Proposal for a sonographic classification of target joints in rheumatoid arthritis

Abstract:In 1987, the American Rheumatism Association issued a set of criteria for the classification of rheumatoid arthritis (RA) to provide a uniform definition of RA patients. Fuzzy set theory and fuzzy logic were used to transform this set of criteria into a diagnostic tool that offers diagnoses at different levels of confidence: a definite level, which was consistent with the original criteria definition, as well as several possible and superdefinite levels. Two fuzzy models and a reference model which provided results at a definite level only were applied to 292 clinical cases from a hospital for rheumatic diseases. At the definite level, all models yielded a sensitivity rate of 72.6% and a specificity rate of 87.0%. Sensitivity and specificity rates at the possible levels ranged from 73.3% to 85.6% and from 83.6% to 87.0%. At the superdefinite levels, sensitivity rates ranged from 39.0% to 63.7% and specificity rates from 90.4% to 95.2%. Fuzzy techniques were helpful to add flexibility to preexisting diagnostic criteria in order to obtain diagnoses at the desired level of confidence.

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The International Classification of Functioning, Disability and Health (ICF) Core Sets: Application to a postmenopausal woman with rheumatoid arthritis and osteoporosis of the spine

Physiotherapy Theory and Practice ◽

10.3109/09593985.2013.773574 ◽

2013 ◽

Vol 29 (7) ◽

pp. 547-561 ◽

Cited By ~ 2

Author(s):

Amanda L. Lorbergs ◽

Norma J. MacIntyre

Keyword(s):

Rheumatoid Arthritis ◽

Postmenopausal Woman ◽

International Classification ◽

International Classification Of Functioning ◽

Disability And Health ◽

Core Sets ◽

Icf Core Sets

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Muscular syndrome in patients with inflammatory and degenerative diseases of joints and vertebral column

Kazan medical journal ◽

10.17816/kazmj65368 ◽

1999 ◽

Vol 80 (2) ◽

pp. 113-116

Author(s):

R. A. Khabirov

Keyword(s):

Rheumatoid Arthritis ◽

Rheumatic Diseases ◽

Clinical Picture ◽

Skeletal Muscles ◽

Vertebral Column ◽

Degenerative Diseases ◽

Muscular System ◽

Pathogenetic Mechanisms ◽

Diagnosis Criteria

The manifestations of muscular syndrome affecting the gravity and prediction of the disease take place in the most widespread and invalidizing rheumatic diseases: osteoarthrosis, rheumatoid arthritis and ankylosing spondylarthritis. Paraclinical studies showed heterogeneity of pathogenetic mechanisms in lesion of skeletal muscles in rheumatic diseases. The differentiated methods of the treatment of patients with osteoarthrosis, rheumatoid arthritis and ankylosing spondylarthritis taking into account the clinical picture and pathogenesis of muscular syndrome, as well as the diagnosis criteria and classification of muscular system lesion are suggested.

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Ultrasonographic Classification of Achilles Tendon Ruptures as a Rationale for Individual Treatment Selection

ISRN Orthopedics ◽

10.5402/2011/869703 ◽

2011 ◽

Vol 2011 ◽

pp. 1-10 ◽

Cited By ~ 14

Author(s):

Michael H. Amlang ◽

Hans Zwipp ◽

Adina Friedrich ◽

Adam Peaden ◽

Alfred Bunk ◽

...

Keyword(s):

Achilles Tendon ◽

Tendon Rupture ◽

Achilles Tendon Rupture ◽

Individual Treatment ◽

Reliable Instrument ◽

Tendon Ruptures ◽

Selection For ◽

Sonographic Classification

Purpose. This work introduces a distinct sonographic classification of Achilles tendon ruptures which has proven itself to be a reliable instrument for an individualized and differentiated therapy selection for patients who have suffered an Achilles tendon rupture. Materials and Methods. From January 1, 2000 to December 31, 2005, 273 patients who suffered from a complete subcutaneous rupture of the Achilles tendon (ASR) were clinically and sonographically evaluated. The sonographic classification was organized according to the location of the rupture, the contact of the tendon ends, and the structure of the interposition between the tendon ends. Results. In 266 of 273 (97.4%) patients the sonographic classification of the rupture of the Achilles tendon was recorded. Type 1 was detected in 54 patients (19.8%), type 2a in 68 (24.9%), type 2b in 33 (12.1%), type 3a in 20 (7.3%), type 3b in 61 (22.3%), type 4 in 20 (7.3%), and type 5 in 10 (3.7%). Of the patients with type 1 and fresh ASR, 96% () were treated nonoperative-functionally, and 4% () were treated by percutaneous suture with the Dresden instrument (pDI suture). Of the patients classified as type 2a with fresh ASR, 31 patients (48%) were treated nonoperatively-functionally and 33 patients (52%) with percutaneous suture with the Dresden instrument (pDI suture). Of the patients with type 3b and fresh ASR, 94% () were treated by pDI suture and 6% () by open suture according to Kirchmayr and Kessler. Conclusion. Unlike the clinical classification of the Achilles tendon rupture, the sonographic classification is a guide for deriving a graded and differentiated therapy from a broad spectrum of treatments.

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Rheumatoid Arthritis: Etiology and Pathogenesis

10.2310/im.1431 ◽

2014 ◽

Author(s):

Gary S. Firestein ◽

Anna-Karin H. Ekwall

Keyword(s):

Rheumatoid Arthritis ◽

Intracellular Signaling ◽

Cartilage Damage ◽

Signs And Symptoms ◽

American College Of Rheumatology ◽

European League Against Rheumatism ◽

Citrullinated Proteins ◽

Definition Of

Rheumatoid arthritis (RA) is among the most common forms of chronic inflammatory arthritis. It affects approximately 1% of adults and is two to three times more prevalent in women than in men. There are no specific laboratory tests for RA; diagnosis depends on a constellation of signs and symptoms that can be supported by serology and radiographs. The disease evolves over many years as a consequence of repeated environmental stress causing inflammation and immune activation followed by a breakdown of tolerance in individuals with a specific genetic background. This review describes the definition of RA; its etiology, including genetics, infections, the role of smoking and citrullination of proteins, and epigenetic mechanisms; and its pathogenesis, including synovial histopathology, bone and cartilage damage, adaptive and innate immunity, and the role of cytokines and intracellular signaling. Tables include the 1987 American Rheumatism Association criteria for the classification of RA and the 2010 American College of Rheumatology/European League Against Rheumatism classification for RA. Figures show citrullinated proteins in airway cells, a section of a proliferative synovium from a patient with a classic RA, and scalloped regions of erosion at the junction between a proliferative inflamed rheumatoid synovium and the bone. This review contains 3 highly rendered figures, 2 tables, and 71 references.

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The Wrightington Classification of Rheumatoid Wrist X-Rays: A Guide to Surgical Management

Journal of Hand Surgery (European Volume) ◽

10.1016/0266-7681_89_90168-x ◽

1989 ◽

Vol 14 (4) ◽

pp. 451-455

Author(s):

S. P. HODGSON ◽

J. K. STANLEY ◽

A. MUIRHEAD

Keyword(s):

Rheumatoid Arthritis ◽

Surgical Management ◽

X Rays ◽

Rheumatoid Disease ◽

Rheumatoid Wrist ◽

Practical Guidance ◽

Surgical Choices ◽

Results Of Surgery

We have reviewed the pre-operative radiological appearances, the type of operation performed and the results of surgery of 234 wrists in 179 patients with rheumatoid arthritis. Based on this, a classification of X-rays of the rheumatoid wrist is described. It is designed to provide practical guidance to the surgeon who is planning surgery in a patient with rheumatoid disease. The surgical choices at each stage of the disease are briefly discussed.

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Miscellaneous vasculitides

Oxford Textbook of Rheumatology ◽

10.1093/med/9780199642489.003.0137_update_002 ◽

2013 ◽

pp. 1153-1162

Author(s):

Richard A. Watts ◽

Eleana Ntatsaki

Keyword(s):

Rheumatoid Arthritis ◽

Central Nervous System ◽

Viral Infections ◽

Systemic Disease ◽

Connective Tissue Diseases ◽

Relapsing Polychondritis ◽

Significant Morbidity ◽

Clinical Presentations ◽

Systemic Rheumatic Diseases

The vasculitides are a group of relatively rare conditions with a broad spectrum of clinical presentations that can cause significant morbidity and mortality. Classification of the vasculitic syndromes is done according to the size of the vessels affected and also the presence of anti-neutrophil cytoplasmic antibodies (ANCA). Vasculitides can be either primary or secondary to an underlying systemic disease, malignancy, or infection. This chapter covers the spectrum of the secondary vasculitides; some of the non-ANCA-associated primary vasculitides and miscellaneous types of vasculitic syndromes. Secondary vasculitis can occur in the background of systemic rheumatic diseases such as rheumatoid arthritis, spondyloarthropathies, or other connective tissue diseases. Vasculitis can also present in relation to precipitants such as drugs (propylthiouracil, hydralazine, leucotriene antagonists) or vaccines. Infection (bacterial, mycobacterial, viral, and fungal) has been associated with vasculitis either as a trigger or as a consequence of iatrogenic immunosuppression. Infection-related vasculitis can affect all types and sizes of vessels. Certain forms of vasculitis such as cryoglobulinaemia are closely associated with viral infections and more specifically with HCV infection. There are forms of vasculitis, which appear to be isolated or localized to a single organ, or site (skin, gastrointestinal, genital, and primary central nervous system vasculitis) that may be histologically similar to systemic syndromes, but have a different prognosis. Other conditions that may mimic vasculitis and miscellaneous conditions such as Cogan’s syndrome and relapsing polychondritis are also discussed.

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