
Systemic Lupus Erythematosus: A Systematic Approach to Arthritis of Rheumatic Diseases: Volume 4
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Systemic lupus erythematosus (SLE) is an autoimmune disease. SLE affects many parts of the body, with joint pain in the knees and hands being commonly reported symptoms. Arthritis is, therefore, one of the most common symptoms of the disease.
This book comprehensively summarizes information about SLE for medical professionals and students. The volume illustrates the process of making accurate diagnoses through systematic interpretation of ABCDEGFGI parameters: A (Alignment): malalignment and deformation; B (Bone): bone changes; C (Capsular lesions): cartilage and intra-articular lesions; D (Distribution): four dimensional distributions; E (Extra-bone): extra-articular soft tissue; F (Further information): further additional medical information; G (Goal): general analysis and integrated comprehensive diagnosis; H (Heal and Heath): treatment and prognosis; and I (Immunological analysis): immunological interpretations.
Key Features:
- Presents information about the clinical features of SLE and differential diagnosis through 11 chapters
- Covers both rheumatic symptoms and systemic symptoms
- Provides a comprehensive approach to SLE diagnosis and management which blends both rheumatology and radiology
- Explains the ABCDEFGI system for diagnosing and treating SLE patients
- Includes more than 750 detailed figures illustrating important information
- Includes references for further reading
The book is an informative resource for a wide range of scholarly and professional readers who may encounter SLE patients in clinical settings: rheumatologists, orthopedists, radiologists, physiatrists, immunologists, pediatricians, general physicians, medical technicians, caregivers and specialists in internal medicine.
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Content
- Intro
- Title
- Copyright
- End User License Agreement
- Contents
- Preface
- List of Contributors
- Introduction of Diagnostic Approach for Systemic Lupus Erythematosus
- Syuichi Koarada1, 2, 3,* and Yoshifumi Tada 3
- 1. INTRODUCTION
- 2. CLASSIFICATION OF LUPUS ARTHROPATHY
- 2.1. Frequency of Arthritis Subtypes
- 2.2. Arthritis Subtypes
- 2.2.1. Non-erosive Arthritis
- 2.2.2. Erosive Arthritis
- 2.3. Osteonecrosis, Avascular Osteonecrosis (AVN)
- 2.4. Osteoporosis
- 2.5. Insufficient Fractures
- 3. APPROACHES TO DIAGNOSIS OF SLE
- 3.1. Approach to Hand X-rays
- 3.1.1. Posteroanterior View, Posterior-anterior View (PA View)
- 3.1.2. Oblique View
- 3.1.3. Ball-catcher's View, Norgaard's View
- 3.1.4. Lateral View
- CONCLUSION
- CONSENT FOR PUBLICATION
- CONFLICT OF INTEREST
- ACKNOWLEDGEMENTS
- REFERENCES
- Alignment of Musculoskeletal System in Systemic Lupus Erythematosus
- Syuichi Koarada1, 2, 3,* and Mitsuteru Akahoshi3
- 1. INTRODUCTION
- 2. NON-EROSIVE ARTHROPATHY, JACCOUD'S ARTHROPATHY
- 3. CHRONIC FIXED DEFORMITIES
- 4. MECHANISM OF DEFORMITIES OF JOINTS
- 5. HANDS
- 5.1. Deformities of Metacarpophalangeal Joints
- 5.1.1. Ulnar Deviation of Metacarpophalangeal Joints
- 5.1.2. Flexion Deformities of MCP Joints
- 5.2. Deformities of DIP and PIP Joints
- 5.2.1. Boutonniere Deformities
- 5.2.2. Swan-neck Deformities
- 5.3. Dislocation
- 5.4. Flexion Contracture of Digits
- 5.5. Osteoarthritis of Hands in SLE
- 5.6. Thumbs
- 5.6.1. Swan-neck Deformities
- 5.6.2. Z-thumbs, Boutonniere Deformities
- 6. WRISTS
- 6.1. Radial Deviation of Wrists
- 6.2. Carpal Collapse
- 7. SHOULDERS
- 8. HIPS
- 8.1. Osteonecrosis of Hips
- 9. KNEES
- 10. FEET
- 10.1. Hallux Valgus
- 10.2. Hammer Toes, Mallet-toes, and Claw-toes
- 10.2.1. Hammer Toes
- 10.2.2. Crossover Toe Deformities
- 10.2.3. Mallet-toes
- 10.2.4. Claw-toes and Curly Toes
- 10.3. Tailor's Bunion, Digitus Quintus Varus
- 10.4. Flat Feet and Pedes Spinatus
- 10.5. Widening of Forefeet
- 11. SPINE
- 11.1. Lumbar Spine
- 11.2. Cervical Spine
- 12. FRACTURES
- 12.1. Hands
- 12.2. Feet (Fig. 63)
- 12.3. Spine (Figs. 64 - 65)
- 12.4. Pelvis
- 12.4.1. Fractures of Pubic Bones (Figs. 66 - 67)
- 12.4.2. Fractures of Ischiopubic Ramus (Fig. 68)
- CONCLUSION
- CONSENT FOR PUBLICATION
- CONFLICT OF INTEREST
- ACKNOWLEDGEMENTS
- REFERENCES
- Bone Lesions of Systemic Lupus Erythematosus
- Syuichi Koarada1,2,3,* and Akihito Maruyama3
- 1. INTRODUCTION
- 2. BONE MINERALIZATION
- 2.1. Periarticular (Juxta-articular) Osteoporosis
- 2.1.1. Hands
- 2.1.2. Wrists (Fig. 45)
- 2.1.3. Elbows (Figs. 47 - 51)
- 2.1.4. Shoulders (Fig. 52)
- 2.1.5. Knees (Fig. 53)
- 2.1.6. Ankles (Fig. 54)
- 2.1.7. Feet (Fig. 55)
- 2.2. Generalized Osteopenia, Generalized Osteoporosis
- 3. OSTEOSCLEROSIS
- 3.1. Hands
- 3.1.1. Acro-osteosclerosis
- 3.1.2. Osteosclerosis of Tufts
- 3.1.3. DIP Joints (Figs. 64 - 65)
- 3.1.4. IP joints (Fig. 66)
- 3.1.5. PIP Joints (Fig. 67)
- 3.1.6. MCP Joints (Fig. 68)
- 3.2. Hips
- 3.3. Knees (Figs. 69 - 70)
- 3.4. Feet
- 3.4.1. MTP Joints (Fig. 71)
- 3.5. Sacroiliac Joints (Fig. 72)
- 3.6. Vertebral End Plates (Fig. 73)
- 4. BONE SHAPE
- 4.1. Erosions
- 4.1.1. Erosions in Rhupus
- 4.1.2. MRI
- 4.1.3. Hands
- 4.1.4. Wrists (Figs. 97 - 103)
- 4.1.5. Feet
- 4.2. Cystic Changes
- 4.2.1. Hands
- 4.4.2. Hips (Fig. 117)
- 4.4.3. Feet
- 4.3. New Bone Formation: Osteophytes and Syndesmophytes
- 4.3.1. Osteophytes
- 5. AVASCULAR NECROSIS OF BONES
- CONCLUSION
- CONSENT FOR PUBLICATION
- CONFLICT OF INTEREST
- ACKNOWLEDGEMENTS
- REFERENCES
- Cartilaginous and Capsular Changes in Systemic Lupus Erythematosus
- Syuichi Koarada1,2,3,* and Sachiko Soejima2
- 1. INTRODUCTION
- 2. SYNOVITIS
- 2.1. Jaccoud's Arthropathy
- 2.2. DIP Joints (Figs. 1 - 3)
- 2.3. IP Joints (Figs. 4 - 5)
- 2.4. PIP Joints
- 2.4.1. Second PIP Joints (Figs. 6 - 8)
- 2.4.2. Third PIP Joints (Figs. 9 - 17)
- 2.4.3. Fourth PIP Joints (Figs. 18 - 22)
- 2.4.4. Fifth PIP Joints (Figs. 23 - 24)
- 2.5. MCP Joints
- 2.5.1. First MCP joints (Figs. 25 - 27)
- 2.5.2. Second MCP Joints (Figs. 28 - 32)
- 2.5.3. Third MCP Joints (Figs. 33 - 45)
- 2.5.4. Fourth MCP Joints (Figs. 46 - 49)
- 2.5.5. Fifth MCP Joints (Figs. 50 - 51)
- 2.6. Wrists (Fig. 52)
- 2.6.1. First Digit Line of Wrist (Figs. 53 - 55)
- 2.6.2. Second Digit Line of the Wrist (Figs. 56 - 60)
- 2.6.3. Third Digit Line of the Wrist (Figs. 61 - 62)
- 2.6.4. Fourth Digit Line of the Wrist (Figs. 76 - 78)
- 2.6.5. Ulna Line of the Wrist (Figs. 79 - 85)
- 2.7. Elbows (Figs. 86 - 88)
- 2.8. Knees (Figs. 89 - 90)
- 2.9. Ankles (Fig. 91)
- 2.10. Feet (Figs. 92 - 96)
- 2.11. Sacroiliac Joints
- 3. JOINT EFFUSIONS
- 3.1. Hands
- 3.1.1. MCP Joints (Figs. 97 - 99)
- 3.2. Wrists (Figs. 100 - 102)
- 3.3. Elbows (Fig. 103)
- 3.4. Knees (Figs. 104 - 117)
- 4. JOINT SPACES
- 4.1. Rhupus
- 4.2. Joint Space Narrowing
- 4.2.1. Hands
- 4.2.2. Elbows (Fig. 132)
- 4.2.3. Knees (Figs. 133 - 134)
- 4.2.4. Sacroiliac Joints
- 4.3. Joint Space Widening (JSW)
- 4.4. Pseudo Joint Space Narrowing (Fig. 135)
- 5. CALCIFICATIONS
- 5.1. Calcifications of Joint Capsules
- 5.1.1. DIP Joints (Figs. 136 - 138)
- 5.1.2. IP Joints (Figs. 139 - 140)
- 5.1.3. PIP Joints (Figs. 141 - 142)
- 5.1.4. MCP Joints (Figs. 143 - 144)
- 5.1.5. Carpal Joints (Fig. 145)
- CONCLUSION
- CONSENT FOR PUBLICATION
- CONFLICT OF INTEREST
- ACKNOWLEDGEMENTS
- REFERENCES
- Distribution, Pattern of Joint Involvement in Systemic Lupus Erythematosus
- Syuichi Koarada1,2,3,* and Mariko Sakai3
- 1. INTRODUCTION
- 1.1. Gallium Scintigraphy (Figs. 2 - 8)
- 1.2. Bone Scintigraphy (Figs. 9 - 11)
- 2. DISTRIBUTION OF ARTHRITIS
- 2.1. General Distribution
- 2.1.1. Distribution of Arthritis by Subtypes
- 2.1.2. Distribution of Bone Cysts
- 2.1.3. Distribution of Osteonecrosis
- 2.1.4. Distribution of Osteonecrosis in Antiphospholipid Antibody Syndrome (APS)
- 2.1.5. Distribution of Bone Infarcts
- 2.1.6. Distribution of Insufficient Fractures
- 2.1.7. Distribution of Myositis
- 2.1.8. Distribution of Infection
- 2.2. Distribution in Regions
- 2.2.1. Hands
- 2.2.2. Lower Limbs
- 2.2.3. Sacroiliac Joints
- 2.2.4. Tenosynovitis (Distribution of Tenosynovitis in the Hands) (Figs. 18 - 19)
- 2.2.5. Axial Skeleton
- 2.3. Distribution in Joints
- 2.4. Distribution of Timeline
- 2.4.1. Early Phase
- 2.4.2. Active Phase
- 2.4.3. Terminal Phase
- CONCLUSION
- CONSENT FOR PUBLICATION
- CONFLICT OF INTEREST
- ACKNOWLEDGEMENTS
- REFERENCES
- Extra-Articular Soft Tissue and Muscular Involvement in Systemic Lupus Erythematosus
- Syuichi Koarada1,2,3,*, Makiko Takayama1, Kouki Takedomi1, Jun Hirano1, Hijiri Hirose1, Yuumi Maeda1, Yuiko Miyajima1, Honoka Mouri1 and Yukiko Takeyama3
- 1. INTRODUCTION
- 2. PERIPHERAL SOFT TISSUE SWELLING
- 2.1. Hand (Figs. 1 - 15)
- 2.2. Wrists (Figs. 16 and 17)
- 2.3. Knees (Figs. 18 - 21)
- 2.4. Ankles (Figs. 22 and 23)
- 3. CALCIFICATIONS
- 3.1. Soft Tissue Calcifications
- 3.2. Calcification Around Joints
- 3.3. Arterial Calcifications
- 4. BURSAE
- 4.1. Knees (Figs. 27 - 33)
- 4.2. Ankles
- 4.2.1. Lateral Premalleolar Bursitis (Figs. 34 - 43)
- 5. TENDONS
- 5.1. Involvement of Tendons
- 5.2. Tendon Sheaths, Tenosynovitis
- 5.2.1. Hands and Wrists
- 5.2.2. Digits
- 5.2.3. Wrists (Figs. 78 - 80)
- 5.2.4. Knees (Figs. 81 - 83)
- 5.3. Peritenon Extensor Tendon Inflammation (PTI)
- 6. LIGAMENTS
- 6.1. Digits
- 7. ENTHESITIS / ENTHESEAL INVOLVEMENTS
- 7.1. DIP Joints (Figs. 92 - 97)
- 7.2. PIP Joints (Figs. 98 - 100)
- 7.3. MCP Joints (Figs. 101 and 102)
- 7.4. Knees (Fig. 103)
- 8. LUPUS MYOPATHY (FIG. 104)
- CONCLUSION
- CONSENT FOR PUBLICATION
- CONFLICT OF INTEREST
- ACKNOWLEDGEMENTS
- REFERENCES
- Skin Manifestations in Patients with Systemic Lupus Erythematosus
- Syuichi Koarada1,2,3,* and Tetsuhiro Maesaki2
- 1. INTRODUCTION
- 2. ACUTE CUTANEOUS LUPUS ERYTHEMATOSUS (ACLE)
- 2.1. Lupus Malar Rash
- 2.1.1. Typical Malar Rash (Figs. 1 - 3)
- 2.1.2. Mild Malar Rash (Figs. 4 - 5)
- 2.1.3. Atypical Malar Rash (Figs. 6 - 8)
- 2.2. Maculopapular Lupus Rashes, Widespread Erythematous Maculopapular Lesions
- 2.2.1. Hands
- 2.2.2. Forearms (Figs. 22 - 23)
- 2.2.3. Elbows (Figs. 24 - 25)
- 2.2.4. Upper Arms (Figs. 26 - 27)
- 2.2.5. Faces (Figs. 28 - 32)
- 2.2.6. Necks and Jaws (Figs. 33 - 36)
- 2.2.7. Backs (Figs. 37 - 39)
- 2.2.8. Abdomens (Fig. 40)
- 2.2.9. Thighs (Fig. 41)
- 2.2.10. Knees (Figs. 42 - 43)
- 2.2.11. Lower Limbs (Figs. 44 - 46)
- 2.2.12. Feet (Figs. 47 - 52)
- 2.3. Palmar Erythema (Fig. 53)
- 2.4. Bullous LE Skin Rashes, Bullous Lesions (BSLE), Bullous Lupus Erythematosus (Figs. 54 - 58)
- 2.5. Toxic epidermal necrolysis (TEN) (Fig. 59)
- 2.6. Photosensitivity
- 2.7. Periungual Erythema (Figs. 60 - 65)
- 2.8. Periungual Telangiectasias (Figs. 66 - 68)
- 3. SUBACUTE CUTANEOUS LUPUS ERYTHEMATOSUS (SCLE)
- 3.1. Annulare SCALE, large polycyclic lesions or small cyclic lesions (Fig. 69)
- 3.2. Mixed form with both annular and psoriasiform lesions (Figs. 70 - 78)
- 3.3. Papulosquamous Psoriasiform Lesions
- 3.3.1. Hands (Figs. 79 - 84)
- 3.3.2. Wrists (Fig. 85)
- 3.3.3. Elbows (Fig. 86)
- 3.3.4. Upper Arms (Figs. 87 - 88)
- 3.3.5. Feet (Fig. 89)
- 4. CHRONIC CUTANEOUS LUPUS
- 4.1. Classic Discoid Rashes, Discoid Lupus Erythematosus (DLE)
- 4.1.1. Ears (Fig. 90)
- 4.1.2. Hands (Figs. 91 - 93)
- 4.1.3. Elbows (Fig. 94)
- 4.1.4. Knees (Figs. 95 - 96)
- 4.1.5. Backs (Figs. 97 - 98)
- 4.1.6. Abdomens (Fig. 99)
- 4.2. Chilblain Lupus Erythematosus, Chilblain Lupus
- 4.2.1. Hands (Figs. 100 - 105)
- 4.2.2. Feet (Figs. 106 - 108)
- 4.3. Hypertrophic or Verrucous Lupus
- 4.3.1. Hands (Figs. 109 - 112)
- 4.3.2. Elbows (Fig. 113)
- 4.3.3. Knees (Figs. 114 - 115)
- 4.3.4. Feet (Figs. 116 - 117)
- 4.4. Lupus Erythematosus Profundus (Figs. 118 - 122)
- 4.5. Mucosal Lupus
- 4.5.1. Oral Ulcers (Figs. 123 - 126)
- 4.5.2. Cheilitis (Figs. 127 - 128)
- 4.5.3. Angular Cheilitis (Fig. 129)
- 4.6. Nodular Cutaneous Lupus Mucinosis
- NCLM (Fig. 130)
- 5. OTHER MANIFESTATIONS OF SKIN
- 5.1. Urticarial Vasculitis in SLE (Figs. 131 - 132)
- 5.2. Livedo Reticularis (Fig. 133)
- 5.3. Raynaud's Phenomenon (Figs. 134 - 142)
- 5.4. Acrocyanosis (Fig. 143)
- 5.5. Erythromelalgia (Figs. 144 - 146)
- 5.6. Gangrene of Extremities (Figs. 147 - 149)
- 5.7. Subcutaneous Hematoma (Fig. 150)
- 5.8. Internal Bleeding (Fig. 151)
- 5.9. Subcutaneous Nodules
- 5.10. Necrotizing Fasciitis (Fig. 152)
- 5.11. Subcutaneous Edema (Figs. 153 - 154)
- 5.12. Soft Tissue Calcifications (Figs. 155 - 158)
- 5.13. Nonscarring Alopecia, Hair Loss/alopecia (Figs. 159 - 160)
- 6. NON-SPECIFIC SKIN LESIONS
- 7. INFECTIONS
- 7.1. Herpes Zoster (Figs. 161 - 165)
- CONCLUSION
- CONSENT FOR PUBLICATION
- CONFLICT OF INTEREST
- ACKNOWLEDGEMENTS
- REFERENCES
- Respiratory Involvement in Systemic Lupus Erythematosus
- Syuichi Koarada1,2,3,* and Yoshinobu Nakao3
- 1. INTRODUCTION
- 2. PLURA
- 2.1. Pleural Effusions
- 2.1.1. Imaging Findings
- 2.2. Pleuritis (Fig. 6)
- 3. PARENCHYMA
- 3.1. Interstitial Pneumonia, Interstitial Lung Disease (ILD)
- 3.1.1. Lupus Pneumonitis
- 3.1.2. Chronic Lupus Pneumonitis
- 3.2. Diffuse Alveolar Hemorrhage (DAH)
- 3.2.1. Imaging Findings
- 3.2.2. Chest CT Scans (Figs. 13 - 15)
- 4. BRONCHI
- 4.1. Bronchiectasis
- 5. DIAPHRAGM
- 5.1. Diaphragmatic Dysfunction
- 5.1.1. Imaging Findings
- 6. PULMONARY INFECTIONS
- 6.1. Bronchopulmonary Infections
- 6.1.1. Pneumonia
- 6.1.2. Pneumocystis Pneumonia (PCP)
- 6.1.3. Aspergillus Pneumonia, Pulmonary Aspergillosis (Figs. 30 - 34)
- 6.1.4. Cryptococcal Pneumonia (Figs. 35 - 37)
- 6.1.5. Legionella Pneumonia (Figs. 38 - 41)
- 6.1.6. Pulmonary Tuberculosis
- CONCLUSION
- CONSENT FOR PUBLICATION
- CONFLICT OF INTEREST
- ACKNOWLEDGEMENTS
- REFERENCES
- Neuropsychiatric Systemic Lupus Erythematosus (NP-SLE)
- Syuichi Koarada1,2,3,* and Yuri Shirahama3
- 1. INTRODUCTION
- 2. CENTRAL NERVOUS SYSTEM
- 2.1. Cerebral Atrophy (Figs. 1 - 2)
- 2.2. Diffuse Cerebral Edema with Leukoencephalopathy (Figs. 3 - 6)
- 2.3. White-matter Lesions in Central Nervous System (CNS) (Fig. 7)
- 2.4. CNS Ischemia
- 2.4.1. Medial Longitudinal Fasciculus Syndrome (Fig. 8)
- 2.5. Occlusion of Dural Venous Sinuses and Deep Cerebral Veins (Fig. 12)
- 2.6. Intracranial Hemorrhage (ICH) (Figs. 13 - 16)
- 2.7. Posterior Reversible Encephalopathy Syndrome (PRES) (Fig. 17)
- 2.8. Lupus Meningitis (Fig. 18)
- 3. PERIPHERAL NEUROPATHY IN SLE
- CONCLUSION
- CONSENT FOR PUBLICATION
- CONFLICT OF INTEREST
- ACKNOWLEDGEMENTS
- REFERENCES
- Cardiovascular and Renal Diseases in Systemic Lupus Erythematosus
- Syuichi Koarada1,2,3,* and Satoko Tashiro3
- 1. INTRODUCTION
- 2. PERICARDITIS (FIGS. 1 - 2)
- 3. MYOCARDITIS
- 3.1. Libman-Sacks Endocarditis
- 3.2. Valvulopathy (Figs. 3 - 4)
- 4. CORONARY VESSELS
- 4.1. Left Anterior Descending (LAD) (Fig. 5)
- 4.2. Right Coronary Artery (RCA) (Fig. 6)
- 4.3. Left Circumflex Artery (LCx) (Fig. 7)
- 5. AORTA AND ITS BRANCHES (FIG. 8)
- 6. PULMONARY ARTERIAL HYPERTENSION (PAH)
- 6.1. Radiography (Fig. 9)
- 6.2. Electrocardiogram (ECG) (Figs. 10 - 11)
- 6.3. Echocardiography (Figs. 12 - 13)
- 6.4. Pulmonary Embolism (PE) (Fig. 14)
- 7. RENAL SYSTEM
- CONCLUSION
- ACKNOWLEDGEMENTS
- REFERENCES
- Gastrointestinal System in Systemic Lupus Erythematosus
- Syuichi Koarada1,2,3,* and Yukihide Ono2
- 1. INTRODUCTION
- 2. SEROSITIS (FIG. 1)
- 3. GASTRITIS (FIG. 2)
- 4. LUPUS ENTERITIS (FIG. 3)
- 5. CHOLECYSTITIS (FIG. 4)
- 6. SPLEEN (FIGS. 5 - 6)
- 7. SALIVARY GLANDS (FIG. 7)
- CONCLUSION
- CONSENT FOR PUBLICATION
- CONFLICT OF INTEREST
- ACKNOWLEDGEMENTS
- REFERENCES
- Subject Index
- Back Cover
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