, Mouna Braham, E. Bouajina","doi":"10.15761/ROM.1000175","DOIUrl":"https://doi.org/10.15761/ROM.1000175","url":null,"abstract":"Background: Cushing's disease is an endocrine disorder and may be associated with non-traumatic osteonecrosis of the hip. We report the case of avascular necrosis of the femoral heads (AVNFH) as the presenting manifestation of Cushing's disease. Case presentation: A 29-year-old male patient was referred to our department because of non-traumatic bilateral hip pain evolving for two years. The pain was associated with lameness when walking. He noticed a drop in libido since one year with erectile dysfunction. Physical examination revealed facio-truncal obesity, abdominal violaceous striae, dorsal hyper-kyphosis, a pain and limitation of internal rotation of the left hip with a Lequesne index of 16. The standard radiography showed a loss of sphericity of the left femoral head with an aspect of eggshell. The MRI confirmed the diagnosis of a bilateral AVNFH. The baseline cortisol level was 287 ng/ml. AVNFH as the presenting manifestation of Cushing's disease was suspected and confirmed by a pituitary MRI which revealed a pituitary adenoma. A discharge of the hips was indicated. The patient underwent surgical resection of the adenoma and was referred to the endocrinology department. The histopathological examination confirmed the diagnosis of pituitary adenoma (corticotrope adenoma). The patient has also received an intravenous perfusion of 5 mg of Zoledronic acid. The follow up was marked by the regression of the symptoms of Cushing's disease and the hip pain. Conclusion: AVNFH as the presenting manifestation of Cushing's disease is rarely described. Hence, it’s needed to exclude endogenous hypercorticism in any patient with idiopathic osteonecrosis.","PeriodicalId":165718,"journal":{"name":"Rheumatology and Orthopedic Medicine","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115525733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Does Serum Vitamin D Concentration Modify the Association Between Arthritis and Cardiovascular Diseases in Both Sexes? 血清维生素D浓度是否改变了两性关节炎和心血管疾病之间的关系?

Rheumatology and Orthopedic Medicine Pub Date : 2020-06-16 DOI: 10.21203/rs.3.rs-35271/v1

Rachelle Saade, D. Laurin, C. Dionne

{"title":"Does Serum Vitamin D Concentration Modify the Association Between Arthritis and Cardiovascular Diseases in Both Sexes?","authors":"Rachelle Saade, D. Laurin, C. Dionne","doi":"10.21203/rs.3.rs-35271/v1","DOIUrl":"https://doi.org/10.21203/rs.3.rs-35271/v1","url":null,"abstract":"\u0000 Background: The scientific literature shows an association between inflammatory arthritis and cardiovascular diseases (CVD) with inflammation being a shared characteristic between the two types of diseases. Among patients with arthritis, it is possible that the protective factors against inflammation, such as vitamin D, are also protective factors against the development of CVD. This effect may be different according to sex.Objective: To evaluate the impact of serum vitamin D concentration on the association between arthritis and CVD separately among men and women (effect modification of vitamin D and sex).Methods: Data came from a large representative sample of the US population: the National Health and Nutrition Examination Survey (NHANES) 2005-2006, which included 3406 adults aged between 20 and 69 years. Measurements of arthritis (primary independent variable) and CVD (dependent variable) were taken during face-to-face interviews, while the measurement of serum vitamin D was carried out on blood samples. Multivariate logistic regression analyses were performed in which the combined modifying effect of vitamin D (<20 ng/ml/> 20 ng/ml) and sex was tested, and adjusted for several potentially confounding variables.Results: Arthritis was statistically associated with CVD in both men and women, with <20 ng/ml or >20 ng/ml serum vitamin D. In men, the adjusted ratio of the odds ratios (ROR) comparing the association at <20 ng/ml vitamin D concentration to the association at >20 ng/ml concentration was 0.8 (95% CI 0.5 to 1.5); in women, the adjusted ROR was 0.7 (95% CI 0.3 to 1.5). Conclusions: In this large cross-sectional study, arthritis and CVD were statistically associated, but this association was not modified by sex nor vitamin D concentrations. Vitamin D supplementation is not recommended as part of the management of patients of both sexes suffering from inflammatory arthritis to prevent CVD.","PeriodicalId":165718,"journal":{"name":"Rheumatology and Orthopedic Medicine","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134342771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The importance of vitamin D 维生素D的重要性

Rheumatology and Orthopedic Medicine Pub Date : 1900-01-01 DOI: 10.15761/ROM.1000171

Maritza Vidal Wilman, N. Lane

引用次数: 0

Dissectional investigation: variations in morphology of the teres minor tendon and muscle-tendon junction 解剖研究:小圆肌腱和肌肉-肌腱连接处形态的变化

Rheumatology and Orthopedic Medicine Pub Date : 1900-01-01 DOI: 10.15761/ROM.1000170

Samuel L Holley, Spencer L. Hill, T. Ottesen, Paul K Vance, L. Challyandra, A. Katrikh, David C Whiting, M. Stark, J. Wisco

引用次数: 2

Congenital clubfoot treatment with external fixation: Italian experience since 2006 外固定支架治疗先天性畸形足:意大利2006年以来的经验

Rheumatology and Orthopedic Medicine Pub Date : 1900-01-01 DOI: 10.15761/ROM.1000173

A. Memeo, L. Montanari, D. Priano, E. Panuccio, L. Rossi

{"title":"Congenital clubfoot treatment with external fixation: Italian experience since 2006","authors":"A. Memeo, L. Montanari, D. Priano, E. Panuccio, L. Rossi","doi":"10.15761/ROM.1000173","DOIUrl":"https://doi.org/10.15761/ROM.1000173","url":null,"abstract":"The term “neglected clubfoot” encompasses several clinical pictures from inveterate clubfoot to relapsed clubfoot or to resistant clubfoot. Treatment with external fixators is a valid option in several case series. In our retrospective study, we wanted to analyze the results obtained in correcting the relapsed /inveterate clubfoot by using external fixators. In our Unit 101 patients underwent surgical procedures for congenital clubfoot correction from September 2006 to August 2019. A total of 8 patients (6 male and 2 female) were enrolled in the present study; in two cases the deformity was bilateral so that the total number of feet considered is 10. The age range of the patients considered at the first treatment of the clubfoot with external fixator ranges from 5 to 10 years with an average age of 7.3 years. The follow-up range is from 13 years to 4 months with an average follow-up of 6.5 years. Of the 10 feet treated with external fixator, 9 were subjected to correction using the Ilizarov apparatus (Ilizarov, TrueLok Orthofix, RRS Dial Medicali) and 1 through Taylor Spatial Frame (TSF Smith & Nephew). In evaluating the results of our study, we considered primary and secondary parameters. The primary outcome was therefore good for 7 feet (70%), discrete for 1 foot and poor in the 2 feet. There is a statistically evidence of all the subdomains of the 2 questionnaires administered (AOFAS and FFI) which demonstrate a clinal and mechanical improvement after treatment. No major complications were recorded among the patients. The principle of distraction-osteogenesis is a useful option and should be considered as a rescue solution in complex deformities. Its execution by surgeons with considerable experience is crucial. The new hexapod fixators simplify the correction process but remain useful tools in expert hands.","PeriodicalId":165718,"journal":{"name":"Rheumatology and Orthopedic Medicine","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114727233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The US7 score is an effective tool of monitoring in patients with rheumatoid arthritis over 6 months of Tocilizumab US7评分是监测类风湿关节炎患者使用Tocilizumab超过6个月的有效工具

Rheumatology and Orthopedic Medicine Pub Date : 1900-01-01 DOI: 10.15761/rom.1000168

M. Erraoui, H. Rkain, I. Bouaddi, S. Aktaou, K. Benbouazza, S. Rostom, B. Amine, R. Bahiri, F. Allali, N. Hajjaj-Hassouni

{"title":"The US7 score is an effective tool of monitoring in patients with rheumatoid arthritis over 6 months of Tocilizumab","authors":"M. Erraoui, H. Rkain, I. Bouaddi, S. Aktaou, K. Benbouazza, S. Rostom, B. Amine, R. Bahiri, F. Allali, N. Hajjaj-Hassouni","doi":"10.15761/rom.1000168","DOIUrl":"https://doi.org/10.15761/rom.1000168","url":null,"abstract":"Objectives: Musculoskeletal Ultrasonography (US) has increasingly been used as an outcome measure in clinical trials of RA. The German ultrasonography 7 (US7) score is a semiquantitative US scoring system that combined soft tissue changes (synovitis and tenosynovitis) and erosive bone lesions in seven preselected joints. We aimed to evaluate clinical and ultrasonographic evolution and their correlation in patients with rheumatoid arthritis (RA) treated with tocilizumab (TCZ) by using the German US7 score. Methods: Twenty-two consecutive patients, affected by RA [19 females, median age of 41 years (35, 50), median disease duration of 72 months (36,171)] who were none or partial responders to methotrexate were commenced on TCZ. The patients underwent clinical, laboratory, and ultrasonographic assessment at 3 visits (baseline and after 3 and 6 months). The Disease Activity Score in 28 joints (DAS28) was recorded at each visit. The German US7 score was performed to assess synovitis, tenosynovitis, erosions and synovial/tenosynovial vascularity. Clinical remission, defined by a DAS 28 < 2.6, was assessed at the 3 visits of follow-up. Results: At baseline, the median DAS28 score was 5.2 (4.4, 6.2) and the synovitis scores were 9.5 (6.7, 15) in GS ultrasound and 2.5 (0, 7.2) in PD ultrasound. After 6 months of therapy, the DAS28 significantly decreased to 1.6 (0.8, 2.4); p <0.001. GS and PD ultrasound scores significantly decreased respectively to 5 (4, 6); p=0.001 and to 0.5 (0, 1.7); p=0.04. Conclusion: The German US7 is effective to reflect the therapeutic response of RA patients under TCZ as same as clinical and biological findings. and functional status parameters changes and ultrasonographic findings variations 6 months after onset basing on the US7 score.","PeriodicalId":165718,"journal":{"name":"Rheumatology and Orthopedic Medicine","volume":"84 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134188698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Is arthritis associated with cardiovascular diseases in both sexes? An analysis of NHANES data 无论男女，关节炎是否与心血管疾病有关?NHANES数据分析

Rheumatology and Orthopedic Medicine Pub Date : 1900-01-01 DOI: 10.15761/ROM.1000183

Rachelle Saade, D. Laurin, C. Dionne

{"title":"Is arthritis associated with cardiovascular diseases in both sexes? An analysis of NHANES data","authors":"Rachelle Saade, D. Laurin, C. Dionne","doi":"10.15761/ROM.1000183","DOIUrl":"https://doi.org/10.15761/ROM.1000183","url":null,"abstract":"Background: Among arthritis patients, cardiovascular morbidity is increased, and sex disparities exist in cardiovascular diseases and arthritis. Thus, the hypothesis that the association between cardiovascular diseases and arthritis might vary according to sex seems plausible. Aim: To examine the relationship of arthritis with the most frequently diagnosed cardiovascular diseases, and to check if sex modifies this association. Methods: We analyzed data from a large representative sample of the U.S. population: The National Health and Nutrition Examination Survey (NHANES) 2005- 2006. Our cross-sectional analyses included 3621 participants aged between 20 and 69 years old. Self-reported diagnoses of arthritis (main independent variable) and cardiovascular diseases (dependent variable) were measured during face-to-face interviews, and different covariates were identified as potential confounders for the association examined. Analyses were stratified by sex. Results: In multivariate analyses, a significant positive association was found between arthritis and cardiovascular diseases (OR: 2.01; 95% CI: 1.38-2.94; p value=0.0003), but there was no effect modification by sex (men: OR: 1.95; 95% CI: 1.32-2.87 / women: OR: 2.38; 95% CI: 0.96-5.86) (p=0,729). Conclusions: In this large cross-sectional study, we observed a statistically significant association between self-reported diagnoses of arthritis and cardiovascular diseases in a cohort of non-institutionalized U.S. adults. The association persisted after adjustment for several confounders but was not modified by sex.","PeriodicalId":165718,"journal":{"name":"Rheumatology and Orthopedic Medicine","volume":"57 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127964370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Tocilizumab treatment of therapy refractory thoracic aortitis in a patient with retroperitoneal fibrosis 托珠单抗治疗腹膜后纤维化患者难治性胸主动脉炎

Rheumatology and Orthopedic Medicine Pub Date : 1900-01-01 DOI: 10.15761/ROM.1000172

J. B. M. Christ, D. Moka, J. Strunk

{"title":"Tocilizumab treatment of therapy refractory thoracic aortitis in a patient with retroperitoneal fibrosis","authors":"J. B. M. Christ, D. Moka, J. Strunk","doi":"10.15761/ROM.1000172","DOIUrl":"https://doi.org/10.15761/ROM.1000172","url":null,"abstract":"In this report, we present the case of a patient with retroperitoneal fibrosis and aortitis. Most authors suggest glucocorticoid treatment as first-line therapy. Further optimal steroid-sparing medication has not been established. Over the years, our patient was treated with mycophenolate mofetil, methotrexate, infliximab, etanercept, azathioprine and several steroid-pulse therapies. Despite of this wide immunosuppressive treatment regular fluor-18-fluorodeoxyglucose positron emission computed tomography scans revealed refractory aortitis of the dilated ascending aorta. Since a growing number of reports support the efficacy of B cell depletion with rituximab in patients with retroperitoneal fibrosis and aortitis, we started medication with rituximab. After nine month of treatment a follow-up fluor-18-fluorodeoxyglucose positron emission computed tomography scan still showed unaffected aortitis. Since the aortitis was refractory to previous immunosuppressive drugs we decided to start medication with tocilizumab. This seemed feasible, since several studies indicated that tocilizumab may be a useful therapy option in patients with inflammatory aortitis and in patients with large vessel vasculitis featuring a positive response upon treatment with tocilizumab. Six we The most recent fluor-18-fluorodeoxyglucose positron emission computed tomography scan after six months of treatment revealed a significant decrease in fluorodeoxyglucose uptake at both the thoracic and abdominal aorta following tocilizumab therapy. To avoid complications like aneurysm or dissection, effective treatment of aortitis related to retroperitoneal fibrosis is necessary. Optimal treatment has not been established, yet. Here, tocilizumab was effective to treat therapy refractory retroperitoneal fibrosis - related aortitis.","PeriodicalId":165718,"journal":{"name":"Rheumatology and Orthopedic Medicine","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129798578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Improvement in urate nephrolithiasis with pegloticase in gout pegloticase对痛风患者尿酸型肾结石的改善作用

Rheumatology and Orthopedic Medicine Pub Date : 1900-01-01 DOI: 10.15761/ROM.1000174

P. Bansal, Austin Cusick, A. Goyal

引用次数: 0

Effects of one-year anti-TNF-α therapy on biomarkers of angiogenesis and functional vascular parameters in arthritides 一年抗tnf -α治疗对关节炎血管生成生物标志物和血管功能参数的影响

Rheumatology and Orthopedic Medicine Pub Date : 1900-01-01 DOI: 10.15761/rom.1000169

E. Balogh, E. Végh, G. Kerekes, A. Pusztai, A. Hamar, K. Hodosi, S. Szamosi, A. Váncsa, P. Csomor, L. Bodoki, L. Pogácsás, F. Balázs, J. McCormick, M. Biniecka, I. Tar, K. Lundberg, N. Kharlamova, S. Szántó, G. Szűcs, Z. Nagy, U. Fearon, Douglas J Veale, Z. Szekanecz

引用次数: 3