In the present study, we investigated bone geometry, microstructure, and volumetric bone mineral density (vBMD) in a cohort of patients with nonradiographic axial spondyloarthritis (nr-axSpA) in order to define the early bone changes occurring in axial spondyloarthritis (axSpA) and to define potential factors for deterioration of bone microstructure. Patients with axSpA (n = 107) and healthy control subjects (n = 50) of similar age and sex were assessed for geometric, volumetric, and microstructural parameters of bone using high-resolution peripheral quantitative computed tomography (HR-pQCT) at the radius. Additionally, demographic and disease-specific characteristics of patients with axSpA were recorded. Patients with nr-axSpA and control subjects were comparable in age, sex, and body mass index. Geometric and microstructural analysis by HR-pQCT revealed a significantly reduced cortical area (p = 0.022) and cortical thickness (p = 0.006) in patients with nr-axSpA compared with control subjects. Total
In our study, edema and contrast enhancement revealing osteitis were seen on all sequences with perfect agreement between observers; however, FS T2 WI and CE FS T1 WI planes showed the highest agreement.. It is crucial to detect active sacroiliitis and differentiate it from chronic changes. Establishing early diagnosis of active sacroiliitis and monitoring it for potential changes after therapies are of particular importance. MRI plays an important role to evaluate sacroiliitis and shows the degree of inflammation without using ionizing radiation.. The earliest signs of sacroiliitis can be identified using MRI. Periarticular bone edema is associated with increased signal in FS FSE T2 W or STIR sequences and with contrast-enhancement in FS FSE T1 W sequences after administration of gadolinium (14). We found that edema and contrast enhancement of periarticular bone revealing active sacroiliitis was shown with the highest agreement and kappa value between observers on CE FS T1 WI within all ...
Current classification criteria for axial spondyloarthritis (axSpA) provide for the inclusion of patients with a wide range of presentations and manifestations. While not considered a formal subclassification, patients are often divided into radiographic or nonradiographic axSpA based on the presence or absence of radiographic sacroiliitis. This review will focus on nonradiographic axSpA and will discuss clinical manifestations of disease that distinguish, or in many cases do not distinguish, this entity from other individuals with axSpA. This review will also cover treatment paradigms for nonradiographic axSpA, particularly the use of biologic therapies, where current data suggest that nonradiographic disease should be managed largely the same as radiographic disease, or classical ankylosing spondylitis.
We confirmed a similar burden of disease (as determined by self-reported disease activity, impaired function, and quality of life) in patients with nonradiographic axial SpA (n = 232) and those with radiographic axial SpA (n = 838). Patients with radiographic axial SpA had higher median levels of acute-phase reactants and higher median AS Disease Activity Scores (ASDAS; 3.2 versus 3.0). Anti-TNF treatment was initiated in 363 patients with radiographic axial SpA and 102 patients with nonradiographic axial SpA, preferentially in those with sacroiliitis on magnetic resonance imaging, peripheral arthritis, a higher C-reactive protein (CRP) level, a higher ASDAS, and a higher Bath Ankylosing Spondylitis Disease Activity Index level. The ASAS criteria for 40% improvement responses at 1 year were higher in patients with radiographic axial SpA compared with those with nonradiographic axial SpA (48.1% versus 29.6%; odds ratio [OR] 2.2, 95% confidence interval [95% CI] 1.12-4.46, P = 0.02). The ...
Postpartum inflammatory sacroiliitis is a well known clinical entity, treatment for which is conservative. Pyogenic sacroiliitis also has been reported in literature following caesarian section. We report a rare case of postpartum tuberculous (TB) sa
We show that low-dose IFX therapy is highly effective in reducing spinal inflammation observed on MRI. This effect was recorded in all patients who had inflammation at baseline. We also show that methods for quantifying spinal inflammation by MRI are equally and highly discriminatory, whether assessment is limited to only the most severely affected regions of the spine (6 DVU score) or includes the entire spine (23 DVU score). The data also reflect the discordance between MRI-defined and clinically defined outcome measures, which has been observed4,19.. The degree of reduction in spinal inflammation using the SPARCC method is comparable to that reported for adalimumab at 12 weeks, with reduction from baseline scores of 54% compared to an increase in the placebo group of 9% using the SPARCC 6 DVU method19. This is similar to reports assessing patients on higher doses of IFX (5 mg/kg) but using a different scoring method and assessing patients at 24 weeks20. A decrease in spinal inflammation has ...
Inflammation of the SACROILIAC JOINT. It is characterized by lower back pain, especially upon walking, fever, UVEITIS; PSORIASIS; and decreased range of motion. Many factors are associated with and cause sacroiliitis including infection; injury to spine, lower back, and pelvis; DEGENERATIVE ARTHRITIS; and pregnancy ...
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ABBOTT PARK, Ill. - Patients with a form of arthritis that affects young adults taking a drug made by Abbott experienced improvements in their condition after a year of treatment, according to late-stage clinical trial results. Abbott announced Monday the first long-term patient-reported health outcomes data for the phase-3 ABILITY-1 trial of Humira (adalimumab) in patients with nonradiographic axial spondyloarthritis, or nr-axSpA. Results of the trial were presented at the American College of Rheumatologys annual scientific meeting in Washington.
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en] Basal cell carcinomas (BCC) are the most common malignant neoplasms in humans. Clinical misdiagnoses are not uncommon. These cancers are classified according to their histological and clinical characteristics which exhibit distinct malignant behaviours. It is important to be aware of the different clinical presentations both for the accurate diagnosis and tumour management. We report the case of a 78-year-old man, who presented an unusual pedunculated and pigmented BCC. This combined aspect is rarely encountered ...
Patients were seen at clinic visits every 7.0% in patients with type 2 diabetes has having diabetes, who are likely to be rep- different clinical presentations were me- lin regimen consisted of a once-daily dose 23 centers.12 All were initially treated by of long-acting or isophane insulin. If the lin therapy. Since type 2 diabetes is char- acterized by steady deterioration of glu- more difficult to attain near-normal gly- insulin doses at 6 and 9 years from diag- cemic control target levels. We report the scribed, by a dietitian, a low-fat, high- 34 U, respectively. At 9 years, the median these target levels with each of the agents months on this diet, patients were strati- fied into 1 of the following therapies ac- Patients ...
Aphthoid ulcers are seen to affect the neoterminal ileum and the colonic mucosa adjacent to the ileocolic anastomosis in a patient who had had a previous extensive colonic resection for Crohns disease. A tight stricture is also apparent at the site of anastomosis (arrow), in keeping with recurrent disease. The patient also has sacroiliitis. ti, terminal ileum; c, colon ...
Results. We found 10.1% of UA (38/375) versus 7.2% (403/5584) of controls were HLA-B27-positive (OR 1.5, 95% CI 1.0-2.1; p = 0.037). HLA-B27-positive patients with UA had more SpA features than HLA-B27-negative patients (mean 1.6, SD 1.0, and 0.9 SD 0.6; p , 0.001), but patients with SpA had significantly more SpA features (mean 4.5, SD 1.5; p , 0.001). Family history and preceding infection were features more common in HLA-B27-positive than in HLA-B27-negative UA (15.8% vs 1.3%, p = 0.04 and 15.8% vs 2.6%, p = 0.04). After HLA-B27 testing, 21 additional patients (5.6%) with UA could potentially have been classified with pSpA according to the ASAS criteria. ...
Results 115 patients (54.8%) fulfilled the modified New York criteria for AS in their radiographic part in the opinion of both readers at baseline, while 95 patients (45.2%) were classified as non-radiographic axial spondyloarthritis. More patients with non-radiographic spondyloarthritis (10.5%) compared with AS (4.4%) showed an estimated true progression by at least one grade according to both readers, although the difference between the two groups was statistically non-significant. The rate of progression from non-radiographic axial spondyloarthritis to AS was 11.6% over 2 years. An elevated level of C-reactive protein (CRP) at baseline was a strong positive predictor of radiographic sacroiliitis progression in non-radiographic axial spondyloarthritis and AS (OR 3.65 and 5.08, respectively, p,0.05).. ...
Objective To evaluate the role of interleukin 6 (IL-6) in the pathogenesis of bilateral erosive sacroiliitis in human tumour necrosis factor transgenic (hTNFtg) mice, an animal model of ankylosing spondylitis (AS).. Methods Histological sections of the sacroiliac joints from hTNFtg and IL-6−/−hTNFtg mice were evaluated, and wild type and IL-6−/−mice served as controls. mRNA levels of inflammation and tissue degradation related genes isolated from sacroiliac joints were also evaluated by quantitative PCR.. Results Severe, erosive bilateral sacroiliitis in 14-week-old hTNFtg animals was accompanied by an upregulation of mRNAs related to tissue inflammation such as matrix metalloproteinase 3 (MMP3), MMP9 and MMP13 or osteoclast activation such as cathepsin K and tartrate-resistant acid phosphatase. In addition, IL-6 was increased in the sera and in the sacroiliac joints of hTNFtg animals. However, high expression of these marker genes in sacroiliac joints from IL-6−/−hTNFtg mice was ...
Sacroiliac Joint Pain, also known as sacroiliitis, is a common cause of low back and buttock pain that frequently misdiagnosed and goes overlooked.
TY - JOUR. T1 - Switching tumor necrosis factor inhibitors in the treatment of axial spondyloarthritis. AU - Deodhar, Atulya (Atul). AU - Yu, David. PY - 2017. Y1 - 2017. N2 - Objective: To assess the impact of switching tumor necrosis factor (TNF)-alpha inhibitors on patients with axial spondyloarthritis (axSpA). Methods: PubMed literature searches were conducted using combinations of search terms including ankylosing spondylitis, spondyloarthropathy, spondyloarthritis, switch/switching, drug survival, and TNF/tumor necrosis factor to identify published articles with data on outcomes related to switching biologic therapies in patients with axSpA. Results: Of the 134 studies screened, 21 were identified as reporting data on switching TNF inhibitors in patients carrying a diagnosis of axSpA or ankylosing spondylitis. The most common reasons for switching from the first TNF inhibitor were lack of efficacy (14-68%), loss of efficacy (13-61%), and adverse events/poor tolerability (13-57%). Switching ...
TY - JOUR. T1 - Incidence and prevalence of axial spondyloarthritis. T2 - Methodologic challenges and gaps in the literature. AU - Bohn, Rhonda. AU - Cooney, Maureen. AU - Deodhar, Atulya (Atul). AU - Curtis, Jeffrey R.. AU - Golembesky, Amanda. PY - 2018/1/1. Y1 - 2018/1/1. N2 - Objective The incidence and prevalence of axial spondyloarthritis (axSpA), including ankylosing spondylitis (AS) and non-radiographic (nr-)axSpA, have been investigated in multiple populations, though there is a paucity of population-level data. Here, we identify population-based studies in AS and nr-axSpA, and describe the methodologic challenges in conducting these, outlining potential reasons for disparate incidence and prevalence estimates. Methods PubMed and Embase were searched for population-based studies providing incidence and prevalence rates, published in English from 1 Jan 2000-30 Jun 2015. Extracted information included incidence/prevalence rates, geographical population, study design, data source, case ...
... : Where does Buttock Pain come from and how to treat it! I have great success in the treatment of buttock pain in my Physiotherapy Clinic.
Non-radiographic axial spondyloarthritis causes inflammation in the spine, which can lead to back pain. Learn what causes this type of arthritis, how its treated, and what to expect.
First randomized, controlled, Phase 3 study of an anti-TNF to enroll patients with active axial spondyloarthritis (axSpA), including patients with ankylosing sp
Learn more about axial spondyloarthritis, the burden for patients, how to identify the signs of the disease and the difference in how it affects men and women.
An expert in the management of axial spondyloarthritis explains how it differs from other rheumatologic conditions, highlights common comorbidities, and reacts to its overall burden on patients’ quality of life.
Buttock pain is a common complaint within the non-athletic and athletic population. Buttock pain can be a difficult problem to diagnose for healthcare professionals as there can be various causes all of which may not be detectable on specific diagnostic tests.
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Learn about the diseases and conditions that may cause pain in the buttocks, and read about the medications used in the treatment of buttock pain. Pinpoint your symptoms and signs with MedicineNets Symptom Checker.
... often strike together, as both of these locations share postural muscles and neurological connections.
List of 38 causes for Sudden onset of triceps pain and Thigh pain and Buttock pain, alternative diagnoses, rare causes, misdiagnoses, patient stories, and much more.
Hip and buttock pain. In: Murtagh J. Murtagh J Ed. John Murtagh.eds. Murtaghs Diagnostic Strategies, 1e New York, NY: McGraw-Hill; . http://murtagh.mhmedical.com/content.aspx?bookid=1684§ionid=116081546. Accessed January 20, 2018 ...
Doctors give trusted, helpful answers on causes, diagnosis, symptoms, treatment, and more: Dr. Poelstra on recurring buttock pain: That lump may be an infection/abscess. Have it checked out by your doctor. You may need minor surgery.
Potential causes of extreme buttock pain include injuries, accident-related trauma, muscle overuse and diseases such as bone cancer of the pelvis and fibromyalgia. Other conditions that can cause...
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GOMES, Kirla Wagner Poti et al. Cutaneous leishmaniasis in a patient with ankylosing spondylitis using adalimumab. Rev. Bras. Reumatol. [online]. 2012, vol.52, n.3, pp.450-452. ISSN 0482-5004. http://dx.doi.org/10.1590/S0482-50042012000300014.. Leishmaniasis is an anthropozoonosis caused by species of Leishmania and can have different clinical presentations, depending on the parasite-host relationship. Tumor necrosis factor-α (TNF-α) is a cytokine essential to infection control, especially against intracellular parasites such as Leishmania. Anti-TNF-α strategies have had a marked impact on the treatment of rheumatic diseases, but the clinical use of those antagonists has been accompanied by an increased report of infections. We report the first case of cutaneous leishmaniasis in a patient with ankylosing spondylitis treated with adalimumab and methotrexate in Brazil. We believe that, in this case, there was no association between the anti-TNF-α treatment and cutaneous leishmaniasis, ...
MYH9-related disease. Mutations in MYH9 cause a Mendelian autosomal-dominant disorder known as MYH9-related disease (MYH9-RD).[36][37][38][39] All affected individuals present congenital hematological alterations consisting in thrombocytopenia, platelet macrocytosis, and inclusions of the MYH9 protein in the cytoplasm of granulocytes. Most patients develop one or more non-congenital manifestations, including sensorineural deafness, kidney damage, presenile cataracts, and/or elevation of liver enzymes.[39][40][41] The term MYH9-RD encompasses four syndromic pictures that were considered for many years as distinct disorders, namely May-Hegglin anomaly, Sebastian syndrome, Fechtner syndrome, and Epstein syndrome. After the identification of MYH9 as the gene responsible for all of these entities, it was recognized that they actually represent different clinical presentations of the same disease, now known as MYH9-RD or MYH9 disorder.[38] MYH9-RD is a rare disease: prevalence is estimated around ...
Have you ever experienced pain in your lower back? If so, chances are it may be due to your sacroiliac joint, also known as the SI joint. The SI joint is in the lower back and it connects the bottom of your spine with your pelvis. It carries a lot of the pressure in your body because it supports your entire torso. This makes it susceptible to injury and pain because its acting as a "shock absorber" for your body.. SI joint pain can be caused by many factors, such as age, traumatic injury, pregnancy, or other conditions that can cause the SI joint to become inflamed. This causes pain that can be a dull ache or very sharp and can spread from your lower back to your thighs. SI joint pain may even affect your everyday movement. If you experience pain in the lower back, check with your doctor to see if it may be something that is affecting your sacroiliac joint.. ...
Non-radiographic axial Spondyloarthritis (nr-axSpA) is an autoimmune disease which causes arthritis in the spine and pelvis. While non-radiographic axial Spondyloarthritis is a very complicated name, it can be understood as: Non-radiographic: the inflammation will not show up on an x-ray (radiograph) but may show up on an MRI (magnetic resonance imaging) scan. Axial: it mainly affects the spine (rather than arms or legs). Spondyloarthritis: arthritis that affects the joints as well as sites where ligaments and tendons join the bone.. For more information, download the information sheet Non-radiographic axial Spondyloarthritis ...
Male and female patients with axial spondyloarthritis experience the disease differently, researchers say. In a cross-sectional study of 466 patients from the ongoing observational Groningen Leeuwarden Axial Spondyloarthritis cohort patient reported measures of disease activity, physical function and quality of life were significantly worse for females. Writing in Rheumatology the researchers said the gender differences could […]
The SImpact Sacroiliac Joint Fixation System consists of cannulated implants offered in various lengths, and threaded congurations to accommodate variations in patient anatomy. It is intended for sacroiliac joint fusion for conditions including degenerative sacroiliitis and sacroiliac joint disruptions.. ...
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Overweight and obesity in axial spondyloarthritis is common and has a negative impact on disease activity, registry data shows. Lead author and rheumatology registrar Gillian Fitzgerald, from the St Jamess hospital in Dublin, Ireland, told ACR 2017 delegates there was a general perception that people with axial spondyloarthritis (axSpA) had a normal BMI. But her […]
Clinical manifestations and disease activity measures are highly comparable between patients with early nonradiographic axial SpA and those with early AS, suggesting that these 2 entities are part of the same disease. Male sex and an elevated CRP level are associated with structural damage on radiog …
Spondyloarthritis news, medical journals, latest articles, and research and treatment studies designed for physicians to stay updated on spondyloarthritis.
Have you ever experienced pain in your lower back? If so, chances are it may be due to your sacroiliac joint, also known as the SI joint. The SI joint is in the
TIDAK. Artritis Psoriatik masuk dalam kelompok penyakit spondiloartropati seronegatif. Pada artritis psoriatik biasanya Rheumatoid Factor (RF) dan anti CCP negatif. Seperti halnya kelompok spondioartropati seronegatif yang lain, pada artritis psoriatik dapat terjadi nyeri pinggang/bokong (sacroiliitis), dan manifestasi luar sendi lainnya. Misalnya Uveitis (mata merah dan nyeri), radang usus, kelainan pada jaringan lunak seperti faciitis plantaris dan tendinitis tendon achiles.. Apa penyebabnya?. Belum diketahui dengan pasti. Tapi unsur genetik cukup berperan penting pada kejadian penyakit ini(HLA-B27). Karena sekitar 40 % persen memiliki riwayat psoriasis dikeluarganya. Teori mengenai penyebabnya beragam, ada yang mengatakan unsur lingkungan, paparan bahan kimiawi atau paska infeksi. Ada juga teori yang mengatakan psoriasis timbul akibat aktivasi sistem imun sesudah infeksi streptokokus.. Apakah psoriasis penyakit MENULAR? ...
Hello, For the past two years I have had pain in my left buttock that radiates down the side and front of my thigh. My entire leg begins to feel heavy
Allan Gibofsky, MD, provides on overview of potential risk factors and common presenting characteristics that help rheumatologists diagnose ankylosing spondyloarthritis in patients.
These injections enable pain doctors to confirm that irritation or damage to the SI joint is the source of your pain. Its also a therapeutic procedure.