scholarly journals Middle east pain syndrome is a pollution-induced new disease mimicking rheumatoid arthritis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Adel A. Elbeialy ◽  
Abdlnby M. Bauomi ◽  
Basma M. Elnaggar ◽  
Hala M. Elzomor
Keyword(s):  
Rheumatoid Arthritis ◽  
Fibromyalgia Syndrome ◽  
Pain Syndrome ◽  
Middle Phalanx ◽  
Ulnar Styloid ◽  
Diagnosis Criteria ◽  
Joint Arthritis ◽  
Vitamin D3 Deficiency ◽  
New Criteria

AbstractMusculoskeletal 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. This study included 400 patients attended certain outpatient clinics of Rheumatology in Egypt and Saudi Arabia, who were not fulfilling criteria for RA diagnosis. Criteria for classification of fibromyalgia syndrome were applied to all patients. We did lab tests and radiological imaging modalities for diagnosis or exclusion of suspected diseases were applied. All patients were fulfilling both old and new criteria of fibromyalgia syndrome, and not fulfilling any RA criteria, and had vitamin D3 deficiency or insufficiency. 75% of patients had abnormally high levels of PTH, without parathyroid gland pathology. Radiology 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 spur-like excrescences.

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.

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

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.

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 Persistent Spinal Pain Syndrome: a proposal for Failed Back Surgery Syndrome and ICD-11

Pain Medicine ◽  
2021 ◽  
Author(s):  
Nick Christelis ◽  
Brian Simpson ◽  
Marc Russo ◽  
Michael Stanton-Hicks ◽  
Giancarlo Barolat ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Spine Surgery ◽  
Pain Syndrome ◽  
Spinal Pain ◽  
Failed Back Surgery Syndrome ◽  
Medical Professionals ◽  
Failed Back Surgery ◽  
Back Surgery ◽  
Spinal Pain Syndrome

Abstract Objective For many medical professionals dealing with patients with persistent pain following spine surgery, the term failed back surgery syndrome (FBSS) as a diagnostic label is inadequate, misleading and potentially troublesome. It misrepresents causation. Alternative terms have been suggested but none has replaced FBSS. The International Association for the Study of Pain (IASP) published a revised classification of chronic pain, as part of the new International Classification of Diseases (ICD-11), which has been accepted by the World Health Organization (WHO). This includes the term Chronic pain after spinal surgery (CPSS), which is suggested as a replacement for FBSS. Methods This article provides arguments and rationale for a replacement definition. In order to propose a broadly applicable yet more precise and clinically informative term, an international group of experts was established. Results 14 candidate replacement terms were considered and ranked. The application of agreed criteria reduced this to a shortlist of four. A preferred option – Persistent spinal pain syndrome – was selected by a structured workshop and Delphi process. We provide rationale for using Persistent spinal pain syndrome and a schema for its incorporation into ICD-11. We propose the adoption of this term would strengthen the new ICD-11 classification. Conclusions This project is important to those in the fields of pain management, spine surgery and neuromodulation, as well as patients labelled with FBSS. Through a shift in perspective it could facilitate the application of the new ICD-11 classification and allow clearer discussion amongst medical professionals, industry, funding organisations, academia, and the legal profession.

Brachydactyly and Pseudo-Pseudohypoparathyroidism

1968 ◽  
Vol 17 (3) ◽  
pp. 428-438 ◽  
Author(s):  
Keith P. Hertzog
Keyword(s):  
Middle Phalanx ◽  
Albright’S Hereditary Osteodystrophy ◽  
Albright's Hereditary Osteodystrophy ◽  
Epiphyseal Union ◽  
A Current ◽  
Little Finger

SummaryShortened fifth middle phalanges, defined as being less than half the length of the fourth middle phalanx, were found in 12 of 96 Philadelphia Chinese and none of 200 Philadelphia Negro children. At least nine of these can be characterized as having stunted cratered diaphyses, with precocious cone epiphyses, which underwent very early epiphyseal union.The possible extension of a current vascular hypothesis for cone epiphyses, to include inherited osseous variation in this region of the little finger, is discussed.A classification of metacarpal brachydactyly is presented, with the intention of investigating the syndrome of pseudopseudohypoparathyroidism. Reports of cases which have been held to negate the theory that Albright's hereditary osteodystrophy is sex linked were found to have the pattern of phalangeal shortening exhibited by one of the forms of metacarpal brachydactyly. This finding lends support to the contention of others that these reported cases are not pseudo-pseudohypoparathyroidism.

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