Like so many inflammatory conditions, complex regional pain syndrome (yes, there's growing evidence it's inflammatory) demands early treatment. Yet it is devilishly difficult to recognize its initial stages. Here are the signs, and an algorithm for management.
New in the nonspecialty journals: A new option for patients with autoimmune disease and HCV infection. The value of combined therapy for osteoporosis. Prognosis predictors for chronic pain, a new opioid adverse effect, and more ...
Is it a form of lupus, myositis, or a drug reaction? Check your knowledge of skin eruptions and the associated rheumatologic conditions in this brief photo essay.
A small, randomized clinical trial from Germany suggests that two weeks of high-dose oral prednisone produces a clinically relevant response in patients with active ankylyosing spondylitis (AS) refractory to NSAIDs.
New in the non-rheumatology journals, much about pain: A review based on 2012 fibromyalgia guidelines from Canada, a viewpoint on safe use of opioids, the evidence to back spinal pain interventions. Also: fast-track arthroplasty, and more newfound genes.
Quest Diagnostics says the biomarker 14-3-3eta in its new test greatly improves sensitivity in detecting early rheumatoid arthritis. But the data is not yet published.
New research has examined 3D motion and muscle activity in knee osteoarthritis, and correlated gait with pain. Result: a better description of knees destined for replacement.
A 39-year-old woman, in her eighth week of pregnancy, experienced aching pain that worsened with activity. Weakness and fatigue set in three days later in her thigh and proximal arm muscle. Then a mildly pruritic rash developed across the forehead, nose, and forearms.
Synovitis is present in 90% of painful knees, and emerging data is showing that this inflammation is "not just a bystander" in osteoarthritis-induced damage. Research is revealing the roles of macrophages and T-cells, and signposts toward new drug targets.
At the OARSI annual meeting in Philadelphia, two osteoarthritis experts tacklde the issue of whether to focus first on structural abnormalities or pain, and merged toward a consensus.
OARSI 2013: More support for the supplement chondroitin sulfate (CS) in osteoarthritis: In a large observational study from Spain, six months' use of CS significantly reduced the likelihood of having total knee replacement. Observers noted the well-known issues in applying this knowledge in the US.
Rheumatoid arthritis studies differ in definitions of symptom onset and progression, designs, and outcomes, but agree on the early treatment timing: 12 weeks.
Successful CRPS management should be viewed as a continuum that requires a flexible treatment approach that incorporates pharmacologic and nonpharmacologic components.
From full-motion video demonstrations of orthopedic clinical tests to suites of disease activity score calculators, these apps for Google and Apple mobile devices provide rheumatologists with useful and easy-to-access information at crucial moments in diagnosis and treatment.
A 56-year-old woman presents with a history of intermittent shoulder pain for the past six months. Early signs point to bursitis, but the plot thickens: She also has sarcoidosis and lymphoma. How would you proceed?
In lupus patients, urinary CD4 T cell counts correlate selectively and specifically with disease activity and renal involvement, well enough to be used to monitor the progress of treatment.
One orthopedic surgeon estimates University of Louisville sophomore guard Kevin Ware will return to the basketball court after six months of healing and rehabilitation following emergency surgery on the athlete's compound fracture in his right tibia.
Iron-deficiency anemia appears to be a good indicator of rapid progression of erosive rheumatoid arthritis not seen using standard disease activity measures.
(AUDIO) Intensive analysis of protein pathways inside joints is showing strong activity among messengers involved in wound healing. In this podcast, learn about the new research that backs the vision of arthritis as a chronic wound, and the implications for management.
New in the New England Journal this week: Skeletal fluorosis from consumption of very strong tea, and a lack of proven benefit for arthroscopic partial meniscectomy.
New research suggests that obesity is not merely a physical force on the knee joint; adipose cells contribute biochemically to inflammation and pain. What are the implications for management of obese patients who need knee replacement surgery?
The largest randomized controlled trial (RCT) so far has found no benefit to arthroscopic partial meniscectomy (APM) even in patients with symptomatic meniscal tears. An editorial advises against the procedure except when physical therapy has not helped at all.
The great majority of knee replacements last for at least 20 years in juvenile arthritis patients, a multicenter study finds. Hip replacements are more problematic.
As more than 60 percent of women with temporomandibular disorders (TMD) also exhibit abdominal pain consistent with irritable bowel syndrome (IBS) symptoms, two researchers in the neural and pain sciences department of the University of Maryland School of Dentistry, in Baltimore, have developed a model to better illustrate the two conditions' comorbidity.
The RADAI joint index designed for rheumatoid arthritis patients provides equally powerful information about disease status in osteoarthritis and psoriatic arthritis, according to a new comparative study. As a guide to severity, it is much quicker than waiting for lab results to come in.
Sports medicine clinicians from the Hospital for Special Surgery (HSS), in New York City, report that platelet-rich plasma (PRP) injections improve joint pain and function in patients with osteoarthritis, a leading cause of disability that affects more than 47 million people in the United States.
Here's a notice for your waiting room bulletin board: Manufacturers are recalling Reumofan Plus, an herbal supplement marketed as "100% natural," found to contain active pharmaceutical ingredients not listed on the packaging.
Beyond the discovery of new disease genes, revelations about how how our microbes influence our immunity and about many new subtypes of T cells--a mixture of commitment and plascticity.
Evidence-based analysis shows that weak opioids have at best a weak effect in rheumatoid arthritis pain. Steroid injections offer no long-term relief for tennis elbow.
Patients with rheumatoid arthritis are at considerably increased risk of asymptomatic carotid artery disease, but standard scores have proven poor predictors of their actual cardiovascular risk. Special vigilance is warranted for these patients.
