1/84. Failure of the hinge mechanism of a trispherical total wrist arthroplasty: a case report and review of the literature.We report a patient with rheumatoid arthritis who developed late catastrophic failure of the hinge mechanism of her trispherical total wrist arthroplasty. This was associated with synovitis secondary to wear debris from titanium, cement, and polyethylene which produced exuberant flexor and extensor tendon synovitis and median nerve compression.- - - - - - - - - - ranking = 1keywords = synovitis (Clic here for more details about this article) |
2/84. Cutaneous mucinous nodules associated with proliferating synovitis of rheumatoid arthritis.Rheumatoid arthritis (RA) is occasionally associated with specific or non-specific cutaneous conditions. In this report, we describe unusual cutaneous nodules arising on the skin overlying the inflamed joints of two patients with RA. The nodules were histopathologically characterized by mucinous granulation tissue associated with neutrophilic infiltration and proliferation of starry-shaped mesenchymal cells. The affected joints of both cases showed synovitis with synovial tissue hyperplasia due to RA. Because hyaluronic mucin, which is the major component of synovial fluids, was deposited in the nodules, intradermal inoculation of synovial cells seemed to be responsible for the nodular development. The nodules of one patient spontaneously resolved in several months. We are unaware of any report describing similar cases. Such nodules should be included as a cutaneous complication of RA, distinct from neoplasias.- - - - - - - - - - ranking = 2.5keywords = synovitis (Clic here for more details about this article) |
3/84. Posterior interosseous nerve palsy in a patient with rheumatoid synovitis of the elbow: a case report and review of the literature.A 54-year-old woman with rheumatoid arthritis developed loss of finger extension in the left hand. history, physical examination, and electromyography led to the diagnosis of posterior interosseous nerve palsy secondary to synovitis of the elbow. Anterior decompression and synovectomy resulted in a complete recovery. A literature review describes similar cases and compares outcomes.- - - - - - - - - - ranking = 2.5keywords = synovitis (Clic here for more details about this article) |
4/84. Pulmonary nodule and aggressive tibialis posterior tenosynovitis in early rheumatoid arthritis.We report the case of a 34-year-old man with a rheumatoid pulmonary nodule preceding the development of articular symptoms of rheumatoid arthritis. Pulmonary nodules are a well known feature of rheumatoid arthritis and are mostly seen in severe established rheumatoid factor-positive cases. To differentiate between benign and malign pulmonary nodules we discuss the use of positron emission tomography (PET). Despite intensive therapy with steroids and methotrexate in our patient, within months he developed a severe tibialis posterior tendinitis, with partial rupture and evolution to a planovalgus deformity requiring surgery. Both these symptoms are rare but demonstrate the need for close follow-up in early rheumatoid arthritis.- - - - - - - - - - ranking = 2keywords = synovitis (Clic here for more details about this article) |
5/84. Evaluating patients with arthritis of recent onset: studies in pathogenesis and prognosis.Inflammatory synovitis of recent onset poses a diagnostic and prognostic challenge to primary care physicians and rheumatologists. A lack of understanding of the underlying etiologic and pathogenic processes limits the ability to distinguish forms of arthritis that follow a benign, self-limiting course from forms that proceed to an aggressive, erosive disease requiring intensive immunosuppressive therapy. It is estimated that between 30% and 40% of patients presenting with early synovitis have disease that remains unclassified. Using data from a cohort of patients with early synovitis and reviewing current literature, we discuss investigational approaches toward a new classification of patients with early synovitis. Although a lack of understanding of this heterogeneous clinical syndrome has led clinicians to take a largely empirical approach to treatment thus far, the evolving awareness of disease predisposition at a genetic level and the expanding ability to specifically manipulate biological pathways may ultimately change the approach to this clinical problem. JAMA. 2000;284:2368-2373.- - - - - - - - - - ranking = 2keywords = synovitis (Clic here for more details about this article) |
6/84. Do B cells influence disease progression in chronic synovitis? Lessons from primary hypogammaglobulinaemia.We describe a 62-yr-old male patient with primary hypogammaglobulinaemia (PH) who fulfilled the 1987 American Rheumatism association/American College of rheumatology revised diagnostic criteria for rheumatoid arthritis (RA) but, despite persistent symmetrical synovitis, did not develop erosions. virology studies and blood and synovial fluid (SF) cultures were consistently negative; a search for crystals in the SF was unrevealing. Peripheral blood (PB) B cells were absent, whilst the PB CD3( ) cell count was normal. The ratio of naive (CD45RA( )) to memory (CD45R0( )) cells was also normal (1:1) but the CD4:CD8 ratio was reversed. To our knowledge, this is the first report which combines the immunophenotypic analysis of the PB with that of the SF and synovial membrane (SM). This confirmed the absence of B cells and the reversed CD4:CD8 ratio. However, as in other chronic arthropathies, the SF and SM cellular infiltrate consisted almost exclusively of memory T cells, consistent with the preferential localization of this subset to inflamed tissues. This case indicates that synovitis can proceed persistently in the absence of B cells and that the migratory mechanisms of T cells are not altered. However, the case suggests that the absence of B cells and negativity for rheumatoid factor, combined with an increased presence of CD8( ) (suppresser/cytotoxic) T cells in the joint, might contribute to the non-erosive nature of the synovitis.- - - - - - - - - - ranking = 3.5keywords = synovitis (Clic here for more details about this article) |
7/84. legionnaires' disease in a patient with rheumatoid arthritis.A 62-year-old male with rheumatoid arthritis (RA) who was taking nonsteroid anti-inflammatory drug for controlling synovitis developed a flare of his arthritis, hepatitis, and pneumonia due to infection with legionella pneumophila serotype 1. adult respiratory distress syndrome (ARDS) occurred following the development of pneumonia. After the introduction of erythromycin and ventilator support with positive end expiratory pressure (PEEP), his condition stabilized and he recovered gradually. We suggest that L. pneumophila should be considered early in the differential diagnosis of pneumonia in RA patients due to their immunocompromised status.- - - - - - - - - - ranking = 0.5keywords = synovitis (Clic here for more details about this article) |
8/84. Rapid onset of cutaneous squamous cell carcinoma in patients with rheumatoid arthritis after starting tumor necrosis factor alpha receptor IgG1-Fc fusion complex therapy.Tumor necrosis factor alpha (TNF-alpha) is now believed to be a major contributor to the pathogenesis of the synovitis and joint destruction in rheumatoid arthritis. Etanercept is a recombinant human TNF-alpha receptor Fc fusion protein consisting of a dimer of the extracellular portion of two p75 TNF-alpha receptors fused to the Fc portion of human IgG1. Etanercept produces significant dose-dependent improvements in disease activity. We describe 7 patients who experienced 1 or more squamous cell carcinomas that showed rapid growth and arose over a 2- to 4-month period of etanercept therapy. Soluble TNF-alpha receptor therapy through inhibition of a T(H)1 cytokine pattern and inhibition of the direct and indirect cytotoxic effects of TNF-alpha may initially decrease mechanisms for controlling subclinical tumors and may contribute to the histologic features seen within these tumors. However, prolonged TNF-alpha inhibition may have some antitumor effects.- - - - - - - - - - ranking = 0.5keywords = synovitis (Clic here for more details about this article) |
9/84. Destructive monarthritis and granulomatous synovitis as the presenting manifestations of Crohn's disease.A twenty-two-year-old woman and a fourteen-year-old boy with Crohn's disease presented with progressive monarticular arthritis with radiologic evidence of altered articular cartilage and subchondral bone. In one individual, granulomatous inflammation of the synovium was demonstrated. Intestinal symptoms were not prominent. In both individuals, the development of the monarthritis led to the discovery of the underlying inflammatory bowel disease.- - - - - - - - - - ranking = 2keywords = synovitis (Clic here for more details about this article) |
10/84. Fine-needle aspiration cytology of pulmonary rheumatoid nodule: case report and review of the major cytologic features.patients with rheumatoid disease may develop extra-articular lesions, affecting viscera and soft tissues. Pulmonary rheumatoid nodules show morphologic features reminiscent of a necrotizing inflammation of rheumatoid synovitis and differ from subcutaneous rheumatoid nodules only by their location, extension, and size. Although cytologic studies on pleural effusions in rheumatoid disease have long been performed, there are no more than three reports concerning the fine-needle aspiration (FNA) diagnosis of pulmonary rheumatoid nodules. The authors report on a case of a 62-yr-old woman with rheumatoid disease in whom a FNA diagnosis of pulmonary rheumatoid nodule was successfully performed. The authors highlight the main cytologic features of the entity and emphasise the high index of clinical and pathologic suspicions needed to be able to diagnose this lesion.- - - - - - - - - - ranking = 0.5keywords = synovitis (Clic here for more details about this article) |
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