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Determinação do Limiar de Dor à Pressão (LDP) da Articulação Temporomandibular (ATM) ideal para determinação diagnóstica de artralgia: um estudo baseado em algometria e ressonância magnética; Determination of the proper Pressure Pain Threshold (PPT) for the diagnosis of Temporomandibular Joint (TMJ) arthralgia: a magnetic ressonance and algometer - based study

Cunha, Carolina Ortigosa
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 25/04/2011 PT
Relevância na Pesquisa
37.51%
A Articulação Temporomandibular (ATM) pode ser acometida por inúmeros distúrbios articulares sendo os mais comuns os distúrbios de desarranjo do disco e os distúrbios inflamatórios. Um sinal clínico importante nesses casos é a sensibilidade dolorosa à palpação digital ou por mensuração do Limiar de Dor à Pressão (LDP), determinado com o uso de um instrumento denominado algômetro. O presente trabalho tem o objetivo de determinar qual o valor de LDP que melhor diferencie ATMs saudáveis daquelas acometidas por distúrbios inflamatórios e dolorosos. Ainda propõem-se a determinar se há diferenças entre o LDP de ATMs saudáveis e ATMs com deslocamento de disco com redução (DDCR) assintomáticos. Para isso, foi utilizada uma amostra de 60 indivíduos de ambos os gêneros com idade entre 18 e 50 anos, avaliados pelos critérios do Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) e divididos em três grupos: 20 indivíduos com diagnóstico clínico de artralgia da ATM (com ou sem deslocamento de disco para anterior, 20 indivíduos com diagnóstico clínico de DDCR (assintomáticos) e 20 indivíduos sem dores ou ruídos na ATM (grupo controle). Toda a amostra foi submetida a exame de ressonância magnética para análise da posição do disco para confirmar o exame físico e validar os critérios de inclusão (RDC/TMD) para formação dos grupos. Foram realizados exames de algometria sobre o pólo lateral das ATMs...

Eficácia do Piroxicam e Laser de Baixa Potência no tratamento da artralgia da articulação temporomandibular: estudo clínico randomizado duplo-cego; Effectiveness of Piroxicam and Low Level Laser in the Treatment of Temporomandibular Joint Arthralgia. A Double-blind clinical randomized trial

Carli, Marina Lara de
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 01/03/2012 PT
Relevância na Pesquisa
37.43%
O presente estudo avaliou a eficácia do piroxicam associado ao laser de baixa potência (LBP) no tratamento da artralgia da articulação temporomandibular (ATM). Trinta e dois pacientes (média de idade de 32,44 anos ± 13,02) com artralgia da ATM foram selecionados e divididos em 3 grupos: LBP+piroxicam (LPi), LBP+placebo de piroxicam (L) e piroxicam+placebo de LBP (Pi). Os pacientes receberam a terapêutica por 10 dias. As avaliações foram feitas no 1º, 3º, 8º, 10º dias de tratamento e 30 dias após o término. A presença e intensidade de dor espontânea, dor à palpação e máxima abertura bucal foram mensurados. Os dados foram analisados usando os testes de Friedman e de Wilcoxon, ou ANOVA e o teste t, adotando-se p<0,05 como nível de significância. Melhoras foram encontradas para os fatores dor espontânea e dor à palpação na análise intragrupo, embora diferenças significantes não foram encontradas entre os grupos. Entretanto, na avaliação de 30 dias, o grupo Pi apresentou menor dor à palpação (p=0,01) e menor dor para o músculo temporal (p=0,02) com diferenças significantes entre os grupos. Os resultados obtidos sugerem que a associação entre LBP e piroxicam não foi mais eficaz que as terapêuticas isoladas no tratamento de artralgia da ATM...

Manifestações musculoesqueléticas associadas à hepatite C crônica; Musculoskeletal manifestations associated with chronic hepatitis C

Nakamura, Andréa Aparecida Siqueira
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 09/09/2013 PT
Relevância na Pesquisa
27.32%
INTRODUÇÃO: A infecção pelo vírus C é um grande problema de saúde pública e tem se tornado a principal indicação de transplante de fígado. Com uma distribuição universal, é a segunda doença crônica viral mais frequente no mundo. No entanto, a hepatite C crônica é mais que uma doença hepática. Pacientes com infecção crônica pelo HCV podem desenvolver um grande número de manifestações extra-hepáticas independentemente da gravidade da doença hepática. Há muitas doenças reumatológicas associadas à infecção pelo HCV, incluindo artralgia, mialgia e artrite. MÉTODOS: Um estudo transversal desenvolvido entre os pacientes atendidos no Ambulatório de Hepatites da Divisão de Clínica de Moléstias Infeciosas e Parasitárias do HCFMUSP, na cidade de São Paulo, no período de 2004 a 2008, selecionou 243 pacientes que preencheram os critérios de inclusão e assinaram o termo de consentimento após esclarecimentos sobre a pesquisa. Foi realizada uma entrevista com os pacientes, em que foram coletadas informações demográficas, epidemiológicas e clinico-laboratoriais. Foram realizados exames laboratoriais, bioquímicos, hematológicos, imunológicos, PCR, HCV, RNA quantitativo e genotipagem do HCV. A avaliação das características da infecção pelo HCV (epidemiológica...

Manifestações músculoesqueléticas e auto-anticorpos em crianças e adolescentes com hanseníase; Musculoskeletal manifestations and autoantibodies in children and adolescents with leprosy

Neder, Luciana
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 11/02/2014 PT
Relevância na Pesquisa
26.88%
Introdução: A hanseníase é uma doença infecciosa crônica causada pelo Mycobacterium leprae. É considerada um dos maiores problemas de saúde pública nos países em desenvolvimento. Os principais sinais clínicos são manchas de pele com perda de sensibilidade e envolvimento de nervos periféricos. Manifestações musculoesqueléticas são descritas em adultos, mas este envolvimento é raramente descrito na população pediátrica. Objetivo: Avaliar envolvimento musculoesquelético e auto-anticorpos em pacientes pediátricos com hanseníase. Métodos: Foram avaliados 50 pacientes com hanseníase e 47 crianças e adolescentes saudáveis de acordo com manifestações musculoesqueléticas (artralgia, artrite e mialgia), síndromes dolorosas musculoesqueléticas (fibromialgia juvenil, síndrome de hipermobilidade articular benigna, síndrome miofascial e tendinite) e painel de auto-anticorpos e crioglobulinas. Escores de avaliação de saúde e tratamento foram realizados nos pacientes com hanseníase. Resultados: A frequência de manifestações musculoesqueléticas foi maior em pacientes com hanseníase comparada aos controles (14% vs. 0%, p=0,0012). Cinco pacientes com hanseníase tinham poliartrite assimétrica das pequenas articulações das mãos (10% vs. 0%...

Sleep bruxism increases the risk for painful temporomandibular disorder, depression and non-specific physical symptoms

Fernandes, G.; Franco, A. L.; Siqueira, J. T. T.; Goncalves, D. A. G.; Camparis, Cinara Maria
Fonte: Wiley-Blackwell Publicador: Wiley-Blackwell
Tipo: Artigo de Revista Científica Formato: 538-544
ENG
Relevância na Pesquisa
26.88%
To explore the relationship between sleep bruxism (SB), painful temporomandibular disorders (TMD) and psychologic status in a cross-sectional study. The sample consisted of 272 individuals. The Research Diagnostic Criteria for TMD (RDC/TMD) was used to diagnose TMD; SB was diagnosed by clinical criteria proposed by The American Academy of Sleep Medicine. The sample was divided into four groups: (1) patients without painful TMD and without SB, (2) patients without painful TMD and with SB, (3) patients with painful TMD and without SB and (4) patients with painful TMD and with SB. Data were analysed by Odds Ratio test with a 95% confidence interval. Patients with SB had an increased risk for the occurrence of myofascial pain (OR = 5.93, 95% CI: 3.1911.02) and arthralgia (2.34, 1.583.46). Group 3 had an increased risk for moderate/severe depression and non-specific physical symptoms (10.1, 3.6727.79; 14.7, 5.3939.92, respectively), and this risk increased in the presence of SB (25.0, 9.6564.77; 35.8, 13.9491.90, respectively). SB seems to be a risk factor for painful TMD, and this in turn is a risk factor for the occurrence of higher depression and non-specific physical symptoms levels, but a causeeffect relationship could not be established.

Effectiveness and satisfaction evaluation of patients submitted to TMJ arthrocenthesis: a case series

GOUVEIA,Mariana Vasconcelos da Cruz; BARBALHO,Jimmy Charles Melo; PEREIRA JÚNIOR,Edwaldo Dourado; NASCIMENTO,Mirella Marques das Mercês; VASCONCELOS,Belmiro Cavalcanti do Egito
Fonte: Sociedade Brasileira de Pesquisa Odontológica - SBPqO Publicador: Sociedade Brasileira de Pesquisa Odontológica - SBPqO
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2015 EN
Relevância na Pesquisa
26.88%
The aim of this study was to evaluate the effectiveness and level of satisfaction of patients who underwent TMJ arthrocentesis under local anesthesia by considering the following parameters: joint pain, mouth opening, mastication, and satisfaction. Fourteen patients (13 women and one man; mean age, 37.6 years with TMJ arthralgia were selected. The patients underwent arthrocentesis under local anesthesia, and pain intensity was measured before, during, and 1 year after treatment using a visual analog pain scale (VAS 0–100 mm). A Likert scale was used to assess patients’ opinion regarding the improvement of mouth opening and mastication. After treatment, patients were questioned on levels of satisfaction provided by arthrocentesis in regard to their quality of life. At the end of 1 year, patients showed a marked improvement in their pain clinical picture (p < 0.0001). Mouth opening and mastication, evaluated separately and then correlated (R2 = 0.925, p < 0.0001), also showed a marked improvement. When questioned, all patients reported being satisfied with the treatment outcome.

Shoulder-hand syndrome and symmetrical arthralgia in patients with tubo-ovarian carcinoma.

Taggart, A J; Iveson, J M; Wright, V
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /06/1984 EN
Relevância na Pesquisa
26.88%
Two cases of bilateral shoulder-hand syndrome and symmetrical arthralgia are described in patients with tubo-ovarian carcinoma. Swelling and contracture of the hands continued to develop despite oral corticosteroid therapy, and one patient underwent surgery in an attempt to prevent the development of further deformity.

Patello-femoral arthralgia in athletes attending a Sports Injury Clinic.

Devereaux, M. D.; Lachmann, S. M.
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /03/1984 EN
Relevância na Pesquisa
26.88%
Over a five year period, 137 athletes presented to a Sports Injury Clinic with patello-femoral arthralgia. This was 5.4% of the total injuries seen and a quarter of all knee problems treated. Running contributed to 32% of the athletes with patello-femoral pain. There was a 4:1 male:female ratio and nearly 70% were in the 16-25 year age range. A follow-up questionnaire was sent to 72 athletes seen in the last two years with a 78% response rate. Symptoms and treatment are discussed. After conservative therapy only 28.6% were entirely symptom free with a mean follow up of 13.1 months.

Arthralgia in Children

Brown, Douglas C. S.
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /11/1983 EN
Relevância na Pesquisa
27.15%
Arthralgia is joint pain unaccompanied by obvious clinical signs of arthritis or trauma. In most children and adolescents, the affected joint is the knee, hip, ankle, or less commonly an arm joint. Causes of arthralgia include arthritis; systemic disease; tumor; infection; growing pains; transient synovitis of the hip; osteochondroses; ostochondritis dissecans; traction syndrome; chondromalacia of the patella and post-traumatic synovitis. Some pains can be diagnosed with confidence with history, examination, X-ray, and laboratory studies. Other pains are vague, but careful observation of wasting and gait analysis may allow the physician to make a diagnosis.

Management of aromatase inhibitor–induced arthralgia

Younus, J.; Kligman, L.
Fonte: Multimed Inc. Publicador: Multimed Inc.
Tipo: Artigo de Revista Científica
Publicado em /02/2010 EN
Relevância na Pesquisa
27.32%
Aromatase inhibitors (ais) are commonly used as adjuvant treatment in postmenopausal women with hormone receptor–positive early breast cancer. With both steroidal and nonsteroidal ais, ai-induced arthralgia is frequently observed. The mechanism of ai-induced arthralgia remains unknown, and the data available from clinical trails using ais are limited. We review the pertinent information from a clinical perspective, including an algorithm to treat ai-induced arthralgia.

Chikungunya Disease: Infection-Associated Markers from the Acute to the Chronic Phase of Arbovirus-Induced Arthralgia

Dupuis-Maguiraga, Laurence; Noret, Marion; Brun, Sonia; Le Grand, Roger; Gras, Gabriel; Roques, Pierre
Fonte: Public Library of Science Publicador: Public Library of Science
Tipo: Artigo de Revista Científica
Publicado em 27/03/2012 EN
Relevância na Pesquisa
27.15%
At the end of 2005, an outbreak of fever associated with joint pain occurred in La Réunion. The causal agent, chikungunya virus (CHIKV), has been known for 50 years and could thus be readily identified. This arbovirus is present worldwide, particularly in India, but also in Europe, with new variants returning to Africa. In humans, it causes a disease characterized by a typical acute infection, sometimes followed by persistent arthralgia and myalgia lasting months or years. Investigations in the La Réunion cohort and studies in a macaque model of chikungunya implicated monocytes-macrophages in viral persistence. In this Review, we consider the relationship between CHIKV and the immune response and discuss predictive factors for chronic arthralgia and myalgia by providing an overview of current knowledge on chikungunya pathogenesis. Comparisons of data from animal models of the acute and chronic phases of infection, and data from clinical series, provide information about the mechanisms of CHIKV infection–associated inflammation, viral persistence in monocytes-macrophages, and their link to chronic signs.

Proposed medications for taxane-induced myalgia and arthralgia (Review)

IMAI, ATSUSHI; MATSUNAMI, KAZUTOSHI; TAKAGI, HIROSHI; ICHIGO, SATOSHI
Fonte: D.A. Spandidos Publicador: D.A. Spandidos
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
27.15%
Taxanes inhibit the disassembly of microtubules, which are involved in mitosis and axoplasmatic transport, and may cause the degeneration of peripheral, mainly small, sensory nerves. Peripheral neurotoxicity is a dose-limiting side-effect of taxanes. Neuroprotective agents may aid in the reduction of neurotoxicity, thus allowing the intensification of cytostatic therapy in patients. An increasing number of medications for the prevention of taxane-induced arthralgia and myalgia are becoming available to oncology teams. The most widely studied medications include so-called analgesics such as Shakuyaku-kanzo-to (a herbal medicine), corticosteroids and antihistamines. Arthralgias and myalgias (muscle spasms, fasciculations and prolonged contractions) may be extremely distressing for patients. New anti-epileptic drugs, particularly gabapentin and pregabalin, have proven to be safe and effective in the treatment of taxane-induced neurotoxicity. The aim of this review was to examine the topical choices available for the protective management of taxane-induced neurotoxicity monitored in preliminary case studies and clinical trials. At present, there is no standard of care for the prevention of taxane-induced arthralgia and myalgia. In combination with taxane-based chemotherapeutic regimens...

Chikungunya Virus-associated Long-term Arthralgia: A 36-month Prospective Longitudinal Study

Schilte, Clémentine; Staikovsky, Frédérik; Couderc, Thérèse; Madec, Yoann; Carpentier, Florence; Kassab, Somar; Albert, Matthew L.; Lecuit, Marc; Michault, Alain
Fonte: Public Library of Science Publicador: Public Library of Science
Tipo: Artigo de Revista Científica
Publicado em 21/03/2013 EN
Relevância na Pesquisa
27.66%
Chikungunya virus (CHIKV) is transmitted to human by mosquitoes. It is a re-emerging virus that has a risk to spread globally, given the expanding dissemination of its mosquito vectors. Chikungunya disease is characterized by acute transient febrile arthralgic illness, but can also lead to chronic incapacitating arthralgia. We have conducted a prospective longitudinal study to investigate in details long-term outcome of CHIKV infection. We found that 60% of patients experienced arthralgia 36 months after the onset of acute disease. Arthralgia affected most often multiple sites and were usually incapacitating. In addition to arthralgia, many patients suffered from myalgia and cutaneous lesions and several cognitive dysfunctions. We also showed that age over 35 years and the presence of arthralgia 4 months after the onset of disease are risk factors for long-term arthralgia. Patients with long-term arthralgia did not display biological markers typically found in autoimmune or rheumatoid diseases. This study demonstrates that chronic arthralgia is a frequent complication of acute Chikungunya disease and suggests that it results from a local rather than systemic inflammation.

Magnetic resonance imaging versus musculoskeletal ultrasonography in detecting inflammatory arthropathy in systemic sclerosis patients with hand arthralgia

Abdel-Magied, Rasha A.; Lotfi, A.; AbdelGawad, Ehab A.
Fonte: Springer Berlin Heidelberg Publicador: Springer Berlin Heidelberg
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
27.51%
The aim of the study was the detection of inflammatory arthropathy in patients with systemic sclerosis (SSc) with arthralgia using musculoskeletal ultrasonography (MSUS) and magnetic resonance imaging (MRI) and to compare between MRI versus MSUS detecting musculoskeletal abnormalities and find out its relation with other clinical and laboratory parameters. Sixteen SSc patients with hand arthralgia had a baseline MSUS for their hands. Six months later, patients had a second MSUS and MRI with gadolinium of their most symptomatic hand. Of the 16 patients examined by MSUS, it was found that on baseline and second examination, tenosynovitis was seen in 8 (50 %) and 7 (43.7 %) patients and synovitis was seen in 4 (25 %) and 5 (31 %) patients, respectively, indicating persistence synovial inflammation, and erosion was seen in only 1 (6.3 %) patient on baseline and second examination. Regarding MRI, 81.3 % (13) patients had tenosynovitis, 87.5 % (14) patients had synovitis, and 62.5 % (10) patients had erosions. Applying the RAMRIS system (a semiquantitative MRI scoring system used in RA), the mean values for synovitis, bone marrow edema, and erosions fell within the range seen in RA. Systemic sclerosis patients with arthralgia that have no obvious clinical inflammatory arthritis were found to have persistent inflammatory erosive arthropathy in their hands and wrists using MSUS and MRI. While both MRI and MSUS are useful in characterizing synovial inflammation in SSc...

Circulating CD4+CD161+ T Lymphocytes Are Increased in Seropositive Arthralgia Patients but Decreased in Patients with Newly Diagnosed Rheumatoid Arthritis

Chalan, Paulina; Kroesen, Bart-Jan; van der Geest, Kornelis S. M.; Huitema, Minke G.; Abdulahad, Wayel H.; Bijzet, Johan; Brouwer, Elisabeth; Boots, Annemieke M. H.
Fonte: Public Library of Science Publicador: Public Library of Science
Tipo: Artigo de Revista Científica
Publicado em 01/11/2013 EN
Relevância na Pesquisa
27.43%
Improved understanding of the immune events discriminating between seropositive arthralgia and clinical synovitis is of key importance in rheumatology research. Ample evidence suggests a role for Th17 cells in rheumatoid arthritis. We hypothesized that CD4+CD161+ cells representing Th17 lineage cells may be modulated prior to or after development of clinical synovitis. Therefore, in a cross-sectional study, we investigated the occurrence of CD4+CD161+ T-cells in seropositive arthralgia patients who are at risk for developing rheumatoid arthritis and in newly diagnosed rheumatoid arthritis patients. In a prospective study, we evaluated the effect of methotrexate treatment on circulating CD4+CD161+ T-cells. Next, we assessed if these cells can be detected at the level of the RA joints. Precursor Th17 lineage cells bearing CD161 were found to be increased in seropositive arthralgia patients. In contrast, circulating CD4+CD161+T-cells were decreased in newly diagnosed rheumatoid arthritis patients. The decrease in CD4+CD161+ T-cells correlated inversely with C-reactive protein and with the 66 swollen joint count. Methotrexate treatment led to normalization of CD4+CD161+ T-cells and reduced disease activity. CD4+CD161+ T cells were readily detected in synovial tissues from both early and late-stage rheumatoid arthritis. In addition...

Analysis of Criteria for MRI Diagnosis of TMJ Disc Displacement and Arthralgia

Shaefer, Jeffry Rowland; Riley, Cara Joy; Caruso, Paul Albert; Keith, David Alexander
Fonte: Hindawi Publishing Corporation Publicador: Hindawi Publishing Corporation
Tipo: Artigo de Revista Científica
EN_US
Relevância na Pesquisa
27.51%
Aims. To improve diagnostic criteria for TMJ disc displacement (DD). Methods:. The standard protocol for MRI diagnosis of DD, using a 12 o'clock reference position, was compared to an alternative protocol. The alternative protocol involves the functional relationship between the condyle and articular eminence, using a line perpendicular to the posterior slope of the eminence as a reference for disc position. The disc location was examined using both protocols, and disc diagnoses were compared in their relationship with joint pain. Statistical analyses included P value, sensitivity, specificity, odds ratio, and kappa statistic. Results:. 58 MRIs were interpreted. 36 subjects reported arthralgia; 22 did not. Both protocols demonstrated significance (standard P = 0.004, alternative P < 0.001) for the ability to predict arthralgia. The odds of arthralgia increased in DD patients diagnosed by standard methods 9.71 times and in DD diagnosed by alternative means 37.15 times. The diagnostic sensitivity decreased 30% using the alternative versus the standard protocol (0.6389 versus 0.9444), while specificity increased 60% (0.9545 versus 0.3636). Conclusions:. A stronger relationship occurs between DD and arthralgia when using a function-based protocol. The alternative protocol correctly identifies subjects without arthralgia...

Long-Term Arthralgia after Mayaro Virus Infection Correlates with Sustained Pro-inflammatory Cytokine Response

Santiago, Felix W.; Halsey, Eric S.; Siles, Crystyan; Vilcarromero, Stalin; Guevara, Carolina; Silvas, Jesus A.; Ramal, Cesar; Ampuero, Julia S.; Aguilar, Patricia V.
Fonte: Public Library of Science Publicador: Public Library of Science
Tipo: Artigo de Revista Científica
Publicado em 23/10/2015 EN
Relevância na Pesquisa
27.32%
Mayaro virus (MAYV), an alphavirus similar to chikungunya virus (CHIKV), causes an acute debilitating disease which results in the development of long-term arthralgia in more than 50% of infected individuals. Currently, the immune response and its role in the development of MAYV-induced persistent arthralgia remain unknown. In this study, we evaluated the immune response of individuals with confirmed MAYV infection in a one-year longitudinal study carried out in Loreto, Peru. We report that MAYV infection elicits robust immune responses that result in the development of a strong neutralizing antibody response and the secretion of pro-inflammatory immune mediators. The composition of these inflammatory mediators, in some cases, differed to those previously observed for CHIKV. Key mediators such as IL-13, IL-7 and VEGF were strongly induced following MAYV infection and were significantly increased in subjects that eventually developed persistent arthralgia. Although a strong neutralizing antibody response was observed in all subjects, it was not sufficient to prevent the long-term outcomes of MAYV infection. This study provides initial immunologic insight that may eventually contribute to prognostic tools and therapeutic treatments against this emerging pathogen.

Analysis of Criteria for MRI Diagnosis of TMJ Disc Displacement and Arthralgia

Shaefer, Jeffry R.; Riley, Cara Joy; Caruso, Paul; Keith, David
Fonte: Hindawi Publishing Corporation Publicador: Hindawi Publishing Corporation
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
27.51%
Aims. To improve diagnostic criteria for TMJ disc displacement (DD). Methods. The standard protocol for MRI diagnosis of DD, using a 12 o'clock reference position, was compared to an alternative protocol. The alternative protocol involves the functional relationship between the condyle and articular eminence, using a line perpendicular to the posterior slope of the eminence as a reference for disc position. The disc location was examined using both protocols, and disc diagnoses were compared in their relationship with joint pain. Statistical analyses included P value, sensitivity, specificity, odds ratio, and kappa statistic. Results. 58 MRIs were interpreted. 36 subjects reported arthralgia; 22 did not. Both protocols demonstrated significance (standard P = 0.004, alternative P < 0.001) for the ability to predict arthralgia. The odds of arthralgia increased in DD patients diagnosed by standard methods 9.71 times and in DD diagnosed by alternative means 37.15 times. The diagnostic sensitivity decreased 30% using the alternative versus the standard protocol (0.6389 versus 0.9444), while specificity increased 60% (0.9545 versus 0.3636). Conclusions. A stronger relationship occurs between DD and arthralgia when using a function-based protocol. The alternative protocol correctly identifies subjects without arthralgia...

Patellofemoral Arthralgia, Overuse Syndromes of the Knee, and Chondromalacia Patella

Welsh, R. Peter
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /03/1985 EN
Relevância na Pesquisa
27.32%
Patellofemoral arthralgia is a very common syndrome affecting athletes. Most often, examination fails to define true pathology. Conservative treatment, an active exercise program, and sports may be undertaken without harm to the knee. The patellofemoral arthralgia syndrome must be differentiated from true chondromalacia patella, where there is actual degeneration of the patella's articular cartilage, and from other sources of internal derangement such as meniscal disease or osteochondral lesions. Careful attention to the history of onset, and provoking activities such as climbing stairs, kneeling, and crouching, will allow the physician to recognize patellofemoral arthralgia. Other common overuse syndromes also should be looked for, and differentiated from problems due to true internal derangement.

Probiotics in arthralgia and spondyloarthropathies in patients with inflammatory bowel disease: Prospective randomized trials are necessary

Karimi,O.; Peña,A. S.
Fonte: Revista Española de Enfermedades Digestivas Publicador: Revista Española de Enfermedades Digestivas
Tipo: info:eu-repo/semantics/article; journal article; info:eu-repo/semantics/publishedVersion Formato: text/html; application/pdf
Publicado em 01/08/2005 ENG
Relevância na Pesquisa
27.32%
Arthralgias and spondyloarthropathies of the peripheral and axial joints are common in inflammatory bowel disease. Evidence for a strong association between these clinical manifestations and diseases of the joints has been provided by several clinical and epidemiological studies. Immunological studies have shown the presence of shared inflammatory cells both in the gut and the synovium in spondyloarthropathies. Genetic factors play a crucial role in the pathogenesis of spondyloarthropathies and inflammatory bowel disease. The role of the ubiquitous bacterial flora and pathogenic microorganisms present in the intestinal lumen may induce these joint diseases in patients with inflammatory bowel disease. In this review we will focus on the pathogenesis of spondyloarthropathies and arthralgia in patients suffering from inflammatory bowel disease. Based on preliminary clinical observations in patients with arthralgia and IBD, we put forward the hypothesis that probiotics may be helpful in the management of common extraintestinal manifestations such as arthralgia in patients with ulcerative colitis and Crohn's disease.