J Rheumatol
-
Skeletal muscle can be the site of inflammatory diseases that lead to muscle weakness, pain, and increased myogenic serum enzymes. Most of these inflammatory myopathies are idiopathic. In some cases inflammatory myopathies are due to infectious agents. ⋯ After treatment with clindamycin and corticosteroids both cases had only partial improvement, case 1 with a residual muscle weakness and case 2 with residual cardiac insufficiency (requiring digoxin). These cases show that the presence of the parasite in myofibers is not enough to induce an inflammatory myositis with muscle cell necrosis. This suggests that immunological disturbances may contribute to the development of inflammatory myositis due to toxoplasma.
-
Comparative Study Clinical Trial Controlled Clinical Trial
Evaluation of patient partners in the teaching of the musculoskeletal examination.
To evaluate student preferences and examination outcomes of 2 different methods of teaching musculoskeletal (MSK) medicine examination techniques. ⋯ Patient partner teaching is as effective a method of teaching clinical skills in MSK medicine as a traditional resident based form of teaching, with student benefits from patient feedback and greater "hands-on" opportunities. The assessment process should incorporate patient partners to assess the unique aspects of patient educator based teaching of MSK examination techniques.
-
Comparative Study
Musculoskeletal examination teaching in rheumatoid arthritis education: trained patient educators compared to nonspecialist doctors.
To assess whether students taught by trained patients acquire the same levels of competence in musculoskeletal examination skills as students taught by nonspecialist doctors. ⋯ Patient partners are either equal or superior to doctors not specifically trained in musculoskeletal medicine or orthopedics, in the teaching of musculoskeletal examination techniques and basic communication skills.
-
The concept that gut inflammation is implicated in the pathogenesis of spondyloarthropathies (SpA) has long been considered. Subclinical intestinal inflammation has been reported in adult patients with SpA by histological examination of intestinal biopsies. We assessed the presence of gut inflammation by abdominal 99mTc-hexamethyl propylene amine oxime (99mTc-HMPAO) labeled leukocyte scintigraphy in a group of children and adolescents with HLA-B27 positive SpA without gastrointestinal (GI) symptoms, and correlated the scintigraphic results to disease activity. ⋯ The presence of intestinal leukocyte uptake only in patients with active joint disease, even if intestinal inflammatory changes were minimal and clinical gut manifestations were absent, supports the role of gut inflammation in the pathogenesis of joint disease in HLA-B27 positive patients with SpA.