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The role of radio-imagistic methods in the study of osteoarticular apparatus and respiratory system at patients with rheumatoid arthritis and systemic lupus eritematosus


Author: Naserallah S.N. Alaa
Degree:doctor of medicine
Speciality: 14.00.19 - Medical Imagistics
Year:2005
Scientific adviser: Sergiu Matcovschi
doctor habilitat, professor, State University of Medicine and Pharmacy "Nicolae Testemitanu"
Institution:
Scientific council:

Status

The thesis was presented on the 10 December, 2004
Approved by NCAA on the 27 January, 2005

Abstract

Adobe PDF document0.26 Mb / in romanian

Thesis

CZU 616.72–002.77–073.75+616–056:616.5–002.524–073.75

Adobe PDF document 2.26 Mb / in romanian
115 pages


Keywords

rheumatoid arthritis, systemic lupus erythematosus, diffuse conjunctival diseases, systemic diseases, collagenoses, imagery methods, conventional methods, computerized tomografy, nucleic magnetic resonance, scanning, osteoarticular apparatus, respiratory system, osteoporosis, rheumatoid nodules, synovites, interstitial fibrosis, pneumonitis, obstructive bronhiolitis pneumonic obliteration, athelectasis, pleurisy

Summary

The pathology of conjunctival tissues, in particular, rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE), which affects the most capable of working contingent of young and medium age people, attributes a social aspect, and the study of this problem occupies one of the central places in the contemporary rheumatology.

The early diagnostic of these processes has one of the basic places in the clinical practice for the opportune application of adequate therapeutical methods. Radiological methods ever were occupying one of the central places in the exposure and objectivisation of these diseases’ manifestations. Most of that, the information, received by classic radiological methods, during most of last 50 years serves like international classification base of grades’ severity and clinical diagnostic criterion of these processes.

There was appeared the necessity to study diagnostic possibilities of new diagnostical methods (so-called imaging methods) since the moment of them start, for optimizing the exposure of RA and SLE.

Investigator studies examinations results of 217 RA and 136 SLE patients against background of radiological symptoms’ morphopathologic understanding and maximal objectifying them with the help of quantitative data, for the appreciation of diagnostic capacities by means of these methods (computed tomography – CT, nucleic magnetic resonance - NMR).

It was confirmed, that classic radiological diagnostic methods are capable revealing secondary (residual) character modifications in articulations of these patients, which appear in late phases of immunogenous development with the deregulation of processes in microcirculating channel.

Contemporary imaging methods, in particular, (NMR), permit visualize the inflammation of articular mild-tissular components, including inflamed synovial membrane of articulations, selective affected by the process, modification’s extend, thickness and succession of this anatomic formation in RA and SLE. And what is more, the author established, that the synovit’s character, his aggressiveness (wear of surfaces, destruction of arthral cartilaginous tissue) in RA sharply differs from SLE synovites by the absence of the inclination to a hypertrophy and a destruction. It is possible to diagnose, including differential diagnosis of this pathology at early stage (not waiting for residual changes), ascertaining synovitis with corresponding characteristics. Proceed from the fact, that patients with systemic diseases have affections of internals too ( in particular lungs), the author made a parallel study of diagnostic possibilities of CT and traditional diagnostic methods at 198 RA and 110 SLE patients.

There were revealed diagnostic possibilities of early exposure of lung’s changes in these patients and before of clinical radiographic RA and SLE manifestations.

Further, the investigator, adduces the systemized nosology of respiratory system’s immunogenic primary pathology, using literary and himself data. There were cited separately respiratory system lesions’ symptoms revealed with the help of СT to this patients’ category, side by side with NMR obtained symptoms has a grand importance for the practical radiographic diagnosis.

The author finishes the study of diagnostical possibilities in the practice of early diagnostic of RA and SLE by the construction of algorithms’ diagnostical use of these methods in the examination of articulations and respiratory system (separately).