J Rheumatol
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One hundred and five patients with polyarthritis chose from 14 sensory and 5 affective pain descriptors derived from the McGill Pain Questionnaire (MPQ), and completed visual analogue scales (VAS) for overall and individual joint pain at rest and on movement. The relative frequency of sensory pain descriptor choice varied for the 4 different circumstances of pain. Over one third of patients volunteered affective words not included in the MPQ. This study suggests that conventional overall measures of pain, such as the MPQ, when used for patients with arthritis may neglect differences in pain experience perceived in individual joints and on movement.
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Sleep physiology and symptoms of 9 patients with fibrositis syndrome secondary to a febrile illness were compared to 9 patients with fibrositis syndrome who did not attribute their symptoms to a febrile illness and to 10 healthy controls. Both patient groups showed an alpha EEG (7.5 to 11 Hz) nonrapid eye movement sleep anomaly, had similar observed tender points, and self-ratings of musculoskeletal pain. These findings suggest that patients with postfebrile fibrositis have a nonrestorative sleep disorder characteristic of patients with fibrositis syndrome and share similar symptoms with patients who have a "chronic fatigue syndrome."
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We report the results of a 1982 pilot survey of pediatric rheumatology physicians and fellowship training programs in the United States. All physicians indicating in the ARA directory that they could care for rheumatic diseases of children were surveyed, with a response rate of 57.6%. ⋯ The survey provided basic information concerning training and practice characteristics of respondent physicians and the sources of funding, size, and emphasis of the fellowship programs. Specific attention is given to indicators of demand for pediatric rheumatology services.
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Recent reports have not emphasized the presence of paresthesias in fibromyalgia syndrome. In our retrospective review of 161 patients with fibromyalgia we found that 84% complained of numbness or tingling at initial evaluation. Most had either bilateral upper and lower extremity or bilateral upper extremity paresthesias. ⋯ At a second assessment performed at a mean of 25 months from time of diagnosis, 56 of these 57 patients reported current paresthesias. Paresthesias are common in fibromyalgia and may mimic a neurologic disorder, although objective abnormalities are rare. Judicious use of neurodiagnostic tests are therefore indicated in the clinical setting of fibromyalgia.
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A 24-year-old black woman with a history of pulmonary and hepatic sarcoidosis followed by foot drop presented with uveitis, eosinophilia, leg ulcers, and sinus opacification. Biopsy of the leg ulcer and review of the past lung biopsy revealed numerous epithelioid noncaseating granulomas and granulomatous vasculitis. Although her clinical presentation raised the possibility of Wegener's granulomatosis, the many discrete granulomas and lack of necrosis on her biopsies were more in favor of sarcoidosis. Although granulomatous vasculitis has been reported as part of necrotizing sarcoid granulomatosis, our patient was unique in the extent and type of her extrapulmonary symptomatology.