Therapeutic Advances in Musculoskeletal Disease最新文献

{"title":"Utilising a non-surgical intervention in the knee osteoarthritis care pathway: a 6-year retrospective audit on NHS patients.","authors":"Robyn Benn,&nbsp;Lewis Rawson,&nbsp;Amanda Phillips","doi":"10.1177/1759720X231187190","DOIUrl":"https://doi.org/10.1177/1759720X231187190","url":null,"abstract":"<p><strong>Background: </strong>Knee osteoarthritis (OA) is a chronic, debilitating, musculoskeletal condition that affects millions. The increase in prevalence and its economic impact on healthcare and society raise the need for additional non-surgical interventions.</p><p><strong>Objective: </strong>To assess the referral rates to secondary care consultation and clinical outcomes in patients with severe knee OA treated with a home-based, non-surgical intervention.</p><p><strong>Design: </strong>This was a retrospective audit on 571 patients with knee OA who met the clinical criteria for total knee replacement (TKR) and received the service between October 2015 and March 2020.</p><p><strong>Methods: </strong>Patients were treated with a non-surgical, home-based, biomechanical intervention that aims to reduce pain and improve function, involving a foot-worn device for gait rehabilitation. The device is adjusted to the patient based on their gait patterns and clinical symptoms. Patients are advised to use the device at home or work and continue their routine. Patients are also advised to return to follow-up appointments to readjust the device and treatment plan. The primary outcome measure was the referral rates to secondary care consultation. Secondary outcomes included patient-reported outcome measures to assess pain and function and a computerised gait test. Follow-up time was between 1 and 6 years post-treatment initiation with a mean follow-up time of 1308.1 (SD = 473.4) days (i.e. 3.5 years.).</p><p><strong>Results: </strong>There were 65 (11.4%) referrals for secondary consultation with an average follow-up of 3.5 years. The mean days to referral was 480.9 (SD = 399.2) days. Of all referrals, 48% (<i>n</i> = 31) occurred during the first year of treatment, and 32% (<i>n</i> = 21) occurred during the second year. The rest were after more than 2 years of treatment.Significant improvements were seen in all clinical outcomes, including a reduction in pain and an improvement in function and gait patterns (<i>p</i> < 0.05 for all).</p><p><strong>Conclusion: </strong>Utilising this intervention as a non-surgical option for patients with knee OA who met the clinical criteria for TKR led to a significant reduction in pain and improvement in function after 3 months that was maintained for up to 3 years. Most patients (89%) did not proceed to secondary care consultation during their time in treatment for up to 6 years.</p>","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":"15 ","pages":"1759720X231187190"},"PeriodicalIF":4.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/29/a3/10.1177_1759720X231187190.PMC10387773.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9917117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The application of machine learning in early diagnosis of osteoarthritis: a narrative review.","authors":"Anran Xuan,&nbsp;Haowei Chen,&nbsp;Tianyu Chen,&nbsp;Jia Li,&nbsp;Shilong Lu,&nbsp;Tianxiang Fan,&nbsp;Dong Zeng,&nbsp;Zhibo Wen,&nbsp;Jianhua Ma,&nbsp;David Hunter,&nbsp;Changhai Ding,&nbsp;Zhaohua Zhu","doi":"10.1177/1759720X231158198","DOIUrl":"https://doi.org/10.1177/1759720X231158198","url":null,"abstract":"<p><p>Osteoarthritis (OA) is the commonest musculoskeletal disease worldwide, with an increasing prevalence due to aging. It causes joint pain and disability, decreased quality of life, and a huge burden on healthcare services for society. However, the current main diagnostic methods are not suitable for early diagnosing patients of OA. The use of machine learning (ML) in OA diagnosis has increased dramatically in the past few years. Hence, in this review article, we describe the research progress in the application of ML in the early diagnosis of OA, discuss the current trends and limitations of ML approaches, and propose future research priorities to apply the tools in the field of OA. Accurate ML-based predictive models with imaging techniques that are sensitive to early changes in OA ahead of the emergence of clinical features are expected to address the current dilemma. The diagnostic ability of the fusion model that combines multidimensional information makes patient-specific early diagnosis and prognosis estimation of OA possible in the future.</p>","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":"15 ","pages":"1759720X231158198"},"PeriodicalIF":4.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ed/cd/10.1177_1759720X231158198.PMC10017946.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9146235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness of specialised manual therapy <i>versus</i> orthopaedic care for musculoskeletal disorders: long-term follow-up and health economic model.","authors":"Stina Lilje,&nbsp;Maurits van Tulder,&nbsp;Anders Wykman,&nbsp;Emmanuel Aboagye,&nbsp;Ulf Persson","doi":"10.1177/1759720X221147751","DOIUrl":"https://doi.org/10.1177/1759720X221147751","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Physiotherapy is usually the first line of treatment for musculoskeletal disorders. If pain persists, an appointment with an orthopaedic surgeon is indicated, but many disorders for which patients are placed on orthopaedic waiting lists cannot be treated in an orthopaedic clinic. Specialised manual therapy, although not mainstream, can be an effective alternative to orthopaedic care, although its cost-effectiveness beyond 12 months is unknown.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To perform an 8-year follow-up of the quality of life and costs of specialised manual therapy versus standard orthopaedic care for working-age patients with common nonsurgical musculoskeletal disorders referred to orthopaedic surgeons and to develop a health economic model.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Cost-effectiveness study using Markov modelling.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The index group of a previously published pragmatic randomised controlled trial received a maximum of five treatment sessions of specialised manual therapy, while the control group received orthopaedic 'care as usual'. At 3, 6, 12 and 96 months, Health-Related Quality of Life and costs were measured with Short Form Health Survey 36, Short Form Health Survey 6D and Diagnostic Related Groups. An incremental cost-effectiveness ratio was calculated, a Markov model was developed and a sensitivity analysis was performed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Overall, 95% (&lt;i&gt;n&lt;/i&gt; = 75) of the participants completed the 8-year follow-up. Recovery rates during the first 3 months ('per protocol') in the index and control group were 69% and 58%, respectively. The index group had 0.159 more gains in quality-adjusted life years and cost 40,270 SEK (€4027) less per patient over 8 years. The sensitivity analysis results were consistent with the main results.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Specialised manual therapy dominated standard care after 8 years. The results of this small but very first study are promising; therefore, further exploration within other health care professions, clinics and/or countries is required. Our study raises questions about the triaging of orthopaedic outpatients, cost-effectiveness and resource allocation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Registration: &lt;/strong&gt;Not applicable per the information provided by ClinicalTrials.gov.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Plain language summary: &lt;/strong&gt;Specialised manual therapy is more cost-effective than 'care as usual' for working-age patients referred to an orthopaedist. This study provides an 8-year follow-up of the cost effects and quality of life of a previously published trial. &lt;b&gt;Why was this study conducted?&lt;/b&gt; The standard care for musculoskeletal pain consists of exercises with a physiotherapist in primary care. If the pain persists, a referral to an orthopaedic clinic is often made. Many of these referrals are inappropriate because they concern pain from muscles and joints that do not benefit from surgery or the resources available ","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":"15 ","pages":"1759720X221147751"},"PeriodicalIF":4.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9896095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10652567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of abatacept in patients with rheumatoid arthritis with previous malignancy.","authors":"Yosuke Kunishita,&nbsp;Kento Ichikawa,&nbsp;Yuji Uzawa,&nbsp;Masaki Mitsuhashi,&nbsp;Yuji Yoshioka,&nbsp;Tadanobu Okubo,&nbsp;Shouhei Nagaoka","doi":"10.1177/1759720X231186874","DOIUrl":"https://doi.org/10.1177/1759720X231186874","url":null,"abstract":"<p><strong>Background: </strong>Abatacept (ABT) is known to lower infection risk than other biologics and is effective and safe in elderly patients with rheumatoid arthritis (RA). However, there were inconsistent reports on the impact of ABT on malignancies which are more common in the elderly and strongly related to prognosis.</p><p><strong>Objectives: </strong>This study aimed to evaluate the efficacy and safety of ABT in patients with RA with previous malignancy in clinical practice.</p><p><strong>Design: </strong>A multicenter, retrospective study.</p><p><strong>Methods: </strong>Patients who received ABT for RA in two hospitals in Yokohama until May 2022 were included in this study. The patients were divided into two groups according to the presence or absence of a history of malignancy (no previous malignancy: NP group, previous malignancy: PM group). The collected parameters were compared between the groups using propensity score matching.</p><p><strong>Results: </strong>In this study, 312 patients were included, of whom 73 had previous malignancies when starting ABT. The age at ABT initiation was significantly higher in the PM group, the rate of methotrexate use was significantly lower in the PM group, and the Steinbrocker stage was significantly higher in the PM group. After matching these 3 factors, 68 patients were selected from each group. No significant differences in the ABT continuation rate, and malignancy incidence were observed between the two groups after ABT initiation. In addition to these factors, when matched for smoking history, interstitial lung disease, disease duration, sex, and inflammatory status, which are known risk factors for malignancy in RA, 40 patients were selected from each group. No significant differences in the ABT continuation rate, and malignancy incidence were observed between the two groups after ABT initiation.</p><p><strong>Conclusion: </strong>In our clinical practice, ABT was as effective and safe in patients with a history of malignancy as in those without.</p>","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":"15 ","pages":"1759720X231186874"},"PeriodicalIF":4.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/55/f1/10.1177_1759720X231186874.PMC10395174.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10301551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>T</i>-score discordance between hip and lumbar spine: risk factors and clinical implications.","authors":"Ming-Hsiu Chiang,&nbsp;Yeu-Chai Jang,&nbsp;Yu-Pin Chen,&nbsp;Wing P Chan,&nbsp;Ying-Chin Lin,&nbsp;Shu-Wei Huang,&nbsp;Yi-Jie Kuo","doi":"10.1177/1759720X231177147","DOIUrl":"https://doi.org/10.1177/1759720X231177147","url":null,"abstract":"<p><strong>Background: </strong><i>T</i>-score discordance is common in osteoporosis diagnosis and leads to problems for clinicians formulating treatment plans.</p><p><strong>Objectives: </strong>This study investigated the potential predictors of <i>T</i>-score discordance and compared fracture risk among individuals with varying <i>T</i>-score discordance status.</p><p><strong>Design: </strong>This was a single-center cross-sectional study conducted at Wan Fang Hospital, Taipei City, between 1 February 2020 and 31 January 2022.</p><p><strong>Methods: </strong>The present study enrolled patients aged ⩾50 years who received advanced bone health examination. Participants with a history of fracture surgery or underlying musculoskeletal diseases were excluded. Bioelectrical impedance analysis and dual-energy X-ray absorptiometry were used to determine the body composition and <i>T</i>-score, respectively. Discordance was defined as different <i>T</i>-score categories between the lumbar spine and hip. The impact of discordance on an individual's fracture risk was assessed using the Fracture Risk Assessment Tool (FRAX).</p><p><strong>Results: </strong>This study enrolled 1402 participants (181 men and 1221 women). Of the 912 participants diagnosed with osteoporosis, 47 (5%) and 364 (40%) were categorized as having major and minor discordance, respectively. Multinomial logistic regression revealed that decreased walking speed was significantly correlated with major discordance but not osteoporosis in both the hip and lumbar spine (odds ratio of 0.25, <i>p</i> = 0.04). The adjusted FRAX scores for the major osteoporotic fracture risks of the major and minor discordance groups were approximately 14%, which was significantly lower than that of people having osteoporosis in both the hip and lumbar spine.</p><p><strong>Conclusions: </strong>Walking speed exhibited the most significant correlation with major discordance in patients with osteoporosis. Although adjusted major fracture risks were similar between the major and minor discordance groups, further longitudinal studies are warranted to confirm this finding.</p><p><strong>Registrations: </strong>This study was approved by the Ethics Committee of Taipei Medical University on 01/04/2022 (TMU-JIRB N202203088).</p>","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":"15 ","pages":"1759720X231177147"},"PeriodicalIF":4.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cf/c8/10.1177_1759720X231177147.PMC10286209.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10302683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral enzyme combination with bromelain, trypsin and the flavonoid rutoside reduces systemic inflammation and pain when used pre- and post-operatively in elective total hip replacement: a randomized exploratory placebo-controlled trial.","authors":"Jiří Vosáhlo,&nbsp;Adam Salus,&nbsp;Michael Smolko,&nbsp;Barbora Němcová,&nbsp;Veit Nordmeyer,&nbsp;Milos Mikles,&nbsp;Stefanie M Rau,&nbsp;Odd Erik Johansen","doi":"10.1177/1759720X231186875","DOIUrl":"https://doi.org/10.1177/1759720X231186875","url":null,"abstract":"<p><strong>Background: </strong>Early mobilization after total hip replacement (THR) is key for fast recovery but is often limited by pain. Oral enzyme combinations (OECs) have demonstrated anti-inflammatory and pain-relieving effects.</p><p><strong>Objectives and design: </strong>This prospective, randomized, double-blind, placebo-controlled exploratory trial evaluated the effects of pre- and post-operative use of OEC (90 mg bromelain, 48 mg trypsin, 100 mg rutoside) following elective THR, on post-operative recovery.</p><p><strong>Methods: </strong>Candidates for primary elective cementless THR owing to osteoarthritis were eligible for participation [age ⩾50 years, body mass index 25-35 kg/m², C-reactive protein (CRP) ⩽6 mg/L]. Following randomization to OEC or placebo, intervention started pre-operatively and continued onwards until day 42. Main outcomes included post-operative CRP levels (days 1-7), self-reported hip pain at rest (by 0-10 cm visual analogue scale on post-operative days 1-42), post-operative analgesic use [by cumulative analgesic consumption score (CACS) days 7-42], tolerability and adverse events.</p><p><strong>Results: </strong>Patients (<i>N</i> = 34) were recruited from a tertiary orthopaedic hospital in the Czech Republic, of whom 33 completed the study (OEC/placebo: <i>n</i> = 15/18). Baseline characteristics across the groups were comparable. Compared with placebo, the OEC group had numerically lower CRP levels on post-operative days 1-7, including peak level [mean (standard deviation) OEC <i>versus</i> placebo: 81.4 (28.3) <i>versus</i> 106.7 (63.3) mg/L], which translated into a significant 32% lower CRP area under the curve (<i>p</i> = 0.034). The OEC group reported significantly less pain during post-operative days 1-7 <i>versus</i> placebo (analysis of variance treatment × visit [<i>F</i>(4) = 3.989]; <i>p</i> = 0.005). Analgesic use was numerically reduced as assessed through an accumulated CACS. No deleterious effects on haemorheological parameters were observed in either group.</p><p><strong>Conclusions: </strong>Pre- and post-operative use of OEC significantly reduced CRP levels and patient self-reported pain. OEC may be an efficacious and safe treatment option to facilitate post-operative recovery following THR.</p><p><strong>Trial registration: </strong>EudraCT number 2016-003078-41.</p>","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":"15 ","pages":"1759720X231186875"},"PeriodicalIF":4.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b4/63/10.1177_1759720X231186875.PMC10387799.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10304667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Osteoarthritis Questionnaire (EOAQ): a tool to assess knee osteoarthritis at initial stage.","authors":"Alberto Migliore,&nbsp;Liudmila Alekseeva,&nbsp;Sachin R Avasthi,&nbsp;Raveendhara R Bannuru,&nbsp;Xavier Chevalier,&nbsp;Thierry Conrozier,&nbsp;Sergio Crimaldi,&nbsp;Gustavo C de Campos,&nbsp;Demirhan Diracoglu,&nbsp;Gianfranco Gigliucci,&nbsp;Gabriel Herrero-Beaumont,&nbsp;Giovanni Iolascon,&nbsp;Ruxandra Ionescu,&nbsp;Jörg Jerosch,&nbsp;Jorge Lains,&nbsp;Emmanuel Maheu,&nbsp;Souz Makri,&nbsp;Natalia Martusevich,&nbsp;Marco Matucci-Cerinic,&nbsp;Karen Pavelka,&nbsp;Robert J Petrella,&nbsp;Raghu Raman,&nbsp;Umberto Tarantino","doi":"10.1177/1759720X221131604","DOIUrl":"https://doi.org/10.1177/1759720X221131604","url":null,"abstract":"<p><strong>Background: </strong>Early stage of osteoarthritis (OA) is characterized by joint stiffness and pain as well as by subclinical structural changes that may affect cartilage, synovium, and bone. At the moment, the lack of a validated definition of early osteoarthritis (EOA) does not allow to make an early diagnosis and adopt a therapeutic strategy to slow disease progression. Also, no questionnaires are available to evaluate the early stage, and therefore this remains an unmet need.</p><p><strong>Objective: </strong>Therefore, the purpose of the technical experts panel (TEP) of 'International Symposium of intra-articular treatment' (ISIAT) was to create a specific questionnaire to evaluate and monitor the follow-up and clinical progress of patients affected by early knee OA.</p><p><strong>Design: </strong>The items for the Early Osteoarthritis Questionnaire (EOAQ) were identified according to the following steps: items generation, items reduction, and pre-test submission.</p><p><strong>Methods: </strong>During the first step, literature has been reviewed and a comprehensive list of items about pain and function in knee EOA was drafted. Then, during the ISIAT (5th edition 2019), the draft has been discussed by the board, which reformulated, deleted, or subdivided some of the items. After the ISIAT symposium, the draft was submitted to 24 subjects affected by knee OA. A score based on the importance and the frequency was created and the items with a score ⩾0.75 were selected. After intermediate evaluation made by a sample of patients, the second and final version of the questionnaire EOAQ was submitted to the whole board for final analysis and acceptance in a second meeting (29 January 2021).</p><p><strong>Results: </strong>After an exhaustive elaboration, the final version of the questionnaire contains two domains (Clinical Features and Patients Reported Outcome) with respectively 2 and 9 questions, for a total of 11 questions. Questions mainly explored the fields of early symptoms and patients reported outcomes. Marginally, the need of the symptoms treatment and the use of painkillers were investigated.</p><p><strong>Conclusions: </strong>Adoption of diagnostic criteria of early OA is strongly encouraged and a specific questionnaire for the whole management of the clinical features and patients' outcome might really improve the evolution of OA in the early stages of the disease, when the treatment is expected to be more effective.</p>","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":"15 ","pages":"1759720X221131604"},"PeriodicalIF":4.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b3/0a/10.1177_1759720X221131604.PMC9969428.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9074715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of the anti-thyroid peroxidase antibody with chronic hand pain in older adults in the Third National Health and Nutrition Examination Survey: a cross-sectional study.","authors":"Clement E Tagoe,&nbsp;Wanyi Wang,&nbsp;Kamil E Barbour","doi":"10.1177/1759720X231154984","DOIUrl":"https://doi.org/10.1177/1759720X231154984","url":null,"abstract":"<p><strong>Background: </strong>Autoimmune thyroid disease (AITD) is the commonest autoimmune disease. Although viewed as a classic form of single-organ autoimmunity, AITD is increasingly associated with non-thyroid sequelae including musculoskeletal manifestations and chronic pain syndromes. However, large population-based studies are needed.</p><p><strong>Objectives: </strong>To examine the relationships between chronic hand pain and the AITD autoantibodies, anti-thyroid peroxidase antibody (TPOAb), and anti-thyroglobulin antibody (TgAb), in the Third National Health and Nutrition Examination Survey (NHANES III).</p><p><strong>Design: </strong>This is a cross-sectional study.</p><p><strong>Methods: </strong>We examined data from NHANES III on 4820 persons aged 60 years or older with respect to hand pain and its association with TPOAb and TgAb. Log-binomial regressions were fit to examine the associations between the anti-thyroid autoantibodies and hand pain.</p><p><strong>Results: </strong>Positive TPOAb was associated with a higher prevalence of hand pain than negative TPOAb [prevalence ratio (PR) = 1.158, <i>p</i> = 0.048] in the unadjusted model. This association was no longer significant after controlling for age, body mass index, gender, and diabetes (<i>p</i> = 0.313). When positive TPOAb was considered as a categorical variable with four levels, the highest quartile was associated with hand pain in the unadjusted (PR = 1.489, <i>p</i> = 0.005) and adjusted models (PR = 1.325, <i>p</i> = 0.042). There was no significant association between TgAb and hand pain when covariates were controlled for.</p><p><strong>Conclusion: </strong>TPOAb may be associated with the presence of chronic hand pain in persons aged over 60 years, especially at higher serum levels.</p>","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":"15 ","pages":"1759720X231154984"},"PeriodicalIF":4.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/68/51/10.1177_1759720X231154984.PMC10102935.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9309001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative validation of the knee inflammation MRI scoring system and the MRI osteoarthritis knee score for semi-quantitative assessment of bone marrow lesions and synovitis-effusion in osteoarthritis: an international multi-reader exercise.","authors":"Walter P Maksymowych,&nbsp;Jacob L Jaremko,&nbsp;Susanne J Pedersen,&nbsp;Iris Eshed,&nbsp;Ulrich Weber,&nbsp;Andrew McReynolds,&nbsp;Paul Bird,&nbsp;Stephanie Wichuk,&nbsp;Robert G Lambert","doi":"10.1177/1759720X231171766","DOIUrl":"https://doi.org/10.1177/1759720X231171766","url":null,"abstract":"<p><strong>Background: </strong>Bone marrow lesions (BMLs) and synovitis on magnetic resonance imaging (MRI) are associated with symptoms and predict degeneration of articular cartilage in osteoarthritis (OA). Validated methods for their semiquantitative assessment on MRI are available, but they all have similar scoring designs and questionable sensitivity to change. New scoring methods with completely different designs need to be developed and compared to existing methods.</p><p><strong>Objectives: </strong>To compare the performance of new web-based versions of the Knee Inflammation MRI Scoring System (KIMRISS) with the MRI OA Knee Score (MOAKS) for quantification of BMLs and synovitis-effusion (S-E).</p><p><strong>Design: </strong>Retrospective follow-up cohort.</p><p><strong>Methods: </strong>We designed web-based overlays outlining regions in the knee that are scored for BML in MOAKS and KIMRISS. For KIMRISS, both BML and S-E are scored on consecutive sagittal slices. The performance of these methods was compared in an international reading exercise of 8 readers evaluating 60 pairs of scans conducted 1 year apart from cases recruited to the OA Initiative (OAI) cohort. Interobserver reliability for baseline status and baseline to 1 year change in BML and S-E was assessed by intra-class correlation coefficient (ICC) and smallest detectable change (SDC). Feasibility was assessed using the System Usability Scale (SUS).</p><p><strong>Results: </strong>Mean change in BML and S-E was minimal over 1 year. Pre-specified targets for acceptable reliability (ICC ⩾ 0.80 and ⩾ 0.70 for status and change scores, respectively) were achieved more frequently for KIMRISS for both BML and synovitis. Mean (95% CI) ICC for change in BML was 0.88 (0.83-0.92) and 0.69 (0.60-0.78) for KIMRISS and MOAKS, respectively. KIMRISS mean SUS usability score was 85.7 and at the 95th centile of ranking for usability versus a score of 55.4 and 20th centile for MOAKS.</p><p><strong>Conclusion: </strong>KIMRISS had superior performance metrics to MOAKS for quantification of BML and S-E. Both methods should be further compared in trials of new therapies for OA.</p>","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":"15 ","pages":"1759720X231171766"},"PeriodicalIF":4.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10345937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9826903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dysfunctional high-density lipoprotein in chronic inflammatory rheumatic diseases.","authors":"Sabina Waldecker-Gall,&nbsp;Felix Seibert,&nbsp;Sebastian Bertram,&nbsp;Adrian Doevelaar,&nbsp;Jürgen Braun,&nbsp;Xenofon Baraliakos,&nbsp;Nina Babel,&nbsp;Christoph Waldecker,&nbsp;Linda Scharow,&nbsp;Nikolaos Pagonas,&nbsp;Timm H Westhoff","doi":"10.1177/1759720X231187191","DOIUrl":"https://doi.org/10.1177/1759720X231187191","url":null,"abstract":"<p><strong>Background: </strong>The mechanism explaining low cholesterol concentrations in chronic inflammatory rheumatic disease (CIRD) is incompletely understood. We hypothesized that chronic inflammation impairs the functionality of high-density lipoprotein (HDL), for example, by oxidative processes.</p><p><strong>Objectives: </strong>Assessment of oxidized HDL (HDL_ox), a marker of dysfunctional HDL, in newly diagnosed patients with CIRD before and after initiation of immunosuppressive therapy and comparison of HDL_ox values of patients with CIRD to non-CIRD controls.</p><p><strong>Design: </strong>Prospective observational trial.</p><p><strong>Methods: </strong>The study was conducted on 44 newly diagnosed CIRD patients, who were initiated on immunosuppressive therapy (baseline). A total of 136 patients without CIRD served as control. Lipid profiles including HDL_ox levels and C-reactive protein (CRP) were measured in both groups at baseline. In CIRD patients, measurements were repeated 12 weeks after baseline. Validated outcome tools for disease activity and function were assessed at baseline and 12 weeks.</p><p><strong>Results: </strong>A total of 33 (75%) patients with rheumatoid arthritis, 7(16%) with axial spondyloarthritis, and 4 (9%) with systemic lupus erythematosus were included. Groups were comparable for age and BMI. CIRD patients had higher HDL_ox concentrations (1.57 <i>versus</i> 0.78, <i>p</i> = 0.02) and tended to have lower low-density lipoprotein cholesterol, HDL cholesterol, and cholesterol concentrations compared to controls. HDL_ox (1.57 <i>versus</i> 1.4, <i>p</i> = 0.26) and CRP levels (2.1 <i>versus</i> 0.7 mg/dl, <i>p</i> < 0.01) decreased in CIRD patients from baseline to follow-up.</p><p><strong>Conclusion: </strong>CIRD is associated with an impairment of the anti-inflammatory properties of HDL as reflected by an increase in HDL_ox concentrations. This effect may contribute to the increased cardiovascular risk in chronic inflammatory diseases.</p>","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":"15 ","pages":"1759720X231187191"},"PeriodicalIF":4.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9f/ac/10.1177_1759720X231187191.PMC10462425.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10475895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}