Zeitschrift für Rheumatologie
-
The medical history of a 46-year-old female patient with dark-blue sclerae showed repeated fractures of the extremity skeleton and clavicular following minor trauma up to the age of 15. The sclerae indicated osteogenesis imperfecta (OI), which leads to disrupted collagen synthesis due to various mutations of the type-1 procollagen gene, which in turn leads to brittle bones with reduced bone density and greater susceptibility to fracture. In OI, distinction is made between varying clinical types which show differing degrees of severity. Bisphosphonates, which can reduce significantly increased bone turnover, are a very promising therapy approach.
-
The characteristic symptoms of fibromyalgia are chronic widespread musculoskeletal pain in various parts of the body and abnormal tenderness at 18 specified tender points. Associated symptoms often reported include stiffness, sleep disorders, fatigue, and problems with concentration. The prevalence is about 3.5% for women and 0.5% for men. ⋯ The disease usually has a chronic course. An abnormality of the central pain-processing mechanisms is highly relevant for the pathogenesis. In addition to early diagnosis and intensive patient education, pharmacotherapy, exercise therapy, behavior therapy, and multidisciplinary treatment are particularly important for the management of fibromyalgia.
-
There are about 1.2-1.6 million psoriasis sufferers in Germany. In about a third of these, the disease manifests before the age of 20. A classic complication of psoriasis is psoriasis arthritis (PsA), which, from the latest figures, effects about 20% of all psoriasis patients. ⋯ The primary medication should preferentially be MTX, if necessary combined with other therapies. In cases of a severe, episodic progression as well as high inflammatory activity, systemic glucocorticosteroids should be considered. Further studies addressing both the clinical course of jPsA compared to the adult manifestation as well as optimal therapeutic procedures should be initiated in the near future.