• 제목/요약/키워드: Early rheumatoid arthritis

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Meta-Analysis of Effect in Serum Bio-Markers for Early Diagnosis: Rheumatoid Arthritis

  • Woo, Myoung Soo;Mun, Sora;Kang, Hee-Gyoo
    • 대한의생명과학회지
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    • 제27권4호
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    • pp.298-309
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    • 2021
  • Rheumatoid arthritis refers to acute and chronic arthritis due to unexplained autoantibody attack. Rheumatoid arthritis should be accompanied by difficulty in mobility and severe distress due to the progression of systemic arthritis. Therefore, this study early diagnoses the effects of Rheumatoid factor (RF), C-reactive protein (CRP), and Anti-cyclic citrullinated peptide (Anti-CCP), which are typical serum markers for rheumatoid arthritis by meta-analysis. Pubmed and EMBASE, were used as PICO criteria, and two independent researchers selected papers according to the criteria set in this study. The selection criteria was a study of patients with rheumatoid arthritis who developed early onset, and the paper was evaluated using the NCS. Forest plot and Funnel plot graphs for each serum marker were calculated using Revman 5.4. After finding 193 papers on Pubmed and 184 papers on EMBASE and selecting according to the criteria, a total of 41 papers were used for the analysis. The magnitude of the effect that appears in the Forest plot of RF with the Mean differnce value is 134.34, CRP is 21.42 and Anti-CCP is 270.41. The magnitude of the effect of Anti-CCP in meta-analysis was analyzed to be larger than that of RF and CRP, and it is considered that the development of early-diagnosis serum markers using Anti-CCP and additional retrospective studies are highly effective. The combination of RF, CRP, and Anti-CCP as a panel marker is expected to be very efficient.

류미티스관절염 (Rheumatoid Arthritis)

  • 강점덕
    • 대한정형도수물리치료학회지
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    • 제14권2호
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    • pp.16-24
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    • 2008
  • Anatomy: Advanced knowledges of cellular and molecular biology led to the development of therapies of rheumatoid arthritis(RA). Rheumatoid arthritis (RA) is a chronic, recurrent, systemic inflammatory disease and results in major deformity or dysfunction of joints. Etiology: Rheumatoid arthritis is now concevied as autoimmune disease. There have been many trials to define the immunological changes in rheumatoid arthritis. But now pathogenesis and significance of immunoglobulin complement and rheumatoid factor are not full accepted. Syndrome: Joints are characteristically involved with early inflammatory changes in the synovial membrane, peripheral portions of the articular cartilage, and lation tissue(pannus) forms, covers, and erodes the articular cartilage, bone and ligaments within the jiont capsule. Inflammatory changes also occur in tendon sheaths(tenosynovitis), and if subjected to a lot of friction, the tendons may fray or rupture. Extra-articular pathological changes sometimes occur, these include rheumatoid nodules, atrophy and fibrosis of muscles, and mild cardiac changes. Treatment: Tumor necrosis factor(TNF) inhibitor for the treatment of rheumatoid arthritis(RA) induces not only significant improvement of symptoms and signs of RA but also substantial inhibition of progressive joint damage.

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류마티스 관절염 치료에 대한 고찰 (A Study on Rheumatoid Arthritis Treatment)

  • 최현석
    • 대한물리치료과학회지
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    • 제4권4호
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    • pp.511-518
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    • 1997
  • For the perfect cure of rheumatoid arthritis, the ultimate hope of patients and therapist, it is necessary to find a patient early and treat him properly and to teach him what rheumatoid arthritis is. 1. Although rheumatoid arthritis is a chronic disease and its cause is uncertain matke the patient understand that there are many ways to reduce symptoms and to prevent deformation. 2. Explain the peculiarity and the procedure of rheumatoid arthritis to the patient and encourage him. 3. Teach the patient how to protect his arthrosises by showing him concrete movement. 4. Teach the patient or his family the ways to relieve rheumatoid arthritis easily in his house for continuous remedy. In order to make that remedy most effective for the patient, a complex and balanced treatment, considering medication, surgical teatment and rehabilitative treatment, has to be applied, which needs team work. Team work occurs when doctors, physiotherapists, nurses, nutritionists, clinical psychologists, prosthesis manufacturers, social workers, employment agents and the family of the patient work together. The members of the tern have to onderstand the procedure of the treatment of rheumatoid arthritis and apply proper remedies according to the condition of the patient.

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Diagnosis and Management of Suspected Case of Early Rheumatoid Arthritis in the Temporomandibular Joint: A Case Report

  • Tae-Seok Kim;Yeon-Hee Lee
    • Journal of Oral Medicine and Pain
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    • 제48권1호
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    • pp.31-36
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    • 2023
  • This report presents the case of a 14-year-old male with rheumatoid arthritis (RA) in both temporomandibular joints (TMJs), in whom a bone scan and laboratory tests were used to confirm the diagnosis. The patient visited the Department of Orofacial Pain and Oral Medicine at the affiliation hospital with a complaint of a 1-year history of bilateral TMJ pain and sound. Clinical examination revealed bilateral TMJ and masseter muscle pain during mouth opening and palpation. Radiological examination revealed no significant morphological changes in either TMJ. The patient was prescribed medications at the first visit to address the pain, inflammation, and stiffness. A bone scan and laboratory tests were planned/scheduled for differential diagnosis between simple arthralgia and osteoarthritis. The bone scan revealed increased radiotracer uptake in both TMJs. The laboratory tests revealed a RA factor of 82.4 IU/mL, which is more than four times the normal range. The final diagnoses were bilateral TMJ early rheumatoid arthritis (ERA) and juvenile idiopathic arthritis. We created a stabilization splint and referred the patient to the Department of Rheumatology for further evaluation of the ERA. After fitting of the stabilization splint and giving instructions regarding its use, the patient has been receiving monthly follow-up checks for symptoms and undergoes follow-up blood tests every 3 months. About 14 months after the initial visit, the pain had significantly decreased from a Visual Analog Scale score of 5 to 1, and the RA factor decreased to 66.6 IU/mL. A regular follow-up check will continue until the end of growth.

류마티스 관절염 진단을 위한 검사의 유용성 비교 (Comparison of the Usefulness of Diagnostic Tests for Rheumatoid Arthritis)

  • 박창은
    • 대한임상검사과학회지
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    • 제47권4호
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    • pp.168-174
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    • 2015
  • 류마티스 관절염은 주로 관절의 활막 세포의 증식, 병리학적 면역 반응과 관절의 진행성 파괴를 특징으로 하는 만성 염증성 질환이다. 이 질환은 중요한 사회적 건강 문제로 대두된다. 이 논문을 통해 분자수준에서 변화와 류마티스 관절염의 진단 또는 질병의 진행에 대한 발병 기전을 새로운 관점에서 발병기전을 제공한다. 또한 조기 진단과 류마티스 관절염의 예후에 도움이 될 것으로 보인다. 새로운 혈청학적 및 면역학적 바이오마커에 초점을 맞추고 있다. 따라서 넓게 질병 진행의 위험 환자를 식별하는 혈청학적, 생체 면역학적 요인 등을 규명하고 적용시키는 것을 도출할 수 있다. 진단 검사 의학을 기반으로 하는 증거는 환자에게 최선의 결과를 제공할 수 있다. 마지막으로. 최근의 연구 데이터는 이 접근을 통해서 치료를 최적화하기 위해 조기 진단 및 치료에 도움이 되는 새로운 접근 방식으로 궁극적인 유용성을 정립하는데 도움이 될 것으로 사료된다.

최근 RA와 관련된 임상 및 실험 논문의 경향 (The direction of the study regarding the treatment of Rheumatoid Arthritis)

  • 김영태;이재동;이윤호
    • Journal of Acupuncture Research
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    • 제19권5호
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    • pp.189-198
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    • 2002
  • Objective : To research the trend of the study related to rheumatoid arthritis(RA) and to establish the hereafter direction of the study on RA. Methods : We have selected 12 medical report about RA in Arthritis & Rheumatism and Journal of Rheumatology recently, reviewed them, and investigated their methods. Results & Conclusions : The pattern of study was as follows: physical & serologic research in 2 articles, immunologic research in 7 articles, and genetic research in 3 articles. There is now evidence of the benefit of treatment early in the disease course and evidence of the impact of treatment on outcomes. New classes of therapeutic agents have also been introduced. Wherever possible, these revised guidelines are evidence-based. By the above results, it would be needed further research on RA mechanism related immunologic and genetic process.

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여성 류마티스관절염 대상자의 고혈압, 당뇨, 이상지질혈증의 유병률, 인지율, 치료율 및 조절률 (Prevalence, Awareness, Treatment, and Control of Hypertension, Diabetes, and Dyslipidemia Among Patients with Rheumatoid Arthritis)

  • 윤혜원;부선주
    • 한국보건간호학회지
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    • 제33권2호
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    • pp.228-241
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    • 2019
  • Purpose: The purpose of this study was to evaluate the prevalence, awareness, treatment and control of hypertension, diabetes, and dyslipidemia among women with rheumatoid arthritis. Methods: This cross-sectional study of 288 women with rheumatoid arthritis was conducted in a university-affiliated hospital. Data were collected by reviewing the women's medical charts and self-report questionnaires. Results: The prevalence of hypertension, diabetes and dyslipidemia was 27.8%, 5.9% and 48.3%, respectively. Despite the high prevalence of dyslipidemia, the subjects'awareness of it and its treatment rates were the lowest, which resulted in a low control rate. Of the 288 subjects, 158 (55%) had at least one of the three conditions. The prevalence of the combination of cardiovascular risk factors increased with age, and 32.7% of those aged 60 or older had two or three of the cardiovascular risk factors. Combinations of cardiovascular risk factors were significantly related with severe pain and fatigue. Conclusion: Cardiovascular risk factors were highly prevalent among the women with rheumatoid arthritis, but the rates of awareness, treatment, and control were suboptimal. There is a pressing need to facilitate the prevention, early detection and appropriate management of hypertension, diabetes and dyslipidemia among patients with rheumatoid arthritis in order to prevent cardiovascular disease.

소아기 류마티스 관절염 (Juvenile rheumatoid arthritis)

  • 김동수
    • Clinical and Experimental Pediatrics
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    • 제50권12호
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    • pp.1173-1179
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    • 2007
  • The diagnosis of juvenile rheumatoid arthritis (JRA) is based on patient's age at disease onset, symptom duration, gender, and clinical manifestations. JRA is of unknown origin, begins under the age of 16, and persists for a minimum of 6 weeks. JRA is categorized into three principal types, systemic, oligoarticular and polyarticular. Infection, other connective tissue diseases, malignancy, trauma, and immunodeficiency are discussed as differential diagnoses for JRA. Because of joint damage, focusing on early diagnosis and intervention, a vigorous initial therapeutic approach must be taken in patients who have poor prognostic factors. A multidisciplinary team approach is also important for the care of patients with JRA.

류마티스 관절염의 임상 연구 동향: 2008년 이후 국내 학술 문헌을 중심으로 (Korean Domestic Trends in Clinical Research on Rheumatoid Arthritis since 2008)

  • 한윤희;우현준;박수연;이창훈;정종혁;이명수;이정한
    • 한방재활의학과학회지
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    • 제31권3호
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    • pp.19-29
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    • 2021
  • Objectives To investigate the trends in clinical study on rheumatoid arthritis in all academic fields in Korea. Methods We searched seven Korean web databases for clinical studies published from 2008 to 2021. All identified studies were reviewed and classified by the year of publication, academic field, and study design. Results A total of 347 clinical studies were selected. An average of 26.7 studies were published each year. Regarding the distribution of studies by academic fields, 309 studies were published in the medical field and 17 studies were published during the same period in Korean medicine, and 21 studies were published in other fields. The distribution of studies by study design was as follows: 8 studies, meta-analyses; 5 studies, systematic reviews; 16 studies, experimental studies; and 318 studies, observational studies. Conclusions Multidisciplinary access and management are required for the early diagnosis of rheumatoid arthritis, effective management of disease progression, and prevention of rheumatoid joint deformities. Additionally, study design with high-level of evidence on the intervention of rheumatoid arthritis are warranted.

말기 류마티스성 발목관절염에 대한 인공관절 전치환술 및 항류마티스 약물 조절 후의 중기 추시 임상 결과 (Intermediate-Term Clinical Outcomes after Total Ankle Arthroplasty for End-Stage Rheumatoid Arthritis with Modification of Perioperative Anti-Rheumatic Medication)

  • 조병기;고반석
    • 대한족부족관절학회지
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    • 제23권3호
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    • pp.91-99
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    • 2019
  • Purpose: This retrospective study reports the intermediate-term clinical outcomes including the practical function in daily and sports activities after total ankle arthroplasty for end-stage rheumatoid arthritis, as well as the effects of modification of perioperative anti-rheumatic medications. Materials and Methods: Twelve patients were followed for a minimum of 2 years after total ankle replacement for end-stage rheumatoid arthritis. Perioperative anti-rheumatic medications in all patients were modified based on a specific guideline. Clinical evaluations consisted of American Orthopaedic Foot and Ankle Society (AOFAS) scores, Foot and Ankle Outcome Score (FAOS), and Foot and Ankle Ability Measure (FAAM) scores. Periodic radiographic evaluation was conducted to detect changes in ankle alignment and postoperative complications. Results: Mean AOFAS, FAOS, and FAAM scores improved significantly from 37.5 to 81.2, 39.1 to 72.4, and 33.8 to 64.0 points at final follow-up, respectively (p<0.001). Functional outcomes in daily and sports activities at final follow-up were found to be 76.5 and 55.8 points for the FAOS and 70.5 and 57.5 points for the FAAM, respectively. As early postoperative complications, there was one case of local wound necrosis, one case of medial malleolar fracture, and one case of deep peroneal nerve injury. Radiological evaluation revealed two cases of asymptomatic heterotopic ossification and one case of progressive arthritis in the talonavicular joint. Reoperation was performed in only one patient (8.3%) with a medial soft tissue impingement at a mean of 35.6 months follow-up. Conclusion: Total ankle arthroplasty appears to be an effective surgical option for end-stage rheumatoid arthritis. Practical functions in daily and sports activities were significantly improved at intermediate-term follow-up. Modification of perioperative anti-rheumatic medications can be one of the solutions to reduce the postoperative complication rate.