Abstract:
OBJECTIVES:To assess the frequency and types of cancer found in children presenting to our Unit with musculoskeletal symptoms over a 10-year period. METHODS:The medical records of patients with musculoskeletal symptoms and a final diagnosis of cancer were reviewed. In each case age, gender, presenting symptoms, laboratory data, diagnostic procedures, provisional and final diagnoses, and time between clinical onset and correct diagnosis were reviewed. RESULTS:An underlying neoplasia was found in 10 of 1,254 patients (<1%) complaining of musculoskeletal symptoms. The types of malignancies found included acute lymphocytic leukemia (ALL) (6 cases), lymphoma (2 cases), neuroblastoma (1 case), and Ewing's sarcoma (1 case). The mean time between disease onset and final diagnosis was 3.2 months. The most common presenting feature was monoarthritis, involving the larger joints such as the elbows, knees or ankles. Juvenile idiopathic arthritis (JIA) was the most frequent provisional diagnosis. In the preliminary hematologic evaluation, eight patients had an increased erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP) value. White blood cell (WBC) count was normal in almost all children, with a normal differential count. Lactic dehydrogenase (LDH) was raised in all children. Bone marrow aspirates and lymph node or bone biopsies were necessary to reach the final diagnosis. CONCLUSIONS:A malignancy should always be excluded in children with musculoskeletal symptoms, especially when the clinical pattern is not characteristic of a specific rheumatic disease. Routine laboratory tests may be misleading. The simultaneous presence of high LDH or alpha-hydroxybutyric dehydrogenase (alpha-HBDH) levels and raised ESR or CRP, even with normal blood cell counts, should lead to additional investigations. RELEVANCE:All patients presenting with arthritis or other musculoskeletal symptoms should have a thorough clinical examination. Disproportionate pain levels and an atypical pattern of "arthritis," especially in the presence of systemic manifestations, suggest a possible underlying malignancy.
journal_name
Semin Arthritis Rheumjournal_title
Seminars in arthritis and rheumatismauthors
Trapani S,Grisolia F,Simonini G,Calabri GB,Falcini Fdoi
10.1053/sarh.2000.5752subject
Has Abstractpub_date
2000-06-01 00:00:00pages
348-59issue
6eissn
0049-0172issn
1532-866Xpii
S0049-0172(00)80022-0journal_volume
29pub_type
杂志文章abstract:CONTEXT:Thoracic lymphadenopathy (LA) has been identified as a key prognostic factor in interstitial lung disease (ILD) of all-cause. Crystalline silica is a risk factor of systemic sclerosis (SSc). The association of a history of crystalline silica exposure with chest high-resolution computed tomography (HRCT) feature...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章
doi:10.1016/j.semarthrit.2020.08.014
更新日期:2020-10-01 00:00:00
abstract:OBJECTIVE:To provide an overview of the underlying scientific principles and standards for developing a biosimilar product. METHODS:An Internet-based literature search through June 2015 was performed for information related to biosimilar manufacturing and development, including a review of regulatory guidelines and re...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1016/j.semarthrit.2016.01.002
更新日期:2016-04-01 00:00:00
abstract::Reproduction capacity and long-term preserved hormonal function are important aspects with big impacts on patients' quality of life. Updated information on the interaction between drug therapy and reproductive function is essential when discussing family planning with patients. Currently, limited data is published reg...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1016/j.semarthrit.2018.01.006
更新日期:2018-10-01 00:00:00
abstract::Traditional pain management strategies have relied on the use of opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), and acetaminophen, as well as other adjuvant analgesics. However, the limited activity of these drugs and the substantial adverse effects associated with their use has left many patients without dep...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1053/sarh.2002.37218
更新日期:2002-12-01 00:00:00
abstract:OBJECTIVES:To systematically review the literature on the prevalence of Cognitive Dysfunction (CD) in SLE patients in studies that used a specified neuropsychological instrument. METHODS:This review was prepared with a protocol following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis-Protocols ...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,meta分析
doi:10.1016/j.semarthrit.2018.02.007
更新日期:2018-10-01 00:00:00
abstract:OBJECTIVES:To provide an update of the current knowledge of the mechanism of action of low-dose methotrexate (MTX) in the treatment of patients with rheumatoid arthritis (RA), with an emphasis on the mechanisms involved in toxicity. We also considered strategies currently used to prevent or decrease toxicity of MTX. M...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1016/s0049-0172(98)80049-8
更新日期:1998-04-01 00:00:00
abstract:OBJECTIVE:Several studies have found an increased fall risk in persons with osteoarthritis (OA). However, most prospective studies did not use a clinical definition of OA. In addition, it is not clear which factors explain this risk. Our objectives were: (1) to confirm the prospective association between clinical OA of...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章
doi:10.1016/j.semarthrit.2020.02.006
更新日期:2020-06-01 00:00:00
abstract:OBJECTIVE:To determine racial/ethnic differences in the use of conventional synthetic or biologic disease-modifying anti-rheumatic drugs (csDMARDs or bDMARDs, respectively) and long-term glucocorticoids (GC) or opioids among beneficiaries of the Social Security Disability Insurance (SSDI) with rheumatoid arthritis (RA)...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章
doi:10.1016/j.semarthrit.2020.07.008
更新日期:2020-10-01 00:00:00
abstract:OBJECTIVES:To analyze if exercise interventions for patients with knee osteoarthritis (OA) following the American College of Sports Medicine (ACSM) definition of muscle strength training differs from other types of exercise, and to analyze associations between changes in muscle strength, pain, and disability. METHODS:...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.semarthrit.2017.03.007
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVE:Due to reduced physical activity, adults with arthritis experience significant disability and comorbidities including cardiovascular disease. This meta-analytic review integrates results from primary research studies testing interventions to increase physical activity in arthritis patients. METHODS:Extensive...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.semarthrit.2007.07.006
更新日期:2008-04-01 00:00:00
abstract:OBJECTIVES:To evaluate the capacity of B-Mode ultrasonography (B-Mode US) and electron-beam computed tomography (EBCT) to detect arterial changes in Takayasu's arteritis. METHODS:EBCT angiography of the thoracoabdominal aorta and pulmonary artery, and B-mode US of large superficial arteries (common carotid, subclavian...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章
doi:10.1053/sarh.2000.8375
更新日期:2000-08-01 00:00:00
abstract:OBJECTIVES:The Dead Sea, the deepest and most saline lake on earth, has been known from biblical times for its healing properties. The aim of this systematic review was to present critically the level of evidence for the claims of therapeutic effects of Dead Sea treatments in several rheumatologic diseases and psoriasi...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1016/j.semarthrit.2012.02.006
更新日期:2012-10-01 00:00:00
abstract:OBJECTIVES:HLA-B*5801 allele carriage (a strong determinant of allopurinol hypersensitivity syndrome) varies substantially among races, which may lead to racial disparities in the risk of Stevens-Johnson Syndrome (SJS) and toxic epidermal necrolysis (TEN) in the context of urate-lowering drug adverse events (ULDAEs). W...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章
doi:10.1016/j.semarthrit.2016.03.014
更新日期:2016-10-01 00:00:00
abstract:OBJECTIVES:To present the data supporting the possible relationship of ocular toxoplasmosis to antitumor necrosis factor-alpha (TNF-alpha) therapy in patients with rheumatoid arthritis (RA). METHODS:A Medline search was performed using the words "toxoplasmosis, anti-TNF-alpha antagonists, chorioretinitis." We report 2...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章
doi:10.1016/j.semarthrit.2006.08.004
更新日期:2007-02-01 00:00:00
abstract::Methotrexate therapy has been effective in the treatment of RA with short term experience suggesting little serious adverse reactions. Our review of 168 patients receiving methotrexate has identified nine patients with probable or possible methotrexate-induced pulmonary toxicity, giving a prevalence of 5% and an incid...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章
doi:10.1016/0049-0172(87)90021-7
更新日期:1987-02-01 00:00:00
abstract:OBJECTIVES:To contrast and compare the spectrum of remitting seronegative symmetrical synovitis with pitting edema (RS3PE) with rheumatoid arthritis (RA) using an illustrative case. METHODS:The relevant English literature of RS3PE was searched using the keywords "RS3PE" alone and in combination with terms such as neop...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1016/j.semarthrit.2008.11.006
更新日期:2010-08-01 00:00:00
abstract::Current interpretation of nailfold capillaroscopy is largely based on qualitative and subjective parameters. These parameters make the accurate assessment of the extent of the nailfold microangiopathy difficult. The authors present a comprehensive method in which several quantitative or semiquantitative parameters are...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章
doi:10.1016/0049-0172(90)90091-s
更新日期:1990-08-01 00:00:00
abstract:OBJECTIVES:To objectively measure physical activity levels in a cohort of juvenile dermatomyositis (JDM) patients; to compare physical capacity and health-related quality of life in JDM patients and their healthy controls (CTRL) matched by physical activity levels; and to associate physical activity variables with dise...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章
doi:10.1016/j.semarthrit.2016.03.010
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:Skeletal muscle involvement has been well documented in patients with polyarteritis nodosa (PAN), and symptoms referable to skeletal muscle are not uncommon. However, polymyositis as a mode of presentation of PAN is uncommon. This unusual presentation of PAN has been reported only once previously in the Engl...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章
doi:10.1053/sarh.2002.32549
更新日期:2002-06-01 00:00:00
abstract:OBJECTIVES:After detailing the different aspects of synovial inflammation (i.e., cellular, biochemical, and vascular) and based on the current knowledge, the aim of this review was to collect the available in vitro and in vivo data regarding the potency of some glycosaminoglycan (GAG) compounds to target synovial infla...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1016/j.semarthrit.2013.10.005
更新日期:2014-04-01 00:00:00
abstract::Hepatitis C virus (HCV) infection has been associated with a plethora of immune and autoimmune perturbations. We review serological and clinical autoimmune manifestations associated with HCV infection, discuss treatment regimens for HCV-related autoimmune diseases, and present a framework for understanding HCV-associa...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1016/s0049-0172(97)80005-4
更新日期:1997-02-01 00:00:00
abstract:OBJECTIVE:To characterize levamisole-induced vasculopathy. METHODS:We performed a systematic review searching MEDLINE for articles published from 1972 to 2016. RESULTS:We retrieved 357 references and abstracts and selected 111 articles. Levamisole-induced vasculopathy was reported in 192 patients, with a female predo...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章
doi:10.1016/j.semarthrit.2018.07.010
更新日期:2019-04-01 00:00:00
abstract:BACKGROUND:Familial Mediterranean Fever (FMF) is a hereditary autoinflammatory syndrome characterized by recurrent serositis or arthritis attacks and, in some patients, chronic subclinical inflammation that predisposes to secondary amyloidosis. Colchicine is the gold standard of treatment, which reduces attack frequenc...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1016/j.semarthrit.2017.03.006
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVES:To analyze the effectiveness of immunosuppressants and biological therapies in autoimmune posterior uveitis, chronic anterior uveitis associated with juvenile idiopathic arthritis, and macular edema. METHODS:Systematic review. We conducted a sensitive literature search in Medline (from 1961) and EMBASE (fro...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1016/j.semarthrit.2010.05.008
更新日期:2011-02-01 00:00:00
abstract:OBJECTIVE:To summarize the evidence about the relationship between polymyalgia rheumatica (PMR) and giant cell arteritis (GCA). METHODS:Review of relevant articles from the English-language literature. RESULTS:Epidemiologic studies suggest that PMR and GCA are closely related conditions affecting people over 50 years...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1016/j.semarthrit.2003.09.008
更新日期:2004-04-01 00:00:00
abstract:OBJECTIVE:To assess the association between pseudotumor cerebri (PC) and systemic lupus erythematosus (SLE), and to seek a pathogenic mechanism that may elucidate the appearance of PC in patients with SLE. DATA SOURCE:Original English articles having the terms SLE, PC, or benign intracranial hypertension in their titl...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1016/s0049-0172(95)80023-9
更新日期:1995-10-01 00:00:00
abstract:OBJECTIVE:To compare effectiveness, drug survival, and safety between infliximab, adalimumab, and etanercept, in a nationwide cohort of rheumatoid arthritis (RA) patients. METHODS:This study is a prospective cohort study of 1208 active RA patients. Effectiveness, drug survival, and serious adverse events during entire...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章
doi:10.1016/j.semarthrit.2013.07.011
更新日期:2014-02-01 00:00:00
abstract:OBJECTIVES:To study the prevalence of connective tissue diseases (CTD) in patients with autoimmune hepatitis (AIH). METHODS:We identified 11 cases of AIH over the past 7 years at our institution, through a systematic chart review of patients with this diagnosis. Their charts were reviewed for the development of system...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章
doi:10.1016/j.semarthrit.2005.12.001
更新日期:2006-06-01 00:00:00
abstract::Gout is currently the most frequent cause of inflammatory arthritis worldwide. It results from elevated serum urate and subsequent deposition of monosodium urate crystals in joints and other tissues. While many patients with gout can be managed with conventional agents (e.g., allopurinol, febuxostat), those with chron...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1016/j.semarthrit.2020.04.011
更新日期:2020-06-01 00:00:00
abstract::Candida species are an uncommon cause of infectious arthritis, although the frequency has increased during recent years. Three cases of septic arthritis caused by Candida species are reported, and the literature is reviewed. The first patient developed a popliteal cyst infected by Candida albicans after multiple intra...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1016/0049-0172(93)80071-m
更新日期:1993-02-01 00:00:00