[Etiological aspects of fibromyalgia].

The etiopathogenesis of primary fibromyalgia still remains an enigma to modern medicine. Several hypotheses have been suggested during the last years, and these are reviewed.

Chronic idiopathic mediastinal fibrosis presenting with malaise, pleuritis and thoracic back pain.

A patient with chronic idiopathic mediastinal fibrosis (MF) without concomitant retroperitoneal fibrosis is reported. He presented with pleuritis, malaise and pain and stiffness in the thoracic spine. During the 3.

[Pustular arthro-osteitis. An affection of the musculoskeletal system in pustulosis palmoplantaris].

Musculoskeletal involvement is seen in approximately 15% of patients with pustulosis palmoplantaris. Usually the upper anterior parts of the trunk are affected, but, not infrequently, the peripheral joints are involved. The author reports the case of a female patient with pustulosis palmoplantaris and arthritis of a wrist and a knee.

[Sternocostoclavicular hyperostosis].

The syndrome of synovitis, acne, pustulosis, hyperostosis and osteomyelitis (SAPHO syndrome) includes disorders with common clinical and radiological manifestations. One of these, sternocostoclavicular hyperostosis, is characterized by inflammation and ossification of ligaments, bones and joints in the upper anterior parts of the trunk. The author reports the case of a 20 year-old female who developed unilateral sternocostoclavicular hyperostosis and complete ankylosis of the second, third and fourth lumbar vertebrae.

The epidemiology of ankylosing spondylitis.

This review focuses on various epidemiological aspects of ankylosing spondylitis (AS). Diagnostic criteria currently available are described, and their use in scientific studies as opposed to everyday clinical practice is discussed. Present knowledge of the prevalence of AS is addressed in detail with particular emphasis on discrepancies caused by variations in population frequencies of HLA B27 and those caused by differences in study designs.

The occurrence of fibromyalgia-like syndromes in a general female population.

In an epidemiological survey of females aged 20-49 years in Arendal, Norway, 217 persons with musculoskeletal pain were examined for the presence of fibromyalgia as defined by the ACR criteria of 1990. Forty females with fibromyalgia were found whereas 129 females had chronic musculoskeletal pain of more than three months duration but failed to meet the criteria. Two females suffered from nonrheumatic disorders which could explain their musculoskeletal pain.

[Bacterial arthritis].

During the years 1980-89, 13 patients were hospitalized because of bacterial arthritis of the peripheral joints. There were five juvenile patients (under 15 years of age). The remaining eight patients were adults, of whom seven were older than 50 years.

Adult idiopathic polymyositis without elevation of creatine kinase. Case report and review of the literature.

A patient fulfilling diagnostic criteria for definite polymyositis, but with normal levels of creatine kinase (CK) is reported. Review of the literature reveals significant variations regarding the frequencies of normal CK reported among cases with myositis. The discrepancies may be partly explained by inclusion of both probable and possible polymyositis, administration of steroid therapy prior to estimations of CK, and possible differences in CK levels between polymyositis and dermatomyositis.

Pneumonia, myocarditis and reactive arthritis due to Chlamydia pneumoniae.

A 37 year old HLA B27 negative man developed erythema nodosum, pneumonia, myocarditis and oligoarthritis due to Chlamydia pneumoniae. He recovered completely over a four month period. This is the first clinical description of reactive arthritis caused by C.

Toxicity of sulphasalazine in rheumatoid arthritis. Possible protective effect of rheumatoid factors and corticosteroids.

Adverse reactions to sulphasalazine were seen in 35 of 100 patients with rheumatoid arthritis. Gastrointestinal side effects, skin reactions and increases of serum liver enzymes were most frequently noted. Serious or fatal adverse reactions were not observed.

The prevalence of ankylosing spondylitis among Norwegian Samis (Lapps).

A population survey of the Sami (Lapp) population of the municipalities Karasjok and Kautokeino in north Norway revealed a prevalence of ankylosing spondylitis (AS) according to the New York criteria of 1.8%. Eleven cases of AS were found, 7 men and 4 women.

Ankylosing spondylitis. Current drug treatment.

The administration of drugs constitutes an important component of the therapeutic programme in ankylosing spondylitis (AS). The main objective of initiating such therapy is to reduce pain, stiffness and discomfort. There are at present 3 groups of drugs available for the management of AS.

The concomitant occurrence of Sjögren's syndrome and polymyositis.

A patient with both Sjögren's syndrome and polymyositis is described. The literature on the concomitant occurrence of these disorders is reviewed.

The prevalence of fibromyalgia among women aged 20-49 years in Arendal, Norway.

In an epidemiological survey of females aged 20-49 years in Arendal, Norway, a prevalence of fibromyalgia according to the ACR criteria of 1990 of 10.5% was found. Thirty-four out of 40 women with fibromyalgia (85.

Joint manifestations in gastrointestinal diseases. 1. Pathophysiological aspects, ulcerative colitis and Crohn's disease.

The many unique structural and functional features of the intestine may offer explanations to the well-established association between arthritis and inflammatory bowel diseases (IBD). In ulcerative colitis (UC) and Crohn's disease (CD) some 6-8% of cases develop peripheral joint disease which frequently correlates with the activity and extent of the underlying bowel disorder. Ankylosing spondylitis is also found rather frequently in UC and CD, but is apparently not related to the severity of colitis.

Joint manifestations in gastrointestinal diseases. 2. Whipple's disease, enteric infections, intestinal bypass operations, gluten-sensitive enteropathy, pseudomembranous colitis and collagenous colitis.

This review addresses the clinical picture of rheumatic diseases seen in Whipple's disease, gluten-sensitive enteropathy, pseudomembranous colitis, collagenous colitis and that developing after enteric infections and intestinal bypass operations for morbid obesity. These disorders exemplify the interplay between antigen entrance through the gastrointestinal canal, specific bacterial properties and genetic host factors such as HLA B27. In most cases such as interplay results in formation of circulating immune complexes causing the development of peripheral joint disease.

[Visceral manifestations of primary Sjogren's syndrome].

The author briefly surveys the visceral manifestations of primary Sjögren's syndrome. Two patients are described where the clinical picture was dominated by symptoms from lungs and kidneys respectively.

[Clinical manifestations of primary Sjogren's syndrome].

The article reviews the symptoms and signs of primary Sjögren's syndrome. It describes the clinical and laboratory investigations of such patients, and briefly discusses the occurrence of malignancy in Sjögren's syndrome.

[Reactive arthritis following Yersinia pseudotuberculosis infection].

A patient developed reactive arthritis due to Yersinia pseudotuberculosis. Five months after the primary infection, the patient still suffered from severe oligoarthritis. The administration of steroids and sulphasalazine had very little effect upon the development of the disease.

Ankylosing spondylitis and pregnancy.

The pregnancy-induced remission typical of RA does not seem to occur in pregnant women with AS. The mechanisms for this difference are not understood, but appear to be related to different pathogenetic mechanisms operating in the two diseases. The vast majority of women with ankylosing spondylitis can expect to have the same rate of fertility, course of pregnancy and birth, and to give birth to normal healthy babies to the same extent as the normal female population.

What is seronegative rheumatoid arthritis?

Between classical, erosive, seropositive rheumatoid arthritis (RA) on one hand, and typical, axial ankylosing spondylitis (AS) on the other, there is a variety of seronegative polyarthritides, which are often difficult to diagnose, classify and also to distinguish from each other. During our studies of HLA antigens and their associations with rheumatic diseases, and particularly that of DR4 with RA, we became increasingly concerned with the problem of defining properly patients with seronegative RA. Both the statement of seronegativity with regard to rheumatoid factors (RF), the diagnosis of RA, and particularly the exclusion of cases of seronegative arthritis other than RA were difficult.

Epidemiological and genetic aspects of IgM rheumatoid factors.

The occurrence of IgM rheumatoid factors (RF) was studied in a random sample of 8807 persons aged between 20 and 50 years in Tromsø, North Norway. Seropositivity for IgM RF was defined as a Waaler titre of 40 or more. A total prevalence of IgM RF of 1.