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Deniz R, Güzelbey T, Mutlu İN, Erdim Ç, Akkuzu G, Karaalioğlu B, Özgür DS, Yıldırım F, Kılıçkesmez Ö, Bes C. Successful treatment of a rheumatoid arthritis patient with severe synovial hypertrophy and impaired shoulder function with microwave ablation technique. Skeletal Radiol 2024; 53:1639-1643. [PMID: 38225401 DOI: 10.1007/s00256-024-04580-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 01/04/2024] [Accepted: 01/05/2024] [Indexed: 01/17/2024]
Abstract
Rheumatoid arthritis (RA) is a chronic, inflammatory systemic disorder of synovial joints and results in polyarthritis, chronical degeneration, and finally deformities and ankylosis in severe cases. Synovitis and pannus formation are results of inflammatory changes and lead into restriction in joint movement. Shoulders are among the later affected and larger joints and formation of synovitis in early active stages and pannus in later stages might be concluded with frozen shoulder and severe impairment in functionality. These late-term changes cannot be controlled with systemic or local anti-inflammatory agents and synovectomy is chosen in some cases. However, the results are not satisfactory and recurrence is common. In this case report, we presented a case of RA with severe shoulder pain, restricted movement due to synovial hypertrophy, and pannus formation which are resistant to local and systemic interventions and not suitable for surgical or chemical synovectomy. Microwave ablation (MWA) was performed successfully without any complication and she well responded in terms of DAS-28, functional, and pain scores. Range of motion and funcitonal restriction were recovered. This case report describes the use and promising results of MWA in RA with severe synovial hypertrophy and pannus formation even in the absence of active arthritis and effusion. MWA is a safe and minimally invasive technique that can be easily performed in coordinance of rheumatologists and interventional radiologists in proper cases.
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Affiliation(s)
- Rabia Deniz
- Department of Rheumatology, University of Health Sciences Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey.
- School of Medicine, Faculty of Health Science, Department of Medical Biology and Genetics, Marmara University, Istanbul, Turkey.
| | - Tevfik Güzelbey
- Department of Radiology, University of Health Sciences Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey
| | - İlhan Nahit Mutlu
- Department of Radiology, University of Health Sciences Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey
| | - Çağrı Erdim
- Department of Radiology, University of Health Sciences Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey
| | - Gamze Akkuzu
- Department of Rheumatology, University of Health Sciences Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey
| | - Bilgin Karaalioğlu
- Department of Rheumatology, University of Health Sciences Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey
| | - Duygu Sevinç Özgür
- Department of Rheumatology, University of Health Sciences Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey
| | - Fatih Yıldırım
- Department of Rheumatology, University of Health Sciences Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey
| | - Özgür Kılıçkesmez
- Department of Radiology, University of Health Sciences Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey
| | - Cemal Bes
- Department of Rheumatology, University of Health Sciences Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey
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Ranker A. Orthetik bei rheumatologischen Erkrankungen. AKTUEL RHEUMATOL 2021. [DOI: 10.1055/a-1655-7215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
ZusammenfassungDie Versorgung von Patienten mit körpernahen Hilfsmitteln wie Orthesen,
Bandagen oder Tapes stellt einen wichtigen Pfeiler der konservativen
Maßnahmen der Versorgung von rheumatologischen Erkrankungen dar. Ziel
ist es dabei stets schmerzauslösende Belastungen zu reduzieren sowie
durch Destruktion instabile Gelenke zu stabilisieren um somit die
Funktionsfähigkeit im Alltag so gut es geht aufrecht zu erhalten. Die
Teilhabe an täglichen Arbeiten kann dadurch oftmals verbessert werden,
was sich konsekutiv auf die Lebensqualität auswirkt. In diesem Beitrag
soll die Systematik von verordnungsfähigen Orthesen erklärt
werden und anschließend darauf aufbauend für wichtige, oftmals
betroffene Gelenke Stabilisationsmöglichkeiten aufgezeigt werden. Die
Evidenz und die Verordnungsweise werden dabei wenn möglich
aufgezeigt.
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Affiliation(s)
- Alexander Ranker
- Rehabilitation Medicine, Hannover Medical School, Hannover,
Deutschland
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