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Category: Cecil Medicine, 23rd Edition

Goldman: Cecil Medicine, 23rd ed. Copyright © 2007 Saunders, An Imprint of Elsevier ULTRASONOGRAPHY In ultrasound imaging, sound waves are pulsed through tissues to obtain an image that can localize and characterize pathology. Through the years, resolution has increased markedly. Portable scanners are also being used, especially by nonradiologists. These units are less expensive. They […]

Goldman: Cecil Medicine, 23rd ed. Copyright © 2007 Saunders, An Imprint of Elsevier COMPUTED TOMOGRAPHY CT employs an x-ray source with multiple detectors housed in a circular gantry that rotates 360 degrees around the patient, who lies on a table surrounded by the gantry. The computer processes the data that is displayed tomographically and in […]

Goldman: Cecil Medicine, 23rd ed. Copyright © 2007 Saunders, An Imprint of Elsevier ARTHROGRAPHY Arthrography involves the intra-articular placement of a needle, followed by aspiration of joint fluid and injection of a contrast agent to enhance imaging. It is often performed to exclude the possibility of infection in patients with hip pain or in those […]

Goldman: Cecil Medicine, 23rd ed. Copyright © 2007 Saunders, An Imprint of Elsevier SCINTIGRAPHY Scintigraphy employs detectors in the form of a gamma camera that can identify decay of intravenously injected radioactive isotopes. Bone scintigraphy is used to identify sites of activity in the rheumatic diseases. The bone scan employs 99m technetium methylene diphosphate (Tc99m-MDP) […]

Goldman: Cecil Medicine, 23rd ed. Copyright © 2007 Saunders, An Imprint of Elsevier SUGGESTED READINGS Adler RS, Finzel KC: The complementary roles of MR imaging and ultrasound of tendons. Radiol Clin North Am 2005; 43:771-807.Provides indications and features of ultrasound and MRI for tendon evaluation American College of Rheumatology Extremity Magnetic Resonance Imaging Task Force: Extremity magnetic resonance imaging in […]

Goldman: Cecil Medicine, 23rd ed. Copyright © 2007 Saunders, An Imprint of Elsevier Chapter 280 – CONNECTIVE TISSUE STRUCTURE AND FUNCTION   Richard F. Loeser   Connective tissue forms the architectural framework of the musculoskeletal system and serves as a scaffold that supports various organs and tissues. Many important structures within the body are composed primarily of connective […]

Goldman: Cecil Medicine, 23rd ed. Copyright © 2007 Saunders, An Imprint of Elsevier LABORATORY EVALUATION OF MUSCULOSKELETAL DISEASE The most common presentation of musculoskeletal disease is pain in and around a joint in association with functional impairment. Collectively, diseases causing joint symptoms are called arthritis, implying inflammation. The extent of inflammation in these diseases varies […]

Goldman: Cecil Medicine, 23rd ed. Copyright © 2007 Saunders, An Imprint of Elsevier SUGGESTED READINGS   Clarkson TW, Magos L, Myers GJ: The toxicology of mercury—current exposures and clinical manifestations. N Engl J Med 2003; 349:1731-1737.Excellent review of the consequences of exposure to methyl mercury in fish, mercury vapor from dental amalgam, and ethyl mercury (in thimerosal)   Department of […]

Goldman: Cecil Medicine, 23rd ed. Copyright © 2007 Saunders, An Imprint of Elsevier LABORATORY EVALUATION OF SYSTEMIC INFLAMMATORY DISEASE   Among rheumatic diseases, some are characterized by severe systemic inflammation that can cause organ-threatening and life-threatening manifestations. These diseases can have arthritis as a component and presenting complaint, although the prominence of extra-articular manifestations, especially […]

Goldman: Cecil Medicine, 23rd ed. Copyright © 2007 Saunders, An Imprint of Elsevier SUGGESTED READINGS Linnik MD, Hu JZ, Heilbrunn KR, et al: Relationship between anti-double-stranded DNA antibodies and exacerbation of renal disease in patients with systemic lupus erythematosus. Arthritis Rheum 2005; 52:1129-1137.Increases in anti-DNA antibodies were associated with flares of renal disease Manzi S, Navratil JS, Ruffing MJ, et al: Measurement of erythrocyte C4d […]

Goldman: Cecil Medicine, 23rd ed. Copyright © 2007 Saunders, An Imprint of Elsevier Chapter 279 – IMAGING STUDIES IN THE RHEUMATIC DISEASES   Lynne S. Steinbach   Imaging in the rheumatic diseases is essential to diagnosis and assessment of the progression of arthropathy. The mainstay for imaging has always been the radiograph. This continues to be the case, […]

Goldman: Cecil Medicine, 23rd ed. Copyright © 2007 Saunders, An Imprint of Elsevier MAGNETIC RESONANCE IMAGING The demands of imaging are increased in this age of effective therapy to halt the progression of arthropathy. Over the last two decades, MRI has become the imaging modality of choice for evaluation of joint soft tissue, marrow structures, […]

Goldman: Cecil Medicine, 23rd ed. Copyright © 2007 Saunders, An Imprint of Elsevier SUGGESTED READINGS Brooks PM: The burden of musculoskeletal disease—a global perspective. Clin Rheumatol 2006; 25:778-781.An epidemiologic review Moore G: Atlas of the Musculoskeletal Examination, Philadelphia, American College of Physicians, 2003. (accessed June 26, 2006). Contains many pictures of joint examination Available at www.acponline.org Thomsen TW, Shen S, Shaffer RW, et al: Videos in […]

Goldman: Cecil Medicine, 23rd ed. Copyright © 2007 Saunders, An Imprint of Elsevier Chapter 278 – LABORATORY TESTING IN THE RHEUMATIC DISEASES David S. Pisetsky The rheumatic diseases are a heterogeneous group of conditions that result from diverse pathophysiologic mechanisms and involve the musculoskeletal system as well as other organs. These conditions range from mild, diffuse joint and […]

Goldman: Cecil Medicine, 23rd ed. Copyright © 2007 Saunders, An Imprint of Elsevier SUGGESTED READINGS Aberer W, Bircher A, Romano A, et al: Drug provocation testing in the diagnosis of drug hypersensitivity reactions: General considerations. Allergy 2003; 58:854-863.An overview of this approach Brockow K, Christiansen C, Kanny G, et al: Management of hypersensitivity reactions to iodinated contrast media. Allergy 2005; 60:150-158.A comprehensive review Gruchalla RS: Drug allergy. J […]

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