PRIMER ON THE INNATE IMMUNE SYSTEM The innate immune system represents the first-line response to immunologic challenges and is composed of cellular defenses (neutrophils, dendritic cells, macrophages, and natural killer…
Pathoetiology. The prevalence and severity of fibromyalgia are determined by impaired slow-wave sleep, the magnitude of mood disturbance, and gene polymorphisms. These factors influence the brain and dorsal horns of…
POLYMYALGIA RHEUMATICA Polymyalgia rheumatica is characterized by proximal symmetric limb girdle pain and stiffness that may be accompanied by systemic inflammatory features. The disease responds in dramatic fashion to low-dose…
Pathophysiology. The cause of giant cell arteritis is unknown. The dominant force in vascular injury is cellmediated immunity. Resident “sentinel” vascular dendritic cells are thought to present antigen. Migrating dendritic…
The mechanism of CPPD deposition in articular cartilage is not yet fully understood but may, in part, relate to genetically determined activity of phosphate transporters. Serum calcium, phosphate, and alkaline…
The nonarticular pain syndromes have been demonstrated to have definite associations with a group of conditions including nonrestorative sleep, irritable bowel syndrome, chronic fatigue, various mood disorders, chronic and migrainous…
SECONDARY GOUT Hyperuricemia and gout may be a consequence of the overproduction of uric acid caused by an increased turnover of nucleic acids in myeloproliferative disorders, sickle cell anemia and…
PRIMARY GOUT Gout is diagnosed mainly in males. Males have higher levels of serum uric acid than women until menopause because estrogen has a uricosuric effect. Although the genetic factors…
Hemarthrosis symptoms vary with the severity of the hemorrhage. A larger hemorrhage initiates an acute inflammatory reaction in the joint, which becomes swollen, warm, very tender, and painful to move….
Clinical Manifestations. Tuberculous arthritis often involves only one joint. In order of frequency, the joints affected are the spine, hip, knee, elbow, ankle, sacroiliac, shoulder, and wrist. The onset of…
