Disorders of the shoulder: an often unrecognised cause of disability in elderly people.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to M Webley.
Explore the source record for details and available documents.
We present the results of synovectomy and excision of the radial head in 65 elbows affected by rheumatoid arthritis. Eighty-four percent of elbows had good pain relief 6 months after operation but after an average of 5 years only 54% remained relatively pain-free. Range of motion remained the same or improved in the majority of patients. Synovitis occurred in 39% of elbows during the followup period and intraarticular steroid injections were frequently given. This undoubtedly modified results of pain relief that might have been attributed to the operation. Destructive changes in the humeroulnar joint were considered the main cause of elbow pain at the time of review.
A review of the literature reveals that radial-head excision for rheumatoid destruction of the elbow is a worthwhile operation, producing complete pain relief in many and substantial improvement in approximately 75%. Recurrence of symptoms eventually occurs in 50% patients.
Episodic arthritis is an uncommon manifestation of cystic fibrosis. We describe the case of a 21-year-old man with cystic fibrosis who suffered from episodic arthritis associated with vasculitic skin lesions. Aetiology is discussed with reference to the possible role of immune complex disease.
Antikeratin antibodies (AKA) were found in the sera of 59% (121/204) of patients with rheumatoid arthritis (RA). There was a significantly higher incidence of AKA (73%) in male patients compared with females (53%) and a correlation between AKA positivity and IgM rheumatoid factor was found. Antibody reactivity was positively associated with the presence of nodules, antinuclear antibody, C-reactive protein and disease severity. AKA would appear to have possible prognostic significance in patients with RA.
Thirty-one patients with rheumatoid arthritis maintained on prednisolone 5 mg daily for an average period of 9.4 years were assessed radiologically to determine the degree of osteoporosis in their spine and peripheral skeleton. They were compared with a control group of 32 rheumatoid patients who had never received corticosteroids. The steroid-treated patients had more severe osteoporosis than the controls, though the difference was not statistically significant. In the female patients the spine appeared to be more sensitive than the peripheral skeleton to the osteoporotic effect of corticosteroids.
Explore the source record for details and available documents.
A family of 4 is described in which both children had calcific periarthritis affecting the shoulders, and the mother had radiological evidence of periarticular calcification near the left greater trochanter.
A collaborative study of 75 selected patients with rheumatoid arthritis (RA) employing 6 different methods for the detection of antibodies to type II collagen showed highly significant correlations between all the assays. The radioimmunoassays showed a greater sensitivity than either the passive haemagglutination or immunofluorescent techniques, and when the native collagen molecule was heat-denatured a higher number of patients showed increased antibody levels. In 33 patients the measurement of serum antibody levels to human, bovine, and rat native type II collagen showed a lack of species specificity, indicating that heterologous collagens can be employed in these assays. A retrospective analysis of the clinical, laboratory, and radiological features in the 41 patients with raised antibody levels and the 34 patients with normal antibody levels showed very few differences, but there was a significantly lower incidence of subcutaneous nodules (24% versus 56%) in patients with raised antibody levels. This study emphasizes the need to standardize assays for the measurement of serum antibody levels to native type II collagen. More extensive studies will be required before the clinical significance of these antibodies can be fully established.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
A 61-year-old patient with treated Conn's syndrome due to multiple bilateral adrenocortical adenomata developed primary hyperparathyroidism. At operation, a parathyroid adenoma and a thyroid colloid nodule were found. Although adrenocortical adenomata and hyperplasia are common findings in multiple endocrine adenopathy type I, they are only rarely functional. Hypertension is often associated with primary hyperparathyroidism, but the relationship is usually unexplained.
Explore the source record for details and available documents.
Owing to the report of an association between rheumatoid arthritis (RA) and obliterative bronchiolitis we have determined the prevalence of airflow obstruction in unselected patients with RA and normal chest radiographs. Spirometry was performed on 100 patients with rheumatoid arthritis and 84 control subjects matched for age, sex, and smoking habits. Patients with rheumatoid arthritis had significantly lower values for FEV1, FVC, FEV1/FVC, and MMEFR when compared with the controls: 39 patients had abnormal spirometry, and at least 32 showed airways obstruction. The prevalence of airflow obstruction is remarkably high, and we suggest that airway disease may be the commonest form of lung involvement in rheumatoid arthritis.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.