Increased Ed-B fibronectin plasma levels in spondyloarthropathies: comparison with rheumatoid arthritis patients and a healthy population.

Objective: To determine, for the first time, plasma levels of general fibronectin (Fn) and two spliced isoforms, Ed-A and Ed-B, in patients with spondyloarthropathy (SpA) in comparison with rheumatoid arthritis (RA) patients and healthy volunteers (HV).

Methods: Plasmas (EDTA) as well as clinical data, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels were collected in two groups of 10 patients fulfilling the European Spondylarthropathy Study Group criteria for SpA or the 1987 American College of Rheumatology criteria for RA. Plasmas of 21 blood donors served as controls.

Unusual onset of rheumatoid arthritis with diffuse pulmonary nodulosis: a diagnostic problem.

We describe a case of a 50-year-old woman presenting articular manifestations of rheumatoid arthritis associated with severe interstitial lung involvement related to multiple pulmonary nodules. Diagnosis of diffuse pulmonary rheumatoid nodulitis was made only after video assisted thoracoscopic lung biopsies.

Factors linked to disease activity in a French cohort of patients with spondyloarthropathy.

Objective: To identify risk factors associated with disease activity, in a group of patients with spondyloarthropathy (SpA) living in France.

Methods: Patients fulfilling the ESSG or Amor criteria for SpA were enrolled in a cross sectional multicenter study. Disease activity was assessed using a French version of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI).

Two cases of discitis due to Propionibacterium acnes.

We report two cases of discitis due to Propionibacterium acnes and review previously published cases of bone and joint infections in which this organism was recovered as a pure culture. P. acnes is an anaerobic organism usually considered a normal inhabitant of the skin but capable of producing a variety of infections including discitis, osteitis, arthritis, and chest wall osteitis.

Evaluation of a French version of the Bath Ankylosing Spondylitis Disease Activity Index in patients with spondyloarthropathy.

Objective: To develop a French version of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and to determine its metric properties in patients with all forms of spondyloarthropathies (SpA).

Methods: A French version of BASDAI was obtained after a translation and back-translation process. Patients fulfilling the European Spondylarthropathy Study Group or Amor criteria for SpA were included.

Misleading clinical aspects of hydroxyapatite deposits: a series of 15 cases.

Objective: To study the characteristics of radiographs in diagnosis of hydroxyapatite deposits in sites other than the shoulders and hips.

Methods: We reviewed the records of patients hospitalized during the last 3 years whose final diagnosis was apatite deposits in sites other than the shoulders and hips.

Results: Ten women and 5 men were studied.

Münchausen's syndrome simulating reflex sympathetic dystrophy.

Rheumatologic presentations of factitious illness such as Münchausen's syndrome are rare. We describe a case of alternate edema of the hands in a 25-year-old man, diagnosed as reflex sympathetic dystrophy. This patient eventually presented all clinical characteristics of Münchausen's syndrome.

Elastase activity in cartilage extracts and synovial fluids from subjects with osteoarthritis or rheumatoid arthritis: the prominent role of metalloproteinases.

Objective: Polymorphonuclear leukocyte (PMN) elastase is able to degrade the extra-cellular matrix components of cartilage. However, in vitro several proteinases can degrade elastin. The purpose of this study was to evaluate the role of the serine proteinases and metalloproteinases in the elastase activity measured in cartilage extracts from patients with osteoarthritis (OA), as well as in synovial fluid (SF) from patients with rheumatoid arthritis (RA) and OA.

Iatrogenically induced vertebral osteomyelitis due to Pseudomonas aeruginosa.

We report three cases of iatrogenically induced vertebral osteomyelitis due to Pseudomonas aeruginosa. One case was a post-nucleotomy and post-operative complication of herniated disk treatment, one was related to infection of an epidural catheter in a patient suffering from rheumatoid arthritis and the third followed urinary investigation in a patient with prostate cancer. Infection was cured in all patients with antibiotic treatment.

Pseudo-felty's syndrome. Report of a case with no symptoms for at least 15 years.

The prognosis of large granular lymphocyte proliferation with rheumatoid arthritis (pseudo-Felty's syndrome) remains uncertain. We report a case with a 15-year follow-up. To date, the patient has not developed lymphadenopathy, splenomegaly, abnormalities in erythrocyte or platelet counts, neutropenia or severe or unexplained infections.

Detectable levels of pyridinoline are present in synovial fluid from various patients with knee effusion: preliminary results.

There is a major interest for using biochemical markers of bone metabolism as a non-invasive tool for diagnostic purposes in the field of bone and joint diseases. Based upon the fact that the pyridinium cross-links of collagen are markers of bone and cartilage degradation, this study was designed to assess the presence of pyridinoline in synovial fluid samples originating from various arthritic and non-arthritic knee joints. Using a sample pooling method, significant levels of pyridinoline could be measured in synovial fluid by high performance liquid chromatography.

Acute polyarthritis after BCG-therapy for bladder carcinoma in a patient with ankylosing spondylitis.

A case of polyarthritis following intravesical administration of bacillus Calmette-Guérin (BCG) for bladder carcinoma is reported in a patient with long-standing ankylosing spondylitis. Possible links between BCG-therapy and joint manifestations are discussed in the light of data from the literature. Patients who develop joint manifestations after BCG-therapy are often HLA B27-positive.

Tenascin distribution in articular cartilage from normal subjects and from patients with osteoarthritis and rheumatoid arthritis.

Objective: To determine whether tenascin is present in normal and diseased human cartilage.

Methods: Immunohistochemical and biochemical assays with a monoclonal antibody against all tenascin isoforms (BC-4) were used.

Results: Cartilage samples from osteoarthritis and rheumatoid arthritis patients contained increased amounts of tenascin compared with the levels in normal cartilage.

General diseases of the spine in rheumatoid arthritis.

The past year has contributed to a better understanding of the management of cervical spine instability in patients with rheumatoid arthritis. Neurologic recovery after surgery is better and the percentage of recurrence is lower in cases of isolated atlantoaxial subluxation (AAS) compared with cases of AAS associated with basilar invagination or with subaxial subluxation. This suggests that the sooner surgery is undertaken in limited AAS, the better the outcome.

Methotrexate serum binding in rheumatoid arthritis.

The serum binding of methotrexate was determined by equilibrium dialysis using radiolabelled methotrexate. Methotrexate was only albumin-bound in serum. The binding was 46% in controls versus 42% in rheumatoid arthritis and 44% in cancer.