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

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.

scholarly journals MANAGEMENT OF KNEE RHEUMATOID ARTHRITIS WITH TOTAL KNEE ARTHROPLASTY: A SYSTEMATIC REVIEW

2017 ◽  
Vol 26 (4) ◽  
pp. 149-153
Author(s):  
Calin Dragosloveanu ◽  
◽  
Serban Dragosloveanu ◽  
Bogdan Cretu ◽  
◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Daily Living ◽  
Structural Damage ◽  
Marked Decrease ◽  
Rheumatoid Disease ◽  
Anesthetic Considerations ◽  
Total Knee ◽  
Results Of Surgery

Total knee arthroplasty (TKA) in patients with rheumatoid arthritis (RA) has different features from those seen in patients with osteoarthritis. In 1970 85% of the patients undergoing TKA had rheumatoid arthritis. Nowadays less than 5% of the patients undergoing TKA have rheumatoid disease. An important reason for the marked decrease is the improvement of the medical treatment. Fewer patients now progress to permanent structural damage requiring arthroplasty. TKA in RA has management difficulties that are unique to the disease. These include ipsilateral hip involvement, bilaterality, anticoagulation needs, flexion contractures, rheumatoid cysts and possibly the need for synovectomy. Patients with rheumatoid arthritis are more vulnerable to both early and late infections. They require a prosthesis and technique that provide adequate flexion for activities of daily living. Their often-profound osteopenia can lead to intraoperative and postoperative fractures. Finally, their cervical spine and temporal-mandibular disease create challenging anesthetic considerations. Nevertheless, given these considerations and the degree of preoperative disability suffered by patients with rheumatoid arthritis, the results of surgery can be extremely dramatic and gratifying to both patient and surgeon.

A Comparison of Two Indices for Ulnar Translation and Carpal Height in the Rheumatoid Wrist

2004 ◽  
Vol 29 (2) ◽  
pp. 144-147 ◽  
Author(s):  
N. BORISCH ◽  
K. LERCH ◽  
J. GRIFKA ◽  
P. HAUSSMANN
Keyword(s):  
Rheumatoid Arthritis ◽  
False Negative ◽  
Hand Surgery ◽  
X Rays ◽  
Joint Surgery ◽  
Rheumatoid Wrist ◽  
Two Indices ◽  
Radiolunate Arthrodesis ◽  
Carpal Height

The indices for ulnar translation described by Chamay et al. (1983 , Annales de Chirurgie de la Main, Vol. 2, pp. 5–17), and Bouman et al. (1994 , Journal of Hand Surgery Vol. 19B, pp. 325–329), and for carpal height described by Youm et al. (1978 , Journal of Bone and Joint Surgery, Vol. 40A, pp. 423–431) and Bouman et al. (1994) were compared in pre- and postoperative wrist X-rays of 91 patients with rheumatoid arthritis undergoing radiolunate arthrodesis. Both indices described by Bouman had a higher applicability and sensitivity than the Chamay and Youm indices and are recommended for use with the rheumatoid wrist. However false-negative values may result when the Bouman index for ulnar translation is used to follow up radiolunate arthrodesis.

scholarly journals Middle East Pain Syndrome (MEPS) Vitamin D3 Deficiency Induced Hyperparathyroidism And Fibromyalgia Mimicking Rheumatoid Arthritis

2021 ◽  
Author(s):  
Adel Elbeialy ◽  
Abdlnby Bauomi ◽  
Basma Elnaggar ◽  
Hala Elzomor
Keyword(s):  
Rheumatoid Arthritis ◽  
Psoriatic Arthritis ◽  
Vitamin D3 ◽  
Fibromyalgia Syndrome ◽  
Pain Syndrome ◽  
X Rays ◽  
Calcium Phosphorus ◽  
Joint Arthritis ◽  
Vitamin D3 Deficiency

Abstract Objectives: Musculoskeletal pains are sometimes misdiagnosed in some diseases, like rheumatoid and psoriatic arthritis, erosive OA, etc. Secondary hyperparathyroidism was not considered a differential diagnosis for RA, despite the fact that it can cause arthralgia or arthritis. Also, fibromyalgia is a psychosomatic condition marked by widespread pain and tenderness. Methods: This study included 400 patients attended outpatient clinics of Al-Azhar Faculty of medicine in Egypt, and Elaj Specialized Clinics in Saudi Arabia, who were not fulfilling criteria for RA diagnosis, and not responding to its treatment. Other diseases like psoriatic arthritis and erosive OA were excluded. Criteria for classification of fibromyalgia syndrome were applied to all patients. We did lab tests of RF, ACPA, ESR, CRP, LFT, RFT, vitamin D3, PTH, calcium, phosphorus, and SUA. Radiological imaging modalities for diagnosis or exclusion of suspected diseases were applied. Results: All patients were fulfilling both old and new criteria of fibromyalgia syndrome, and not fulfilling any RA criteria, 18% were seropositive with low RF titers and negative ACPA. All patients had vitamin D3 deficiency or insufficiency. 75% of patients had abnormally high levels of PTH, and had no parathyroid gland pathology. X-rays showed subperiosteal and subchondral resorption of mainly thumbs, subchondral osteopenia of proximal and middle phalanges, mild subperiosteal resorption along the radial aspect of the middle phalanx and mild tuft erosions, besides changes in the carpus closely resembling those of rheumatoid arthritis, of ulnar styloid resorption, radiocarpal and scapho-trapezoid joint arthritis. Of special interest, the presence of tuft spurs-like excrescences.

Development and Evaluation of Fuzzy Criteria for the Diagnosis of Rheumatoid Arthritis

1996 ◽  
Vol 35 (04/05) ◽  
pp. 334-342 ◽  
Author(s):  
K.-P. Adlassnig ◽  
G. Kolarz ◽  
H. Leitich
Keyword(s):  
Rheumatoid Arthritis ◽  
Reference Model ◽  
American Rheumatism Association ◽  
Uniform Definition ◽  
Sensitivity Rate ◽  
Fuzzy Techniques ◽  
Definition Of ◽  
Different Levels ◽  
Specificity Rate

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.

scholarly journals SAT0056 INITIAL PRESENTATION OF RHEUMATOID ARTHRITIS (RA) – IS IT STILL “SYMMETRIC POLYARTHRITIS”?

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 960.2-960
Author(s):  
T. Sokka-Isler ◽  
K. Paalanen ◽  
M. Kauppi ◽  
E. Nikiphorou
Keyword(s):  
Rheumatoid Arthritis ◽  
Demographic Data ◽  
Initial Presentation ◽  
X Rays ◽  
Clinical Database ◽  
Duration Of Symptoms ◽  
The Public ◽  
Small Joint ◽  
New Diagnosis ◽  
Sat 1

Background:RA is traditionally described as a symmetric polyarthritis. The ACR/EULAR 2010 criteria are met if patient has high positive ACPA, symptoms >=6 wks and one small joint swollen. The public and all steps of health care have been informed for many years that RA should be found early.Objectives:To study variations in pattern on first presentation of RA.Methods:All patients with the new diagnosis of RA were extracted from the GoTreatIT clinical database between 2008 to 2019 at a single RA clinic that covers a population of 250.000. Demographic data, clinical variables, labs, x-rays, joint status and PROs at baseline were included in the analysis. Appropriate parametric/non-parametric tests were used to study differences between groups.Results:A total of 1044 (73.5% CCP+) patients with no prior diagnosis of RA were included; 683 (65%) female, mean age 56; 361 (35%) male, mean age 61. At initial presentation in 2008, 60% had >=6 swollen joints (Figure) and a mean DAS28 of 4.4 compared to 22% and 3.8 respectively, in 2019 (p<0.007). Duration of symptoms prior to diagnosis decreased from 6 to 4 months (p=0.033), and the proportion of patients with erosions from 20% in 2008 to 14% in 2019 (ns). Symptoms (PROs) such as pain, fatigue and global health were similar/slightly worse in 2019 compared to 2008.Conclusion:RA cannot be marketed as “symmetric polyarthritis”, as more than half of the patients have a maximum of 2 swollen joints at the time of the diagnosis at the most recent years. Patients with RA can be identified earlier, with less disease activity and damage, compared to previous years.Figure:Disclosure of Interests:None declared

scholarly journals Spectral Tomography for 3D Element Detection and Mineral Analysis

Minerals ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 598
Author(s):  
Jose R. A. Godinho ◽  
Gabriel Westaway-Heaven ◽  
Marijn A. Boone ◽  
Axel D. Renno
Keyword(s):  
Energy Spectrum ◽  
3D Imaging ◽  
X Rays ◽  
3D Images ◽  
Characterization Methods ◽  
X Ray ◽  
Additional Information ◽  
Mineral Phases ◽  
Spectral Computed Tomography

This paper demonstrates the potential of a new 3D imaging technique, Spectral Computed Tomography (sp-CT), to identify heavy elements inside materials, which can be used to classify mineral phases. The method combines the total X-ray transmission measured by a normal polychromatic X-ray detector, and the transmitted X-ray energy spectrum measured by a detector that discriminates between X-rays with energies of about 1.1 keV resolution. An analysis of the energy spectrum allows to identify sudden changes of transmission at K-edge energies that are specific of each element. The additional information about the elements in a phase improves the classification of mineral phases from grey-scale 3D images that would be otherwise difficult due to artefacts or the lack of contrast between phases. The ability to identify the elements inside the minerals that compose ore particles and rocks is crucial to broaden the application of 3D imaging in Earth sciences research and mineral process engineering, which will represent an important complement to traditional 2D imaging mineral characterization methods. In this paper, the first applications of sp-CT to classify mineral phases are showcased and the limitations and further developments are discussed.

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