Fibromyalgia syndrome (FMS) is characterized by widespread chronic pain and tenderness. Persons with FMS are a diverse population, with widely variable symptom presentation and severity, as well as secondary symptoms. Because the symptoms are so diverse, diagnosis and management become challenging. Mounting evidence supports altered CNS processing of nociceptive stimuli as a mechanism.
As the population ages and persons live longer with more medical comorbidities, the incidences of both gout and pseudogout will continue to increase. Uric acid metabolism is crucial to the pathogenesis of gout. Patients who have the arthritis associated with crystal-deposition disease typically present clinically with acute attacks of joint pain, swelling, and erythema and have asymptomatic periods between acute attacks.
Clinical study findings of recent years support the notion that patients with rheumatoid arthritis (RA) should be treated earlier and more aggressively. Monotherapy with disease-modifying antirheumatic drugs (DMARDs) is effective in some cases, but triple DMARD therapy is superior to double therapy or monotherapy in early or late RA. Leflunomide is at least as effective as methotrexate (MTX) and sulfasalazine and more effective than placebo.
A disruption in any part of the vitamin D physiological pathway can result in vitamin D deficiency, which may lead to bone pain, muscle weakness, falls, low bone mass, and fractures.
A pleomorphic hyalinizing angiectatic tumor (PHAT) is a rare soft tissue lesion that mainly affects superficial soft tissue in the lower extremities. PHAT is classified as a borderline/intermediate-grade soft tissue tumor because of the substantial risk of local recurrence.
The severity scores of dyspepsia symptoms and dyspepsia-related quality of life disturbance are higher in patients with fibromyalgia syndrome (FMS) than in patients with rheumatoid arthritis (RA) and in healthy persons.
Sustained disease-modifying antirheumatic drug (DMARD)-free remission occurs in about 10% of patients with rheumatoid arthritis (RA). It can be predicted by several clinical variables that are assessed routinely in outpatient clinics.
Reduced toe flexor strength and the presence of toe deformities increase the risk of falling in older persons, according to researchers at the Biomechanics Research Laboratory, University of Wollongong, in Australia
An 81-year-old man with had a one-year history of right knee pain that had worsened in recent weeks despite no trauma or injury. What does the X-ray show?
An 84-year-old woman presented with pain and swelling in her knees and hands. She had a history of severe psoriasis and osteoarthritis. How can you make a differential diagnosis when OA may coexist with rheumatoid arthritis, psoriatic arthritis, OA, and crystal arthritis? Read on to find out.
The precautionary recommendations for the H1N1 (swine) flu in persons with lupus currently are not different from those for the general public, according to the Lupus Foundation of America (LFA). However, because persons with lupus often are at increased risk for infections, especially if they are taking immunosuppressive agents, they should be particularly vigilant about taking the generally recommended precautions.
Although many medications are used for the management of systemic lupus erythematosus (SLE) and its complications, only aspirin, corticosteroids, and the antimalarial drug hydroxychloroquine (HCQ) are specifically approved by the FDA.1 Most other medications used for SLE treatment are commercially available off label (Table 1), usually borrowed from cancer or transplant regimens. In some cases, medications have been approved for a specific clinical manifestation seen in both idiopathic disease and SLE, such as bosentan for pulmonary hypertension.
The name and identifying features derive from what happens to the skin: it becomes thickened and swollen from deposition of excessive amounts of collagen.
The impact of biomechanical factors on rheumatoid arthritis (RA) has gained increased attention from researchers, as evidenced by studies reported in Clinical Biomechanics. For example, reevaluating knee kinematics over time is important in patients with RA who wear a mobile-bearing total knee prosthesis, according to investigators at the Biomechanics and Imaging Group, Department of Orthopaedics, Leiden University Medical Center, Leiden, the Netherlands.
ABSTRACT: Pay for performance (P4P) is causing physicians to examine how they provide care individually and collectively within local health systems. It is the most recent attempt by Medicare and commercial payers to reduce the cost and improve the outcomes of health care. Understanding P4P and deciding how to manage the multiple programs being implemented by payers will challenge physicians' ethics and practice resources. Improving health care for musculoskeletal diseases will require cooperation among the specialties that share responsibility for this care and improved methods for coordinating and documenting it. (J Musculoskel Med. 2009;26:207-212)
Shoulder pain has many causes: tendinopathy, impingement, rotator cuff tear, adhesive capsulitis ("frozen shoulder"), and arthritis. This review describes tests that can help narrow the differential diagnosis.
A new clinical practice guideline for low back pain (LBP) favors the use of noninvasive treatments over interventional procedures and suggests shared decision making between physicians and patients for better outcomes. Issued by the American Pain Society (APS), the guideline provides clinicians with several recommendations to help determine the best approaches to treating patients with LBP.
Pundits, analysts, and other industry observers have been weighing in with their thoughts on what the President's proposals will call for, what effect they may have on the nation's healthcare system, their chances of being enacted, and how we're going to pay for it all.
As a consequence of playing the role of the weekend warrior, recreational athletes often present with knee or leg pain. Generally, these patients can be categorized in 1 of 3 age-related groups (although, paradoxically, the injuries are not necessarily age-dependent):
Clinicians caring for patients with musculoskeletal disorders may see patients who have underlying conditions that typically are evaluated and managed by allergy and immunology specialists. Although diagnosis of these conditions may be challenging, new insights into their pathogenesis have led to advances in diagnosis and therapy.
Researchers and clinicians often point to biomechanical elements, particularly aberrant biomechanical forces and pathological responses to them, as key factors in osteoarthritis (OA) disease progression.
Ultrasound may be a helpful tool for diagnosing and treating rheumatoid arthritis, a new study has found.
Personal health records, designed to help patients keep all of their medical records in one place and make it easier for doctors to access patient files, may actually lead to inaccurate information and, as a result, improper treatment, some doctors fear.
This young woman sustained a hip fracture while running the Chicago Marathon. The case review suggests that training error was a critical factor. Be alert: Runners may experience stress fractures and ignore the pain.
Once a diagnosis of systemic lupus erythematosus (SLE) has been made, numerous neurological and psychiatric manifestations may be found to accompany the disease.
Heel pain (calcaneodynia) is most commonly due to plantar fasciitis, but has many other causes including nerve entrapment, stress fracture, and sciatica. This review describes an overall approach to diagnosis, discusses conservative treatments and highlights the most prevalent surgical procedures.
The features of systemic lupus erythematosus (SLE) are common in the lifetime course of rheumatoid arthritis (RA) and are significantly associated with an increased mortality risk, even after adjusting for well-described RA-specific predictors of mortality. For some SLE features, the increased risk may be as high as 6-fold.
Cervical spine injuries are common in athletes, particularly those engaged in contact sports.
Soft tissue musculoskeletal conditions are common causes of pelvic and lower extremity pain.
Hemochromatosis is a disorder of iron metabolism that may lead to abnormalities in multiple organ systems.
