Because of the similarity between the diagnostic criteria for acute rheumatic fever (ARF) and post-streptococcal reactive arthritis (PSRA), therefore diagnosis and treatment of PSRA are not well defined. To clarify whether PSRA is a separate disease entity? And to evaluate the extent of joint affection by using various clinical, laboratory and radiological tools. Fifty patients with arthritis secondary to infection with Group A ß-haemolytic streptococcus (GAβS) attended Outpatient Rheumatology Clinics of Rheumatology and Rehabilitation and Internal Medicine Departments; Assuit University Hospitals, in addition to 20 healthy volunteers as controls were included in this study. All patients were submitted to complete medical history and clinical examination. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Rheumatoid factor (RF), Antinuclear antibody (ANA), throat swab, Anti-streptolycin-O titre (ASOT), Electrocardiography (ECG) and Echocardiography have been done to all patients. Plain radiography, ultrasonography (US) and Magnetic Resonance Imaging (MRI) to both knees and ankles were done to all patients. ASOT was positive with a range (200-800) IU. Culture of throat swab was positive for GAßS in 72%, staphylococci in 24% and pneumococci in 16% of the patients. All patients had non migratory arthritis of lower limbs. Knees and ankles synovitis with minimal effusion was detected in 36% of the patients by US, and 32% and 40% by MRI respectively. Synovitis with marked effusion of knees and ankles was detected in 36% and 44% of patients respectively by US and 40% by MRI. In conclusion, PSRA is a separate disease entity. The extent of joint affection might be evaluated by the use of US and MRI as the findings were concordant in knee joint affection. MRI was preferable in evaluating ankle joint synovitis.

Because of the similarity between the diagnostic criteria for acute rheumatic fever (ARF) and post-streptococcal reactive arthritis (PSRA), therefore diagnosis and treatment of PSRA are not well defined. To clarify whether PSRA is a separate disease entity? And to evaluate the extent of joint affection by using various clinical, laboratory and radiological tools. Fifty patients with arthritis secondary to infection with Group A ß-haemolytic streptococcus (GAβS) attended Outpatient Rheumatology Clinics of Rheumatology and Rehabilitation and Internal Medicine Departments; Assuit University Hospitals, in addition to 20 healthy volunteers as controls were included in this study. All patients were submitted to complete medical history and clinical examination. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Rheumatoid factor (RF), Antinuclear antibody (ANA), throat swab, Anti-streptolycin-O titre (ASOT), Electrocardiography (ECG) and Echocardiography have been done to all patients. Plain radiography, ultrasonography (US) and Magnetic Resonance Imaging (MRI) to both knees and ankles were done to all patients. ASOT was positive with a range (200-800) IU. Culture of throat swab was positive for GAßS in 72%, staphylococci in 24% and pneumococci in 16% of the patients. All patients had non migratory arthritis of lower limbs. Knees and ankles synovitis with minimal effusion was detected in 36% of the patients by US, and 32% and 40% by MRI respectively. Synovitis with marked effusion of knees and ankles was detected in 36% and 44% of patients respectively by US and 40% by MRI. In conclusion, PSRA is a separate disease entity. The extent of joint affection might be evaluated by the use of US and MRI as the findings were concordant in knee joint affection. MRI was preferable in evaluating ankle joint synovitis.

Because of the similarity between the diagnostic criteria for acute rheumatic fever (ARF) and post-streptococcal reactive arthritis (PSRA), therefore diagnosis and treatment of PSRA are not well defined. To clarify whether PSRA is a separate disease entity? And to evaluate the extent of joint affection by using various clinical, laboratory and radiological tools. Fifty patients with arthritis secondary to infection with Group A ß-haemolytic streptococcus (GAβS) attended Outpatient Rheumatology Clinics of Rheumatology and Rehabilitation and Internal Medicine Departments; Assuit University Hospitals, in addition to 20 healthy volunteers as controls were included in this study. All patients were submitted to complete medical history and clinical examination. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Rheumatoid factor (RF), Antinuclear antibody (ANA), throat swab, Anti-streptolycin-O titre (ASOT), Electrocardiography (ECG) and Echocardiography have been done to all patients. Plain radiography, ultrasonography (US) and Magnetic Resonance Imaging (MRI) to both knees and ankles were done to all patients. ASOT was positive with a range (200-800) IU. Culture of throat swab was positive for GAßS in 72%, staphylococci in 24% and pneumococci in 16% of the patients. All patients had non migratory arthritis of lower limbs. Knees and ankles synovitis with minimal effusion was detected in 36% of the patients by US, and 32% and 40% by MRI respectively. Synovitis with marked effusion of knees and ankles was detected in 36% and 44% of patients respectively by US and 40% by MRI. In conclusion, PSRA is a separate disease entity. The extent of joint affection might be evaluated by the use of US and MRI as the findings were concordant in knee joint affection. MRI was preferable in evaluating ankle joint synovitis.

Because of the similarity between the diagnostic criteria for acute rheumatic fever (ARF) and post-streptococcal reactive arthritis (PSRA), therefore diagnosis and treatment of PSRA are not well defined. To clarify whether PSRA is a separate disease entity? And to evaluate the extent of joint affection by using various clinical, laboratory and radiological tools. Fifty patients with arthritis secondary to infection with Group A ß-haemolytic streptococcus (GAβS) attended Outpatient Rheumatology Clinics of Rheumatology and Rehabilitation and Internal Medicine Departments; Assuit University Hospitals, in addition to 20 healthy volunteers as controls were included in this study. All patients were submitted to complete medical history and clinical examination. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Rheumatoid factor (RF), Antinuclear antibody (ANA), throat swab, Anti-streptolycin-O titre (ASOT), Electrocardiography (ECG) and Echocardiography have been done to all patients. Plain radiography, ultrasonography (US) and Magnetic Resonance Imaging (MRI) to both knees and ankles were done to all patients. ASOT was positive with a range (200-800) IU. Culture of throat swab was positive for GAßS in 72%, staphylococci in 24% and pneumococci in 16% of the patients. All patients had non migratory arthritis of lower limbs. Knees and ankles synovitis with minimal effusion was detected in 36% of the patients by US, and 32% and 40% by MRI respectively. Synovitis with marked effusion of knees and ankles was detected in 36% and 44% of patients respectively by US and 40% by MRI. In conclusion, PSRA is a separate disease entity. The extent of joint affection might be evaluated by the use of US and MRI as the findings were concordant in knee joint affection. MRI was preferable in evaluating ankle joint synovitis.

Because of the similarity between the diagnostic criteria for acute rheumatic fever (ARF) and post-streptococcal reactive arthritis (PSRA), therefore diagnosis and treatment of PSRA are not well defined. To clarify whether PSRA is a separate disease entity? And to evaluate the extent of joint affection by using various clinical, laboratory and radiological tools. Fifty patients with arthritis secondary to infection with Group A ß-haemolytic streptococcus (GAβS) attended Outpatient Rheumatology Clinics of Rheumatology and Rehabilitation and Internal Medicine Departments; Assuit University Hospitals, in addition to 20 healthy volunteers as controls were included in this study. All patients were submitted to complete medical history and clinical examination. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Rheumatoid factor (RF), Antinuclear antibody (ANA), throat swab, Anti-streptolycin-O titre (ASOT), Electrocardiography (ECG) and Echocardiography have been done to all patients. Plain radiography, ultrasonography (US) and Magnetic Resonance Imaging (MRI) to both knees and ankles were done to all patients. ASOT was positive with a range (200-800) IU. Culture of throat swab was positive for GAßS in 72%, staphylococci in 24% and pneumococci in 16% of the patients. All patients had non migratory arthritis of lower limbs. Knees and ankles synovitis with minimal effusion was detected in 36% of the patients by US, and 32% and 40% by MRI respectively. Synovitis with marked effusion of knees and ankles was detected in 36% and 44% of patients respectively by US and 40% by MRI. In conclusion, PSRA is a separate disease entity. The extent of joint affection might be evaluated by the use of US and MRI as the findings were concordant in knee joint affection. MRI was preferable in evaluating ankle joint synovitis.

Abstract Background. Recent data provided evidence on the implication of the adipocytokines adiponectin, visfatin, and resistin in inflammation, immune response, and tissue destruction and revealed several links between them and arthritis. Aim of the study. The purpose of this study was to assess the levels of adiponectin, visfatin, and resistin in serum and synovial fluid of patients with rheumatoid arthritis (RA) and determine their relationship with disease activity. Subjects and methods. A total of 70 female patients with RA and 30 age- and sex matched healthy controls were enrolled. The clinical activity of RA patients was assessed according to the 28 joint count Disease Activity Score and patients were classified into two groups: 39 patients with active disease (group A) and 31 patients in remission(group B). Synovial fluid was obtained by arthrocentesis of the affected knee joints from 39 patients with active disease. Serum adiponectin, visfatin, and resistin concentrations were measured in RA patients and controls, while a specific enzyme-linked immunosorbent assay was used to measure the synovial concentrations of adiponectin, visfatin, and resistin in the group of patients with active RA. Results. Serum levels of adiponectin and visfatin were significantly higher in all RA patients and patients with active disease compared to the control group and patients in remission. No significant difference was observed in the resistin level between patients and controls. Serum and synovial adiponectin and visfatin were positively correlated with DAS28-ESR in RA patients with active disease. Conclusion. Our data demonstrated that adiponectin and visfatin are related to disease activity in RA patients and might be involved in the progression of RA.

Abstract Background. Recent data provided evidence on the implication of the adipocytokines adiponectin, visfatin, and resistin in inflammation, immune response, and tissue destruction and revealed several links between them and arthritis. Aim of the study. The purpose of this study was to assess the levels of adiponectin, visfatin, and resistin in serum and synovial fluid of patients with rheumatoid arthritis (RA) and determine their relationship with disease activity. Subjects and methods. A total of 70 female patients with RA and 30 age- and sex matched healthy controls were enrolled. The clinical activity of RA patients was assessed according to the 28 joint count Disease Activity Score and patients were classified into two groups: 39 patients with active disease (group A) and 31 patients in remission(group B). Synovial fluid was obtained by arthrocentesis of the affected knee joints from 39 patients with active disease. Serum adiponectin, visfatin, and resistin concentrations were measured in RA patients and controls, while a specific enzyme-linked immunosorbent assay was used to measure the synovial concentrations of adiponectin, visfatin, and resistin in the group of patients with active RA. Results. Serum levels of adiponectin and visfatin were significantly higher in all RA patients and patients with active disease compared to the control group and patients in remission. No significant difference was observed in the resistin level between patients and controls. Serum and synovial adiponectin and visfatin were positively correlated with DAS28-ESR in RA patients with active disease. Conclusion. Our data demonstrated that adiponectin and visfatin are related to disease activity in RA patients and might be involved in the progression of RA.

Abstract Background. Recent data provided evidence on the implication of the adipocytokines adiponectin, visfatin, and resistin in inflammation, immune response, and tissue destruction and revealed several links between them and arthritis. Aim of the study. The purpose of this study was to assess the levels of adiponectin, visfatin, and resistin in serum and synovial fluid of patients with rheumatoid arthritis (RA) and determine their relationship with disease activity. Subjects and methods. A total of 70 female patients with RA and 30 age- and sex matched healthy controls were enrolled. The clinical activity of RA patients was assessed according to the 28 joint count Disease Activity Score and patients were classified into two groups: 39 patients with active disease (group A) and 31 patients in remission(group B). Synovial fluid was obtained by arthrocentesis of the affected knee joints from 39 patients with active disease. Serum adiponectin, visfatin, and resistin concentrations were measured in RA patients and controls, while a specific enzyme-linked immunosorbent assay was used to measure the synovial concentrations of adiponectin, visfatin, and resistin in the group of patients with active RA. Results. Serum levels of adiponectin and visfatin were significantly higher in all RA patients and patients with active disease compared to the control group and patients in remission. No significant difference was observed in the resistin level between patients and controls. Serum and synovial adiponectin and visfatin were positively correlated with DAS28-ESR in RA patients with active disease. Conclusion. Our data demonstrated that adiponectin and visfatin are related to disease activity in RA patients and might be involved in the progression of RA.

Abstract Background. Recent data provided evidence on the implication of the adipocytokines adiponectin, visfatin, and resistin in inflammation, immune response, and tissue destruction and revealed several links between them and arthritis. Aim of the study. The purpose of this study was to assess the levels of adiponectin, visfatin, and resistin in serum and synovial fluid of patients with rheumatoid arthritis (RA) and determine their relationship with disease activity. Subjects and methods. A total of 70 female patients with RA and 30 age- and sex matched healthy controls were enrolled. The clinical activity of RA patients was assessed according to the 28 joint count Disease Activity Score and patients were classified into two groups: 39 patients with active disease (group A) and 31 patients in remission(group B). Synovial fluid was obtained by arthrocentesis of the affected knee joints from 39 patients with active disease. Serum adiponectin, visfatin, and resistin concentrations were measured in RA patients and controls, while a specific enzyme-linked immunosorbent assay was used to measure the synovial concentrations of adiponectin, visfatin, and resistin in the group of patients with active RA. Results. Serum levels of adiponectin and visfatin were significantly higher in all RA patients and patients with active disease compared to the control group and patients in remission. No significant difference was observed in the resistin level between patients and controls. Serum and synovial adiponectin and visfatin were positively correlated with DAS28-ESR in RA patients with active disease. Conclusion. Our data demonstrated that adiponectin and visfatin are related to disease activity in RA patients and might be involved in the progression of RA.

Abstract Aim(s) of the work: To explore early changes in the predictors of bone turnover in children with juvenile idiopathic arthritis (JIA). To identify osteoprotegerin/receptor activator of nuclear factor-jB ligand (OPG/RANKL) ratio in the serum of the same patients and its relation to the parameters of joint inflammation and joint destruction. Patients and methods: Seventy children with JIA and 30 healthy children individually matched for age, sex, race, and county of residence were included in this study. Serum levels of calcium(Ca), phosphorus (Ph), alkaline phosphatase (ALP), osteocalcin (OC), RANKL and (OPG) were measured. Urinary concentration of deoxypyridinoline (DPD) was also done. All involved joints were assessed by plain radiography. Results: Significant low serum concentrations of ALP and OPG was observed in JIA group, while there was a significant increase in serum level of RANKL and urine level of DPD compared to controls. OPG/RANKL ratio was significantly lower in JIA patients than in controls. OPG/RANKL ratio is correlated with most clinical characteristics, disease activity variables, JIA outcome measures and radiographic findings. DPD, RANKL and OPG/RANKL ratio, respectively,are considered as independent predictors of juxta-articular osteoporosis. OPG/RANKL ratio was the only predictor of bone erosion. Conclusion: The OPG/RANKL ratio could be an early predictor of increased bone resorption and a valuable biomarker for joint inflammation and bone injury in JIA patients.