Arthritis and rheumatism
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Arthritis and rheumatism · May 2002
Knee pain reduces joint space width in conventional standing anteroposterior radiographs of osteoarthritic knees.
A suspected, but heretofore undemonstrated, limitation of the conventional weight-bearing anteroposterior (AP) knee radiograph, in which the joint is imaged in extension, for studies of progression of osteoarthritis (OA) is that changes in knee pain may affect extension, thereby altering the apparent thickness of the articular cartilage. The present study was undertaken to examine the effect of changes in knee pain of varying magnitudes on radiographic joint space width (JSW) in the weight-bearing extended and the semiflexed AP views, in which radioanatomic positioning of the knee was carefully standardized by fluoroscopy. ⋯ JSW in weight-bearing extended-view radiographs of highly symptomatic OA knees can be altered significantly by changes in joint pain. In clinical trials and in epidemiologic studies of OA progression that use this radiographic technique, longitudinal variations in pain may confound changes in the apparent thickness of the articular cartilage.
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Arthritis and rheumatism · May 2002
Randomized Controlled Trial Clinical TrialTreatment of rheumatoid arthritis with methotrexate and hydroxychloroquine, methotrexate and sulfasalazine, or a combination of the three medications: results of a two-year, randomized, double-blind, placebo-controlled trial.
To compare the efficacy of combination therapy with methotrexate (MTX) and hydroxychloroquine (HCQ), MTX and sulfasalazine (SSZ), and MTX, HCQ, and SSZ in patients with rheumatoid arthritis (RA). ⋯ The triple combination of MTX, SSZ, and HCQ is well-tolerated, and its efficacy is superior to that of the double combination of MTX and SSZ and is marginally superior to that of the double combination of MTX and HCQ.
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Arthritis and rheumatism · May 2002
Functional magnetic resonance imaging evidence of augmented pain processing in fibromyalgia.
To use functional magnetic resonance imaging (fMRI) to evaluate the pattern of cerebral activation during the application of painful pressure and determine whether this pattern is augmented in patients with fibromyalgia (FM) compared with controls. ⋯ The fact that comparable subjectively painful conditions resulted in activation patterns that were similar in patients and controls, whereas similar pressures resulted in no common regions of activation and greater effects in patients, supports the hypothesis that FM is characterized by cortical or subcortical augmentation of pain processing.
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Arthritis and rheumatism · May 2002
Comparative StudyHigh prevalence of lateral knee osteoarthritis in Beijing Chinese compared with Framingham Caucasian subjects.
We recently reported that, despite their thinness, elderly subjects in Beijing, China had an equal prevalence (in men) or higher prevalence (in women) of both radiographic and symptomatic knee osteoarthritis (OA) compared with that in the Framingham, Massachusetts cohort of elderly subjects. Our objective was to evaluate whether Chinese subjects might have more medial disease than do Caucasians, given a report of varus alignment in the knee joints of Chinese elderly. ⋯ In this first attempt to compare the characteristics of OA in different racial groups, we conclude that, opposite to expectations, Chinese subjects have much more lateral OA than do Caucasian subjects in the Framingham cohort, a predilection possibly explained in the men by differences in anatomic alignment.