Correlates of radiographic changes in Nigerian patients with osteoarthritis of the knee

Background:To determine the relationship between age, gender,and duration of Knee Osteoarthritis and radiographic changes using the Kellgren – Lawrence (K – L) grading.Methods:The study was retrospective and cross-sectional.We reviewed the case notes of patients with knee osteoarthritis attending a  rheumatology clinic in Lagos over a ten year period,looking at their ages,gender,disease duration,K-L grading and deformities from radiological reports.Results:Three hundred and eighteen patients were studied, of which 261(82.08%) were females.Their ages range between 31 and 91 years, with a mean of 60.92±10.96.The least duration of complaints at the time of presentation was 1.5 months, the longest 348 months, with a median of 48 months. Right knee joint alone was affected in 31 (9.84%), left knee in 21(6.67%), and both in 263 (83.49%) patients.The right knee joint alone was affected in 31 (9.75%) patients,left knee in 21(6.60%) patients,and both knees in 266 (83.65%) patients.Six patients (1.89%) had K-L grade 0,12 had 1 (3.77%),168 had 2 (52.83 %),107 had 3 (33.65%),and 25 (7.86%) had K-L grade 4. Deformities noted in 32 patients, among which Genu valgus seen in 18 (56.25%), Genu Varus in 11 (34.38%), and fixed flexion deformities in 1 patient (3.13%); both Valgus and Varus in 1 patient (3.13), and both Varus and Fixed flexion deformities in 1 patient(3.13%). Among patients who were 44yrs and below,19 (79%) had K-L grade II;while in those 65yrs and above, 57 (44%) had grade III, with a p value of 0.00. But there were no statistically significant differences in K-L grading between males and females, and between K-L grading withdeformities, or with the duration of knee OA at the time of presentation (p> 0.05).Conclusion:This study,as in previous ones,showed that the age of the patient with knee OA is directly proportional to the likely severity of the K-L radiographic grading, but not with disease duration.Key Words: Knee Osteoarthritis,Relationships,Kellgren – Lawrence (K – L) gradin

Generalized lymphadenopathy as an initial presentation of systemic lupus erythematosus: case report and review of the literature

Abstract Background Systemic lupus erythematosus (SLE) is a chronic multisystemic autoimmune disorder with a wide array of clinical manifestations. Lymphadenopathy is occasionally observed in patients with SLE, and although it is sometimes a feature of active disease, it is rarely the initial presenting feature at the time of diagnosis. Case presentation We report the case of a 35-year-old woman with clinical features of generalized lymphadenopathy, fatigue, fever, and malaise of approximately 3 months duration with no other constitutional disorders or systemic involvement suggestive of SLE. Despite extensive laboratory, radiological, and histological evaluations for malignancies and infectious causes of generalized lymphadenopathy, all results returned normal. About a month later, she developed inflammatory polyarthritis, with a markedly elevated erythrocyte sedimentation rate (ESR) of 120 mm/h, and a subsequent serologic workup confirmed the diagnosis of SLE. Autoimmune serology testing revealed positive results for various antibodies, including antinuclear antibody (ANA) at a titre of 1:5120, homogenous and speckled pattern, anti-Sm, anti-dsDNA, U1-snRNP, Ku, SSA-AntiRo, SSB-AntiLa, anti-SM/RNP, anti-Histone, ribosomal-p protein, and anti-nucleosome antibodies. The diagnosis of SLE was established using the 2019 European League Against Rheumatism/American College of Rheumatology (EULAR/ ACR) criteria. She was on oral prednisolone, hydroxychloroquine, and calcium/vitamin D3 tablets. The patient improved remarkably, all swollen lymph nodes regressed spontaneously and she had no further need for a hematology review. Conclusion While similar cases have been reported in Europe and some parts of Asia, in Africa, a careful search of the literature revealed that such cases have been reported only from Egypt in North Africa and not from other parts of the continent; hence, this case report highlights the importance of recognizing atypical presentations of SLE to improve awareness and diagnosis in different regions

Prevalence and Predictors of Chronic Kidney Disease in a Semiurban Community in Lagos

Background and Objectives. The prevalence of noncommunicable diseases like chronic kidney disease is on the rise in third-world countries. In Nigeria and most sub-Saharan African countries, there is dearth of community-based studies on prevalence and predictors of chronic kidney disease, prompting us to undertake this study. Materials and Methods. This was a cross-sectional study, aimed at ascertaining the prevalence and predictors of chronic kidney disease (CKD) in a semiurban community in Lagos, Southwest Nigeria. The study’s subjects were recruited from Agbowa community in Ikosi-Ejirin Local Council Development Area of Lagos state. The community was randomly selected. Questionnaires were used to obtain relevant information from the subjects. Body mass index, anthropometric measurements, and other relevant data were also collected. Results. CKD was observed in 30 subjects given prevalence of 7.5% in the community. Nine out of the 30 subjects (30%) with CKD were males, while 21 (70%) subjects were females. The prevalence of CKD was significantly higher in the female population. 28 of the subjects with CKD were in stage 3, while 2 of the subjects with CKD were in stage 4. Age, hypertension, and hyperuricemia were significantly associated with CKD. Using multiple logistic regression analysis, 4 variables predicted CKD in the study population. These were age (P =0.01, OR = 0. 274, CI = 0.102 – 0.739), hypertension (p = 0.011, OR = 0. 320, CI = 0.132 – 0.773), hyperuricemia (p=0.001, OR = 0.195, CI =0.083 – 0.461), and female sex (p = 0.009, OR = 3.775, CI = 1.401 – 10.17). Conclusion. The prevalence of CKD in the population is low compared with other studies from other parts of the country, and the predictors included age, hypertension, hyperuricemia, and female gender. This is the first community-based study in Nigeria to identify hyperuricemia as a risk factor for chronic kidney disease in the country