1/34. Neutrophilic lobular (pustular) panniculitis associated with rheumatoid arthritis: a case report and review of the literature.Rheumatoid nodules, which affect the subcutis around joints, are the most frequent specific cutaneous lesions of rheumatoid arthritis (RA). panniculitis is a rarely reported and nonspecific complication of RA. We report a 42-year-old woman with seropositive RA who presented with a 2-month history of lower leg panniculitis. biopsy of a leg nodule showed a lobular neutrophilic infiltrate with lipophages and central basophilic necrosis. In addition, focal changes of lipomembranous fat necrosis indicative of ischemic damage were identified at the margins of the lobular infiltrate. Neutrophilic lobular panniculitis is commonly detected in panniculitis secondary to bacterial infections, pancreatitis, and factitial causes. However, this pattern of panniculitis has also been reported in some cases of erythema nodosum-like lesions found in Behcet disease or bowel bypass syndrome and in rare cases of seropositive RA. These reported histologic findings fall into the spectrum of neutrophilic vascular reactions described by Jorizzo and Daniels for RA-associated dermatoses. In view of these findings. RA and related neutrophilic dermatoses (e.g., Behcet disease) should be included in the differential diagnosis of neutrophilic lobular panniculitis.- - - - - - - - - - ranking = 1keywords = arthritis (Clic here for more details about this article) |
2/34. Synchronous pyomyositis and septic hip arthritis.The authors report a rare concomitant pyogenic infection of the iliopsoas, iliacus and external obturator muscles and of the hip joint in a 68-year-old woman. Because the patient showed the classic symptomatic triad of limping, hip pain and fever, in addition to positive hip arthrocentesis, the diagnosis of septic hip arthritis was routine, but the simultaneous pyomyositis was almost overlooked. Unusual localised heat and swelling on the front of the proximal thigh prompted a CT scan that identified remarkable muscle abscesses in addition to the septic arthritis. Surgical debridement and antibiotics resolved the infection relatively rapidly without sequelae. We noted that reaching a definitive diagnosis of such a concomitant infection requires a suspicion of the presence of pyomyositis, which can be definitively determined using advanced imaging studies.- - - - - - - - - - ranking = 1.2keywords = arthritis (Clic here for more details about this article) |
3/34. Multifocal streptococcal pyomyositis complicated by acute compartment syndrome: case report.A 5-year-old girl sought treatment for pyrexia of unknown origin. Despite prompt surgical drainage of a streptococcal septic arthritis of the ankle joint, her condition deteriorated. Multifocal pyomyositis was subsequently diagnosed. This was complicated by acute compartment syndrome in three extremities. With aggressive surgical and medical management, the child made a complete recovery. Orthopaedic clinicians in nontropical areas must familiarize themselves with this rare, potentially life-threatening, but eminently curable disease.- - - - - - - - - - ranking = 0.2keywords = arthritis (Clic here for more details about this article) |
4/34. Some clinical, immunological and bacteriological observations in a case of pyogenic arthritis due to bacteroides fragilis.A case of recurrent pyogenic arthritis in a knee joint and abscess formation of the lower limb is described. The infection occurred in a 70-year-old male patient treated with steroids for rheumatoid arthritis. A strain of bacteroides fragilis was repeatedly isolated both from the knee joint and the abscess. The isolated strain was used as antigen in tube agglutination tests and significant titre changes were observed during the course of the disease. The isolated strain was initially sensitive to doxycycline but developed resistance to this drug during therapy. The sensitivity to lincomycin remained unaffected.- - - - - - - - - - ranking = 1.2keywords = arthritis (Clic here for more details about this article) |
5/34. Pneumococcal purulent genual arthritis after allogeneic bone marrow transplantation.A 21-year-old male patient with non-Hodgkin's lymphoma (diffuse large T-cell type, clinical stage IV) received allogeneic bone marrow transplantation (BMT) from a partially HLA-mismatched unrelated donor in July 1998 and achieved complete remission. Thereafter, he suffered from chronic graft-versus-host disease (GVHD) and was continuously administered immunosuppressive drugs for a long time. Two years after the BMT, he complained of severe pain in the right knee, which was swollen, and was diagnosed as having pneumococcal purulent genual arthritis. He underwent arthroscopic synovectomy and was administered systemic and intra-articular antibiotics, leading to a gradual improvement. Streptococcal infections are often seen in patients in the late phase after allogeneic BMT because of immunodeficiency associated with chronic GVHD and hyposplenism. Most streptococcal infections are respiratory tract infections and septicemia, and there have been very few reports on cases of purulent genual arthritis. Administration of prophylactic antibiotics and control of chronic GVHD, which is a risk factor of pneumococcal infection, seem to be important to prevent purulent genual arthritis.- - - - - - - - - - ranking = 1.4keywords = arthritis (Clic here for more details about this article) |
6/34. Pyogenic lumbar facet joint arthritis with intradural extension: a case report.There have been 40 previously reported cases of lumbar facet joint pyogenic infection. These have been well characterized earlier. Intradural pyogenic extension has never been reported from a facet joint origin. This case demonstrates an elderly diabetic man with acute onset of nontraumatic back pain with no other source of infectious pathology. Surgical exploration identified a purulent left L4-L5 facet joint with epidural and intradural extension. Minimal spinal fluid leak was present. Wound cultures were positive for Group B beta Full resolution occurred with appropriate intravenous vancomycin antibiotic therapy.- - - - - - - - - - ranking = 0.8keywords = arthritis (Clic here for more details about this article) |
7/34. Anterior tibial compartment syndrome due to the pyomyositis in a patient with rheumatoid arthritis. A case report.Anterior tibial compartment syndrome was developed due to pyomyositis in a 33-year-old male patient with rheumatoid arthritis while receiving steroid therapy during the follow-up period. The preoperative physical examination, laboratory findings, MRI images, intraoperative observation and postoperative histopathological examinations confirmed the association with pyomyositis. The surgical drainage and antibiotic treatment were effective, and in the follow-up period, neuromuscular dysfunctions disappeared completely within 6 months. The patient has been asymptomatic for 4 years of follow-up. To date, anterior tibial compartment syndrome due to pyomyositis in a case with rheumatoid arthritis has not been reported.- - - - - - - - - - ranking = 1.2keywords = arthritis (Clic here for more details about this article) |
8/34. Primary pyogenic abscess of the psoas muscle.Nine children who were less than nine years old and had a primary pyogenic abscess of the psoas muscle were treated in a five-year period. This rare lesion often simulated septic arthritis of the hip. ultrasonography was found to be the most reliable and easily performed diagnostic study. Because of the rarity of the lesion, the diagnosis requires a high index of suspicion. The best treatment is early operative drainage and administration of systemic antibiotics.- - - - - - - - - - ranking = 0.2keywords = arthritis (Clic here for more details about this article) |
9/34. Duration of antimicrobial therapy for acute suppurative osteoarticular infections.From 1974 to 1983, inclusive, 274 children with acute suppurative osteoarticular infections were treated with antibiotic regimens that were shorter than usually recommended. The median duration of antibiotic treatment for acute suppurative arthritis caused by staphylococci, streptococci, haemophilus influenzae type b, gram-negative cocci, or other gram-negative bacteria was 23, 16, 16, 15, and 22 days, respectively. For acute osteomyelitis caused by staphylococci, streptococci, H influenzae, or other gram-negative bacteria the median duration of antibiotic therapy was 24, 23, 17, and 22.5 days, respectively. osteoarthritis usually had to be treated for about a month. 180 patients received large dosages of oral antimicrobials after clinical stabilisation with intravenous treatment, the median duration of intravenous therapy being about a week (range up to 7 weeks). 99% of patients underwent needle aspiration for diagnostic reasons. 36%, 71%, and 63% of the patients with acute suppurative arthritis, osteomyelitis, and osteoarthritis, respectively, underwent incision and drainage. recurrence occurred in 4 patients with acute osteomyelitis (3.8% of cases). There was no recurrence of arthritis.- - - - - - - - - - ranking = 1keywords = arthritis (Clic here for more details about this article) |
10/34. Subcorneal pustular dermatosis: a variant of pustular psoriasis.A patient with clinical lesions typical of subcorneal pustular dermatosis of Sneddon and Wilkinson also had stigmata of psoriasis, namely psoriatic plaques, pitting of nails, and psoriatic arthritis. Histologic studies of the pustular lesions were consonant with pustular psoriasis. Correlating the phenomena of previously reported cases of subcorneal pustular dermatosis with those of our patient, we conclude that subcorneal pustular dermatosis of Sneddon and Wilkinson is but another variant of psoriasis.- - - - - - - - - - ranking = 0.2keywords = arthritis (Clic here for more details about this article) |
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