Zeitschrift für Rheumatologie
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Case Reports
[Purulent osteomyelitis with epidural abcess in an adult over a decade after cervical spine injury].
Cervical osteomyelitis and epidural abscess are rare and potentially fatal conditions with severe neurological manifestations. Changes on plain radiography and computed tomography are non-specific, while contrast enhanced magnetic resonance imaging shows high sensitivity and specificity in establishing early diagnosis.
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Postoperative periprosthetic fracture is a rare but serious complication after joint replacement surgery. Due to poor bone quality, multiple joint involvement with the replacement of different joints and considerable comorbidity, the presence of rheumatoid arthritis is associated with a high risk of periprosthetic fractures. ⋯ On the basis of the current literature, the present work describes different aspects of the epidemiology of periprosthetic fractures, principles of their classification, different treatment options and the results of treatment of these fractures. Special attention is paid to the situation of patients with rheumatoid arthritis.
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Conventional radiography and magnetic resonance imaging (MRI) are currently the most widely used imaging methods for the initial diagnostic evaluation and follow-up of patients with ankylosing spondylitis (AS). Scintigraphy, computed tomography (CT), and positron emission tomography (PET) only play minor roles, although some are being further developed. AS is characterized by inflammatory changes to the sacroiliac joints (SIJs) and spine, as well as asymmetrical arthritis of the peripheral joints and joints near the trunk. ⋯ Various MRI scoring systems have been proposed to quantify these changes, but they require further validation. This review article presents the imaging modalities used in AS patients, typical findings, and relevant methods of analysis. The most recent developments are discussed.
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Periodic fever syndromes comprise a group of disorders characterized by attacks of seemingly unprovoked inflammation. The genetic causes of five hereditary autoinflammatory syndromes have been identified in the last few years: familial Mediterranean fever, the cryopyrinopathies [Muckle-Wells, chronic infantile neurological, cutaneous, articular syndrome (CINCA) and familial autoinflammatory syndromes], TNF-receptor associated periodic syndrome, cyclic neutropenia syndrome and periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome. The study of periodic fever syndromes has progressed from clinical characterization to genetic analysis and to the definition of the functional defects linking genes or domains to apoptotic proteins and signal transduction pathways. This new research opens the way for more specific treatment options with a further improvement in prognosis and outcome.