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Biomedical subjects

G Evison

Publications and source records attributed to G Evison.

At least 19 recordsLinked to original sources
PubMed2000

Ankylosing spondylitis and the shoulder: commonly involved but infrequently disabling.

OBJECTIVE: To undertake 2 independent studies of shoulder involvement in patients with ankylosing spondylitis (AS) and assess the frequency of shoulder pain, stiffness, and loss of movement and function. To evaluate and correlate shoulder symptoms, function, range of movement, and radiology. METHODS: A cross sectional design was used in both studies. In Study A, a self-administered questionnaire was sent to members of the National Ankylosing Spondylitis Society of the UK and patients attending the Royal National Hospital for Rheumatic Diseases. In Study B, a clinical assessment of 88 patients with AS was undertaken that included a radiological assessment of 26 consecutive patients. RESULTS: In Study A, 15.2% and 13.8% of subjects had severe/very severe shoulder pain or stiffness, respectively. In Study B the corresponding findings were 9.6% and 17.6%. Patient reported disability associated with shoulder involvement was uncommon. Study A revealed that patients with severe/very severe shoulder pain were more likely to have significant hip and knee involvement. Significant shoulder involvement appears to be as common as involvement of the hip joint. In Study B radiological changes were common, being present in 31% of patients, but were often minor. There was a significant correlation between the sum of the stiffness, abduction, and flexion scores for both shoulders and the total radiological score (r = 0.87; p<0.001). CONCLUSION: The results suggest that shoulder symptoms and loss of shoulder mobility are common in patients with AS, and correlate with higher pain scores and influence of AS on their lives as assessed by the Arthritis Impact Measurement Scale, but are rarely disabling. Involvement of the shoulder joint in AS correlates with involvement of other peripheral joints as well as the extent of radiographic change on shoulder radiographs.

Adult↗
PubMed1995

Air in the oesophagus: a sign of oesophageal involvement in systemic sclerosis.

An air oesophagogram, defined as a column of air involving the entire oesophagus, seen on a lateral chest X-ray was observed in 6 (20%) of 30 consecutive patients with systemic sclerosis (SSc) but in none of the controls. The presence of this sign was unrelated to the clinical subset of SSc and to age but was associated with the symptom of regurgitation.

Adult↗
PubMed1994

The cervical spine in psoriatic arthritis: a clinical and radiological study.

Cervical spondylitis has been reported in 35-75% of patients with PsA. The clinical and radiological changes of the cervical spine were evaluated in 75 patients with PsA. Cervical spine involvement was found in 45% of those examined and 36% of patients X-rayed. The pattern of disease was ankylosing in 85% of patients, characterized by ankylosis, syndesmophytes and ligamentous ossification. Twelve per cent had radiological evidence of cervical spondylitis without clinical evidence of disease. The major predictor of cervical spine disease was the duration of psoriatic arthropathy. Cervical spondylitis was not related to disease severity, extent of skin or nail involvement and neither did it reflect any homogeneous pattern of disease.

Adult↗
PubMed1994

Psoriatic arthritis: outcome of disease subsets and relationship of joint disease to nail and skin disease.

Subgroups of PsA have been described but their relationship to the mode of onset of arthritis, to DIP joint disease and to nail and skin disease remains controversial. Therefore, the pattern of disease was documented in 100 patients with PsA in whom the mode of onset was known. The patients were divided into six subgroups: monoarthritis; DIP joint disease only; oligoarthritis; polyarthritis; spondyloarthropathy and arthritis mutilans. Sixty-four patients changed pattern. Nail disease (67% of total) was more common in patients with DIP joint disease (27% of total) and was significantly associated with adjacent DIP joint disease. Skin and nail disease severity did not correlate with joint severity, joint activity or functional status, nor differ between subgroups. Therefore, the mode of onset does not predict outcome in the majority. The topographic association of nail disease and involvement of the adjacent DIP joints suggests a common local inflammatory mechanism.

Adolescent↗
PubMed1992

Pseudoarthroplastic' hand in arthritis mutilans.

A 46-year-old man with arthritis mutilans and hand radiographic appearance suggestive of previous surgery is described. We propose the term 'pseudoarthroplastic' hand for this radiological finding.

Adult↗
PubMed1991

Predictors of the long-term outcome of early synovitis: a 5-year follow-up study.

One hundred patients who presented to an Early Synovitis Clinic in 1979-81 were called for review after a minimum of 5 years. Sufficient data for analysis were obtained in 88 cases, of whom 36 had a final diagnosis of rheumatoid arthritis (19 seropositive, 17 seronegative) and 16 human parvovirus B19 arthropathy. Outcome was assessed by persistence of symptoms greater than 24 months and functional disability by Health Assessment Questionnaire. Sixty-two patients had persistent disease, with 26 showing some functional impairment (positive HAQ FDI). A number of presenting features were assessed for their ability to predict outcome at 5 years. Polyarticular onset of disease was associated with a poor prognosis but lacked both specificity and sensitivity. Certain laboratory tests at presentation, including positive rheumatoid factor and low serum sulphydryl levels, also indicated a poor outcome. Combining these serological abnormalities gave 100% specificity for detecting persistent, disabling disease but with rather low sensitivity. Thus, other test systems are required to increase further the successful prediction of clinical outcome in patients with early synovitis.

Adolescent↗
PubMed1990

Arthropathy of hands and feet in systemic lupus erythematosus.

Hand and foot radiographs of 51 patients with systemic lupus erythematosus (SLE) were examined prospectively and correlations made between radiological, clinical and serological data. At least one abnormality was present in the hands of 53% and in the feet of 66.7% of patients. Jaccoud's type arthropathy affected the hands of 12% and the feet of 8% of patients. Erosions of the ulnar styloids were common (27.5%) but their presence did not correlate with any clinical or laboratory feature of SLE. Antibodies to U1 RNP correlated with hand deformity, while severity of radiological damage related mainly to disease duration.

Adolescent↗
PubMed1989

HLA-DO-related restriction fragment length polymorphisms in rheumatoid arthritis: evidence for a link with disease expression.

Eighty-three patients with rheumatoid arthritis (RA) were investigated for HLA-DQ and DR locus restriction fragment length polymorphisms (RFLP). Of the 83 patients, 61 (73%) possessed the DR4 allele and within this group we have investigated the relative frequencies of two DQ beta gene variants of DQw3, DQw7 and DQw8, one of which we had previously found to be raised in Felty's syndrome. This analysis revealed a significantly higher frequency of DQw7 containing haplotypes in DR4 positive rheumatoid patients (64%) than in DR-matched healthy controls (42%). Furthermore, the distribution of DQw7 was biased towards those patients with greater disability indicated by the HAQ score, more systemic disease and higher titres of rheumatoid factor, suggesting that DQw7 may contribute to disease expression.

Arthritis, Rheumatoid↗
PubMed1986

Unusual radiographic features in a female patient with ankylosing spondylitis.

A 71 year old woman suffering from ankylosing spondylitis with aggressive peripheral joint disease for 46 years developed unusual radiographic features in the hips and knees. The pathogenic processes responsible are uncertain, and no histology is yet available. Although she had been treated with radiotherapy to the knees, there was no similar history to explain the hitherto unreported appearance of the hips.

Aged↗
PubMed1983

Osteoarthritis and articular chondrocalcinosis in the elderly.

One hundred consecutive admissions to an acute geriatric unit were examined for clinical and radiographic evidence of osteoarthritis (OA) and articular chondrocalcinosis (ACC). Thirty-four patients had ACC. This was age related, the prevalence rising from 15% in patients aged 65-74 years to 44% in patients over 84 years. The commonly involved joints were the knee (25%), public symphysis (15%), and wrist (9%). No other aetiological factors predisposing to ACC were found. Of the 25 patients with ACC in the knee 7 had no symptoms or signs and no radiographic evidence of OA at that site. However, the combination of ACC and radiographic OA was characterised by an increase in clinical joint disease. Features of inflammation (joint swelling and joint line tenderness) involving the knee, wrist, and elbow were particularly common in ACC. It is concluded that ACC is common in the elderly and is associated with an increased incidence of joint disease.

Aged↗
PubMed1981

Bone formation associated with osseous metastases from bladder carcinoma.

Twenty-four cases of carcinoma of the urinary bladder, involving bone, have been reviewed. Eighteen of these were distant metastases beyond the pelvis. The lesions were predominantly osteolytic. Ossification in the soft tissues adjacent to the bone metastasis was observed in three cases, all involving the left tibia. The reason for this site of predilection remains obscure.

Adult↗