scholarly journals Delayed Diagnosis: Tuberculous Arthritis of Right Knee Joint in a Patient with Rheumatoid Arthritis

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
H. Senarathna ◽  
K. Deshapriya
Keyword(s):  
Rheumatoid Arthritis ◽  
Knee Joint ◽  
Delayed Diagnosis ◽  
Sri Lankan ◽  
Tuberculous Arthritis ◽  
Immunosuppressive Medications ◽  
History Of ◽  
One Year ◽  
Tb Pcr ◽  
High Degree

Background. Though skeletal tuberculosis (TB) accounts about 3% of all TB cases, it occupies 10–35% of extrapulmonary TB cases. Common osteoarticular sites involved include the spine (40%), hip (25%), and knee (8%). Co-occurrence of rheumatoid arthritis (RA) and tuberculous arthritis involving peripheral joint is rarely reported in the literature. Case Presentation. We present a case of 42-year-old Sri Lankan-Sinhalese male with right knee joint pain and swelling for one-year duration. This patient had a history of long-standing RA with interstitial lung disease for which he was on multiple immunosuppressive medications including methotrexate, sulfasalazine, leflunomide, mycophenolate mofetil, and prednisolone. His knee joint aspiration fluid was positive for both acid fast bacilli (AFB) and polymerase chain reaction for TB (TB-PCR). He was started on anti-tuberculous chemotherapy. Conclusion. TB should be considered as an important differential diagnosis for chronic mono-arthritis of knee joint with a high degree of suspicion, particularly where TB is endemic.

scholarly journals A Single Surgeon, 10 Year Experience with the Oxford Partial Knee System: What a Difference Experience, Instruments, Implants, and Technique Can Make

2017 ◽  
Vol 7 (2) ◽  
Author(s):  
David Mauerhan ◽  
Nigel L Rozario
Keyword(s):  
Mobile Bearing ◽  
Cost Effective ◽  
History Of ◽  
Total Knee ◽  
One Year ◽  
High Degree ◽  
The Impact ◽  
Partial Knee Replacement ◽  
Lower Morbidity

Partial knee (unicompartmental) arthroplasty (PKA) for medial compartment disease of the knee has a long and well documented history of successful results over long periods of follow up. The Oxford Partial Knee Replacement has been available in the U.S. since 2004. After completing an FDA required instructional course, surgeons may use the device. Both the implant and the instruments have evolved since its introduction in 2004. This paper outlines the authors continuous cohort of 249 patients, 286 knees from 2004 to 2014 with minimum 2 year follow up, and reports the results while discussing the impact of experience, instruments and implants, and technique on the outcome of patients in this series. For the aggregate group of 286 knees, there were 17(5.9%) all-cause revisions to TKA, including 2(0.7%) dislocations, resulting in a (83%) survivorship at ten years. The survivorship at ten years for retained implants was 97% if non-implant related causes are not included. At one year, there were 89% excellent and good results, 5% fair, and 6% poor. At two years, there were 93% excellent and good, 1 % fair, and 5.5% poor.  The causes for the poor results at one and two years were tibial sided failure or persistent pain. Three (12%) of patients with a poor result at one year had converted to good and excellent at two years. The use of the Oxford Mobile Bearing™ PKA has been shown to be a useful part of the surgeon’s surgical armamentarium when dealing with anteromedial osteoarthritis or osteonecrosis of the knee. PKA has been shown to have a lower morbidity and mortality and is cost effective when compared to total knee arthroplasty. The author’s experience, as demonstrated in this study, adds validity to the concept that understanding the pathoanatomy of anteromedial osteoarthritis and gaining surgical experience through increased surgical volume, adherence to well documented technique, and the use of a time proven implant, can be accomplished with a high degree of successful outcomes for patients with the appropriate indications.

scholarly journals Improved quality of life and joint functions in patients with knee rheumatoid arthritis who underwent five portal arthroscopic synovectomy

PeerJ ◽  
2018 ◽  
Vol 6 ◽  
pp. e4727 ◽  
Author(s):  
Wen-Xin Liu ◽  
Yao Jiang ◽  
Qing-Xiang Hu ◽  
Xie-Bo You
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Knee Joint ◽  
Class I ◽  
Arthroscopic Synovectomy ◽  
Pharmaceutical Therapy ◽  
Das 28 ◽  
Group A ◽  
One Year

Objectives To evaluate the outcomes of patients with rheumatoid arthritis (RA) of the knee who underwent five portal arthroscopic synovectomy, with or without post-operative negative pressure drainage (NPD). Material and Methods A prospective clinical trial was performed. Patients with class I, II, and III RA of the knee were enrolled. They underwent five portal arthroscopic synovectomy. Post-operatively, they received either NPD (group A) or non-NPD (group B). Health assessment questionnaire (HAQ), disease activity score 28 (DAS 28), and Lysholm knee joint score were evaluated before the operations, and at six weeks, three months, and one year after the operations. Results A total of 36 patients were enrolled into the study, with 63.9% (23) female patients and mean age of 47.2 years old. All of the patients had clinical symptoms (joint swelling, pain, and dysfunction) for at least six months with poor responses to the traditional pharmaceutical therapy. There were 12, 16, and eight patients in class I, II, and III RA groups, respectively (six IA, six IB, eight IIA, eight IIB, four IIIA, and four IIIB). One year after the operation, patients had statistically significant improvements on HAQ, DAS 28, and Lysholm knee joint scores. More improvements were observed in patients with class I diseases. There were no statistically significant differences between group A and B. Conclusion Five portal arthroscopic synovectomy could increase the quality of life, decrease disease activities, and improve joint functions in patients with RA. More benefits were observed in patients with early disease developments. Patients in the NPD group did not show more improvements compared to the patients in the non-NPD group.

scholarly journals An arm and a leg: A case of rheumatoid vasculitis and antiphospholipid antibody syndrome

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110158
Author(s):  
Jay Ghadiali ◽  
Aditya Talwar ◽  
Colin Ligon
Keyword(s):  
Rheumatoid Arthritis ◽  
High Dose ◽  
Antiphospholipid Antibody ◽  
Antiphospholipid Antibody Syndrome ◽  
Rheumatoid Vasculitis ◽  
Organ Systems ◽  
Left Femoral Artery ◽  
History Of ◽  
High Degree ◽  
Common Manifestation

Rheumatoid vasculitis is a rare extra-articular complication of rheumatoid arthritis. The most common manifestation is cutaneous; however, it can manifest in various organ systems and is associated with a high degree of morbidity and mortality. Diagnosis is challenging, and there are no validated diagnostic or classification criteria. Most cases should be confirmed with tissue biopsy when possible given the severity of disease and the extent of immunosuppression required to treat this condition. We report the case of a 54-year-old white woman with long-standing, uncontrolled, and seropositive rheumatoid arthritis with a history of elevated anticardiolipin IgG and IgM antibodies who presented with acute stenosis of her left femoral artery which ultimately required a left above-the-knee amputation. Histopathology revealed findings consistent with vasculitis and thrombosis, and subsequent imaging revealed multifocal arterial and venous thromboses. She was diagnosed with rheumatoid vasculitis and antiphospholipid antibody syndrome, and was treated with high-dose glucocorticoids, cyclophosphamide, and warfarin. Rheumatoid vasculitis is a rare but devastating complication of rheumatoid arthritis, and vigilance for this condition must be maintained, especially in patients with long-standing, seropositive disease.

scholarly journals Rhinoscleroma with laryngotracheal involvement: a case report

2020 ◽  
Vol 6 (3) ◽  
pp. 595
Author(s):  
Saroo Singh ◽  
Ankur Gupta ◽  
Nishi Sharma
Keyword(s):  
Rural Areas ◽  
Young Male ◽  
Nasal Discharge ◽  
Upper Respiratory Tract ◽  
Long Term Follow Up ◽  
Progression Of Disease ◽  
History Of ◽  
One Year ◽  
High Degree

<p class="abstract">Rhinoscleroma is a chronic, slowly progressive, granulomatous inflammatory disease of the upper respiratory tract. It is more common in developing countries and rural areas and endemic in Asia, Africa and South and Latin America. We report a case of rhinoscleroma in a young male presented to our Outpatient Department with complaint of hoarseness since one and half years. He had history of dyspnoea on exertion. Patient also had history of bilateral nasal discharge and obstruction. A nasal specimen was taken for histological diagnosis which confirmed rhinoscleroma. Patient was put on medical management and was assessed weekly for improvement by nasal endoscopy and laryngeal examination for one year. A high degree of suspicion is required by clinician to diagnose the disease and prompt treatment should be given to avoid the progression of disease and complications. Patient requires long term follow up for proper management.</p>

scholarly journals A Severe Rash (Questions)

2008 ◽  
Vol 7 (1) ◽  
pp. 45-45
Author(s):  
S Bonny ◽  
◽  
N Jagirdar ◽  
S Khan ◽  
J Bene ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Inflammatory Markers ◽  
Maculopapular Rash ◽  
Whole Body ◽  
General Malaise ◽  
History Of ◽  
One Year ◽  
Severe Rash

A fifty-one-year-old man with history of treated hypertension and seronegative rheumatoid arthritis presented to hospital with a three day history of a rash affecting the whole body and general malaise. He had been commenced on sulfasalazine 2 weeks ago to control his rheumatoid arthritis, which the patient had discontinued taking three days prior to admission. On examination, he was comfortable with a temperature of 39oC and a widespread erythematous maculopapular rash. Investigations revealed a normal FBC, UEs, LFTs but high inflammatory markers with a CRP 125.9 and ESR 52. One day later the patient developed odynophagia and blisters on his lips and mouth shown in the picture below (Figure 1 and 2).

scholarly journals Effect of Ksheera Vaitarana Vasti, Janu Vasti along with Adjuvant Ayurveda Drugs in the management of Sandhigatavata (Osteoarthritis in knee joint)- A case study

2021 ◽  
Vol 5 (2) ◽  
pp. 57-63
Author(s):  
ERHSS Ediriweera ◽  
H.D.R. Ferando ◽  
K.D.C.M. Weerasinghe
Keyword(s):  
Knee Joint ◽  
Oral Administration ◽  
Treatment Regimen ◽  
Sri Lankan ◽  
Degenerative Arthritis ◽  
Osteoarthritis Knee ◽  
Physician Family ◽  
History Of

Sandhigatavata is a disease with Shoola (pain), Shotha (swelling) and Hanti Sandhi Gatah Sandhi (impairment of the functions of joints). This can be correlated with osteoarthritis. Osteoarthritis is a degenerative arthritis. While any joint can be affected in osteoarthritis, knee joint is most commonly affected. Vangasena Samhitha mentions Ksheera Vaitarana Vasti as a treatment for Janu Sankocha (stiffness of joint), Kati Prushta Shoola Shotha (swelling and pain in waist, knee and back). Prasarana Akunchanayoh Pravrutthishca Savedana (pain during contraction and extension of limbs) is described as a symptom of Sandhigatavata and stiffness in joint is a symptom of osteoarthritis. Sri Lankan traditional physician family ‘Weerasinghe’ treat Sandhigatavata with Belimul Thippilimul Amu Inguru Kashaya with effective results. Gugguladi Thaila is described in Sri Lankan Ayurveda Pharmacopeia in treatment of Vata Roga. Susruta advises to conduct Snehana in treatment of Vata Roga. Janu Vasti is one method of administering Bhahya Snehana to Janu Sandhi (knee joint). A 65 years old female with an 8 years history of Sandhigatavata Ayurveda treatments for 21 days. Ksheera Vaitarana Vasti was conducted for seven days and from Day 8 to 21, with oral administration of Belimul Thippilimul Amu Inguru Kashaya along with Janu Vasti using Gugguladi Thaila. After completion of treatment, it was observed that swelling, tenderness and pain during contraction and extension of limbs were completely relived. It is concluded that above treatment regimen is effective in treatment of Sandhigatavata (osteoarthritis).

An unusual cause of meningitis

2005 ◽  
Vol 4 (3) ◽  
pp. 106-107
Author(s):  
T.M. Pasha ◽  
◽  
K. Trower ◽  
D. Bhatia ◽  
H.K. Thaker ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Elbow Joint ◽  
Vital Signs ◽  
Left Elbow ◽  
Normal Limits ◽  
The Usa ◽  
History Of ◽  
Background History ◽  
Disease Modifying ◽  
One Year

A 57 year old man patient presented with fever and frontal headache. He had a background history of sero-positive rheumatoid arthritis which was well controlled on immunomodulatory disease modifying anti-rheumatoid drugs (DMARDS) including methotrexate and leflunomide. Six months earlier he had returned from Massachussetts in the USA after a one year period of residence there. On examination his vital signs were within normal limits and he was afebrile with a temperature of 36.1o C. His left elbow joint was warm, tender and swollen; examination was otherwise normal.

scholarly journals Strongyloides Infection in a Man with Abdominal Pain and a History of Rheumatoid Arthritis

2018 ◽  
Vol 10 (1) ◽  
pp. 23-28
Author(s):  
Fariborz Mansour-Ghanaei ◽  
Farahnaz Joukar ◽  
Alireza Samadi ◽  
Sara Mavaddati ◽  
Arash Daryakar
Keyword(s):  
Rheumatoid Arthritis ◽  
Severe Pain ◽  
Immunocompromised Patient ◽  
Gastrointestinal Symptoms ◽  
Strongyloides Stercoralis ◽  
Stool Examination ◽  
Immunocompromised Patients ◽  
Pathological Analysis ◽  
Immunosuppressive Medications ◽  
History Of

Background:Strongyloidiasis is self-limited by the complete immune system, it may be complicated and causes hyperinfection in immunocompromised patients. Objective: Here, we report a case of an immunocompromised patient with duodenal involvement ofStrongyloides stercoralis.Case Report:A 65-year-old man presented with severe pain in central abdomen and periumbilical regions. He had no history of alcohol consumption, smoking and surgery but the history of RA (Rheumatoid Arthritis) and hypothyroidism taking immunosuppressive medications. The patient underwent endoscopy and colonoscopy which pathological analysis of the biopsies revealed remarkable findings in favor of Strongyloidiasis. After two consecutive day’s consumption of ivermectin 200µg/kg, the symptoms were completely removed. Also, the stool examination was negative forS.stercoralislarvae two weeks after end of the treatment.Conclusions:It seems that in immunocompromised patients with gastrointestinal symptoms assumption of parasite-like infections such as Strongyloidiasis should be considered as one of the diagnosis options. Due to the physiological and gut microbial alternations, these patients are more susceptible to infectious diseases.

Sign in / Sign up

Export Citation Format

Share Document