Pattern Of Joint Involvement Research Articles

Individual joints involvement pattern in psoriatic arthritis: A cross-sectional study in China.

Psoriatic arthritis (PsA) is characterized by multi-joint involvement, primarily affecting the small joints in the hands and feet. However, the specific pattern of joint involvement at an individual level remains uncertain. This study aimed to elucidate the pattern of joint involvement in a PsA cohort. Patients diagnosed with PsA were recruited for this cross-sectional study. Demographic, clinical, laboratory, personal and family history, and comorbidity data were collected. Descriptive statistical analysis was performed, and univariate and multivariate regression models were used to examine baseline factors influencing joint involvement. A total of 264 PsA patients (156 males) were included in the study. The results revealed a predominant involvement of peripheral facet joints. The second proximal interphalangeal joint (PIP) of the right hand exhibited the highest prevalence of swelling (18.9%), while the right knee joint had the highest prevalence of tenderness (24.2%). Older age and earlier onset of PsA were identified as independent factors associated with the swelling of the second PIP of the right hand. Older age, earlier onset of PsA, lower Psoriasis Area and Severity Index and higher Dermatology Life Quality Index scores were identified as independent factors associated with the tenderness of the right knee joint. In conclusion, the most commonly affected joints in PsA are the second PIP of the right hand and the right knee joint.

New Insight into the Effects of Different Types of Midfoot and Hindfoot Deformities on the Functional Outcomes of Rheumatoid Arthritis Patients

In advanced stages of rheumatoid arthritis (RA), the pattern of joint involvement leads to varied types of foot deformities such as forefoot, midfoot, and hindfoot deformities. We aim to evaluate midfoot and hindfoot deformities and their effect on functional outcomes in RA patients. In this prospective cross-sectional study clinical and radiological evaluations of 100 adult RA patients were studied for midfoot and hindfoot deformities. The RA disease activity, functional disability level, specific foot and ankle assessments, gait speed, and balance tests were assessed. Radiological examinations of the weight-bearing feet in a standing position were done. We found that the most frequent deformity type was the planovalgus foot (24%). There were statistically significant differences between the types of foot deformities and disease duration, disease activity, falls, Tinetti and Berg balance Test, and health assessment questionnaire-disability index. The multivariate regression analysis of independent correlates of falling detected that patients with equinovarus deformity were 2.5 times more liable for falling with 63.5% predictive power. According to the predictive criteria of deformity type for falling, the equinocavovarus type had accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of 91%, 84.5%, 98.5%, 99%, and 84%, respectively. We found in RA patients, midfoot and hindfoot deformities cause a significant reduction of functional ability and quality of life. The early detection of foot deformities requires a good awareness of the clinical and radiographic diagnosis of different types of deformities thus reducing the possible functional disabilities via early management by combined orthotic, physiotherapy, and surgical treatments.

Assessment of Epidemiology and Clinical Profile of Psoriatic Arthritis Patients in India.

Psoriasis is an inflammatory skin disease associated with significant comorbidity. However, the characteristics of patients with psoriasis are not well documented in India, and a more detailed understanding is needed to delineate the epidemiologic profile at the regional level for better management of psoriasis. Herein, we reported the clinical profile and demographic pattern of psoriasis to further understand its burden in the Indian setting. We conducted a retrospective observational study of patients diagnosed with psoriasis who fulfilled the classification criteria for psoriatic arthritis (CASPAR) criteria. Patients were included from the rheumatology outpatient department of Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute in Mumbai, India. The outcomes included demographic and clinical profiles, patterns of joint involvement, and comorbidities associated with psoriasis. A p-value of <0.05 was considered significant. We enrolled 60 patients, with a mean age of 50.87 years and a higher proportion of females (62%). The majority of patients with less than five joints had associated comorbidities (40 out of 60). Psoriatic arthritis (PsA) occurred in 41 patients [mean ± standard deviation (SD) age of onset-38.88 ± 13.24 years], with the highest occurrence in the 30-50 years (53.3%). The majority of patients with PsA developed it within 2 to ≥5 years of psoriasis occurrence. We did not find any significant correlation between the occurrence of PsA and comorbidities, as well as the duration of PsA and the number of joints (p = 0.152). Pitting and enthesitis were the most common morphological changes noted in almost half of the patients. Our study provides an overview of the epidemiologic and clinical characteristics of psoriasis patients in India. These findings could be useful for early diagnosis of PsA and help clinicians in assessing the progression of psoriasis into PsA.

Osteoarthritis.

The clinical appearance and radiological pattern of osteoarthritis have been identified in the skeletons of dinosaurs some 50-70 million years old, and in Egyptian mummies, and in ancient skeletons in England. Osteoarthritis patterns of joint involvement, often referred to as primary osteoarthritis, can be seen in the hands, spinal facet joints, hips, knees and feet, but can also be termed secondary osteoarthritis when seen in any joint that has had trauma, sepsis, surgery or metabolic insult. The prevalence of osteoarthritis increases with age. The histology and pathophysiology both demonstrate an inflammatory process. While there have been studies of genetic predisposition, the basic cause of primary osteoarthritis has not been determined.

Распространенность и характеристики рентгенологического остеоартроза костей кисти у сельских туркмен

Introduction. The knowledge about the prevalence of hand osteoarthritis (OA) in different populations, the pattern of joint involvement, and the association with age, sex, and weight might be helpful in the understanding of the etiology and in developing the prevention strategy of hand OA. It can be important from a public health perspective. The study aimed to evaluate the prevalence and pattern of radiographic hand OA in the Turkmen community-based sample and its association with age, sex, and body mass index. Materials and methods. The study population was comprised of Turkmens (277 males and 427 females, aged 19–90 years). Radiographic hand OA was evaluated for 14 joints of each hand according to the Kellgren and Lawrence grading scheme. Statistical analyses included prevalence estimation, linear regression, and χ2 tests. Results. 13.8% of individuals before age 36 had at least one joint with OA, and the prevalence reached 100% after age 65. After adjustment for age, we found that females with severe obesity have a higher risk of development of radiographic hand OA than those with normal weight (OR(95%CI): 3.88 (1.20-12.60)). Conclusion. In the present study, after adjusting for age, we found that in men there was no association between the prevalence of hand OA and BMI. However, women with severe obesity are almost four times more likely to develop hand OA than women of normal weight.

Systematic Review of Non-surgical Therapies for Osteoarthritis of the Hand: An Update.

Hand osteoarthritis is a common disease with significant morbidity. This review aimed to update our earlier systematic reviews which included all published randomized controlled trials evaluating pharmacological and non-pharmacological therapies in patients with hand osteoarthritis. A total of 133 randomized controlled trials evaluating pharmacological and nonpharmacological therapies in hand osteoarthritis were reviewed. Overall, the methodological quality of randomized controlled trials has improved since the last update. Almost all new studies described their methods for randomization, blinding, and allocation concealment. However, studies continued to underreport features specific to hand osteoarthritis, such as pattern of joint involvement and number of affected joints. Standardized outcome assessments for pain and function were commonly presented, but measures of other hand osteoarthritis specific outcomes, such as health-related quality of life and patient global assessments, continued to be underreported. Future trials should consistently report on hand osteo arthritis specific features and outcome assessments in order to make clinically relevant conclusions about the efficacy of the diverse treatment options available.

ODP327 Joint Pain Score is Higher in Acromegaly Patients Despite Pain Relief Therapy and Joint Surgeries.

Abstract Objective Arthropathy is common in acromegaly (ACRO) and profoundly impacts patients’ quality of life. The aim of this study was to compare joint pain score, usage of pain relief therapy and history of joint surgery between patients with history of ACRO and patients with non-functioning pituitary adenoma (NFA) who had previously undergone surgery. Methods Sex- and age-matched participants (n=34 for both groups) were recruited from the Halifax Neuropituitary Program to complete an online survey. All ACRO patients were in remission with or without medical therapy. An anchored visual analog scale (0-100 mm) was employed to assess joint pain, and additional questions assessed usage of pain relief therapy and history of joint surgeries. Demographic and joint pain data were compared using paired t-tests, whereas usage of pain relief therapy and history of joint surgeries were compared using exact McNemar's tests. Results Height and weight were not significantly different between the ACRO and NFA groups; (height: 171.2±11.3 cm vs. 171.9±9.6 cm, p=0.796; weight: 88.9±20.6 kg vs. 94.2±27.8 kg, p=0.350), respectively. At the time of original presentation, ACRO patients were significantly younger than NFA patients (44.4±13. 0 yrs vs55.9±10.5 yrs, p &amp;lt;0. 001). Joint pain scores were significantly higher for ACRO than for NFA for shoulder (23.6±30.1 mm vs. 8.3±17.2 mm, p=0. 013), back (38.5±34.5 mm vs. 20. 0±25.9 mm, p=0. 012), hip (27.4±27.7 mm vs. 9.2±17.1 mm, p=0. 004), and knee (25. 0±27. 0 mm vs. 11.9±20.1 mm, p=0. 026), while no significant differences were found for the hand/wrist, elbows, neck, and ankle/foot. Despite these differences in joint pain scores, usage of pain relief therapy was not significantly different between groups (p=0.143), and no significant differences in joint surgery history were found for any joint (hand/wrist, elbow, shoulder, neck, back, hip, knee, ankle/foot: Range p: 0.25-1). Similarly, no significant differences were revealed between groups for number of patients with surgery on 1 joint (p=0.581), 2 joints (p=1), &amp;gt;3joints (p=1) or no history of joint surgery (p=0.815). Conclusion Patients with ACRO had higher pain scores for shoulder, hips, knees and back despite no differences in usage of pain relief therapy or history of joint surgeries when compared with NFA. This raises the question if ACRO patients are potentially being undertreated for joint symptoms. Additionally, the pattern of joint involvement is somewhat distinct in ACRO such that larger and proximal joints are more typically involved. Presentation: No date and time listed

P18 A case report on Atypical Polymyalgia Rheumatica in Young Adult

Introduction/BackgroundPolymyalgia Rheumatica is a common inflammatory condition after the age of 50 years. It typically presents with shoulder, neck and pelvic pain and stiffness associated with raised inflammatory markers. We report a case of Polymyalgia Rheumatica in a young male of 40 years in which clinical presentation was not typical.Description/MethodA 40-year-old male manager in a retail shop was reviewed in Rheumatology Outpatient clinic with a few months history of back and pelvic pain with progressively worsening early morning stiffness for upto 40 minutes associated with marked fatigue ability. There was also pain in the right shoulder following a trauma causing rotator cuff tear shown on MRI done a year ago. His CRP was 19 and ESR 52. Initial assessment was inflammatory Axial Spondyloarthropathy.MRI of spine and SI joints as discussed in radiology MDT didn’t show inflammatory changes in the spine or SI joints. It showed bilateral Osteonecrosis of Femoral heads and ill-defined oedema in left acetabulum. A repeat MRI and CT of pelvis showed sclerotic lesion in left Acetabulum. The patient was discussed in bone and soft tissue tumour MDT with conclusion of non-malignant lesion without requiring biopsy and seen by orthopaedics.The pain progressed to involve left shoulder as well despite regular use of NSAIDs. The stiffness deteriorated and became generalised for up to 2 hours. The fatigability also got worse with some interference in his Job. CRP readings were 19, 19, 25 and 20 whereas ESR was 52, 48, 32 and 40 with an interval of a month each.Multiple other investigations including WCC, Hb, U& Es, LFTs, TSH, CK, bone profile, RF, anti CCP, ANA, ENA, ANCA, Serum protein electrophoresis, Myeloma screen, urine analysis, XR chest and ECG were normal.He went on to have PET CT that showed increased uptake suggestive of arthritis in both shoulders, sternoclavicular joints, 1st Costochondral joint, left hip and posterior spinal ligament. The findings were discussed in Radiology MDT again with a conclusion of diagnosis of Polymyalgia Rheumatica based on the distribution of joints involved.Discussion/ResultsThe patient was started on Prednisolone at a dose of 20mg daily. His symptoms improved within 3 to 4 days of start of Prednisolone. Inflammatory markers also improved were checked after 4 weeks with CRP 4 and ESR 18 and they remained normal in two subsequent readings after two and three months. He is currently on tapering dose of Prednisolone without recurrence of symptoms as well as rise in inflammatory markers.Pattern of joint involvement on PET CT and dramatic response to steroids confirmed the diagnosis of PMR.Key learning points/ConclusionAlthough PMR is most commonly seen in adults over 50 years but it can present in young adults like in this patient.Because of young age and atypical presentation mutiple investigations including PET CT was required to reach to the diagnosis of PMR that otherwise is made based on clinical presentation associated with raised raised inflammatory markers.Osteonecrosis of Femoral heads in the absence of any other positive investigation was thought most likely secondary to Inflammation that again is not very common presentation of PMR.A long term follow up is required for this patient to monitor the response of reducing and then stopping of steroids.

Clinical Profile of Filipino Patients with Young-onset Gout

Objectives. Recent studies show that patients with young-onset gout present with visible tophi or nephrolithiasis on diagnosis. In the Philippines, where gout is prevalent, there is no published work on this subset of patients. This study presents the clinical characteristics of a cohort of Filipino patients with gout whose symptoms started at 30 years of age or younger.&#x0D; Methods. The case records of all patients who fulfilled the 1977 American College of Rheumatology (ACR) criteria for gout seen in four adult rheumatology services were reviewed. We selected those whose age of onset of gout was at 30 years or younger. The demographic characteristics, medical history, laboratory parameters, and presenting manifestations were described.&#x0D; Results. Six hundred sixty-nine records of patients with gout were reviewed; 101 (15%) fulfilled the young-onset gout criteria. The mean age of onset was 25±4.40 years (range 14-30), and the mean disease duration before diagnosis was 12.64±11.91 years. All of the patients were male and most were married; 76% were alcoholic beverage drinkers and 38% were smokers. A family history of gout was noted in 47%. Most patients (66%) were already on nonsteroidal anti-inflammatory drugs (NSAIDs), 24% on colchicine, and 14% on urate-lowering therapy before consult at the rheumatology clinic. By history, at onset, the most common pattern of joint involvement was monoarthritis (95%), affecting the ankles (60%), knees (52%), and 1st metatarsophalangeal (MTP) joint (51%). However, on the first rheumatology clinic visit, 34% of arthritis was polyarticular, more than 68% had more than three arthritis attacks per year, and there were tophi in 35%. The mean duration before visible tophi formation was 2.81±6.75 years. Around 21% had nephrolithiasis or a history thereof. The mean serum uric acid (SUA) was 9.18 mg/dL and the mean serum creatinine was 1.5 mg/dL. Thirty-seven percent had estimated glomerular filtration rate (GFR) &lt;60 mL/min.&#x0D; Conclusion. Young-onset gout was present in 15% of our patients and gout was familial in 47%. There was a delay in diagnosis of as long as ten years in most of the patients. On presentation at the rheumatology clinic, more than 34% had polyarticular arthritis, 35% had tophi, and 37% had low estimated GFR. This emphasizes the importance of awareness and prompt diagnosis to ensure correct treatment and prevention of complications

Factors associated with time to presentation of patients to rheumatology clinics at the National Hospital of Sri Lanka

Background: Delay in diagnosis of rheumatic diseases is associated with less favorable outcomes. However, there is paucity of local data on diagnostic delay. Therefore, the aim of this study was to describe factors associated with time to presentation of patients to rheumatology clinics at the National Hospital of Sri Lanka (NHSL).Methods: A descriptive cross-sectional study was conducted at the three rheumatology clinics of NHSL. A total of 120 patients whose first presen- tation to the clinics had been within 6 weeks period to the date of data collection were recruited using systematic sampling. An interviewer administered questionnaire was used. Patient delay, healthcare delay and total delay were the three main aspects of delays considered.Results: The median total delay in presentation was 12 months, patient delay was 6 months and healthcare delay was 6 months. Increasing age (p=0.013), high monthly income (p=0.007) and patients diagnosed with rheumatoid arthritis (p=0.018) showed a significant positive association with delay in presentation while mechanical backache (p=0.022), neck pain (p=0.044) and systemic lupus erythematosus (p=0.044) showed negative association with delay in presentation. Gender, education level, pattern of joint involvement and health seeking behaviors were not associated with delay.Conclusion: There was a significant delay in presentation of the overall study population to the rheumatology clinics. Increasing age, high monthly income and patients diagnosed with rheumatoid arthritis was associated with delayed presentation.

O006. Clinical features of paediatric HIV arthropathy

Abstract Background Advanced HIV infection is associated with an inflammatory arthritis, however few reports have described this disorder in children. This study aimed to describe the clinical features of HIV arthropathy in a case series of children in South Africa and compare these with features of JIA. Methods Retrospective data were collected from HIV-infected children with HIV arthropathy enrolled in a Paediatric Rheumatology clinic in Cape Town, South Africa. Data from a recently described, published cohort of children with JIA enrolled in the same clinic were included for comparison. Ethical approval was granted by the Human Research Ethics Committee of the University of Cape Town, with a waiver for consent. Results Eleven cases of HIV arthropathy were identified. Cases predominantly affected boys (8/11), and the median age of onset was 10.3 years (IQR 6.9–11.6). Most cases presented in the setting of advanced immunosuppression, with a median absolute CD4+ count of 389 cells/uL (IQR 322–449) and median CD4+ proportion of 19.5% (IQR 14.8–25.0) at presentation. The clinical presentation was variable, with both oligoarthritis (6/11) and polyarthritis (5/11) being prevalent. All cases exhibited large joint involvement, which was usually asymmetrical. In addition, four children had asymmetrical small joint involvement. Associated features included enthesitis (4/11) and dactylitis (1/11). The most consistent laboratory feature was elevated acute phase reactants, and typical ultrasonographic findings were joint effusions and synovial hypertrophy. JIA and HIV arthropathy presented at a similar age, with median age at HIV arthritis onset of 10.3 years (IQR 6.9–11.6) versus 9.25 years (IQR 4.5–12.3) at arthritis onset in the JIA subgroup. HIV arthropathy cases were predominantly male (M/F ratio 3.0), whereas JIA cases had an equal sex distribution (M/F ratio 0.9). Oligo-articular disease was more frequently described in children with HIV arthropathy (55%), compared to those with JIA (38%). Conclusion In this series, most cases of HIV arthropathy exhibited asymmetrical large joint oligoarthritis or polyarthritis, and presented in older boys with advanced immunosuppression. HIV arthropathy appears to present at a similar age to JIA, with a comparable pattern of joint involvement to oligo-articular and poly-articular JIA subtypes.

O11 Neisseria Meningitidis as a cause of isolated bilateral polyarticular native knee joint septic arthritis

O11 <i>Neisseria Meningitidis</i> as a cause of isolated bilateral polyarticular native knee joint septic arthritis

Functional genomics atlas of synovial fibroblasts defining rheumatoid arthritis heritability

BackgroundGenome-wide association studies have reported more than 100 risk loci for rheumatoid arthritis (RA). These loci are shown to be enriched in immune cell-specific enhancers, but the analysis so far has excluded stromal cells, such as synovial fibroblasts (FLS), despite their crucial involvement in the pathogenesis of RA. Here we integrate DNA architecture, 3D chromatin interactions, DNA accessibility, and gene expression in FLS, B cells, and T cells with genetic fine mapping of RA loci.ResultsWe identify putative causal variants, enhancers, genes, and cell types for 30–60% of RA loci and demonstrate that FLS account for up to 24% of RA heritability. TNF stimulation of FLS alters the organization of topologically associating domains, chromatin state, and the expression of putative causal genes such as TNFAIP3 and IFNAR1. Several putative causal genes constitute RA-relevant functional networks in FLS with roles in cellular proliferation and activation. Finally, we demonstrate that risk variants can have joint-specific effects on target gene expression in RA FLS, which may contribute to the development of the characteristic pattern of joint involvement in RA.ConclusionOverall, our research provides the first direct evidence for a causal role of FLS in the genetic susceptibility for RA accounting for up to a quarter of RA heritability.

Symptomatic osteonecrosis of the hip and knee in patients with systemic lupus erythematosus: Prevalence, pattern, and comparison of natural course.

Osteonecrosis (ON), also known as avascular necrosis, is characterized by the collapse of the architectural bone structure secondary to the death of the bone marrow and trabecular bone. Osteonecrosis may accompany many conditions, especially rheumatic diseases. Among rheumatic diseases, osteonecrosis is most commonly associated with systemic lupus erythematosus (SLE). We assessed prevalence and distribution pattern of symptomatic ON in patients with SLE and compare the natural courses of hip and knee ON. 912 SLE patients admitted between 1981 and 2012 were reviewed. SLE patients with symptomatic ON were retrospectively identified both from the existing SLE/APS database. The prevalence of symptomatic ON was calculated; with ON, the joint involvement pattern was determined by examining the distribution of the joints involved, and then the data about the hip and knee joints were entered in the Kaplan-Meier analysis. Kaplan-Meier methods were used to calculate 5- and 10-year rates of ON-related hip (the hip group) and knee survival (the knee group). Symptomatic ON developed in various joints in 97 of 912 patients with SLE, and the overall prevalence of ON was detected as 10.6%. The mean age at the time of SLE and ON diagnoses were 27.9 ± 9.9 (14-53) and 34.2 ± 11.3 (16-62) years, respectively. The mean duration from diagnosis of SLE to the first development of ON was 70.7± 60.2 (range = 0-216) months. The most common site for symptomatic ON was the hips (68%, n=66), followed by the knees (38%, n = 37). According to Kaplan-Meier analysis, hip and knee joint survival rates associated with 5-year ON were 51% and 88%, and 10-year survival rates were 43% and 84%, respectively. We observed that the prevalence of symptomatic ON in patients with SLE was 10.6%. With the estimated 10-year survival rates of 40% versus 84% for the hip and knee joints, respectively, hip involvement may demonstrate a more aggressive course to end-stage osteoarthritis than the knee involvement.

Frequency of Different Types of Arthritis in patients of Psoriasis

Background: Psoriatic arthritis (PsA) is type of inflammatory arthritis associated with psoriasis. There are multiple patterns of joint involvement in patients with psoriasis Aim: To determine the frequency of arthritis and its different types in patients of psoriasis presenting at a tertiary care hospital in Lahore Methods: This cross Sectional study was conducted in Dermatology Department of Services Hospital, Lahore from 11th April, 2017 to 10th October, 2017. Two hundred and sixty patients having psoriasis were enrolled in the study, Patients’ detailed history about psoriasis, duration of psoriasis and joint pain or stiffness was taken. After written and informed consent Physical examination was done to determine the type of psoriasis and nail involvement. All the joints were examined for tenderness and deformities to assess the evidence of arthritis and its different types according to the site of involved joints. Results: Total numbers of patients included in the study was 260; in which 176 (67.7%) patients were males and 84 (32.3%) were females with the total mean age of 38 ±13.22 years. Out of 260 patients, 62(23.8%) patients had psoriatic arthritis (PsA), Out of these 62 patients having PsA, 23(37.1%) patients had Oligoarthritis, followed by Symmetric arthritis 19(30.6%) patients, Distal interphalangeal arthritis (DIP) in 15 (24.2 %). Conclusion: Our study concluded that almost one fourth of psoriasis patients had arthritis, asymmetrical oligoarthritis/monoarthritis came out to be the most common type in our study followed by symmetric polyarthritis, distal interphalangeal arthritis (DIP), Arthritis mutilans and axial arthritis Keywords: Psoriasis, types of psoriasis, arthritis, psoriatic arthropathy

The joint involvement in adult onset Still's disease is characterised by a peculiar magnetic resonance imaging and a specific transcriptomic profile

Adult onset Still's disease (AOSD) is a rare systemic autoinflammatory disease, characterised by fever, arthritis, and skin rash, and joint involvement is one of its clinical manifestations. The aims of this work were to assess joint involvement, to describe main patterns of involvement, and associated clinical characteristics. In this work, we aimed at assessing the joint involvement in AOSD by using MRI, to describe main patterns and associated clinical characteristics. In addition, we aimed at assessing the global transcriptomic profile of synovial tissues in AOSD to elucidate possible pathogenic pathways involved. We also evaluated the global transcriptomic profile of synovial tissues to elucidate possible pathogenic pathways involved in the disease. Thus, AOSD patients, who underwent to MRI exam on joints, were assessed to describe patterns of joint involvement and associated clinical characteristics. Some synovial tissues were collected for RNA-sequencing purposes. The most common MRI finding was the presence of synovitis on 60.5%, mainly in peripheral affected joints, with low to intermediate signal intensity on T1-weighted images and intermediate to high signal intensity on T2-fat-saturated weighted and STIR images. Bone oedema and MRI-bone erosions were reported on 34.9% and 25.6% MRI exams, respectively. Patients with MRI-bone erosions showed a higher prevalence of splenomegaly, a more frequent chronic disease course, lower levels of erythrocyte sedimentation rate, and ferritin. In AOSD synovial tissues, a hyper-expression of interleukin (IL)-1, IL-6, and TNF pathways was shown together with ferritin genes. In conclusion, in AOSD patients, the most common MRI-finding was the presence of synovitis, characterised by intermediate to high signal intensity on T2-fat-saturated weighted and STIR images. MRI-bone erosions and bone oedema were also observed. In AOSD synovial tissues, IL-1, IL-6, and TNF pathways together with ferritin genes resulted to be hyper-expressed.

Clinical presentation of psoriatic arthritis among sudanese: hospital based study

Back ground: Psoriasis is a common papulo-squamous disorder affecting 2% of the population and is characterized by well demarcated red scaly plaques. Psoriatic Arthritis (PsA) may be defined as an inflammatory arthritis which is seronegative for Rheumatoid Factor (RF) and enthesitis that is associated with psoriasis. The aims of our study is to identify different clinical presentations and types of psoriatic arthritis. Methods: This is a descriptive cross sectional hospital based study conducted at Omdurman military hospital, Khartoum, Sudan, for a period of six months. The study included 96 patients confirm diagnosed by dermatologist as psoriasis, the data obtain with designed questionnaire contains the clinical presentations of the disease, lab result and radiological imaging, the study analyzed by SPSS v.20 by using one way a nova method to determine the P. value. Results: From the total number of patients with Psoriasis, more than one third was psoriatic arthritis, 6% of patients with psoriatic arthritis were oligo-arthritis joint involvements, 14% were polyarthritis, 9% were distal inter phalangeal joint, 9% were spondylitis/sacroillitis and the remaining 5% were arthritis mutilants. In conclusion: the study found out most common pattern of joint involvement in psoriatic arthritis is oligoarthritis, which is not known to be common in psoriatic arthritis previously.

Факторы риска и молекулярные основы этиопатогенеза остеоартроза коленного сустава (обзор литературы)

Introduction Osteoarthritis (OA) is a heterogenic group of disorders of different etiology with similar biological, morphological and clinical manifestations and outcomes. OA is now considered a disease of the whole joint, including alterations in the articular cartilage, subchondral bone, synovial membrane, ligaments, capsule and periarticular muscles. OA of the knee as the most commonly affected joint accounts for the great medical, medical, social and economic impact. Material and methods A literature review assessing Russian and foreign studies on molecular mechanisms of etiology and pathogenesis of knee OA identified a set of factors for which there was consistent evidence for their association with onset of knee OA. A search of studies published in Russian and in English for the last ten years was conducted using bibliographic databases, including PubMed, PubMedCentral, GoogleScholar, eLIBRARY. Search terms included 'knee osteoarthritis', 'etiology', 'pathogenesis', 'risk factors'. Results Review of the literature showed that patients with knee OA are characterized by changes in cartilage, subchondral bone, synovium, suggesting common mechanisms of joint degeneration during OA development. Osteoarthritis (OA) is multifactorial in origin and closely associated with a wide spectrum of local (previous injury, muscle weakness, knee malalignment, knee surgeries, abnormal mechanical loading, excessive high impact sports, occupational physical activities) and systemic risk factors (advanced age, female sex, height, greater body mass index and obesity, hormone status, family history, mineral bone density, vitamin D deficiency, ethnicity). The prevalence of the knee OA and patterns of joint involvement vary among different racial and ethnic groups. Conclusion The literature review allowed us to identify the molecular mechanisms of etiopathogenesis of knee OA and the major risk factors for the pathology.

Role of Serum level of IL-1B and MMP-13 in detection of severity and functional impairment in hand Osteoarthritis patients

Hand Osteoarthritis (HOA) is one of the most common chronic degenerative joint diseases. Pain and decreased function are the leading symptom in HOA. Previously HOA was considered a pure degenerative disease, but this concept has changed and current research has demonstrated that inflammation is one of the key factors leading to the cartilage destruction. Cytokines as Interleukin-1β (IL1- β) induces expression and release of proteolytic enzymes such as matrix metalloproteinases (MMPs) and aggrecanases. Chondrocyte-derived MMPs are the main enzymes involved in the breakdown of cartilage collagens and proteoglycans. Research in the area of Hand OA is important to help early diagnosis, stop the progression of the disease, and preventing disability.The aim was to determine role of serum level of IL-1β and MMP-13 in detection of severity and functional impairment in patients with HOA.The study was carried out on 30 patients diagnosed with HOA, fulfilling the ACR 1990 criteria for diagnosis of HOA. Demographic data and anthropometric measurements were recorded for all participants. Clinical characteristics of the disease including duration of disease, pattern of joint involvement, pain and disease severity as well as functional assessment of HOA were assessed. Radiographic severity of HOA was assessed by Kellgren and Lawrence (K-L) score. Serum IL-1β and MMP-13 were assessed using double-antibody sandwich enzyme-linked immunosorbent assay method in both patients and control.The conclusion was that Interleukin-1B and MMP-13 seem to have an insignificant role in detection of severity and functional impairment in mild to moderate HOA.

Comparison of Prevalence of Osteoarthritis in the Hand: A Multicenter Retrospective Cohort Study

Introduction Several studies have previously been undertaken to investigate the prevalence of radiologic hand osteoarthritis (OA) in Caucasian, Japanese, Chinese, and Arabic populations. To date, there has been no direct international comparison study on the prevalence of radiologic hand OA between a Western and a Southeast Asian population. We hypothesize that there is difference in the pattern of joint involvement among individuals of both populations.Materials and Methods Consecutive hand radiographs from individuals aged 60 years and above were reviewed. Radiographic evidence of osteoarthritis in the various joints in the hands was graded using Kellgren–Lawrence (K-L) score. Chi-square test, Fisher's exact test, or Student's t-test was used as appropriate. Multiple logistic regression analysis was performed to evaluate the associations and relationships of radiographic hand OA between joints.Results A total of 194 patients exhibited radiographic OA. Singaporean patients were more likely to have radiographic OA of the thumb interphalangeal joint (IPJ) (65.1%) compared with the thumb carpometacarpal joint (CMCJ; 40.2%); British patients were more likely to have CMCJ (43.3%) OA than thumb IPJ (21.0%). The difference was statistically significant (p = 0.00026). In the Singapore population, it was more likely that a patient had concurrent OA of both thumb and finger joints, whereas in the British population, this was apparent in only the above-80-year-old group. The most commonly affected joint was the left thumb IPJ (joint specific prevalence of 35%) in the Singapore population, and the right index finger distal interphalangeal joint (DIPJ; joint specific prevalence of 41.5%) in the British population.Conclusion Our study, the first study to compare between Singaporean and British populations, showed statistically significant difference in the prevalence of OA in the hands. These findings suggest ethnic and cultural factors play a part in such a distribution trend.