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Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies01:22

Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies

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The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
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Imaging Studies for Cardiovascular System IV: CMRI01:21

Imaging Studies for Cardiovascular System IV: CMRI

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Cardiovascular magnetic resonance imaging, or CMRI, is a non-invasive diagnostic test that employs a magnetic field and radiofrequency waves to create precise images of the heart and arteries. It provides comprehensive information about cardiac anatomy, function, perfusion, and tissue characterization without ionizing radiation.IndicationsCMRI diagnoses various heart conditions, including tissue damage from heart attacks, ischemic heart disease, myocarditis, aortic issues (tears, aneurysms,...
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Cardiomyopathy IV: Restrictive Cardiomyopathy01:29

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Restrictive cardiomyopathy (RCM) is a rare heart muscle disease characterized by impaired ventricular filling due to stiffened ventricular walls, leading to significant diastolic dysfunction.EtiologyRestrictive cardiomyopathy can arise from both inherited and acquired diseases, many of which are systemic. It is categorized into four main types: infiltrative, storage, non-infiltrative, and endomyocardial diseases.Infiltrative diseases, such as amyloidosis, lead to RCM by depositing amyloid...
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Rheumatic Heart Disease III: Medical Management01:21

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Rheumatic heart disease (RHD) management can be divided into two main strategies: prevention and long-term management.Primary PreventionPrimary prevention focuses on timely diagnosis and management of group A streptococcal pharyngitis to prevent acute rheumatic fever. The most widely used antibiotic for treating this condition is intramuscular benzathine penicillin G.Acute Rheumatic Fever TreatmentThe primary treatment goal for a patient diagnosed with acute rheumatic fever is to suppress the...
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Imaging Studies IV: Magnetic Resonance Imaging01:27

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Introduction:Magnetic Resonance Imaging, or MRI, can include a specialized imaging technique of the urinary system known as Magnetic Resonance Urography (MRU). This radiation-free technique uses strong magnetic fields and radio waves to produce detailed images with the help of a computer. MRU is particularly effective for visualizing fluid-filled structures like the kidneys, ureters, and bladder.Applications of MRI in the Genitourinary SystemKidneys and Ureters: MRI detects tumors, cysts,...
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Imaging methods in polymyalgia rheumatica: a systematic review.

L Mekenyan1,2,3, R Karalilova4,5, P Todorov4,5

  • 1Department of Propedeutics of Internal Diseases, Medical University-Plovdiv, Plovdiv, Bulgaria. lili_mekenyan@abv.bg.

Rheumatology International
|February 28, 2023
PubMed
Summary

Diagnosing polymyalgia rheumatica (PMR) is challenging. This review explores imaging methods like ultrasound and MRI for early PMR diagnosis, assessing disease activity, and guiding treatment, highlighting their potential and limitations.

Keywords:
ImagingPolymyalgia rheumaticaSubclinical vasculitis

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Area of Science:

  • Rheumatology and Immunology
  • Diagnostic Imaging
  • Clinical Medicine

Background:

  • Polymyalgia rheumatica (PMR) presents diagnostic challenges due to non-specific symptoms and lack of definitive biomarkers.
  • Early diagnosis, disease activity assessment, and treatment response evaluation in PMR are crucial for effective patient management.
  • Understanding the role of imaging in PMR is essential given the limitations of current diagnostic tools.

Approach:

  • A systematic literature review was conducted using PubMed and Scopus databases up to June 2022.
  • Selected studies focused on imaging techniques for diagnosing and managing PMR in patients over 50 years of age.
  • Sixty-one articles were analyzed, evaluating radiography, scintigraphy, MRI, PET/CT, and ultrasound in PMR.

Key Points:

  • Ultrasound and MRI show promise in detecting extraarticular inflammation (tendons, entheses, bursae) in PMR patients.
  • Subclinical large vessel vasculitis was frequently observed, suggesting shared pathogenetic mechanisms with other inflammatory conditions.
  • Imaging methods offer potential for early diagnosis, disease activity assessment, and monitoring therapeutic response in PMR.

Conclusions:

  • Imaging modalities, particularly ultrasound, demonstrate significant potential in evaluating articular and extraarticular manifestations of PMR.
  • Further research is needed to fully elucidate the diagnostic, therapeutic, and prognostic value of various imaging techniques in PMR.
  • The findings underscore the need for standardized imaging protocols to improve PMR diagnosis and management.