Clinical rheumatology
-
Clinical rheumatology · Jan 2000
Clinical assessment of spinal mobility measurements in ankylosing spondylitis: a compact set for follow-up and trials?
Different spinal ranges of motion (ROM) were measured and the results of 17 repeated tests correlated with spinal radiological changes in 52 male patients with ankylosing spondylitis (AS). Both Schober tests and measurements of lumbar and cervical rotations (TRi, TR, CR, CRt) and lateral flexions (LFLf, LFLx, CLFLt, CLFLm), together with thoracolumbar flexion (ThFL), cervical flexion-extension measurements (CFL, CExt), and tragus - wall and occiput - wall distances (OWD,TWD), showed significant correlations with detailed radiological spinal changes. Cervical rotation (CRm, CRt) and flexion (CFLm) correlated only with cervical changes, and thoracolumbar rotation as assessed by instrument (TRi) correlated only weakly with lumbar changes, while chin-chest distance (CCD) and chest expansion (CE) showed no correlation. ⋯ Three new tape methods for measuring thoracolumbar and cervical rotations and cervical lateral flexion also proved to be valid and reliable, as did the Schober-S1 modification. We conclude that the thoracolumbar segment (Schober), whole (ThFL) and lateral (LFL) flexions and rotation (TR), and chest expansion (CE) (after careful standardisation) together with cervical rotation (CR), extension (CExt) and/or lateral flexion (CLFL) comprise the set of mobility tests for the follow-up and assessment of disease progression in AS. On the other hand, cervical (forward) flexion (CFL), chin-chest distance (CCD) and an instrument method for thoracolumbar rotation (TRi) are not approaches to be recommended.
-
The authors report a rare concomitant pyogenic infection of the iliopsoas, iliacus and external obturator muscles and of the hip joint in a 68-year-old woman. Because the patient showed the classic symptomatic triad of limping, hip pain and fever, in addition to positive hip arthrocentesis, the diagnosis of septic hip arthritis was routine, but the simultaneous pyomyositis was almost overlooked. ⋯ Surgical debridement and antibiotics resolved the infection relatively rapidly without sequelae. We noted that reaching a definitive diagnosis of such a concomitant infection requires a suspicion of the presence of pyomyositis, which can be definitively determined using advanced imaging studies.
-
Clinical rheumatology · Jan 2000
Case ReportsAchilles tendinitis as the presentation form of Löfgren's syndrome.
Löfgren's syndrome is characterised by bilateral hilar adenopathy arthritis and erythema nodosum. Achilles tendinitis as the presentation form of Löfgren's syndrome is very unusual. Herein we present a case of bilateral achilles tendinitis as the presentation form of Löfgren's syndrome.
-
Clinical rheumatology · Jan 2000
Case ReportsJuvenile neutrophilic eccrine hidradenitis: a vasculitis-like plantar dermatosis.
Neutrophilic eccrine hidradenitis is a variety of neutrophilic dermatosis described in patients with different neoplasms, most often leukaemia, and different chemotherapy regimens. It is characterised by neutrophilic infiltration of the eccrine coils of sweat glands. Recently it has been described in healthy juveniles, involving primarily the soles of the feet. We describe five new cases of juvenile neutrophilic eccrine hidradenitis all showing a good prognosis or a self-limiting course.
-
Clinical rheumatology · Jan 1999
Assessment of thoracolumbar rotation in ankylosing spondylitis: a simple tape method.
Results of a 'new' method for thoracolumbar rotation by tape (TRPav), simple instrumental rotation (TRi), the modified Schober test and thoracolumbar flexion (ThFL) were correlated with radiological changes in patients with ankylosing spondylitis (AS). TRPav showed a significant radiological correlation (Ls-r: 0.38; Th-r: 0.31), while the instrument method (TRi) did not; both the Schober test and ThFL, again, correlated fairly highly (Ls-r: 0.71, 0.62; Th-r: 0.49, 0.42). ⋯ Thoracolumbar rotation is one of the three principal levels of spinal motion and seems to be less affected by age. TRPav proved a valid and reliable method for measuring thoracolumbar rotation and clinically is a non-invasive, quick and easy complement to AS measurement methodologies.