No abstract available.
Antibodies* ; Arthritis, Rheumatoid* ; Diagnosis ; Prognosis

INTRODUCTION: Rheumatoid arthritis (RA) is one of systemic chronic progressive inflammatory disorders based on immunological disharmonies. Poorly controlled systemic inflammation in RA often leads to renal diseases such as secondary amyloidosis. CASE PRESENTATION: A 30-year-old man complained of swelling and tenderness of multiple joints gradually worsened the past 7 years. His laboratory examination showed anemia, positive rheumatoid factor (RF) and anti-citrullinated protein antibody (ACPA). C-reactive protein (CRP) was 48.7 mg/L (Normal value is <5 mg/L), increase in serum creatinine and protein was +3 in urine. His estimated glomerular filtration rate (e-GFR) was 58.3 mL/min/1.73 m2 Radiologic examinations of joints revealed features that support the diagnosis of rheumatoid arthritis. Renal biopsy was done revealed amyloid deposit. He was diagnosed with rheumatoid arthritis and secondary renal amyloidosis. CONCLUSION: Early proper diagnosis of RA is important and immunosuppressive drugs might slow disease progression by controlling the inflammatory process We discussed the importance of early diagnosis and the use of better treatment in managing RA to prevent renal amyloidosis.
Amyloidosis ; Arthritis, Rheumatoid ; Early Diagnosis

Animals ; Arthritis ; diagnosis ; pathology ; Arthritis, Rheumatoid ; diagnosis ; pathology ; Humans

No abstract available.
Arthritis, Rheumatoid* ; Birds* ; Early Diagnosis* ; Humans

Phenotypic characteristics of complex diseases such as rheumatoid arthritis are a consequence of interactions of genetic and environmental factors. Biomolecules closely interact with other molecular components and form functional modules, resulting in significant biologic action capability. While traditional biochemical research focuses on a single disease using narrowly constrained data, systems biology aims to interpret large volumes of highly complex and multilevel data obtained from high-through-put technologies to understand how biological systems function as a whole. Such a systems approach to complex diseases, so-called network medicine, can shape our comprehensive understanding of disease mechanisms by identifying modules temporally and spatially perturbed in the context of health and diseases. Given the unmet needs for diagnosis, monitoring, and treatment in rheumatoid arthritis, systems biology is obviously an emerging powerful tool to gain insight into disease mechanisms, study comorbidities, analyze therapeutic drugs and their targets, and discover novel network-based biomarkers.
Arthritis, Rheumatoid* ; Biomarkers ; Comorbidity ; Diagnosis ; Systems Biology

The introduction of new therapeutic agents in recent years has led the early diagnosis of rheumatoid arthritis (RA) increasingly important. Therapeutic intervention early in the disease course of RA allows earlier disease control and less joint damage. The 1987 American College of Rheumatology classification criteria for RA, however, does not reach full efficiency for providing clinicians to distinguish RA from other arthritides in the early phase of the disease. Therefore, diagnostic tools are needed to establish a reliable diagnostic criteria although the lack of an independent gold standard for RA makes it challenging in the evaluation of diagnostic studies. RA has no disease specific clinical, radiological or immunological features. This review describes the diagnostic values of medical history, physical examination, laboratory tests and imaging studies as well as the 1987 American College of Rheumatology classification criteria in the diagnosis of RA in its early phase.
Arthritis ; Arthritis, Rheumatoid ; Early Diagnosis ; Joints ; Physical Examination ; Rheumatology

Rheumatoid arthritis (RA) can be evaluated with ultrasound using both gray scale and Doppler mode. Gray scale provides cross-sectional images of joints, whereas Doppler shows the vascularity of the proliferated synovium. In RA, ultrasound can detect sub-clinical or early synovitis, assess arthritis more accurately than through clinical examination, and predict recurrence. In particular, a Doppler signal detected inside the joint cavity correlates with disease activity. Imaging remission can reflect the true remission status more accurately than with clinical remission. In this review, we focus on the use of ultrasonographic findings for the diagnosis, assessment, and prediction of RA.
Arthritis ; Arthritis, Rheumatoid* ; Diagnosis ; Joints ; Recurrence ; Synovial Membrane ; Synovitis ; Ultrasonography

OBJECTIVE: This study was designed to evaluate clinical features of 20 patients with rhupus syndrome and compare its characteristics with systemic lupus erythematosus(SLE) and rheumatoid artiritis(RA). METHODS: Patients considered to have rhupus who met the American College of Rheumatology(ACR) 1997 and 1987 revised criteria for SLE and RA, respectively and age, sex, and disease duration matched 64 patients with RA and 56 patients with SLE were selected for comparison. RESULTS: Twenty patients were all female and their mean age was 43.7+/-9.6 years(range 25~68). They had 5.5 ACR criteria for RA and 5 criteria for SLE. The mean age at onset of RA was 35.2+/-10.5 years(19~63) and that of SLE was 38.2+/-10.0 years(20~63), giving a mean interval between the diagnoses of the two diseases of 3.0+/-5.7 years (14~(-6)). There were 2 patients(10%) with rheumatoid nodule, and 18 patients(90%) with rheumatoid factor, and 16 patients(80%) with bone erosions on hand or wrist joints. The criterial for SLE included malar rash(20%), discoid rash(0%), photosensitivity(30%), oral ulcer(45%), arthritis(100%), serositis(35%), renal disorder(15%), neurologic disorder(0%), hematologic disorder(100%), immunologic disorder(90%), and positive antinuclear antibody(100%). Anti-dsDNA was more than 7.0U/ml in 15 patients(75%). The patients with rhupus syndrome showed lower amount of 24 hour urine protein, more severe radiologic involvement, younger age at onset of arthritis, higher titer of rheumatoid factor, lower frequency of low C3, and less complicated clinical course when compared with the patients with SLE(p<0.05). More frequent anemia, Rayanud's phenomenon, and more complicated clinical course in rhupus when compared with the patientw with RA(p<0.05), but the radiologic stage of hand and wrist was similar between rhupus and RA. CONCLUSION: Rupus syndrome showed somethisg different clinical characteristics and clinical course when compared with SLE and RA.
Anemia ; Arthritis ; Arthritis, Rheumatoid* ; Diagnosis ; Female ; Hand ; Humans ; Lupus Erythematosus, Systemic* ; Rheumatoid Factor ; Rheumatoid Nodule ; Wrist ; Wrist Joint

OBJECTIVES: To investigate the clinical, laboratory and radiological features of psoriatic arthritis. METHODS: Seventeen patients with psoriatic arthritis were studied. The diagnosis of psoriatic arthritis was based on the presence of an inflammatory arthritis associated with psoriasis, usually seronegative. Other rheumatic conditions were excluded. RESULTS: 1) There were 8 men and 9 women(male to female ratio of 1:1.13) and mean age was 41 years old. 2) Thirteen patients developed arthritis an average of 7. 3 years after the onset of psoriasis ; Three had a simultaneous onset of skin and joint disease(within 6 months), while in one patient the arthritis preceded psoriasis by a 10 years. 3) Ten patients had nail lesions, and dactyliris was presented in 6 patients. 4) The frequency of positive rheumatoid factor was 18 percent of the patients, and HLA-B27 was detected in 24 percent. 5) The prevalences of clinical patterns were as follows : oligoarthritis(41.2%), polyarthritis(29.4%), spondyloarthritis(23.5%) and arthritis in distal joint (5.9%). CONCLUSIONS: In contrast to rheumatoid arthritis, psoriatic arthritis occured frequently in males as in females and oligoarthritis was the most common joint pattern.
Adult ; Arthritis ; Arthritis, Psoriatic* ; Arthritis, Rheumatoid ; Diagnosis ; Female ; HLA-B27 Antigen ; Humans ; Joints ; Male ; Prevalence ; Psoriasis ; Rheumatoid Factor ; Skin

Multicentric reticulohistiocytosis (MRH) is a rare multisystemic granulomatous disease of unknown cause, characterized by severe debilitating polyarthritis and papular to nodular mucocutaneous lesions. This disease usually manifests as a progressive, destructive polyarthritis with mucocutaneous eruptions consisting of erythematous to brownish-colored papules and nodules. MRH is important, not only because of its disfiguring and disabling manifestations and systemic involvements, but also due to its association with internal malignancy. The histological features of skin and synovial lesions are infiltration of multinucleated giant cells, and histiocytes which contain abundant eosinophilic cytoplasm and have a ground glass appearance. Without the accompanying skin nodules, the patients can be misdiagnosed as having rheumatoid arthritis or psoriatic arthritis, and this inaccurate diagnosis will affect treatment. We report a case of MRH which was misdiagnosed as rheumatoid arthritis.
Arthritis ; Arthritis, Psoriatic ; Arthritis, Rheumatoid* ; Cytoplasm ; Diagnosis ; Eosinophils ; Giant Cells ; Glass ; Histiocytes ; Humans ; Skin