Hepatotoxicity associated with sulfasalazine in inflammatory arthritis: A case series from a local surveillance of serious adverse events
Paresh Jobanputra , Roshan Amarasena , Fiona Maggs , Dawn Homer , Simon Bowman , Elizabeth Rankin , Andrew Filer , Karim Raza and Ronald Jubb
BMC Musculoskeletal Disorders 2008, 9:48
Serious hepatotoxicity associated with sulfasalazine appears to be under-appreciated and intensive monitoring and vigilance in the first 6 weeks of treatment is especially important.
Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease of unknown cause that primarily affects the peripheral joints in a symmetric pattern. Constitutional symptoms, including fatigue, malaise, and morning stiffness, are common. Extra-articular involvement of organs such as the skin, heart, lungs, and eyes can be significant. RA causes joint destruction and thus often leads to considerable morbidity and mortality. The treatment of RA is rapidly advancing with the recent addition of new and innovative therapies.
Synonyms and related keywords: RA, systemic inflammatory disease, rheumatoid factor, RF, cyclooxygenase, COX-1, COX-2, nonsteroidal anti-inflammatory drugs, NSAIDs, disease-modifying antirheumatic drugs, disease-modifying anti-rheumatic drugs, DMARDs, joint destruction, uncontrolled inflammation, cartilage destruction, bone destruction, morning stiffness, rheumatoid nodules
Howard R Smith, MD 2006
What does this mean for my patients?
Upon completing this activity, you should be able to differentiate between the van der Heijde-modified Sharp, modified Genant, and Larsen scoring systems and describe how they are utilized in measuring joint alterations in RA patients, identify 3 different imaging techniques used in assessing RA severity and the benefits and limitations of each, evaluate magnetic resonance imaging, ultrasonography, and x-ray data for joint alterations due to RA, and more.
Authors - Orrin M. Troum, MD John V. Crues, III, MD Sergio Schwartzman, MD
Osteoarthritis (OA) is a degenerative condition in which the articular cartilage on the surfaces of the bones that form joints progressively deteriorates. The terms osteoarthrosis and OA are often used interchangeably. Although inflammation is generally absent in this degenerative condition, most physicians commonly refer to it as OA. Hence, this is the term in daily use.1
OA is common in weight-bearing joints. Although the wrist is not a weight-bearing joint, OA of the wrist is not an uncommon condition that orthopedic surgeons encounter in day-to-day practice.
Wrist arthritis is also common in patients with rheumatoid arthritis (RA), which is a systemic autoimmune inflammatory disorder that affects the joints; in the upper limb, the wrist is most frequently affected. RA invariably results in functional difficulty over time.
Synonyms and related keywords: OA, osteoarthritis, RA, rheumatoid arthritis, wrist osteoarthritis, wrist dysfunction, wrist pain, wrist stiffness, upper extremity arthritis, upper extremity osteoarthritis, Kienböck disease, Mannerfelt lesion, caput ulna syndrome, wrist arthroscopy, wrist denervation, wrist synovectomy, wrist arthrodesis, triscaphe arthrodesis, lunate-triquetrum arthrodesis, lunatetriquetrum arthrodesis, radioscaphoid arthrodesis, radio-scaphoid arthrodesis, scapholunocapitate fusion, radiolunate fusion, total wrist fusion, TWF, proximal row carpectomy, total wrist arthroplasty
Lakshmanan & Sher 2008