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"cabecera" => "<span class="elsevierStyleTextfn">Images in Clinical Rheumatology</span>" "titulo" => "Subcutaneous Edema in Juvenile Dermatomyositis" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "e49" "paginaFinal" => "e50" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Edema subcutáneo en dermatomiositis juvenil" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1225 "Ancho" => 1633 "Tamanyo" => 363494 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Muscle biopsy which shows endomysial lymphocytary infiltrate and myocyte 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"aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Deisy" "apellidos" => "Barrios-Barreto" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Ismael" "apellidos" => "Said-Criado" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 3 => array:3 [ "nombre" => "Carlos" "apellidos" => "de la Puente-Bujidos" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Servicio de Radiodiagnóstico, Hospital Universitario Ramón y Cajal, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Neumología, Hospital Universitario Ramón y Cajal, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Medicina Interna, Hospital La Milagrosa, Madrid, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Servicio de Reumatología, Hospital Universitario Ramón y Cajal, Madrid, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Diagnóstico de policondritis recidivante en una paciente con tos crónica y sin condritis nasal ni auricular" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1702 "Ancho" => 1005 "Tamanyo" => 189125 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) CT axial view where a noticeable thickening of the tracheal walls (arrows) may be observed, together with highly significant reduction in their lumens. (B) CT axial view (lung imaging window) where major circumferential thickening of the walls of both main bronchi may also be observed, together with serious reduction in their lumen quality (arrows).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We present the case of a 68-year-old patient, a non smoker, who sought medical attention due to a dry cough of several months onset. During the previous few weeks the patient had presented with intermittent, low-grade fever in the evenings. The patient's medical background only highlighted several episodes of anterior uveitis which responded to topical treatment with glucocorticoids. A chest X-ray did not show any radiologic changes, but computerised tomography (CT) of the chest revealed a noticeable circumferential thickening of the walls of the trachea (respecting the posterior tracheal wall) and the main bronchi which had led to a major reduction in their lumens (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). Subsequent to these findings, a diagnosis of relapsing polychondritis (RP) was made, which was confirmed with transbronchial biopsy performed by fibrobronscopy. The latter revealed inflammatory changes to the pericartilaginous structures, thus meeting the Damiani and Levine criteria for the diagnosis of RP.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> Respiratory function tests only showed a slight airflow obstruction. Other rheumatic, endocrine and haematological diseases which may be associated with RP in up to 33% of cases, were ruled out. The patient responded favourably to treatment with glucocorticoids and azathioprine.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">RP is a rare multisystemic disease characterised by recurrent and progressive episodes of inflammation and the destruction of cartilaginous tissue affecting, among other organs, the outer ear, nose and airways. For most patients with RP initial clinical symptoms are usually nasal and/auricular chondritis. Both ocular involvement (in the form of uveitis, scleritis or keratitis) and the involvement of tracheobronchial cartilage are highly uncommon forms of RP presentation, and they remind us that initial atypical manifestations of this disease exist and require differential diagnosis to apparently banal symptoms.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">2–5</span></a></p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical liabilities</span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Protection of people and animals</span><p id="par0015" class="elsevierStylePara elsevierViewall">The authors declare that for this research no experimentation has been carried out on human beings or animals.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Data confidentiality</span><p id="par0020" class="elsevierStylePara elsevierViewall">The authors declare that they have adhered to the protocol of their centre of work on the publication of patient data.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Right to privacy and informed consent</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article.</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conflict of interests</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:3 [ "identificador" => "sec0005" "titulo" => "Ethical liabilities" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0010" "titulo" => "Protection of people and animals" ] 1 => array:2 [ "identificador" => "sec0015" "titulo" => "Data confidentiality" ] 2 => array:2 [ "identificador" => "sec0020" "titulo" => "Right to privacy and informed consent" ] ] ] 1 => array:2 [ "identificador" => "sec0025" "titulo" => "Conflict of interests" ] 2 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2017-05-15" "fechaAceptado" => "2017-06-09" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Gorospe Sarasúa L, Barrios-Barreto D, Said-Criado I, de la Puente-Bujidos C. Diagnóstico de policondritis recidivante en una paciente con tos crónica y sin condritis nasal ni auricular. Reumatol Clin. 2019;15:e51–e52.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1702 "Ancho" => 1005 "Tamanyo" => 189125 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) CT axial view where a noticeable thickening of the tracheal walls (arrows) may be observed, together with highly significant reduction in their lumens. (B) CT axial view (lung imaging window) where major circumferential thickening of the walls of both main bronchi may also be observed, together with serious reduction in their lumen quality (arrows).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Relapsing polychondritis. Report of ten cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J.M. Damiani" 1 => "H.L. 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Ernst" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ccm.2010.04.004" "Revista" => array:6 [ "tituloSerie" => "Clin Chest Med" "fecha" => "2010" "volumen" => "31" "paginaInicial" => "513" "paginaFinal" => "518" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20692543" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735743/0000001500000005/v1_201910260908/S2173574318301242/v1_201910260908/en/main.assets" "Apartado" => array:4 [ "identificador" => "5795" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in Clinical Rheumatology" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735743/0000001500000005/v1_201910260908/S2173574318301242/v1_201910260908/en/main.pdf?idApp=UINPBA00004M&text.app=https://reumatologiaclinica.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574318301242?idApp=UINPBA00004M" ]
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2024 August | 71 | 39 | 110 |
2024 July | 63 | 28 | 91 |
2024 June | 54 | 25 | 79 |
2024 May | 82 | 26 | 108 |
2024 April | 66 | 22 | 88 |
2024 March | 60 | 32 | 92 |
2024 February | 48 | 36 | 84 |
2024 January | 48 | 22 | 70 |
2023 December | 48 | 25 | 73 |
2023 November | 66 | 30 | 96 |
2023 October | 67 | 25 | 92 |
2023 September | 82 | 38 | 120 |
2023 August | 73 | 15 | 88 |
2023 July | 67 | 24 | 91 |
2023 June | 51 | 22 | 73 |
2023 May | 70 | 22 | 92 |
2023 April | 64 | 7 | 71 |
2023 March | 81 | 30 | 111 |
2023 February | 66 | 22 | 88 |
2023 January | 72 | 13 | 85 |
2022 December | 73 | 28 | 101 |
2022 November | 65 | 22 | 87 |
2022 October | 78 | 33 | 111 |
2022 September | 60 | 32 | 92 |
2022 August | 63 | 39 | 102 |
2022 July | 52 | 36 | 88 |
2022 June | 51 | 25 | 76 |
2022 May | 66 | 42 | 108 |
2022 April | 81 | 40 | 121 |
2022 March | 91 | 33 | 124 |
2022 February | 68 | 30 | 98 |
2022 January | 87 | 33 | 120 |
2021 December | 63 | 43 | 106 |
2021 November | 51 | 45 | 96 |
2021 October | 59 | 48 | 107 |
2021 September | 45 | 42 | 87 |
2021 August | 40 | 36 | 76 |
2021 July | 45 | 29 | 74 |
2021 June | 39 | 29 | 68 |
2021 May | 66 | 39 | 105 |
2021 April | 139 | 99 | 238 |
2021 March | 67 | 41 | 108 |
2021 February | 65 | 18 | 83 |
2021 January | 48 | 20 | 68 |
2020 December | 29 | 19 | 48 |
2020 November | 51 | 18 | 69 |
2020 October | 18 | 15 | 33 |
2020 September | 30 | 18 | 48 |
2020 August | 45 | 24 | 69 |
2020 July | 21 | 13 | 34 |
2020 June | 25 | 11 | 36 |
2020 May | 31 | 16 | 47 |
2020 April | 19 | 17 | 36 |
2020 March | 3 | 3 | 6 |
2019 September | 1 | 0 | 1 |
2019 July | 4 | 0 | 4 |