The Osteoarthritis Research Society International's World Congress on Osteoarthritis concluded on April 21, with a clear focus on finding new ways to recognize the disease early and identify and slow progression.
Conferences page on Musculoskeletal Network features reports on the latest in osteoarthritis research, including:
New in the non-rheumatology journals: Among osteoarthritis patients in the UK, 10-year survival rates were doubled after metal-on-metal (MoM) hip resurfacing, compared with other types of hip replacement. More »
Lower odds of cardiovascular disease found after arthroplasty for knee or hip OA, and an explanation of statistical techniques that make this observational data "persuasive," but not conclusive. Also new in the non-rheumatology journals: Support for minimally invasive spacers in lumbar spinal... More »
(VIDEO) Another dictum from medical school gives way to medical research: Clicking, popping, and locking are not useful for diagnosis and prognosis of suspected meniscal tear in patients over 45. Harvard's Dr. Jeffrey Katz reveals signs that actually are informative in this age group. More »
ACR2013: Urate crystals turned up in dual-energy CT and pathology studies of OA patients never diagnosed with gout who came to the Mayo Clinic for knee replacement, raising intriguing questions. More »
ACR2013: Research continues to implicate the obesity-associated molecule leptin as a factor in osteoarthritis, independent of the mechanical effects of body weight. Factors that control leptin show promise as future treatments. More »
Internists gain some guidance on identifying systemic lupus erythematosus (SLE) and why they should work with rheumatologists. Meanwhile, two UK studies outline paths to successful gout treatment and lower mortality rates after hip replacement surgery. Finally, the use of imaging, including... More »
Results from the Framingham Ostoporosis Study show that change in bone mineral density over baseline offers little predictive value. Also last week: More support for diet and exercise to reduce the pain of knee OA. More »
PML and Rituximab: What Rheumatologists Should Know
The risk for progressive multifocal leukoencephalopathy among RA patients on rituximab is extremely low, about 5/100,000. For MS patients on long-term (>24 months) natalizumab and infected with relevant pathogen, the JC virus, it is cited as 1/100. . ..
Pharmacogenetics in Rheumatology: Disappointment, Success, and a Few Challenges
The enzyme that prevents toxic reactions to the lupus drug azathioprene has little or no activity in 0.3% of individuals and only intermediate activity in 10%. The test for this, advised on the label, is a rare example of effective pharmacogenetics in rheumatology. . ..
EMG is a very helpful to differentiate myositis from disorders of the brain, nerves, or spinal cord, but among children MRI is often used to avoid the morbidity associated with muscle biopsy and EMG. Absent skin manifestations, muscle biopsy is the gold standard. . ..
Systemic Lupus Erythematosus With Features of Castleman Disease
Lymphadenopathy, fever, anemia, elevated ESR, and hypergammaglobulinemia occur often in the plasma cell type of Castleman Disease. Unlike another cause in the differential, malignancy, these are completely reversible in Castleman Disease. . ..
All About Gout and Pseudogout: Meeting A Growing Challenge
Most patients with hyperuricemia do not go on to have gout, and it may be seen with any other cause of acute monoarthritis. On the other hand, serum uric acid levels may drop to normal values during an acute gout attack, due to an increase in renal excretion, so a normal value does not exclude this diagnosis. . ..
Joint Aspiration and Injection: A Look at the Basics
Cellulitis overlying a swollen joint is not a contraindication if it is the only portal for intra-articular access. The risk of introducing infection by aspirating through cellulitic skin is far less than the risk of unmanaged septic arthritis. . ..
Limited Joint Mobility in Diabetes Mellitus: The Clinical Implications
Take care not to be overenthusiastic about the prayer-sign test for limited joint mobility, for instance in patients with diabetes. One study found that 26% of healthy controls were not able to make complete contact of the palmar surfaces. . ..
Viral causes are implicated in potentially deadly A-DRESS SYNDROME (dermatitis, hepatitis, interstitial nephritis, and eosinophilia) among allopurinol users. Skin biopsy and a wide panel of viral titers are well advised. . ..
Over two million anterior cruciate ligament (ACL) injuries occur worldwide annually, and the greater prevalence for ACL injury in young female athletes is one of the major problems in sports medicine. Optimal treatment of ACL injury requires individualised management. Patient selection is of utmost importance, and so is respect for the patient's functional demands and interests. All patients with an ACL tear may not need surgery, however athletes and persons with an active lifestyle with high knee fun
Purpose: The purpose of this study was to assess the degree of osteoarthritis, degree of laxity, and quality-of-life (QOL) scores in primary and revision anterior cruciate ligament (ACL) reconstruction.Methods: This was a cross-sectional study; 25 patients who had undergone revision ACL reconstruction with allografts were identified and compared with 27randomly selected primary ACL reconstruction patients operated on in the same hospital in the same period with the same technique. The main outcome mea
Although it is generally accepted that osteoarthritis is a degenerative condition of the cartilage, other tissues such as synovium in which immunological and inflammatory reactions occur contribute to the development of joint pathology. This sheds new light on the potential mechanism of action of mesenchymal stem cell therapy in osteoarthritis. Rather than tissue repair due to local transformation of injected mesenchymal stem cells to chondrocytes and filling defects in cartilage, such treatment might sup
How Physicians Can Manage Unexpected Free Time Jennifer Frank, MD, October 22, 2013 Whether you have an unexpected patient no-show, or two hours before bed, figuring out how to spend spurts of free time can be a work-life balance stressor.