Distal extremity swelling with pitting edema in psoriatic arthritis: evidence of 2 pathological mechanisms.
Identifieur interne : 004C19 ( PubMed/Corpus ); précédent : 004C18; suivant : 004C20Distal extremity swelling with pitting edema in psoriatic arthritis: evidence of 2 pathological mechanisms.
Auteurs : C. Salvarani ; F. Cantini ; I. Olivieri ; L. Niccoli ; C. Senesi ; L. Macchioni ; L. Boiardi ; A. PadulaSource :
- The Journal of rheumatology [ 0315-162X ] ; 1999.
English descriptors
- KwdEn :
- Adult, Arthritis, Psoriatic (diagnosis), Arthritis, Psoriatic (diagnostic imaging), Arthritis, Psoriatic (physiopathology), Edema (diagnosis), Edema (etiology), Female, Hand (diagnostic imaging), Hand (pathology), Humans, Magnetic Resonance Imaging, Male, Middle Aged, Radiography, Tenosynovitis (diagnosis), Tenosynovitis (diagnostic imaging), Tenosynovitis (etiology).
- MESH :
- diagnosis : Arthritis, Psoriatic, Edema, Tenosynovitis.
- diagnostic imaging : Arthritis, Psoriatic, Hand, Tenosynovitis.
- etiology : Edema, Tenosynovitis.
- pathology : Hand.
- physiopathology : Arthritis, Psoriatic.
- Adult, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Radiography.
Abstract
Distal extremity swelling with pitting edema due to altered lymphatic drainage has been reported in some patients with psoriatic arthritis (PsA). The edema usually affected the upper limbs in an asymmetric pattern and was resistant to therapy. We describe 2 additional cases. The distal swelling and pitting edema responded promptly and completely to corticosteroids in the first patient but persisted in the second. Lymphoscintigraphy and magnetic resonance imaging (MRI) revealed a predominant tenosynovitis in the hand without lymphedema in the first patient, and impaired lymphatic drainage without tenosynovial sheath involvement in the second. We conclude that 2 different mechanisms, characterized by a different response to therapy, may be associated with the same clinical picture of distal swelling with pitting edema in patients with psoriatic arthritis. Lymphoscintigraphy and MRI are useful in defining the structures involved and in predicting the prognosis.
PubMed: 10451085
Links to Exploration step
pubmed:10451085Le document en format XML
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<author><name sortKey="Salvarani, C" sort="Salvarani, C" uniqKey="Salvarani C" first="C" last="Salvarani">C. Salvarani</name>
<affiliation><nlm:affiliation>Servizio di Reumatologia, Arcispedale S. Maria Nuova, Reggio Emilia, Italy. salvarani.carlo@asmn.re.it</nlm:affiliation>
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<author><name sortKey="Cantini, F" sort="Cantini, F" uniqKey="Cantini F" first="F" last="Cantini">F. Cantini</name>
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<author><name sortKey="Olivieri, I" sort="Olivieri, I" uniqKey="Olivieri I" first="I" last="Olivieri">I. Olivieri</name>
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<author><name sortKey="Niccoli, L" sort="Niccoli, L" uniqKey="Niccoli L" first="L" last="Niccoli">L. Niccoli</name>
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<author><name sortKey="Senesi, C" sort="Senesi, C" uniqKey="Senesi C" first="C" last="Senesi">C. Senesi</name>
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<author><name sortKey="Macchioni, L" sort="Macchioni, L" uniqKey="Macchioni L" first="L" last="Macchioni">L. Macchioni</name>
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<author><name sortKey="Boiardi, L" sort="Boiardi, L" uniqKey="Boiardi L" first="L" last="Boiardi">L. Boiardi</name>
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<author><name sortKey="Padula, A" sort="Padula, A" uniqKey="Padula A" first="A" last="Padula">A. Padula</name>
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<author><name sortKey="Olivieri, I" sort="Olivieri, I" uniqKey="Olivieri I" first="I" last="Olivieri">I. Olivieri</name>
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<author><name sortKey="Niccoli, L" sort="Niccoli, L" uniqKey="Niccoli L" first="L" last="Niccoli">L. Niccoli</name>
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<author><name sortKey="Senesi, C" sort="Senesi, C" uniqKey="Senesi C" first="C" last="Senesi">C. Senesi</name>
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<author><name sortKey="Macchioni, L" sort="Macchioni, L" uniqKey="Macchioni L" first="L" last="Macchioni">L. Macchioni</name>
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<author><name sortKey="Boiardi, L" sort="Boiardi, L" uniqKey="Boiardi L" first="L" last="Boiardi">L. Boiardi</name>
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<term>Arthritis, Psoriatic (diagnosis)</term>
<term>Arthritis, Psoriatic (diagnostic imaging)</term>
<term>Arthritis, Psoriatic (physiopathology)</term>
<term>Edema (diagnosis)</term>
<term>Edema (etiology)</term>
<term>Female</term>
<term>Hand (diagnostic imaging)</term>
<term>Hand (pathology)</term>
<term>Humans</term>
<term>Magnetic Resonance Imaging</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Radiography</term>
<term>Tenosynovitis (diagnosis)</term>
<term>Tenosynovitis (diagnostic imaging)</term>
<term>Tenosynovitis (etiology)</term>
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<keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Arthritis, Psoriatic</term>
<term>Edema</term>
<term>Tenosynovitis</term>
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<keywords scheme="MESH" qualifier="diagnostic imaging" xml:lang="en"><term>Arthritis, Psoriatic</term>
<term>Hand</term>
<term>Tenosynovitis</term>
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<keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Edema</term>
<term>Tenosynovitis</term>
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<keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Arthritis, Psoriatic</term>
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<keywords scheme="MESH" xml:lang="en"><term>Adult</term>
<term>Female</term>
<term>Humans</term>
<term>Magnetic Resonance Imaging</term>
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<front><div type="abstract" xml:lang="en">Distal extremity swelling with pitting edema due to altered lymphatic drainage has been reported in some patients with psoriatic arthritis (PsA). The edema usually affected the upper limbs in an asymmetric pattern and was resistant to therapy. We describe 2 additional cases. The distal swelling and pitting edema responded promptly and completely to corticosteroids in the first patient but persisted in the second. Lymphoscintigraphy and magnetic resonance imaging (MRI) revealed a predominant tenosynovitis in the hand without lymphedema in the first patient, and impaired lymphatic drainage without tenosynovial sheath involvement in the second. We conclude that 2 different mechanisms, characterized by a different response to therapy, may be associated with the same clinical picture of distal swelling with pitting edema in patients with psoriatic arthritis. Lymphoscintigraphy and MRI are useful in defining the structures involved and in predicting the prognosis.</div>
</front>
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<Title>The Journal of rheumatology</Title>
<ISOAbbreviation>J. Rheumatol.</ISOAbbreviation>
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<ArticleTitle>Distal extremity swelling with pitting edema in psoriatic arthritis: evidence of 2 pathological mechanisms.</ArticleTitle>
<Pagination><MedlinePgn>1831-4</MedlinePgn>
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<Abstract><AbstractText>Distal extremity swelling with pitting edema due to altered lymphatic drainage has been reported in some patients with psoriatic arthritis (PsA). The edema usually affected the upper limbs in an asymmetric pattern and was resistant to therapy. We describe 2 additional cases. The distal swelling and pitting edema responded promptly and completely to corticosteroids in the first patient but persisted in the second. Lymphoscintigraphy and magnetic resonance imaging (MRI) revealed a predominant tenosynovitis in the hand without lymphedema in the first patient, and impaired lymphatic drainage without tenosynovial sheath involvement in the second. We conclude that 2 different mechanisms, characterized by a different response to therapy, may be associated with the same clinical picture of distal swelling with pitting edema in patients with psoriatic arthritis. Lymphoscintigraphy and MRI are useful in defining the structures involved and in predicting the prognosis.</AbstractText>
</Abstract>
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