Pathogenesis. Microorganisms first traverse the highly vascular synovial membrane and subsynovial tissue, where they propagate. This incites an acute inflammatory process characterized histologically by infiltration with polymorphonuclear cells and later…
Two types of bacteria cause reactive arthritis in the majority of cases: • Bacteria that cause bowel infection such as Salmonella, Shigella, Yersinia, Campylobacter, Clostridium difficile, and Chlamydia pneumoniae •…
Clinical Manifestations. Most people who develop psoriatic arthritis have skin symptoms of psoriasis first; however, in 15% of people symptoms of arthritis may appear before the diagnosis of psoriasis. There…
• DMARDs, preferably sulfasalazine, may be given along with NSAIDs to slow or stop the progression of the disease in patients with predominant peripheral arthritis. • Glucocorticoid injections can be…
Radiographic Findings. One of the hallmarks of ankylosing spondylitis is involvement of the sacroiliac joints, and this has been the key radiographic finding that is needed to help confirm the…
The male-to-female ratio is approximately 3 to 1, with prevalence from 0.1% to 6.0% across different populations. The onset of clinical manifestations usually occurs in young adults. Pathology. The primary…
Intra-articular corticosteroid administration is extremely helpful for local flares for relief of pain and inflammatory swelling. Too-frequent use should be avoided owing to concerns regarding joint overuse and aggravation of…
NSAIDs, either traditional nonselective or COX-2–selective agents, are generally more efficacious than analgesics alone. Although all NSAIDs, selective or nonselective, have the potential for gastrointestinal complications such as peptic ulceration,…
Nonpharmacologic interventions include an umbrella-like group of approaches that should be universally considered in all patients. Advising and educating the patient as to treatment objectives and the importance of exercise,…
Hip Joint Involvement Osteoarthritis of the hip (malum coxae senilis) is a major crippling and painful form of osteoarthritis. Standing and walking often cause severe localized hip pain that may…
