By Nicholas Bellamy MD(Glasgrow), MSc(McMaster), MRCP(UK), FRCP(C), FACP (auth.)
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Extra resources for Colour Atlas of Clinical Rheumatology
6). Involvement of the cervical spine eventually occurs in 50% of children and results in pain and restricted spinal mobility. 8 Iritis - note irregular pupil due to formation of posterior synechiae. (Courtesy of Dr A. C. 9 Band keratopathy - note opaque band extending across the cornea. (Courtesy of Dr A. C. 7 Oligoarticular disease in right knee showing flexion deformity. (Courtesy of Dr J. E. Boone) apophyseal joints. Temporomandibular joint involvement is relatively common in lCA but cricoarytenoid arthritis occurs infrequently.
74). 76). Involvement of the coronary vasculature or mesenteric vessels may be fatal, and is frequently associated with a sensory or mixed motorsensory peripheral neuropathy. 70 Splenomegaly in leukopaenic (3000 cellsl mm 3 ) patient with Felty's syndrome The eye may be affected by rheumatoid disease as well as by the drugs used in its treatment. Sjogren's syndrome (keratoconjunctivitis sicca, xerostomia and arthritis) is the most frequent ocular complication of rheumatoid arthritis and is present in up to one-third of patients.
17). 14). In severe rheumatoid -arthritis, restricted physical function results in muscle weakness and wasting. 18). 19 Active synovitis of right elbow. 21 Severe erosion of the elbow joint. 19). 21). Early treatment with physiotherapy and intra-articular steroid injections is important, since established flexion contractures are rarely amenable to such treatment. In addition to abnormalities in flexion and extension the patient may also experience pain and limitation during supination and pronation of the forearm.