PubMed · 3954810
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I Kushner. 1986. Explaining the term "arthritis".. https://doi.org/10.1002/art.1780290224
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Sydenham's chorea (SC) is a major manifestation of rheumatic fever characterized by an array of neuropsychiatric symptoms that vary in severity, timing, and character. Some of the same symptoms are seen in Tourette's syndrome and childhood-onset obsessive-compulsive disorder. Genetic vulnerability appears to play a role in all three conditions. The term PANDAS (pediatric autoimmune neuropsychiatric disorder associated with streptococcus) has been introduced to describe a putative subset of obsessive-compulsive disorder and Tourette's syndrome that bears some resemblance to Sydenham's chorea. This article discusses whether PANDAS should be subsumed under Sydenham's chorea, thus expanding the diagnostic boundaries of Sydenham's chorea to include primarily neuropsychiatric presentations now classified as cases of obsessive-compulsive disorder or Tourette's syndrome. We conclude that PANDAS is a useful construct, but that it would be premature to view it as a subset of Sydenham's chorea-whether defined narrowly or broadly.
For many years radiosynovectomy has proved its worth in the treatment of inflammatory joint disease. More recently there has also been growing interest in the use of this method for outpatient treatment. In this overview we discuss the established and new indications. With increasing use of the method, interest should be focused on adequate quality control. Accordingly, basic requirements for correct performance of radiosynovectomy in clinical practice are addressed. Our results, based on five years' experience of radiosynovectomy in outpatients, have shown improvement of clinical symptoms in 60-70% of cases. However, success rates of this kind require high quality standards and close cooperation with the referring rheumatologists.