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Ochronosis
A 56-year-old gentleman had a history suggestive of inflammatory arthritis with knee joint swelling with hip and shoulder pain for 12 years. Axial symptoms of back pain and gradually developing immobility were also present. He had received a diagnosis of ankylosing spondylitis, and non-steroidal anti-inflammatory drugs with disease modifying antirheumatic drugs had been tried without much relief. He underwent surgical replacement of the knees 8 months ago, when the surgeon noticed that the cartilage was black in colour. No one in the family was similarly affected. Examination showed scleral hyperpigmented lesions...
Source: Postgraduate Medical Journal - September 22, 2016 Category: Journals (General) Authors: Zanwar, A., Phatak, S., Misra, R. Tags: Journalology, Patients, Genetics, Immunology (including allergy), Pain (neurology), Ankylosing spondylitis, Connective tissue disease, Rheumatoid arthritis, Ethics, Calcium and bone, Metabolic disorders Images in medicine Source Type: research

MRI vertebral corner inflammation followed by fat deposition is the strongest contributor to the development of new bone at the same vertebral corner: a multilevel longitudinal analysis in patients with ankylosing spondylitis
Conclusions Both VCI and VCFD contribute to new bone formation in ankylosing spondylitis (AS), especially if VCI precedes VCFD. However, VCI, VCFD and this particular sequence of events only partially explain the development of new bone in AS.
Source: Annals of the Rheumatic Diseases - July 7, 2016 Category: Rheumatology Authors: Machado, P. M., Baraliakos, X., van der Heijde, D., Braun, J., Landewe, R. Tags: Immunology (including allergy), Inflammation, Ankylosing spondylitis, Connective tissue disease, Degenerative joint disease, Musculoskeletal syndromes, Rheumatoid arthritis, Calcium and bone Clinical and epidemiological research Source Type: research

Flare in axial spondyloarthritis. The dark side of the outcome
Spondyloarthritis (SpA) is a chronic inflammatory rheumatic disease with many phenotypes,1 but the frame of the disease is still a matter of debate, particularly regarding the non-radiographic forms of axial SpA.2 3 The disease evolution may have several profiles, mainly related to the treatment strategy, balancing from periods of remission or low disease activity to flares of the disease. The recommended treatment strategies are supposed to be tailored to the disease activity, aiming to reach remission or low disease activity in a T2T strategy,4 with management of remission (reduction of dosage or increase in interval of ...
Source: Annals of the Rheumatic Diseases - May 9, 2016 Category: Rheumatology Authors: Wendling, D., Prati, C. Tags: Inflammatory bowel disease, Immunology (including allergy), Pain (neurology), Ophthalmology, Ankylosing spondylitis, Connective tissue disease, Degenerative joint disease, Musculoskeletal syndromes, Rheumatoid arthritis, Calcium and bone Editorials Source Type: research

Cow's Milk Allergy and Bone Mineral Density in Prepubertal Children
CONCLUSIONS: These prepubertal children with persistent CMA had lower lumbar spine BMD z scores than children with NCMA, which likely resulted from lower calcium intake.
Source: PEDIATRICS - May 1, 2016 Category: Pediatrics Authors: Mailhot, G., Perrone, V., Alos, N., Dubois, J., Delvin, E., Paradis, L., Des Roches, A. Tags: Nutrition, Allergy/Immunology Article Source Type: research

XXIV World Allergy Congress 2015
Table of Contents A1 Pirfenidone inhibits TGF-b1-induced extracellular matrix production in nasal polyp-derived fibroblasts Jae-Min Shin, Heung-Man Lee, Il-Ho Park A2 The efficacy of a 2-week course of oral steroid in the treatment of chronic spontaneous urticaria refractory to antihistamines Hyun-Sun Yoon, Gyeong Yul Park A3 The altered distribution of follicular t helper cells may predict a more pronounced clinical course of primary sjögren’s syndrome Margit Zeher A4 Betamethasone suppresses Th2 cell development induced by langerhans cell like dendr...
Source: World Allergy Organization Journal - April 18, 2016 Category: Allergy & Immunology Source Type: research

The detrimental effects of iron on the joint: a comparison between haemochromatosis and haemophilia
Joint damage due to (recurrent) joint bleeding in haemophilia causes major morbidity. Although the exact pathogenesis has not been fully elucidated, a central role for iron is hypothesised. Likewise, in hereditary haemochromatosis joint destruction is caused by iron overload. A comparison between these types of arthropathy could provide more insight in the influence of iron in inducing joint damage. A literature review was performed to compare both disorders with respect to their clinical and histological characteristics, and preclinical studies on the influence of iron on different joint components were reviewed. Similari...
Source: Journal of Clinical Pathology - July 20, 2015 Category: Pathology Authors: van Vulpen, L. F. D., Roosendaal, G., van Asbeck, B. S., Mastbergen, S. C., Lafeber, F. P. J. G., Schutgens, R. E. G. Tags: Immunology (including allergy), Inflammation, Degenerative joint disease, Musculoskeletal syndromes, Osteoporosis Review Source Type: research

EULAR recommendations for the use of imaging in the diagnosis and management of spondyloarthritis in clinical practice
A taskforce comprised of an expert group of 21 rheumatologists, radiologists and methodologists from 11 countries developed evidence-based recommendations on the use of imaging in the clinical management of both axial and peripheral spondyloarthritis (SpA). Twelve key questions on the role of imaging in SpA were generated using a process of discussion and consensus. Imaging modalities included conventional radiography, ultrasound, magnetic resonance imaging, computed tomography (CT), positron emission tomography, single photon emission CT, dual-emission x-ray absorptiometry and scintigraphy. Experts applied research eviden...
Source: Annals of the Rheumatic Diseases - June 10, 2015 Category: Rheumatology Authors: Mandl, P., Navarro-Compan, V., Terslev, L., Aegerter, P., van der Heijde, D., D'Agostino, M. A., Baraliakos, X., Pedersen, S. J., Jurik, A. G., Naredo, E., Schueller-Weidekamm, C., Weber, U., Wick, M. C., Bakker, P. A. C., Filippucci, E., Conaghan, P. G., Tags: Immunology (including allergy), Inflammation, Radiology, Musculoskeletal syndromes, Osteoporosis, Clinical diagnostic tests, Radiology (diagnostics), Calcium and bone Recommendation Source Type: research

Association study of genes related to bone formation and resorption and the extent of radiographic change in ankylosing spondylitis
Conclusions These findings support roles for bone resorption and prostaglandins pathways in the osteoproliferative changes in AS.
Source: Annals of the Rheumatic Diseases - June 10, 2015 Category: Rheumatology Authors: Cortes, A., Maksymowych, W. P., Wordsworth, B. P., Inman, R. D., Danoy, P., Rahman, P., Stone, M. A., Corr, M., Gensler, L. S., Gladman, D., Morgan, A., Marzo-Ortega, H., Ward, M. M., SPARCC (Spondyloarthritis Research Consortium of Canada), TASC (Austral Tags: Genetics, Immunology (including allergy), Radiology, Ankylosing spondylitis, Connective tissue disease, Degenerative joint disease, Musculoskeletal syndromes, Rheumatoid arthritis, Clinical diagnostic tests, Radiology (diagnostics), Calcium and bone Cli Source Type: research

Efficacy of TNF{alpha} blockers in patients with ankylosing spondylitis and non-radiographic axial spondyloarthritis: a meta-analysis
Conclusions Compared with placebo, TNFα blockers improve disease activity and functional capacity clinically meaningful for both AS and nr-axSpA patients.
Source: Annals of the Rheumatic Diseases - May 8, 2015 Category: Rheumatology Authors: Callhoff, J., Sieper, J., Weiss, A., Zink, A., Listing, J. Tags: Immunology (including allergy), Ankylosing spondylitis, Connective tissue disease, Degenerative joint disease, Musculoskeletal syndromes, Rheumatoid arthritis, Epidemiology, Calcium and bone Clinical and epidemiological research Source Type: research

Does spinal MRI add incremental diagnostic value to MRI of the sacroiliac joints alone in patients with non-radiographic axial spondyloarthritis?
Conclusions Combined spine and SIJ MRI added little incremental value compared with SIJ MRI alone for diagnosing patients with nr-axSpA and enhancing confidence in this diagnosis.
Source: Annals of the Rheumatic Diseases - May 8, 2015 Category: Rheumatology Authors: Weber, U., Zubler, V., Zhao, Z., Lambert, R. G., Chan, S. M., Pedersen, S. J., Ostergaard, M., Rufibach, K., Maksymowych, W. P. Tags: Immunology (including allergy), Pain (neurology), Ankylosing spondylitis, Connective tissue disease, Degenerative joint disease, Musculoskeletal syndromes, Rheumatoid arthritis, Calcium and bone Clinical and epidemiological research Source Type: research

Quantitative syndesmophyte measurement in ankylosing spondylitis using CT: longitudinal validity and sensitivity to change over 2 years
Conclusions CT-based syndesmophytes measurements had very good longitudinal validity and better sensitivity to change than radiography or MRI. This method shows promise for longitudinal clinical studies of syndesmophyte development and growth.
Source: Annals of the Rheumatic Diseases - January 7, 2015 Category: Rheumatology Authors: Tan, S., Yao, J., Flynn, J. A., Yao, L., Ward, M. M. Tags: Immunology (including allergy), Radiology, Ankylosing spondylitis, Connective tissue disease, Degenerative joint disease, Musculoskeletal syndromes, Rheumatoid arthritis, Clinical diagnostic tests, Radiology (diagnostics), Calcium and bone Clinical and Source Type: research

Evolution of radiographic damage in ankylosing spondylitis: a 12 year prospective follow-up of the OASIS study
Conclusions Long term radiographic progression in AS is highly variable in the individual patient, more severe in HLA-B27 positive men and still occurs after decades of disease. At the group level, however, progression in AS follows an approximately linear course.
Source: Annals of the Rheumatic Diseases - December 4, 2014 Category: Rheumatology Authors: Ramiro, S., Stolwijk, C., van Tubergen, A., van der Heijde, D., Dougados, M., van den Bosch, F., Landewe, R. Tags: Immunology (including allergy), Ankylosing spondylitis, Connective tissue disease, Degenerative joint disease, Musculoskeletal syndromes, Rheumatoid arthritis, Calcium and bone Clinical and epidemiological research Source Type: research

Elevated serum level of the vascular endothelial growth factor predicts radiographic spinal progression in patients with axial spondyloarthritis
Conclusions An elevated serum level of VEGF (>600 pg/mL) is highly specific as a predictor of radiographic spinal progression in patients with axSpA, especially in patients who are at high risk for further progression due to the presence of syndesmophytes.
Source: Annals of the Rheumatic Diseases - October 30, 2014 Category: Rheumatology Authors: Poddubnyy, D., Conrad, K., Haibel, H., Syrbe, U., Appel, H., Braun, J., Rudwaleit, M., Sieper, J. Tags: Immunology (including allergy), Ankylosing spondylitis, Connective tissue disease, Degenerative joint disease, Musculoskeletal syndromes, Rheumatoid arthritis, Calcium and bone Clinical and epidemiological research Source Type: research

Which spinal lesions are associated with new bone formation in patients with ankylosing spondylitis treated with anti-TNF agents? A long-term observational study using MRI and conventional radiography
Conclusions Parallel occurrence of inflammation and FD at baseline and development of FD without prior inflammation after 2 years were significantly associated with syndesmophyte formation after 5 years of anti-tumour necrosis factor (TNF) therapy. However, the sequence ‘inflammation–FD–new bone formation’ was rarely observed, an argument against the TNF-brake hypothesis. Whether an early suppression of inflammation leads to a decrease of the risk for new bone formation remains to be demonstrated.
Source: Annals of the Rheumatic Diseases - September 4, 2014 Category: Rheumatology Authors: Baraliakos, X., Heldmann, F., Callhoff, J., Listing, J., Appelboom, T., Brandt, J., Van den Bosch, F., Breban, M., Burmester, G., Dougados, M., Emery, P., Gaston, H., Grunke, M., Van Der Horst-Bruinsma, I. E., Landewe, R., Leirisalo-Repo, M., Sieper, J., Tags: Immunology (including allergy), Inflammation, Radiology, Ankylosing spondylitis, Connective tissue disease, Degenerative joint disease, Musculoskeletal syndromes, Rheumatoid arthritis, Clinical diagnostic tests, Radiology (diagnostics), Calcium and bone Source Type: research

Higher disease activity leads to more structural damage in the spine in ankylosing spondylitis: 12-year longitudinal data from the OASIS cohort
Conclusions This is the first study showing that disease activity contributes longitudinally to radiographic progression in the spine in AS. This effect is more pronounced in men and in the earlier phases of the disease.
Source: Annals of the Rheumatic Diseases - July 3, 2014 Category: Rheumatology Authors: Ramiro, S., van der Heijde, D., van Tubergen, A., Stolwijk, C., Dougados, M., van den Bosch, F., Landewe, R. Tags: Editor's choice, Immunology (including allergy), Pain (neurology), Ankylosing spondylitis, Connective tissue disease, Degenerative joint disease, Musculoskeletal syndromes, Rheumatoid arthritis, Calcium and bone Clinical and epidemiological research Source Type: research

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