Newly diagnosed rheumatoid arthritis

Weisman, Michael H.

doi:10.1136/ard.61.4.287

Cited by 8 publications

(2 citation statements)

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“…Its mainstay was a squeeze test of the MCP and/or MTP joints. Interestingly, the squeeze test had previously been found to be an important factor for distinguishing early RA from other inflammatory and noninflammatory conditions (3), and in some new prediction models, it has been found to be useful as a diagnostic and prognostic test (4). This test was first described by the American surgeon Frederick Julius Gaenslen, who lived from 1877 to 1937 in Milwaukee and, therefore, the test is referred to as Gaenslen's test (GT).…”

Section: Introductionmentioning

confidence: 99%

Compression Test (Gaenslen's Squeeze Test) Positivity, Joint Tenderness, and Disease Activity in Patients With Rheumatoid Arthritis

Wiesinger¹,

Smolen²,

Aletaha³

et al. 2013

Arthritis Care & Research

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Objective. Gaenslen's test (GT) positivity is characterized by tenderness upon lateral compression (squeezing) of the metacarpophalangeal (MCP) or metatarsophalangeal (MTP) joints. We aimed to assess the factors related to a positive GT and to explore differences in disease activity between GT-positive and -negative patients. Methods. The GT was performed routinely in outpatients with rheumatoid arthritis (RA). In total, 229 patients had a positive GT (GT-positive group). To this group, we matched a GT-negative group (n ‫؍‬ 222) comparable in sex, age, disease duration, and rheumatoid factor (RF) positivity. Disease activity scores, swollen and tender joint counts, patient pain and global assessments, evaluator's global assessment, morning stiffness, disability assessments, acute phase reactants, RF, and anti-citrullinated protein antibody levels were assessed and used for correlation analyses. A comparison between the GT-positive and -negative groups was performed and a regression model was calculated. Results. All clinical variables, including disease activity scores, joint counts, and disability assessments, were significantly higher in the GT-positive group than the GT-negative group. Also, there were significantly fewer patients in remission or with low disease activity in the GT-positive group. GT positivity correlated most strongly (r > 0.5) with joint tenderness (32-and 28-joint counts). Tender proximal interphalangeal, MCP, and MTP joints appeared mostly responsible for a positive GT, but more than 1 MCP/MTP joint had to be tender to explain a positive GT. Conclusion. The GT is related primarily to tenderness in MCP and MTP joints and signifies a moderate to high disease activity among patients with RA.

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Section: Introductionmentioning

confidence: 99%

Compression Test (Gaenslen's Squeeze Test) Positivity, Joint Tenderness, and Disease Activity in Patients With Rheumatoid Arthritis

Wiesinger¹,

Smolen²,

Aletaha³

et al. 2013

Arthritis Care & Research

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“…Ранний ревматоидный артрит (РА) является условно вы деляемой клинико-патогенетической стадией болезни с дли тельностью активного синовита не более 1 года, характери зующейся антигенспецифической активацией С 04 + Т -л и мфоцитов, гиперпродукцией "провоспалительных" цитокинов и отсутствием признаков хронизации воспаления [1,11]. Вы деление понятия "ранний РА" связано со сложившимися в настоящее время представлениями о патогенезе болезни и необходимости проведения ранней активной терапии РА [2].…”

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Clinical and immunological features of early rheumatoid arthritis

Шостак¹,

Muradyants²,

Loginova³

et al. 2004

rsp

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Резюме Цель. Изучить клинико-иммунологические особенности ранней стадии ревматоидного артри та (РА). Материал и методы. Обследовано 130 больных РА в возрасте от 16 до 80 лет (в среднем 52,2 г.), 105 жен. и 25 муж. Продолжительность заболевания до 1 г. определена у 55, от 1 г. до 3 лету 34, более 3 лет-у 41 больных. У 43 больных с ранним РА, помимо общ епринятого обсле дования, проводилась оценка состояния рецепторного аппарата лимфоцитов с помощью моно клональных антител; оценивалась экспрессия антигенов CD3, CD72, CD4, CD8, CD 16. Результаты. Наиболее частыми ранними симптомами, предшествовавшими появлению типич ной картины РА были: артралгии (39,2%), повышение температуры (34,6%), снижение массы тела (24,6%). Выявлены следующие особенности дебюта РА: моно-олигоартритический харак тер поражения суставов у 61,5% больных в первый месяц заболевания с быстрой последующей трансформацией в полиартрит. Наиболее частыми "масками" раннего РА с соответствующим неправильным диагнозом являлись "остеоартроз" (25,1%), "реактивный артрит" (24,9%) и "по дагра" (4,6%). У мужчин в сравнении с лицами женского пола отмечались большая продолжи тельность утренней скованности, более высокие уровни С-реактивного белка и функциональ ной недостаточности, повыш енная активация Т-и В-клеточного звеньев иммунитета (р<0,05). Заключение. Ранний РА имеет ряд особенностей, понимание которых позволит своевременно диагностировать заболевание.

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Mitogen-Activated Protein Kinases as Therapeutic Targets for Rheumatoid Arthritis

Paunović

Harnett

2013

Drugs

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Rheumatoid arthritis (RA) is a chronic autoimmune disease in which imbalances in pro- and anti-inflammatory cytokines promote the induction of autoimmunity, inflammation and joint destruction. Methotrexate, the standard disease-modifying anti-rheumatic drug (DMARD), has shown a gradual loss of efficacy in a significant proportion of patients, probably due to the onset of drug resistance, and thus it was hoped that the development of biologics would revolutionise RA management. Even though biologics have improved the therapy of patients refractive to DMARDs, they require parenteral administration and may leave patients open to serious infection and cancer. Therefore, attention has also been focused on inhibitors of mitogen-activated protein kinases (MAPKs), signalling enzymes that play key roles in pathogenic cytokine production, and their downstream effector pathways, in order to create safe and effective oral drugs. This article therefore provides an overview of the structure and function of MAPKs and their role in the pathogenesis of RA as context to describing the advances in the development of specific, druggable MAPK inhibitors. Their potential as therapies in the management of RA is also discussed.

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Newly diagnosed rheumatoid arthritis

Cited by 8 publications

References 20 publications

Compression Test (Gaenslen's Squeeze Test) Positivity, Joint Tenderness, and Disease Activity in Patients With Rheumatoid Arthritis

Compression Test (Gaenslen's Squeeze Test) Positivity, Joint Tenderness, and Disease Activity in Patients With Rheumatoid Arthritis

Clinical and immunological features of early rheumatoid arthritis

Mitogen-Activated Protein Kinases as Therapeutic Targets for Rheumatoid Arthritis

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