RESUMO
O lúpus eritematoso sistêmico é uma doença autoimune que envolve múltiplos sistemas orgânicos. O acometimento musculoesquelético é uma das manifestações mais comuns da doença, com envolvimento ósseo, articular, muscular, tendíneo e ligamentar, tanto primário como relacionado ao tratamento instituído. Neste artigo revisamos e ilustramos as alterações articulares e complicações musculoesqueléticas mais comuns relacionadas a esta doença.
Systemic lupus erythematosus is an autoimmune disease involving multiple organ systems. Musculoskeletal involvement is one of the most frequent presentations of the disease, affecting bones, joints, muscles, tendons and ligaments, either as a primary manifestation or secondary to the treatment of the disease. In the present article, the authors review and illustrate the joint disorders and the most common musculoskeletal abnormalities seen in this disorder.
Assuntos
Humanos , Pessoa de Meia-Idade , Anormalidades Musculoesqueléticas/diagnóstico , Lúpus Eritematoso Sistêmico , Osteonecrose , Reumatologia , Artrite , Artropatias , Miosite Ossificante/etiologia , RadiografiaRESUMO
OBJECTIVE: To perform a detailed magnetic resonance imaging (MRI) analysis of the hands of patients with Jaccoud's arthropathy (JA) secondary to systemic lupus erythematosus (SLE). METHODS: The hand with more expressive deformities compatible with JA from a group of SLE patients was examined by 1.5-T MRI. The protocol included coronal, sagittal, and axial turbo-spin-echo images before and after the administration of contrast medium. The presence of synovitis, edema, erosion, cysts, and tenosynovitis in the carpometacarpal, metacarpophalangeal, and proximal interphalangeal joints were scored based on a modified Outcome Measures in Rheumatology recommendations. RESULTS: Twenty SLE patients, (19 women and one man) with median age of 44.7 years (range: 20-76 years), median disease duration of 14.7 years (range: 5-26 years), and median arthritis duration of 13.7 years (range: 4-26 years) were studied. Of the 300 joints evaluated, 202 (67.3%) had some degree of synovitis. Sixteen out of 300 examined joints (5.3%) small areas of erosion were seen in 10 out of the 20 patients (50%). Subchondral bone edema was found in eight out of the 20 (40%) patients or a total of 18 joints (6%). A total of 200 compartments tendons were evaluated, and changes were found in 77 (38.5%) of them. In four out of the 20 patients, the MRI revealed bone cysts. CONCLUSIONS: The MRI seems to be a non-invasive diagnostic tool in patients with JA secondary to SLE, and may contribute to understanding the mechanism involved in the development of this deformity.
Assuntos
Artrite/patologia , Lúpus Eritematoso Sistêmico/patologia , Imageamento por Ressonância Magnética/métodos , Adulto , Idoso , Artrite/etiologia , Cistos Ósseos/etiologia , Cistos Ósseos/patologia , Articulações do Carpo/patologia , Edema/etiologia , Edema/patologia , Feminino , Humanos , Lúpus Eritematoso Sistêmico/complicações , Masculino , Articulação Metacarpofalângica/patologia , Pessoa de Meia-Idade , Tenossinovite/etiologia , Tenossinovite/patologia , Adulto JovemRESUMO
Presently, bariatric surgery is considered the most effective treatment for reducing excess body weight and maintaining weight loss in severely obese. On the other hand, several early and late complications have been described after this procedure. This article reports two patients who developed a spondyloarthritis-like syndrome after bariatric surgery. Probable etiopathogenic mechanisms are discussed.