Objectives and study: Arthritis associated with inflammatory bowel diseases is mainly part of systemic sterile inflammation. Authors studied occurrence of locomotive system's inflammation, by prospective and partly retrospective methods in 35 pediatric cases (17 boys and 18 girls) with inflammatory bowel disease (IBD), carried out in Pediatric Health Centre, Borsod-Abauj-County University Hospital, Miskolc, Hungary. Methods: Data of patients history, physical (pediatric gastroenterologist, orthopedic surgeon), X-ray, and/ or ultrasound examinations were analized. Results: Diagnosis of IBD was performed at 4.5- 17 years of age. Signs of locomotive system's inflammation appeared before, in same time, or after diagnosing bowel's inflammation. 9/35 (25.7%) patients presented knee-joint gout, swelling, synovial fluid production. 18/35 (50.3%) of them had migrating peripherial arthitis, 4/35 (11.4%) axial form. Transient rheumatic factor positivity appeared in 2/35 patients (5.5%). 29/35 pediatric IBD patients have some joint-mouvement system's complaints. Drugs of IBD therapy (nonsteroid antiinflammatory drugs, corticosteroids, azathioprin, biologics) were effective in associated arthritis also. Conclusion: Antiinflammatory-immunesupressive drugs with systemic effect ease inflammation not only in bowel, but in joints also. It is important to consider joint inflammation when doctors propose therapy of patients with IBD.

The lower urinary tract is a complicated structure and there has been some controversy regarding the biomechanics and dynamics of bladder and sphincter function. Investigation of the function and morphological anomalies is very important. Videourodynamics (VUD) combined with conventional voiding cystourethrography (VCUG) seems to be the most appropriate method. Over a 12-year study period (January 1990 to December 2001), 422 children (aged 5 days to 20 years) prospectively underwent VUD to further define their urinary tract abnormalities. In all children the history was recorded, clinical examination, urinalysis, culture, and ultrasonography performed, and serum creatinine determined before VUD. The selection criteria included a history of recurrent urinary tract infections (UTI) in 310 patients (74%), urinary tract dilatation without UTI in 31 patients (7%), suspected neurogenic bladder dysfunction in 42 patients (10%), and voiding difficulties in 39 patients (9%). VUD consists of cystometry (CM), which is the measurement of detrusor pressure during controlled bladder filling and subsequent voiding, and was combined with VCUG using X-ray contrast material. CM is used to assess detrusor activity, sensation, capacity, and compliance. CM measurements were recorded on a computer and vesicoureteric reflux (VUR) was documented at the same time with plain films and later in a PACS system. The VUD diagnosis was of normal bladder function in 46 patients (9%), VUR in 212 (43%), unstable bladder dysfunction in 152 (31%), neurogenic bladder dysfunction in 35 (7%), urine outflow obstruction in 15 (3%), wide bladder neck in 22 (4%), and vaginal reflux in 9 (2%). Neurogenic bladder dysfunction was excluded in 7 patients (1%). VUD is useful for the investigation of the lower urinary tract function together with X-ray morphology. The advantage of these studies is that they combine the objectivity of urodynamics with the visual radiographic image, leading to lower radiation doses and a more logical interpretation of the results.

Testicular tumors are very rare in boys, approximately 1.5% of these are Leydig cell tumors. The authors present a 4.5 year-old boy with Leydig cell tumor of left testis, which was associated with increased sex steroid production that caused precocious puberty. These tumors are benign processes in prepubertal children. Beyond the rarity of this case the authors would like to report about its diagnostic difficulties and testis-sparing remove of it. The plasma 17-hydroxyprogesterone levels provide the distinction between congenital adrenal hyperplasia and Leydig cell tumor in patient with precocious puberty.

A total of 42 neurologically normal children with different voiding problems have been studied urodynamically during the last 4 years. Seventeen patients had unstable bladder, with significantly decreased capacity. The degree of volume decrease depended on the severity of instability and on the type of micturition problems. Eight patients had trabeculation of the bladder wall and 2 had wide bladder neck. Six children had vesicoureteral reflux in 8 ureters. Eleven patients were treated with Ditropan. Four children had repeated cystomanometry after treatment. They had stable bladder and its capacity has increased.

Anomalies of the vesicoureteric junction are important, particularly obstruction and reflux, as they may predispose to urinary tract infection. Over a 5-year period, 52 babies were referred with dilatation of the urinary tract detected antenatally or/and postnatally by ultrasound. Sixteen had an anomaly of the vesicoureteric junction: 9 had vesicoureteric reflux, 3 had ureteroceles, 1 had urethral stenosis with secondary reflux and 3 had stenosis of the vesicoureteric junction. Ten patients underwent 14 surgical procedures. The mean time to reconstructive surgery was 9.3 months. Ultrasonography showed regression of the dilatation in all patients who underwent surgery. Seven patients with minor dilatation are still under observation. In only 1 case was there loss of renal parenchyma. With conservative medical treatment the patients are 1 year old before reconstructive surgery is undertaken; with reflux, however, progression may indicate earlier surgery.

The simultaneous recording of urodynamic parameters and x-ray imaging of the lower urinary tract is the ideal technique for a complex investigation of the lower urinary tract morphology and function. The urodynamic and micturating cystourethrography findings were reviewed in 57 children. The causes of the examinations were recurrent urinary tract infection, voiding dysfunction and urinary tract dilatation by ultrasound. 53/57 patients had a clear cystomanometry results. 4 did not cooperate. 15/53 had unstable bladder. 34/57 had vesico-ureteric reflux. Unilateral reflux was more frequently noted in children with an unstable bladder. In cases of a stable bladder, bilateral reflux occurred more frequently. The ureteric reflux in children with unstable bladder should resolve with therapy to decrease bladder activity. Urodynamics is complementary rather than competitive with radiologic investigations. It is necessary to make micturating cystourethrography with cystomanometry.

Pancreas pseudocysts in childhood. On the basis of experience obtained with 9 patients treated over 31 years the authors publish the first comprehensive study in Hungary on the pancreas pseudocyst in childhood. Having reviewed their series and the medical literature main features and the possible prevention and management of this disease is outlined. Review of these patients with ultrasonography and chemistry tests is advised in order to follow-up the recovery and to screen the error in the glucose metabolism.

The authors studied the distribution of acetylator phenotypes among 136 AS patients (100 male, 36 female). 67 per cent of all patients were slow acetylators, 72 per cent of the males. Both rates are higher than that of the healthy Hungarian population. The authors draw attention to the clinical importance of investigating the acetylator type before sulphasalazine treatment because it may help in prescribing the effective dose and avoiding side effects.

Arthritis & RheumatismVolume 24, Issue 9 p. 1213-1213 ArticleFree to Read Septic prepatellar bursitis due to erysipelas Eva Borbás MD, Eva Borbás MD National Institute of Rheumatology and Physiotherapy Budapest II Frankel Leó u. 17–19 1525 Budapest, 114 Postafiók 54, HungarySearch for more papers by this authorGyöRgy Genti MD, GyöRgy Genti MD National Institute of Rheumatology and Physiotherapy Budapest II Frankel Leó u. 17–19 1525 Budapest, 114 Postafiók 54, HungarySearch for more papers by this authorGéza Bálint MD, Géza Bálint MD National Institute of Rheumatology and Physiotherapy Budapest II Frankel Leó u. 17–19 1525 Budapest, 114 Postafiók 54, HungarySearch for more papers by this author Eva Borbás MD, Eva Borbás MD National Institute of Rheumatology and Physiotherapy Budapest II Frankel Leó u. 17–19 1525 Budapest, 114 Postafiók 54, HungarySearch for more papers by this authorGyöRgy Genti MD, GyöRgy Genti MD National Institute of Rheumatology and Physiotherapy Budapest II Frankel Leó u. 17–19 1525 Budapest, 114 Postafiók 54, HungarySearch for more papers by this authorGéza Bálint MD, Géza Bálint MD National Institute of Rheumatology and Physiotherapy Budapest II Frankel Leó u. 17–19 1525 Budapest, 114 Postafiók 54, HungarySearch for more papers by this author First published: September 1981 https://doi.org/10.1002/art.1780240919Citations: 5AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat No abstract is available for this article. References 1 Sharrard WJW: Aetiology and pathology of beat knee. Br J Intern Med 20: 24–31, 1963 PubMedWeb of Science®Google Scholar 2 Goldenberg DL, Cohen AS: Acute infectious arthritis:a review of patients with nongonococcal joint infections. Am J Med 60: 369–377, 1976 10.1016/0002-9343(76)90753-1 CASPubMedWeb of Science®Google Scholar 3 Balboni VG: cit. Hollander JL: Arthritis and Allied Conditions, Philadelphia, Lea and Febiger, 1967. p 1052 Google Scholar 4 Fullerton A: The surgical anatomy of the synovial membrane of the knee joint. Br J Surg 4: 191–200, 1916 10.1002/bjs.1800041316 Web of Science®Google Scholar 5 Ho G, Tice AD, Kaplan SR: Septic bursitis in the prepatellar and olecranon bursae. Ann Intern Med 89: 21–27, 1978 10.7326/0003-4819-89-1-21 PubMedWeb of Science®Google Scholar 6 Winter FE, Runyon EH: Prepatellar bursitis caused by Mycobacterium marinum. J Bone Joint Surg 47A (No 2): 375–379, 1965 Google Scholar 7 Levinsky WJ: Sporotrichial arthritis:report of a case mimicking gout. Arch Intern Med 129: 118–119, 1972 CASPubMedWeb of Science®Google Scholar 8 Nosanchuk JS, Greenberg DD: Protothecosis of the olecranon bursa caused by achloric algae. Am J Clin Pathol 59: 567–573, 1973 10.1093/ajcp/59.4.567 PubMedWeb of Science®Google Scholar Citing Literature Volume24, Issue9September 1981Pages 1213-1213 ReferencesRelatedInformation