Annals of the rheumatic diseases
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Historical Article
Palaeopathology of spinal osteophytosis, vertebral ankylosis, ankylosing spondylitis, and vertebral hyperostosis.
Five hundred and sixty intact skeletons and several thousand disarticulated vertebrae have been examined with special reference to spinal fusion. In period they ranged from a 21st dynasty Egyptian mummy to a mid-19th century skeleton. Osteophytes were found in about half of the specimens, as reported previously. ⋯ The remaining 13 had typical features of Forrestier's disease, and extraspinal findings indicative of diffuse idiopathic skeletal hyperostosis (DISH) were also common. A review of the available literature suggests that many palaeopathological specimens previously reported as anklylosing spondylitis are examples of DISH or other seronegative spondylarthropathies. The antiquity and palaeopathology of AS needs reappraisal.
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Cartilage-pannus junctions of the rheumatoid lesion have been examined by histochemical and ultrastructural techniques in an attempt to identify the cells responsible for cartilage degradation. Mast cells have been identified at sites of cartilage erosion in 3 specimens of rheumatoid joint. It is known that mast cells participate in immunological reactions, produce the vasoactive and proteinase-modulating agents histamine and heparin as well as their own degradative proteinases. The close association of mast cells with sites of cartilage erosion suggests they may play an important role in the pathophysiology of joint destruction in rheumatoid arthritis.
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We report 2 contrasting cases of a seronegative polyarthritis associated with angioimmunoblastic lymphadenopathy (AILD). Both cases were nonerosive, with symmetrical involvement of the elbows, wrists, knees, and ankles. ⋯ The second presented with polyarthritis 18 months before the onset of AILD. This patient received azathioprine for 11 months before developing AILD, which raises the possibility of this drug being the causative agent.
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A patient with seropositive rheumatoid arthritis and recurrent oedema of the forearm was shown to have a leak from a multilobulated olecranon bursa.
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Rheumatoid arthritis (RA) is a disease characterised by joint deformity and subluxation. Although many joints may be involved, dislocation of the manubriosternal joint is extremely rare. A case of dislocation of this in a woman with RA is presented.