Temporomandibular Arthritis in Association with Rheumatoid Arthritis -a Differential Diagnostic Approach to Temporomandibular Pain in Dental Practice

Reumatoidni je artritis sustavska kronična bolest koja često zahvaća i temporomandibularne zglobove. Ponekad je takav znak i prvi simptom početka bolesti. Stomatolog praktičar u svojemu radu može se susresti s takvom kazuistikom. Rad prikazuje pregled simptoma i kliničkih znakova koji se manifestiraju u bolesnika s reumatoidnim artritisom, osobito u području temporomandibularnoga zgloba. Navedeni su i drugi diferencijalnodijagnostički uzroci boli u području temporomandibularnoga zgloba.Rheumatoid arthritis is a chronic systemic disease, which often also affects temporomandibular joints. Occasionally such a sign may indicate the first symptom of the commencement of the disease. A dentist in practice can encounter such casuistics. The paper presents a review of symptoms and clinical signs manifesting in a patient with rheumatoid arthritis, particularly in the area of the temporomandibular joint. Other differential diagnostic causes of pain in the area of temporomandibular joint are also mentioned

The role of diagnostic ultrasound of hands and feet in the patients with rheumatoid arthritis

Dijagnostički ultrazvuk (UZV) muskuloskeletnog sustava posljednjih 10-ak godina revolucionarno je promijenio pristup liječenju reumatoloških bolesnika, posebice s upalnim reumatskim bolestima. Potrebni su dodatni napori kako bi se ta metoda još više uvriježila u svakodnevnoj reumatološkoj praksi. Ključan je dobar trening i standardizacija treninga, a posljednjih godina na tom planu vidljivi su znatni pomaci. Glavni nedostatak primjene je nedostatak vremena za provođenje metode. Ostaju otvorena pitanja validnosti i reproducibilnosti metode, a iz godine u godinu i ta pitanja se postupno rješavaju. U reumatologiji potencijal za korištenje dijagnostičkog ultrazvuka leži u mogućnosti rane i točne dijagnostike artritisa, praćenju bolesti i provođenju ultrazvučno vođenih intervencija.In the past decade diagnostic musculoskeletal ultrasound (US) has revolutionized the approach of treating the patients with inflammatory rheumatic conditions. There is still need for further efforts in establishing the US as a standard tool in everyday rheumatologic practice. Appropriate education and training is essential to standardize the method. Main limitation of the method is the lack of time for performing US examination because the US is time consuming. Concerns regarding the validity and reproducibility are being addressed. Nowadays in rheumatology, potential in using US lies in its possibility for early and accurate diagnosis of arthritis, monitoring of the disease and conduction of US-lead interventions in rheumatology

The hip in musculoskeletal disorders - nonsurgical management

U tekstu su opisana osnovna načela konzervativnog liječenja kuka u najčešćim reumatskim bolestima. Naglašena je važnost nefarmakološkog liječenja poput korekcije predispionirajućih činitelja, smanjenja tjelesne težine u pretilih bolesnika ili korekcije varus-valgus deformacija koljena. Rehabilitacija je usmjerena individualno prema svakom bolesniku i uz edukaciju znatno pripomaže bolesniku postizanju maksimalnih ciljeva u rehabilitaciji. Nesteroidni protuupalni lijekovi predstavljaju lijekove prvog izbora u liječenju bolesti kuka u reumatskim bolestima. To su istodobno i najčešće primjenjivani lijekovi koji u manjim dozama djeluju čisto analgetski, u višim dozama imaju protuupalni učinak.Basic principles of nonsurgical management of hip diseases encountered in most frequent rheumatic conditions are described. Non-pharamacologic therapy like correction of predisposing factors, weight reduction in the obese patients and correction of valgus and varus knee deformities are emphasised. Individually prescribed rehabilitation and education assissts the patient in reaching his or her maximal potential. Nonsteroidal antiinflammatory drugs (NSAR) are the drugs of first choice in pharmacological management. They are widely used; in low dosages NSAR are effective analgesics; in higher dosages, they have anti-inflammatory activity

Complex regional pain syndrome - pathophysiology, clinical presentation and treatment

1994. godine skupina stručnjaka okupljena od strane Međunarodnog udruženja za proučavanje boli (eng. International Association for the Study of Pain - IASP) donijela je nove dijagnostičke kriterije za refleksnu simpatičku distrofiju (RSD) i kauzalgiju i preimenovala ta stanja u kompleksni regionalni bolni sindrom (KRBS), tip I i tip II. KRBS jest složeni patofiziološki entitet obilježen boli, oteklinom, trofičkim i vazomotornim promjenama, ograničenom funkcijom i relativno brzim razvojem osteoporoze zahvaćenog dijela. U radu su detaljno opisani mogući patofiziološki mehanizmi nastanka boli, klinička slika i farmakološko liječenje uz intervencijske procedure.In 1994, a consensus group of experts gathered by the International Association for the Study of Pain (IASP) agreed on new diagnostic criteria for the reflex sympathetic dystrophy (RSD) and causalgia, and renamed them complex regional pain syndrome (CRPS) types I and II, respectively. CRPS is a complex pathophysiological entity characterised by pain, trophic and vasomotoric changes, limited function of affected body part and relatively fast development of osteoporosis of affected region. We described possible pathophysiological mechanisms which caused the pain, clinical presentation of the disease and tretment which includes all available pharmacological modalities as well as interventional procedures

The new therapeutic options in the treatment of rheumatoid arthritis

Reumatoidni artitis (RA) kronična je, upalna, autoimuna bolest od koje boluje približno 1% svjetske populacije. Složena mreža citokina odgovorna je za pokretanje i održavanje upalnih zbivanja u reumatoidnom artritisu. Ovaj pregled prikazuje najnovija saznanja o terapiji reumatoidnog artritisa lijekovima usmjerenim prema tumor-necrosis factor-alpha (TNF-alfa), inhibitorima interleukin-1, te lijekovima usmjerenim prema stanicama T i B poput abatacepta i rituksimaba.Rheumatoid arthritis(RA) is a chronic, inflammatory, autoimmune disease wich affects approximately 1% of world population. Multiple cytokines operate as a network in a redundant and overlapping manner in rheumatoid artrhitis. This review highlights recent data on tumor-necrosis factor alpha (TNF-alfa), interleukin-1 inhibitors, as well as new biological agents abatacept and rituximab wich are specifically targeted to T cells and to population of B cells

The new therapeutic options in the treatment of spondiloarthritides

Terapijske opcije za liječenje bolesnika s težim formama pondiloartritisa prilično su ograničene. U pregledu su prikazana novija saznanja i lijekovi u liječenju spondiloartritisa. Danas postoje brojni jasni dokazi da je terapija lijekovima usmjerenim prema tumor-necrosis factor-alpha (TNF-alfa) vrlo učinkovita u bolesnika sa SpA, posebice u psorijatičnom artritisu (PsA) i ankilozantnom spondilitisu (AS).Therapeutic options for patients suffering from the more severe forms of SpA have been rather limited. The review focuses on the new therapeutic options in treatment spondyloarthritides. There is now clearly evidence that TNF-alpha inhibitors are effective and safe agents in managing psoriathic arthritis (PsA) and ankylosing spondylitis (AS)