1/37. Posterior interosseous nerve palsy in a patient with rheumatoid synovitis of the elbow: a case report and review of the literature.A 54-year-old woman with rheumatoid arthritis developed loss of finger extension in the left hand. history, physical examination, and electromyography led to the diagnosis of posterior interosseous nerve palsy secondary to synovitis of the elbow. Anterior decompression and synovectomy resulted in a complete recovery. A literature review describes similar cases and compares outcomes.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
2/37. Pearls of the plain film.Three case presentations from a general rheumatologic practice show the importance of the plain x-ray in making the diagnosis of arthritis. Clinical history, physical examination, and the plain x-ray are likely to provide the diagnosis most often over laboratory and more technologically advanced imaging studies for arthritis.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
3/37. A patient with severe palindromic rheumatism and frequent episodes of pain.A 44-year-old man began to experience episodes of joint pain with erythema in his knees, elbows, shoulders, and hands in April 1996. He was diagnosed as having palindromic rheumatism. Due to the increasing frequency and severity of these episodes, he was admitted to our hospital in May 1999. Heat therapy to the affected area produced a rapid improvement in symptoms. In addition, the continued use of physical therapy during symptom-free periods tended to reduce the frequency and severity of pain attacks. We present this case and discuss treatment options in patients with palindromic rheumatism.- - - - - - - - - - ranking = 0.12727416694642keywords = physical (Clic here for more details about this article) |
4/37. The use of traction methods to correct severe cervical deformity in rheumatoid arthritis patients: a report of five cases.STUDY DESIGN: A case series is presented. OBJECTIVES: To describe the methods of correction used in this study for flexible severe cervical deformity, and to report the results in patients with rheumatoid arthritis. SUMMARY OF BACKGROUND DATA: Long-standing rheumatoid arthritis can lead to severe cervical deformity, causing significant functional deficits and poor cosmesis. Information on the use of traction combined with surgical stabilization to achieve correction of flexible deformity in rheumatoid patients is sparse in the English literature. methods: A review of five cases, including pertinent history, physical examination, radiographic evaluation, traction techniques, surgical stabilization, and outcomes, was conducted. RESULTS: Excellent correction of deformity and radiographic union were achieved in all the patients. One patient had minimal loss of correction after surgery and thereafter remained stable. Pin tract infections were the only significant complication. CONCLUSIONS: Severe cervical flexible deformity in rheumatoid patients can cause significant disability and can be treated successfully with a combination of traction techniques and surgical stabilization.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
5/37. Cricoarytenoid arthritis: a cause of acute upper airway obstruction in rheumatoid arthritis.PURPOSE: To report acute upper airway obstruction due to cricoarytenoid arthritis, a well known but uncommon complication of rheumatoid arthritis. CLINICAL FEATURES: We report the case of a 70-yr-old female scheduled for a colostomy who had been suffering from rheumatoid arthritis for 17 years. Preoperative history and physical examination revealed no cardiopulmonary compromise. anesthesia was induced while an assistant immobilized the cervical spine and an atraumatic intubation was performed. Surgery was uneventful. Muscle paralysis was reversed, demonstrated by normalization of the train-of-four response, and the patient was extubated awake. Shortly postextubation, the patient developed inspiratory stridor, which disappeared after a second dose of neostigmine. The patient was transported to the postanesthesia care unit. Just prior to arrival the patient once again developed inspiratory stridor, became distressed, and oxygen saturation decreased. Direct laryngoscopy followed by a nasal fibreoptic examination of the larynx was performed. Cricoarytenoid arthritis secondary to rheumatoid arthritis with airway compromise was diagnosed. An uneventful awake tracheostomy was performed. The patient was discharged on day ten with a colostomy and a tracheostomy in place. One month postdischarge the patient's trachea was decannulated. On follow-up, a normal voice and mobile cords were observed. CONCLUSION: Cricoarytenoid arthritis is an infrequent complication of rheumatoid arthritis. A thorough history and physical examination are necessary to recognize signs and symptoms of cricoarytenoid arthritis. Prompt recognition of airway obstruction due to cricoarytenoid arthritis is essential for appropriate management.- - - - - - - - - - ranking = 2keywords = physical examination, physical (Clic here for more details about this article) |
6/37. Anterior tibial compartment syndrome due to the pyomyositis in a patient with rheumatoid arthritis. A case report.Anterior tibial compartment syndrome was developed due to pyomyositis in a 33-year-old male patient with rheumatoid arthritis while receiving steroid therapy during the follow-up period. The preoperative physical examination, laboratory findings, MRI images, intraoperative observation and postoperative histopathological examinations confirmed the association with pyomyositis. The surgical drainage and antibiotic treatment were effective, and in the follow-up period, neuromuscular dysfunctions disappeared completely within 6 months. The patient has been asymptomatic for 4 years of follow-up. To date, anterior tibial compartment syndrome due to pyomyositis in a case with rheumatoid arthritis has not been reported.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
7/37. employment and chronic non-cancer pain: insights into work retention and loss.OBJECTIVES: To explore the work experiences of three individuals who have chronic non-cancer pain and to identify factors which may affect their ability to remain in employment. methods: Three cases were selected from a data set of six, to illustrate distinct employment history scenarios. All participants had a diagnosis of rheumatoid arthritis. Data was gathered using semi-structured, in-depth interviews that were audiotaped and later transcribed for qualitative, content analysis. Themes identified were those which related to employment experiences and appeared to be important factors influencing the retention of work. FINDINGS: Four main themes were identified: the nature of physical barriers to employment, autonomy at work, social networks, and the importance and motivation to remain in employment. CONCLUSION: These findings support existing research in relation to chronic pain and employment in general and expands upon the nature and importance of social support at work. It is suggested that the qualitative methodology illustrated here, which explores the perspectives of those still in employment (as well as those who have stopped working) may be a useful approach to investigating this important area of research.- - - - - - - - - - ranking = 0.12727416694642keywords = physical (Clic here for more details about this article) |
8/37. Nonoperative management of functional hallux limitus in a patient with rheumatoid arthritis.BACKGROUND AND PURPOSE: Functional hallux limitus (FHL) is a condition that affects motion at the first metatarsophalangeal joint and may lead to abnormal forefoot plantar pressures, pain, and difficulty with ambulation. The purpose of this case report is to describe a patient with rheumatoid arthritis (RA) and FHL who was managed with foot orthoses, footwear, shoe modifications, and patient education. CASE DESCRIPTION: The patient was a 55-year-old woman diagnosed with seropositive RA 10 years previously. Her chief complaint was bilateral foot pain, particularly under the left great toe. Her foot pain had been present for several years, but during the past 5 months it had intensified and interfered with her work performance, activities of daily living, and social life. OUTCOMES: Following 4 sessions of physical therapy over a 6-week time period, the patient reported complete relief of forefoot pain despite no change in medication use or RA disease pathophysiology. She was able to continuously walk for up to 4 hours. Left hallux peak plantar pressures were reduced from 43 N/cm2 to 18 N/cm2 with the foot orthoses. DISCUSSION: patients with RA who develop FHL may benefit from physical therapist management using semirigid foot orthoses, footwear, shoe modifications, and patient education.- - - - - - - - - - ranking = 0.25454833389284keywords = physical (Clic here for more details about this article) |
9/37. Palmar rheumatoid nodulosis associated with local pressure.Rheumatoid nodulosis is a term used to describe adult patients with rheumatoid arthritis with little or no clinical joint inflammation who have numerous subcutaneous nodules indistinguishable from those of patients with active rheumatoid arthritis. This paper reports the case of a woman with quiescent rheumatoid arthritis who developed palmar nodulosis three weeks after the strenuous activity of painting her apartment. This case illustrates the direct association between the appearance of nodulosis and physical pressure despite inactive disease.- - - - - - - - - - ranking = 0.12727416694642keywords = physical (Clic here for more details about this article) |
10/37. Normal pressure hydrocephalus found after anesthesia--a case report.Normal pressure hydrocephalus (NPH) is characterized by insidious onset and gradual development of the triad of gait disturbance, dementia, and urinary incontinence. nausea, vomiting, and signs of increased intracranial pressure do not occur. A 71-year-old male patient was scheduled for total knee replacement due to osteoarthritis of right knee joint. No neurological symptoms and signs except mild forgetfulness were detected during physical examination following admission. Due to operational mistakes, the anesthesiologist was informed that the surgery was cancelled just after completion of induction of general anesthesia. The patient was allowed to emerge from anesthesia. Unfortunately, his consciousness became drowsy the next morning. After a series of examinations, he was at last diagnosed as a case of NPH principally by the brain computed tomography scan. So he was scheduled again but this time for vetriculoperitoneal (V-P) shunt. The patient regained consciousness after V-P shunt. From this case, we learned that NPH may remain in concealment in the patients we contacted in our daily practice. A vigilant physician should keep in mind that the presentation of gait disturbance, dementia, and urinary incontinence in a patient may indicate the likelihood of NPH.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
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