Clinical rheumatology
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Clinical rheumatology · Jul 2017
Review"Hiker's feet": a novel cutaneous finding in the inflammatory myopathies.
Mechanic's hands is a well-characterized manifestation of select idiopathic inflammatory myopathy (IIM) syndromes. Less well characterized is the hyperkeratosis of the toes and plantar surface of the feet that can also accompany these disorders. We aim to describe common pedal signs in the context of IIM, and suggest that it may be another key feature in the presentation of these syndromes. ⋯ Although the term "mechanic's feet" has been used to describe this clinical finding in patients in our myositis cohort, we propose the term "hiker's feet," given that the presentation resembles a callousing pattern more typical of avid hikers or long-distance walkers. Prevalence data are not yet known but should be considered for further study. If the presenting signs of IIM are expanded to include hiker's feet, it could aid in not only diagnosis and management but also provide insights into the pathophysiology of these diseases.
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Clinical rheumatology · Jul 2017
Fibromyalgia in patients with thyroid autoimmunity: prevalence and relationship with disease activity.
Fibromyalgia (FM) is a syndrome characterised by chronic musculoskeletal pain, tenderness and other somatic symptoms. The prevalence of FM is approximately 2-7% in the general global population and is 30-40% in the population of Hashimoto thyroiditis (HT) with a structural pathology. In 2010, new classification criteria for FM were proposed, as an alternative to the American College of Rheumatology (ACR) 1990 criteria. ⋯ Concomitant FM is a common clinical problem in HT and its recognition is important for the optimal management of the disease. The new set of diagnostic criteria for FM reinforces this situation. Consideration of the FM component in the management of HT increases the likelihood of treatment success.
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Clinical rheumatology · Jun 2017
Translation and cross-cultural adaptation of the Shoulder Pain and Disability Index (SPADI) into Chinese.
The aim of this study is to translate and cross-culturally adapt the Shoulder Pain and Disability Index (SPADI) for the Chinese language, and to evaluate its psychometric properties. The SPADI was translated and cross-culturally adapted for the Chinese language according to established guidelines. Participants completed the SPADI questionnaire, a visual analogue scale (VAS), and the 36-item short form health survey (SF-36), and were assessed using the Constant-Murley shoulder outcome score. ⋯ A very good correlation was observed between the SPADI and the Constant-Murley score (r = 0.69), a good correlation between the SPADI and the VAS (r = 0.40), and a fair correlation between the SPADI and the SF-36 (r = 0.36). There were no significant floor and ceiling effects in the total Chinese SPADI. The Chinese version of the SPADI is a valid and reliable tool that could be used to measure the degree of pain and disability in Chinese-speaking patients with shoulder pain.
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Clinical rheumatology · Jun 2017
Pain extent is associated with pain intensity but not with widespread pressure or thermal pain sensitivity in women with fibromyalgia syndrome.
Widespread pain is considered a sign of central sensitization in people with chronic pain. Our aim was to examine whether pain extent, assessed from the pain drawing, relates to measures from quantitative sensory testing in fibromyalgia syndrome (FMS). Thirty women with FMS and no other co-morbid conditions completed pain drawings (dorsal and ventral views) and clinical and related disability questionnaires. ⋯ No significant association was observed between pain extent and the remaining outcomes. Pain drawings constitute an easy and accurate approach to quantify widespread pain. Larger pain extent is associated with pain intensity but not with signs of central sensitization in women with FMS.
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Clinical rheumatology · Jun 2017
Prevalence and characterization of non-sicca onset primary Sjögren syndrome with interstitial lung involvement.
Primary Sjögren syndrome (pSS)-related interstitial lung disease (ILD) involved about 10-20% of patients. In 20% of cases, ILD can be diagnosed before pSS; anyway, few studies have investigated the frequency of ILD as the first clinically relevant manifestation of pSS, generally referred to retrospective studies. Aim of our prospective study was to describe prevalence, clinical, serological, and instrumental features of non-sicca onset pSS patients with interstitial lung involvement. ⋯ Interestingly, UIP pattern was the most frequently detected, while typical autoantibodies were often absent. These features stressed the importance of differential diagnosis in the first stage of the disease, considering the possible poorer prognosis in this subgroup of patients. Multidisciplinary approach is crucial for a correct and early diagnosis, at both onset and follow-up.