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The Journal of Musculoskeletal Medicine Vol 26 No 11

Managing obesity in patients who have knee osteoarthritis

November 05, 2009

Obesity is a modifiable risk factor for knee osteoarthritis (OA). Weight loss may reduce the risk of knee OA, and increased levels of physical activity may result in improvements in disability-related outcomes. However, intensity of physical activity is not as important in weight loss as total energy expended.

Identifying and managing pulmonary arterial hypertension

November 04, 2009

Pulmonary arterial hypertension (PAH) may lead to increased pulmonary vascular resistance, compromised vasoreactivity, right heart failure, and death. PAH, a subset of pulmonary hypertension (PH), classically is associated with systemic sclerosis but also occurs with other rheumatologic conditions. Early diagnostic strategies are essential. The symptoms of PAH often are nonspecific; the most common presenting symptom is dyspnea.

Shoulder Pain in Older Patients: Interpreting Clinical Findings

November 03, 2009

Older patients experience shoulder pain more frequently than younger patients and present with different issues. Using a combination of tests with a detailed history is the best approach to narrowing the differential.

Subjective symptoms influence patients’ carpal tunnel surgery decisions

November 02, 2009

Subjective symptoms are the most important consideration for patients who have carpal tunnel syndrome (CTS) in deciding whether to undergo carpal tunnel release. Those who cancel surgery have self-reported outcome scores similar to those who choose to undergo the procedure.

Sonographic guidance boosts intra-articular injection performance

November 02, 2009

Intra-articular injections performed with sonographic image guidance are significantly superior to palpation-guided methods in all outcome measures. They significantly reduce procedural pain, reduce pain scores at outcome, increase responder rates, and reduce nonresponder rates.

Cartilage mineralization is common in end-stage osteoarthritis

November 02, 2009

Contrary to earlier reports, mineralization of articular cartilage is a common event in end-stage osteoarthritis (OA) and is closely associated with disease progression. There is a significant correlation between clinical symptoms and the amount of mineralized cartilage.

Vertebroplasty not worthwhile for patients with osteoporosis?

November 02, 2009

For patients with recent osteoporotic vertebral fractures, there is no significant benefit of vertebroplasty compared with a sham procedure. Only modest improvement was seen over time in patients who underwent both procedures in overall scores for pain and scores for pain at rest and during the night, physical functioning, and quality of life.

Cardiovascular disease linked with inflammatory arthritis

November 02, 2009

Patients who have inflammatory arthritis and receive care from general practitioners have an almost 2-fold increased risk of prevalent cardiovascular disease (CVD) compared with those who do not. Therefore, assessing CVD risk and using prevention strategies in every patient who has inflammatory arthritis is important.

Rheumatoid arthritis and lupus are genetically distinct

November 02, 2009

Although rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) have some genes in common, including STAT4, HLA, and PTPN22, none of 9 other newly identified genes for SLE is associated with RA. This finding supports the notion that the genetic component of each disease contributes significantly to the different disease phenotypes.

Survey results spur new osteoporosis management tool

October 31, 2009

Patients fear the impact of osteoporosis on their quality of life far more than physicians think, according to an International Osteoporosis Foundation (IOF) survey (Table), but they lack the information and tools needed to address their concerns and improve their osteoporosis management. As a result, the IOF launched a community-based networking program designed to promote better communication among patients with osteoporosis and their physicians and achieve improved understanding and outcomes.

Studies geared to enhancing ACL injury prevention efforts

October 30, 2009

Determining which components of the typical 90-minute anterior cruciate ligament (ACL) injury prevention program work best to reduce injuries is the focus of a new study at the University of Michigan Bone & Joint Injury Prevention & Rehabilitation Center. The researchers suggest that improved efforts in ACL injury prevention could result in improved osteoarthritis (OA) prevention, noting that close to 70% of ACL injuries lead to an early onset of painful OA.

Functional ankle instability linked with low back pain?

October 29, 2009

The jump protocol with analysis of time to stabilization (TTS) can discriminate between persons with and those without functional ankle instability (FAI), according to researchers in the Department of Sport and Exercise Science at the University of Auckland in New Zealand. Persons with FAI have delayed trunk muscle reflexes to a sudden perturbation, supporting theoretical and experimental descriptions of proximal adaptations associated with ankle injury.

Biomechanics studies help explain whiplash injury

October 28, 2009

The mechanism of whiplash injuries remains less than completely understood, partly because obvious tissue damage detectable by radiography or MRI may not accompany the injury, according to researchers at Daping Hospital, Third Military Medical University, in Chongqing, China.