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Biomedical subjects

J J Canoso

Publications and source records attributed to J J Canoso.

14 recordsLinked to original sources

Subcutaneous bursitis in scleroderma.

We encountered 3 types of subcutaneous bursitis in our patients with scleroderma: dry bursitis characterized by a rub, sterile bursitis characterized by inflammatory effusions without crystals by polarizing microscopy, and septic (staphylococcal) subcutaneous bursitis. The latter, which occurred in 6 of 40 consecutive patients, had a protracted course, was often complicated by fistulas, and tended to involve several bursae particularly in patients with extensive calcinosis.

Adult

Lupus-like presentation of human parvovirus B19 infection.

The diagnosis of systemic lupus erythematosus (SLE) was a leading initial consideration in 2 patients with rash, arthritis and hypocomplementemia. One patient also had leukopenia and thrombocytopenia. Spontaneous regression occurred. In both patients antinuclear antibodies were negative. Serologic studies indicated recent human parvovirus B19 infection. We propose adding human parvovirus B19 infection to the list of conditions that may masquerade as SLE.

Adult

A review of the use, evaluations, and criticisms of the preliminary criteria for the classification of systemic lupus erythematosus.

The use of the Preliminary Criteria for the Classification of Systemic Lupus Erythematosus (SLE) has been reviewed. Most authors describing 10 or more patients have used the criteria. Although originally designed for classification of patients, the criteria have often been used for the diagnosis of SLE. The sensitivity of the criteria was evaluated and found to be similar to the 90% reported in the original ARA trial. Studies on specificity yielded conflicting results. Various suggestions to improve the criteria have been made, including a more detailed description of some of the organ involvements and the adoption of laboratory tests that have been improved since or were unavailable at the time of original publication of the criteria.

Antibodies, Antinuclear

Reaction of superficial bursae in response to specific disease stimuli.

Although microscopic studies have shown similarities between bursal and joint membranes, little is known about bursae and their response to disease states. Eighty-six cases of superficial bursitis due to trauma, bacterial infection, or gout were reviewed and compared with cases of joint inflammation due to the same etiologies. In traumatic bursitis the bursal fluid mucin test was more abnormal and the viscosity lower than that of joint fluid in traumatic arthritis. The bursal fluid total leukocyte count of septic bursitis was less than 20,000/mm3 in 8 of 13 cases but in only 1 of 21 synovial fluids from cases of septic arthritis (P = 0.005). In gouty bursitis the mean total leukocyte count of bursal fluid was 2800/mm3, compared with a mean synovial fluid total leukocyte count of 28,700 in gouty arthritis (P less than 0.02). These findings indicate that superficial bursae react less intensely than diarthrodial joints to specific disease stimuli and that a relatively low bursal fluid leukocyte count is often present in cases of septic and gouty bursitis.

Arthritis

Acute gouty bursitis: report of 15 cases.

Fifteen cases of acute gouty bursitis were seen among 136 crystal-proved cases of gout. Bursal aspirate yielded yellow or pink fluid in 10, chalky white fluid in 1, and a small amount of bloody fluid in 4. Monosodium urate crystals were present in all. Bursal fluid leucocyte counts averaged 2.9 X 10(9)/1 compared with synovial fluid leucocyte counts that averaged 25.5 X 10(9)/1 in cases of articular gout (P less than 0.05). Gouty, septic, and idiopathic (traumatic) bursitis share clinical features, and detailed bursal fluid analysis is crucial for diagnosis.

Acute Disease

Progressive systemic sclerosis with eosinophilia and a fulminating course.

A case of progressive systemic sclerosis, with blood and pleural fluid eosinophilia and a fulminating course, is presented. Wide-mouth colonic diverticula developed within 10 weeks. Death from renal failure occured five and a half months after the onset of symptoms. The possibility of eosinophilia as a marker of severe disease in progressive systemic sclerosis is raised.

Acute Kidney Injury

Gout without crystals on initial synovial fluid analysis.

In five patients with acute arthritis in whom gout was eventually documented, an initial synovial fluid analysis failed to reveal urate crystals. Four of the patients were seen in one hospital during a period of 30 months in which 103 cases of gout were documented on initial aspiration. While this is an uncommon event, the importance of being able to make a definitive diagnosis of gout is such that re-aspiration of the same or other joints may be justified under certain circumstances.

Adult

Whipple's disease and ankylosing spondylitis simultaneous occurrence in HLA-B27 positive male.

A 57 year old male had recurrent arthritis and uveitis for 34 years, spinal symptoms for 10 years, and malabsorption for four months leading to the diagnosis of ankylosing spondylitis and Whipple's disease. HLA-B27 was positive. Out of the four cases of Whipple's and ankylosing spondylitis in the literature, only one had been tested for HLA-B27 and was found to be negative.

HLA Antigens

Aseptic meningitis in systemic lupus erythematosus. Report of three cases.

Three patients with aseptic meningitis were subsequently diagnosed as having lupus erythematosus. One patient had a single meningitic episode, another had chronic meningitis, and the third two acute episodes 5 years apart. All 3 patients developed further neurophychiatric manifestations of SLE, leading to death in 1. Aseptic meningitis appears to be an early manifestation of SLE and may herald more serious brain damage. No new cases of aseptic meningitis occurred in this series after initiation of therapy for SLE. In contrast, bacterial meningitis did occur as a late complication of the disease.

Adult

Idiopathic or traumatic olecranon bursitis. Clinical features and bursal fluid analysis.

Thirty cases of idiopathic olecranon bursitis were studied. Most had previous local trauma. The process was unilateral and often associated with nontender pitting edema in cases of short duration. Ten patients exhibited a bony spur at the olecranon process, and amorphous calcific deposits were seen in 6. The bursal fluid was hemorrhagic with a xanthochromic supernatant, and the mucin clot test was poor or fair. Leukocyte count averaged 878/mm3, predominantly mononuclears. Many cells contained inclusion bodies. Glucose, total protein, and complement (C3) concentration averaged 80, 60, and 60% of the respective serum values.

Adult

Septic subcutaneous bursitis. Report of sixteen cases.

Sixteen cases of bacterial infection of subcutaneous bursae were reviewed. Septic subcutaneous bursitis usually occurred following injury to the skin overlying the bursa. Two cases developed after bursal corticosteroid injection for treatment of aseptic bursitis. Bursal fluid culture yielded staphlococci in 14 cases and streptococci in 2. Blood cultures obtained in 8 patients were negative. No patient had clinical manifestations suggestive of bacteremia. Needle and/or incisional drainage of the bursa plus systemic antibiotics led to uneventful recovery in 14 patients. Two patients had chronic drainage. One resolved spontaneously and the other required bursectomy.

Adult