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Psoriatic Arthritis
Psoriatic arthritis is a long-term inflammatory arthritis that occurs in people affected by the autoimmune disease psoriasis. The classic feature of psoriatic arthritis is swelling of entire fingers and toes with a sausage-like appearance. This often happens in association with changes to the nails such as small depressions in the nail (pitting), thickening of the nails, and detachment of the nail from the nailbed. Skin changes consistent with psoriasis (e.g., red, scaly, and itchy plaques) frequently occur before the onset of psoriatic arthritis but psoriatic arthritis can precede the rash in 15% of affected individuals. It is classified as a type of seronegative spondyloarthropathy. Genetics are thought to be strongly involved in the development of psoriatic arthritis. Obesity and certain forms of psoriasis are thought to increase the risk. Psoriatic arthritis affects up to 30% of people with psoriasis and occurs in both children and adults. Approximately 40–5 ...
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Rheumatology
Rheumatology (Greek ''ῥεῦμα'', ''rheûma'', flowing current) is a branch of medicine devoted to the diagnosis and management of disorders whose common feature is inflammation in the bones, muscles, joints, and internal organs. Rheumatology covers more than 100 different complex diseases, collectively known as rheumatic diseases, which includes many forms of arthritis as well as lupus and Sjögren's syndrome. Doctors who have undergone formal training in rheumatology are called rheumatologists. Many of these diseases are now known to be disorders of the immune system, and rheumatology has significant overlap with immunology, the branch of medicine that studies the immune system. Rheumatologist A rheumatologist is a physician who specializes in the field of medical sub-specialty called rheumatology. A rheumatologist holds a board certification after specialized training. In the United States, training in this field requires four years undergraduate school, four yea ...
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African People
The population of Africa has grown rapidly over the past century and consequently shows a large youth bulge, further reinforced by a low life expectancy of below 50 years in some African countries. Total population as of 2020 is estimated at more than 1.3 billion, with a growth rate of more than 2.5% p.a. The total fertility rate (births per woman) for Sub-Saharan Africa is 4.7 as of 2018, the highest in the world according to the World Bank. The most populous African country is Nigeria with over 206 million inhabitants as of 2020 and a growth rate of 2.6% p.a. Population Genetics History Alternative Estimates of African Population, 0–1998 AD (in thousands) Source: Maddison and others. (University of Groningen). Shares of Africa and World Population, 0–2018 AD (% of world total) Source: Maddison and others (University of Groningen) and others. Vital Statistics 1950–2021AD Registration of vital events in most of Africa is incomplete. The website Our World ...
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Genome-wide Association Study
In genomics, a genome-wide association study (GWA study, or GWAS), also known as whole genome association study (WGA study, or WGAS), is an observational study of a genome-wide set of genetic variants in different individuals to see if any variant is associated with a trait. GWA studies typically focus on associations between single-nucleotide polymorphisms (SNPs) and traits like major human diseases, but can equally be applied to any other genetic variants and any other organisms. When applied to human data, GWA studies compare the DNA of participants having varying phenotypes for a particular trait or disease. These participants may be people with a disease (cases) and similar people without the disease (controls), or they may be people with different phenotypes for a particular trait, for example blood pressure. This approach is known as phenotype-first, in which the participants are classified first by their clinical manifestation(s), as opposed to genotype-first. Each pe ...
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Arthritis Mutilans
Arthritis mutilans is a rare medical condition involving severe inflammation damaging the joints of the hands and feet, and resulting in deformation and problems with moving the affected areas; it can also affect the spine. As an uncommon arthropathy, arthritis mutilans was originally described as affecting the hands, feet, fingers, and/or toes, but can refer in general to severe derangement of any joint damaged by arthropathy. First described in modern medical literature by Marie and Leri in 1913, in the hands, arthritis mutilans is also known as opera glass hand (''la main en lorgnette'' in French), or chronic absorptive arthritis. Sometimes there is foot involvement in which toes shorten and on which painful calluses develop in a condition known as opera glass foot, or ''pied en lorgnette''. Signs and symptoms For a person with arthritis mutilans in the hands, the fingers become shortened by arthritis, and the shortening may become severe enough that the hand looks paw-like, wi ...
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Plantar Fasciitis
Plantar fasciitis or plantar heel pain (PHP) is a disorder of the plantar fascia, which is the connective tissue which supports the arch of the foot. It results in pain in the heel and bottom of the foot that is usually most severe with the first steps of the day or following a period of rest. Pain is also frequently brought on by bending the foot and toes up towards the shin. The pain typically comes on gradually, and it affects both feet in about one-third of cases. The cause of plantar fasciitis is not entirely clear. Risk factors include overuse, such as from long periods of standing, an increase in exercise, and obesity. It is also associated with inward rolling of the foot, a tight Achilles tendon, and a sedentary lifestyle. It is unclear if heel spurs have a role in causing plantar fasciitis even though they are commonly present in people who have the condition. Plantar fasciitis is a disorder of the insertion site of the ligament on the bone characterized by micro ...
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Enthesitis
Enthesitis is inflammation of the entheses, the sites where tendons or ligaments insert into the bone. It is an enthesopathy, a pathologic condition of the entheses. Early clinical manifestations are an aching sensation akin to "working out too much", and it gets better with activity. It is worse in the morning (after sleeping and not moving). The muscle insertion hurts very focally as it joins into the bone, but there is little to no pain at all with passive motion. There are some cases of isolated, primary enthesitis which are very poorly studied and understood. It is known to be associated with other autoimmune diseases, like spondyloarthropathies and psoriasis (thought to often precede psoriatic arthritis). A common autoimmune enthesitis is at the heel, where the Achilles tendon attaches to the calcaneus. It is associated with HLA B27 arthropathies, such as ankylosing spondylitis, psoriatic arthritis, and reactive arthritis. Symptoms include multiple points of tenderness ...
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Spondylitis
Spondylitis is an inflammation of the vertebrae. It is a form of spondylopathy. In many cases, spondylitis involves one or more vertebral joints, as well, which itself is called spondylarthritis. __TOC__ Types Pott disease is a tuberculous disease of the vertebrae marked by stiffness of the vertebral column, pain on motion, tenderness on pressure, prominence of certain vertebral spines, and occasionally abdominal pain, abscess formation, and paralysis. Ankylosing spondylitis (pronounced ank-kih-low-sing spon-dill-eye-tiss),  or AS, is a form of arthritis that primarily affects the spine, although other joints can become involved. It causes inflammation of the spinal joints (vertebrae) that can lead to severe, chronic pain and discomfort. In more advanced cases this inflammation can lead to ankylosis, new bone formation in the spine causing sections of the spine to fuse in a fixed, immobile position. A combination of spondylitis and inflammation of the intervertebral disc spa ...
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Sacroiliitis
Sacroiliitis is inflammation within the sacroiliac joint. It is a feature of spondyloarthropathies, such as axial spondyloarthritis (including ankylosing spondylitis), psoriatic arthritis, reactive arthritis or arthritis related to inflammatory bowel diseases, including ulcerative colitis or Crohn's disease. It is also the most common presentation of arthritis from brucellosis. Symptoms and signs People suffering from sacroiliitis can often experience symptoms in a number of different ways, however it is commonly related to the amount of pressure that is put onto the sacroiliac joint. Sacroiliitis pain is typically axial, meaning that the location of the condition is also where the pain is occurring. Symptoms commonly include prolonged, inflammatory pain in the lower back region, hips or buttocks. However, in more severe cases, pain can become more radicular and manifest itself in seemingly unrelated areas of the body including the legs, groin and feet. Symptoms are typically a ...
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Sacrum
The sacrum (plural: ''sacra'' or ''sacrums''), in human anatomy, is a large, triangular bone at the base of the spine that forms by the fusing of the sacral vertebrae (S1S5) between ages 18 and 30. The sacrum situates at the upper, back part of the pelvic cavity, between the two wings of the pelvis. It forms joints with four other bones. The two projections at the sides of the sacrum are called the alae (wings), and articulate with the ilium at the L-shaped sacroiliac joints. The upper part of the sacrum connects with the last lumbar vertebra (L5), and its lower part with the coccyx (tailbone) via the sacral and coccygeal cornua. The sacrum has three different surfaces which are shaped to accommodate surrounding pelvic structures. Overall it is concave (curved upon itself). The base of the sacrum, the broadest and uppermost part, is tilted forward as the sacral promontory internally. The central part is curved outward toward the posterior, allowing greater room for the p ...
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Hyperkeratosis
Hyperkeratosis is thickening of the stratum corneum (the outermost layer of the epidermis, or skin), often associated with the presence of an abnormal quantity of keratin,Kumar, Vinay; Fausto, Nelso; Abbas, Abul (2004) ''Robbins & Cotran Pathologic Basis of Disease'' (7th ed.). Saunders. Page 1230. . and also usually accompanied by an increase in the granular layer. As the corneum layer normally varies greatly in thickness in different sites, some experience is needed to assess minor degrees of hyperkeratosis. It can be caused by vitamin A deficiency or chronic exposure to arsenic. Hyperkeratosis can also be caused by B-Raf inhibitor drugs such as Vemurafenib and Dabrafenib.Niezgoda, Anna; Niezgoda, Piotr; Czajkowski, Rafal (2015) ''Novel Approaches to Treatment of Advanced Melanoma: A Review of Targeted Therapy and Immunotherapy'' BioMed Research International It can be treated with urea-containing creams, which dissolve the intercellular matrix of the cells of the stratum ...
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Onycholysis
Onycholysis is a common medical condition characterized by the painless detachment of the nail from the nail bed, usually starting at the tip and/or sides. On the hands, it occurs particularly on the ring finger but can occur on any of the fingernails. It may also happen to toenails. Onycholysis can occur in many conditions, including psoriasis. In thyrotoxicosis, it is thought to be due to sympathetic overactivity. It may also be seen in infections or trauma. Causes * Unknown * Trauma, excessive manicuring * Infection: especially fungal * Skin disease: psoriasis, dermatitis * Impaired peripheral circulation, e.g. Raynaud's syndrome * Systemic disease: hyperthyroidism, hypothyroidism, reactive arthritis, porphyria cutanea tarda * Reaction to detergents (e.g. washing dishes with bare hands, using detergent-based shampoos or soaps). * Patients with hepatocellular dysfunction may develop hair-thinning or hair loss and nail changes such as clubbing, leukonychia (whitening), or o ...
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Interphalangeal Articulations Of Hand
The interphalangeal joints of the hand are the hinge joints between the phalanges of the fingers that provide flexion towards the palm of the hand. There are two sets in each finger (except in the thumb, which has only one joint): * "proximal interphalangeal joints" (PIJ or PIP), those between the first (also called proximal) and second (intermediate) phalanges * "distal interphalangeal joints" (DIJ or DIP), those between the second (intermediate) and third (distal) phalanges Anatomically, the proximal and distal interphalangeal joints are very similar. There are some minor differences in how the palmar plates are attached proximally and in the segmentation of the flexor tendon sheath, but the major differences are the smaller dimension and reduced mobility of the distal joint. Joint structure The PIP joint exhibits great lateral stability. Its transverse diameter is greater than its antero-posterior diameter and its thick collateral ligaments are tight in all positions duri ...
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