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Subcutaneous nodules in a patient with polyarthritis

Article Abstract:

Diseases other than rheumatoid arthritis (RA), such as Wegener's granulomatosis (WG), may cause joint pain and the development of soft tissue masses, or nodules. WG is a degenerative disease affecting the blood vessels of the respiratory tract, kidney, and other peripheral vessels. Doctors presented the case of a 56-year-old patient initially diagnosed with RA who had joint pain, nodules below the skin at the elbows, and a positive test for rheumatoid factor. Further evidence of kidney disease on biopsy, respiratory damage, and elevated antibody levels led to a diagnosis of WG. Chemotherapy and anti-inflammatory and vasodilating drugs effectively treated this patient. Patients with WG who have skin nodules typically have them at skin level rather than below skin level. However, physicians should consider evaluating patients for diseases other than RA when patients have any soft tissue nodules accompanied by kidney disease.

Wegener's granulomatosis

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Epidemiology of adult Still's disease: estimate of the incidence by a retrospective study in west France

Article Abstract:

Still's disease is a form of rheumatoid arthritis that normally affects children but can also occur in adults. Researchers surveyed hospitals and physicians to identify and characterize the 62 reported cases of adult Still's disease (ASD) over a 10-year period. The patients completed a questionnaire documenting their social and medical history. In reference to 1990 census data, the incidence of this disease seems to be 0.16 cases per 100,000 people. Forty-four percent of the patients reported one systemic episode of the disease while 32% reported more than one systemic episode. Twenty-four percent of the patients experienced a long-term form of ASD with joint involvement. There were approximately an equal number of male (30) and female (32) cases. There were two peaks in the patients' average age at 15-25 yrs and 36-45 yrs. The overall average age of the patients was 36 yrs.

Demographic aspects

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Antiperinuclear factors are present in polyarthritis before ACR criteria for rheumatoid arthritis are fulfilled

Article Abstract:

Antiperinuclear factor (APF) may prove a better indicator for the early diagnosis of rheumatoid arthritis than rheumatoid factors (RF) in patients with polyarthritis. Researchers periodically tested blood samples for APF in 60 patients who had experienced polyarthritis for less than one year at the time of the initial evaluation. At the end of three years, 31 of 40 patients tested positive for APF versus 21 out of 40 for RF. The American College of Rheumatology criteria had not yet been fulfilled in nearly half the cases at the time they tested positive for APF.

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