Scandinavian journal of rheumatology
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Scand. J. Rheumatol. · Jan 1996
Comparative StudyTechnetium-99m labelled human immunoglobulin scintigraphy predicts rheumatoid arthritis in patients with arthralgia.
The ability of 99mTc-IgG scintigraphy to predict the development of rheumatoid arthritis (RA) in 47 patients with arthralgia was investigated. 99mTc-IgG scintigraphy and the serum test for rheumatoid factor (RF), measured at the beginning of a year long study, were compared for their ability to predict RA. During the study 8 patients developed RA. ⋯ The sensitivity and negative predictive values of RF were 100% and of 99mTc-IgG-scintigraphy 88% and 97% respectively. In conclusion, 99mTc-IgG scintigraphy has additional value to RF with respect to the prediction of the development of RA in patients with arthralgia.
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Scand. J. Rheumatol. · Jan 1996
Spondylodiscitis in ankylosing spondylitis, inflammation or trauma? A description of six cases.
An uncommon, but well recognised complication of Ankylosing Spondylitis (AS) is spondylodiscitis, a destructive discovertebral lesion also called the Andersson lesion. We describe six cases, with variable clinical presentation and radiological appearance. Two had multiple lesions, in one patient spondylodiscitis was the presenting symptom of AS. ⋯ In two cases histopathology was studied and suggested sterile inflammation as the main etiologic factor. The literature is reviewed regarding the mechanisms that may contribute to these lesions: mainly inflammatory like increasing enthesopathy or mainly mechanical like pseudoarthrosis about a fracture site. It may be that both mechanisms can result in similar destructive intervertebral disc lesions.
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Scand. J. Rheumatol. · Jan 1995
Randomized Controlled Trial Clinical TrialPain analysis in patients with fibromyalgia. Effects of intravenous morphine, lidocaine, and ketamine.
Pain intensity, muscle strength, static muscle endurance, pressure pain threshold, and pain tolerance at tender points and control points were assessed in 31 patients with fibromyalgia (FM), before and after intravenous administration of morphine (9 patients), lidocaine (11 patients), and ketamine (11 patients). The three different studies were double-blind and placebo-controlled. The patients were classified as placebo-responders, responders (decrease in pain intensity by > 50%) and non-responders. ⋯ Tenderness at tender points decreased and endurance increased significantly, while muscle strength remained unchanged. The present results support the hypothesis that the NMDA receptors are involved in pain mechanisms in fibromyalgia. These findings also suggest that central sensitization is present in FM and that tender points represent secondary hyperalgesia.
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Scand. J. Rheumatol. · Jan 1995
The reliability and validity of pain threshold measurements in osteoarthritis of the knee.
The purpose of this study was to examine the reliability and validity of measuring pain threshold (PT) of persons with osteoarthritis (OA) of the knee. The PTs of women with and without OA of the knee were measured on 3 occasions at 6 sites at the knee with a pressure dolorimeter. Subjects with OA also recorded their pain on a visual analogue scale (VAS) and on the McGill Pain Questionnaire (MPQ). ⋯ The correlations between PT and measures of pain intensity were poor. It is concluded that the measurement of PT at the knee distinguishes OA from healthy controls, and that it has moderate reliability. However, it cannot substitute for a measure of pain intensity.
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Scand. J. Rheumatol. · Jan 1995
Are tender point scores assessed by manual palpation in fibromyalgia reliable? An investigation into the variance of tender point scores.
To determine the reliability of tender point assessment by manual palpation in patients with fibromyalgia, and to investigate the sources of variance, tender point scores by manual palpation were obtained in 30 fibromyalgia patients by 2 investigators; the assessments were repeated after 1 week. Test-retest stability and inter-observer agreement of tender point scores was moderate to high. ⋯ It seems to be not less than reliability of assessment by pressure algometer. Tender point scores in fibromyalgia reflect individual differences in mean pain thresholds as well as individual tender point profiles.