Successful treatment of a rheumatoid arthritis patient with severe synovial hypertrophy and impaired shoulder function with microwave ablation technique.

Autor: Deniz R; Department of Rheumatology, University of Health Sciences Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey. dr.rabiadeniz@gmail.com.; School of Medicine, Faculty of Health Science, Department of Medical Biology and Genetics, Marmara University, Istanbul, Turkey. dr.rabiadeniz@gmail.com., Güzelbey T; Department of Radiology, University of Health Sciences Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey., Mutlu İN; Department of Radiology, University of Health Sciences Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey., Erdim Ç; Department of Radiology, University of Health Sciences Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey., Akkuzu G; Department of Rheumatology, University of Health Sciences Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey., Karaalioğlu B; Department of Rheumatology, University of Health Sciences Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey., Özgür DS; Department of Rheumatology, University of Health Sciences Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey., Yıldırım F; Department of Rheumatology, University of Health Sciences Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey., Kılıçkesmez Ö; Department of Radiology, University of Health Sciences Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey., Bes C; Department of Rheumatology, University of Health Sciences Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey.
Jazyk: angličtina
Zdroj: Skeletal radiology [Skeletal Radiol] 2024 Aug; Vol. 53 (8), pp. 1639-1643. Date of Electronic Publication: 2024 Jan 15.
DOI: 10.1007/s00256-024-04580-z
Abstrakt: 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.
(© 2024. The Author(s), under exclusive licence to International Skeletal Society (ISS).)
Databáze: MEDLINE
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