1989 Volume XIV, 4, 4º Trimestre - Acta Reumatológica Portuguesa ...

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218 A. TRAVERSO, A. SPITALERI, T. MANCA, A BALDARI, F. CATALANI, A. SHENONE, I. DE MARTINI rheumatoid arthritis, which had already been diagnosed in 1974. The symptoms disappeared after 20 days treatment with Indomethacin. About 6 months later he was readmitted complaining of hyposthenia in the upper limbs and there was a further worsennig of the general clinical picture. A clinical examination revealed muscular hypotrophy of the scapular girdle and of the hand muscles, widespread reduction in the articular mobility and, in particular, difficulty in flexing the lower limbs. The patients also had difficulty in swallowing and coordinating his tongue movements. The neurological examination revealed widespread hypotrophy of the tongue, which presented fasciculations, dysphonia with open rhinolalia, hyposthenia (force=2) of the four limbs and an advanced degree of hypotropia of the scapular girdle and of the upper limbs (both proximal and distal tract). There were also rare fasciculations of the biceps and triceps and reduced OTR of the upper limbs. There also seemed to be slight hypotrophy of the right rectus femoris muscle; Patellar jerk was bilaterally vivacious. There was no evidence of any alterations in either the superficial or the sensitivity in depth, or in coordination, and the "fundus oculi" was normal. Besides, the following tests evidenced abnormalities: E.S.R = 50at 1st hour. C.R.P.=+++ A.L.P. = 131 R.A. Test = 1/80 Waaler Rose = 160 U.I. E.C.G. = There was total arhytmia, as a result of a. f., frequent ventricular ectopias. Diffuse alterations in repolarization probably caused by previous ischemic attacks. THORAX Radiographic = RIGHT: signs of pachi-pleuritis with obliteration of the rib-phrenic sinus. LEFT: obliteration of the rib-phrenic sinus and disventilatory striae of the pulmonary base. Increased cardiac transverse diameters. Sclerosis and ectasia of the aorthic arch. RADIOGRAPHS 1) Cervical spine: reduction of the physiologic lordosis with spondilo-arthritis and osteophitosis. Diffuse reduction of the interspinal spaces and reducted flexing. 2) Dorsal spine: spondiloarthrosis and yielding of D12 3) trophic paralysis in the area of the spinal with disk lesions of Ll, L2, L3, L4 and L5. Widespread reduced bobne density. 4) Hands: signs of serious bilateral rheumatoid arthristis, with marginal erosions, narrowing of articular spaces, subluxation of first right metacarpophalangeal joint and destruction in the wrists, particulary in the radiocarpal joint (Fig. 1). ELECTROMYOGRAPHY: signs of peripheral neurological damage at the brachial biceps bilaterally, at the left brachial triceps and at the right tibial ACTA REUMATOLÓGICA PORTUGUESA
QUANDO O PROBLEMA í A RESPOSTA IMUNITÁRIA timopentina REGUIA O SISTEMA IMUNITÁRIO XVII
Page 1 and 2: CAPA E ÍNDICE I m cã utubro-Dezem
Page 3 and 4: VOLUME XIV - TOMO 4 ACTA REUMATOLÓ
Page 5 and 6: EDITORIAL A REUMATOLOGIA ACTA REUMA
Page 7 and 8: NOS SÍNDROMAS DOLOROSOS REUMATISMA
Page 9 and 10: Todo este esforço necessita de ser
Page 11 and 12: 190 LICÍNIO POÇAS motivo de grand
Page 13 and 14: 60 mg de acemetacina retard (acemet
Page 15 and 16: 192 LICÍNIO POÇAS Fé — "quando
Page 17 and 18: 194 LICÍNIO POÇAS FISIOPATOLOGIA
Page 19 and 20: na artrose na artrite reumatóide V
Page 21 and 22: 196 LICfNIO POÇAS cos implicados n
Page 23 and 24: 198 LICÍNIO POÇAS médico. A apre
Page 25 and 26: ARTROSES ARTRITE REUMATÓIDE I i i
Page 27 and 28: 200 LICÍNIO POÇAS dor não tem me
Page 29 and 30: 202 LICÍNIO POÇAS TRATAMENTO DA D
Page 31 and 32: yv O nico anti-inflamatório nâo e
Page 33 and 34: 204 LICfNIO POÇAS — Derivados in
Page 35 and 36: 206 LICfNIO POÇAS espinotalamicas
Page 37 and 38: Está na sua mão, com tão pouco,
Page 39 and 40: 208 JACQUES G. PEYRON Homraes Femme
Page 41 and 42: 210 JACQUES G. PEYRON Collagéne II
Page 43 and 44: xiv contra inflamação
Page 45 and 46: 212 JACQUES G. PEYRON Contenu Extra
Page 47 and 48: 214 JACQUES G. PEYRON 16. Manicourt
Page 49 and 50: na dor articular aguda (3 exlefle X
Page 51: CASO CLINICO THE COEXISTENCE OF RHE
Page 55 and 56: THE COEXISTENCE OF RHEUMATOID ARTHR
Page 57 and 58: THE COEXISTENCE OF RHEUMATOID ARTHR
Page 59 and 60: NaprosyifSOOmg (Naproxen) i f f •
Page 61 and 62: 224 J. C. ROMEU, J. T. DA COSTA, A.
Page 63 and 64: 226 J. C, ROMEU. J. T. DA COSTA, A.
Page 65 and 66: 228 J. c, ROMEU. J. T. DA COSTA, A,
Page 67 and 68: 230 J. C ROMEU. J 1 DA COSTA, A MAT
Page 69 and 70: » ARTRITE GOTOSA A AMEAÇA SILENCI
Page 71 and 72: 232 J. C, ROMEU, J. T. DA COSTA, A.
Page 73 and 74: 234 J. C, ROMEU, J. T, DA COSTA, A.
Page 75 and 76: 236 J. C, ROMEU, J, T, DA COSTA, A.
Page 77 and 78: 238 J. C. ROMEU, J. T. DA COSTA, A.
Page 79 and 80: REUMON-GEL REUMON-CREME etofenamato
Page 81 and 82: 240 VIVIANA TAVARES, G. FIGUEIREDO,
Page 89 and 90: d***** 0 f Hifotwa^i INSVW Côas &*
Page 93 and 94: INDEX SUMÁRIO (SOMMAIRE) (CONTENTS
Page 95 and 96: 252 INDEX — Acne Almeida, M.O.
Page 97 and 98: 254 WDEX — Joelho (1983/85) — O
Page 99 and 100: Exmo.(s) Colega(s) I Senhor(es): A
Page 101: Apresentação 5 ampolas a 0,25 mg

1989 Volume XIV, 4, 4º Trimestre - Acta Reumatológica Portuguesa ...

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