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Telescoping of Fingers. J Clin Rheumatol 2019; 26:e291-e292. [PMID: 31524851 DOI: 10.1097/rhu.0000000000001142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Lindqvist U, Gudbjornsson B, Iversen L, Laasonen L, Ejstrup L, Ternowitz T, Ståhle M. Disease activity in and quality of life of patients with psoriatic arthritis mutilans: the Nordic PAM Study. Scand J Rheumatol 2017; 46:454-460. [PMID: 28276958 DOI: 10.1080/03009742.2017.1278787] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To describe the social status and health-related quality of life of patients with psoriatic arthritis mutilans (PAM) in the Nordic countries. METHOD Patients with at least one mutilated joint confirmed by radiology were studied. Disease activity involving joints and skin, physician-assessed disease activity, and patient's education and work status were recorded. Data from the 36-item Short Form Health Survey, Health Assessment Questionnaire and Dermatology Life Quality Index questionnaire were gathered and correlated with disease duration, pain, and general well-being (visual analogue scale). The controls were 58 Swedish patients with long-standing psoriatic arthritis sine PAM. RESULTS Sixty-seven patients were included. Patients with PAM had a protracted disease history (33 ± 14 years) and disease onset at a relatively early age (30 ± 12 years). Overall inflammatory activity at inclusion was mild to moderate. The mean number of mutilated joints was 8.2 and gross deformity was found in 16% of patients. Forty per cent were treated with biological and 32% with conventional synthetic disease-modifying anti-rheumatic drugs. Forty-two per cent had retired early or were on sick leave. Impaired functional capacity with little or no ability to perform self-care or everyday tasks was reported by 21% of the patients. Patients between 45 and 60 years of age reported the most impaired quality of life in comparison to the control group. CONCLUSION PAM seriously affects social functioning. Whether early recognition of PAM and new forms of therapy can improve disease outcome and quality of life remains to be studied.
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Affiliation(s)
- U Lindqvist
- a Department of Medical Sciences , Uppsala University , Uppsala , Sweden
| | - B Gudbjornsson
- b Centre for Rheumatology Research, University Hospital and Faculty of Medicine , University of Iceland , Reykjavik , Iceland
| | - L Iversen
- c Department of Dermatology , Aarhus University Hospital , Aarhus , Denmark
| | - L Laasonen
- d Helsinki Medical Imaging Center , Helsinki University Central Hospital , Helsinki , Finland
| | - L Ejstrup
- e Department of Rheumatology , Odense University Hospital , Odense , Denmark
| | - T Ternowitz
- f Department of Dermatology , Stavanger University Hospital , Stavanger , Norway
| | - M Ståhle
- g Dermatology Unit, Department of Medicine , Karolinska Institutet , Stockholm , Sweden
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Varilla V, Taxel P, Tannenbaum S. Metastatic Inflammatory Breast Cancer Associated With Multicentric Reticulohistiocytosis Successfully Treated With Zoledronic Acid. Clin Breast Cancer 2016; 16:e203-e207. [PMID: 27435627 DOI: 10.1016/j.clbc.2016.06.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 05/27/2016] [Accepted: 06/17/2016] [Indexed: 11/26/2022]
Affiliation(s)
| | - Pamela Taxel
- Division of Endocrinology and Metabolism, UConn Health, Farmington, CT
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Fontaine C, Mouliade S, Wavreille G, Chantelot C. Wrist arthrodesis with intercalated iliac crest graft in mutilans rheumatoid arthritis. ACTA ACUST UNITED AC 2014; 33:336-43. [DOI: 10.1016/j.main.2014.07.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Revised: 07/14/2014] [Accepted: 07/17/2014] [Indexed: 10/24/2022]
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Baek IW, Yoo SH, Yang H, Park J, Kim KJ, Cho CS. A case of multicentric reticulohistiocytosis. Mod Rheumatol 2014; 27:165-168. [PMID: 25211404 DOI: 10.3109/14397595.2014.952702] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Multicentric reticulohistiocytosis (MRH) is a rare non-Langerhans histiocytosis of unknown etiology with a predilection for joint and skin. The characteristic clinical features are papulonodular skin eruptions and inflammatory polyarthritis, sometimes progressive to arthritis mutilans, a severe destructive arthropathy. Although these manifestations can present at the same time, it is more common that one feature precedes the others. Notably, these features are similar to those found in some rheumatic diseases, such as rheumatoid arthritis or dermatomyositis, and this can lead to a misdiagnosis, especially during periods where only one feature is present. Herein, we report a female patient with polyarthralgia and subsequent skin eruptions, who was eventually diagnosed with MRH. Her symptoms seemed to resemble those of some rheumatic diseases, but several features such as affected joints and the characteristic shape of the skin lesions did not correspond to that. The histological result of infiltration of histiocytes and multinucleated giant cells in the skin ultimately facilitated the correct diagnosis. In this paper, we review MRH briefly and highlight several differential points which enable us to increase the likelihood of correctly diagnosing MRH.
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Affiliation(s)
- In-Woon Baek
- a Division of Rheumatology, Department of Internal Medicine , College of Medicine, The Catholic University of Korea , Seoul , Republic of Korea
| | - Sang Hoon Yoo
- a Division of Rheumatology, Department of Internal Medicine , College of Medicine, The Catholic University of Korea , Seoul , Republic of Korea
| | - Hyun Yang
- a Division of Rheumatology, Department of Internal Medicine , College of Medicine, The Catholic University of Korea , Seoul , Republic of Korea
| | - Jeongmi Park
- a Division of Rheumatology, Department of Internal Medicine , College of Medicine, The Catholic University of Korea , Seoul , Republic of Korea
| | - Ki-Jo Kim
- a Division of Rheumatology, Department of Internal Medicine , College of Medicine, The Catholic University of Korea , Seoul , Republic of Korea
| | - Chul-Soo Cho
- a Division of Rheumatology, Department of Internal Medicine , College of Medicine, The Catholic University of Korea , Seoul , Republic of Korea
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Affiliation(s)
- Ronald R Butendieck
- Division of Rheumatology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, Florida, USA
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Johnsson PM, Eberhardt K. Hand deformities are important signs of disease severity in patients with early rheumatoid arthritis. Rheumatology (Oxford) 2009; 48:1398-401. [DOI: 10.1093/rheumatology/kep253] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Codriansky KA, Rünger TM, Bhawan J, Kantarci A, Kissin EY. Multicentric reticulohistiocytosis: a systemic osteoclastic disease? ACTA ACUST UNITED AC 2008; 59:444-8. [PMID: 18311766 DOI: 10.1002/art.23320] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Aliu O, Netscher DT, Peltier M. Failure of small joint arthrodesis from resorption around a compression screw in a patient with lupus-associated arthritis mutilans: case report. Hand (N Y) 2008; 3:72-5. [PMID: 18780125 PMCID: PMC2528981 DOI: 10.1007/s11552-007-9055-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2007] [Accepted: 05/25/2007] [Indexed: 11/27/2022]
Abstract
We report the unusual case of a patient with systemic lupus erythematosus (SLE)-associated arthritis mutilans. Arthritis mutilans is a variant of erosive arthritis that is more commonly reported with psoriatic and rheumatoid arthritis and not with SLE. Joint fusion has been shown to be the most effective measure to preserve bone length and prevent further erosive joint changes in arthritis mutilans. We attempted to enhance success of a thumb interphalangeal joint fusion in our patient by adding compression across the fusion with implant screws, given the difficulty of achieving solid bone fusion ordinarily. Osteolysis around the compression screw resulted in arthrodesis failure. We were finally able to achieve successful fusion with iliac crest corticocancellous bone grafts and Kirschner wire fixation. Implant athroplasty in patients with bone loss is risky as it often furthers joint instability because of bone resorption around the prosthesis. This is a point of caution regarding use of any implant (including large screws) in patients with arthritis mutilans, as osteolysis around the implant may occur.
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Affiliation(s)
- Oluseyi Aliu
- Office of Student Affairs, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030 USA
| | - David T. Netscher
- Division of Plastic Surgery, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030 USA
- Hand Surgery Service, Department of Orthopedic Surgery, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030 USA
- Plastic Surgery Section, Texas Children’s Hospital, Houston, TX USA
- The Michael E. DeBakey, Veterans Affairs Medical Center Houston, TX, 6624, Fannin St. #2730, Houston, TX 77030 USA
| | - Marcia Peltier
- The Michael E. DeBakey, Veteran Affairs Medical Center, 2002 Holcombe Blvd, Houston, TX 77030 USA
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Abstract
Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease of unknown etiology affecting both articular tissues and extraarticular organs. The disease is often progressive and results in pain, stiffness, and swelling of joints culminating in significant morbidity and increased mortality. This chapter discusses the epidemiology, possible etiology, clinical manifestations, diagnostic approach and treatment options of RA.
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Affiliation(s)
- Ritu Khurana
- Section of Rheumatology, Center of Excellence for Arhritis and Rheumatology, Louisiana State University, Health Sciences Center, School of Medicine in Shreveport, 1501 Kings Highway, Shreveport, LA 71130, USA
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Laiho K, Kauppi M, Savolainen A, Belt EA. The cervical spine in mutilant juvenile chronic arthritis. Joint Bone Spine 2001; 68:425-9. [PMID: 11707009 DOI: 10.1016/s1297-319x(01)00299-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To describe inflammatory cervical spine disorders in juvenile chronic arthritis (JCA) patients with arthritis mutilans (AM) hand deformity. METHODS The series consisted of 18 patients affected by AM hand deformity who fulfilled the European League of Associations for Rheumatology criteria for JCA. The patient records and the most recent cervical spine radiographs were evaluated for subluxations, atlantoaxial impaction (AAI) and apophyseal joint ankylosis. RESULTS Seventeen (94%) patients had subluxation, AAI or apophyseal joint ankylosis in the cervical spine. Apophyseal joint ankylosis was noted in 12 (67%) patients and AAI in 10 (56%). Anterior atlantoaxial subluxation was detected in five (28%) patients. CONCLUSION Almost all of the JCA patients with AM hand deformity evinced some inflammatory changes in the cervical spine. Apophyseal joint ankylosis, AAI and multiplicity of changes in cervical spine may be considered characteristic in this subset of JCA patients. Patients with JCA and AM hand deformity tend to have severe changes also in the cervical spine.
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Affiliation(s)
- K Laiho
- Rheumatism Foundation Hospital, Heinola, Finland.
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