Pub Date : 2021-01-01DOI: 10.37532/1758-4272.2021.16(2).079
Z. Taha, Shaima N. Elgenaid, M. Ahmed
Systemic Lupus Erythromatous (SLE) is an auto immune disease characterized by multi-organ affection, Guillain–Barre syndrome (GBS) is considered as an unusual and one of the least neuropsychiatric syndromes in SLE, this case report aiming to report a rare association of GBS as an initial presentation for an SLE in a female patient. A middle age female was presented with palpitation, shortness of breath and body weakness, she was admitted for four days and diagnosed with atypical GBS. She received Intravenous immunoglobulin (IVIG) for three days but no improvement was been noticed. The patient complained of dry cough, shortness of breath, palpitations and generalized weakness in association with back pain and paraesthesia of the fingers. General examination and lab workup were done and revealed a presence of SLE in relation to GBS. IVIG was then commenced 0.4 g/kg body/weight/day with Hydroxychloroquine 200mg tabs BID, Prednisolone 40mg, calcicare and Mycophenolatemofetil. Significant improvement was noted after receiving the above-mentioned medications and over a period of three months all her symptoms and complains were subside.
{"title":"Guillain - Barre syndrome as the first presentation in a patient with systemic lupus erythromatous; case report","authors":"Z. Taha, Shaima N. Elgenaid, M. Ahmed","doi":"10.37532/1758-4272.2021.16(2).079","DOIUrl":"https://doi.org/10.37532/1758-4272.2021.16(2).079","url":null,"abstract":"Systemic Lupus Erythromatous (SLE) is an auto immune disease characterized by multi-organ affection, Guillain–Barre syndrome (GBS) is considered as an unusual and one of the least neuropsychiatric syndromes in SLE, this case report aiming to report a rare association of GBS as an initial presentation for an SLE in a female patient. A middle age female was presented with palpitation, shortness of breath and body weakness, she was admitted for four days and diagnosed with atypical GBS. She received Intravenous immunoglobulin (IVIG) for three days but no improvement was been noticed. The patient complained of dry cough, shortness of breath, palpitations and generalized weakness in association with back pain and paraesthesia of the fingers. General examination and lab workup were done and revealed a presence of SLE in relation to GBS. IVIG was then commenced 0.4 g/kg body/weight/day with Hydroxychloroquine 200mg tabs BID, Prednisolone 40mg, calcicare and Mycophenolatemofetil. Significant improvement was noted after receiving the above-mentioned medications and over a period of three months all her symptoms and complains were subside.","PeriodicalId":13740,"journal":{"name":"International Journal of Clinical Rheumatology","volume":"71 1","pages":"079"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78722420","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}
Pub Date : 2021-01-01DOI: 10.37532/1758-4272.2021.16(8).239
A. Khodiev
Background: Because articular chondrocyte-based Autologous Chondrocyte Implantations (ACIs) have restrictively restored articular cartilage defects, alternative cell sources as a new therapeutic option for cartilage repair have been introduced. Purpose: To assess whether implantation of a Costal Chondrocyte–Derived Pellet-Type (CCP) ACI allows safe, functional, and structural restoration of full-thickness cartilage defects in the knee. Study Design Case series: Level of evidence, Methods: In this first-in-human study, 7 patients with symptomatic, full-thickness cartilage lesions were enrolled. The chondrocytes isolated from the patients’ costal cartilage were expanded, followed by 3-dimensional pellet culture to prepare the CCP-ACI. Implantation of the pellets was performed via minimal arthrotomy and secured with a fibrin sealant. Clinical scores, including the International Knee Documentation Committee (IKDC) subjective, Lysholm, and Tegner activity scores, were estimated preoperatively and at 1, 2, and 5 years postoperatively. High-resolution magnetic resonance imaging was also performed to evaluate cartilage repair as well as to calculate the MOCART (magnetic resonance observation of cartilage repair tissue) score. Results: The costal chondrocytes of all patients formed homogeneous-sized pellets, which showed the characteristics of the hyaline cartilaginous tissue with lacunae-occupied chondrocytes surrounded by glycosaminoglycan and type II collagen-rich extracellular matrix. There were no treatment-related serious adverse events during the 5-year follow-up period. Significant improvements were seen in all clinical scores from preoperative baseline to the 5-year follow-up (IKDC subjective score, 34.67 to 75.86; Lysholm score, 34.00 to 85.33; Tegner activity score, 1.17 to 4.67; and MOCART score, 28.33 to 83.33). Two patients had complete defect filling on magnetic resonance imaging evaluation at 1 year. Moreover, at 5 years postoperatively, complete defect filling was observed in 4 patients, and hypertrophy or incomplete defect filling (50%-100%) was observed in 2 patients. Conclusion: The overall results of this clinical study suggest that CCP-ACI can emerge as a promising therapeutic option for articular cartilage repair with good clinical outcomes and structural regeneration and with stable results at midterm follow-up.
{"title":"Chondrocyte Implantation for Treatment of Articular Cartilage","authors":"A. Khodiev","doi":"10.37532/1758-4272.2021.16(8).239","DOIUrl":"https://doi.org/10.37532/1758-4272.2021.16(8).239","url":null,"abstract":"Background: Because articular chondrocyte-based Autologous Chondrocyte Implantations (ACIs) have restrictively restored articular cartilage defects, alternative cell sources as a new therapeutic option for cartilage repair have been introduced. Purpose: To assess whether implantation of a Costal Chondrocyte–Derived Pellet-Type (CCP) ACI allows safe, functional, and structural restoration of full-thickness cartilage defects in the knee. Study Design Case series: Level of evidence, Methods: In this first-in-human study, 7 patients with symptomatic, full-thickness cartilage lesions were enrolled. The chondrocytes isolated from the patients’ costal cartilage were expanded, followed by 3-dimensional pellet culture to prepare the CCP-ACI. Implantation of the pellets was performed via minimal arthrotomy and secured with a fibrin sealant. Clinical scores, including the International Knee Documentation Committee (IKDC) subjective, Lysholm, and Tegner activity scores, were estimated preoperatively and at 1, 2, and 5 years postoperatively. High-resolution magnetic resonance imaging was also performed to evaluate cartilage repair as well as to calculate the MOCART (magnetic resonance observation of cartilage repair tissue) score. Results: The costal chondrocytes of all patients formed homogeneous-sized pellets, which showed the characteristics of the hyaline cartilaginous tissue with lacunae-occupied chondrocytes surrounded by glycosaminoglycan and type II collagen-rich extracellular matrix. There were no treatment-related serious adverse events during the 5-year follow-up period. Significant improvements were seen in all clinical scores from preoperative baseline to the 5-year follow-up (IKDC subjective score, 34.67 to 75.86; Lysholm score, 34.00 to 85.33; Tegner activity score, 1.17 to 4.67; and MOCART score, 28.33 to 83.33). Two patients had complete defect filling on magnetic resonance imaging evaluation at 1 year. Moreover, at 5 years postoperatively, complete defect filling was observed in 4 patients, and hypertrophy or incomplete defect filling (50%-100%) was observed in 2 patients. Conclusion: The overall results of this clinical study suggest that CCP-ACI can emerge as a promising therapeutic option for articular cartilage repair with good clinical outcomes and structural regeneration and with stable results at midterm follow-up.","PeriodicalId":13740,"journal":{"name":"International Journal of Clinical Rheumatology","volume":"32 1","pages":"239"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80914581","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}
Pub Date : 2021-01-01DOI: 10.37532/1758-4272.2021.16(2).088
Àlex, P. erRozin
COVID-19 vaccine became clear card life-saving medication. Due to over world vaccination a rate of prevalence and incidence of coronal infection is going to back down. However, we meet different side effects of the vaccine. Two cases of subdeltoid bursitis after COVID-19 vaccination discussed.
{"title":"Are subdeltoid bursitis and polymyalgia rheumatica preferances of COVID-19 vaccine?","authors":"Àlex, P. erRozin","doi":"10.37532/1758-4272.2021.16(2).088","DOIUrl":"https://doi.org/10.37532/1758-4272.2021.16(2).088","url":null,"abstract":"COVID-19 vaccine became clear card life-saving medication. Due to over world vaccination a rate of prevalence and incidence of coronal infection is going to back down. However, we meet different side effects of the vaccine. Two cases of subdeltoid bursitis after COVID-19 vaccination discussed.","PeriodicalId":13740,"journal":{"name":"International Journal of Clinical Rheumatology","volume":"167 1","pages":"088"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77829433","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}
Pub Date : 2021-01-01DOI: 10.37532/1758-4272.2021.16(6).172
H. A. Aldaoseri
Objectives: To investigate the relevance of Concomitant Trabecular Bone Score (TBS) and Areal Bone Mineral Density (aBMD) assessments to estimate fracture risk in patients with Degenerative Lumbar Spine Stenosis (DLSS). Methods: A cross-sectional prospective study was performed. Dual energy X-ray absorptiometry scans of the lumbar spine and hip were acquired in 50 patients with DLSS. TBS and aBMD were calculated from the anteroposterior views of L1-L4 vertebrae. The World Health Organisation Fracture Risk Assessment Tool (FRAX) was utilised to estimate hip or Major Osteoporotic Fracture (MOF) risk. Results: L1-L4 TBS scores revealed degraded microarchitecture, (TBS ≤ 1.20), partially degraded microarchitecture (TBS >1.20 and <1.35) or normal appearances (TBS ≥ 1.35) in 9 (18%), 14 (28%) and 27 (54%) patients, respectively. L1-L4 aBMD assessment demonstrated osteoporosis (T-score ≤- 2.5), osteopenia (T-score between -1.1 and -2.4) or normal bone density in 15 (30%), 11 (22%) and 24 (48%) patients, respectively. There was no relationship seen between L1-L4 aBMD and TBS measurements (r = 0.046; p = 0.75). A negative relationship was observed between TBS and body mass index (r = -0.438; p = 0.001) andbetween L1-L4 aBMD and FRAX (r = -0.617; p < 0.001); the latter included MOF and risk of hip fracture (r = -0.497; p < 0.001).No relationship was observed between TBS and FRAX included MOF and risk of hip fracture (r = -0.118; p = 0.416 and r = -0.014; p = 0.926, respectively) Conclusion: In patients with DLSS, TBS is a reliable, strong and standalone indicator of fracture risk
{"title":"The role of trabecular bone score, inaddition to FRAX, for the measurementof fracture risk in patients withdegenerative lumbar spine stenosis","authors":"H. A. Aldaoseri","doi":"10.37532/1758-4272.2021.16(6).172","DOIUrl":"https://doi.org/10.37532/1758-4272.2021.16(6).172","url":null,"abstract":"Objectives: To investigate the relevance of Concomitant Trabecular Bone Score (TBS) and Areal Bone Mineral Density (aBMD) assessments to estimate fracture risk in patients with Degenerative Lumbar Spine Stenosis (DLSS). Methods: A cross-sectional prospective study was performed. Dual energy X-ray absorptiometry scans of the lumbar spine and hip were acquired in 50 patients with DLSS. TBS and aBMD were calculated from the anteroposterior views of L1-L4 vertebrae. The World Health Organisation Fracture Risk Assessment Tool (FRAX) was utilised to estimate hip or Major Osteoporotic Fracture (MOF) risk. Results: L1-L4 TBS scores revealed degraded microarchitecture, (TBS ≤ 1.20), partially degraded microarchitecture (TBS >1.20 and <1.35) or normal appearances (TBS ≥ 1.35) in 9 (18%), 14 (28%) and 27 (54%) patients, respectively. L1-L4 aBMD assessment demonstrated osteoporosis (T-score ≤- 2.5), osteopenia (T-score between -1.1 and -2.4) or normal bone density in 15 (30%), 11 (22%) and 24 (48%) patients, respectively. There was no relationship seen between L1-L4 aBMD and TBS measurements (r = 0.046; p = 0.75). A negative relationship was observed between TBS and body mass index (r = -0.438; p = 0.001) andbetween L1-L4 aBMD and FRAX (r = -0.617; p < 0.001); the latter included MOF and risk of hip fracture (r = -0.497; p < 0.001).No relationship was observed between TBS and FRAX included MOF and risk of hip fracture (r = -0.118; p = 0.416 and r = -0.014; p = 0.926, respectively) Conclusion: In patients with DLSS, TBS is a reliable, strong and standalone indicator of fracture risk","PeriodicalId":13740,"journal":{"name":"International Journal of Clinical Rheumatology","volume":"11 1","pages":"172"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81425818","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}
Pub Date : 2021-01-01DOI: 10.37532/1758-4272.2021.16(8).228
Halime Ki̇bar, Derya Bugayci Nurdan Paker
Aim: Foot and ankle joints are among the joints evaluated in Rheumatoid Arthritis (RA), but not for the calculation of Disease Activity Score-28 (DAS28). The aim of the study is to evaluate the frequency of foot complaints in RA patients and to investigate the relationship between DAS28 and foot complaints and functional statuses. Method: DAS28 (with Erythrocyte Sedimentation Rate), Health Assessment Questionnaire (HAQ), Foot Function Index (FFI), Foot Function Index Pain subscale (FPI), Foot Function Index Deficiency subscale (FDI), Foot Function Index Limitation subscale (FLI), 6-meter (mt) walking time, Visual Analog Scale (VAS) are used to investigate the relationship between DAS28 and other index and scales. Results: 103 patients with RA are included in the study. 91.3% of the patients are female and 8.7 % are male. 66% of the patients have foot and ankle complaints and 34% have no complaints. It is observed that DAS28 is correlated positively with VAS (p<0.001, r=0.702), HAQ (p<0.001, r=0.530 ), FPI (p<0.001, r=0.490 ), FLI (p=0.002, r=0.311 ), FDI (p<0.001, r=0.495 ), FFI (p<0.001, r=0.485 ), 6 mt walking time (p=0.049, r= 0.198) and Erythrocyte Sedimentation Rate (p<0.001, r=0.57) respectively . In addition, it is observed that FFI is correlated positively with duration of disease (p=0.015, r=0.226), body mass index (p=0.002, r=0.292), VAS (p<0.001, r=0.639), HAQ (p<0.001, r=0.376), 6 mt walking time ( p<0.001, r =0.551 ) and the Erythrocyte Sedimentation Rate ( p<0.001, r=0.247). Conclusion: Foot complaints in patients with RA are seen at high rates. Despite the extent of the problem, the rheumatoid foot is neglected. Patients with foot complaints are more likely to have higher inflammatory levels and have more functional limitations. The DAS28 score can also be used for follow-up in patients with foot complaints. In addition, foot complaints must be questioned and clinical and functional follow-up should be done. FFI and subscores can be used in evaluating and following foot complaints in patients with RA.
{"title":"The Relationship Between Foot Symptoms With Disease Activity And Functional State In Patients With Rheumatoid Arthritis","authors":"Halime Ki̇bar, Derya Bugayci Nurdan Paker","doi":"10.37532/1758-4272.2021.16(8).228","DOIUrl":"https://doi.org/10.37532/1758-4272.2021.16(8).228","url":null,"abstract":"Aim: Foot and ankle joints are among the joints evaluated in Rheumatoid Arthritis (RA), but not for the calculation of Disease Activity Score-28 (DAS28). The aim of the study is to evaluate the frequency of foot complaints in RA patients and to investigate the relationship between DAS28 and foot complaints and functional statuses. Method: DAS28 (with Erythrocyte Sedimentation Rate), Health Assessment Questionnaire (HAQ), Foot Function Index (FFI), Foot Function Index Pain subscale (FPI), Foot Function Index Deficiency subscale (FDI), Foot Function Index Limitation subscale (FLI), 6-meter (mt) walking time, Visual Analog Scale (VAS) are used to investigate the relationship between DAS28 and other index and scales. Results: 103 patients with RA are included in the study. 91.3% of the patients are female and 8.7 % are male. 66% of the patients have foot and ankle complaints and 34% have no complaints. It is observed that DAS28 is correlated positively with VAS (p<0.001, r=0.702), HAQ (p<0.001, r=0.530 ), FPI (p<0.001, r=0.490 ), FLI (p=0.002, r=0.311 ), FDI (p<0.001, r=0.495 ), FFI (p<0.001, r=0.485 ), 6 mt walking time (p=0.049, r= 0.198) and Erythrocyte Sedimentation Rate (p<0.001, r=0.57) respectively . In addition, it is observed that FFI is correlated positively with duration of disease (p=0.015, r=0.226), body mass index (p=0.002, r=0.292), VAS (p<0.001, r=0.639), HAQ (p<0.001, r=0.376), 6 mt walking time ( p<0.001, r =0.551 ) and the Erythrocyte Sedimentation Rate ( p<0.001, r=0.247). Conclusion: Foot complaints in patients with RA are seen at high rates. Despite the extent of the problem, the rheumatoid foot is neglected. Patients with foot complaints are more likely to have higher inflammatory levels and have more functional limitations. The DAS28 score can also be used for follow-up in patients with foot complaints. In addition, foot complaints must be questioned and clinical and functional follow-up should be done. FFI and subscores can be used in evaluating and following foot complaints in patients with RA.","PeriodicalId":13740,"journal":{"name":"International Journal of Clinical Rheumatology","volume":"62 1","pages":"228"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90614110","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}
Pub Date : 2021-01-01DOI: 10.37532/1758-4272.2021.16(2).073
R. Salesi
Objective: To compare the efficacy of Adalimumab versus Infliximab in patients with active Ankylosing Spondylitis. Method: 80 patients with active AS who were candidates for receiving anti TNF drugs were randomly assigned to Adalimumab receiving group (group A) or Infliximab receiving group (group B). At beginning, BASDAI score, ESR level, CRP level, presence or absence of peripheral arthritis and enthesitis, need for NSAID use, schober test and occiput to wall distance were recorded. A second rheumatologist who was unaware of the type of drug used, evaluated patients 2 months and 4 months after initiating treatment and new data was recorded. Data were analyzed using SPSS software version 26 with T-test, Mann-Whitney U test, Chi-squared test, McNemar and Wilcoxon test. Results: after 2 and 4 months treatment, patients of both groups showed significant improvement in the BASDAI score, ESR level, CRP level and Schober test. They all needed less NSAID to control their pain. Both drugs had similar effects on clinical and laboratory variables. Conclusion: Adalimumab and Infliximab are both effective for improving clinical and physical status and quality of life in patients with active AS. Since there is no significant difference for the effectiveness of these 2 drugs, accessibility, price and administration of these drugs can help physicians decide between these drugs.
{"title":"Effectiveness of adalimumab versus infliximab in patients with ankylosing spondylitis: A randomized double blinded clinical trial","authors":"R. Salesi","doi":"10.37532/1758-4272.2021.16(2).073","DOIUrl":"https://doi.org/10.37532/1758-4272.2021.16(2).073","url":null,"abstract":"Objective: To compare the efficacy of Adalimumab versus Infliximab in patients with active Ankylosing Spondylitis. Method: 80 patients with active AS who were candidates for receiving anti TNF drugs were randomly assigned to Adalimumab receiving group (group A) or Infliximab receiving group (group B). At beginning, BASDAI score, ESR level, CRP level, presence or absence of peripheral arthritis and enthesitis, need for NSAID use, schober test and occiput to wall distance were recorded. A second rheumatologist who was unaware of the type of drug used, evaluated patients 2 months and 4 months after initiating treatment and new data was recorded. Data were analyzed using SPSS software version 26 with T-test, Mann-Whitney U test, Chi-squared test, McNemar and Wilcoxon test. Results: after 2 and 4 months treatment, patients of both groups showed significant improvement in the BASDAI score, ESR level, CRP level and Schober test. They all needed less NSAID to control their pain. Both drugs had similar effects on clinical and laboratory variables. Conclusion: Adalimumab and Infliximab are both effective for improving clinical and physical status and quality of life in patients with active AS. Since there is no significant difference for the effectiveness of these 2 drugs, accessibility, price and administration of these drugs can help physicians decide between these drugs.","PeriodicalId":13740,"journal":{"name":"International Journal of Clinical Rheumatology","volume":"17 1","pages":"073"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75258853","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}
Pub Date : 2021-01-01DOI: 10.37532/1758-4272.2021.16(2).084
Adam Kilian, Ma Ch, Maha Almackenzie, NadineMbuyi, S. Bilal, Gelareh Atefi Victoria K. Shanmugam
During January 2021, rheumatologic care in Washington DC was affected by both the peak of the COVID-19 pandemic in the United States as well as a deadly insurrection and attack on the US Capitol. As rheumatologists practicing a few blocks from the White House, the authors discuss the crucial role that telemedicine served in delivering healthcare to patients with rheumatic diseases during and after the attack on the US Capitol as threats of violence, physical barriers, military vehicles, and armed troops challenged traditional means of caring for patients. The authors also discuss the role for telemedicine in safely providing future healthcare delivery.
{"title":"COVID catalyst: telemedicine in rheumatology protects patient care beyond just the pandemic","authors":"Adam Kilian, Ma Ch, Maha Almackenzie, NadineMbuyi, S. Bilal, Gelareh Atefi Victoria K. Shanmugam","doi":"10.37532/1758-4272.2021.16(2).084","DOIUrl":"https://doi.org/10.37532/1758-4272.2021.16(2).084","url":null,"abstract":"During January 2021, rheumatologic care in Washington DC was affected by both the peak of the COVID-19 pandemic in the United States as well as a deadly insurrection and attack on the US Capitol. As rheumatologists practicing a few blocks from the White House, the authors discuss the crucial role that telemedicine served in delivering healthcare to patients with rheumatic diseases during and after the attack on the US Capitol as threats of violence, physical barriers, military vehicles, and armed troops challenged traditional means of caring for patients. The authors also discuss the role for telemedicine in safely providing future healthcare delivery.","PeriodicalId":13740,"journal":{"name":"International Journal of Clinical Rheumatology","volume":"74 1","pages":"084"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77182256","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}
Pub Date : 2021-01-01DOI: 10.37532/1758-4272.2021.16(7).216
Pooja Pithadia, Pratham Singh
Objective: To evaluate the effect of combining ultrasound-guided Platelet-Rich Plasma (PRP) therapy with physical therapy for rotator cuff tendinopathy. Design: We present a case report of rotator cuff tendinopathy treated with ultrasound-guided Platelet-Rich Plasma (PRP) injections followed by physical therapy. Methods: After undergoing conventional treatment modalities, a patient underwent a course of ultrasound guided PRP injection followed by physical therapy (core strengthening) for 10 weeks. The patient outcome was measured using the numerical Pain Rating Scale (NPRS), Oxford Scoring System (OSS), and the Western Ontario and McMaster Universities Arthritis (WOMAC) Index. Radiological examination using Magnetic Resonance Imaging (MRI) was also performed before and after PRP treatment. Results: Following treatment, the patient reported pain relief within a week. As the patient continued core strengthening exercise for 10 weeks, he showed drastic improvement in function with no pain and discomfort as determined by NPRS, OSS, and WOMAC index respectively. At the same time, there were no significant complications. Even the repeat MRI performed after 18 m showed no supraspinatus tendinopathy tear. Conclusion: In this case report, PRP injections in combination with physical therapy for the treatment of rotator cuff tendinopathy demonstrated improvement in all outcome measures. This highlights the need for conducting more controlled trials to determine the effect of this combinational treatment.
{"title":"Effect of platelet-rich plasma therapy in conjunction with physical therapy for rotator cuff tendinopathy","authors":"Pooja Pithadia, Pratham Singh","doi":"10.37532/1758-4272.2021.16(7).216","DOIUrl":"https://doi.org/10.37532/1758-4272.2021.16(7).216","url":null,"abstract":"Objective: To evaluate the effect of combining ultrasound-guided Platelet-Rich Plasma (PRP) therapy with physical therapy for rotator cuff tendinopathy. Design: We present a case report of rotator cuff tendinopathy treated with ultrasound-guided Platelet-Rich Plasma (PRP) injections followed by physical therapy. Methods: After undergoing conventional treatment modalities, a patient underwent a course of ultrasound guided PRP injection followed by physical therapy (core strengthening) for 10 weeks. The patient outcome was measured using the numerical Pain Rating Scale (NPRS), Oxford Scoring System (OSS), and the Western Ontario and McMaster Universities Arthritis (WOMAC) Index. Radiological examination using Magnetic Resonance Imaging (MRI) was also performed before and after PRP treatment. Results: Following treatment, the patient reported pain relief within a week. As the patient continued core strengthening exercise for 10 weeks, he showed drastic improvement in function with no pain and discomfort as determined by NPRS, OSS, and WOMAC index respectively. At the same time, there were no significant complications. Even the repeat MRI performed after 18 m showed no supraspinatus tendinopathy tear. Conclusion: In this case report, PRP injections in combination with physical therapy for the treatment of rotator cuff tendinopathy demonstrated improvement in all outcome measures. This highlights the need for conducting more controlled trials to determine the effect of this combinational treatment.","PeriodicalId":13740,"journal":{"name":"International Journal of Clinical Rheumatology","volume":"29 1","pages":"216"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76146685","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}
Pub Date : 2021-01-01DOI: 10.37532/1758-4272.2021.16(8).249
J. M. Torres
Reactive arthritis is classified in the group of spondyloarthritis, it has been frequently associated with bacterial infections, however, it has also been linked with viral infections. Recently, different patterns of arthritis have been reported in convalescent COVID-19 patients, with involvement of large and small joints. We report the first case of post-covid 19 arthritis evaluated with ultrasound, highlighting the examination of tendons and entheses. We found an asymmetric polyarticular inflammatory pattern characterized by synovial hypertrophy, effusion, tenosynovitis, and ultrasound signs of enthesitis, based on OMERACT definitions. Ultrasound is a tool that has greater sensitivity than physical examination for the diagnosis as well as for the follow-up of patients with autoimmune diseases.
{"title":"Ultrasound findings in Reactive arthritis after COVID-19: Case Report","authors":"J. M. Torres","doi":"10.37532/1758-4272.2021.16(8).249","DOIUrl":"https://doi.org/10.37532/1758-4272.2021.16(8).249","url":null,"abstract":"Reactive arthritis is classified in the group of spondyloarthritis, it has been frequently associated with bacterial infections, however, it has also been linked with viral infections. Recently, different patterns of arthritis have been reported in convalescent COVID-19 patients, with involvement of large and small joints. We report the first case of post-covid 19 arthritis evaluated with ultrasound, highlighting the examination of tendons and entheses. We found an asymmetric polyarticular inflammatory pattern characterized by synovial hypertrophy, effusion, tenosynovitis, and ultrasound signs of enthesitis, based on OMERACT definitions. Ultrasound is a tool that has greater sensitivity than physical examination for the diagnosis as well as for the follow-up of patients with autoimmune diseases.","PeriodicalId":13740,"journal":{"name":"International Journal of Clinical Rheumatology","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80886673","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}
Pub Date : 2021-01-01DOI: 10.37532/1758-4272.2021.16(2).121
S. Sharif, Kristaq Koci, Z. Chaudhry, A. Baqir, Naureen Kabani Olga Dvorkina
Background: Kikuchi Fujimoto Disease (KFD) is a rare autoimmune disorder manifesting with prolonged fevers and lymphadenitis. It is proposed to be triggered by infectious agents in genetically susceptible patients. Diagnosis is confirmed with lymph node biopsy. In most patients, symptoms resolve spontaneously but rarely glucocorticoids are required for remission. Clinical Summary: This is a unique case of KFD with mesenteric lymphadenitis leading to a new diagnosis of Systemic Lupus Erythematosus (SLE) in a 24-year-old African American male presenting with two weeks of epigastric pain and fever. Initial CT abdomen showed a heterogeneous soft tissue mass followed by CT guided core biopsy of mesenteric lymph nodes revealing necrotic lymphadenopathy. He was empirically treated for intraabdominal infection with antibiotics and then discharged home. A week later he was re-admitted for similar complaints. He was febrile and tachycardic. Labs showed neutropenia and elevated inflammatory markers. Infectious work up was negative. Autoimmune panel was positive for an Anti-Nucleic Acid (ANA), Ribonucleoprotein (RNP), Smooth Muscle (SM) Antibodies and Urine Protein: Creatinine Ratio (UPCR) of 0.5 gr and 1.2 gron two separate occasions. He was treated empirically with IV antibiotics followed by filgrastim. Mesenteric lymph node open biopsy demonstrated large areas of necrosis and characteristic absence of neutrophils. Thus, KFD and SLE were diagnosed based on SLICC criterion of SLE diagnosis. Treatment with Solumedrol 40 mg IV Q12 resulted in clinical improvement and discharge from hospital. Hydroxychloroquine 200 BID was added with steroid taper as patient continued to improve during outpatient follow ups. Conclusion: It is the first reported case of KFD with mesenteric lymphadenitis as the initial manifestation in a young African American male. This rare presentation masquerades the diagnosis leading to unnecessary procedures and empiric treatments. It warrants further research on the underlying pathophysiology and the need for a standardized diagnostic criterion and treatment guidelines of the disease.
背景:菊池藤本病(KFD)是一种罕见的自身免疫性疾病，表现为持续发热和淋巴结炎。它被认为是由遗传易感患者的传染性病原体引发的。通过淋巴结活检确诊。在大多数患者中，症状自发消退，但很少需要糖皮质激素缓解。临床总结:这是一例独特的KFD合并肠系膜淋巴结炎导致系统性红斑狼疮(SLE)的新诊断，患者为24岁的非裔美国男性，表现为两周的上腹部疼痛和发烧。腹部初始CT显示异质软组织肿块，随后CT引导下肠系膜淋巴结核心活检显示坏死淋巴结病。他经验性地用抗生素治疗腹内感染，然后出院回家。一周后，他因类似的投诉再次入院。他发热，心跳过速。实验室显示中性粒细胞减少和炎症标志物升高。传染功呈阴性。自身免疫组抗核酸(ANA)、核糖核蛋白(RNP)、平滑肌(SM)抗体阳性，尿蛋白:肌酐比(UPCR)分别为0.5克和1.2克。经验性给予静脉注射抗生素，随后给予非格拉西汀治疗。肠系膜淋巴结开放性活检显示大面积坏死和中性粒细胞缺失。因此，根据SLE诊断的SLICC标准诊断KFD和SLE。应用舒美地醇40mg IV Q12治疗，临床改善，出院。在门诊随访中，随着患者持续改善，羟氯喹200bid与类固醇逐渐增加。结论:这是首例报道的以肠系膜淋巴结炎为首发表现的KFD，患者为年轻的非裔美国男性。这种罕见的表现掩盖了诊断，导致不必要的程序和经验性治疗。它需要进一步研究潜在的病理生理学和需要一个标准化的诊断标准和治疗指南的疾病。
{"title":"Fever of unknown origin and mesenteric mass: a case of kikuchi fujimoto disease and systemic lupus erythematosus","authors":"S. Sharif, Kristaq Koci, Z. Chaudhry, A. Baqir, Naureen Kabani Olga Dvorkina","doi":"10.37532/1758-4272.2021.16(2).121","DOIUrl":"https://doi.org/10.37532/1758-4272.2021.16(2).121","url":null,"abstract":"Background: Kikuchi Fujimoto Disease (KFD) is a rare autoimmune disorder manifesting with prolonged fevers and lymphadenitis. It is proposed to be triggered by infectious agents in genetically susceptible patients. Diagnosis is confirmed with lymph node biopsy. In most patients, symptoms resolve spontaneously but rarely glucocorticoids are required for remission. Clinical Summary: This is a unique case of KFD with mesenteric lymphadenitis leading to a new diagnosis of Systemic Lupus Erythematosus (SLE) in a 24-year-old African American male presenting with two weeks of epigastric pain and fever. Initial CT abdomen showed a heterogeneous soft tissue mass followed by CT guided core biopsy of mesenteric lymph nodes revealing necrotic lymphadenopathy. He was empirically treated for intraabdominal infection with antibiotics and then discharged home. A week later he was re-admitted for similar complaints. He was febrile and tachycardic. Labs showed neutropenia and elevated inflammatory markers. Infectious work up was negative. Autoimmune panel was positive for an Anti-Nucleic Acid (ANA), Ribonucleoprotein (RNP), Smooth Muscle (SM) Antibodies and Urine Protein: Creatinine Ratio (UPCR) of 0.5 gr and 1.2 gron two separate occasions. He was treated empirically with IV antibiotics followed by filgrastim. Mesenteric lymph node open biopsy demonstrated large areas of necrosis and characteristic absence of neutrophils. Thus, KFD and SLE were diagnosed based on SLICC criterion of SLE diagnosis. Treatment with Solumedrol 40 mg IV Q12 resulted in clinical improvement and discharge from hospital. Hydroxychloroquine 200 BID was added with steroid taper as patient continued to improve during outpatient follow ups. Conclusion: It is the first reported case of KFD with mesenteric lymphadenitis as the initial manifestation in a young African American male. This rare presentation masquerades the diagnosis leading to unnecessary procedures and empiric treatments. It warrants further research on the underlying pathophysiology and the need for a standardized diagnostic criterion and treatment guidelines of the disease.","PeriodicalId":13740,"journal":{"name":"International Journal of Clinical Rheumatology","volume":"39 1","pages":"121"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91166615","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：