Reumatizam, Vol. 64 No. 2, 2017.
Professional paper
INTERMETATARSAL BURSITIS AS A MANIFESTATION OF RHEUMATOID ARTHRITIS – A CASE PRESENTATION
Mirna Reihl
Miroslav Mayer
Branimir Anić
Abstract
We present a patient with an exacerbation of rheumatoid arthritis featuring intermetatarsal bursitis. Inflammatory changes in the intermetatarsal bursae were confi rmed by ultrasonography, whereas there was no sign of inflammation in the metatarsophalangeal joints. Enlarged structures of the intermetatarsal bursae that transgressed the
normal anatomical boundaries, thus producing the ‘hourglass’ sign, were visualized by magnetic resonance imaging. Ultrasound-controlled infiltration of depo-methylprednisolon administered to the affected bursae led to clinical improvement and radiological regression. Administration of a biological agent would be the next disease management option in line with the therapeutic guidelines in the setting of active arthritis suspected in our patient’s arthritis fl are-up. Thus we would like to emphasize the value of musculosceletal US and targeted intervention in ‘tight-control’ disease management and in diff erentiating the cause of metatarsalgia in patients with inflammatory rheumatic diseases. Further investigations are required to determine the incidence of intermetatarsal bursitis in rheumatoid arthritis as well as their clinical and prognostic significance and optimal therapeutic approach.
Keywords
Bursitis – diagnostic imaging, drug therapy, etiology; Bursa, synovial – diagnostic imaging, drug effects; Methylprednisolone – therapeutic use; Arthritis, rheumatoid – complications, drug therapy; Metatarsalgia – drug therapy, etiology; Metatarsal bones – diagnostic imaging; Metatarsophalangeal joint – diagnostic imaging; Antirheumatic agents – therapeutic use; Ultrasonography
Hrčak ID:
198826
URI
Publication date:
29.3.2018.
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