Biomedical subjects
Publications and source records attributed to G Gemignani.
We report the case of a man with ankylosing spondylitis involving the symphysis pubis and some intervertebral discs in addition to the sacroiliac joints. The bone adjacent to each inflammatory area showed an unusually exuberant sclerosis. In the early phases of evolution the appearance of sacroilitis was indistinguishable from that of osteitis condensans ilii.
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A 53-year-old man affected by ankylosing spondylitis associated with psoriasis developed bilateral tarsal tunnel syndrome caused by synovitis of the accompanying sheaths of the tendons that run through the 'fibro-osseous tunnel'. This report confirms the hypothesis that the tarsal tunnel syndrome may be a clinical manifestation of seronegative spondyloarthropathy.
The development of articular manifestations in the course of chronic urticaria or in urticarial vasculitis has been widely reported. It is not completely clear, however, whether common pathogenetic mechanisms are involved in all patients with these clinical features. Four consecutive patients with simultaneous urticarial and articular manifestations, but without any evidence of an immune complex mediated disease, are described. The HLA-B51 antigen was positive in all these patients, suggesting that a common genetic background may be present in some cases of urticaria with articular complaints.
Two more cases of B27 associated peripheral arthritis triggered by physical injury are reported. One patient developed arthritis after a minor insult and in the other Reiter's syndrome occurred after the injury. Possibly, trauma causes release of self antigens from the injured joints.
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Behçet's disease is a multisystemic vasculitis of unknown aetiology. Generally, it is characterized by recurrent aphthous stomatitis, recurrent genital ulcers, uveitis with hypopion. Recently some authors reported that patients with Behçet's disease show frequently audio-vestibular involvement. We observed a 40 year-old man (case A) and a 66 year-old woman (case B) affected by Behçet's disease for more than 10 years, showing a sudden deafness occurring during an exacerbation of the disease. In both cases there was a sensorineural hearing-loss, unilateral or bilateral. One patient received early high-dose cortisone therapy. General symptoms and audiovestibular function, both have completely recovered.
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The case of a 45 year old woman affected by both Behçet's syndrome (BS) and ankylosing spondylitis (AS) is reported. Cervical spine involvement was observed long before the appearance of the sacroiliac and lumbar changes.
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The case of a 37 year old man with a longstanding HLA-B27 associated bilateral Achilles tendinitis without seronegative spondyloarthropathy is reported. This case suggests that heel enthesopathy may for a long time be the only clinical manifestation of the HLA-B27 associated disease process.
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The authors examine the diagnostic value of two non-invasive techniques--i.e. ultrasound and computerized teletermography--in the diagnosis of patellar enthesopathies. Such a pathology is quite frequent in young athletes, at various stages. The patients were grouped in two categories, according to their age when the trauma occurred, and to the peculiarities of both enthesopathic localization and imaging. The use of both techniques, either one prevailing over the other according to the different evolutive phases of enthesopathies, provides useful information as to detecting and determining the disease. Finally, the authors recommend a combined use of these techniques, especially in young athletes, possibly avoiding conventional X-rays.
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