Hungarian Radiology

[A paradox of articular protective phenomenon: more serious-damaged rudimentary hand in rheumatoid arthitis]

SZÁNTÓ Dezső, SZŰCS Gabriella, DITRÓI Edit

JANUARY 20, 2003

Hungarian Radiology - 2003;77(01)

[INTRODUCTION - The joints have been secured from rheumatoid arthritis by diminution of biomechanical effeciency. This effect was analyzed and named articular protective phenomenon three decades ago. CASE REPORT - A case of bilateral rheumatoid arthritis associated with unilateral developmental abnormality hand and bronchial asthma in a 35 year old female patient is presented. Her left 2nd, 3rd, 4th and 5th metacarpal bones moreover her fingers had not evolved. The patient has been treated by antiasthmatic steroid drugs for five years. Rheumatoid disorders of the affected left hand were more severe, than the abnormality of the normal upper limb. Eight years later the most severe bony lesions (ankylosis and mutilation) appeared on this side, only. CONCLUSION - The patient's hand was not saved by inborn bone defect in rheumatoid arthritis. The absence of articular protective phenomenon can be explained by the undisturbed innervation of limb, the motility of hypotrophic carpus besides to steroid-induced suppression.]



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[INTRODUCTION - Simultaneous presence of intrauterine and extrauterine gestations is very rare. CASE REPORT - A 26 year old multiparous woman known to be 10 weeks pregnant presented with severe abdominal pain. Transabdominal sonography revealed a concomitant ectopic pregnancy with large amount of intraperitoneal fluid. Cardiac activities of both the intrauterine and the ectopic fetuses were clearly visible on abdominal ultrasound. Emergency laparoscopy confirmed intraabdominal hemorrhage and rupture of the left fallopian tube. The laparoscopic salpingectomy did not affect the ongoing intrauterine pregnancy. The woman subsequently delivered a healthy infant. CONCLUSION - Though heterotopic pregnancy especially without previous ovarian hyperstimulation is extremely rare. The confirmation of an intrauterine pregnancy does not exclude a co-existing ectopic pregnancy as well as in case of extrauterine pregnancy the simultaneous presence of an intrauterine pregnancy must be considered.]

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