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Biomedical subjects

K Dale

Publications and source records attributed to K Dale.

At least 37 records · Page 2Linked to original sources
PubMed1985

Radiographic evaluation of patients with Bechterew's syndrome (ankylosing spondylitis) and their first-degree relatives. Findings in the spine and sacro-iliac joints and relations to non-radiographic findings.

One hundred and twenty-two hospitalized patients, 35 years or more of age with confirmed bilateral sacro-iliitis and 239 first-degree relatives, 25 years or more of age, were examined. All but 3 of the patients had confirmed ankylosing spondylitis (AS) in accordance with established criteria. The sacro-iliac joints were scored by a recently developed grading system. The prevalence of grade V sacro-iliits--extensive ankylosis--was greater in HLA B27-positive than in HLA B27-negative patients, and ankylosis of apophyseal joints, ossification of the interspinous ligament, or block vertebrae were not seen in HLA B27-negative patients. Shining corners and/or squared vertebrae were the most frequent findings of the dorsolumbar spine in patients with a disease course of less than 10 years. Mixed osteophytes were rare in patients below 40 years of age. All radiographic inflammatory changes scored in the spine-except for shining corners--were most often seen in patients with a disease history exceeding 20 years. Syndesmophytes and/or ankylosed apophyseal joints were less extensive in female than in male patients. No differences in the severity of radiographic changes in sacro-iliac joints or in frequency, severity or localization of different radiographic changes of the dorsolumbar spine were observed between HLA B27-positive patients with and those without psoriasis or acute anterior uveitis. Definite sacro-iliitis was restricted to HLA B27-positive relatives of HLA B27-positive probands and demonstrated in one-fifth of them. Shining corners and/or squared vertebrae were frequent findings in relatives with sacro-iliitis (45%), whereas apophyseal joint ankylosis, ossification of the interspinous ligament, block vertebrae and bridging syndesmophytes were not seen. Our results support the view that AS is not a defined disease entity and should be regarded as a syndrome. AS is an improper name for all patients fulfilling the Rome and/or New York criteria for definite AS, since many of them will probably never develop ankylosis of the spine or sacro-iliac joints.

Adult↗
PubMed1985

Bechterew's syndrome (ankylosing spondylitis). A syndrome with distinct subgroups.

The results of tests for associations among radiographic findings of the dorsolumbar spine, peripheral joints, tendon insertions and the pubic symphysis are presented. Ankylosis of sacro-iliac joints, ankylosis of apophyseal joints, bridging syndesmophytes, ossified interspinous ligament, block vertebrae, arthritis of the pubic symphysis and new bone formation of the ischium were strongly mutually associated. They probably belong to the same subgroup of disease. Such findings were negatively associated with distal peripheral joint arthritis. Mixed osteophytes, parasyndesmophytes or shining corners (anterior spondylitis) showed associations suggesting that the etiology may be mixed. A late stage of sacro-iliitis, regressive changes, characterized by narrow joint spaces without extensive ankylosis and with minimal sclerosis (grade IV sacro-iliitis) was associated with distal peripheral joints arthritis, but negatively associated with signs of ankylosing processes of the dorsolumbar spine. On the basis of the radiographic findings, distinct subgroups of AS could be identified. These results confirm our previous results of an association pattern between clinical findings. We would also recommend that the grading system of sacro-iliitis put forward by Dale be adopted, since it turned out that this grading system often distinguished between distinct subgroups of this heterogeneous condition(s).

Adult↗
PubMed1984

Family studies in Bechterew's syndrome (ankylosing spondylitis). I. Prevalences of symptoms and signs in relatives of HLAB27 positive probands.

All available adult first-degree relatives of 66 patients with HLAB27 positive ankylosing spondylitis were examined clinically and radiographically and their white blood cells were HLA typed. Ten per cent of all relatives and 20% of HLAB27 positive relatives had Bechterew's syndrome. An additional 10% had minimal radiographical changes in the sacro-iliac joints, or peripheral arthropathy. Sixteen out of 19 persons who had minimal radiographical changes in the sacro-iliac joints were HLAB27 positive. Backache was common (25% or more) in any group of relatives, and did not discriminate well between relatives with or without Bechterew's syndrome. Spine or chest stiffness should prompt examination for Bechterew's syndrome, but is an inadequate diagnostic criterion for the syndrome. Typing for HLAB27 is probably the best prognostic test, although most HLAB27 positive persons did not exhibit any objective sign of disease. Repeated radiographical examination of HLAB27 negative persons should be avoided.

Adult↗
PubMed1984

Family studies in Bechterew's syndrome (ankylosing spondylitis). II. Prevalences of symptoms and signs in relatives of HLAB27 negative probands.

All available adult first-degree relatives of 9 probands with HLAB27 negative ankylosing spondylitis were examined. Completion rate was 90%. Prevalences of symptoms and signs and distributions of chest and spinal mobility are presented. No secondary case of Bechterew's syndrome was found among the relatives, compared with 10% among the relatives of HLAB27 positive probands (p = 0.05). We conclude from this study and that of relatives of HLAB27 positive probands, that a HLAB27 negative relative runs a low risk of contracting Bechterew's syndrome, irrespective of the HLAB27 status of the proband.

Adult↗
PubMed1983

Radiographic changes, HLA B27 and back pain in patients with psoriasis or acute anterior uveitis.

Twenty-five female and 23 male consecutive patients hospitalized because of severe psoriasis, and 34 consecutive patients hospitalized because of acute anterior uveitis (AAU) were examined. Twelve of the patients with AAU (35%) and 11 of the patients with psoriasis (23%) had definite sacro-iliitis, which was unilateral in 6 (55%) of the former and in 2 (17%) of the latter. No definite radiographic differences in sacro-iliitis between HLA B27-positive and -negative patients could be detected. The radiographic changes of the dorso-lumbar junction (Th9-L2) related to the diseases, were seen only in HLA B27 positive patients with sacro-iliitis. Scattered lateral syndesmophytes were the commonest paravertebral ossifications in patients with psoriasis, whereas more diffuse and more numerous lateral mixed osteophytes appeared most frequently in AAU patients. Parasyndesmophytes were seen both in patients with psoriasis and in those with AAU. Asymptomatic sacro-iliitis was frequently found in unilateral, psoriatic sacro-iliitis (4 out of 6 patients) but was not restricted to this group. No radiographic indications of aortic valve insufficiency or apical lung fibrosis were found.

Acute Disease↗
PubMed1981

Radiographic temporomandibular joint abnormality in adults with micrognathia and juvenile rheumatoid arthritis.

Radiographic findings of the upper and lower jaw bone of 20 adult patients with micrognathia, bird face, and juvenile rheumatoid arthritis are reported. In all patients a symmetrically underdeveloped mandible with the chin posteriorly positioned was found at cephalometry. Arthritic lesion of the temporomandibular joint, mostly symmetric, with limitation of movement and secondary arthrosis, was observed in all patients. Complete absence of the tubercle. Abnormal anterior position of the mandibular head occurred in almost half of the patients. The degree of mandibular growth disturbance seemed to be correlated to the severity of the arthritis, indicating the arthritis to be a causal mechanism of micrognathia.

Adolescent↗
PubMed1981

Temporomandibular joint abnormalities in rheumatoid arthritis: comparison of different radiographic methods.

Transantral (infraorbital, transmaxillary) examination of the temporomandibular joint was compared with conventional transcranial examination and lateral tomography of patients with rheumatoid arthritis aged 23 to 83. Abnormalities were most frequently found at tomography, and equally frequent at transantral and transcranial examinations. The various examinations appeared to be rather supplementary. Bone erosion was frequently observed at transantral examination, which appeared to be the preferable radiographic method for detecting arthritis of this joint. Combined with transcranial examination, the method is recommended for the evaluation of temporomandibular joint abnormalities in rheumatoid arthritis if tomographic equipment is not available.

Adult↗
PubMed1981

Radiographic abnormalities of the temporomandibular joint in children with juvenile rheumatoid arthritis.

Radiographic lesion of the temporomandibular joint was found in 41 of 100 children with juvenile rheumatoid arthritis using a combination of radiographic techniques. In patients with abnormality, unilateral lesion occurred in 41 per cent. In patients with definite affection, a varying degree of destructions was observed in 93 per cent, restricted translatory movement of the mandibular head in 83 per cent. In many cases dystrophic or dysplasia-like changes occurred, with stump and thick, anteriorly positioned mandibular head and flat fossa. The lesions seemed to be most frequently associated with the polyarticular type, early onset and long duration of the disease.

Adolescent↗