scholarly journals Hand Erosive Osteoarthritis and Distal Interphalangeal Involvement in Psoriatic Arthritis: The Place of Conservative Therapy

2021 ◽  
Vol 10 (12) ◽  
pp. 2630
Author(s):  
Elena Poletto ◽  
Ilaria Tinazzi ◽  
Antonio Marchetta ◽  
Nicola Smania ◽  
Elena Rossato
Keyword(s):  
Psoriatic Arthritis ◽  
Range Of Motion ◽  
Conservative Therapy ◽  
Treatment Strategies ◽  
Limited Range ◽  
Current Evidence ◽  
Pharmacological Intervention ◽  
Erosive Osteoarthritis ◽  
Limited Range Of Motion ◽  
Wide Range

Hand erosive osteoarthritis (HEOA) and Psoriatic Arthritis (PsA) with DIP involvement are common diseases affecting the hand. Both of them evolve with a progressive limitation in grip due to limited range of motion of the affected joints and stenosing tenosynovitis. Pharmacological options currently available (corticosteroids and clodronate or Idrossicloroquine) for the treatment of EHOA are mostly symptomatic and currently there are no effective drugs able to modify the course of the disease. In addition, data on drug effectiveness of PsA with DIP involvement are lacking. Conservative therapy should be considered in order to reduce pain and improve hand functionality. There are many studies debating a wide range of non-pharmacological intervention in the management of HEOA: joint protection program, range of motion and strengthening exercise, hand exercise with electromagnetic therapy, application of heat with paraffin wax or balneotherapy, occupational therapy and education. Concerning conservative treatment strategies to treat PsA, on the contrary, current evidence is still weak. Further research is needed to find the correct place of physical therapy to prevent stiffness and ankylosis due to the vicious circle of inflammation-pain-immobility-rigidity.

scholarly journals Delta-like 1 and Delta-like 4 differently require their extracellular domains for triggering Notch signaling in mice

eLife ◽  
2020 ◽  
Vol 9 ◽  
Author(s):  
Ken-ichi Hirano ◽  
Akiko Suganami ◽  
Yutaka Tamura ◽  
Hideo Yagita ◽  
Sonoko Habu ◽  
...  
Keyword(s):  
Notch Signaling ◽  
Range Of Motion ◽  
Limited Range ◽  
Functional Difference ◽  
Dependent Manner ◽  
Loop Structure ◽  
Limited Range Of Motion ◽  
Wide Range ◽  
Reduced Activity ◽  
Notch Ligands

Delta-like (Dll) 1 and Dll4 differently function as Notch ligands in a context-dependent manner. As these ligands share structural properties, the molecular basis for their functional difference is poorly understood. Here, we investigated the superiority of Dll4 over Dll1 with respect to induction of T cell development using a domain-swapping approach in mice. The DOS motif, shared by Notch ligands—except Dll4—contributes to enhancing the activity of Dll for signal transduction. The module at the N-terminus of Notch ligand (MNNL) of Dll4 is inherently advantageous over Dll1. Molecular dynamic simulation revealed that the loop structure in MNNL domain of Dll1 contains unique proline residues with limited range of motion. The Dll4 mutant with Dll1-derived proline residues showed reduced activity. These results suggest that the loop structure—present within the MNNL domain—with a wide range of motion ensures the superiority of Dll4 and uniquely contributes to the triggering of Notch signaling.

P080 Acroosteolysis: a rare complication or a co-occurrence with Juvenile Idiopathic Arthritis?

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_5) ◽  
Author(s):  
Makhlouf Yasmine ◽  
Miladi Saoussen ◽  
Fazaa Alia ◽  
Sellami Mariem ◽  
Souabni Leila ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Psoriatic Arthritis ◽  
Rare Complication ◽  
Plain Radiograph ◽  
Limited Range ◽  
Acute Phase Reactants ◽  
Limited Range Of Motion ◽  
Macular Rash ◽  
Oligoarticular Juvenile Idiopathic Arthritis ◽  
Dysmorphic Syndrome

Abstract Background Acroosteolysis refers to a destructive process involving the distal phalanges of the fingers and toes that may extend to metacarpals or metatarsals. Rarely idiopathic, the diagnosis of primary acroosteolysis requires ruling out other causes. Juvenile idiopathic arthritis is an exceptional aetiology of acroosteolysis occurring mainly in psoriatic arthritis. Here by a case of juvenile idiopathic arthritis associated with acroosteolysis of the toes. Methods A 13-year-old girl with no past medical history, presented to our department of rheumatology with oligoarthritis affecting both wrists and knees. She had no familiar history of psoriasis nor rheumatic diseases. She described a dull ache and recurring swelling of knees evolving for >6 years associated with a macular rash of the chest without fever. On examination, the knees were swollen with a limited range of motion of < 90°. Examination of the spine and sacroiliac joints was unremarkable. There was no deformity, no dysmorphic syndrome nor ligamentous hyper laxity. The mucocutaneous examination was normal. Similarly, there was no hepatosplenomegaly or swollen lymph nodes. Laboratory investigations showed high acute phase reactants and normal blood count. Rheumatoid factor, anti-cyclic citrullinated peptide antibodies and antinuclear antibodies were also negative. Besides, she was negative for HLAB-27. Ophthalmic examination did not show any sequelae of uveitis. Results Plain radiograph of the feet revealed bone resorption of the second and fifth distal phalanges without signs of reconstruction. Other secondary causes of acroosteolysis were ruled out. The diagnosis of oligoarticular juvenile idiopathic arthritis was made. In view of the involvement of the distal phalanges, the phenotype of psoriatic arthritis was probable. The patient was initially treated with non-steroidal anti-inflammatory drugs as well as intraarticular injections of corticosteroids in knees. As the flares persisted, she was put on Methotrexate at a dosage of 15 mg per week with marked clinical improvement. Conclusion Our case illustrates a possible occurrence of acroosteolysis of the feet in the field of an active juvenile idiopathic arthritis. It is important to rule out other causes and make a rapid diagnosis in order to ensure appropriate management decisions.

Simulated Compensatory Motion of Transradial Prostheses

2008 ◽  
Author(s):  
Derek Lura ◽  
Rajiv Dubey ◽  
Stephanie L. Carey ◽  
M. Jason Highsmith
Keyword(s):  
Range Of Motion ◽  
Shoulder Joint ◽  
Degrees Of Freedom ◽  
Biomechanical Model ◽  
Elbow Flexion ◽  
Limited Range ◽  
Joint Movement ◽  
Range Of Movement ◽  
Limited Range Of Motion ◽  
Compensatory Motion

The prostheses used by the majority of persons with hand/arm amputations today have a very limited range of motion. Transradial (below the elbow) amputees lose the three degrees of freedom provided by the wrist and forearm. Some myoeletric prostheses currently allow for forearm pronation and supination (rotation about an axis parallel to the forearm) and the operation of a powered prosthetic hand. Older body-powered prostheses, incorporating hooks and other cable driven terminal devices, have even fewer degrees of freedom. In order to perform activities of daily living (ADL), a person with amputation(s) must use a greater than normal range of movement from other body joints to compensate for the loss of movement caused by the amputation. By studying the compensatory motion of prosthetic users we can understand the mechanics of how they adapt to the loss of range of motion in a given limb for select tasks. The purpose of this study is to create a biomechanical model that can predict the compensatory motion using given subject data. The simulation can then be used to select the best prosthesis for a given user, or to design prostheses that are more effective at selected tasks, once enough data has been analyzed. Joint locations necessary to accomplish the task with a given configuration are calculated by the simulation for a set of prostheses and tasks. The simulation contains a set of prosthetic configurations that are represented by parameters that consist of the degrees of freedom provided by the selected prosthesis. The simulation also contains a set of task information that includes joint constraints, and trajectories which the hand or prosthesis follows to perform the task. The simulation allows for movement in the wrist and forearm, which is dependent on the prosthetic configuration, elbow flexion, three degrees of rotation at the shoulder joint, movement of the shoulder joint about the sternoclavicular joint, and translation and rotation of the torso. All joints have definable restrictions determined by the prosthesis, and task.

scholarly journals Impact of Size of Fire boot and SCBA Cylinder on Firefighters’ Mobility

2018 ◽  
Vol 37 (2) ◽  
pp. 103-118 ◽  
Author(s):  
Huiju Park ◽  
Rumit Singh Kakar ◽  
Jie Pei ◽  
Joshua M. Tome ◽  
Jeffrey Stull
Keyword(s):  
Negative Impact ◽  
National Fire Protection Association ◽  
Limited Range ◽  
Upper Body ◽  
Lower Body ◽  
Leg Length ◽  
Neck Extension ◽  
Limited Range Of Motion ◽  
Wide Range ◽  
Biomechanical Tests

The authors conducted biomechanical tests with 21 firefighters and found that there is a significant correlation between boot height and lower body mobility and that using a fixed boot height mandated by National Fire Protection Association 1971 standard decreased lower body ranges of motion during various firefighters’ job-related tasks. Statistical analysis of large anthropometric data also shows a fixed boot height cannot accommodate a wide range of firefighters’ leg length. These findings indicate that shorter firefighters are likely to have limited lower body mobility due to reduced clearance between the knee and top of the boot and thus decreased space causing greater mechanical binding between multiple layers of turnout pants. The authors discovered a greater negative impact of fixed length of self-contained breathing apparatus cylinder on short firefighters on their upper body mobility, evidenced by limited range of motion in neck extension and lumbopelvic flexion while carrying fire gear compared to without any fire gear.

Traumatic bilateral posterior dislocation of the shoulder: a case report

Open Medicine ◽  
2013 ◽  
Vol 8 (6) ◽  
pp. 810-813
Author(s):  
C. Garving ◽  
T. Dienstknecht ◽  
K. Horst ◽  
M. Pishnamaz ◽  
P. Kobbe ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Shoulder Dislocation ◽  
Limited Range ◽  
Clinical Suspicion ◽  
Posterior Dislocation ◽  
X Rays ◽  
Posterior Shoulder Dislocation ◽  
Limited Range Of Motion ◽  
Posterior Shoulder ◽  
Bilateral Posterior Shoulder Dislocation

AbstractIntroduction. Bilateral posterior dislocation of the shoulder is a rare injury, accounted for about 2–5% of all shoulder dislocations. Main courses are electrical shock, epilepsy or extreme trauma with uncontrolled muscle forces. We report about a case of bilateral posterior shoulder dislocation without additional fractures but with a concomitant acromioclavicular joint dislocation. Case presentation. A 46-year-old Caucasian motorcyclist presented to our facility after a fall on slippery ground. He claimed pain in both shoulders with limited range of motion. The initial X-rays were inconclusive, clinical examination showed typical findings of a Rockwood injury with an additional limited external rotation so that a posterior shoulder dislocation was suspected. The CT scan confirmed the clinical suspicion. A closed reduction was performed followed by immobilization in a shoulder abduction pillow for 4 weeks and continuous physiotherapy. Upon follow up normal function with full range of motion was observed. Conclusion. A bilateral posterior shoulder dislocation can be caused by trauma and results in a limited range of motion with often additional injuries. Due to the unusually presentation the risk of missing the injury is increased. Therefore it is most important to consider this rare diagnosis and in case of clinical suspicion perform a careful algorithm of diagnostic.

How to Replace Gears by Mechanisms (Linkages)

1959 ◽  
Vol 81 (2) ◽  
pp. 126-130
Author(s):  
Kurt Hain ◽  
Gerhard Marx
Keyword(s):  
Range Of Motion ◽  
Practical Method ◽  
Limited Range ◽  
Transmission Ratio ◽  
Limited Range Of Motion ◽  
Transmission Angle

A practical method is shown for designing four-bar mechanisms having a prescribed transmission ratio held within prescribed tolerances, for a limited range of motion. Such mechanisms may economically replace gears in many applications. Charts enable the designer to choose the mechanism having the best transmission angle possible.

scholarly journals An Unusual Presentation of Charcot Arthropathy Caused by Syringomyelia Mimicking a Soft Tissue Tumor

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Cuneyd Gunay ◽  
Ebru Atalar ◽  
Baybars Ataoglu
Keyword(s):  
Soft Tissue ◽  
Range Of Motion ◽  
Soft Tissue Tumor ◽  
Limited Range ◽  
Unusual Presentation ◽  
Charcot Arthropathy ◽  
Neuropathic Arthropathy ◽  
Tissue Tumor ◽  
Limited Range Of Motion

Charcot arthropathy is a chronic, degenerative condition and is associated with decreased sensorial innervation. Numerous causes of this arthropathy have been described. Here we report a case of neuropathic arthropathy secondary to syringomyelia which was misdiagnosed as a soft tissue tumor and treated surgically and additionally with radiotherapy at another institution. The patient had clinical and radiological signs of syringomyelia, associated with a limited range of motion, swelling, and pain in the affected joint. Neuropathic arthropathy, although less common, should be considered in cases of unexplained joint swelling, pain, and limited range of motion of the affected joint.

Sign in / Sign up

Export Citation Format

Share Document