Clinical Medicine Insights. Arthritis And Musculoskeletal Disorders[JOURNAL]
Sun
200 papers
Importance of Myofascial Pain Syndrome of the Psoas Major Muscle and Ultrasound-Guided Treatment Algorithm.
Ayyıldız A, Dede BT, Temel MH … +3 more , Alyanak B, Yıldızgören MT, Bağcıer F
Clin Med Insights Arthritis Musculoskelet Disord · 2025 · PMID 40655134 · Full text
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Usage Patterns, Trust Generated, and Influence of Information in Internet and Social Media on Decision-Making by Patients Diagnosed With Rheumatic Diseases in Latin America.
Chaparro CA, Fernández-Ávila DG, Fuentes Y … +3 more , Ferreyra L, Brance ML, Muñoz OM
Clin Med Insights Arthritis Musculoskelet Disord · 2025 · PMID 40519801 · Full text
INTRODUCTION: Internet and social media are widely available tools for several purposes, including search of health information. This study aims to describe the usage patterns, the trust generated, and the influence of s...
INTRODUCTION: Internet and social media are widely available tools for several purposes, including search of health information. This study aims to describe the usage patterns, the trust generated, and the influence of such information on decision-making by patients diagnosed with systemic lupus erythematosus and rheumatoid arthritis. METHODS: A cross-sectional study was conducted, administering a survey to patients with rheumatic diseases at multiple centers in Latin America, virtually or on paper. Three domains were evaluated: access/patterns of use, perception, and confidence generated by the health information found. Subgroup analysis based on key characteristics was performed. RESULTS: In total, 244 surveys were analyzed, identifying 96.7 % respondents as regular internet users, mainly through smartphones (79.5%). About 86.5% used social media regularly, around 15.2 % used it for finding health information. YouTube was the most frequently used (67.6%). 64.3 % perceive searching information as straightforward and 65.6% as not frustrating; academic institutions were the most and "influencers" were the least trusted. Most expressed high confidence in the ability to use information and perceive it as beneficial. Different patterns of use, perception, and confidence were identified according to disease, age, educational level, country of origin and survey method of collection. CONCLUSIONS: This study illustrates the high prevalence of Internet and social media access in Latin America, primarily through mobile devices, which represents an opportunity to develop educational strategies for the population that have access to these tools. These strategies can be tailored according to specific use patterns and differential characteristics of distinct subgroups of patients.
Disappearance of the Chondrocalcinosis Border in Arthritis of the Wrist: Important Role in Diagnostic Mistakes.
Nigro A
Clin Med Insights Arthritis Musculoskelet Disord · 2025 · PMID 40519800 · Full text
We report a case of calcium pyrophosphate dihydrate crystal deposition (CPPD) disease presenting as acute arthritis of the left wrist. A 66-year-old woman with no significant family history was admitted with a 7-day hist...
We report a case of calcium pyrophosphate dihydrate crystal deposition (CPPD) disease presenting as acute arthritis of the left wrist. A 66-year-old woman with no significant family history was admitted with a 7-day history of swelling, persistent pain, and limitation of motion in her left wrist. She reported no recent trauma, surgery, or severe illness, and had no known comorbidities other than mild hypertension treated with low-dose thiazide diuretics. She was not on chronic glucocorticoids or other immunosuppressive drugs. Plain radiographs of her wrist, obtained during the initial days of arthritis, showed chondrocalcinosis in her left wrist. A diagnosis of pseudogout was made. After 30 days, a repeat X-ray demonstrated the disappearance of the chondrocalcinosis border in the left wrist; however, follow-up radiography revealed chondrocalcinosis in asymptomatic joint areas, such as the pubic symphysis and knees. With this case report, we highlight the important role of radiographs in the early diagnosis of CPPD disease. Radiographic detection of crystal deposition can occasionally be transient, and its disappearance may lead to diagnostic confusion. Identifying such changes early can help avoid misdiagnosis and inappropriate management.
The Effect of NSAID Use on Dextrose Prolotherapy in Patients With Knee Osteoarthritis: A Prospective Case Series.
Kim AR, McNeary-Garvin A, Thornton JA … +1 more , Covey CJ
Clin Med Insights Arthritis Musculoskelet Disord · 2025 · PMID 40291827 · Full text
OBJECTIVE: The objective was to determine whether oral non-steroidal anti-inflammatory drugs (NSAIDs) affect the efficacy of dextrose prolotherapy (DPT) in patients with knee osteoarthritis, and if the combination of the...
OBJECTIVE: The objective was to determine whether oral non-steroidal anti-inflammatory drugs (NSAIDs) affect the efficacy of dextrose prolotherapy (DPT) in patients with knee osteoarthritis, and if the combination of these treatments is safe and well-tolerated. METHODS: Five patients with symptomatic knee osteoarthritis were included in this prospective case series. Participants underwent a series of three DPT injections at four-week intervals in their symptomatic knee(s) and were immediately prescribed a seven-day course of Ibuprofen after each injection. The main outcome measures included changes in the Knee Injury in Osteoarthritis (KOOS) questionnaire subscales (pain, symptoms, quality of life, sports and recreation function, and activities of daily living) and the Numeric Pain Rating Scale (NPRS). RESULTS: There was a statistically significant improvement in the KOOS subscales of pain ( < 0.0001), Symptoms ( = 0.01), and Quality of Life ( = 0.001) after 12 weeks. The KOOS subscales for Sports and Recreation function ( = 0.06) and Activities of Daily Living ( = 0.10) showed numerical improvement over time that fell short of statistical significance. There was a statistically significant improvement in the NPRS scores compared with baseline NPRS scores after 12 weeks ( < 0.0001). In addition, NPRS scores were significantly lower at one-week follow-up after each DPT injection ( = 0.01); ( = 0.025); ( < 0.0001). There were no reported adverse events. CONCLUSIONS: Concomitant use of NSAIDS with dextrose prolotherapy injections is safe and well-tolerated with no adverse events and results in improvements in pain, symptoms, and overall quality of life associated with chronic knee OA. Controlled trials of this treatment are warranted.
Lung Ultrasound for Assessment of Interstitial Lung Disease in Systemic Sclerosis: Relationship With High-Resolution Computed Tomography and Nailfold Capillaroscopy.
Elziaty RA, Aboelyazeed AA, Hegazy SN … +2 more , Khalifa AA, Khalil SA
Clin Med Insights Arthritis Musculoskelet Disord · 2025 · PMID 40008078 · Full text
BACKGROUND: Lung ultrasound (LUS) has been recently proposed as a convenient and radiation-free imaging modality for the evaluation of systemic sclerosis-related interstitial lung disease. OBJECTIVES: The current study e...
BACKGROUND: Lung ultrasound (LUS) has been recently proposed as a convenient and radiation-free imaging modality for the evaluation of systemic sclerosis-related interstitial lung disease. OBJECTIVES: The current study evaluates the relation between LUS and both high-resolution computed tomography (HRCT) and capillaroscopy findings in patients with systemic sclerosis. DESIGN: This cross-sectional study included 32 patients with systemic sclerosis. METHODS: Besides clinical evaluation, all participants underwent LUS, HRCT, pulmonary function tests (PFT), and nailfold video-capillaroscopy (NVC). All participants' data were compared and correlated. RESULTS: There is an excellent agreement between number of B-lines and HRCT score (interclass correlation = 0.864, -value < .001). A significant positive correlation exists between number of B-lines and disease duration ( = 0.459, -value = .008). Conversely, the number of B-lines is negatively correlated with capillary density ( = -0.687, -value < .001), forced expiratory volume in the first second (FEV1) ( = -0.886, -value < .001), and forced vital capacity (FVC) ( = -0.898, -value < .001). Patients with either neoangiogenesis or previous/current digital ulcers had significantly higher number of B-lines than those without (-value < .001, .016, respectively). CONCLUSION: The number of B-lines parallels the HRCT score and the extent of digital vascular damage as indicated by NVC and clinical digital ulcers. Lung ultrasound has proven to be a reliable radiation-free modality for screening of systemic sclerosis-related interstitial lung disease and detecting its extent.
Retrospective Analysis of 28 Cases of Complex Regional Pain Syndrome.
Beizeng W, Wen B, Xiaoxia L … +2 more , Yanhong H, Shubin Q
Clin Med Insights Arthritis Musculoskelet Disord · 2025 · PMID 40008077 · Full text
BACKGROUND: Complex Regional Pain Syndrome (CRPS) is a chronic condition characterized by persistent pain and local autonomic dysfunction. Its exact cause remains unclear, making diagnosis and treatment challenging. OBJE...
BACKGROUND: Complex Regional Pain Syndrome (CRPS) is a chronic condition characterized by persistent pain and local autonomic dysfunction. Its exact cause remains unclear, making diagnosis and treatment challenging. OBJECTIVE: The objective was to investigate the clinical characteristics of CRPS patients and identify risk factors influencing its onset. DESIGN: Retrospective analysis of medical records from 28 CRPS patients, examining variables such as demographics, comorbidities, triggering events, pain duration and location, previous examinations and treatments, clinical findings, auxiliary tests, initial and follow-up treatment outcomes, symptom relief time, and degree. METHODS: Statistical methods were used to analyze the clinical data of 28 CRPS patients, assessing general characteristics and risk factors associated with the disease. RESULTS: Females accounted for 57.14% of the cases, with an average patient age of 57.89 years. About 82.14% of patients experienced a triggering event prior to the onset of pain. The median time to diagnosis was 4.5 months, with a maximum duration of up to 7 years. Misdiagnosis occurred in 46.43% of patients. Laboratory tests showed that 77.78% (7 of 9) had abnormal bone metabolism; among those who underwent bone density scans, 66.67% (6 of 9) had osteoporosis, whereas 11.11% (1 of 9) had reduced bone mass. X-rays of 25 patients revealed that 44% (11 of 25) had either reduced bone mass or osteoporosis, with 2 showing more severe osteoporosis on the affected side compared with the healthy side. Rheumatoid arthritis was observed in 7.14% of patients. Post-treatment, significant pain relief was noted in 26 patients. CONCLUSION: This study helps clinicians more accurately identify and manage CRPS, reducing misdiagnosis and delayed diagnosis. In addition, the data suggest that osteoporosis and rheumatoid arthritis may be potential risk factors for CRPS.
A Case Study of Concurrent Parsonage-Turner Syndrome and Ankylosing Spondylitis: Diagnostic and Management Considerations.
Tabibi P, Babaee M, Shiari R … +2 more , Rehman K, Shiari S
Clin Med Insights Arthritis Musculoskelet Disord · 2025 · PMID 40008076 · Full text
Parsonage-Turner syndrome (PTS) and ankylosing spondylitis (AS) are distinct clinical entities with unique pathogenic mechanisms. The coexistence of these conditions in a single patient is rare and presents diagnostic an...
Parsonage-Turner syndrome (PTS) and ankylosing spondylitis (AS) are distinct clinical entities with unique pathogenic mechanisms. The coexistence of these conditions in a single patient is rare and presents diagnostic and management challenges especially in adolescent patient. In this case report, we present a unique and intriguing case of an 18-year-old boy presented with acute onset shoulder pain and weakness, consistent with PTS. However, further evaluation revealed additional features suggestive of AS, including chronic low back pain and morning stiffness. Diagnostic workup, including imaging studies and laboratory investigations, confirmed the presence of both PTS and AS. The management approach involved a multidisciplinary approach, including physical therapy, analgesics, and corticosteroids. This case report underscores the significance of considering the possibility of concurrent PTS and AS in patients presenting with atypical symptoms or overlapping clinical features. Clinicians should be aware of the potential overlap between PTS and AS to guide optimal treatment strategies and improve patient outcomes.
Knowledge, Attitude and Practice Regarding Nonsteroidal Anti-inflammatory Drugs and Corticosteroids Use Among Patients With Chronic Rheumatology Condition: A Cross-Sectional Study From Vietnam.
Nguyen HTN, Nguyen QM, Ha KTK … +2 more , Le QTN, Bui BH
Clin Med Insights Arthritis Musculoskelet Disord · 2024 · PMID 39717067 · Full text
OBJECTIVES: To identify gaps in knowledge, attitude, and practice regarding the use of corticosteroids and nonsteroidal anti-inflammatory drugs (NSAIDs) among patients with chronic rheumatic diseases. METHODS: A cross-se...
OBJECTIVES: To identify gaps in knowledge, attitude, and practice regarding the use of corticosteroids and nonsteroidal anti-inflammatory drugs (NSAIDs) among patients with chronic rheumatic diseases. METHODS: A cross-sectional study was conducted using a questionnaire including 12 knowledge questions, 13 attitude assessment statements, 5 barrier assessment statements, and 7 practical scenarios. We counted the total numbers of correct answers in knowledge, positive attitudes, barriers, and appropriate practices and fitted using Poisson regression to examine factors associated with knowledge, attitudes, and practices. RESULTS: A total of 182 participants were included in this study, a large proportion of them had never heard of corticosteroids (34%) and NSAIDs (54%) before. Physicians were the source of information regarding corticosteroids and NSAIDs in 83% and 84% of the cases, respectively. Gastric ulcer was the most commonly recognized adverse drug reaction (ADR) for corticosteroids (64%) and the only ADR recognized for NSAIDs (95%), while only few patients were aware of life-threatening ADRs. The primary barrier, with a 40% agreement, was health care providers' time constraints in providing medication information to patients. Our study findings did not reveal any gaps in practice, nor did they show any correlation between patients' knowledge and attitudes to the practice of using corticosteroids and NSAIDs. CONCLUSION: There were gaps in knowledge, attitudes, and barriers to information access regarding NSAIDs and corticosteroid use in Vietnamese patients with chronic rheumatic diseases. Potential solutions include allocating more time for information exchange between physicians and patients, creating new channels to provide reliable information for patients, and emphasizing the important ADRs.
Is CRPS-1 a Chronic Disabling Disease? A Long-term, Real-Life Study on Patients Treated With Neridronate.
Varenna M, Zucchi F, Orsini F … +3 more , Crotti C, Calabrese G, Caporali R
Clin Med Insights Arthritis Musculoskelet Disord · 2024 · PMID 39512444 · Full text
BACKGROUND: Complex Regional Pain Syndrome type 1 (CRPS-1) is severely debilitating and painful disease that is difficult to treat. OBJECTIVE: The objective was to evaluate the long-term residual disability of patients w...
BACKGROUND: Complex Regional Pain Syndrome type 1 (CRPS-1) is severely debilitating and painful disease that is difficult to treat. OBJECTIVE: The objective was to evaluate the long-term residual disability of patients with CRPS-1 following parenteral neridronate treatment. DESIGN: This is real-life retrospective observational study. METHODS: Patients affected by CRPS-1 of the upper limb were treated with neridronate infusions (400 mg over 10 days) between February 2017 and December 2021 for whom clinical and demographic information was collected. From November 2022, patients treated ⩾1 year previously were recalled for clinical evaluation. A dedicated instrument (DASH questionnaire, Disabilities of the Arm, Shoulder and Hand) was employed to assess residual disability. Multivariate logistic regression analysis was used to investigate predictors of disability. RESULTS: Forty-nine patients aged 61.1 ± 11.5 years and 73.5% female with CRPS-1 of the upper limb were included. Disease duration before treatment was 9.9 ± 8.0 weeks, and the mean length of follow-up was 4 years (47.7 ± 22.0 months). The disease had fully resolved in 46 patients (93.9%) for whom the diagnostic criteria were no longer recognized. According to the DASH score, 38 patients (77.6%) resulted free of functional limitations, whereas 11 patients (22.4%) were still suffering from disability. The DASH score was positively correlated with residual visual analogue scale (VAS; Spearman's Rho = 0.61; < .001). Predictors of residual disability were younger age (odds ratio [OR]: 0.77, 95% CI: 0.63-0.93; = .012) and delay between disease onset and treatment (OR: 1.45, 95% CI: 1.13-1.96; = .004). CONCLUSIONS: In this real-life study, neridronate parenteral treatment provided a full recovery of CRPS-1 in over 3 quarters of patients, provided they are treated early.
The Impact of Tobacco Smoking on Systemic Sclerosis, Idiopathic Inflammatory Myositis, and Systemic Lupus Erythematosus.
El Hasbani G, Madi M, Zoghbi MASE … +3 more , Srour L, Uthman I, Jawad AS
Clin Med Insights Arthritis Musculoskelet Disord · 2024 · PMID 39430769 · Full text
This narrative review aims specifically to explore the relationship between tobacco exposure and systemic sclerosis (SSc), idiopathic inflammatory myositis (IIM), and systemic lupus erythematosus (SLE). Relevant articles...
This narrative review aims specifically to explore the relationship between tobacco exposure and systemic sclerosis (SSc), idiopathic inflammatory myositis (IIM), and systemic lupus erythematosus (SLE). Relevant articles were obtained by searching key terms such as "tobacco," "smoking," "scleroderma," "myositis," "lupus," and "Sjögren's" in PubMed and Google Scholar databases. The selected articles ranged from the years 2010 to 2023. Inclusion criteria were based on the relevance and contribution to the field of study. Systemic sclerosis is a complex condition involving multiple immune cell lines that can be influenced by tobacco. However, the existing literature does not provide sufficient evidence to support an increased risk of SSc in smokers or the impact on treatment options. Cigarette smoking does increase the risk of skin ulcerations in SSc patients. In addition, cigarette smoking has been associated with IIM through genetic and molecular mechanisms. Smokers with dermatomyositis or polymyositis are at an elevated risk of atherosclerosis and interstitial lung disease. Similarly, smoking in patients with SLE increases the risk of organ damage, thrombosis, and disease severity compared with non-smokers. Smokers with SLE also have more difficulty in controlling disease flares compared with non-smokers. Tobacco exposure can lead to secondary complications in patients with IIM and SLE, although the course of treatment may not differ significantly. No definitive conclusions can be drawn to the clear relationship between tobacco smoking and Sjögren's's syndrome.
Role of Interleukin-17 in Predicting Activity of Rheumatoid Arthritis and Systemic Lupus Erythematosus.
Samaan SF, Taha SI, Mahmoud FA … +3 more , Elsaadawy Y, Khalil SA, Gamal DM
Clin Med Insights Arthritis Musculoskelet Disord · 2024 · PMID 39351141 · Full text
BACKGROUND: Although high serum levels of interleukin (IL)-17 and its producing cells have been found in rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) in earlier research, it is still unclear how these...
BACKGROUND: Although high serum levels of interleukin (IL)-17 and its producing cells have been found in rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) in earlier research, it is still unclear how these findings relate to disease activity. OBJECTIVES: This study examines the link between serum levels of IL-17 and the activity of both RA and SLE. DESIGN: This pilot case-control study included 100 patients with RA, 100 with SLE, and 100 healthy controls. METHODS: The Disease Activity Score-28 (DAS28) scores assessed the activity of RA, whereas the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) scores assessed SLE activity. All participants' data were compared and correlated. RESULTS: Serum levels of IL-17 were significantly higher in RA and SLE patients compared with the controls ( < .001) and showed significantly positive correlations ( < .001) with rheumatoid factor titer, anti-cyclic citrullinated peptide (anti-CCP) and DAS28 score among the RA patients. Although among SLE patients, they were significantly positively correlated ( < .001) with anti-double-stranded DNA (anti-ds DNA) levels and the SLEDAI-2K scores, the best cut-off value of IL-17 for predicting moderate and high disease activity was > 175 pg/mL among RA patients and > 95 pg/mL among SLE patients. CONCLUSIONS: There is a significant correlation between RA and SLE activity and serum levels of IL-17. This discovery emphasizes IL-17 as a potential therapeutic target.
Good Short- and Mid-term Outcome After Cross-Linked Hyaluronic Acid Infiltration for Hallux Rigidus: A Case Report.
Capell Morera A, De Planell-Mas E, Pérez Palma L … +1 more , Manzanares Céspedes MC
Clin Med Insights Arthritis Musculoskelet Disord · 2024 · PMID 39149615 · Full text
We report a first case of hallux rigidus successfully treated in an elderly patient by intra-articular infiltration of cross-linked hyaluronic acid (HA) 21 mg/mL with mannitol (Desirial Plus) and review the previous lite...
We report a first case of hallux rigidus successfully treated in an elderly patient by intra-articular infiltration of cross-linked hyaluronic acid (HA) 21 mg/mL with mannitol (Desirial Plus) and review the previous literature on the different compositions of HA infiltrative treatment applied to hallux rigidus. A 77-year-old female patient with moderate unilateral pain of 6 months of evolution and stiffness of the movement of the first metatarsophalangeal joint of the left foot, corresponding to grade 2 of the classification proposed by Coughlin and Shurnas. The objective of the study was to perform a pilot test to (a) evaluate the correct technique of intra-articular infiltration as well as (b) the use of a commercial cross-linked HA 21 mg/mL with mannitol, to a voluntary patient diagnosed with hallux rigidus. A single cross-linked HA infiltration is applied to the first metatarsophalangeal joint with an administered amount of 1 mL. The loaded dorsiflexion, the unloaded dorsiflexion, and the unloaded plantarflexion angles of the first metatarsophalangeal joint improved from 15°, 20°, and 10°, respectively, before injection to 45°, 52°, and 22°, respectively, at 14 days after injection. Moreover, these improvements maintained until the final follow-up (400 days). The intensity of pain, according to the visual analog scale, improved from 7 of 10 before the injection, passing through 4 of 10 at 14 days after the injection, to 1 of 10 at 60 days after the injection. Cross-linked HA 21 mg/mL with mannitol improves symptomatology, joint mobility of the first metatarsophalangeal joint, and quality of life in the patient with stiff hallux submitted to the pilot test. These effects have been maintained for more than 14 months.
Obesity and the Development of Arthritis Among Adults in the United States Using NHANES Data.
Baah E, Kohlmeier M
Clin Med Insights Arthritis Musculoskelet Disord · 2024 · PMID 39091588 · Full text
BACKGROUND: The alarming increase in the prevalence of obesity and arthritis in America in recent times is concerning both in terms of the deleterious health effects on the individuals and economic cost. The wear and tea...
BACKGROUND: The alarming increase in the prevalence of obesity and arthritis in America in recent times is concerning both in terms of the deleterious health effects on the individuals and economic cost. The wear and tear on the musculoskeletal and the inflammatory effects of obesity may be the reasons for the rise in arthritis among individuals with obesity. OBJECTIVE: To investigate the association between obesity and the development of arthritis among adults in the United States. DESIGN: A total of 17 016 participants were included from the 2012 to 2018 National Health and Nutrition Examination Survey (NHANES). Most of the participants were aged 30 years and above (79.7%). The racial distribution included 64.0% Non-Hispanic whites, 15.3% Hispanics, 11.4% Non-Hispanics blacks, and 9.4% from all other races. METHODS: Obesity was defined as a body mass index (BMI) > 30 kg/m², and the outcome variable of interest, arthritis status, was self-reported. Survey weighted logistic regression was performed to calculate the odds ratio (OR) and 95% confidence interval controlling for potential confounding factors. RESULT: Nearly 40% of all participants were individuals with obesity, and 27.5% reported having some form of arthritis. The risk of developing arthritis was higher in individuals with obesity (OR: 1.55, 95% CI: 1.35-1.80), women (OR: 1.94, 95%CI: 1.66-2.28), and individuals 30 years or older (OR: 10.81, 95% CI: 6.36-18.37) with non-Hispanic whites being the most affected race. The C-reactive protein (CRP) and white blood cell count (WBC) levels were higher in all individuals with obesity even though there was no statistical difference between individuals with obesity with and without arthritis. CONCLUSIONS: Obesity substantially heightens the risk of developing arthritis due to the mechanical stress on weight-bearing joints and subsequent chronic-low level inflammation contributing to disease progression.
Idiopathic Granulomatous Mastitis, Erythema Nodosum, and Polyarthritis.
Tarhini A, El Hasbani G, Farhat L … +2 more , Ghieh D, Uthman I
Clin Med Insights Arthritis Musculoskelet Disord · 2024 · PMID 39071728 · Full text
Idiopathic granulomatous mastitis (IGM) is an inflammatory-mediated rare disease that can be linked to rare manifestations. Erythema nodosum (EN) and polyarthritis, seen in a multitude of autoinflammatory and autoimmune...
Idiopathic granulomatous mastitis (IGM) is an inflammatory-mediated rare disease that can be linked to rare manifestations. Erythema nodosum (EN) and polyarthritis, seen in a multitude of autoinflammatory and autoimmune diseases, have been rarely linked to IGM. Despite the cause of IGM being unclear, Corynebacterium infections are thought to play a role in the pathophysiology of IGM. Unusually, IGM has a relapsing and remitting course, which also applies to its systemic manifestations. As such, we present a case of IGM in a middle-aged lady who was initially thought to have Corynebacterium-containing unilateral abscesses for which drainage was performed. However, several abscesses devoid of bacterial growth started recurring, and the disease course was complicated by EN and polyarthritis. IGM, EN, and polyarthritis eventually resolved and were managed with symptomatic treatment.
Dextrose Prolotherapy for the Treatment of Chronic Shoulder Pain in Patients With Joint Hypermobility: A Case Series.
Michalak N, Banks D, Kane L … +1 more , Siefferman J
Clin Med Insights Arthritis Musculoskelet Disord · 2024 · PMID 39055287 · Full text
Hypermobile Ehlers-Danlos syndrome (hEDS) and hypermobility spectrum disorders (HSD) are common causes of chronic musculoskeletal pain. Current practices rely on analgesics, physical therapy, bracing, and assistive devic...
Hypermobile Ehlers-Danlos syndrome (hEDS) and hypermobility spectrum disorders (HSD) are common causes of chronic musculoskeletal pain. Current practices rely on analgesics, physical therapy, bracing, and assistive devices. Dextrose prolotherapy (DPT) is a regenerative injection modality used to treat chronic painful musculoskeletal conditions through stimulation of tissue proliferation. The effectiveness of DPT for the treatment of chronic shoulder pain in patients with hEDS/HSD has not been established in the literature. Three patients with hEDS or HSD presented with refractory shoulder pain due to microinstability. Patients were treated with 20% DPT injected in the glenohumeral joint and surrounding structures as indicated. Outcomes assessed were pain and clinical improvement in joint stability at 2- to 7-week follow-up intervals. All patients reported subjective improvement in their shoulder pain and function. Disabilities of the Arm, Shoulder and Hand (DASH) scores after DPT decreased from initial assessment in all patients. Patients reported a cumulative improvement in pain and joint stability with each injection. Regenerative treatment with DPT may help restore structural integrity of affected joints and serve as an adjunctive therapy for the management of chronic shoulder pain due to microinstability in patients with hEDS/HSD.
Exploring Talarozole as a Novel Therapeutic Approach for Osteoarthritis: Insights From Experimental Studies.
Iqbal L, Zameer U, Iqbal Malick M
Clin Med Insights Arthritis Musculoskelet Disord · 2024 · PMID 38292917 · Full text
Osteoarthritis (OA) is a prevalent degenerative joint disease characterized by the slow degeneration of joint components that primarily affects the elderly. There is currently no cure for OA; thus, treatment focuses on s...
Osteoarthritis (OA) is a prevalent degenerative joint disease characterized by the slow degeneration of joint components that primarily affects the elderly. There is currently no cure for OA; thus, treatment focuses on symptom reduction. This article investigates the potential of talarozole, a retinoic acid metabolism-blocking agent (RAMBA), as a new treatment for hand OA. Talarozole showed promising results by inhibiting retinoic acid degradation and increasing its levels in the body. Six hours after destabilization of the medial meniscus, talarozole significantly reduced inflammation in mice's cartilage. The findings underscore the importance of the protein encoded by the ALDH1A2 gene in retinoic acid metabolism, shedding light on its potential implications for the management of OA. Maintaining adequate retinoic acid levels may help to reduce mechano-inflammatory gene regulation. Furthermore, RAMBAs like talarozole may emerge as disease-modifying OA therapies, promising improved symptom control and slower disease progression. In conclusion, this research provides critical genetic insights into severe hand OA and promotes talarozole as a prospective therapy option. These findings pave the door for additional research that could revolutionize OA treatment by targeting retinoic acid metabolism to reduce symptoms and slow disease progression.
Evaluation of Depression and Anxiety in Rheumatoid Arthritis Patients During COVID-19 Pandemic.
Abd El-Khalik DM, Eltohamy M
Clin Med Insights Arthritis Musculoskelet Disord · 2023 · PMID 38115857 · Full text
BACKGROUND: Rheumatoid arthritis (RA) disease activity, associated comorbidities, and therapy-related side effects impair the physical, social, and emotional dimensions of the patient's health. Presently, the ongoing COV...
BACKGROUND: Rheumatoid arthritis (RA) disease activity, associated comorbidities, and therapy-related side effects impair the physical, social, and emotional dimensions of the patient's health. Presently, the ongoing COVID-19 pandemic has been associated with a broad range of psychosocial disorders in various populations. Patients with RA are especially vulnerable to such effects. OBJECTIVES: Detect the prevalence of recent COVID-19 infection among patients with RA, assess depression and anxiety in these patients and their associated factors during the COVID-19 pandemic and their potential relation to disease activity. DESIGN AND METHODS: This is a cross-sectional study conducted on 120 adult Egyptian patients diagnosed with RA during the COVID-19 pandemic. The prevalence of recent COVID-19 infection among the patients was evaluated. The patients underwent psychological assessment using the Hamilton Depression Rating Scale (Ham-D) and the Hamilton Anxiety Rating Scale (Ham-A) to measure levels of depression and anxiety levels. The RA disease activity was assessed using Disease Activity Score (DAS) Das-28-ESR. RESULTS: This study encompasses a total of 120 RA patients. The prevalence of patients with a recent history of COVID-19 infection was 40.8%. Both groups exhibited significantly elevated mean scores on the Das-28-ESR scale and also scored higher on measures of depression and anxiety. Interestingly, the COVID-19 group exhibited a higher percentage of unmarried individuals, had educational attainment below the university level, and were unemployed. Patients with recent COVID-19 had significantly lower numbers of children, higher disease duration, higher Das-28-ESR scores, and elevated depression and anxiety scores. The statistical analysis revealed that the COVID-19 infection and disease duration were significant predictors of depression and anxiety. The results also exhibited that the depression score was positively correlated with age and DAS scores. CONCLUSIONS: It was observed that patients diagnosed with RA revealed a higher prevalence of COVID-19 infection. The occurrence of depression and anxiety was observed to be widespread among patients diagnosed with RA and, more significantly, prevalent in RA patients who had a recent COVID-19 and had a higher level of disease activity. The occurrence of COVID-19 and disease duration were identified as factors that can anticipate the development of depression and anxiety.
Surgical Repair for Rhomboid Major Tear: A Case Report.
Furuhata R, Yamaguchi S, Tanji A
Clin Med Insights Arthritis Musculoskelet Disord · 2023 · PMID 38115856 · Full text
Rhomboid tears are a rare type of tendon injury. Although rhomboid tears can present with periscapular pain and scapular dyskinesis, their clinical presentations and diagnostic procedures remain largely unknown. In addit...
Rhomboid tears are a rare type of tendon injury. Although rhomboid tears can present with periscapular pain and scapular dyskinesis, their clinical presentations and diagnostic procedures remain largely unknown. In addition, few reports are available on the surgical treatment of rhomboid tears. We report a rhomboid repair case for a complete rhomboid major tear diagnosed based on physical findings and magnetic resonance imaging (MRI). A 28-year-old man presented with right medial scapular pain that appeared after carrying a heavy box. He had right medial scapular tenderness, with worsening pain during shoulder joint elevation. The inferior pole of the right scapula was lateral compared with the left scapula, and a dent was observed on the medial scapula. Magnetic resonance imaging revealed a tear in the right rhomboid major at its insertion, with muscle retraction. Two months of conservative treatment failed to improve his symptoms; therefore, we performed a surgical repair. We created the bone holes on the medial border of the scapula and repaired the torn rhomboid major muscle to its insertion using the Krackow stitch technique. He had a satisfactory functional outcome without postoperative retearing. This case report provides new information on the clinical presentation and surgical procedure of rhomboid major tears and the first MRI finding that depicts a rhomboid tear clearly. In cases of rhomboid tears, persistent medial scapular pain and winging scapula can be clinically problematic, requiring surgery. In addition to physical findings, a periscapular MRI is useful in diagnosing rhomboid tears. The results of this case study suggest that surgical repair using locking sutures is an option for treating complete rhomboid tears with muscle retraction.
Patient-Reported Outcome Measures for Patients with Upper Extremity Arthritis: Overview of Systematic Reviews.
Dabbagh A, Ziebart C, Furtado R … +2 more , Boutsikari EC, MacDermid JC
Clin Med Insights Arthritis Musculoskelet Disord · 2023 · PMID 38076224 · Full text
BACKGROUND: Arthritis leads to disabilities impacting patients' physical and mental health. OBJECTIVE: To synthesize the evidence on measurement properties of the patient-reported outcome measures (PROMs) for people with...
BACKGROUND: Arthritis leads to disabilities impacting patients' physical and mental health. OBJECTIVE: To synthesize the evidence on measurement properties of the patient-reported outcome measures (PROMs) for people with upper extremity arthritis. DESIGN: Overview of systematic reviews (SRs). METHODS: We performed an electronic search of 6 databases to retrieve SRs looking at any measurement property related to PROMs for people with upper extremity arthritis. Two authors rated the risk of bias (ROB) of the included SRs using AMSTAR. We extracted data on measurement properties from each SR. RESULTS: From 6 included SRs, 6 PROMs (Arthritis Impact Measurement Scale [AIMS], AIMS-2, AIMS-Short Form, Cedars-Sinai Health-Related Quality of Life for Rheumatoid Arthritis (CSHQ-RA), Revised CSHQ-RA, and Influence of Rheumatic Disease on General Health and Lifestyle) were evaluated in 2 or more SRs. The ROB of the included SRs ranged from moderate to high. Low- to moderate-quality evidence was found of good construct and criterion validity, acceptable content validity, and good responsiveness of the AIMS. We found low- to moderate-quality evidence of good internal consistency, test-retest reliability, and construct validity of the CSHQ-RA. CONCLUSION: We found a moderate to high ROB in the included SRs on the upper extremity PROMs for patients with arthritis. More evidence was specific to upper extremity arthritis in measures not in common use versus well-validated measures used in upper extremity conditions and recommended in current core sets. These factors suggest an urgent need for additional research to improve the scope and quality of evidence before recommendations can be made specific to patients with arthritis. REGISTRATION NUMBER: on PROSPERO CRD 42019137491.
Revealing the Effect of Spinopelvic Alignment on Hip Disorders.
Soydan Z, Bayramoglu E, Altas O … +1 more , Şen C
Clin Med Insights Arthritis Musculoskelet Disord · 2023 · PMID 37701625 · Full text
BACKGROUND: Hip osteoarthritis (HOA) is a growing burden and one of the leading causes of hip pain. The relationship between the HOA and the alignment of the spinopelvic region has been intensively studied, however the i...
BACKGROUND: Hip osteoarthritis (HOA) is a growing burden and one of the leading causes of hip pain. The relationship between the HOA and the alignment of the spinopelvic region has been intensively studied, however the issue remains controversial. Spinopelvic imbalance, HOA, and dysplasia were investigated in relation to sagittal spinopelvic parameters in this study. METHODS: We collected computerized tomography (CT) topograms of the pelvis or abdomen from 380 patients. In antero-posterior (AP) topograms, Tonnis grading, center-edge angle (CEA) and Sharp's acetabular angle (AA) measurements were performed on each patient. Lateral topograms were used to evaluate the following spinopelvic parameters for each patient: pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), sacral table angle (STA), lumbar lordosis (LL), proximal lumbar lordosis (PLL), distal lumbar lordosis (DLL), and PI-LL difference. Initially, the cohort was divided into two subgroups based on whether or not they had HOA. Then, they were divided into two subgroups based on whether or not they had dysplasia. Ultimately, it was divided in half based on the PI-LL imbalance. Statistical analyses were conducted to determine the likely correlations between the spinopelvic parameters of these subgroups. In addition, the correlations between spinopelvic parameters were investigated. RESULTS: There were 380 patients evaluated. We found no association between HOA or dysplasia and spinopelvic parameters. In addition, there was no association between PI-LL imbalance and HOA or dysplasia. CONCLUSION: There was no difference in constant PI and STA angle, besides other variable parameters, between groups having HOA and dysplasia or not. PI-LL imbalance has no effect on HOA and dysplasia.
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