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1.
Psoriatic Arthritis: Interrelationships between Skin and Joint Manifestations Related to Onset,Course and Distribution 总被引:4,自引:0,他引:4
To assess the relationships between skin and joint disease, 70 patients with psoriatic arthritis were consecutively evaluated.
Data were obtained regarding age, sex, duration of disease, age at onset, and flares of both skin and joint disease. Rheumatological
assessment included morning stiffness, number of swollen, tender and deformed joints, involvement of distal interphalangeal
joints (DIP), presence of dactylitis, Achilles tendinitis, and clinical lumbar and cervical involvement. Skin assessment included
recording of the distribution of skin lesions and nail involvement, and grading of psoriasis severity using the PASI. The
scalp was the most frequently involved site. Significant correlation was found between the PASI score and the number of deformed
joints and Schober’s test. The scalp score was found to correlate with the number of swollen joints, deformed joints, sausage
finger and DIP involvement. Synchronous flares of skin and joint were significantly more frequent in the patients with onset
of skin and joint diseases within the same year. Likewise, these patients showed a highly significant association between
the PASI score and the number of tender, swollen and deformed joints, Schober’s test and cervical involvement, whereas no
such associations were found among patients with separate onset of skin and joint diseases.
Received: 9 August 1999 / Accepted: 10 February 2000 相似文献
2.
Seronegative Spondyloarthropathy Initiated by Physical Trauma 总被引:1,自引:1,他引:0
We undertook this study to demonstrate the pattern of onset and the course of arthritis on the traumatised joint in spondyloarthropathy
(SpA) initiated by physical trauma. Among 288 patients with SpA, 12 (4.2%) whose arthropathies were associated with trauma
were reviewed retrospectively. There were seven patients with ankylosing spondylitis (AS), three with juvenile onset AS and
two undifferentiated SpA. The type of trauma was direct injury to the joint and injuries at other sites, except in spinal
surgery, for example. In eight cases the initial evidence of disease was peripheral arthritis. The disease first occurred
in traumatised joints in five cases. Only three cases showed recurrent inflammatory episodes in the traumatised joints throughout
the disease course. SpA initiated by trauma initially manifested as peripheral arthritis at the traumatised joints in about
half of the cases. Inflammatory episodes preferentially involved other joints apart from the traumatised joints throughout
the whole course of the disease.
Received: 4 August 1999 / Accepted: 25 January 2000 相似文献
3.
The purpose of this study was to evaluate the serum levels of hyaluronic acid (HA) in a group of patients with psoriatic
arthritis (PsA), with special emphasis on the relationships between HA levels and clinical parameters of joint and skin activity.
Thirty-four patients with PsA, 34 patients with rheumatoid arthritis (RA) and 49 healthy volunteers participated in the study.
Assessment of joint disease in patients with PsA included duration of morning stiffness, number of tender and swollen joints,
right and left grip, the presence of inflammatory back pain and Schober’s test. The current severity of skin involvement was
graded according to the Psoriasis Area Severity Index (PASI). Serum levels of HA were measured by a radiometric assay. The
mean HA serum levels of patients with PsA and RA were significantly increased in comparison with healthy controls (107 ± 39.6
μg/dl in patients with PsA, whereas in patients with RA it was 168 ± 32.4 μg/dl and 36.7 ± 5.5 μg/dl in healthy controls).
A highly significant correlation was found between levels of HA and index of skin involvement, but no association was found
between HA levels and clinical parameters of joint severity. We conclude that in this cohort of patients with PsA, HA levels
clearly reflected psoriatic skin involvement although it did not correlate with joint disease.
Received: 18 June 1999 / Accepted: 5 April 2000 相似文献
4.
Radiologic changes of cervical spine in ankylosing spondylitis 总被引:1,自引:0,他引:1
Ankylosing spondylitis (AS) is characterised by its effects on the axial skeleton. The cervical spine is also vulnerable
to the disease process. Our aim was to determine the frequency of radiologic changes to the cervical spine and their correlation
with clinical variables. We also used the Bath Ankylosing Spondylitis Radiology Index (BASRI) system, which is one of the
reliable scoring systems of radiography, to score the global radiologic changes to the cervical and lumbar spine and the hip
joints in our AS cohort. There were 181 patients with anteroposterior and lateral full-flexion views on radiography of the
cervical spine here included in the study. A radiologist examined the radiologic changes to all anatomical compartments of
the cervical spine in detail and graded them according to the BASRI system. We used the clinical and demographic data of our
AS cohort to determine their relation to the radiographic changes. Eighty-eight patients (48.6%) showed radiological changes
to the cervical spine; to the discovertebral joint 35.9%; the apophyseal joint 26.0%; atlantoaxial articulation 22.1% (atlantoaxial
subluxation 13.8%); the costovertebral joint 18.2%; and to the posterior ligamentous attachment 11.6%. Using the BASRI system,
73 patients (40.3%) showed radiologic changes to the cervical spine and were graded as score 1 (1.7%), 2 (22.7%), 3 (6.6%)
or 4 (9.4%). Among those graded as normal by the BASRI system, 17 showed some changes to the cervical spine, such as atlantoaxial
joint subluxation or narrowing, and severe osteoporosis with no other radiographic changes. Current age, disease duration,
inflammatory back pain and cervical symptoms were associated with the radiographic changes to the cervical spine. The BASRI-cervical
spine score correlated with the BASRI-lumbar spine and hip joint score, sacroiliitis, disease duration, and duration of inflammatory
back pain and cervical symptoms. Our data suggest that radiographic changes to the cervical spine are frequent in AS, and
can be predicted in the patients with old age, long duration of disease and inflammatory back pain, and cervical symptoms.
Also, the BASRI scoring system showed similar results as a detailed assessment of the cervical spine in our study.
Received: 25 August 2000 / Accepted: 14 March 2001 相似文献
5.
Computed tomography (CT) was compared with plain radiography and quantitative sacroiliac (SI) scintigraphy in 28 patients with early ankylosing spondylitis (AS) of less than or equal to 10 years duration. Compared with conventional radiography, CT improved delineation of the SI joints and revealed more abnormalities and higher grades of sacroiliitis; this was significant in patients with early AS of less than or equal to 3 years duration. Quantitative sacroiliac scintigraphy showed higher SI joint: sacrum ratios of radioisotope uptake in patients with AS compared with controls. However, its diagnostic usefulness was limited by the frequency of inconsistent results and the lack of specificity. CT examination of the SI joints may be a useful adjunct in the diagnosis of early AS. 相似文献
6.
Aortic insufficiency, myocardial fibrosis and conduction disturbances are known complications of ankylosing spondylitis (AS).
However, few studies have assessed left ventricular diastolic function and no data are available about P-wave analysis. In
this study 88 AS patients and 31 healthy volunteers underwent clinical examination, electrocardiography, echocardiography
and signal-averaged P-wave analysis for the evaluation of asymptomatic cardiac involvement. The aortic root in AS patients
was larger and this was correlated with the duration of the disease. Five of 88 AS patients (5.7%) had evidence of mitral
valve prolapse, six (6.8%) had thick and redundant mitral valves without prolapse, five (5.7%) had mild mitral regurgitation,
two had moderate (2.3%) and two had mild (2.3%) aortic regurgitation. Examination of diastolic function revealed a lower peak
of E-wave velocity (E) and E/A ratio, a higher peak of A-wave velocity (A) and acceleration rate of the A wave, a longer deceleration
time of E-wave velocity and isovolumic relaxation time in the AS group compared to controls. Mean filtered P-wave duration
(PWD) in AS was similar to that of controls. However, PWD in AS patients was positively correlated with left atrial dimension
and acceleration rate of the A wave and negatively correlated with E and E/A ratio. In conclusion, cardiac involvement may
be seen in AS patients in the absence of clinical manifestations. Echocardiographic examination of diastolic function can
be used in this asymptomatic period. Further studies are needed to clarify the prognostic significance of diastolic abnormalities
and the value of P-wave analysis in cardiac evaluation of these patients.
Received: 5 June 2001 / Accepted: 18 September 2001 相似文献
7.
Al-Arfaj AS 《Clinical rheumatology》2002,21(6):493-496
The association between articular chondrocalcinosis and osteoarthritis was sought by studying 92 patients over the age of
60. Anteroposterior and lateral X-ray projections of knees, hands and wrists were studied for the presence of chondrocalcinosis
and osteoarthritis. Of the 92 patients (60 males, 32 females), six had chondrocalcinosis of the knees; two of them also had
it in the wrist. The six cases with chondrocalcinosis were compared to the 86 cases without, for the presence of osteoarthritis
in the different compartments of the knees, intercarpal joints (IC) and metacarpophalangeal joints (MCP). We found an association
between chondrocalcinosis and osteoarthritis of the lateral knee compartment (odd ratio (OR) 10.59, 95% CI 3.47–34.9), second
MCP joint (OR 3.27 95% CI 1.44–8.93), third MCP joints (OR 6.92, 95% CI 1.99–25.54) and IC joint (OR 5.69, 95% CI 1.14–29.7).
No association was found with overall knee OA, medial knee compartment OA or patellofemoral OA. In conclusion, chondrocalcinosis
was associated with OA of the lateral knee compartment, second MCP, third MCP and IC joints.
Received: 25 January 2002 / Accepted: 10 June 2002
Correspondence and offprint requests to: Dr Abdurhman S. Al-Arfaj, PO Box 34471, Riyadh 11468, Saudi Arabia. E-mail: asarfaj@ksu.edu.sa 相似文献
8.
Queiro R Belzunegui J González C De DJ Sarasqueta C Torre JC Figueroa M 《Clinical rheumatology》2002,21(1):10-13
The aim of this study was to analyse retrospectively the prevalence and the clinical features of clinically asymptomatic
axial involvement in patients with psoriasis and axial radiological features of spondyloarthropathy (PsSpA). We performed
a cross-sectional study based on the clinical records of 70 patients, 44 men and 26 women, with a mean age of 48.7 t 14.2
years. PsSpA was defined by the presence of radiographic sacroiliitis (SI) greater than or equal to grade 2, and/or any other
typical radiological sign of spondylitis in patients with psoriasis. When the radiological signs were present in the absence
of inflammatory back pain and/or buttock pain, patients were grouped as having asymptomatic axial disease. HLA-B27 was determined
by serological methods in the 70 patients and in 82 healthy controls from our general population. Fourteen patients (20%),
11 with radiological SI, two with facet joint erosion-fusion and one with aseptic discitis, showed no evidence of symptomatic
spinal disease. Twenty-nine patients (41%) showed cervical spine disease (CSD), but only 17 of them (58.6%) had pain and rigidity
at this level, whereas 12 (41.4%) did not show clinical symptoms. CSD was associated with duration of arthritis (P= 0.043) and peripheral erosions (P = 0.037). HLA-B27 correlated well with bilateral SI (P = 0.002) and PsSpA (P<0.0004, RR 6.4), but showed no association with unilateral SI nor with syndesmophytes or asymptomatic disease. Univariate
analysis demonstrated associations between symptomatic disease and longer duration of arthritis (P = 0.041) and higher IgM values (P = 0.05). There is a high prevalence of asymptomatic involvement in patients with PsSpA The significance of these asymptomatic
changes is not known, but they probably represent a common characteristic of spondyloarthropathies rather than a specific
feature associated with psoriasis.
Received: 30 October 2000 / Accepted: 6 August 2001 相似文献
9.
Imaging of Sacroiliitis 总被引:14,自引:0,他引:14
Inflammation of one or both sacroiliac joints is a characteristic feature of patients with spondyloarthropathies (SpA). Sacroiliitis
often leads to inflammatory back pain (IBP). IBP and asymmetric peripheral arthritis of the lower limbs are the main clinical
symptoms and criteria for classification and diagnosis of SpA in which sacroiliac joints are uni- or bilaterally affected
with an intensity ranging from mild to very severe inflammation resulting in partial or complete ankylosis Sacroiliitis is
a very frequent feature of undifferntiated SpA. In ankylosing spondylitis (AS) inflammation in the axial skeleton occurs rarely
in the absence of sacroiliitis. Objective evidence of sacroiliitis obtained by imaging procedures, especially x-rays, has
always been part of diagnostic and classification criteria for AS. This is in contrast to spinal radiography which, however,
has been recently included in a core set of outcome items to be assessed in clinical studies. In early and acute stages of
sacroiliitis the diagnosis can be difficult because conventional radiographs - which are known to have considerable intra-
and interobserver variability - may be normal. Since IBP is not a specific indicator of sacroiliitis there is need for valuable
imaging techniques. Scintigraphy lacks specificity. Computed tomography (CT) is a very good method to demonstrate already
established bony changes and magnetic resonance imaging (MRI) has the advantage of combining a good visualisation of the complicated
anatomy of the sacroiliac joint with the ability to localise different degrees of inflammation and oedema and prove a possible
spread to muscles as it occurs in septic sacroiliitis, an important differential diagnosis.
Received: 3 March 1999 / Accepted: 3 March 1999 相似文献
10.
A. El Maghraoui F. Tabache A. Bezza A. Abouzahir D. Ghafir V. Ohayon M. I. Archane 《Clinical rheumatology》2001,20(3):189-191
The aim of the study was to evaluate the prevalence of sacroiliitis in a group of patients with Beh?et’s disease (BD). Pelvic
X-rays of 27 patients with BD responding to the International Study Group of BD and 30 controls (15 AS and 15 sciatica) were
read blind and sacroiliac involvement was graded according to the New York criteria. In a second step, patients or controls
with equivocal sacroiliitis had a sacroiliac CT scan. Two patients with BD (7.4%) and all patients with AS had evident bilateral
sacroiliitis (at least grade 2). One patient with BD and two patients with sciatica had equivocal sacroiliitis (grade 1).
CT confirmed sacroiliitis in the two patients with BD and eliminated inflammatory sacroiliitis in the three other patients
with equivocal sacroiliitis showing mild degenerative lesions. A review of the literature showed that sacroiliitis and AS
are rarely associated with BD. There remains insufficient evidence to suggest that sacroiliitis is an intrinsic feature of
BD and that BD belongs to the group of SpA.
Received: 11 May 2000 / Accepted: 27 October 2000 相似文献
11.
The aim of this study was to identify potential markers of aggressive joint manifestations and HLA associations in patients
with psoriatic arthritis (PsA) in northern Sweden. Patients with PsA were examined clinically, with laboratory tests and radiologically.
The classification of the disease was based on peripheral and/or axial engagement. HLA B17, B37 and B62 were significantly
increased in PsA patients. Univariate analyses suggest that the HLA antigens B37, B62 and some clinical variables were associated
with disease course. However, in multivariate analyses distal interphalangeal joint affliction and polyarticular manifestations
were the only variables remaining significantly associated with irreversible joint destruction or deformity. There were no
significant effects of HLA antigens. In this cross-sectional study, clinical manifestations were more reliable predictors
of aggressive joint damage than were specific HLA antigens. However, HLA antigens seemed to modify the expression of the joint
disease rather than being involved in joint disease susceptibility.
Received: 13 August 2001 / Accepted: 11 February 2002 相似文献
12.
OBJECTIVE: Translation and validation of the Bath Ankylosing Spondylitis Disease Activity Index ( BASDAI) for defining disease status in ankylosing spondylitis (AS) and related diseases. METHODS: The German version BASDAI-D was translated with only a few modifications. It contains six 10 cm horizontal visual analog scales to measure severity of fatigue, spinal and peripheral joint pain, tenderness and morning stiffness. A total of 318 patients with AS and other spondarthropathies completed the instrument at the beginning and at the end of their medical rehabilitation. Psychometric evaluation was performed separately for patients with AS corresponding to the modified New York Criteria ( SPA-NY, N=211) and for a second group of patients, which fulfilled the early diagnostic criteria for AS or the ESSG criteria of spondylarthropathies (Fd/Spond., N=86). RESULTS: SPA-NY: Factor analysis yielded one factor explaining 54.8% of variance. The sum score with a standard deviation of 1.94 is nearly symmetrical distributed with mean of 4.7. Reliability analysis yielded high internal consistency (Cronbach's alpha=0.83). Corrected item-total correlations are also high and are large ranging from 0.48 to 0.71. Concerning concordant validity the BASDAI-D showed a substantial correlation with the scale bodily pain of the SF 36 (r = -0.72). There are no correlations with objective clinical parameters. Furthermore the assessment of disease activity by the physician correlates significantly, albeit low with the BASDAI-D. Sensitivity to change yields effect sizes up to 0.60. Fd/Spond.: The results for this group are almost identical with SPA-NY (one factor explaining 53.8% variance, mean 4.6+/-1.75; corrected item-total correlations from 0.50 to 0.75; correlation with the scale bodily pain r = -0.62). Analysis for subgroups showed higher scores for women in both groups SPA-NY and Fd/Spond. CONCLUSION: BASDAI-D ist applicable for patients with AS and likewise for patients fulfilling the early diagnostic criteria for AS or the ESSG criteria of spondylarthropathies. In summary, BASDAID is reliable and valid. Because of its good acceptance and usability BASDAI-D is easy to use in research as well as in clinical practice. 相似文献
13.
We report on a 46-year-old man with a 4-year history of predominantly nocturnal pain at the thoracic and lumbar spine as
well as accompanying morning stiffness and episodes of alternating buttock pain. At physical examination the patient presented
with the typical traits for Marfan’s syndrome (MFS), along with limitation of both chest expansion and movement in all planes
of the lumbar spine. Pelvic and lumbar spine radiographs showed findings consistent with ankylosing spondylitis (AS). Laboratory
tests were consistent with an inflammatory state and HLA typing was positive for the B27 antigen. Transthoracic echocardiography
showed prolapse of the posterior mitral leaflet and mild aortic insufficiency. We diagnosed co-existent MFS and AS. The association
of these two pathologies is particularly interesting, owing to the co-existence of hypermobility of peripheral joints due
to MFS ligamentous hyperlaxity, and the reduction of both axial skeleton motility and chest expansion related to AS. As both
of these diseases may damage the cardiovascular system over time, follow-up with echocardiography monitoring is indispensable
Received: 2 June 2000 / Accepted: 3 October 2000 相似文献
14.
Patients with rheumatoid arthritis (RA) show lower cardiorespiratory fitness than normal subjects. This study was planned to investigate the pulmonary function tests (PFT), respiratory muscle strength and endurance, and aerobic capacity of patients with RA, as well as the relationship of these parameters to clinical and functional status. Twenty-five RA patients aged 25-71 (48.52 +/- 14.09) and 21 control subjects aged 25-66 (45.67 +/- 13.27) participated in the study. PFT, maximum volunteer ventilation, maximum inspiratory and maximum expiratory pressures and cardiorespiratory exercise tests were carried out in all subjects to evaluate the respiratory involvement, inspiratory and expiratory muscle strength and endurance, and aerobic capacity. Patients' duration of disease, smoking and alcohol habits, duration of morning stiffness, visual analogue scale scores, ARA functional classifications and Ritchie articular indexes were recorded. All the patients and control subjects were non-exercising individuals. As a result, we found that RA patients have normal PFT but reduced respiratory muscle strength and endurance, and also reduced aerobic capacity compared to controls. According to this result, respiratory and aerobic exercises may be recommended to improve respiratory muscle strength and endurance and aerobic capacity in these patients. 相似文献
15.
We report a 50-year-old male patient with hereditary multiple exostoses (HME) and ankylosing spondylitis (AS). This is the
first case reporting the coexistence of HME and AS. Our patient has multiple exostoses around the knee, elbow and wrist joints.
At the age of 40 years, pain in the lower back associated with morning stiffness lasting about an hour and improving with
exercise began. His son also has hereditary multiple exostoses but has no sign of AS. HME is an autosomal dominant disorder.
AS has a remarkably strong association with the histocompatibility antigen HLA-B27. Owing to the different genetic mechanisms,
it is not possible to differentiate between coincidence and association. Coexistence of HME and AS in our patient probably
represents a coincidence rather than a real association.
Received: 4 September 1998 / Accepted: 4 April 1999 相似文献
16.
A. Yildirir S. Aksoyek M. Calguneri K. Aytemir S. Apras S. Kiraz G. Kabakci K. Ovunc A. Oto S. Kes 《Clinical rheumatology》2001,20(3):185-188
The aim of this study was to investigate the involvement of autonomic nervous system (ANS) function by using power spectral
analysis of heart rate variability (HRV) method in patients with ankylosing spondylitis (AS). The study included 94 AS patients
all fulfilling the New York criteria for AS, and 49 healthy volunteers. Recordings for HRV were obtained with a PC-based high-resolution
electrocardiographic system and analysed using power spectral analysis. The peak around 0.04–0.15 Hz was defined as low-frequency
peak (LF) and the other, around 0.15–0.40 Hz, was defined as high-frequency peak (HF), representing mostly the sympathetic
and the parasympathetic components of the ANS, respectively. The following variables were calculated and compared between
groups: the LF in absolute and normalised units (LF nU); the HF in absolute and normalised units (HF nU); and LF/HF ratio.
The AS group included 47 male and 47 female subjects with a mean age of 33 ± 11 years (range 16–64). In the control group
there were 23 male and 26 female healthy subjects (mean age 33 ± 8; range 19–60). None of the patients or control subjects
had any cardiac or neurological symptoms. Both groups were similar with respect to age and sex characteristics (p >0.05). The HRV analysis indicated that the peaks of LF, LF nU, HF, HF nU and LF/HF ratio were similar in both groups. Groups
also did not differ with respect to heart rate at the time of examination. Our data demonstrated no evidence of ANS involvement
as assessed by HRV analysis in AS patients.
Received: 19 July 2000 / Accepted: 25 October 2000 相似文献
17.
Amyopathic Dermatomyositis and Pulmonary Fibrosis 总被引:1,自引:0,他引:1
‘Amyotrophic dermatomyositis’ (ADM) is used to describe a small subgroup of patients with the typical skin rash associated
with dermatomyositis but without muscle involvement. Lung involvement in ADM is rare. We report on the management of a patient
with ADM associated with pulmonary fibrosis at presentation, and her response to corticosteroid treatment.
Received: 14 September 1999 / Accepted: 18 April 2000 相似文献
18.
THE RELATIONSHIP OF CLINICAL AND LABORATORY MEASUREMENTS TO RADIOLOGICAL CHANGE IN ANKYLOSING SPONDYLITIS 总被引:5,自引:1,他引:5
TAYLOR H. G.; WARDLE T.; BESWICK E. J.; DAWES P. T. 《Rheumatology (Oxford, England)》1991,30(5):330-335
Methods for scoring the severity of radiological change in patientswith ankylosing spondylitis using plain X-rays of the sacroiliac(SI) joints and lumbar spine and computerized tomographic (CT)scans of the SI joints were evaluated in a cohort of 70 patients.Analysis of reproducibility was by the kappa statistic. Significantchange over 12 months in a subgroup of patients was demonstratedby these scores. Ankylosis correlates negatively with erosionsand sclerosis and the change in SI joint ankylosis correlatesnegatively with change in SI joint erosions as seen on CT scan.The clinical and laboratory correlates of these findings wereexamined. Pain, stiffness and sleep disturbance correlated positivelywith increasing SI joint sclerosis on CT scanning (r = 0.45;P<0.05) but negatively with ankylosis (r = 0.43; P<0.05).Orosomucoid levels predicted an increase in the radiologicallumbar spine score. No other clinical or laboratory variablepredicted radiological change. KEY WORDS: Computerized tomographic scan, X-ray, Assessment
*Present address: Department of Rheumatology, Leicester RoyalInfirmary, Leicester LE1 5WW. 相似文献
19.
Systems to assess the progression of finger joint osteoarthritis and the effects of disease modifying osteoarthritis drugs 总被引:2,自引:0,他引:2
Our objective was to assess the progression of osteoarthritis (OA) using scoring systems based on the anatomical changes
recorded in the finger joints on standard radiographs and to test how far these scoring systems could be used to evaluate
the effects of candidate ‘disease modifying osteoarthritis drugs’ (DMOAD). The appearance and growth of osteophytes, narrowing
of the joint space and subchondral bone changes allowed the classic OA-associated anatomical lesions to be used to score the
progression of finger joint OA. Progression of OA in the finger joints was also assessed by the their evolution through previously
described and predictable anatomical phases on standard X-rays. These phases were characterised by complete loss of the joint
space preceding or coinciding with the appearance of subchondral cysts eroding the entire subchondral plate, and have been
described in ‘inflammatory’ or ‘erosive’ OA. The erosive episodes were followed by processes of remodelling. In order to interfere
with the progression of osteoarthritis, two chondroitin sulphates with possible DMOAD effects were used in two series of patients
with OA of the finger joints. The patients were included in two separate randomised, double-blind placebo-controlled trials:
46 of them received chondroitin polysulphate and 34 received chondroitin sulphate. Eighty-five patients were kept on placebo
medication and were used as controls. All 165 patients were followed for 3 years. Posteroanterior X-rays of the metacarpophalangeal
and interphalangeal (IP) finger joints were obtained at the start of this prospective study and at yearly intervals thereafter.
Almost 80% of the distal IP and 50% of the proximal IP were affected at study entry. In approximately 40% of the patients
the classic picture of OA of the IP joints was complicated by manifest erosive OA changes. The two systems to score the progression
of OA (Anatomical Lesion and Anatomical Phase Progression Score System) showed definite progression within 3 years of follow-up,
especially in the IP joints. When compared with the placebo controls, none of the chondroitin sulphates prevented OA from
occurring in previously normal finger joints. However, when the classic OA-associated anatomical lesions were considered,
OA was less progressive in both active treatment groups. Furthermore, fewer patients from both chondroitin sulphate- and chondroitin
polysulphate-treated groups developed ‘erosive’ osteoarthritis. In conclusion, conventional radiographs can be used to assess
the morbidity and progression of hand OA. The systems used to score the progression of finger joint OA allowed the DMOAD effects
of both chondroitin sulphates to be evaluated. The data recorded during these pilot studies should help investigators to design
future long-term clinical experiments.
Received: 23 July 2001 / Accepted: 12 December 2001 相似文献
20.
The Differing Patterns of Subclinical Pulmonary Involvement in Connective Tissue Diseases as Shown by Application of Factor Analysis 总被引:1,自引:0,他引:1
To explore common patterns of interstitial lung disease (ILD) in symptomless patients with connective tissue disease (CTD),
we applied factorial analysis to determine the relationship among the factors. A selected cohort of 71 non-smoking patients
with a confirmed diagnosis of CTD [24 with primary Sjo¨gren’s syndrome (pSS), 21 with systemic sclerosis (SS), 20 with rheumatoid
arthritis (RA) and six with polymyositis/dermatomyositis (PM/DM)] were identified. The diagnostic techniques included pulmonary
function tests, bronchoalveolar lavage (BAL), chest radiographs and high-resolution computed tomography (HRCT). Disease extent
and severity were assessed by a radiological and HRCT grading system. Three factors, accounting for 67% of the total variance,
were extracted. The first factor (disease duration, diffusing lung capacity, neutrophils and CD8+ T cells on BAL, radiographic
score and HRCT reticular score), with the highest percentage of variance (36.5%), defines a fibrotic lung pattern. The second
factor (17.9% of variance) identifies an inflammatory lung pattern (macrophages, lymphocytes and eosinophils on BAL and HRCT
ground-glass score). The third factor (12.6% of variance) represents a ventilatory function pattern (forced vital capacity,
total lung capacity and forced respiratory volume in 1 s). The negative correlation between the fibrotic lung pattern and
ventilatory function pattern, but not with the inflammatory lung pattern, suggests the presence of a significant derangement
of the alveolar structures. In conclusion, application of factor analysis reveals various lung disease patterns in patients
with CTD that might have different prognostic implications.
Received: 2 March 1999 / Accepted: 9 July 1999 相似文献