Clinical rheumatology
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Clinical rheumatology · Dec 2010
Review Case ReportsA case of refractory adult-onset Still's disease successfully controlled with tocilizumab and a review of the literature.
Adult-onset Still's disease (AOSD) is an uncommon systemic inflammatory disease of unknown aetiology. Up to 80% of AOSD cases can be controlled with corticosteroids; however, reports on those unresponsive to corticosteroids, conventional disease modifying drugs and biological agents, including anti-IL1 inhibitors, are emerging. We present a case of AOSD with severe poylarthritis unresponsive to corticosteroids, methotrexate, anakinra and etanercept, but successfully stabilised with a humanized monoclonal anti-IL-6 receptor antibody, tocilizumab, administered once monthly. Thereafter, we compare our case with case reports available in the literature and suggest that for anakinra refractive AOSD patients with arthritis, tocilizumab could be the drug of choice.
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Intra-articular corticosteroid injection (IACI) is a very popular procedure. In this review, we wanted to review all that had been published about local effects of IACIs. English literature search was made through PubMed using the terms intra-articular and local effect. ⋯ IACI is associated with a wide range of local effects. Subjective and functional favorable response is prominent mainly in juvenile idiopathic arthritis patients. Adverse effects are either rare or insignificant.
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Clinical rheumatology · Oct 2009
ReviewChiropractic treatment for fibromyalgia: a systematic review.
Many patients use chiropractic as a treatment of fibromyalgia, and many chiropractors seem to be convinced that it is effective for that condition. The aim of the study was to conduct a systematic review of randomised clinical trials testing the effectiveness of chiropractic care for fibromyalgia. Six electronic literature searches were conducted. ⋯ Their methodological quality was poor. They generated no evidence to suggest that chiropractic care is effective for fibromyalgia. Currently, there is insufficient evidence to conclude that chiropractic is an effective treatment for fibromyalgia.
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Clinical rheumatology · Oct 2009
ReviewChiropractic treatment for fibromyalgia: a systematic review.
Many patients use chiropractic as a treatment of fibromyalgia, and many chiropractors seem to be convinced that it is effective for that condition. The aim of the study was to conduct a systematic review of randomised clinical trials testing the effectiveness of chiropractic care for fibromyalgia. Six electronic literature searches were conducted. ⋯ Their methodological quality was poor. They generated no evidence to suggest that chiropractic care is effective for fibromyalgia. Currently, there is insufficient evidence to conclude that chiropractic is an effective treatment for fibromyalgia.
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Clinical rheumatology · Aug 2009
ReviewDiscovertebral (Andersson) lesions of the spine in ankylosing spondylitis revisited.
A well-known complication in patients with ankylosing spondylitis (AS) is the development of localised vertebral or discovertebral lesions of the spine, which was first described by Andersson in 1937. Since then, many different terms are used in literature to refer to these localised lesions of the spine, including the eponym 'Andersson lesion' (AL). The use of different terms reflects an ongoing debate on the exact aetiology of the AL. ⋯ There is no indication for a diagnostic biopsy. Surgical instrumentation and fusion is considered the principle management in symptomatic AL that fails to resolve from a conservative treatment. We advise to use the term Andersson lesion for these spinal lesions in patients with AS.