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(been reported as an unusual complication in patients with a)Tj
0.16721 Tw 0 -1.2 TD
(variety of inflammatory arthropathies)Tj
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(3-13)Tj
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(. In addition to the)Tj
0.0683 Tw -16.7137 -1.2 Td
[(obvious limitation of ocular mobility)64.9 (, acquired Brown\222)54.9 (s syn-)]TJ
0.21159 Tw T*
(drome owing to tenosynovitis of the superior oblique ten-)Tj
0.0036 Tw T*
(don/trochlea is often associated with diplopia on upward gaze)Tj
0.02499 Tw T*
(and orbital pain and swelling in the region of the trochlea.)Tj
0.1723 Tw 1.2371 -1.2 Td
[(The clinical diagnosis of acquired Brown\222)55 (s syndrome is)]TJ
0.0621 Tw -1.2371 -1.2 Td
[(generally not dif)17.8 (ficult. Imaging modalities such as computed)]TJ
0.0554 Tw T*
(tomography or MRI may be helpful to confirm the diagnosis)Tj
0.13541 Tw T*
[(of Brown\222)54.9 (s syndrome. Some, but not all patients show evi-)]TJ
-0.01559 Tw T*
(dence of inflammation of the superior oblique tendon/trochlea)Tj
0.0076 Tc 0.3674 Tw T*
(complex on imaging studies)Tj
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[(5-7,1)57.1 (1-13)]TJ
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(. MRI of our patient)Tj
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(showed mild enhancement of the right superior oblique ten-)Tj
0.20821 Tw T*
[(don/trochlea. He had rapid resolution of the Brown\222)54.9 (s syn-)]TJ
0.0554 Tw T*
(drome following institution of prednisone therapy and others)Tj
0.3018 Tw T*
(have also reported that systemic corticosteroid or locally)Tj
0.11411 Tw T*
[(injected corticosteroid therapy is highly ef)17.8 (fective in treating)]TJ
-0.00011 Tc 0.02499 Tw T*
[(acquired Brown\222)54.8 (s syndrome)]TJ
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(4-10,13)Tj
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(.)Tj
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[(Our patient developed Brown\222)54.9 (s syndrome as a complica-)]TJ
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(tion of PSRA. Goldsmith and Long in 1982)Tj
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(14)Tj
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(first described)Tj
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[(PSRA)-355.4 (in a report of 12 children who developed prolonged)]TJ
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(arthritis following a streptococcal infection. Since then, there)Tj
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[(have been a number of reports of PSRA)-453.5 (in children and)]TJ
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(adults)Tj
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(15-19)Tj
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(. )Tj
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[(PSRA)-570.1 (dif)17.8 (fers from acute rheumatic fever in several)]TJ
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(respects. In PSRA, the interval between the streptococcal)Tj
0.36099 Tw T*
(infection and the onset of arthritis is short, often 7\22610)Tj
-0.00011 Tc 0 Tw T*
(days)Tj
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(17,19)Tj
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[(. )17.8 (The arthritis of PSRA)-224.5 (involves both lar)17.8 (ge and small)]TJ
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(joints and it is frequently nonmigratory)Tj
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(15,17,19)Tj
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[(. )17.8 (The duration of)]TJ
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(arthritis is often prolonged, lasting up to several months, and)Tj
-0.00011 Tc 0.07339 Tw T*
(arthralgia may persist for several months after the resolution)Tj
0 Tc -0.00369 Tw T*
(of objective arthritis. In addition, tenosynovitis is a prominent)Tj
-0.00011 Tc 0.20239 Tw T*
(feature of PSRA)Tj
0.0004 Tc 0 Tw 6.3 0 0 6.5 122.0279 205.4616 Tm
(15,17,18)Tj
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[(. PSRA)-397.5 (is relatively unresponsive to)]TJ
0.01891 Tw -9.2882 -1.2 Td
(nonsteroidal antiinflammatory agents, whereas the arthritis of)Tj
0.00259 Tc 0.37241 Tw T*
(acute rheumatic fever responds promptly to therapy)Tj
0.00301 Tc 0 Tw 6.3 0 0 6.5 277.3076 181.4616 Tm
(17,19)Tj
0 Tc 9.7 0 0 10 291.5755 178.1616 Tm
(.)Tj
0.0619 Tw -24.4923 -1.2 Td
[(Lastly)64.9 (, the incidence of carditis in PSRA)-257 (is much lower than)]TJ
0.1127 Tw T*
[(in patients with acute rheumatic fever)39.8 (, but carditis has been)]TJ
-0.00011 Tc 0.2531 Tw T*
(reported in roughly 5% of patients with PSRA)Tj
0.0004 Tc 0 Tw 6.3 0 0 6.5 250.8596 145.4616 Tm
(15,19)Tj
-0.00011 Tc 0.23531 Tw 9.7 0 0 10 265.0458 142.1616 Tm
(. Thus,)Tj
0 Tc 0.0242 Tw -21.7573 -1.2 Td
[(patients with PSRA)-219.3 (should receive penicillin prophylaxis)]TJ
0.0004 Tc 0 Tw 6.3 0 0 6.5 277.3889 133.4616 Tm
(15,19)Tj
0 Tc 9.7 0 0 10 291.5751 130.1616 Tm
(.)Tj
0.0533 Tw -23.2552 -1.2 Td
[(W)79.8 (e describe a child who developed Brown\222)54.9 (s syndrome as)]TJ
0.3477 Tw -1.2371 -1.2 Td
(a complication of poststreptococcal reactive arthritis and)Tj
-0.00011 Tc 0.136 Tw T*
[(review the clinical features of PSRA)-331.2 (and the association of)]TJ
0.02499 Tw T*
[(inflammatory arthritis with Brown\222)54.8 (s syndrome.)]TJ
/TT1 1 Tf
0 Tw 27.2165 63.1 Td
(REFERENCES)Tj
/TT0 1 Tf
0 Tc 0.0249 Tw 8 0 0 8 325 703.1616 Tm
[(1.)-875 (Brown HW)91.8 (. )17.7 (T)34.9 (rue and simulated superior oblique tendon sheath)]TJ
1.675 -1.25 Td
(syndromes. Doc Ophthalmol 1973;34:123-36.)Tj
-0.00011 Tc -1.675 -1.25 Td
[(2.)-875.1 (Sanford-Smith JH. Intermittent superior oblique tendon sheath)]TJ
0 Tc 1.675 -1.25 Td
(syndrome. Br J Ophthalmol 1969;53:412-7.)Tj
-0.00011 Tc -1.675 -1.25 Td
[(3.)-875.1 (W)79.7 (ang FM, )17.7 (W)79.7 (ertenbaker C, Behrens MM, Jacobs JC. )54.8 (Acquired)]TJ
0 Tc 1.675 -1.25 Td
[(Brown\222)54.9 (s syndrome in children with juvenile rheumatoid arthritis.)]TJ
0 -1.25 TD
(Ophthalmology 1984;91:23-6.)Tj
-0.00011 Tc -1.675 -1.25 Td
[(4.)-875.1 (Kemp )54.8 (AS, Searle C, Horne S. )17.7 (T)34.8 (ransient Brown\222)54.8 (s syndrome in)]TJ
0 Tc 1.675 -1.25 Td
[(juvenile chronic arthritis. )54.9 (Ann Rheum Dis 1984;43:764-5.)]TJ
-0.00011 Tc -1.675 -1.25 Td
[(5.)-875.1 (Moore )54.8 (A)111 (T)73.9 (, Morin JD. Bilateral acquired inflammatory Brown\222)54.8 (s)]TJ
0 Tc 1.675 -1.25 Td
(syndrome. J Pediatr Ophthalmol Strabismus 1985;22:26-30.)Tj
-0.00011 Tc -1.675 -1.25 Td
[(6.)-875.1 (Roifman CM, Lavi S, Moore )54.8 (A)111 (T)73.9 (, Morin DJ, Stein LD, Gelfand EW)91.7 (.)]TJ
1.675 -1.25 Td
[(T)69.7 (enosynovitis of the superior oblique muscle \(Brown syndrome\))]TJ
0 Tc T*
(associated with juvenile rheumatoid arthritis. J Pediatr)Tj
0 Tw T*
(1985;106:617-9.)Tj
-0.00011 Tc 0.02499 Tw -1.675 -1.25 Td
[(7.)-875.1 (Kaufman LD, Sibony P)91.7 (A, )54.8 (Anand )54.8 (AK, Gruber BL. Superior oblique)]TJ
1.675 -1.25 Td
[(tenosynovitis \(Brown\222)54.8 (s syndrome\) as a manifestation of adult Still\222)54.8 (s)]TJ
0 Tc T*
(disease. J Rheumatol 1987;14:625-7.)Tj
-0.00011 Tc -1.675 -1.25 Td
[(8.)-875.1 (Killian PJ, McClain B, Lawless OJ. Brown\222)54.8 (s syndrome. )54.8 (An unusual)]TJ
0 Tc 1.675 -1.25 Td
[(manifestation of rheumatoid arthritis. )54.8 (Arthritis Rheum)]TJ
0 Tw T*
(1977;20:1080-4.)Tj
-0.00011 Tc 0.02499 Tw -1.675 -1.25 Td
[(9.)-875.1 (Cooper C, Kirwan JR, McGill NW)91.7 (, Dieppe P)91.7 (A. Brown\222)54.8 (s syndrome:)]TJ
0 Tc 1.675 -1.25 Td
[(an unusual ocular complication of rheumatoid arthritis. )54.9 (Ann Rheum)]TJ
T*
(Dis 1990;49:188-9.)Tj
-2.175 -1.25 Td
[(10.)-875 (Alonso-V)110.8 (aldivielso JL, )54.8 (Alvarez Lario B, )54.8 (Alegre Lopez J, Sedano)]TJ
-0.00011 Tc 2.175 -1.25 Td
[(T)69.7 (ous MJ, Builtrago Gomez )54.8 (A. )54.8 (Acquired Brown\222)54.8 (s syndrome in a)]TJ
0 Tc T*
[(patient with systemic lupus erythematosus. )54.8 (Ann Rheum Dis)]TJ
0 Tw T*
(1993;52:63-4.)Tj
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[(1)36.8 (1)-0.1 (.)-875.1 (Whitefield L, Isenber)17.7 (g DA, Brazier DJ, Forbes J. )54.8 (Acquired Brown\222)54.8 (s)]TJ
0 Tc 2.1381 -1.25 Td
(syndrome in systemic lupus erythematosus. Br J Rheumatol)Tj
0 Tw T*
(1995;34:1092-4.)Tj
-0.00011 Tc 0.02499 Tw -2.175 -1.25 Td
[(12.)-875.1 (Bradshaw DJ, Bray )17.7 (VJ, Enzenauer R)54.8 (W)91.7 (, Enzenauer RJ, )17.7 (T)34.8 (ruwit CL,)]TJ
2.175 -1.25 Td
[(Damiano )17.7 (TR. )54.8 (Acquired Brown syndrome associated with)]TJ
0 Tc T*
(enteropathic arthropathy: a case report. J Pediatr Ophthalmol)Tj
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[(Strabismus 1994;31:1)36.8 (18-9.)]TJ
0 Tc -2.175 -1.25 Td
[(13.)-875 (Thorne JE, )17.7 (V)129.2 (o)0.1 (lpe NJ, Liu GT)74 (. Magnetic resonance imaging of)]TJ
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[(acquired Brown syndrome in a patient with psoriasis. )54.8 (Am J)]TJ
T*
(Ophthalmol 1999;127:233-5.)Tj
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[(14.)-875 (Goldsmith DP)110.8 (, Long SS. Streptococcal disease of childhood \227 a)]TJ
2.175 -1.25 Td
[(changing syndrome [abstract]. )54.9 (Arthritis Rheum 1986;29 Suppl)]TJ
0 Tw T*
(4:S18.)Tj
0.0249 Tw -2.175 -1.25 Td
[(15.)-875 (DeCunto CL, Giannini EH, Fink CW)91.8 (, Brewer EJ, Person DA.)]TJ
-0.00011 Tc 2.175 -1.25 Td
(Prognosis of children with poststreptococcal reactive arthritis.)Tj
T*
(Pediatr Infect Dis J 1988;7:683-6.)Tj
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[(16.)-875.1 (Arnold MH, )17.7 (T)69.7 (yndall )54.8 (A. Poststreptococcal reactive arthritis. )54.8 (Ann)]TJ
0 Tc 2.175 -1.25 Td
(Rheum Dis 1989;48:686-8.)Tj
-2.175 -1.25 Td
[(17.)-875 (Fink CW)91.8 (. )17.8 (The role of the streptococcus in poststreptococcal)]TJ
2.175 -1.25 Td
(reactive arthritis and childhood polyarteritis nodosa. J Rheumatol)Tj
T*
(1991;18 Suppl 29:14-20.)Tj
-0.00011 Tc -2.175 -1.25 Td
[(18.)-875.1 (Gutierrez-Urena S, Molina J, Molina JF)79.7 (, Garcia CO, Cuellar ML,)]TJ
0 Tc 2.175 -1.25 Td
(Espinoza LR. Poststreptococcal reactive arthritis, clinical course,)Tj
T*
(and outcome in 6 adult patients. J Rheumatol 1995;22:1710-3.)Tj
-2.175 -1.25 Td
[(19.)-875 (Ahmed S, )54.8 (A)92 (youb EM, Scornik JC, )17.7 (W)79.8 (a)0.1 (ng CY)128.9 (, She JX.)]TJ
-0.00011 Tc 2.175 -1.25 Td
[(Poststreptococcal reactive arthritis. )54.8 (Arthritis Rheum 1998;)]TJ
0 Tc 0 Tw T*
(41:1096-102.)Tj
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[(Figur)36.8 (e 1.)]TJ
/TT0 1 Tf
0.06731 Tw 4.0691 0 Td
[(Schematic representation of Brown\222)54.8 (s syndrome af)17.7 (fecting the right)]TJ
0 Tc 0.02499 Tw -4.0691 -1.25 Td
[(eye. )17.8 (The right eye is unable to be elevated while in full adduction.)]TJ
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0 0 0 0 scn
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/CS0 CS 0 0 0 1 SCN
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558 54 l
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-0.00011 Tc 8 0 0 8 54.5 35.9844 Tm
[(Faust, et al: Br)36.8 (own\222)128.8 (s syndr)36.8 (ome)]TJ
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(2749)Tj
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120.092 51 Td
(Personal non-commercial use only. The Journal of Rheumatology Copyright\
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