• Title/Summary/Keyword: Ankylosing Spondylitis

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Clinical Study on East-West Combination Treatment in Joint Disorders (관절.류마티스 질환의 한.양방 협진에 관한 임상적 고찰)

  • Shin, Ye-Jji;Kim, Chan-Young;Kwon, Na-Hyoun;Kwon, Sin-Ae;Lee, Jung-Woo;Koh, Hyung-Kyun;Woo, Hyun-Su;Park, Dong-Suk;Baek, Yong-Hyeon
    • Journal of Acupuncture Research
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    • v.26 no.6
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    • pp.121-132
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    • 2009
  • Objectives : To evaluate the current status of East-West combination treatment in joint disorders. Methods : The medical records of patients who visited the Joints & Rheumatism Center at the Kyung Hee East-West Neo Medical Center from April 2006 to June 2009 were evaluated. The general characteristics of patients who underwent combination treatment, trend in number of cross-system referrals, and disorders and involved body regions of patients referred to the Eastern medical hospital from the Western medical hospital were initially assessed. 6 major disorders were found from the initial scanning. The trend in number of cross-hospital referrals, number of visits to the Eastern medical hospital, current status of combination treatment, treatment modality, and reason for cross-system referral was evaluated. Results : 1. 1510 patients were referred from the Eastern medical hospital to the Western medical hospital, and 1065 patients were referred from the Western medical hospital to the Eastern medical hospital. First visit patients reached a peak at the second quarter of 2007 and fourth quarter of 2006 respectively, and have steadily decreased from then on. Referrals of female patients were twice as common as male patient referrals. Patients in their sixth or seventh decade of life were most commonly referred, and more outpatients were referred compared to inpatients. 2. Patients with knee joint disorders were most commonly referred from the Western medical hospital to the Eastern medical hospital, followed by hip, shoulder, ankle, wrist, and elbow joint disorders. The most common disorders for each of the above regions in referred patients were knee osteoarthritis, avascular necrosis of the hip, adhesive capsulitis, and ankle strain and sprain. The generalized disorders rheumatoid arthritis and ankylosing spondylitis followed. 3. Patients referred to the Eastern hospital received approximately 3 to 10 Eastern medical treatment sessions. 45 percent remained on constant combination treatment, and 98 percent of referred patients received acupuncture treatment. Conclusions : In regard to the number of patients and duration of combination treatment, combination treatment was successfully performed for knee osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis, while it was not so for avascular necrosis of the hip, adhesive capsulitis, and ankle strain and sprain. Further research on this subject is required.

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Etiopathogenesis of sacroiliitis: implications for assessment and management

  • Baronio, Manuela;Sadia, Hajra;Paolacci, Stefano;Prestamburgo, Domenico;Miotti, Danilo;Guardamagna, Vittorio A.;Natalini, Giuseppe;Bertelli, Matteo
    • The Korean Journal of Pain
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    • v.33 no.4
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    • pp.294-304
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    • 2020
  • The sacroiliac joints connect the base of the sacrum to the ilium. When inflamed, they are suspected to cause low back pain. Inflammation of the sacroiliac joints is called sacroiliitis. The severity of the pain varies and depends on the degree of inflammation. Sacroiliitis is a hallmark of seronegative spondyloarthropathies. The presence or absence of chronic sacroiliitis is an important clue in the diagnosis of low back pain. This article aims to provide a concise overview of the anatomy, physiology, and molecular biology of sacroiliitis to aid clinicians in the assessment and management of sacroiliitis. For this narrative review, we evaluated articles in English published before August 2019 in PubMed. Then, we selected articles related to the painful manifestations of the sacroiliac joint. From the retrieved articles, we found that chronic sacroiliitis may be caused by various forms of spondyloarthritis, such as ankylosing spondyloarthritis. Sacroiliitis can also be associated with inflammatory bowel disease, Crohn's disease, gout, tuberculosis, brucellosis, and osteoarthritis, indicating common underlying etiological factors. The pathophysiology of sacroiliitis is complex and may involve internal, environmental, immunological, and genetic factors. Finally, genetic factors may also play a central role in progression of the disease. Knowing the genetic pre-disposition for sacroiliitis can be useful for diagnosis and for formulating treatment regimens, and may lead to a substantial reduction in disease severity and duration and to improved patient performance.

A Study on Efficiency of Pain Management by Questionnaire using Visual Analogue Scale in Back - Pain Patients (Visual Analogue Scale(VAS)을 이용한 동통평가표에 의한 동통관리의 효용성에 관한 연구)

  • Lee, Bok-Hee;Yoon, Hong-Il;Park, Ji-Whan
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.1 no.1
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    • pp.105-112
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    • 1995
  • This study was designed to investigate the efficiency of subjective assessment that exams the subjective symptom of patients with back pain at the department of physical therapy. To assess the subjective symptom, we used the pain questionnaire using visual analogue scale (VAS) that was developed by Wang on 1995. Questionnaires were administered to 31 adult patients(male : 11, female : 20) with herniated lumbar disk(13), low back pain(8), myofascial pain syndrom(5), lumbar strain(4), ankylosing spondylitis(1). Mean age was 36.3 ranged from 20 to 65. The results of this study were as follows : 1) In each of 15 subjects, there was a significant decrease in VAS between pre- and post-treatment(p<0.05). 2) Mean VAS of total subjects was $6.26{\pm}2.55$ in pre-treatment, $4.50{\pm}2.47$ in post-treatment (p<0.001). Result of this study was shown efficiency of pain management by subjective assessment. The continuous study is needed for many interesting illue of pain management using VAS.

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A Study on Efficiency of Pain Management by Questionnaire using Visual Analogue Scale in Back- Pain Patients (VAS를 이용한 동통평가표에 의한 동통관리의 효용성에 관한 연구)

  • Lee, Bok-Hee;Yoon, Hong-Il;Park, Ji-Whan
    • Journal of Korean Physical Therapy Science
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    • v.2 no.3
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    • pp.679-689
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    • 1995
  • This study was designed to investigate the efficiency of subjective assessment that exams the subjective symptom of patients with back pain at the department of physical therapy. To assess the subjective symptom, we used the pain questionnaire using visual analogue scale(VAS) that was developed by Wang on 1995. Questionnaires were administered to 31 adult patients(male : 11, female: 20) with herniated lumbar disk(13), low back pain(8), myofascial pain syndrom(5), lumbar strain(4), ankylosing spondylitis(1). Mean age was 36.3 ranged from 28 to 65. The results of this study were as follows: 1) In each of 15 subjects, there was a significant decrease in VAS between pre-and post-treatment(p < 0.05 -p<0.001). 2) Mean VAS of total subjects was $6.26{\pm}2.55$ in pre-treatment, $4.50{\pm}2.47$ in post-treatment(p < 0.001). The result of this study was shown efficiency of pain management by subjective assessment. The continuous study is needed for many interesting issue of pain management using VAS.

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Analysis of Health Counseling by the Internet - on the Home page of Korean Rheumatology Health Professions Society (인터넷을 이용한 관절염 환자의 건강상담 내용분석 -대한류마티스 건강전문학회 홈페이지를 대상으로-)

  • Lee, Eun-Ok;Lee, Young-Sook
    • Journal of muscle and joint health
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    • v.7 no.1
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    • pp.40-52
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    • 2000
  • Recently with the development in computer technology and its communication system, many changes in medical informatics enable us to use various medical information regardless of time or place. There are many home pages on the web, which provide medical counseling and hospital information. On May 11th 1999, Korean Rheumatology Health Professions Society began its new service as a home page on the web with various rheumatologic health information, questioning/ answering, and so on. This study was undertaken to examine the content and the purpose of health counseling on the web. The data was collected from 173 questioners who visited questioning/ answering site in the KRHPS home page for May 11th, 1999 through November 10th, 1999. Most of the questioners consulted the health problems of their or their families. Over two thirds of them were already diagnosed medically. Rheumatoid arthritis was the most frequent one. Other diseases, such as, osteoarthritis, ankylosing spondylitis, Still's disease were also on the list. Most of the questioners wanted to know treatment strategies, to consult about their symptoms, and to make diagnosis. And many questioners wanted detailed explanations about their diseases or the informations regarding the hospital. These findings suggest that the health counseling on the web may be used to supplement the lack of direct medical interviews with doctors. It also is expected to guide the patients to the right direction.

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Role of Bone Scan in Rheumatic Diseases (류마티스 질환에서 골스캔의 역할)

  • Choi, Yun-Young
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.3
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    • pp.137-146
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    • 2003
  • Rheumatic diseases can be categorized by pathology into several specific types of musculoskeletal problems, including synovitis (e.g. rheumatoid arthritis), enthesopathy (e.g. ankylosing spondylitis) and cartilage degeneration (e.g. osteoarthritis). Skeletal radiographs have contributed to the diagnosis of these articular diseases, and some disease entities need typical radiographic changes as a factor of the diagnostic criteria. However, they sometimes show normal radiographic findings in the early stage of disease, when there is demineralization of less than 30-50 %. Bone scans have also been used in arthritis, but not widely because the findings are nonspecific and it is thought that bone scans do not add significant information to routine radiography. Bone scans do however play a different role than simple radiography, and it is a complementary imaging method in the course of management of arthritis. The Image quality of bone scans can be improved by obtaining regional views and images under a pin-hole collimator, and through a variety of scintigraphic techniques including the three phase bone scan and bone SPECT. Therefore, bone scans could improve the diagnostic value, and answer multiple clinical questions, based on the pathophysiology of various forms of arthritis.

Marfan syndrome and symptomatic dural ectasia: A case report and literature review

  • Eom, Si Nae;Kim, Dong Chan;Kim, Kwang Nam;Kim, Sung Hye
    • Journal of Genetic Medicine
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    • v.11 no.2
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    • pp.83-85
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    • 2014
  • Dural ectasia refers to the widening or ballooning of the dural sac surrounding the spinal cord. It can affect any plane of the spinal canal, but occurs primarily in the lumbosacral region. Dural ectasia is present in 63-92% patients who have Marfan syndrome, and is related to Ehlers-Danlos syndrome, neurofibromatosis type I, and ankylosing spondylitis. The most common symptoms are low back pain, headache, weakness, numbness above and below the affected limb, and occasional rectal and genital pain. However, in most patients, dural ectasia is usually asymptomatic. We report the case of a 5-year-old boy who presented with a severe headache who had been diagnosed with Marfan syndrome. During the evaluation, magnetic resonance imaging of the lumbar and sacral spine revealed dural ectasia. To our knowledge, this is the first report on Marfan syndrome with symptomatic dural ectasia in Korea. We concluded that dural ectasia should be suspected in patients diagnosed with Marfan syndrome who have a severe headache.

Facet joint disorders: from diagnosis to treatment

  • Yeong-Min Yoo;Kyung-Hoon Kim
    • The Korean Journal of Pain
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    • v.37 no.1
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    • pp.3-12
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    • 2024
  • One of the most common sources of spinal pain syndromes is the facet joints. Cervical, thoracic, and lumbar facet joint pain syndromes comprise 55%, 42%, and 31% of chronic spinal pain syndromes, respectively. Common facet joint disorders are degenerative disorders, such as osteoarthritis, hypertrophied superior articular process, and facet joint cysts; septic arthritis; systemic and metabolic disorders, such as ankylosing spondylitis or gout; and traumatic dislocations. The facet pain syndrome from osteoarthritis is suspected from a patient's history (referred pain pattern) and physical examination (tenderness). Other facet joint disorders may cause radicular pain if mass effect from a facet joint cyst, hypertrophied superior articular process, or tumors compress the dorsal root ganglion. However, a high degree of morphological change does not always provoke pain. The superiority of innervating nerve block or direct joint injection for diagnosis and treatment is still a controversy. Treatment includes facet joint injection in facet joint osteoarthritis or whiplash injury provoking referred pain or decompression in mass effect in cases of hypertrophied superior articular process or facet joint cyst eliciting radicular pain. In addition, septic arthritis is treated using a proper antibiotic, based on infected tissue or blood culture. This review describes the diagnosis and treatment of common facet joint disorders.

Targeted Immunotherapy for Autoimmune Disease

  • Seung Min Jung;Wan-Uk Kim
    • IMMUNE NETWORK
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    • v.22 no.1
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    • pp.9.1-9.23
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    • 2022
  • In the past few decades, biological drugs and small molecule inhibitors targeting inflammatory cytokines, immune cells, and intracellular kinases have become the standard-of-care to treat autoimmune diseases. Inhibition of TNF, IL-6, IL-17, and IL-23 has revolutionized the treatment of autoimmune diseases, such as rheumatoid arthritis, ankylosing spondylitis, and psoriasis. B cell depletion therapy using anti-CD20 mAbs has shown promising results in patients with neuroinflammatory diseases, and inhibition of B cell survival factors is approved for treatment of systemic lupus erythematosus. Targeting co-stimulatory molecules expressed on Ag-presenting cells and T cells is also expected to have therapeutic potential in autoimmune diseases by modulating T cell function. Recently, small molecule kinase inhibitors targeting the JAK family, which is responsible for signal transduction from multiple receptors, have garnered great interest in the field of autoimmune and hematologic diseases. However, there are still unmet medical needs in terms of therapeutic efficacy and safety profiles. Emerging therapies aim to induce immune tolerance without compromising immune function, using advanced molecular engineering techniques.

Sarcoidosis Induced by Adalimumab in Rheumatoid Arthritis (류마티스 관절염 환자에서 Adalimumab 사용 후 발생한 사르코이드증 1예)

  • Lee, Seung-Ho;Kim, Sa-Il;Song, June-Seok;Kim, Tae-Hyung;Sohn, Jang-Won;Kim, Sang-Heon;Yoon, Ho-Joo;Kim, Tae-Hwan;Shin, Dong-Ho;Park, Sung-Soo;Kwak, Hyun-Jung
    • Tuberculosis and Respiratory Diseases
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    • v.71 no.6
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    • pp.464-469
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    • 2011
  • Adalimumab is a full human monoclonal antibody that inhibits tumor necrosis factor-alpha (TNF-${\alpha}$). This has recently been shown to be effective in the treatment of rheumatoid arthritis (RA), ankylosing spondylitis, and other conditions. Sacoidosis is known to be the target for adalimumab but we describe a patient who has developed sarcoidosis with lung involvement during adalimumab therapy for RA. A 48-year-old woman, who was treated with adalimumab for 5 months, was admitted because of chronic cough and both hilar lymphadenopathy on chest radiography. Chest computed tomography revealed the enlargement of multiple lymph nodes in the right supraclavicular, subcarinal, both hilar and right axillary area. She was diagnosed with sarcoidosis based on the biopsy of supraclavicular lymph node, skin and lung through video-associated thoracoscopic surgery, which was non-caseating epitheloid cell granuloma and excluded from a similar disease. She was treated for sarcoidosis with prednisolone and methotrexate instead of adalimumab.