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Biomedical subjects

R F Shapiro

Publications and source records attributed to R F Shapiro.

30 records · Page 2Linked to original sources
PubMed1977

Clinical, radiographic and pathologic abnormalities in calcium pyrophosphate dihydrate deposition disease (CPPD): pseudogout.

Clinical, radiographic and pathologic abnormalities in calcium pyrophosphate dihydrate deposition disease (CPPD) (pseudogout) are outlined in an investigation of 85 patients with definite or probable disease and available cadaveric and human surgical material. Pyrophosphate arthropathy produced distinctive roentgenographic abnormalities with were most frequent in the knee, wrist and metacarpophalangeal joints. Although the alterations superficially resembled osteoarthritis, they were frequently more severe and progressive with extensive fragmentation of bone, causing intra-articular osseous bodies. Pyrophosphate arthropathy occurred in unusual locations, such as the radiocarpal compartment of the wrist, elbow, and patellofemoral compartment of the knee. These characteristics allow the radiologist to suggest a probable diagnosis of CPPD even in the absence of articular calcification.

Aged↗
PubMed1976

HLA-B27 and modified bone formation.

Of the many associations between histocompatibility antigens and human diseases a prominent one is that between HLA-B27 and inflammatory arthropathies. Hypotheses to explain this association include the B27 gene being linked to a specific immune-response gene required for disease expression and the B27 antigen acting via molecular mimicry with a microorganism or as a microorganism receptor. Alternatively, the HLA-B27 gene might be closely related to a gene which influences bone formation. The finding of a significant association between B27 and Forestier's disease, a disease characterised by abundant new bone formation, supports such a hypothesis.

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PubMed1976

Clinical and radiographic abnormalities in ankylosing spondylitis: a comparison of men and women.

A clinical and radiographic study of 98 patients with definite ankylosing spondylitis (Rome criteria) was undertaken to evaluate differences in men and women with the disease. Clinical manifestations which were atypical in the 18 female patients when compared to those of the men included older age of disease onset, higher incidence of initial and subsequent peripheral joint disease, more common cervical spine symptomatology, and milder disease course. Radiographic differences in the women included a high incidence of cervical spine abnormalities, a combination of cervical spine and sacroiliac joint alterations with a normal intervening thoracic and lumbar segment, and frequent and severe osteitis pubis.

Adult↗
PubMed1976

Clinical and radiographic "reankylosis" following hip surgery in ankylosing spondylitis.

Eleven patients with ankylosing spondylitis underwent reconstructive hip surgery (21 hips). In 10 of these hips multiple surgical procedures had been performed. The final procedure included total hip arthroplasties (16 hips), femoral cup arthroplasties (four hips) and an Austin-Moore prosthetic replacement (one hip). A clinical and radiographic evaluation in the postoperative period revealed a high incidence of decreased joint motion and heterotopic ossification. Clinically moderate to severe restriction of motion was noted in 12 hips, and in six of these "reankylosis" was present. Radiographically moderate to severe new bone formation was seen in 11 hips, and in nine of these "reankylosis" was suggested. An association of excessive ossification and multiple surgical procedures was evident. It would appear that when the prime indication for hip surgery in patients with ankylosing spondylitis is restricted motion, the operation may not be beneficial.

Adult↗
PubMed1976

The association of HL-A B27 with Forestier's disease (vertebral ankylosing hyperostosis).

Despite the lack of apophyseal or sacroiliac joint involvement, Forestier's disease (vertebral ankylosing hyperostosis) shares with the inflammatory forms of spondylitis, the roentgenographic appearance of spinal new bone formation. Because of this apparent similarity, the prevalence of the HL-A B27 antigen was determined in 47 white patients with Forestier's disease. Sixteen of the patients (34 per cent) possessed the B27 antigen (P is less than 0.001). The mere presence of B27 therefore, does not confirm the diagnosis of inflammatory spondylitis in all patients with roentgenographic evidence of osseous bridging. Applying available epidemiologic information, these data further suggest that patients with the B27 antigen may be at substantial risk of developing Forestier's disease. As Forestier's disease and virtually all of the other B27 associated arthropathies manifest abundant new bone, an association may exist between this antigen and genes controlling new bone formation.

Aged↗
PubMed1975

Fistulization of rheumatoid joints. Spectrum of identifiable syndromes.

Eight patients with rheumatoid arthritis developed cutaneous fistulae adjacent to affected joints. Rheumatoid factor was positive in eight patients; subcutaneous nodules were noted in seven. Two patients had features of rheumatoid vasculitis. A spectrum of syndrome characterized by cutaneous fistulae was observed. Three patients showed classical fistulous rheumatism. Four patients developed septic arthritis which subsequently fistulized; in two, infection was associated with total joint replacement. One patient showed a cutaneous sinus accompanying a large calf cyst. A variety of diagnoses must be considered when cutaneous fistulae appear near joints in patients with rheumatoid arthritis.

Aged↗
PubMedDate not supplied

Radiographic abnormalities of rheumatoid arthritis in patients with diffuse idiopathic skeletal hyperostosis.

Radiographic abnormalities of rheumatoid arthritis (RA) in 8 patients with diffuse idiopathic skeletal hyperostosis (DISH) included atypical features: lack of osteoporosis, bone sclerosis and proliferation about erosions, osteophytosis, and bony ankylosis. Atypical clinical features included a high incidence of flexion contractures of elbows, wrists, ankles, or knees. It is not surprising that bone production occurs about involved articulations in patients with RA-DISH, as the latter disorder is characterized by bony proliferation at sites of ligament and tendon attachment to bone in the axial and extraaxial skeleton, perhaps related to stress.

Aged↗
PubMedDate not supplied

Current concepts in synovial fluid analysis.

The systematic examination of synovial fluid confirms the noninflammatory nature of degenerative joint disease, is diagnostic of gout, pseudogout, and septic arthritis, and will usually allow the identification of rheumatoid arthritis, systemic lupus erythematosus and Reiter's syndrome.

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