Journal of arthritis最新文献

{"title":"Does the Size of the Femoral Condyle Contribute to the Development ofOsteoarthritis of the Knee? A Retrospective Randomised MRI Study","authors":"G. Dehn, D. Kieser, R. Maxwell, G. Hooper, C. Frampton, M. Coates","doi":"10.37532/JAHS.2019.8(4).284","DOIUrl":"https://doi.org/10.37532/JAHS.2019.8(4).284","url":null,"abstract":"Aim: Cam impingement in the hip is well recognised with the relative incongruity between the femoral head and acetabulum implicated in the development of osteoarthritis (OA). We propose that a similar situation may occur in the knee joint and explain the commonly observed anteromedial OA in medial compartment disease. This study asked whether a relatively larger femoral condyle could cause impingement on the smaller tibial articular surface and result in early osteoarthritis (OA). \u0000 \u0000Methods: A retrospective randomised study of 400 age and sex matched knee x-ray and MRI scans of patients aged between 40 and 60 years was performed. Patients with any conditions that could affect their knee joint congruence or predispose them to degenerative changes were excluded. Measurements of the femoral and tibial articular surfaces were performed in the coronal and sagittal planes. The degree of OA was assessed with the modified ICRS grading system. Inter- and intra-observer bias was measured. \u0000 \u0000Results: There were 234 knees with OA,171 (42.7%) with medial compartment OA, 35 (8.8%) lateral compartment OA and 28 (7%) with bicompartment OA. A significant difference was found between the ratio of the coronal width of the medial femoral condyle and the medial tibial plateau in the presence of early OA (0.85, 95% CI 0.842-0.858) compared those without OA (0.91, 95% CI 0.902-0.919) (p=0.001), and for the same comparison on the lateral side (0.866, (95% CI 0.853-0.879) for knees with OA and 0.917 (95% CI 0.911-0.924) without OA) (p=0.001). Additionally, knees with medial compartment OA had a relative ratio (comparison between medial and lateral ratios) of 0.905 (95% CI 0.896-0.913) compared to 0.993 in knees without OA (95% CI 0.984-1.002) (p=0.001). \u0000 \u0000Conclusion: Knees with OA had a significantly smaller femur to tibia coronal articular surface ratio. These findings did not support impingement of the femur on the tibial articular surface as a cause for OA. Given this previously unrecognised association, further research is needed to confirm and determine its clinical effect.","PeriodicalId":91304,"journal":{"name":"Journal of arthritis","volume":"8 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2019-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43280445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Intra-Articular Hyaluronic Acid and Cortisone Compared to Cortisone alone for Symptomatic Hip Osteoarthritis","authors":"P. Crook, J. Shah, Kory R. Lee, Gaurav Synghal, Rayce D Yanney, J. Rollins, Br, on Couch, M. Nickell, L. Rollins, Alex Kreines Do, Mark Adickes","doi":"10.4172/2167-7921.1000278","DOIUrl":"https://doi.org/10.4172/2167-7921.1000278","url":null,"abstract":"Background: Viscosupplementation through intraarticular injection of hyaluronic acid (HA) has shown beneficial effects in the treatment of hip osteoarthritis. Cortisone injections for have also been shown to alleviate symptoms in hip osteoarthritis. While studies in knee osteoarthritis have shown the safety and synergistic effect of a combination HA and cortisone injection, there have been no studies on the use of a combination HA and cortisone injection in the hip. Hypothesis: The purpose of this study is to determine the efficacy of a combination of intra-articular HA and cortisone when compared to cortisone alone in the treatment of symptomatic hip osteoarthritis. Study design: Case- control study Methods: All hip injections for osteoarthritis carried out from January 2009 to December 2014 were retrospectively reviewed. Pain severity using the numerical rating scale and osteoarthritis severity using the Tonnis classification were recorded for each patient. All injections were performed with fluoroscopic guidance and patients received either cortisone or a combination of cortisone and HA. Results: 119 patients who received cortisone alone were matched 1:1 with respect to age, gender, BMI, and diagnosis with 119 patients who received cortisone and HA. Mean duration of follow up was 26 months. Median duration of pain relief was 32.3 days in the cortisone group and 128.6 days in the cortisone plus HA group (p=0.000001) Conclusions: This is the first study to evaluate the efficacy of a combination injection of intra-articular hyaluronic acid and cortisone in hip OA. While no difference in post injection pain relief when compared to cortisone alone was noted, there was a significant difference in the duration of pain relief with the combination providing more than 3 additional months of relief.","PeriodicalId":91304,"journal":{"name":"Journal of arthritis","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-7921.1000278","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70837090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Amyopathic Dermatomyositis and Rheumatoid Arthritis: An Uncommon Presentation of Overlap Syndrome","authors":"R. A. Rivera, V. Lopez, R. León","doi":"10.37532/jahs.2020.8(4).288","DOIUrl":"https://doi.org/10.37532/jahs.2020.8(4).288","url":null,"abstract":"Overlap syndrome is a term used to describe two or more systemic rheumatic diseases identified in the same patient, in which each disease fulfils its own diagnostic criteria. Inflammatory myopathies such as Dermatomyositis are associated with an increased risk of malignancy and interstitial lung disease. It may overlap with Systemic Sclerosis, Systemic Lupus Erythematosus, Mixed Connective Tissue Disease and less often Rheumatoid Arthritis.","PeriodicalId":91304,"journal":{"name":"Journal of arthritis","volume":"8 1","pages":"0-0"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69925061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection of Non-Traumatic Knee Effusion among Asymptomatic Individual with Different type of Lifestyle and Selected Sociodemographic Factors Using Fluid Shift Test and Ultrasonography","authors":"Myint Swe, Ramani Subramanium, Sabridah Ismail, Biju Benjamin","doi":"10.4172/2167-7921.1000270","DOIUrl":"https://doi.org/10.4172/2167-7921.1000270","url":null,"abstract":"Background history: Non-traumatic knee effusion might be the result of overuse leading to wear and tear processes or systemic diseases. Knee effusion-synovitis was a predictive of some structural abnormalities in the joint suggesting a potential role in early osteoarthritis changes. It is postulated that the active life style with prolonged standing hours predisposed for the increase prevalence of non-traumatic knee effusion even in the young age.Method: Final year medical students and clerical office staffs from Royal college of Medicine Perak were randomly selected. Those who had some kind of physical activities (walking, jogging or any kind of sports) for more than half an hour a day at least three times per week among the students and the clerical office staffs were included in active life style group and the remaining were listed in sedentary life style group. All were assessed for knee effusion by two orthopaedic surgeons clinically and then assessed by ultrasound examination on the same day. All were less than 30 years of age.Results: Data from 46 staffs and 53 students (total 99) were analysed. Number of participants in active life style group was 72 and that in sedentary life style groups was 27. Among the 99 participants, 53 (53.53%) had positive fluid shift test and 46 (46.5%) had effusion on ultrasound examination. \u0000The respondents who practice active lifestyle and respondents with BMI more than 25 had more prevalence than non-active respondents and respondents with BMI less than 25 respectively.Conclusion: The persons with active life style had more chance of having knee effusion. The five-point scale method of fluid shift test or stroke test is a reliable test for detection of small amounts of fluid in knee.","PeriodicalId":91304,"journal":{"name":"Journal of arthritis","volume":" ","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2018-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-7921.1000270","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48203191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pigmented Villonodular Synovitis","authors":"S. Dhanda, T. Quek","doi":"10.4172/2167-7921.1000i106","DOIUrl":"https://doi.org/10.4172/2167-7921.1000i106","url":null,"abstract":"Pigmented villonodular synovitis is a benign proliferative synovial disorder of unknown origin that may affect the joints, bursae, or tendon sheaths, most frequently the knee. It can occur in diffuse or focal form. MR imaging is routinely used for diagnosis and follow-up in patients with pigmented villonodular synovitis. The lesions show hemosiderin deposition due to their tendency to bleed and a characteristic hypointense signal with all pulse sequences, an important diagnostic feature on MRI which helps in making the diagnosis in a young adult with monarticular involvement by synovial soft tissue mass without calcifications, with preserved joint space and normal juxtarticular bones.","PeriodicalId":91304,"journal":{"name":"Journal of arthritis","volume":"7 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2018-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-7921.1000i106","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46389874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Intra-Articular Steroid Injection in Osteoarthritis Patients","authors":"F. Sofi, Mushtaq Ahmad, Bilal, Ashiq, Arif","doi":"10.4172/2167-7921.1000269","DOIUrl":"https://doi.org/10.4172/2167-7921.1000269","url":null,"abstract":"Introduction: Osteoarthritis (OA) is a clinical syndrome of joint pain accompanied by varying degrees of functional limitation and reduced quality of life due to chronic degenerative arthropathy. It is most common form of arthritis and one of the leading causes of pain and disability worldwide in population above 50 years. \u0000Material and Methods: 162 patients of symptomatic osteoarthritis were given intra articular triamcinolone acetonide injections over a period of 5 years at SKIMS Soura Srinagar J&K. \u0000Results: Among the patients 107 (66%) were females and 55 (34%) were males. Knee joint was most common involved joint. 15 patients had to receive repeated intraarticular steroid injection. \u0000Conclusion: Intra articular triamcinolone injection revealed good efficacy for pain relief and functional outcome without adverse effects.","PeriodicalId":91304,"journal":{"name":"Journal of arthritis","volume":"7 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2018-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-7921.1000269","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42779452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of the Implementation of a New Selective Screening Program for Neonatal Hip Ultrasound in Cardiff and Vale University Health Board","authors":"A. Poacher, C. Carpenter","doi":"10.4172/2167-7921.1000265","DOIUrl":"https://doi.org/10.4172/2167-7921.1000265","url":null,"abstract":"Objective: Developmental dysplasia of the hip (DDH) is a common and preventable cause of disability. Early detection of DDH (<3 months) is associated with reduced risk of surgical treatment, hence in addition to the traditional clinical screening, NIPE guidelines advocate the use of selective screening of those with DDH associated risk factors. In 2016, Cardiff and Vale University Health Board (CAVUHB) implemented a selective screening program for DDH. This research will determine the impact and up-to-date cost effectiveness of a selective screening for DDH. \u0000Methods: A retrospective study of all patients born between 1st of January 2016 and the 31st of December 2016, who underwent ultra-sonographic screening for DDH in CAVUHB. Ultrasounds were graded using Graf’s classification, treatment outcomes were determined by patient’s records and costings were based on 2016 NHS tariffs. The research took place at the University Hospital of Wales (UHW). \u0000Results: Screening of those with risk factors for DDH, but a normal examination diagnosed 72% of all DDH cases and 38% of treated DDH cases. Screening for risk factors cost CAVUHB £98914, with a cost per favorable outcome, defined as early detection and successful treatment of DDH without surgical intervention, of £12364. The mean cost of DDH treatment of a patient missed by screening was £14431. All DDH cases were detected through breech presentation or family history risk factors. Screening only those with these risk factors is more cost effective and equally successful with a cost per favorable outcome of £9095. \u0000Conclusion: The selective screening program was successful and cost effective in detecting and treating cases of DDH. However, the screening process can be made more cost-effective without reducing DDH detection rate, by omitting statistically insignificant risk factors from the screening criteria. Early detection of DDH is important for effective treatment. CAVUHB cost-effectively reduced morbidity and potential surgical mortality within the neonatal population because of its selective screening program for DDH.","PeriodicalId":91304,"journal":{"name":"Journal of arthritis","volume":"7 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2018-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-7921.1000265","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42750900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conventional vs Robotic Arm Assisted Total Hip Arthroplasty (THA) Surgical Time, Transfusion rates, Length of Stay, Complications and Learning Curve","authors":"Y. Heng, R. Gunaratne, C. Ironside, A. Taheri","doi":"10.4172/2167-7921.1000272","DOIUrl":"https://doi.org/10.4172/2167-7921.1000272","url":null,"abstract":"Background: Total hip arthroplasty (THA) is increasingly more popular with our aging population. Robotic arm assisted THA uses patient specific information gathered from a pre-operative CT scan and correlation with intraoperative checkpoints to improve the accuracy and reproducibility of component positioning. Despite the various advantages robotic arm assisted THA can offer, there are still concerns regarding increased surgical time, technical complexity, complications and costs.Method: Retrospective review of a single surgeons’ last 45 conventional THA performed prior to changing to the robotic arm assisted system with the first 45 robotic arm assisted THA. Surgical time, Length of stay (LOS) in hospital, LOS in rehabilitation, transfusion rates and any complications were compared.Results: Average surgical time was 96.7 mins for the rob otic group and 84.9 mins for conventional group; however each robotic operation was approximately one minute shorter than the previous operation and the average time for the last 10 cases reduced to 82.9 mins. Compared to conventional THA there is no increased risk of complications or transfusions and interestingly there may be less chance of intraoperative acetabular fractures due to the single ream, minimal bone resection technique. LOS in the robotic group that did not go to rehabilitation was shorter by approximately 1 day and although statistically analyse for LOS in rehabilitation was not done due to small numbers there was a tendency for shorter LOS in the robotic group as well.Conclusion: This reduction in LOS, comparable surgical times and potential for less complications may outweigh the increased initial costs associated with the robotic system.","PeriodicalId":91304,"journal":{"name":"Journal of arthritis","volume":"7 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70836587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modern Non-Pharmacological and Non-Surgical Treatments for Hip Pain","authors":"P. Lee, S. Rozewicz, M. Chandrappa, Ahmed Othman, C. Jury, Bethan Whiting","doi":"10.4172/2167-7921.1000262","DOIUrl":"https://doi.org/10.4172/2167-7921.1000262","url":null,"abstract":"Osteoarthritis of the hip describes a clinical syndrome of joint pain accompanied by varying degrees of functional limitation and reduced quality of life. Osteoarthritis may not be progressive and most patients will not need surgery, with their symptoms adequately controlled by non-surgical measures. The treatment of hip osteoarthritis is aimed at reducing pain and stiffness and improving joint mobility. Total hip replacement remains the most effective treatment option but it is a major surgery with potential serious complications. NICE guideline has suggested a holistic approach to management of hip osteoarthritis which includes both nonpharmacological and pharmacological treatments. The non-pharmacological treatments range from education ,physical therapy and behavioral changes ,walking aids .The ESCAPE (Enabling Self-Management and Coping of Arthritic Pain Through Exercise) rehabilitation programme for hip and knee osteoarthritis which integrates simple education, self-management and coping strategies, with an exercise regimen has shown to be more cost-effective than usual care. There is a choice of reviewed pharmacological treatments available, but there are few current reviews of possible nonpharmacological methods. This review will focus on the non-pharmacological and non-surgical methods.","PeriodicalId":91304,"journal":{"name":"Journal of arthritis","volume":"7 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-7921.1000262","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70836934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Critical Analysis of Biomechanical and Biological basis of Management of the Varus Knee","authors":"K. Alva, Varun Gupta, P. Gupta","doi":"10.4172/2167-7921.1000271","DOIUrl":"https://doi.org/10.4172/2167-7921.1000271","url":null,"abstract":"Stability of the knee depends on the alignment of the long bones, the structure of the articular cartilage or the soft tissue structures surrounding the knee mainly the ligaments and the capsule. Varus deformity of the knee increases the load on the medial compartment causing progressive degenerative changes leading to medial compartmental osteoarthritis. Julies Wolff in the early 19th century defined Wolff's Law which states that bone in a healthy organism will adapt to the loads under which it is placed. This means that biological responses can be mathematically determined in relation to mechanical forces in remodelling.","PeriodicalId":91304,"journal":{"name":"Journal of arthritis","volume":"7 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-7921.1000271","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70836897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}