To study whether the addition of dimethylsulfoxide (DMSO) to synovial fluid (SF) samples could be helpful to store frozen samples to improve the rates of detection and identification of crystals.
Cross-sectional study of samples of SF consecutively obtained. Three aliquots were generated: one for immediate observation by a senior observer, and 2 to be frozen, one with 10% DMSO (DMSO+) and one without DMSO (DMSO–). Each aliquot was randomly allocated and blinded for further observation when once the samples were unfrozen 3 months afterward. Variables included for analysis were total leucocyte count, detection of crystals, identification of present crystals as monosodium urate (MSU) or calcium pyrophosphate (CPP), number of fields to the first crystal observation, and number of crystals per field. The vitality of leucocytes was evaluated using a trypan blue stain. All samples were examined using ordinary light and polarized light with a red compensator, and unfrozen samples by both senior and junior observers.
In the 30 reference samples of SF studied, the mean leucocyte count was 13.1 × 109/L, and 18/30 samples showed crystals (8 MSU, 10 CPP). Once unfrozen, leucocyte counts were 58% lower in DMSO aliquots vs. 22% in DMSO+ aliquots, with vitality (> 50% cells) reduced from 100% in the reference sample to 76.6% in the DMSO+ aliquots to none in the DMSO− aliquots. Agreement in the detection of crystals was much better in DMSO+ aliquots than DMSO− (kappa 1.00 vs. 0.69 and 0.65 vs. 0.11 for the senior and junior observers respectively). Moreover, 4/5 false-negative crystal detection in DMSO− aliquots showed CPP in the reference simple, even though a high density of crystals was observed in the reference sample.
The addition of 10% DMSO to SF samples allows freezing and storage with a small loss of leucocyte counts and excellent agreement in the detection and identification of crystals. Cellular lysis may account for the false negative results in aliquots without DMSO, especially in the case of CPP, non-refringent crystals.
Gout often presents as acute arthritis but may also present with chronic joint inflammation. For the diagnosis of an acute gout attack with its typical symptoms, the differentiation towards a bacterial joint infection is critical and mandatory. The detection of intracellular uric acid crystals in the synovial fluid of affected joints is important for the initial diagnosis of gout. In the case of a chronic course with polyarticular joint involvement, the differentiation from other inflammatory rheumatic diseases such as rheumatoid arthritis (RA) can be challenging. The case presented here is of interest because the patient initially had characteristic clinical symptoms of tophaceous gout including a typical medical history—even though rheumatoid factor and anti-citrullinated protein antibodies (anti-CCP) were positive. The course of the disease and the critical evaluation of all findings also, and most interestingly, including histological results finally suggested a main diagnosis of RA.
[Names] => David Kiefer ... Juergen Braun [Doi] => 10.37349/emd.2023.00003 [Published] => February 24, 2023 [Viewed] => 3253 [Downloaded] => 44 [Subject] => Case Report [Year] => 2023 [CiteUrl] => https://api.crossref.org/works/10.37349/emd.2023.00003 [Inline] => 1 [Type] => 1 [Issue] => 1 [Topic] => 0 [TitleAbbr] => Explor Musculoskeletal Dis. [Pages] => 2023;1:11–19 [Recommend] => 1 [Keywords] => Arthritis urica, rheumatoid arthritis, rheumatoid nodule, tophus, polyarthritis [DetailTitle] => [DetailUrl] => [Id] => 10073 [ris] => https://www.explorationpub.com/uploads/Article/A10073/cd9d5cbcd60b89a6ef60061aa596d84d.ris [bib] => https://www.explorationpub.com/uploads/Article/A10073/7a3d0a2a5a063abdfd9bc5d7befb5633.bib [ens] => [Cited] => 1 [Cited_Time] => 2024-04-26 [CitethisArticle] => Kiefer D, Erkenberg J, Braun J. Similarities and differences between gouty arthritis and rheumatoid arthritis—an interesting case with a short look into the literature. Explor Musculoskeletal Dis. 2023;1:11–9. https://doi.org/10.37349/emd.2023.00003 [Jindex] => 0 [CName] => DavidKiefer, [CEmail] => david.kiefer@elisabethgruppe.de, [Ris_Time] => 2023-02-23 05:16:00 [Bib_Time] => 2023-02-23 05:16:00 [KeysWordContens] => Similarities and differences between gouty arthritis and rheumatoid arthritis—an interesting case with a short look into the literature, Arthritis urica, rheumatoid arthritis, rheumatoid nodule, tophus, polyarthritis, Gout often presents as acute arthritis but may also present with chronic joint inflammation. For the diagnosis of an acute gout attack with its typical symptoms, the differentiation towards a bacterial joint infection is critical and mandatory. The detection of intracellular uric acid crystals in the synovial fluid of affected joints is important for the initial diagnosis of gout. In the case of a chronic course with polyarticular joint involvement, the differentiation from other inflammatory rheumatic diseases such as rheumatoid arthritis (RA) can be challenging. The case presented here is of interest because the patient initially had characteristic clinical symptoms of tophaceous gout including a typical medical history—even though rheumatoid factor and anti-citrullinated protein antibodies (anti-CCP) were positive. The course of the disease and the critical evaluation of all findings also, and most interestingly, including histological results finally suggested a main diagnosis of RA. ,David Kiefer ... Juergen Braun [PublishedText] => Published [IsEdit] => 0 [AccountId] => 38 [Zh] => 1 ) [3] => Array ( [ArticleId] => 489 [Create_Time] => 2023-02-27 [zipUrl] => https://www.explorationpub.com/uploads/zip/202304/20230410083907.zip [xmlUrl] => https://www.explorationpub.com/uploads/Article/A10074/10074.xml [pdfUrl] => https://www.explorationpub.com/uploads/Article/A10074/10074.pdf [coverUrl] => https://www.explorationpub.com/uploads/Article/A10074/10074_cover.png [JournalsId] => 9 [Title] => Towards a more ambitious uricemia target to improve joint and cardiovascular outcomes in gout [Abstract] => Gout is the most common inflammatory arthritis and a global health problem. In addition to joint involvement, urate crystals induce chronic inflammation, leading to increased cardiovascular risk in gout. Thus, cardiovascular disease is the leading cause of death in gout and numerous studies have revealed an increase in cardiovascular-related mortality in these patients. However, despite the efficacy of urate-lowering therapies, such as allopurinol and febuxostat, suboptimal management of gout and poor adherence continue to make it difficult to achieve better outcomes. Treat-to-target strategy may help change this, as in other diseases such as rheumatoid arthritis. Nevertheless, even with a well-defined clinical target (absence of flares and tophi disappearance), the numerical target [serum uric acid (SUA) < 5 mg/dL or < 6 mg/dL] still varies depending on current guidelines and consensus documents. Recently, several trials [Long-Term Cardiovascular Safety of Febuxostat Compared with Allopurinol in Patients with Gout (FAST), REasons for Geographic And Racial Differences in Stroke (REGARDS)] have shown better cardiovascular outcomes in those patients who achieve SUA levels < 5 mg/dL. Likewise, some observational studies, mostly based on imaging tests such as ultrasound and dual-energy computed tomography, have found better results in the magnitude and speed of reduction of urate joint deposition when SUA < 5 mg/dL is achieved. Based on an analysis of the available evidence, SUA < 5 mg/dL is postulated as a more ambitious target within the treat-to-target approach for the management of gout to achieve better joint and cardiovascular outcomes in patients with cardiovascular risk or severe disease. [AbstractComplete] =>Gout is the most common inflammatory arthritis and a global health problem. In addition to joint involvement, urate crystals induce chronic inflammation, leading to increased cardiovascular risk in gout. Thus, cardiovascular disease is the leading cause of death in gout and numerous studies have revealed an increase in cardiovascular-related mortality in these patients. However, despite the efficacy of urate-lowering therapies, such as allopurinol and febuxostat, suboptimal management of gout and poor adherence continue to make it difficult to achieve better outcomes. Treat-to-target strategy may help change this, as in other diseases such as rheumatoid arthritis. Nevertheless, even with a well-defined clinical target (absence of flares and tophi disappearance), the numerical target [serum uric acid (SUA) < 5 mg/dL or < 6 mg/dL] still varies depending on current guidelines and consensus documents. Recently, several trials [Long-Term Cardiovascular Safety of Febuxostat Compared with Allopurinol in Patients with Gout (FAST), REasons for Geographic And Racial Differences in Stroke (REGARDS)] have shown better cardiovascular outcomes in those patients who achieve SUA levels < 5 mg/dL. Likewise, some observational studies, mostly based on imaging tests such as ultrasound and dual-energy computed tomography, have found better results in the magnitude and speed of reduction of urate joint deposition when SUA < 5 mg/dL is achieved. Based on an analysis of the available evidence, SUA < 5 mg/dL is postulated as a more ambitious target within the treat-to-target approach for the management of gout to achieve better joint and cardiovascular outcomes in patients with cardiovascular risk or severe disease.
[Names] => Enrique Calvo-Aranda, Fernando Perez-Ruiz [Doi] => 10.37349/emd.2023.00004 [Published] => February 27, 2023 [Viewed] => 697 [Downloaded] => 25 [Subject] => Perspective [Year] => 2023 [CiteUrl] => https://api.crossref.org/works/10.37349/emd.2023.00004 [Inline] => 1 [Type] => 1 [Issue] => 1 [Topic] => 0 [TitleAbbr] => Explor Musculoskeletal Dis. [Pages] => 2023;1:20–25 [Recommend] => 0 [Keywords] => Gout, uric acid, urate, crystals, treat-to-target, cardiovascular, arthritis [DetailTitle] => [DetailUrl] => [Id] => 10074 [ris] => https://www.explorationpub.com/uploads/Article/A10074/bf5043206b0d4e616a9ba41c659a6cbf.ris [bib] => https://www.explorationpub.com/uploads/Article/A10074/6040f4350b1655af545c11b29ad23bf6.bib [ens] => [Cited] => 0 [Cited_Time] => [CitethisArticle] => Calvo-Aranda E, Perez-Ruiz F. Towards a more ambitious uricemia target to improve joint and cardiovascular outcomes in gout. Explor Musculoskeletal Dis. 2023;1:20–5. https://doi.org/10.37349/emd.2023.00004 [Jindex] => 0 [CName] => EnriqueCalvo-Aranda, [CEmail] => ecalvoa@hotmail.com, [Ris_Time] => 2023-02-27 03:36:03 [Bib_Time] => 2023-02-27 03:36:03 [KeysWordContens] => Towards a more ambitious uricemia target to improve joint and cardiovascular outcomes in gout, Gout, uric acid, urate, crystals, treat-to-target, cardiovascular, arthritis, Gout is the most common inflammatory arthritis and a global health problem. In addition to joint involvement, urate crystals induce chronic inflammation, leading to increased cardiovascular risk in gout. Thus, cardiovascular disease is the leading cause of death in gout and numerous studies have revealed an increase in cardiovascular-related mortality in these patients. However, despite the efficacy of urate-lowering therapies, such as allopurinol and febuxostat, suboptimal management of gout and poor adherence continue to make it difficult to achieve better outcomes. Treat-to-target strategy may help change this, as in other diseases such as rheumatoid arthritis. Nevertheless, even with a well-defined clinical target (absence of flares and tophi disappearance), the numerical target [serum uric acid (SUA) < 5 mg/dL or < 6 mg/dL] still varies depending on current guidelines and consensus documents. Recently, several trials [Long-Term Cardiovascular Safety of Febuxostat Compared with Allopurinol in Patients with Gout (FAST), REasons for Geographic And Racial Differences in Stroke (REGARDS)] have shown better cardiovascular outcomes in those patients who achieve SUA levels < 5 mg/dL. Likewise, some observational studies, mostly based on imaging tests such as ultrasound and dual-energy computed tomography, have found better results in the magnitude and speed of reduction of urate joint deposition when SUA < 5 mg/dL is achieved. Based on an analysis of the available evidence, SUA < 5 mg/dL is postulated as a more ambitious target within the treat-to-target approach for the management of gout to achieve better joint and cardiovascular outcomes in patients with cardiovascular risk or severe disease. ,Enrique Calvo-Aranda, Fernando Perez-Ruiz [PublishedText] => Published [IsEdit] => 0 [AccountId] => 45 [Zh] => 1 ) [4] => Array ( [ArticleId] => 502 [Create_Time] => 2023-02-27 [zipUrl] => https://www.explorationpub.com/uploads/zip/202304/20230410052117.zip [xmlUrl] => https://www.explorationpub.com/uploads/Article/A10075/10075.xml [pdfUrl] => https://www.explorationpub.com/uploads/Article/A10075/10075.pdf [coverUrl] => https://www.explorationpub.com/uploads/Article/A10075/10075_cover.png [JournalsId] => 9 [Title] => Infection after reconstruction of the anterior cruciate ligament [Abstract] => Aim: Postoperative infection after the anterior cruciate ligament reconstruction (ACLR) can destroy the knee cartilage, necessitate graft removal, and cause arthrofibrosis, instability, limitatio [AbstractComplete] =>Postoperative infection after the anterior cruciate ligament reconstruction (ACLR) can destroy the knee cartilage, necessitate graft removal, and cause arthrofibrosis, instability, limitation of motion, chronic pain, and disability. While being an uncommon complication, the actual number of infected patients might be rather high due to a large number of operations performed. As the operation is usually indicated in young, healthy, and active individuals, failure to achieve the expected improvement, due to complications, is perceived as much graver. The purpose of this study was to analyze the infecting organisms in patients that underwent ACLR at our institution, a tertiary care center, for precise microbiological diagnosis and bacterial susceptibility and resistance to antibiotics.
The rate of infection, the infecting organisms, the antibiotic susceptibility, and the resistance were analyzed in 1,395 patients that underwent ACLR using descriptive statistics.
Three patients (0.93%) were diagnosed with a postoperative infection; all underwent arthroscopic debridement and lavage. All infections were caused by Staphylococci [3 Staphylococcus aureus (S. aureus, all oxacillin sensitive), 6 coagulase-negative Staphylococci (3 oxacillin resistant)]. No gram-negative, gastrointestinal tract bacteria, fungal or polymicrobial infections were detected. Thirty eight and a half percent of patients had returned to previous or near previous levels of activity.
Preventing infection by controlling risk factors, prophylactic antibiotics, proper surgical preparation, and surgical technique is mandatory. When infection does occur, rapid recognition and prompt treatment are necessary to avoid irreversible damage to the knee joint and the need for graft removal. Despite appropriate treatment, the functional outcomes were inferior to expected after an uncomplicated ACLR.
Congenital fused/blocked vertebrae are an incidental finding in most cases. It remains asymptomatic unless there is a traumatic event or there is an increased biomechanical load which may be attributed to a task that is not typically performed by the individual. Symptomatic cases can present with several musculoskeletal symptoms including neck pain. Physiotherapy management strategies may help patients recover from the mechanical strains on the cervical neuromuscular structures. The present case is of a 21-year-old male engineering student who was referred for physiotherapy, he presented with complaints of neck pain (non-radiating in nature) for a week. The intensity of the pain had been intermittently increasing/decreasing for about a year and there were about 2–3 episodes in a month for approximately one year. He presented with an X-ray that showed C3–C4 cervical vertebrae synostosis (block vertebrae). The patient was managed using pain education and exercises along with ergonomic advice. Patient-reported pain decreased significantly from the initial visit and he was able to sit for a longer duration and had a considerable improvement in function.
[Names] => Sarah Quais, Ammar Suhail [Doi] => 10.37349/emd.2023.00006 [Published] => March 27, 2023 [Viewed] => 2046 [Downloaded] => 35 [Subject] => Case Report [Year] => 2023 [CiteUrl] => https://api.crossref.org/works/10.37349/emd.2023.00006 [Inline] => 1 [Type] => 1 [Issue] => 2 [Topic] => 0 [TitleAbbr] => Explor Musculoskeletal Dis. [Pages] => 2023;1:31–36 [Recommend] => 0 [Keywords] => Neck pain, block vertebra, exercise therapy, hypermobility [DetailTitle] => [DetailUrl] => [Id] => 10076 [ris] => https://www.explorationpub.com/uploads/Article/A10076/e548e953abb1e6c42b163ed009bc525f.ris [bib] => https://www.explorationpub.com/uploads/Article/A10076/20f6810b68e04d8079dda2830f34ab2f.bib [ens] => [Cited] => 0 [Cited_Time] => [CitethisArticle] => Quais S, Suhail A. Physiotherapy management of a patient with neck pain having block vertebra: a case report. Explor Musculoskeletal Dis. 2023;1:31–6. https://doi.org/10.37349/emd.2023.00006 [Jindex] => 0 [CName] => AmmarSuhail, [CEmail] => asuhail38@gmail.com, [Ris_Time] => 2023-03-17 07:43:09 [Bib_Time] => 2023-03-17 07:43:09 [KeysWordContens] => Physiotherapy management of a patient with neck pain having block vertebra: a case report, Neck pain, block vertebra, exercise therapy, hypermobility, Congenital fused/blocked vertebrae are an incidental finding in most cases. It remains asymptomatic unless there is a traumatic event or there is an increased biomechanical load which may be attributed to a task that is not typically performed by the individual. Symptomatic cases can present with several musculoskeletal symptoms including neck pain. Physiotherapy management strategies may help patients recover from the mechanical strains on the cervical neuromuscular structures. The present case is of a 21-year-old male engineering student who was referred for physiotherapy, he presented with complaints of neck pain (non-radiating in nature) for a week. The intensity of the pain had been intermittently increasing/decreasing for about a year and there were about 2–3 episodes in a month for approximately one year. He presented with an X-ray that showed C3–C4 cervical vertebrae synostosis (block vertebrae). The patient was managed using pain education and exercises along with ergonomic advice. Patient-reported pain decreased significantly from the initial visit and he was able to sit for a longer duration and had a considerable improvement in function. ,Sarah Quais, Ammar Suhail [PublishedText] => Published [IsEdit] => 0 [AccountId] => 55 [Zh] => 1 ) [6] => Array ( [ArticleId] => 524 [Create_Time] => 2023-04-12 [zipUrl] => https://www.explorationpub.com/uploads/zip/202304/20230412071226.zip [xmlUrl] => https://www.explorationpub.com/uploads/Article/A10077/10077.xml [pdfUrl] => https://www.explorationpub.com/uploads/Article/A10077/10077.pdf [coverUrl] => https://www.explorationpub.com/uploads/Article/A10077/10077_cover.png [JournalsId] => 9 [Title] => Quality of care, referral, and early diagnosis of axial spondyloarthritis [Abstract] => [AbstractComplete] => [Names] => Jürgen Braun ... Xenofon Baraliakos [Doi] => 10.37349/emd.2023.00007 [Published] => April 12, 2023 [Viewed] => 972 [Downloaded] => 47 [Subject] => Editorial [Year] => 2023 [CiteUrl] => https://api.crossref.org/works/10.37349/emd.2023.00007 [Inline] => 1 [Type] => 1 [Issue] => 2 [Topic] => 0 [TitleAbbr] => Explor Musculoskeletal Dis. [Pages] => 2023;1:37–42 [Recommend] => 0 [Keywords] => [DetailTitle] => [DetailUrl] => [Id] => 10077 [ris] => https://www.explorationpub.com/uploads/Article/A10077/74e9025ce43d5b0992217c5460d64c4f.ris [bib] => https://www.explorationpub.com/uploads/Article/A10077/7739ce0c1f3b2a43a363c9f717b3cc31.bib [ens] => [Cited] => 0 [Cited_Time] => [CitethisArticle] => Braun J, Kiltz U, Baraliakos X. Quality of care, referral, and early diagnosis of axial spondyloarthritis. Explor Musculoskeletal Dis. 2023;1:37–42. https://doi.org/10.37349/emd.2023.00007 [Jindex] => 0 [CName] => [CEmail] => [Ris_Time] => 2023-04-09 08:08:15 [Bib_Time] => 2023-04-09 08:08:15 [KeysWordContens] => Quality of care, referral, and early diagnosis of axial spondyloarthritis,,,Jürgen Braun ... Xenofon Baraliakos [PublishedText] => Published [IsEdit] => 0 [AccountId] => 22 [Zh] => 1 ) [7] => Array ( [ArticleId] => 573 [Create_Time] => 2023-04-27 [zipUrl] => https://www.explorationpub.com/uploads/zip/202306/20230615010625.zip [xmlUrl] => https://www.explorationpub.com/uploads/Article/A10078/10078.xml [pdfUrl] => https://www.explorationpub.com/uploads/Article/A10078/10078.pdf [coverUrl] => https://www.explorationpub.com/uploads/Article/A10078/10078_cover.png [JournalsId] => 9 [Title] => Is there a place for magnetic resonance imaging in diffuse idiopathic skeletal hyperostosis? [Abstract] => Diffuse idiopathic skeletal hyperostosis (DISH) is a systemic condition characterized by the new bone formation and enthesopathies of the axial and peripheral skeleton. The diagnosis of DISH current [AbstractComplete] =>Diffuse idiopathic skeletal hyperostosis (DISH) is a systemic condition characterized by the new bone formation and enthesopathies of the axial and peripheral skeleton. The diagnosis of DISH currently relies upon the end-stage radiographic criteria of Resnick and Niwayama, in which bridging osteophytes are present over at least four thoracic vertebras. The pathogenesis of DISH is not well understood, and it is currently considered a non-inflammatory condition with an underlying metabolic derangement. However, an inflammatory component was suggested due to the similarities between DISH and spondyloarthritis (SpA) in spinal and peripheral entheseal new bone formation. Magnetic resonance imaging (MRI) is the imaging modality of choice in the diagnostic work-up and follow-up of patients with SpA, as well as in understanding its pathogenesis. The aims of the current review were to evaluate the current and future role of MRI in imaging DISH.
[Names] => Iris Eshed [Doi] => 10.37349/emd.2023.00008 [Published] => April 27, 2023 [Viewed] => 1512 [Downloaded] => 35 [Subject] => Review [Year] => 2023 [CiteUrl] => https://api.crossref.org/works/10.37349/emd.2023.00008 [Inline] => 1 [Type] => 1 [Issue] => 2 [Topic] => 119 [TitleAbbr] => Explor Musculoskeletal Dis. [Pages] => 2023;1:43–53 [Recommend] => 1 [Keywords] => Diffuse idiopathic skeletal hyperostosis, magnetic resonance imaging, spine, sacroiliac joints, entheses, osteophytes [DetailTitle] => Diffuse Idiopathic Skeletal Hyperostosis- A common but neglected disease [DetailUrl] => https://www.explorationpub.com/Journals/emd/Special_Issues/119 [Id] => 10078 [ris] => https://www.explorationpub.com/uploads/Article/A10078/89ab4d0d940ebbd0be115d350bc3a18b.ris [bib] => https://www.explorationpub.com/uploads/Article/A10078/9ea6bc399488f2f6bd082af9dd96de9f.bib [ens] => [Cited] => 0 [Cited_Time] => [CitethisArticle] => Eshed I. Is there a place for magnetic resonance imaging in diffuse idiopathic skeletal hyperostosis? Explor Musculoskeletal Dis. 2023;1:43–53. https://doi.org/10.37349/emd.2023.00008 [Jindex] => 0 [CName] => IrisEshed, [CEmail] => iriseshed@gmail.com, [Ris_Time] => 2023-04-26 08:32:46 [Bib_Time] => 2023-04-26 08:32:46 [KeysWordContens] => Is there a place for magnetic resonance imaging in diffuse idiopathic skeletal hyperostosis?, Diffuse idiopathic skeletal hyperostosis, magnetic resonance imaging, spine, sacroiliac joints, entheses, osteophytes, Diffuse idiopathic skeletal hyperostosis (DISH) is a systemic condition characterized by the new bone formation and enthesopathies of the axial and peripheral skeleton. The diagnosis of DISH currently relies upon the end-stage radiographic criteria of Resnick and Niwayama, in which bridging osteophytes are present over at least four thoracic vertebras. The pathogenesis of DISH is not well understood, and it is currently considered a non-inflammatory condition with an underlying metabolic derangement. However, an inflammatory component was suggested due to the similarities between DISH and spondyloarthritis (SpA) in spinal and peripheral entheseal new bone formation. Magnetic resonance imaging (MRI) is the imaging modality of choice in the diagnostic work-up and follow-up of patients with SpA, as well as in understanding its pathogenesis. The aims of the current review were to evaluate the current and future role of MRI in imaging DISH. ,Iris Eshed [PublishedText] => Published [IsEdit] => 0 [AccountId] => 57 [Zh] => 1 ) [8] => Array ( [ArticleId] => 627 [Create_Time] => 2023-06-29 [zipUrl] => https://www.explorationpub.com/uploads/zip/202306/20230629072326.zip [xmlUrl] => https://www.explorationpub.com/uploads/Article/A10079/10079.xml [pdfUrl] => https://www.explorationpub.com/uploads/Article/A10079/10079.pdf [coverUrl] => https://www.explorationpub.com/uploads/Article/A10079/10079_cover.png [JournalsId] => 9 [Title] => Quantitative magnetic resonance spectroscopy and imaging analysis of the lipid content in the psoas major and its association with intervertebral disc degeneration: a cross-sectional study [Abstract] => Aim: It is shown that the diminished function of the psoas major is mainly associated with increased lipid content; nonetheless, whether the fat content of the psoas major is associated with inte [AbstractComplete] =>It is shown that the diminished function of the psoas major is mainly associated with increased lipid content; nonetheless, whether the fat content of the psoas major is associated with intervertebral disc degeneration (IVDD) is still under study. It is hypothesized that IVDD is correlated with the lipid content of the psoas major and that IVDD can be comprehensively investigated using quantitative magnetic resonance imaging (MRI). Consequently, this study aimed to analyse the association between the psoas major extramyocellular lipid (EMCL) and intramyocellular lipid (IMCL) content and disc degeneration quantified using MRI T2 mapping in patients with chronic low back pain (CLBP).
In this study, 20 men and 23 women (mean age, 63.1 years ± 2.6 years) underwent magnetic resonance spectroscopy (MRS). The psoas major IMCL and EMCL content of patients was analysed. T2 values of the anterior annulus fibrosus (AF), nucleus pulposus (NP), and posterior AF were evaluated using MRI T2 mapping. Multiple linear regression analysis was used to determine the possible correlations of the psoas major EMCL and IMCL content with the T2 values of the anterior AF, NP, and posterior AF.
The EMCL content and T2 values of the anterior AF were significantly and negatively correlated [standardised partial regression coefficient (β) = −0.60, P < 0.01]. There were no significant correlations between the EMCL content and T2 values of the NP (β = −0.16, P = 0.30) or posterior AF (β = −0.14, P = 0.49) or between the IMCL content and T2 values of the anterior AF (β = −0.04, P = 0.82), NP (β = 0.05, P = 0.73), or posterior AF (β = −0.11, P = 0.58).
The EMCL content and T2 values of the anterior AF were correlated. Conversely, the IMCL content and T2 values were not correlated.
To identify constitutional morphological features at the knee that associate with knee osteoarthritis (OA, KOA).
This was a case-control study using data from the Genetics of Osteoarthritis and Lifestyle (GOAL) study. Radiographic measurements at the knee were undertaken by a single trained observer. Measurement of 12 characteristics was undertaken in 815 controls with asymptomatic structurally normal knees to examine right-left symmetry and variation with gender and age. Measurements were then compared to “cases” (315 asymptomatic and structurally unaffected knees of people with radiographic and symptomatic OA in the contralateral knee) on the assumption that the morphology of the unaffected knee represented the morphology of the contralateral knee prior to the development of OA. Right-left symmetry of morphological measures in controls was examined using paired t test and minimal detectable change (MDC). Linear regression was used to examine the association between measurements and demographic characteristics. Association of morphological features and unilateral KOA [defined as OA in either patellofemoral (PF) or tibiofemoral (TF) joints], PFOA and TFOA were determined using binary logistic regression and odds ratio (OR) and 95% confidence interval (CI) calculated. Cumulative risk of measurements in determining OA was examined using receiver operating characteristic (ROC) curves.
Narrow sulcus and condylar angles, increasing distal femoral, proximal tibial tilt, and increasing varus alignment associated with KOA. ROC curves including all significant morphological features and age, gender, height, and weight predicted knee, PF joint (PFJ), and TF joint (TFJ) OA with area under the curve (AUC) of 0.91, 0.89, and 0.90 respectively. On the contrary, a model only containing age, gender, height, and weight predicted knee, PFJ, and TFJ OA with AUC of 0.59, 0.67, and 0.59 respectively.
Five morphological features associated independently with KOA were identified. Together they explain a large proportion of risk for OA.
Systemic vasculitis is a heterogeneous group of disorders characterized by inflammation and necrosis in the vessel wall. Patients usually present a quite broad spectrum of manifestations which vary in terms of vessels’ size affected, organs involvement, and the extent of inflammatory process as well as an immunological diversity, including autoantibodies profile. Though, the diagnosis is based on clinical features, tissue biopsy, imaging investigations, and serologic tests. The main autoantibodies, important not only in the diagnosis but also in monitoring and prognosis of systemic vasculitides, are anti-neutrophil cytoplasmic antibodies (ANCA), anti-glomerular basement membrane antibodies (anti-GBM), anti-complement component C1q antibodies (anti-C1q), and cryoglobulins. Although other autoantibodies have been analyzed, their clinical utility still needs further investigation. The current work aimed to review the clinical associations of main autoantibodies in systemic vasculitis.
[Names] => Katarzyna Fischer, Marek Brzosko [Doi] => 10.37349/emd.2023.00012 [Published] => July 17, 2023 [Viewed] => 364 [Downloaded] => 19 [Subject] => Review [Year] => 2023 [CiteUrl] => https://api.crossref.org/works/10.37349/emd.2023.00012 [Inline] => 1 [Type] => 1 [Issue] => 4 [Topic] => 0 [TitleAbbr] => Explor Musculoskeletal Dis. [Pages] => 2023;1:77–83 [Recommend] => 0 [Keywords] => Systemic vasculitis, anti-neutrophil cytoplasmic antibodies, anti-glomerular basement membrane antibodies, anti-complement component C1q antibodies, cryoglobulins [DetailTitle] => [DetailUrl] => [Id] => 100712 [ris] => https://www.explorationpub.com/uploads/Article/A100712/2fb7f0f133551dd9a2988fab819bc62d.ris [bib] => https://www.explorationpub.com/uploads/Article/A100712/8dab142a93fe3a61df791743c6c8ab29.bib [ens] => [Cited] => 0 [Cited_Time] => [CitethisArticle] => Fischer K, Brzosko M. Significance of autoantibodies in diagnostics of systemic vasculitis. Explor Musculoskeletal Dis. 2023;1:77–83. https://doi.org/10.37349/emd.2023.00012 [Jindex] => 0 [CName] => [CEmail] => [Ris_Time] => 2023-07-17 06:02:19 [Bib_Time] => 2023-07-17 06:02:19 [KeysWordContens] => Significance of autoantibodies in diagnostics of systemic vasculitis, Systemic vasculitis, anti-neutrophil cytoplasmic antibodies, anti-glomerular basement membrane antibodies, anti-complement component C1q antibodies, cryoglobulins, Systemic vasculitis is a heterogeneous group of disorders characterized by inflammation and necrosis in the vessel wall. Patients usually present a quite broad spectrum of manifestations which vary in terms of vessels’ size affected, organs involvement, and the extent of inflammatory process as well as an immunological diversity, including autoantibodies profile. Though, the diagnosis is based on clinical features, tissue biopsy, imaging investigations, and serologic tests. The main autoantibodies, important not only in the diagnosis but also in monitoring and prognosis of systemic vasculitides, are anti-neutrophil cytoplasmic antibodies (ANCA), anti-glomerular basement membrane antibodies (anti-GBM), anti-complement component C1q antibodies (anti-C1q), and cryoglobulins. Although other autoantibodies have been analyzed, their clinical utility still needs further investigation. The current work aimed to review the clinical associations of main autoantibodies in systemic vasculitis. ,Katarzyna Fischer, Marek Brzosko [PublishedText] => Published [IsEdit] => 0 [AccountId] => 55 [Zh] => 1 ) [12] => Array ( [ArticleId] => 1071 [Create_Time] => 2024-01-18 [zipUrl] => https://www.explorationpub.com/uploads/zip/202401/20240118005612.zip [xmlUrl] => https://www.explorationpub.com/uploads/Article/A100729/100729.xml [pdfUrl] => https://www.explorationpub.com/uploads/Article/A100729/100729.pdf [coverUrl] => https://www.explorationpub.com/uploads/Article/A100729/100729-cover.png [JournalsId] => 9 [Title] => Psoriasis, bone and bowel: a comprehensive review and new insights [Abstract] => Psoriasis is a chronic immune-mediated disorder affecting about 2% of the population worldwide which is associated with significant morbidity. The disease usually presents as raised, well-demarcated [AbstractComplete] =>Psoriasis is a chronic immune-mediated disorder affecting about 2% of the population worldwide which is associated with significant morbidity. The disease usually presents as raised, well-demarcated erythematous plaques with adherent silvery scales. Psoriasis can appear at any age but it has two peaks occurring at 15–20 and 55–60 years of age. It affects males and females equally. Despite the multitude of investigations about psoriasis and even development of drugs with satisfactory results, its pathogenesis is not fully understood yet and its course is unpredictable. Various environmental triggers, e.g., obesity, stress and drugs may induce disease in genetically susceptible patients. Although psoriasis was considered primarily as a disease of the skin, more investigations have been revealed its systemic nature. Psoriatic arthritis (PsA) may complicate up to one-third of cases of psoriasis vulgaris (PV). Also, the association between psoriasis and a variety of other immune-mediated disorders such as inflammatory bowel disease (IBD) and celiac disease (CD) has been confirmed in various studies. Moreover, a growing body of evidences indicates that psoriasis shares some common histological and phenotypical properties with the spectrum of osteoimmunological diseases such as Paget’s disease of bone (PDB). Thus, exploring the common molecular and genetic mechanisms underlying psoriasis and related disorders is of paramount importance for better elucidating disease pathogenesis and designing more targeted treatments.
[Names] => Fakhreddin Sabooniha [Doi] => 10.37349/emd.2024.00029 [Published] => January 18, 2024 [Viewed] => 425 [Downloaded] => 16 [Subject] => Review [Year] => 2024 [CiteUrl] => https://api.crossref.org/works/10.37349/emd.2024.00029 [Inline] => 1 [Type] => 1 [Issue] => 1 [Topic] => 155 [TitleAbbr] => Explor Musculoskeletal Dis. [Pages] => 2024;2:1–19 [Recommend] => 0 [Keywords] => Psoriasis, psoriatic arthritis, celiac disease, Paget’s disease of bone, osteoprotegerin, antibodies, Dickkopf-1 [DetailTitle] => Psoriatic disease: from the skin to the musculoskeletal system and beyond [DetailUrl] => https://www.explorationpub.com/Journals/emd/Special_Issues/155 [Id] => 100729 [ris] => https://www.explorationpub.com/uploads/Article/A100729/8c9a4384147d2623e5f8599fb58b0f75.ris [bib] => https://www.explorationpub.com/uploads/Article/A100729/d239ea4e99de78d10a50ec0c741ff0fd.bib [ens] => [Cited] => 0 [Cited_Time] => [CitethisArticle] => Sabooniha F. Psoriasis, bone and bowel: a comprehensive review and new insights. Explor Musculoskeletal Dis. 2024;2:1–19. https://doi.org/10.37349/emd.2024.00029 [Jindex] => 0 [CName] => [CEmail] => [Ris_Time] => 2024-01-08 07:30:14 [Bib_Time] => 2024-01-08 07:30:14 [KeysWordContens] => Psoriasis, bone and bowel: a comprehensive review and new insights, Psoriasis, psoriatic arthritis, celiac disease, Paget’s disease of bone, osteoprotegerin, antibodies, Dickkopf-1, Psoriasis is a chronic immune-mediated disorder affecting about 2% of the population worldwide which is associated with significant morbidity. The disease usually presents as raised, well-demarcated erythematous plaques with adherent silvery scales. Psoriasis can appear at any age but it has two peaks occurring at 15–20 and 55–60 years of age. It affects males and females equally. Despite the multitude of investigations about psoriasis and even development of drugs with satisfactory results, its pathogenesis is not fully understood yet and its course is unpredictable. Various environmental triggers, e.g., obesity, stress and drugs may induce disease in genetically susceptible patients. Although psoriasis was considered primarily as a disease of the skin, more investigations have been revealed its systemic nature. Psoriatic arthritis (PsA) may complicate up to one-third of cases of psoriasis vulgaris (PV). Also, the association between psoriasis and a variety of other immune-mediated disorders such as inflammatory bowel disease (IBD) and celiac disease (CD) has been confirmed in various studies. Moreover, a growing body of evidences indicates that psoriasis shares some common histological and phenotypical properties with the spectrum of osteoimmunological diseases such as Paget’s disease of bone (PDB). Thus, exploring the common molecular and genetic mechanisms underlying psoriasis and related disorders is of paramount importance for better elucidating disease pathogenesis and designing more targeted treatments. ,Fakhreddin Sabooniha [PublishedText] => Published [IsEdit] => 0 [AccountId] => 76 [Zh] => 1 ) [13] => Array ( [ArticleId] => 722 [Create_Time] => 2023-08-30 [zipUrl] => https://www.explorationpub.com/uploads/zip/202308/20230829083045.zip [xmlUrl] => https://www.explorationpub.com/uploads/Article/A100713/100713.xml [pdfUrl] => https://www.explorationpub.com/uploads/Article/A100713/100713.pdf [coverUrl] => https://www.explorationpub.com/uploads/Article/A100713/100713_cover.png [JournalsId] => 9 [Title] => Perioperative management, operative techniques, and pitfalls in the surgical treatment of patients with diffuse idiopathic skeletal hyperostosis: a narrative review [Abstract] => Diffuse idiopathic skeletal hyperostosis (DISH) can lead to dysphagia, airway obstruction, and unstable vertebral fractures. Surgery can be performed to relieve cervical compression or stabilize fra [AbstractComplete] =>Diffuse idiopathic skeletal hyperostosis (DISH) can lead to dysphagia, airway obstruction, and unstable vertebral fractures. Surgery can be performed to relieve cervical compression or stabilize fractures of the spinal column, with or without decompression of spinal cord injuries. In this review, the peri-operative surgical techniques in cases with DISH are discussed, as well as the pre-operative and post-operative pearls and pitfalls. It is essential for spine surgeons, including orthopedic surgeons and neurosurgeons, to be aware of the considerations, anticipations, and approaches for the management of dysphagia, airway obstruction, and fractures in DISH patients in order to improve patient outcomes for this specific at-risk patient population.
[Names] => Netanja I. Harlianto ... Jorrit-Jan Verlaan [Doi] => 10.37349/emd.2023.00013 [Published] => August 29, 2023 [Viewed] => 531 [Downloaded] => 16 [Subject] => Review [Year] => 2023 [CiteUrl] => https://api.crossref.org/works/10.37349/emd.2023.00013 [Inline] => 1 [Type] => 1 [Issue] => 4 [Topic] => 119 [TitleAbbr] => Explor Musculoskeletal Dis. [Pages] => 2023;1:84–96 [Recommend] => 0 [Keywords] => Diffuse idiopathic skeletal hyperostosis, surgical approach, surgical technique, surgical management, surgical complications, vertebral fracture, dysphagia [DetailTitle] => Diffuse Idiopathic Skeletal Hyperostosis- A common but neglected disease [DetailUrl] => https://www.explorationpub.com/Journals/emd/Special_Issues/119 [Id] => 100713 [ris] => https://www.explorationpub.com/uploads/Article/A100713/13fd5a643e92e74c56304de846844f0a.ris [bib] => https://www.explorationpub.com/uploads/Article/A100713/f28b37966bb50d23061003a209e98772.bib [ens] => [Cited] => 1 [Cited_Time] => 2024-04-26 [CitethisArticle] => Harlianto NI, Kuperus JS, Verlaan JJ. Perioperative management, operative techniques, and pitfalls in the surgical treatment of patients with diffuse idiopathic skeletal hyperostosis: a narrative review. Explor Musculoskeletal Dis. 2023;1:84–96. https://doi.org/10.37349/emd.2023.00013 [Jindex] => 0 [CName] => [CEmail] => [Ris_Time] => 2023-08-26 05:11:40 [Bib_Time] => 2023-08-26 05:11:40 [KeysWordContens] => Perioperative management, operative techniques, and pitfalls in the surgical treatment of patients with diffuse idiopathic skeletal hyperostosis: a narrative review, Diffuse idiopathic skeletal hyperostosis, surgical approach, surgical technique, surgical management, surgical complications, vertebral fracture, dysphagia, Diffuse idiopathic skeletal hyperostosis (DISH) can lead to dysphagia, airway obstruction, and unstable vertebral fractures. Surgery can be performed to relieve cervical compression or stabilize fractures of the spinal column, with or without decompression of spinal cord injuries. In this review, the peri-operative surgical techniques in cases with DISH are discussed, as well as the pre-operative and post-operative pearls and pitfalls. It is essential for spine surgeons, including orthopedic surgeons and neurosurgeons, to be aware of the considerations, anticipations, and approaches for the management of dysphagia, airway obstruction, and fractures in DISH patients in order to improve patient outcomes for this specific at-risk patient population. ,Netanja I. Harlianto ... Jorrit-Jan Verlaan [PublishedText] => Published [IsEdit] => 0 [AccountId] => 76 [Zh] => 1 ) [14] => Array ( [ArticleId] => 730 [Create_Time] => 2023-08-30 [zipUrl] => https://www.explorationpub.com/uploads/zip/202308/20230831011903.zip [xmlUrl] => https://www.explorationpub.com/uploads/Article/A100714/100714.xml [pdfUrl] => https://www.explorationpub.com/uploads/Article/A100714/100714.pdf [coverUrl] => https://www.explorationpub.com/uploads/Article/A100714/100714_cover.png [JournalsId] => 9 [Title] => Real-life results of urate-driven pharmacotherapy with three urate lowering drugs in gout: allopurinol, febuxostat and benzbromarone [Abstract] => Aim: This study aims to assess outcomes of gout patients from the treat to target (T2T) perspective at 6 months and 12 months while using urate lowering therapy (ULT): allopurinol, febuxostat, an [AbstractComplete] =>This study aims to assess outcomes of gout patients from the treat to target (T2T) perspective at 6 months and 12 months while using urate lowering therapy (ULT): allopurinol, febuxostat, and/or benzbromarone.
All gout patients visiting the Rheumatology department between 2015 to 2021 were identified from the digital hospital system. The diagnosis of gout was based on the American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) 2015 classification criteria. Patient outcomes were predefined intention to treat (ITT) categories: category 1: patients with serum uric acid (sUA) ≤ 0.360 mmol/L (ACR target for gout); category 2: patients with sUA ≤ 0.300 mmol/L (ACR/EULAR target for severe gout); category 3: patients with sUA > 0.360 (failure to meet ACR target).
Gout diagnoses were present in 1,186 patients: 986 (83.1%) males and 200 (16.9%) females. A follow-visit at 6 months was present in 76.9% (n = 856) out of 1,113 patients reaching sUA < 0.36 mmol/L, but 257 (23%) failed to reach the 0.36 mmol/L target. At 12 months, a follow-up visit was available in 792 (71.1%) patients, and from these, 710 (90%) had reached sUA < 0.36 mmol/L target. The use of benzbromarone was a strong predictor of reaching the sUA < 0.30 mmol/L target: odds ratio (OR) 3.2, 95% confidence interval (CI) (1.735, 6.017) at 6 months. Diabetic patients had the highest proportion of not reaching the target: 18%. Male patients needed higher dosages of allopurinol to reach the sUA target at 6 months compared to female patients.
This is a large study on a T2T approach based in a real-life clinical setting. Only 42% reached the sUA target at 6 months with allopurinol 300 mg quaque die (QD) monotherapy. About 77% of gout patients reach the predefined sUA target of 0.36 mmol/L at 6 months with the availability of three ULTs. There is still a significant unmet need in gout as many patients failed to achieve predefined sUA targets.
Hyperuricemia is known to be a necessary and causal condition for gout, but much more prevalent than gout. Medicine has standardized treatments for gout, but has no such determination for asymptomatic hyperuricemia. Nevertheless, people with hyperuricemia, gouty or not, too often continue to be at risk for shortened lifespans from life-threatening comorbidities, all of which are known to be consequences of obstructive sleep apnea (OSA), which is shown herein to cause most hyperuricemia. This review also presents the wide variety of OSA consequences, many of which are irreversible and life-threatening, as the rationale for treating all hyperuricemia (gouty and asymptomatic) by diagnostic testing and effective treatment for OSA as soon as hyperuricemia is detected. It advocates frequent ultrasonic screening for aggregated urate crystals. Multiple epidemiological studies have found OSA to be significantly more prevalent in those people with gout diagnosed with OSA than it is in those never diagnosed with it. A clinical study shows an even higher prevalence of OSA in people with gout. The pathophysiology of hypoxia from OSA explains how it would lead to both the overproduction and the underexcretion of uric acid, leading to hyperuricemia and the precipitation of monosodium urate crystals which cause a gout flare. Resolving OSA has been shown to prevent or even reverse life-threatening diseases that are recognized comorbidities of hyperuricemia and gout, and can prevent further gout flares. In order to extend the length and quality of life of people with gout or hyperuricemia, when either first manifests a patient sleep study is recommended, followed by effective OSA treatment as warranted.
[Names] => Burton Abrams [Doi] => 10.37349/emd.2023.00015 [Published] => August 31, 2023 [Viewed] => 1035 [Downloaded] => 29 [Subject] => Review [Year] => 2023 [CiteUrl] => https://api.crossref.org/works/10.37349/emd.2023.00015 [Inline] => 1 [Type] => 1 [Issue] => 4 [Topic] => 189 [TitleAbbr] => Explor Musculoskeletal Dis. [Pages] => 2023;1:106–120 [Recommend] => 0 [Keywords] => Gout, hyperuricemia, sleep apnea, hypoxia, urate, metabolic comorbidities, ultrasonic [DetailTitle] => Hyperuricemia current state and prospects [DetailUrl] => https://www.explorationpub.com/Journals/emd/Special_Issues/189 [Id] => 100715 [ris] => https://www.explorationpub.com/uploads/Article/A100715/717e108a8f5170f8c9d45c7fcc0b5e8b.ris [bib] => https://www.explorationpub.com/uploads/Article/A100715/0783a178ad037c5c2fbf7adb36e5ff9b.bib [ens] => [Cited] => 0 [Cited_Time] => [CitethisArticle] => Abrams B. Premature mortality with gout and hyperuricemia may be reduced by early resolution of comorbid obstructive sleep apnea. Explor Musculoskeletal Dis. 2023;1:106–20. https://doi.org/10.37349/emd.2023.00015 [Jindex] => 0 [CName] => [CEmail] => [Ris_Time] => 2023-08-31 07:59:47 [Bib_Time] => 2023-08-31 07:59:47 [KeysWordContens] => Premature mortality with gout and hyperuricemia may be reduced by early resolution of comorbid obstructive sleep apnea, Gout, hyperuricemia, sleep apnea, hypoxia, urate, metabolic comorbidities, ultrasonic, Hyperuricemia is known to be a necessary and causal condition for gout, but much more prevalent than gout. Medicine has standardized treatments for gout, but has no such determination for asymptomatic hyperuricemia. Nevertheless, people with hyperuricemia, gouty or not, too often continue to be at risk for shortened lifespans from life-threatening comorbidities, all of which are known to be consequences of obstructive sleep apnea (OSA), which is shown herein to cause most hyperuricemia. This review also presents the wide variety of OSA consequences, many of which are irreversible and life-threatening, as the rationale for treating all hyperuricemia (gouty and asymptomatic) by diagnostic testing and effective treatment for OSA as soon as hyperuricemia is detected. It advocates frequent ultrasonic screening for aggregated urate crystals. Multiple epidemiological studies have found OSA to be significantly more prevalent in those people with gout diagnosed with OSA than it is in those never diagnosed with it. A clinical study shows an even higher prevalence of OSA in people with gout. The pathophysiology of hypoxia from OSA explains how it would lead to both the overproduction and the underexcretion of uric acid, leading to hyperuricemia and the precipitation of monosodium urate crystals which cause a gout flare. Resolving OSA has been shown to prevent or even reverse life-threatening diseases that are recognized comorbidities of hyperuricemia and gout, and can prevent further gout flares. In order to extend the length and quality of life of people with gout or hyperuricemia, when either first manifests a patient sleep study is recommended, followed by effective OSA treatment as warranted. ,Burton Abrams [PublishedText] => Published [IsEdit] => 0 [AccountId] => 57 [Zh] => 1 ) [16] => Array ( [ArticleId] => 839 [Create_Time] => 2023-10-23 [zipUrl] => https://www.explorationpub.com/uploads/zip/202310/20231023063251.zip [xmlUrl] => https://www.explorationpub.com/uploads/Article/A100718/100718.xml [pdfUrl] => https://www.explorationpub.com/uploads/Article/A100718/100718.pdf [coverUrl] => https://www.explorationpub.com/uploads/Article/A100718/100718_cover.png [JournalsId] => 9 [Title] => Genetic basis for skeletal new bone formation [Abstract] => Bone formation is a complex process that occurs throughout life, and is normally limited to the skeletal system. In bone formation, osteoprogenitor cells follow several developmental stages, includi [AbstractComplete] =>Bone formation is a complex process that occurs throughout life, and is normally limited to the skeletal system. In bone formation, osteoprogenitor cells follow several developmental stages, including differentiation in osteoblasts, proliferation, matrix maturation, and mineralization. The mechanisms involved in the mineralization process of bone, such as in the new bone formation, are extremely complex and have been under intense investigation for many years. Bone formation follows two distinct processes, intramembranous and endochondral ossification; both are regulated by signaling pathways involving numerous genes. Disturbance of these signaling pathways may cause a large spectrum of skeletal diseases characterized by new bone formation and bone growth anomalies. This review will only focus on the key genetic pathways involved in heterotopic bone formation. Wingless/integrated (Wnt), hedgehog (HH), and transforming growth factor beta (TGFβ)/bone morphogenetic protein (BMP) signaling pathways are described and illustrated; their relation with new bone formation is demonstrated through their involvement in bone formation disorders.
[Names] => Bruna Parreira ... Jácome Bruges-Armas [Doi] => 10.37349/emd.2023.00018 [Published] => October 23, 2023 [Viewed] => 694 [Downloaded] => 26 [Subject] => Review [Year] => 2023 [CiteUrl] => https://api.crossref.org/works/10.37349/emd.2023.00018 [Inline] => 1 [Type] => 1 [Issue] => 5 [Topic] => 119 [TitleAbbr] => Explor Musculoskeletal Dis. [Pages] => 2023;1:143–170 [Recommend] => 0 [Keywords] => Bone, genetics, genes, pathways, wingless/integrated, hedgehog, transforming growth factor beta-bone morphogenetic protein [DetailTitle] => Diffuse Idiopathic Skeletal Hyperostosis- A common but neglected disease [DetailUrl] => https://www.explorationpub.com/Journals/emd/Special_Issues/119 [Id] => 100718 [ris] => https://www.explorationpub.com/uploads/Article/A100718/c4330634a8b7ac4f21db2a3375667dab.ris [bib] => https://www.explorationpub.com/uploads/Article/A100718/3e2801aae1d7f4100f193509cad77875.bib [ens] => [Cited] => 0 [Cited_Time] => [CitethisArticle] => Parreira B, Couto AR, Pinheiro L, Bruges-Armas J. Genetic basis for skeletal new bone formation. Explor Musculoskeletal Dis. 2023;1:143–70. https://doi.org/10.37349/emd.2023.00018 [Jindex] => 0 [CName] => [CEmail] => [Ris_Time] => 2023-10-12 05:30:50 [Bib_Time] => 2023-10-12 05:30:50 [KeysWordContens] => Genetic basis for skeletal new bone formation, Bone, genetics, genes, pathways, wingless/integrated, hedgehog, transforming growth factor beta-bone morphogenetic protein, Bone formation is a complex process that occurs throughout life, and is normally limited to the skeletal system. In bone formation, osteoprogenitor cells follow several developmental stages, including differentiation in osteoblasts, proliferation, matrix maturation, and mineralization. The mechanisms involved in the mineralization process of bone, such as in the new bone formation, are extremely complex and have been under intense investigation for many years. Bone formation follows two distinct processes, intramembranous and endochondral ossification; both are regulated by signaling pathways involving numerous genes. Disturbance of these signaling pathways may cause a large spectrum of skeletal diseases characterized by new bone formation and bone growth anomalies. This review will only focus on the key genetic pathways involved in heterotopic bone formation. Wingless/integrated (Wnt), hedgehog (HH), and transforming growth factor beta (TGFβ)/bone morphogenetic protein (BMP) signaling pathways are described and illustrated; their relation with new bone formation is demonstrated through their involvement in bone formation disorders. ,Bruna Parreira ... Jácome Bruges-Armas [PublishedText] => Published [IsEdit] => 0 [AccountId] => 55 [Zh] => 1 ) [17] => Array ( [ArticleId] => 824 [Create_Time] => 2023-09-28 [zipUrl] => https://www.explorationpub.com/uploads/zip/202309/20230928010314.zip [xmlUrl] => https://www.explorationpub.com/uploads/Article/A100716/100716.xml [pdfUrl] => https://www.explorationpub.com/uploads/Article/A100716/100716.pdf [coverUrl] => https://www.explorationpub.com/uploads/Article/A100716/100716_cover.png [JournalsId] => 9 [Title] => Prevalence and factors associated to diffuse idiopathic skeletal hyperostosis in gout [Abstract] => Aim: To evaluate the prevalence, associated factors, and the impact of diffuse idiopathic skeletal hyperostosis (DISH) in patients with gout. Methods: Patients with gout entering into an in [AbstractComplete] =>To evaluate the prevalence, associated factors, and the impact of diffuse idiopathic skeletal hyperostosis (DISH) in patients with gout.
Patients with gout entering into an inception cohort were evaluated for either spinal or peripheral hyperostosis from January 2022 to April 2023. Age, gender, along with comorbid conditions associated to gout and DISH were analyzed, including the presence either axial or peripheral hyperostosis and associated calcium pyrophosphate arthritis (CPPA).
The prevalence of DISH was 25.6% (31/121) patients, neat peripheral joint hyperostosis affecting 51.6% (16/31). CPPA was also present in 11.6% (14/121) patients. Only older age and male gender were independently associated to the presence of DISH. The presence of hyperostosis in peripheral joints was not associated to a worse initial evaluation of the severity of gout.
The presence of DISH in patients with gout seems to be related mostly to aging. Conditions apparently associated to DISH in gout patients seem therefore to be related to aging.
Rheumatoid arthritis (RA) is a chronic immune-mediated inflammatory disease of unknown origin. Although it mainly affects joints, it can have extra-articular manifestations, with the lung being one of the most affected organs. The estimated incidence of diffuse interstitial lung disease (ILD) is 4 cases to 4.5 cases/1000 patient-years. The most common forms are usual interstitial pneumonia (UIP) and nonspecific interstitial pneumonia (NSIP; 44–46% and 33–44%, respectively), although there have been reports of cases involving all the histopathologic forms described for the disease. RA-ILD is associated with specific risk factors, such as male sex, older age, smoking, and positive rheumatoid factor (RF) and anti-citrullinated peptide antibody (ACPA) levels. The clinical course of ILD ranges from asymptomatic forms to rapidly progressive disease in a minority of cases. It has been estimated that the risk of death is up to 3-fold higher in patients with RA-ILD than in those without ILD, making RA-ILD the second most common cause of death after cardiovascular disease. Treatment of RA has improved considerably in recent years with the advent of biologics; however, the use of these agents has been restricted in patients with ILD owing to safety concerns. Many doubts continue to surround the treatment of patients with RA-ILD. Therefore, the objective of this review is to examine the current management of affected patients in terms of diagnosis, treatment, and follow-up.
[Names] => Gloria Candelas Rodríguez, Virginia Villaverde [Doi] => 10.37349/emd.2023.00017 [Published] => October 20, 2023 [Viewed] => 748 [Downloaded] => 41 [Subject] => Review [Year] => 2023 [CiteUrl] => https://api.crossref.org/works/10.37349/emd.2023.00017 [Inline] => 1 [Type] => 1 [Issue] => 5 [Topic] => 141 [TitleAbbr] => Explor Musculoskeletal Dis. [Pages] => 2023;1:128–142 [Recommend] => 0 [Keywords] => Rheumatoid arthritis, interstitial lung disease, management [DetailTitle] => Comorbidities in rheumatoid arthritis [DetailUrl] => https://www.explorationpub.com/Journals/emd/Special_Issues/141 [Id] => 100717 [ris] => https://www.explorationpub.com/uploads/Article/A100717/8f51c37e258d259b6fc17d7f9eead5f4.ris [bib] => https://www.explorationpub.com/uploads/Article/A100717/2ee92cb99e989df3670af7d623266f4b.bib [ens] => [Cited] => 0 [Cited_Time] => [CitethisArticle] => Rodríguez GC, Villaverde V. Interstitial lung disease in patients with rheumatoid arthritis: a narrative review. Explor Musculoskeletal Dis. 2023;1:128–42. https://doi.org/10.37349/emd.2023.00017 [Jindex] => 0 [CName] => [CEmail] => [Ris_Time] => 2023-10-11 08:37:24 [Bib_Time] => 2023-10-11 08:37:24 [KeysWordContens] => Interstitial lung disease in patients with rheumatoid arthritis: a narrative review, Rheumatoid arthritis, interstitial lung disease, management, Rheumatoid arthritis (RA) is a chronic immune-mediated inflammatory disease of unknown origin. Although it mainly affects joints, it can have extra-articular manifestations, with the lung being one of the most affected organs. The estimated incidence of diffuse interstitial lung disease (ILD) is 4 cases to 4.5 cases/1000 patient-years. The most common forms are usual interstitial pneumonia (UIP) and nonspecific interstitial pneumonia (NSIP; 44–46% and 33–44%, respectively), although there have been reports of cases involving all the histopathologic forms described for the disease. RA-ILD is associated with specific risk factors, such as male sex, older age, smoking, and positive rheumatoid factor (RF) and anti-citrullinated peptide antibody (ACPA) levels. The clinical course of ILD ranges from asymptomatic forms to rapidly progressive disease in a minority of cases. It has been estimated that the risk of death is up to 3-fold higher in patients with RA-ILD than in those without ILD, making RA-ILD the second most common cause of death after cardiovascular disease. Treatment of RA has improved considerably in recent years with the advent of biologics; however, the use of these agents has been restricted in patients with ILD owing to safety concerns. Many doubts continue to surround the treatment of patients with RA-ILD. Therefore, the objective of this review is to examine the current management of affected patients in terms of diagnosis, treatment, and follow-up. ,Gloria Candelas Rodríguez, Virginia Villaverde [PublishedText] => Published [IsEdit] => 0 [AccountId] => 55 [Zh] => 1 ) [19] => Array ( [ArticleId] => 867 [Create_Time] => 2023-10-31 [zipUrl] => https://www.explorationpub.com/uploads/zip/202310/20231031083933.zip [xmlUrl] => https://www.explorationpub.com/uploads/Article/A100719/100719.xml [pdfUrl] => https://www.explorationpub.com/uploads/Article/A100719/100719.pdf [coverUrl] => https://www.explorationpub.com/uploads/Article/A100719/100719_cover.png [JournalsId] => 9 [Title] => Lessons to be learned from real life data based on 98 gout patients using benzbromarone [Abstract] => Aim: This study aims to analyze the efficacy and safety of benzbromarone as uricosuric, in a real-life clinical setting of a retrospective hospital-based gout cohort. Methods: Data from gou [AbstractComplete] =>This study aims to analyze the efficacy and safety of benzbromarone as uricosuric, in a real-life clinical setting of a retrospective hospital-based gout cohort.
Data from gout patients were retrieved from the digital hospital dossiers. Demographics, clinical variables, and laboratory parameters were collected at baseline and 6 months. Efficacy was measured by reaching a serum uric acid (sUA) target < 0.30 mmol/L at 6 months, and the fractional excretion of uric acid (FeUA) was used as a parameter with a potential predictor value.
Data from 98 gout patients were analyzed. Patients were 70 (± 12) years of age, and 90% were male. After 6 months of treatment, 68 out of 98 patients (69%) reached a sUA level < 0.30 mmol/L (5 mg/dL). In patients with a FeUA < 4.5%, so-called low excretors, the FeUA increase was most impressive from 3.2% (± 1.0%) to 12.1% (± 6.9%) after 6 months of benzbromarone treatment (mean increase +8.9% [95% confidence interval (CI): +6.5 to +11.5%], P < 0.001). In non-low excretors, FeUA was on average 7.3% (± 5.1%) and increased to 9.7% (± 6.1%): a mean +2.1% change (95% CI: –2.2 to +6.6%). The increase differed insignificantly in low versus non-low excretors: P > 0.05. Four patients stopped benzbromarone treatment because of a progressive decline in renal function, a condition that was already present before benzbromarone was initiated. Remarkably 38% of patients is still using benzbromarone after 3.8 (± 3.4) years of treatment.
Using the uricosuric benzbromarone in real-life gout patients proved effectivity in lowering sUA levels within 6 months by increasing FeUA significantly. Particularly low excretors benefit from benzbromarone treatment manipulating this mode of action. Determining FeUA in gout patients may further help to find the patient profile benefiting the most from benzbromarone treatment.
Rheumatoid arthritis (RA) is an inflammatory arthritis that affects synovial joints, and it is not surprising that the temporomandibular joint (TMJ), a synovial joint, is also affected. However, TMJ is rarely the first affected joint in the course of RA. Often, RA patients come to the physician with more focus on complaints in other peripheral joints. Therefore, asking TMJ complaints and symptoms, and TMJ examination in RA patients is often neglected by doctors too, because they focus more on other joints. This neglect may cause serious damage to the joints and cause disability. Examination of TMJs, which is a crucial component of vital activities such as nutrition and speech, should be added to the routine. Also, further studies may be focused on adding TMJ assessment to disease activity scales and health assessment questionnaires.
[Names] => Manolya Ilhanli, Ilker Ilhanli [Doi] => 10.37349/emd.2023.00020 [Published] => October 31, 2023 [Viewed] => 398 [Downloaded] => 13 [Subject] => Perspective [Year] => 2023 [CiteUrl] => https://api.crossref.org/works/10.37349/emd.2023.00020 [Inline] => 1 [Type] => 1 [Issue] => 5 [Topic] => 141 [TitleAbbr] => Explor Musculoskeletal Dis. [Pages] => 2023;1:180–185 [Recommend] => 0 [Keywords] => Disability, malnutrition, obesity, rheumatoid arthritis, temporomandibular joint [DetailTitle] => Comorbidities in rheumatoid arthritis [DetailUrl] => https://www.explorationpub.com/Journals/emd/Special_Issues/141 [Id] => 100720 [ris] => https://www.explorationpub.com/uploads/Article/A100720/c1f8099be3796f8f29f49e1ccd1df850.ris [bib] => https://www.explorationpub.com/uploads/Article/A100720/72096718d46a0fb1821a4d90285b07a7.bib [ens] => [Cited] => 0 [Cited_Time] => [CitethisArticle] => Ilhanli M, Ilhanli I. Nutritional problems in rheumatoid arthritis patients with temporomandibular joint involvement. Explor Musculoskeletal Dis. 2023;1:180–5. https://doi.org/10.37349/emd.2023.00020 [Jindex] => 0 [CName] => [CEmail] => [Ris_Time] => 2023-10-26 05:27:37 [Bib_Time] => 2023-10-26 05:27:37 [KeysWordContens] => Nutritional problems in rheumatoid arthritis patients with temporomandibular joint involvement, Disability, malnutrition, obesity, rheumatoid arthritis, temporomandibular joint, Rheumatoid arthritis (RA) is an inflammatory arthritis that affects synovial joints, and it is not surprising that the temporomandibular joint (TMJ), a synovial joint, is also affected. However, TMJ is rarely the first affected joint in the course of RA. Often, RA patients come to the physician with more focus on complaints in other peripheral joints. Therefore, asking TMJ complaints and symptoms, and TMJ examination in RA patients is often neglected by doctors too, because they focus more on other joints. This neglect may cause serious damage to the joints and cause disability. Examination of TMJs, which is a crucial component of vital activities such as nutrition and speech, should be added to the routine. Also, further studies may be focused on adding TMJ assessment to disease activity scales and health assessment questionnaires. ,Manolya Ilhanli, Ilker Ilhanli [PublishedText] => Published [IsEdit] => 0 [AccountId] => 87 [Zh] => 1 ) [21] => Array ( [ArticleId] => 892 [Create_Time] => 2023-11-01 [zipUrl] => https://www.explorationpub.com/uploads/zip/202311/20231101002451.zip [xmlUrl] => https://www.explorationpub.com/uploads/Article/A100721/100721.xml [pdfUrl] => https://www.explorationpub.com/uploads/Article/A100721/100721.pdf [coverUrl] => https://www.explorationpub.com/uploads/Article/A100721/100721_cover.png [JournalsId] => 9 [Title] => Association of mutations in hemochromatosis genes with clinical severity of calcium pyrophosphate arthritis [Abstract] => Aims: To study factors associated with the development of calcium pyrophosphate (CPP) arthritis and the severity phenotype. Methods: Transversal case-control study. Cases had to be confirme [AbstractComplete] =>To study factors associated with the development of calcium pyrophosphate (CPP) arthritis and the severity phenotype.
Transversal case-control study. Cases had to be confirmed by both X-ray chondrocalcinosis and CPP crystals in synovial fluid. Controls had neither chondrocalcinosis nor CPP crystals in synovial fluid. Patients and controls with hemochromatosis or primary hyperparathyroidism were not included. Mutations of hemochromatosis genes (HFE), magnesium (Mg), calcium (Ca), phosphate, iron (Fe), transferrin saturation, ferritin, parathyroid hormone (PTH), and calcifediol levels were studied.
Three hundred patients and 300 sex and age matched controls were compared. Lower serum Mg (sMg) and higher ferritin levels were found among patients. Hypomagnesemia (HypoMg) and HFE mutations were more frequent among patients. Involvement of over one joint was observed in 199 (66.4%) patients whereas persistent joint inflammation was retrieved in 154 (51.4%) of the patients. Initial analysis showed that the frequency of polyarticular and inflammatory phenotypes seemed to be progressively overrepresented in patients with HFE mutations. Further bivariate and multivariate analysis adjusted for the time from onset disclosed that the presence of genotypes with C282Y mutations was associated with polyarticular disease (hazard risk 3.501, 95% confidence interval 1.862–6.581, P < 0.001). Although C282Y mutations also seemed to be associated with inflammatory patterns, the association did not reach statistical significance (P = 0.173).
Low sMg and high ferritin levels are associated with CPP arthritis (CPPA). In patients without hemochromatosis, HFE mutations, and specifically C282Y mutations seem to associate with the polyarticular disease phenotype, and plausibly with the chronic inflammatory phenotype.
Diffuse idiopathic skeletal hyperostosis (DISH) and axial spondyloarthritis (axSpA) are diseases with inflammatory involvement of the axial skeleton that can result in new bone formation that may lead to total ankylosis of the spine and functional impairment of different extent in individual patients. In these diseases, the new bone formation may lead to total ankylosis of the spine and impaired mobility with functional impairment. This review will highlight the similarities and differences of these two conditions. In axSpA, the genetic background with the association with human leukocyte antigen-B27 (HLA-B27) is known for 50 years, while in DISH, a genetic contribution is not yet proven. The phenotype of new bone formation and its anatomic features are different between these diseases. In axSpA symmetric, thin and marginal syndesmophytes representing an ossification of enthesitic inflammation at the area of the attachment of the annulus fibrosus that may extend to the adjacent deeper layers anterior longitudinal ligament and are typical, while in DISH the so-called “chunky bridging osteophytes” grow as an additional layer on the anterior longitudinal ligament. Besides distinct anamnestic and clinical features, magnetic resonance imaging is helpful differentiating the two diseases since inflammatory changes with the typical pattern of axSpA are reliably visualized. Similar in both diseases is the high prevalence of vertebral fractures, which are mainly caused by the local osteoporosis and decreased flexibility of the affected bones, and therefore may occur even after minor traumata. The presence of extraarticular manifestations like uveitis, inflammatory bowel disease or psoriasis are only linked to axSpA. In contrast, DISH is associated with obesity, diabetes mellitus, and other metabolic diseases. Although DISH and axSpA are distinct conditions, the cooccurrence of these two diseases exists in some patients. Various therapeutic options are becoming available for axSpA, but no therapy has been approved for DISH yet.
[Names] => David Kiefer ... Xenofon Baraliakos [Doi] => 10.37349/emd.2023.00022 [Published] => November 20, 2023 [Viewed] => 659 [Downloaded] => 25 [Subject] => Review [Year] => 2023 [CiteUrl] => https://api.crossref.org/works/10.37349/emd.2023.00022 [Inline] => 1 [Type] => 1 [Issue] => 6 [Topic] => 119 [TitleAbbr] => Explor Musculoskeletal Dis. [Pages] => 2023;1:194–206 [Recommend] => 0 [Keywords] => Diffuse idiopathic skeletal hyperostosis, ankylosing spondylitis, axial spondyloarthritis, enthesopathies, syndesmophytes [DetailTitle] => Diffuse Idiopathic Skeletal Hyperostosis- A common but neglected disease [DetailUrl] => https://www.explorationpub.com/Journals/emd/Special_Issues/119 [Id] => 100722 [ris] => https://www.explorationpub.com/uploads/Article/A100722/e395aff80eb9e53a134d06d7097abb30.ris [bib] => https://www.explorationpub.com/uploads/Article/A100722/714a31e2f6d956cb651ede96ea2bbf29.bib [ens] => [Cited] => 0 [Cited_Time] => [CitethisArticle] => Kiefer D, Khan MA, Baraliakos X. Diffuse idiopathic skeletal hyperostosis and axial spondyloarthritis—similarities and differences. Explor Musculoskeletal Dis. 2023;1:194–206. https://doi.org/10.37349/emd.2023.00022 [Jindex] => 0 [CName] => [CEmail] => [Ris_Time] => 2023-11-13 06:12:50 [Bib_Time] => 2023-11-13 06:12:50 [KeysWordContens] => Diffuse idiopathic skeletal hyperostosis and axial spondyloarthritis—similarities and differences, Diffuse idiopathic skeletal hyperostosis, ankylosing spondylitis, axial spondyloarthritis, enthesopathies, syndesmophytes, Diffuse idiopathic skeletal hyperostosis (DISH) and axial spondyloarthritis (axSpA) are diseases with inflammatory involvement of the axial skeleton that can result in new bone formation that may lead to total ankylosis of the spine and functional impairment of different extent in individual patients. In these diseases, the new bone formation may lead to total ankylosis of the spine and impaired mobility with functional impairment. This review will highlight the similarities and differences of these two conditions. In axSpA, the genetic background with the association with human leukocyte antigen-B27 (HLA-B27) is known for 50 years, while in DISH, a genetic contribution is not yet proven. The phenotype of new bone formation and its anatomic features are different between these diseases. In axSpA symmetric, thin and marginal syndesmophytes representing an ossification of enthesitic inflammation at the area of the attachment of the annulus fibrosus that may extend to the adjacent deeper layers anterior longitudinal ligament and are typical, while in DISH the so-called “chunky bridging osteophytes” grow as an additional layer on the anterior longitudinal ligament. Besides distinct anamnestic and clinical features, magnetic resonance imaging is helpful differentiating the two diseases since inflammatory changes with the typical pattern of axSpA are reliably visualized. Similar in both diseases is the high prevalence of vertebral fractures, which are mainly caused by the local osteoporosis and decreased flexibility of the affected bones, and therefore may occur even after minor traumata. The presence of extraarticular manifestations like uveitis, inflammatory bowel disease or psoriasis are only linked to axSpA. In contrast, DISH is associated with obesity, diabetes mellitus, and other metabolic diseases. Although DISH and axSpA are distinct conditions, the cooccurrence of these two diseases exists in some patients. Various therapeutic options are becoming available for axSpA, but no therapy has been approved for DISH yet. ,David Kiefer ... Xenofon Baraliakos [PublishedText] => Published [IsEdit] => 0 [AccountId] => 76 [Zh] => 1 ) [23] => Array ( [ArticleId] => 935 [Create_Time] => 2023-11-20 [zipUrl] => https://www.explorationpub.com/uploads/zip/202311/20231120080957.zip [xmlUrl] => https://www.explorationpub.com/uploads/Article/A100723/100723.xml [pdfUrl] => https://www.explorationpub.com/uploads/Article/A100723/100723.pdf [coverUrl] => https://www.explorationpub.com/uploads/Article/A100723/100723_cover.png [JournalsId] => 9 [Title] => Relationship between tendon elastography and clinical and ultrasound enthesitis scores in patients with psoriasis or psoriatic arthritis [Abstract] => Aim: To determine the existence of a correlation between the elastographic study of the patellar and Achilles tendons and the enthesis evaluation in patients with psoriasis with or without psoria [AbstractComplete] =>To determine the existence of a correlation between the elastographic study of the patellar and Achilles tendons and the enthesis evaluation in patients with psoriasis with or without psoriatic arthritis.
Observational, cross-sectional study. Patients with psoriasis, psoriatic arthritis and healthy controls were included. The elastography results of the patellar and Achilles tendons of the non-dominant leg of the three groups were compared and tested for correlation with the Madrid Sonographic Enthesis Index (MASEI) score, as well as an entheses clinical evaluation score [Spondyloarthritis Research Consortium of Canada (SPARCC)].
Forty-eight patients were included, 24 with psoriasis and 24 with psoriatic arthritis, as well as 48 healthy controls. Patients with psoriatic arthritis had a higher clinical enthesitis score than patients with psoriasis (8.0 vs. 1.0, P < 0.001). The mean (standard deviation) or median (25–75 percentile) of control subjects patellar and Achilles’ tendon stiffness, 127.8 kPa (18.5 kPa) and 198.0 kPa (183.2–212.0 kPa) were significantly higher than observed in patients with psoriatic arthritis, 119.2 kPa (19.7 kPa) and 184.8 kPa (175.5–193.9 kPa; P < 0.001 and P = 0.018, respectively). A strong inverse correlation between MASEI score and the patellar and Achilles’ tendon stiffness was also detected (Spearman’s Rho coefficient of –0.813 and –0.941, respectively).
Patients with psoriatic arthritis present less stiffness in those load-bearing tendons than healthy controls. There is an inverse correlation between the enthesis involvement demonstrated by ultrasound and the elastography of these tendons. Tendon elastography can be considered a useful quantitative tool in assessing patients with psoriatic disease.
It has been suggested that diffuse idiopathic skeletal hyperostosis (DISH), a skeletal disease characterized by the ligamentous ossification of the anterolateral spine, is a radiological entity with no clinical implications; however, many patients suffer from chronic back pain, decreased spinal mobility, and postural abnormalities. Additionally, the pathological new bone formation at the cervical and thoracic levels may mainly produce dysphagia and breathing disturbances. Over the last 20 years, a close association between DISH, obesity, diabetes mellitus (DM), and metabolic syndrome (MS) has emerged. However, a causal relationship has not yet been established. It has been suggested that the longer life expectancy and the growing incidence of MS in Western populations, associated with the tendency of DISH to manifest in later life, may increase the DISH prevalence rates in the following decades. Future investigations should focus on the early DISH phase to clarify pathogenetic mechanisms and identify targeted therapies.
[Names] => Fabiola Atzeni ... Reuven Mader [Doi] => 10.37349/emd.2023.00024 [Published] => December 04, 2023 [Viewed] => 893 [Downloaded] => 14 [Subject] => Review [Year] => 2023 [CiteUrl] => https://api.crossref.org/works/10.37349/emd.2023.00024 [Inline] => 1 [Type] => 1 [Issue] => 6 [Topic] => 119 [TitleAbbr] => Explor Musculoskeletal Dis. [Pages] => 2023;1:216–227 [Recommend] => 0 [Keywords] => Diffuse idiopathic skeletal hyperostosis, cardiovascular disease, diagnostic criteria, extra-spinal involvement, metabolic syndrome [DetailTitle] => Diffuse Idiopathic Skeletal Hyperostosis- A common but neglected disease [DetailUrl] => https://www.explorationpub.com/Journals/emd/Special_Issues/119 [Id] => 100724 [ris] => https://www.explorationpub.com/uploads/Article/A100724/af9a118bfc75772ae02996fda827fb38.ris [bib] => https://www.explorationpub.com/uploads/Article/A100724/d1724f0752bc08457baecc69d260a501.bib [ens] => [Cited] => 0 [Cited_Time] => [CitethisArticle] => Atzeni F, Alciati A, Brikman S, Mader R. Diffuse idiopathic skeletal hyperostosis, beyond the musculoskeletal system. Explor Musculoskeletal Dis. 2023;1:216–27. https://doi.org/10.37349/emd.2023.00024 [Jindex] => 0 [CName] => [CEmail] => [Ris_Time] => 2023-11-30 09:19:21 [Bib_Time] => 2023-11-30 09:19:21 [KeysWordContens] => Diffuse idiopathic skeletal hyperostosis, beyond the musculoskeletal system, Diffuse idiopathic skeletal hyperostosis, cardiovascular disease, diagnostic criteria, extra-spinal involvement, metabolic syndrome, It has been suggested that diffuse idiopathic skeletal hyperostosis (DISH), a skeletal disease characterized by the ligamentous ossification of the anterolateral spine, is a radiological entity with no clinical implications; however, many patients suffer from chronic back pain, decreased spinal mobility, and postural abnormalities. Additionally, the pathological new bone formation at the cervical and thoracic levels may mainly produce dysphagia and breathing disturbances. Over the last 20 years, a close association between DISH, obesity, diabetes mellitus (DM), and metabolic syndrome (MS) has emerged. However, a causal relationship has not yet been established. It has been suggested that the longer life expectancy and the growing incidence of MS in Western populations, associated with the tendency of DISH to manifest in later life, may increase the DISH prevalence rates in the following decades. Future investigations should focus on the early DISH phase to clarify pathogenetic mechanisms and identify targeted therapies. ,Fabiola Atzeni ... Reuven Mader [PublishedText] => Published [IsEdit] => 0 [AccountId] => 76 [Zh] => 1 ) [25] => Array ( [ArticleId] => 962 [Create_Time] => 2023-12-05 [zipUrl] => https://www.explorationpub.com/uploads/zip/202312/20231206090711.zip [xmlUrl] => https://www.explorationpub.com/uploads/Article/A100725/100725.xml [pdfUrl] => https://www.explorationpub.com/uploads/Article/A100725/100725.pdf [coverUrl] => https://www.explorationpub.com/uploads/Article/A100725/100725_Cover.png [JournalsId] => 9 [Title] => Impact of disease activity on patient-reported subjective cognitive decline in patients with rheumatoid arthritis [Abstract] => Aim: To evaluate the association of disease activity with patient-reported subjective cognitive decline (SCD) in patients with rheumatoid arthritis (RA) stratified by age. Methods: A cross- [AbstractComplete] =>To evaluate the association of disease activity with patient-reported subjective cognitive decline (SCD) in patients with rheumatoid arthritis (RA) stratified by age.
A cross-sectional analysis using data from the CorEvitas RA registry was utilized. The clinical disease activity index (CDAI) was used along with patient-reported problems thinking, age, and gender. The association of CDAI with patient-reported SCD was estimated using logistic regression models adjusted for sociodemographic characteristics, comorbidities, RA disease characteristics, and medication use. Additional models estimated and tested the moderating effect of patient age (< 55 years vs. ≥ 55 years).
A total of 3,041 out of 33,537 patients (9.1%), reported SCD with a mean CDAI of 16.2 [standard deviation (SD): 12.5] vs. 10.1 (SD: 10.8) in those who did not. The adjusted odds ratio (OR) for low, moderate, and severe disease activity vs. remission was 2.17 [95% confidence intervals (CI): 1.88–2.50], 3.25 (95% CI: 2.82–3.75), and 3.84 (95% CI: 3.29–4.48) respectively. Age had a moderating effect with the association of disease activity and self-reported SCD more prevalent in those aged < 55 years. The ORs for low, moderate, and severe disease activity were 3.37, 5.59, and 5.76 respectively for age < 55 vs. 1.90, 2.67, and 3.37 respectively for age ≥ 55 (P = 0.0001). The patient global component of CDAI displayed the highest OR of risk for SCD broken out by quartiles (1, 1.62, 2.80, and 4.55).
Increasing disease activity is associated with a higher likelihood of patient-reported SCD. The effect was more pronounced in younger RA patients and patients with a higher patient global score.
There is an increasing need for appropriate effective treatment and long-term disease control in patients with psoriasis because of the decreased quality of life, increased physicosocial deficits and associated co-morbidities. Systemic conventional treatments that are the first step in the management of moderate-to-severe plaque psoriasis include methotrexate (MTX), acitretin, cyclosporine and fumarates. MTX is considered the gold standard in the treatment of moderate-to-severe chronic plaque type psoriasis. It is also used to treat pustular psoriasis, erythrodermic psoriasis and psoriatic arthritis. Acitretin monotherapy is less effective than other conventional systemic treatments for plaque psoriasis, while superior to generalized, palmoplantar pustular, and hyperkeratotic variants. Cyclosporine is preferred in the presence of unstable acute clinical conditions (erythrodermic or generalized pustular psoriasis) and also in induction phase of rotational and sequential therapy for severe resistant psoriasis, due to its rapid effect. Dimethyl fumarate, which has similar efficacy to MTX, is an appropriate option in the induction and long-term systemic treatment for adult patients with moderate to severe plaque psoriasis without psoriatic arthritis. Although they are often overshadowed by biologics at the stage of preference by most physicians and patients today, they are classical and inexpensive agents with known long-term results. When the appropriate patient profile and psoriasis type are selected at the right time and necessary laboratory and clinical follow-ups are made, each of them is an effective treatment with reliable and satisfactory results. In this article, important points (recommendations according to patient characteristics, psoriasis type and comorbidities) to be considered in clinical practice when using the conventional anti-psoriatic agents in the treatment of psoriasis are overviewed.
[Names] => Sevgi Akarsu [Doi] => 10.37349/emd.2023.00026 [Published] => December 05, 2023 [Viewed] => 505 [Downloaded] => 9 [Subject] => Review [Year] => 2023 [CiteUrl] => https://api.crossref.org/works/10.37349/emd.2023.00026 [Inline] => 1 [Type] => 1 [Issue] => 6 [Topic] => 155 [TitleAbbr] => Explor Musculoskeletal Dis. [Pages] => 2023;1:241–256 [Recommend] => 0 [Keywords] => Psoriasis, conventional treatment, comorbidity, methotrexate, acitretin, cyclosporine, fumarates [DetailTitle] => Psoriatic disease: from the skin to the musculoskeletal system and beyond [DetailUrl] => https://www.explorationpub.com/Journals/emd/Special_Issues/155 [Id] => 100726 [ris] => https://www.explorationpub.com/uploads/Article/A100726/53f4536e461755e5340c3008199e2da8.ris [bib] => https://www.explorationpub.com/uploads/Article/A100726/77aafa6d5b2bc4850e8a09162d4a53ed.bib [ens] => [Cited] => 0 [Cited_Time] => [CitethisArticle] => Akarsu S. How should we do in the selection and follow-up of systemic conventional treatments in psoriasis? Explor Musculoskeletal Dis. 2023;1:241–56. https://doi.org/10.37349/emd.2023.00026 [Jindex] => 0 [CName] => [CEmail] => [Ris_Time] => 2023-11-30 09:46:36 [Bib_Time] => 2023-11-30 09:46:36 [KeysWordContens] => How should we do in the selection and follow-up of systemic conventional treatments in psoriasis?, Psoriasis, conventional treatment, comorbidity, methotrexate, acitretin, cyclosporine, fumarates, There is an increasing need for appropriate effective treatment and long-term disease control in patients with psoriasis because of the decreased quality of life, increased physicosocial deficits and associated co-morbidities. Systemic conventional treatments that are the first step in the management of moderate-to-severe plaque psoriasis include methotrexate (MTX), acitretin, cyclosporine and fumarates. MTX is considered the gold standard in the treatment of moderate-to-severe chronic plaque type psoriasis. It is also used to treat pustular psoriasis, erythrodermic psoriasis and psoriatic arthritis. Acitretin monotherapy is less effective than other conventional systemic treatments for plaque psoriasis, while superior to generalized, palmoplantar pustular, and hyperkeratotic variants. Cyclosporine is preferred in the presence of unstable acute clinical conditions (erythrodermic or generalized pustular psoriasis) and also in induction phase of rotational and sequential therapy for severe resistant psoriasis, due to its rapid effect. Dimethyl fumarate, which has similar efficacy to MTX, is an appropriate option in the induction and long-term systemic treatment for adult patients with moderate to severe plaque psoriasis without psoriatic arthritis. Although they are often overshadowed by biologics at the stage of preference by most physicians and patients today, they are classical and inexpensive agents with known long-term results. When the appropriate patient profile and psoriasis type are selected at the right time and necessary laboratory and clinical follow-ups are made, each of them is an effective treatment with reliable and satisfactory results. In this article, important points (recommendations according to patient characteristics, psoriasis type and comorbidities) to be considered in clinical practice when using the conventional anti-psoriatic agents in the treatment of psoriasis are overviewed. ,Sevgi Akarsu [PublishedText] => Published [IsEdit] => 0 [AccountId] => 76 [Zh] => 1 ) [27] => Array ( [ArticleId] => 965 [Create_Time] => 2023-12-06 [zipUrl] => https://www.explorationpub.com/uploads/zip/202312/20231212082907.zip [xmlUrl] => https://www.explorationpub.com/uploads/Article/A100727/100727.xml [pdfUrl] => https://www.explorationpub.com/uploads/Article/A100727/100727.pdf [coverUrl] => https://www.explorationpub.com/uploads/Article/A100727/100727_cover.png [JournalsId] => 9 [Title] => Calcium pyrophosphate crystal deposition disease—what’s new? [Abstract] => [AbstractComplete] => [Names] => Jürgen Braun [Doi] => 10.37349/emd.2023.00027 [Published] => December 06, 2023 [Viewed] => 388 [Downloaded] => 16 [Subject] => Editorial [Year] => 2023 [CiteUrl] => https://api.crossref.org/works/10.37349/emd.2023.00027 [Inline] => 1 [Type] => 1 [Issue] => 6 [Topic] => 261 [TitleAbbr] => Explor Musculoskeletal Dis. [Pages] => 2023;1:257–263 [Recommend] => 0 [Keywords] => [DetailTitle] => Calcium Pyrophosphate Deposition Disease [DetailUrl] => https://www.explorationpub.com/Journals/emd/Special_Issues/261 [Id] => 100727 [ris] => https://www.explorationpub.com/uploads/Article/A100727/3d6ea50d71214311b3c8b8a5108f39a2.ris [bib] => https://www.explorationpub.com/uploads/Article/A100727/c2acdd29f0fbc692f2c8099086d2edd5.bib [ens] => [Cited] => 0 [Cited_Time] => [CitethisArticle] => Braun J. Calcium pyrophosphate crystal deposition disease—what’s new? Explor Musculoskeletal Dis. 2023;1:257–63. https://doi.org/10.37349/emd.2023.00027 [Jindex] => 0 [CName] => [CEmail] => [Ris_Time] => 2023-12-01 00:44:38 [Bib_Time] => 2023-12-01 00:44:38 [KeysWordContens] => Calcium pyrophosphate crystal deposition disease—what’s new?,,,Jürgen Braun [PublishedText] => Published [IsEdit] => 0 [AccountId] => 87 [Zh] => 1 ) [28] => Array ( [ArticleId] => 966 [Create_Time] => 2023-12-06 [zipUrl] => https://www.explorationpub.com/uploads/zip/202312/20231206081243.zip [xmlUrl] => https://www.explorationpub.com/uploads/Article/A100728/100728.xml [pdfUrl] => https://www.explorationpub.com/uploads/Article/A100728/100728.pdf [coverUrl] => https://www.explorationpub.com/uploads/Article/A100728/100728_cover.png [JournalsId] => 9 [Title] => Rheumatoid arthritis and cardiovascular comorbidities [Abstract] => Rheumatoid arthritis (RA) is the most common rheumatologic disease characterized by inflammation with a definite relationship with heart disease. Impaired immunity, chronic inflammation, genetic sus [AbstractComplete] =>Rheumatoid arthritis (RA) is the most common rheumatologic disease characterized by inflammation with a definite relationship with heart disease. Impaired immunity, chronic inflammation, genetic susceptibility, autonomic nervous system (ANS) dysfunction, altered metabolic profile have been blamed for ischemic and non-ischemic heart diseases in RA patients. Medications used in RA treatment can also modify the risk of heart diseases by different mechanisms. Understanding the pathogenesis is essential to prevent early cardiac dysfunction in RA patients. Fundamental cellular and molecular mechanisms of pathogenesis await further elucidation. Disease management is of great importance since the cardiovascular (CV) events are known to be reduced with low disease activity. Discovery of new mechanisms will pave the way for the development of novel treatment modalities. This review highlights the epidemiology, pathogenesis, risk factors, diagnosis and screening methods and management of CV comorbidities in RA patients. Besides impact of RA medications and exercise on CV risk are summarized.
[Names] => Uğur Özkan ... Murat Birtane [Doi] => 10.37349/emd.2023.00028 [Published] => December 06, 2023 [Viewed] => 512 [Downloaded] => 22 [Subject] => Review [Year] => 2023 [CiteUrl] => https://api.crossref.org/works/10.37349/emd.2023.00028 [Inline] => 1 [Type] => 1 [Issue] => 6 [Topic] => 141 [TitleAbbr] => Explor Musculoskeletal Dis. [Pages] => 2023;1:264–288 [Recommend] => 0 [Keywords] => Rheumatoid arthritis, cardiovascular disease, cardiovascular comorbidity, cardiovascular risk factors, epidemiology, exercise, management [DetailTitle] => Comorbidities in rheumatoid arthritis [DetailUrl] => https://www.explorationpub.com/Journals/emd/Special_Issues/141 [Id] => 100728 [ris] => https://www.explorationpub.com/uploads/Article/A100728/531e2e44cbbf5e415a8624c2021de290.ris [bib] => https://www.explorationpub.com/uploads/Article/A100728/34042bebbd7a163ee4d0caf025b11100.bib [ens] => [Cited] => 0 [Cited_Time] => [CitethisArticle] => Özkan U, Kakilli N, Gürdoğan M, Taştekin N, Birtane M. Rheumatoid arthritis and cardiovascular comorbidities. Explor Musculoskeletal Dis. 2023;1:264–88. https://doi.org/10.37349/emd.2023.00028 [Jindex] => 0 [CName] => [CEmail] => [Ris_Time] => 2023-12-01 01:06:26 [Bib_Time] => 2023-12-01 01:06:26 [KeysWordContens] => Rheumatoid arthritis and cardiovascular comorbidities, Rheumatoid arthritis, cardiovascular disease, cardiovascular comorbidity, cardiovascular risk factors, epidemiology, exercise, management, Rheumatoid arthritis (RA) is the most common rheumatologic disease characterized by inflammation with a definite relationship with heart disease. Impaired immunity, chronic inflammation, genetic susceptibility, autonomic nervous system (ANS) dysfunction, altered metabolic profile have been blamed for ischemic and non-ischemic heart diseases in RA patients. Medications used in RA treatment can also modify the risk of heart diseases by different mechanisms. Understanding the pathogenesis is essential to prevent early cardiac dysfunction in RA patients. Fundamental cellular and molecular mechanisms of pathogenesis await further elucidation. Disease management is of great importance since the cardiovascular (CV) events are known to be reduced with low disease activity. Discovery of new mechanisms will pave the way for the development of novel treatment modalities. This review highlights the epidemiology, pathogenesis, risk factors, diagnosis and screening methods and management of CV comorbidities in RA patients. Besides impact of RA medications and exercise on CV risk are summarized. ,Uğur Özkan ... Murat Birtane [PublishedText] => Published [IsEdit] => 0 [AccountId] => 87 [Zh] => 1 ) [29] => Array ( [ArticleId] => 1072 [Create_Time] => 2024-01-23 [zipUrl] => https://www.explorationpub.com/uploads/zip/202401/20240123003923.zip [xmlUrl] => https://www.explorationpub.com/uploads/Article/A100730/100730.xml [pdfUrl] => https://www.explorationpub.com/uploads/Article/A100730/100730.pdf [coverUrl] => https://www.explorationpub.com/uploads/Article/A100730/100730-cover.png [JournalsId] => 9 [Title] => Scoping review on remote disease monitoring in rheumatoid arthritis: does it actually help the patient? [Abstract] => Remote monitoring technologies (RMTs) are an emerging tool for assessing, monitoring, and following up on patients with chronic diseases including autoimmune rheumatic diseases (AIRDs). The best use [AbstractComplete] =>Remote monitoring technologies (RMTs) are an emerging tool for assessing, monitoring, and following up on patients with chronic diseases including autoimmune rheumatic diseases (AIRDs). The best use of these exponentially expanding technologies warrants optimum evidence. Rheumatoid arthritis (RA) is a chronic inflammatory process that requires close monitoring of disease activity, response to treatment, and the potential adverse effects. Though there are several studies that have explored RMTs in RA, there is little head-to-head comparison between the individual technologies or the standard of care. Before investing in potentially high-cost strategies like RMTs, it is prudent to estimate their pragmatic role in the management and potentially with long-term follow-up including drug titration. A thorough search of the literature was conducted across PubMed/MEDLINE, Scopus, and WebOfScience databases for recent and relevant literature looking at the acceptance, practical utility, and outcomes in RA using RMTs. This scoping review aims to summarize the current level of evidence in favor of RMTs, estimate real-world benefits and costs, potential hazards and limitations, and finally, identify future studies needed before endeavoring to mainstream RMTs. It emphasizes randomized trials using RMTs, patients reported outcomes and disparities in the usage of RMTs.
[Names] => Prakashini Mruthyunjaya ... Debashish Danda [Doi] => 10.37349/emd.2024.00030 [Published] => January 22, 2024 [Viewed] => 369 [Downloaded] => 14 [Subject] => Review [Year] => 2024 [CiteUrl] => https://api.crossref.org/works/10.37349/emd.2024.00030 [Inline] => 1 [Type] => 1 [Issue] => 1 [Topic] => 116 [TitleAbbr] => Explor Musculoskeletal Dis. [Pages] => 2024;2:20–30 [Recommend] => 0 [Keywords] => Rheumatoid arthritis, rheumatology, digital medicine, telemedicine, remote monitoring [DetailTitle] => Digital health technologies in rheumatology: emerging evidence and innovation [DetailUrl] => https://www.explorationpub.com/Journals/emd/Special_Issues/116 [Id] => 100730 [ris] => https://www.explorationpub.com/uploads/Article/A100730/56e0e6f2f9ecde778293eade7c0824a0.ris [bib] => https://www.explorationpub.com/uploads/Article/A100730/1fe8a5520f43540189af66873d297f72.bib [ens] => [Cited] => 0 [Cited_Time] => [CitethisArticle] => Mruthyunjaya P, Ahmed S, Danda D. Scoping review on remote disease monitoring in rheumatoid arthritis: does it actually help the patient? Explor Musculoskeletal Dis. 2024;2:20–30. https://doi.org/10.37349/emd.2024.00030 [Jindex] => 0 [CName] => [CEmail] => [Ris_Time] => 2024-01-26 06:19:49 [Bib_Time] => 2024-01-08 08:07:12 [KeysWordContens] => Scoping review on remote disease monitoring in rheumatoid arthritis: does it actually help the patient?, Rheumatoid arthritis, rheumatology, digital medicine, telemedicine, remote monitoring, Remote monitoring technologies (RMTs) are an emerging tool for assessing, monitoring, and following up on patients with chronic diseases including autoimmune rheumatic diseases (AIRDs). The best use of these exponentially expanding technologies warrants optimum evidence. Rheumatoid arthritis (RA) is a chronic inflammatory process that requires close monitoring of disease activity, response to treatment, and the potential adverse effects. Though there are several studies that have explored RMTs in RA, there is little head-to-head comparison between the individual technologies or the standard of care. Before investing in potentially high-cost strategies like RMTs, it is prudent to estimate their pragmatic role in the management and potentially with long-term follow-up including drug titration. A thorough search of the literature was conducted across PubMed/MEDLINE, Scopus, and WebOfScience databases for recent and relevant literature looking at the acceptance, practical utility, and outcomes in RA using RMTs. This scoping review aims to summarize the current level of evidence in favor of RMTs, estimate real-world benefits and costs, potential hazards and limitations, and finally, identify future studies needed before endeavoring to mainstream RMTs. It emphasizes randomized trials using RMTs, patients reported outcomes and disparities in the usage of RMTs. ,Prakashini Mruthyunjaya ... Debashish Danda [PublishedText] => Published [IsEdit] => 0 [AccountId] => 76 [Zh] => 1 ) [30] => Array ( [ArticleId] => 1080 [Create_Time] => 2024-01-23 [zipUrl] => https://www.explorationpub.com/uploads/zip/202401/20240123032533.zip [xmlUrl] => https://www.explorationpub.com/uploads/Article/A100731/100731.xml [pdfUrl] => https://www.explorationpub.com/uploads/Article/A100731/100731.pdf [coverUrl] => https://www.explorationpub.com/uploads/Article/A100731/100731_cover.png [JournalsId] => 9 [Title] => Multifaceted aspects of chronic disease: do diffuse idiopathic skeletal hyperostosis affect the quality of life? [Abstract] => Diffuse idiopathic skeletal hyperostosis (DISH) is a common condition that affects the spine and peripheral joints, characterized by the progressive ossification of ligaments and tendons. It is a no [AbstractComplete] =>Diffuse idiopathic skeletal hyperostosis (DISH) is a common condition that affects the spine and peripheral joints, characterized by the progressive ossification of ligaments and tendons. It is a non-inflammatory degenerative disease that affects predominantly the elderly population. It has been associated with reduced mobility and chronic pain, which can have a significant impact on patients’ quality of life (QOL). Although DISH has always been considered a benign condition, patients with DISH report higher levels of pain, stiffness, and disability compared to the general population. It can affect their ability to perform daily activities and participate in social and recreational activities. In addition, extra-spinal manifestations such as enthesopathy and involvement of peripheral joints, but still dysphagia and airway obstruction have been described in DISH. These, although not as common, when present result in signs and symptoms significantly impacting the patient’s QOL. The objective of this review is to assess the QOL in individual with DISH. This involves an examination of various facets of the condition, including pain, spinal and extraspinal manifestations, fractures, and metabolic syndrome.
[Names] => Greta Pellegrino ... Piercarlo Sarzi-Puttini [Doi] => 10.37349/emd.2024.00031 [Published] => January 23, 2024 [Viewed] => 345 [Downloaded] => 12 [Subject] => Review [Year] => 2024 [CiteUrl] => https://api.crossref.org/works/10.37349/emd.2024.00031 [Inline] => 1 [Type] => 1 [Issue] => 1 [Topic] => 119 [TitleAbbr] => Explor Musculoskeletal Dis. [Pages] => 2024;2:31–39 [Recommend] => 0 [Keywords] => Diffuse idiopathic skeletal hyperostosis, quality of life, chronic pain, spinal involvement, extra-spinal involvement [DetailTitle] => Diffuse Idiopathic Skeletal Hyperostosis- A common but neglected disease [DetailUrl] => https://www.explorationpub.com/Journals/emd/Special_Issues/119 [Id] => 100731 [ris] => https://www.explorationpub.com/uploads/Article/A100731/bc736ecc3bfbfdcf90ac3690c0c7e516.ris [bib] => https://www.explorationpub.com/uploads/Article/A100731/585afa0497f9378f6e43aa851895489b.bib [ens] => [Cited] => 0 [Cited_Time] => [CitethisArticle] => Pellegrino G, Giorgi V, Sarzi-Puttini P. Multifaceted aspects of chronic disease: do diffuse idiopathic skeletal hyperostosis affect the quality of life? Explor Musculoskeletal Dis. 2024;2:31–9. https://doi.org/10.37349/emd.2024.00031 [Jindex] => 0 [CName] => [CEmail] => [Ris_Time] => 2024-01-23 03:25:33 [Bib_Time] => 2024-01-23 03:25:33 [KeysWordContens] => Multifaceted aspects of chronic disease: do diffuse idiopathic skeletal hyperostosis affect the quality of life?, Diffuse idiopathic skeletal hyperostosis, quality of life, chronic pain, spinal involvement, extra-spinal involvement, Diffuse idiopathic skeletal hyperostosis (DISH) is a common condition that affects the spine and peripheral joints, characterized by the progressive ossification of ligaments and tendons. It is a non-inflammatory degenerative disease that affects predominantly the elderly population. It has been associated with reduced mobility and chronic pain, which can have a significant impact on patients’ quality of life (QOL). Although DISH has always been considered a benign condition, patients with DISH report higher levels of pain, stiffness, and disability compared to the general population. It can affect their ability to perform daily activities and participate in social and recreational activities. In addition, extra-spinal manifestations such as enthesopathy and involvement of peripheral joints, but still dysphagia and airway obstruction have been described in DISH. These, although not as common, when present result in signs and symptoms significantly impacting the patient’s QOL. The objective of this review is to assess the QOL in individual with DISH. This involves an examination of various facets of the condition, including pain, spinal and extraspinal manifestations, fractures, and metabolic syndrome. ,Greta Pellegrino ... Piercarlo Sarzi-Puttini [PublishedText] => Published [IsEdit] => 0 [AccountId] => 77 [Zh] => 1 ) [31] => Array ( [ArticleId] => 1086 [Create_Time] => 2024-02-01 [zipUrl] => https://www.explorationpub.com/uploads/zip/202402/20240201064937.zip [xmlUrl] => https://www.explorationpub.com/uploads/Article/A100732/100732.xml [pdfUrl] => https://www.explorationpub.com/uploads/Article/A100732/100732.pdf [coverUrl] => https://www.explorationpub.com/uploads/Article/A100732/100732_cover.png [JournalsId] => 9 [Title] => Redefining comorbidity understanding in rheumatoid arthritis through novel approaches using real-world data [Abstract] => Rheumatoid arthritis (RA) is a prevalent chronic disease that is associated with numerous comorbidities. Accurate assessment of these coexisting conditions, as reported by clinicians, is critical fo [AbstractComplete] =>Rheumatoid arthritis (RA) is a prevalent chronic disease that is associated with numerous comorbidities. Accurate assessment of these coexisting conditions, as reported by clinicians, is critical for an improved understanding of the impact of the disease and patient care. This perspective aims to evaluate the utility of real-world data (RWD) for enhancing the understanding of comorbidities in RA and to assess its potential in reshaping clinical management. RWD approaches, specifically the use of structured databases or data extracted from electronic health records, offer promising alternatives to overcome the limitations of traditional methodologies. Structured databases provide a systematic approach to data analysis, utilizing diagnosis codes to study large patient cohorts, revealing the prevalence of conditions, and demonstrating the potential for long-term disease trend analysis. Meanwhile, natural language processing (NLP) and artificial intelligence (AI) image analysis can bridge the gap between structured and unstructured data, by extracting meaningful information from unstructured fields such as free text or imaging. NLP has proven effective in the identification of RA patients and research outcomes, while AI image analysis has enabled the discovery of hidden findings in cardiovascular assessments, establishing a basis for the assessment of comorbidities in RA. However, while the benefits of using RWD are substantial, challenges remain. Ensuring comprehensive data capture, managing missing data, and improving data detection are key areas requiring attention. The involvement of clinicians and researchers in rheumatology is crucial in unlocking the potential of RWD studies, offering the promise of significant improvements in disease characterization and patient health outcomes.
[Names] => Diego Benavent, Chamaida Plasencia-Rodríguez [Doi] => 10.37349/emd.2024.00032 [Published] => February 01, 2024 [Viewed] => 373 [Downloaded] => 11 [Subject] => Perspective [Year] => 2024 [CiteUrl] => https://api.crossref.org/works/10.37349/emd.2024.00032 [Inline] => 1 [Type] => 1 [Issue] => 1 [Topic] => 141 [TitleAbbr] => Explor Musculoskeletal Dis. [Pages] => 2024;2:40–48 [Recommend] => 0 [Keywords] => Rheumatoid arthritis, real-world evidence, structured databases, natural language processing [DetailTitle] => Comorbidities in rheumatoid arthritis [DetailUrl] => https://www.explorationpub.com/Journals/emd/Special_Issues/141 [Id] => 100732 [ris] => https://www.explorationpub.com/uploads/Article/A100732/c180b07171352914a99010ae7d45a1cb.ris [bib] => https://www.explorationpub.com/uploads/Article/A100732/4bc52233a532b2c85589d497cf2e6e6b.bib [ens] => [Cited] => 0 [Cited_Time] => [CitethisArticle] => Benavent D, Plasencia-Rodríguez C. Redefining comorbidity understanding in rheumatoid arthritis through novel approaches using real-world data. Explor Musculoskeletal Dis. 2024;2:40–8. https://doi.org/10.37349/emd.2024.00032 [Jindex] => 0 [CName] => [CEmail] => [Ris_Time] => 2024-02-01 06:49:37 [Bib_Time] => 2024-02-01 06:49:37 [KeysWordContens] => Redefining comorbidity understanding in rheumatoid arthritis through novel approaches using real-world data, Rheumatoid arthritis, real-world evidence, structured databases, natural language processing, Rheumatoid arthritis (RA) is a prevalent chronic disease that is associated with numerous comorbidities. Accurate assessment of these coexisting conditions, as reported by clinicians, is critical for an improved understanding of the impact of the disease and patient care. This perspective aims to evaluate the utility of real-world data (RWD) for enhancing the understanding of comorbidities in RA and to assess its potential in reshaping clinical management. RWD approaches, specifically the use of structured databases or data extracted from electronic health records, offer promising alternatives to overcome the limitations of traditional methodologies. Structured databases provide a systematic approach to data analysis, utilizing diagnosis codes to study large patient cohorts, revealing the prevalence of conditions, and demonstrating the potential for long-term disease trend analysis. Meanwhile, natural language processing (NLP) and artificial intelligence (AI) image analysis can bridge the gap between structured and unstructured data, by extracting meaningful information from unstructured fields such as free text or imaging. NLP has proven effective in the identification of RA patients and research outcomes, while AI image analysis has enabled the discovery of hidden findings in cardiovascular assessments, establishing a basis for the assessment of comorbidities in RA. However, while the benefits of using RWD are substantial, challenges remain. Ensuring comprehensive data capture, managing missing data, and improving data detection are key areas requiring attention. The involvement of clinicians and researchers in rheumatology is crucial in unlocking the potential of RWD studies, offering the promise of significant improvements in disease characterization and patient health outcomes. ,Diego Benavent, Chamaida Plasencia-Rodríguez [PublishedText] => Published [IsEdit] => 0 [AccountId] => 77 [Zh] => 1 ) [32] => Array ( [ArticleId] => 1091 [Create_Time] => 2024-02-06 [zipUrl] => https://www.explorationpub.com/uploads/zip/202402/20240229083402.zip [xmlUrl] => https://www.explorationpub.com/uploads/Article/A100733/100733.xml [pdfUrl] => https://www.explorationpub.com/uploads/Article/A100733/100733.pdf [coverUrl] => https://www.explorationpub.com/uploads/Article/A100733/100733_cover.png [JournalsId] => 9 [Title] => Participatory action ultrasound imaging in increasing clinician confidence with new approaches to trigger point dry needling of the lateral pterygoid [Abstract] => Upon self-reflection, some clinicians privately confess a lack of confidence in being able to safely perform trigger point dry needling (TrPDN) or trigger point injection (TrPI) on craniofacial musc [AbstractComplete] =>Upon self-reflection, some clinicians privately confess a lack of confidence in being able to safely perform trigger point dry needling (TrPDN) or trigger point injection (TrPI) on craniofacial muscles. Procedural performance anxiety seems to be more pronounced relative to those muscles that cannot be palpated and/or have an increased risk of iatrogenic injury to neurovascular structures. Participatory action ultrasound imaging (PAUI) can be a useful tool in enhancing clinician confidence. A clinician-subject with a left lateral pterygoid trigger point was dry-needled under ultrasound guidance by a clinician-needler with extensive training and experience relative to evaluation and treatment of patients with craniofacial pain. Prior to PAUI, both the clinician-needler and clinician-observer describe low-to-moderate anxiety in the performance of TrPDN of the lateral pterygoid, using a lateral-to-medial approach. By contrast, both the clinician-needler and clinician-observer expressed high anxiety, objectively confirmed by the state-trait anxiety inventory (STAI) form Y-1 (STAI Y-1), in the performance of a newly learned cephalo-caudal approach. Following an initial round of clinical training without PAUI, subjective anxiety remained high despite a lower theoretical risk to the maxillary artery using the cepalo-caudal approach. A second round of training was performed with the addition of PAUI; the clinician-needler was able to reach the target tissue within 2 min in each of 3 attempts. Upon visual inspection and interpretation of the images and cine, the clinician-needler and clinician-observer both expressed a “significant” decrease in self-reported anxiety in performing the cephalo-caudal approach, objectively verified by improvements in the STAI Y-1 score of both clinicians. This case report presents PAUI as a means for future research and clinician education regarding risk assessment of TrPDN or TrPI of muscles with risk of iatrogenic injury.
[Names] => Andrew Ball ... Jordan Spennato [Doi] => 10.37349/emd.2024.00033 [Published] => February 05, 2024 [Viewed] => 2290 [Downloaded] => 14 [Subject] => Case Report [Year] => 2024 [CiteUrl] => https://api.crossref.org/works/10.37349/emd.2024.00033 [Inline] => 1 [Type] => 1 [Issue] => 1 [Topic] => 269 [TitleAbbr] => Explor Musculoskeletal Dis. [Pages] => 2024;2:49–55 [Recommend] => 0 [Keywords] => Craniofacial pain, orofacial pain, temporomandibular disorder, trigger point, dry needling, musculoskeletal ultrasound, participatory action research, clinical education [DetailTitle] => New Advances in Imaging and Therapy Approaches for MSK Diseases [DetailUrl] => https://www.explorationpub.com/Journals/emd/Special_Issues/269 [Id] => 100733 [ris] => https://www.explorationpub.com/uploads/Article/A100733/60dcdcd3e51561571e89e325ccd4cf1e.ris [bib] => https://www.explorationpub.com/uploads/Article/A100733/13cffe990c15a9b0ecf82249bde0e01b.bib [ens] => [Cited] => 0 [Cited_Time] => [CitethisArticle] => Ball A, Levi S, Barrett S, Miller D, Ball E, Spennato J. Participatory action ultrasound imaging in increasing clinician confidence with new approaches to trigger point dry needling of the lateral pterygoid. Explor Musculoskeletal Dis. 2024;2:49–55. https://doi.org/10.37349/emd.2024.00033 [Jindex] => 0 [CName] => [CEmail] => [Ris_Time] => 2024-02-05 08:32:32 [Bib_Time] => 2024-01-26 03:39:44 [KeysWordContens] => Participatory action ultrasound imaging in increasing clinician confidence with new approaches to trigger point dry needling of the lateral pterygoid, Craniofacial pain, orofacial pain, temporomandibular disorder, trigger point, dry needling, musculoskeletal ultrasound, participatory action research, clinical education, Upon self-reflection, some clinicians privately confess a lack of confidence in being able to safely perform trigger point dry needling (TrPDN) or trigger point injection (TrPI) on craniofacial muscles. Procedural performance anxiety seems to be more pronounced relative to those muscles that cannot be palpated and/or have an increased risk of iatrogenic injury to neurovascular structures. Participatory action ultrasound imaging (PAUI) can be a useful tool in enhancing clinician confidence. A clinician-subject with a left lateral pterygoid trigger point was dry-needled under ultrasound guidance by a clinician-needler with extensive training and experience relative to evaluation and treatment of patients with craniofacial pain. Prior to PAUI, both the clinician-needler and clinician-observer describe low-to-moderate anxiety in the performance of TrPDN of the lateral pterygoid, using a lateral-to-medial approach. By contrast, both the clinician-needler and clinician-observer expressed high anxiety, objectively confirmed by the state-trait anxiety inventory (STAI) form Y-1 (STAI Y-1), in the performance of a newly learned cephalo-caudal approach. Following an initial round of clinical training without PAUI, subjective anxiety remained high despite a lower theoretical risk to the maxillary artery using the cepalo-caudal approach. A second round of training was performed with the addition of PAUI; the clinician-needler was able to reach the target tissue within 2 min in each of 3 attempts. Upon visual inspection and interpretation of the images and cine, the clinician-needler and clinician-observer both expressed a “significant” decrease in self-reported anxiety in performing the cephalo-caudal approach, objectively verified by improvements in the STAI Y-1 score of both clinicians. This case report presents PAUI as a means for future research and clinician education regarding risk assessment of TrPDN or TrPI of muscles with risk of iatrogenic injury. ,Andrew Ball ... Jordan Spennato [PublishedText] => Published [IsEdit] => 0 [AccountId] => 88 [Zh] => 1 ) [33] => Array ( [ArticleId] => 1092 [Create_Time] => 2024-02-07 [zipUrl] => https://www.explorationpub.com/uploads/zip/202402/20240221083307.zip [xmlUrl] => https://www.explorationpub.com/uploads/Article/A100734/100734.xml [pdfUrl] => https://www.explorationpub.com/uploads/Article/A100734/100734.pdf [coverUrl] => https://www.explorationpub.com/uploads/Article/A100734/100734-cover.png [JournalsId] => 9 [Title] => Soft tissue sarcoma: clinical recognition and approach to the loneliest cancer [Abstract] => Soft tissue sarcoma (STS) is a rare malignancy with a high incidence. Early diagnosis can reduce the rate of amputations and increase survival, however, this is typically delayed. The diagnosis and [AbstractComplete] =>Soft tissue sarcoma (STS) is a rare malignancy with a high incidence. Early diagnosis can reduce the rate of amputations and increase survival, however, this is typically delayed. The diagnosis and treatment of smaller lesions have a better prognosis; nonetheless, patients present to physicians when the soft tissue mass is large with obvious signs of red flags. In addition, the symptoms of this disease are highly non-specific and overlap greatly with benign conditions, resulting in a lack of clinical suspicion and low awareness among practitioners and the general public. Thusly, it is entitled as “the loneliest cancer”. This can make an accurate diagnosis difficult, with a great proportion of misdiagnoses leading subsequent inadvertent to incomplete STS excision, affecting the overall prognosis of the disease and devastating consequences in the disease process. A timely and precise diagnosis is essential because half of people with STS progress toward quietly aggressive illness. The purpose of this review is to raise awareness of STSs so that early recognition, accurate work-up, overview of conventional treatment plans, and appropriate referral to a tumor center can be achieved, avoiding whoop situations, and improving patient outcomes. In addition, insight into the advances in immunotherapy, nanotechnology, and artificial intelligence (AI) can lead to STS diagnosis and treatment prognosis.
[Names] => Sujan Shakya ... Xiang Zhou [Doi] => 10.37349/emd.2024.00034 [Published] => February 06, 2024 [Viewed] => 320 [Downloaded] => 21 [Subject] => Review [Year] => 2024 [CiteUrl] => https://api.crossref.org/works/10.37349/emd.2024.00034 [Inline] => 1 [Type] => 1 [Issue] => 1 [Topic] => 0 [TitleAbbr] => Explor Musculoskeletal Dis. [Pages] => 2024;2:56–68 [Recommend] => 0 [Keywords] => Soft tissue sarcoma, soft tissue lump, referral system, biopsy, diagnosis, treatments [DetailTitle] => [DetailUrl] => [Id] => 100734 [ris] => https://www.explorationpub.com/uploads/Article/A100734/69dcf117d7daa1c45d0c0c236882c1af.ris [bib] => https://www.explorationpub.com/uploads/Article/A100734/ef9688348630443a342a6291445a7114.bib [ens] => [Cited] => 0 [Cited_Time] => [CitethisArticle] => Shakya S, Banneyake EL, Cholekho S, Singh J, Zhou X. Soft tissue sarcoma: clinical recognition and approach to the loneliest cancer. Explor Musculoskeletal Dis. 2024;2:56–68. https://doi.org/10.37349/emd.2024.00034 [Jindex] => 0 [CName] => [CEmail] => [Ris_Time] => 2024-01-26 07:09:16 [Bib_Time] => 2024-01-26 07:09:16 [KeysWordContens] => Soft tissue sarcoma: clinical recognition and approach to the loneliest cancer, Soft tissue sarcoma, soft tissue lump, referral system, biopsy, diagnosis, treatments, Soft tissue sarcoma (STS) is a rare malignancy with a high incidence. Early diagnosis can reduce the rate of amputations and increase survival, however, this is typically delayed. The diagnosis and treatment of smaller lesions have a better prognosis; nonetheless, patients present to physicians when the soft tissue mass is large with obvious signs of red flags. In addition, the symptoms of this disease are highly non-specific and overlap greatly with benign conditions, resulting in a lack of clinical suspicion and low awareness among practitioners and the general public. Thusly, it is entitled as “the loneliest cancer”. This can make an accurate diagnosis difficult, with a great proportion of misdiagnoses leading subsequent inadvertent to incomplete STS excision, affecting the overall prognosis of the disease and devastating consequences in the disease process. A timely and precise diagnosis is essential because half of people with STS progress toward quietly aggressive illness. The purpose of this review is to raise awareness of STSs so that early recognition, accurate work-up, overview of conventional treatment plans, and appropriate referral to a tumor center can be achieved, avoiding whoop situations, and improving patient outcomes. In addition, insight into the advances in immunotherapy, nanotechnology, and artificial intelligence (AI) can lead to STS diagnosis and treatment prognosis. ,Sujan Shakya ... Xiang Zhou [PublishedText] => Published [IsEdit] => 0 [AccountId] => 76 [Zh] => 1 ) [34] => Array ( [ArticleId] => 1095 [Create_Time] => 2024-02-18 [zipUrl] => https://www.explorationpub.com/uploads/zip/202402/20240218034339.zip [xmlUrl] => https://www.explorationpub.com/uploads/Article/A100735/100735.xml [pdfUrl] => https://www.explorationpub.com/uploads/Article/A100735/100735.pdf [coverUrl] => https://www.explorationpub.com/uploads/Article/A100735/100735_cover.png [JournalsId] => 9 [Title] => Newborn hip screening experience in Türkiye [Abstract] => In this review article, newborn hip screening experience in Türkiye was summarized. The nationwide newborn hip screening program was officially initiated in 2013. The program currently includes the [AbstractComplete] =>In this review article, newborn hip screening experience in Türkiye was summarized. The nationwide newborn hip screening program was officially initiated in 2013. The program currently includes the ultrasonographic examination of the hips of almost all newborns within the first two months of life. The rate of minor surgical interventions (closed/open reduction and casting) was 0.47 per 1,000 live births in 2015 and was 0.89 per 1,000 live births in 2020. Thus, an increase of 89% in the rate of minor surgical interventions was observed. The rate of major surgical interventions (pelvic/femoral osteotomies) was 0.74 per 1,000 live births in 2015 and was 0.21 per 1,000 live births in 2020. Thus, a decrease of 72% in the rate of major surgical interventions was observed between 2015 and 2020. While minor surgical interventions constituted about 39% of the overall surgical interventions in 2015, this ratio raised to 81% in 2020. Based on the experiences in Türkiye universal newborn ultrasonography (US) hip screening is advocated to lessen the rate of extensive surgeries in developmental dysplasia of the hip (DDH) during childhood and adulthood and to have as many as possible functional hips in the long-term follow-up of patients with DDH.
[Names] => Hakan Ömeroğlu ... Feza Korkusuz [Doi] => 10.37349/emd.2024.00035 [Published] => February 18, 2024 [Viewed] => 295 [Downloaded] => 23 [Subject] => Mini Review [Year] => 2024 [CiteUrl] => https://api.crossref.org/works/10.37349/emd.2024.00035 [Inline] => 1 [Type] => 1 [Issue] => 1 [Topic] => 267 [TitleAbbr] => Explor Musculoskeletal Dis. [Pages] => 2024;2:69–74 [Recommend] => 0 [Keywords] => Developmental dysplasia of the hip, hip ultrasonography, newborn hip screening [DetailTitle] => Baby Hip Sonography Worldwide: Experience, Results, and Recommendations [DetailUrl] => https://www.explorationpub.com/Journals/emd/Special_Issues/267 [Id] => 100735 [ris] => https://www.explorationpub.com/uploads/Article/A100735/c4b77bbceb52e4179295a1a8bf1434df.ris [bib] => https://www.explorationpub.com/uploads/Article/A100735/f462dab2ce4e2cf43d085cc56aa916c5.bib [ens] => [Cited] => 0 [Cited_Time] => [CitethisArticle] => Ömeroğlu H, Kapıcıoğlu MİS, Korkusuz F. Newborn hip screening experience in Türkiye. Explor Musculoskeletal Dis. 2024;2:69–74. https://doi.org/10.37349/emd.2024.00035 [Jindex] => 0 [CName] => [CEmail] => [Ris_Time] => 2024-02-18 05:59:20 [Bib_Time] => 2024-01-29 02:28:57 [KeysWordContens] => Newborn hip screening experience in Türkiye, Developmental dysplasia of the hip, hip ultrasonography, newborn hip screening, In this review article, newborn hip screening experience in Türkiye was summarized. The nationwide newborn hip screening program was officially initiated in 2013. The program currently includes the ultrasonographic examination of the hips of almost all newborns within the first two months of life. The rate of minor surgical interventions (closed/open reduction and casting) was 0.47 per 1,000 live births in 2015 and was 0.89 per 1,000 live births in 2020. Thus, an increase of 89% in the rate of minor surgical interventions was observed. The rate of major surgical interventions (pelvic/femoral osteotomies) was 0.74 per 1,000 live births in 2015 and was 0.21 per 1,000 live births in 2020. Thus, a decrease of 72% in the rate of major surgical interventions was observed between 2015 and 2020. While minor surgical interventions constituted about 39% of the overall surgical interventions in 2015, this ratio raised to 81% in 2020. Based on the experiences in Türkiye universal newborn ultrasonography (US) hip screening is advocated to lessen the rate of extensive surgeries in developmental dysplasia of the hip (DDH) during childhood and adulthood and to have as many as possible functional hips in the long-term follow-up of patients with DDH. ,Hakan Ömeroğlu ... Feza Korkusuz [PublishedText] => Published [IsEdit] => 0 [AccountId] => 88 [Zh] => 1 ) [35] => Array ( [ArticleId] => 1172 [Create_Time] => 2024-03-07 [zipUrl] => https://www.explorationpub.com/uploads/zip/202403/20240307020956.zip [xmlUrl] => https://www.explorationpub.com/uploads/Article/A100736/100736.xml [pdfUrl] => https://www.explorationpub.com/uploads/Article/A100736/100736.pdf [coverUrl] => https://www.explorationpub.com/uploads/Article/A100736/100736_cover.png [JournalsId] => 9 [Title] => Return-to-play decision-making following ankle injury: a comprehensive case analysis of the functional hop test [Abstract] => Following anterior cruciate ligament (ACL) injury of the knee, the functional hop test (an averaging of 4 component hop tests including single-hop, triple-hop, cross-over-hop, and 6-meter-hop) is co [AbstractComplete] =>Following anterior cruciate ligament (ACL) injury of the knee, the functional hop test (an averaging of 4 component hop tests including single-hop, triple-hop, cross-over-hop, and 6-meter-hop) is commonly used by sports medicine physicians, doctors of physical therapy, and athletic trainers in return-to-practice and return-to-play decision making. In this case report, the functional hop test was applied to a 31-year-old recreational basketball player status-post full-tear of the anterior talofibular ligament (ATFL) to examine the applicability of a standardized, efficient, and easy-to-administer functional test in making return-to-play decisions following an ankle injury. The functional hop test was administered 5 times across a treatment course of 11 physical therapy sessions emphasizing pain-free range of motion, baseline strength, weight-bearing loading, and sport-specific training. The functional hop test was found to be a helpful (albeit imperfect) tool for clinical decision-making following an ankle injury. Specifically, improvements in landing skill/confidence of single hop accounted for the greatest gains in total score in the early phase of rehabilitation, while momentum and plyometric skill/control of triple hop accounted for the greatest gains in total score in the later phase of rehabilitation. Modification of the functional hop test to include sub-component tests of strength, endurance, and/or lateral hops are discussed.
[Names] => Michael Crinion ... Michael Agnone [Doi] => 10.37349/emd.2024.00036 [Published] => March 06, 2024 [Viewed] => 1780 [Downloaded] => 24 [Subject] => Case Report [Year] => 2024 [CiteUrl] => https://api.crossref.org/works/10.37349/emd.2024.00036 [Inline] => 1 [Type] => 0 [Issue] => 0 [Topic] => 0 [TitleAbbr] => Explor Musculoskeletal Dis. [Pages] => 2024;2:75–81 [Recommend] => 0 [Keywords] => Ankle, sprain, functional hop test, return to sport, physical therapy [DetailTitle] => [DetailUrl] => [Id] => 100736 [ris] => https://www.explorationpub.com/uploads/Article/A100736/c324994e21f453daab2fb2a102bf5a81.ris [bib] => https://www.explorationpub.com/uploads/Article/A100736/5c8570115d6a874c192d47e3403c0909.bib [ens] => [Cited] => 0 [Cited_Time] => [CitethisArticle] => Crinion M, Ball A, Agnone M. Return-to-play decision-making following ankle injury: a comprehensive case analysis of the functional hop test. Explor Musculoskeletal Dis. 2024;2:75–81. https://doi.org/10.37349/emd.2024.00036 [Jindex] => 0 [CName] => [CEmail] => [Ris_Time] => 2024-03-04 08:04:37 [Bib_Time] => 2024-03-04 08:24:10 [KeysWordContens] => Return-to-play decision-making following ankle injury: a comprehensive case analysis of the functional hop test, Ankle, sprain, functional hop test, return to sport, physical therapy, Following anterior cruciate ligament (ACL) injury of the knee, the functional hop test (an averaging of 4 component hop tests including single-hop, triple-hop, cross-over-hop, and 6-meter-hop) is commonly used by sports medicine physicians, doctors of physical therapy, and athletic trainers in return-to-practice and return-to-play decision making. In this case report, the functional hop test was applied to a 31-year-old recreational basketball player status-post full-tear of the anterior talofibular ligament (ATFL) to examine the applicability of a standardized, efficient, and easy-to-administer functional test in making return-to-play decisions following an ankle injury. The functional hop test was administered 5 times across a treatment course of 11 physical therapy sessions emphasizing pain-free range of motion, baseline strength, weight-bearing loading, and sport-specific training. The functional hop test was found to be a helpful (albeit imperfect) tool for clinical decision-making following an ankle injury. Specifically, improvements in landing skill/confidence of single hop accounted for the greatest gains in total score in the early phase of rehabilitation, while momentum and plyometric skill/control of triple hop accounted for the greatest gains in total score in the later phase of rehabilitation. Modification of the functional hop test to include sub-component tests of strength, endurance, and/or lateral hops are discussed. ,Michael Crinion ... Michael Agnone [PublishedText] => Published [IsEdit] => 0 [AccountId] => 22 [Zh] => 1 ) [36] => Array ( [ArticleId] => 1187 [Create_Time] => 2024-04-09 [zipUrl] => https://www.explorationpub.com/uploads/zip/202404/20240424073219.zip [xmlUrl] => https://www.explorationpub.com/uploads/Article/A100737/100737.xml [pdfUrl] => https://www.explorationpub.com/uploads/Article/A100737/100737.pdf [coverUrl] => https://www.explorationpub.com/uploads/Article/A100737/100737_cover.png [JournalsId] => 9 [Title] => Opportunities of digital health technologies for rheumatology: from clinics to quality and research [Abstract] => Recent developments in digital health technologies are overwhelming, and their use in routine work is still difficult to anticipate. This narrative review summarizes the concept of consecutive cohor [AbstractComplete] =>Recent developments in digital health technologies are overwhelming, and their use in routine work is still difficult to anticipate. This narrative review summarizes the concept of consecutive cohorts in the literature, together with local research experiences in consecutive rheumatic outpatients. Digital health techniques have to reflect the clinicians’ needs, support real-life care of patients, and allow for the specific assessment of quality parameters fulfilling the Donabedian aspect of qualified health care, using quality indicators to improve health care and research. Rapidly growing observational cohorts will perform best to provide follow-up data as the basis for further development of healthcare approaches for rheumatic patients. The challenges of a selection bias, patients with limited disease expression, and chances of early detection of patients with rare diseases are addressed. For research purposes, sequential analyses with growing cohort size, comparative cross-sectional studies with sequential hypothesis testing and other prognostic, diagnostic, and therapeutic aspects of patient management can be performed. With the support of new technologies, young clinicians can easily approach such clinical topics, and learn about clinical data analyses. The use of quality standards as proposed in international recommendations for diagnostic issues and classification criteria, management recommendations, monitoring, and training issues can be supported by digital technologies. In conclusion, collaborative projects allow detailed clinical analyses of large cohorts, but local initiatives can prepare these co-operations, provide first local logistics and research experiences, and teach clinicians how to perform clinical research. Digital health technologies will strongly support these local initiatives.
[Names] => Michael Schirmer ... Johannes D. Pallua [Doi] => 10.37349/emd.2024.00037 [Published] => April 08, 2024 [Viewed] => 153 [Downloaded] => 11 [Subject] => Perspective [Year] => 2024 [CiteUrl] => https://api.crossref.org/works/10.37349/emd.2024.00037 [Inline] => 1 [Type] => 0 [Issue] => [Topic] => 116 [TitleAbbr] => Explor Musculoskeletal Dis. [Pages] => 2024;2:82–91 [Recommend] => 0 [Keywords] => Digital health, rheumatology, quality, observational trial [DetailTitle] => Digital health technologies in rheumatology: emerging evidence and innovation [DetailUrl] => https://www.explorationpub.com/Journals/emd/Special_Issues/116 [Id] => 100737 [ris] => https://www.explorationpub.com/uploads/Article/A100737/f12bba29d1660ab67ab6bac791185cbb.ris [bib] => https://www.explorationpub.com/uploads/Article/A100737/736e1bf85b764f138d36e9a75b09d5a2.bib [ens] => [Cited] => 0 [Cited_Time] => [CitethisArticle] => Schirmer M, Kampik L, Pallua JD. Opportunities of digital health technologies for rheumatology: from clinics to quality and research. Explor Musculoskeletal Dis. 2024;2:82–91. https://doi.org/10.37349/emd.2024.00037 [Jindex] => 0 [CName] => [CEmail] => [Ris_Time] => 2024-04-24 07:32:19 [Bib_Time] => 2024-04-24 07:32:19 [KeysWordContens] => Opportunities of digital health technologies for rheumatology: from clinics to quality and research, Digital health, rheumatology, quality, observational trial, Recent developments in digital health technologies are overwhelming, and their use in routine work is still difficult to anticipate. This narrative review summarizes the concept of consecutive cohorts in the literature, together with local research experiences in consecutive rheumatic outpatients. Digital health techniques have to reflect the clinicians’ needs, support real-life care of patients, and allow for the specific assessment of quality parameters fulfilling the Donabedian aspect of qualified health care, using quality indicators to improve health care and research. Rapidly growing observational cohorts will perform best to provide follow-up data as the basis for further development of healthcare approaches for rheumatic patients. The challenges of a selection bias, patients with limited disease expression, and chances of early detection of patients with rare diseases are addressed. For research purposes, sequential analyses with growing cohort size, comparative cross-sectional studies with sequential hypothesis testing and other prognostic, diagnostic, and therapeutic aspects of patient management can be performed. With the support of new technologies, young clinicians can easily approach such clinical topics, and learn about clinical data analyses. The use of quality standards as proposed in international recommendations for diagnostic issues and classification criteria, management recommendations, monitoring, and training issues can be supported by digital technologies. In conclusion, collaborative projects allow detailed clinical analyses of large cohorts, but local initiatives can prepare these co-operations, provide first local logistics and research experiences, and teach clinicians how to perform clinical research. Digital health technologies will strongly support these local initiatives. ,Michael Schirmer ... Johannes D. Pallua [PublishedText] => Published [IsEdit] => 0 [AccountId] => 77 [Zh] => 1 ) [37] => Array ( [ArticleId] => 1191 [Create_Time] => 2024-04-09 [zipUrl] => https://www.explorationpub.com/uploads/zip/202404/20240409072401.zip [xmlUrl] => https://www.explorationpub.com/uploads/Article/A100738/100738.xml [pdfUrl] => https://www.explorationpub.com/uploads/Article/A100738/100738.pdf [coverUrl] => https://www.explorationpub.com/uploads/Article/A100738/100738_cover.png [JournalsId] => 9 [Title] => Empowering rheumatology through digital health technologies: contributions and barriers [Abstract] => Rheumatology, the medical specialty dealing with the diagnosis and treatment of rheumatic and musculoskeletal diseases (RMDs), is evolving with the emergence of digital health technologies, such as [AbstractComplete] =>Rheumatology, the medical specialty dealing with the diagnosis and treatment of rheumatic and musculoskeletal diseases (RMDs), is evolving with the emergence of digital health technologies, such as electronic health records (EHRs), virtual visits, mobile health (mHealth), wearable medical devices, social media, websites, digital therapeutics, artificial intelligence (AI) and machine learning. These technologies offer new opportunities to improve essential aspects of care, such as care access or disease management. They can significantly reduce the risk of errors and the workload of rheumatologists, while enhancing communication between physicians and patients, resulting in better quality of care. Moreover, digital health technologies can significantly improve research outcomes. However, digital health technologies in rheumatology also face specific barriers such as privacy, security concerns, incremental costs as well as limited digital health literacy and access. Therefore, further analysis, actions and strategies are needed to overcome these barriers. This article explores the impact of digital health technologies on rheumatology practice and highlights their contributions and challenges. By understanding the immense potential and overcoming the obstacles, the way for a future where digital health technologies are integrated into daily rheumatology care may be envisioned, in order to empower patients and healthcare providers.
[Names] => Diego Benavent ... Antonio Gómez-Centeno [Doi] => 10.37349/emd.2024.00038 [Published] => April 9, 2024 [Viewed] => 239 [Downloaded] => 16 [Subject] => Perspective [Year] => 2024 [CiteUrl] => https://api.crossref.org/works/10.37349/emd.2024.00038 [Inline] => 1 [Type] => 0 [Issue] => 2 [Topic] => 116 [TitleAbbr] => Explor Musculoskeletal Dis. [Pages] => 2024;2:92–105 [Recommend] => 0 [Keywords] => Rheumatology, digital health technologies, benefits, barriers [DetailTitle] => Digital health technologies in rheumatology: emerging evidence and innovation [DetailUrl] => https://www.explorationpub.com/Journals/emd/Special_Issues/116 [Id] => 100738 [ris] => https://www.explorationpub.com/uploads/Article/A100738/7552ba211cb045f91a0d0c2452bb5abc.ris [bib] => https://www.explorationpub.com/uploads/Article/A100738/b07eb6117635ddf01122b3cdd4705499.bib [ens] => [Cited] => 0 [Cited_Time] => [CitethisArticle] => Benavent D, Carmona L, Llorente JFG, Montoro M, Ramirez S, Otón T, et al. Empowering rheumatology through digital health technologies: contributions and barriers. Explor Musculoskeletal Dis. 2024;2:92–105. https://doi.org/10.37349/emd.2024.00038 [Jindex] => 0 [CName] => [CEmail] => [Ris_Time] => 2024-03-26 08:37:45 [Bib_Time] => 2024-03-28 06:07:41 [KeysWordContens] => Empowering rheumatology through digital health technologies: contributions and barriers, Rheumatology, digital health technologies, benefits, barriers, Rheumatology, the medical specialty dealing with the diagnosis and treatment of rheumatic and musculoskeletal diseases (RMDs), is evolving with the emergence of digital health technologies, such as electronic health records (EHRs), virtual visits, mobile health (mHealth), wearable medical devices, social media, websites, digital therapeutics, artificial intelligence (AI) and machine learning. These technologies offer new opportunities to improve essential aspects of care, such as care access or disease management. They can significantly reduce the risk of errors and the workload of rheumatologists, while enhancing communication between physicians and patients, resulting in better quality of care. Moreover, digital health technologies can significantly improve research outcomes. However, digital health technologies in rheumatology also face specific barriers such as privacy, security concerns, incremental costs as well as limited digital health literacy and access. Therefore, further analysis, actions and strategies are needed to overcome these barriers. This article explores the impact of digital health technologies on rheumatology practice and highlights their contributions and challenges. By understanding the immense potential and overcoming the obstacles, the way for a future where digital health technologies are integrated into daily rheumatology care may be envisioned, in order to empower patients and healthcare providers. ,Diego Benavent ... Antonio Gómez-Centeno [PublishedText] => Published [IsEdit] => 0 [AccountId] => 88 [Zh] => 1 ) [38] => Array ( [ArticleId] => 1192 [Create_Time] => 2024-04-10 [zipUrl] => https://www.explorationpub.com/uploads/zip/202404/20240424065237.zip [xmlUrl] => https://www.explorationpub.com/uploads/Article/A100739/100739.xml [pdfUrl] => https://www.explorationpub.com/uploads/Article/A100739/100739.pdf [coverUrl] => https://www.explorationpub.com/uploads/Article/A100739/100739_cover.png [JournalsId] => 9 [Title] => Measuring itch occurrence in various chronic pain conditions: across sectional study [Abstract] => Aim: The relationship between chronic pain conditions and itch occurrence has been studied; however, reports on itch among patients with different chronic pain conditions are limited. It is also [AbstractComplete] =>The relationship between chronic pain conditions and itch occurrence has been studied; however, reports on itch among patients with different chronic pain conditions are limited. It is also unclear how pain medications affect itch experienced alongside chronic pain. The primary aim of the current study is to investigate the occurrence of itch among patients with various chronic pain conditions, and the secondary aim is to assess the impact of pain medication on itch episodes.
In the initial quarter of 2019, three hundred seventeen patients with chronic pain conditions were followed up at Hamad medical corporation (HMC)’s pain clinics. Of these, 285 met the study criteria and consented to participate. For patients who reported itch during the routine pain assessment, the 5-D score was utilized for the itch evaluation. The effect of pain medications on itch was also documented.
Among the 285 patients, 41 (14.4%) reported experiencing an itchy sensation. Out of those 41 patients, 31 (75.6%) were diagnosed with neuropathic pain. This condition was found to be significantly associated with itch (P < 0.0001) compared to other conditions such as musculoskeletal (MSK) and fibromyalgia/myofascial pain, which accounted for only 12% of those who reported itch. Moreover, 25 (60.97%) of the patients with itch reported that they experienced concomitant itch sensations with pain episodes. Notably, 28 patients (68.3%) responded positively to pain medication. Furthermore, the study identified a significant correlation between the duration of pain and the incidence of itch (P < 0.0001).
The current study findings highlight neuropathic pain as the most prevalent chronic pain condition associated with itch. Additionally, the duration of pain was found to impact itch incidence.
This paper provides a review of the years of experience of hip sonography since the first ultrasound (US) course in Italy in 1987. Clinical and US findings were correlated in 1,000 newborns examined consecutively in a study in 1991. Developmental dysplasia of the hip (DDH) was present even in the absence of clinical signs, including the Ortolani sign. The percentage of US diagnosis of DDH in newborns was 2.8%, while instability according to the Ortolani test was present in 0.75%. After recommendations from the American Academy of Pediatrics against universal US screening, early diagnosis decreased from 74.4% in the period 1992–2002 (43,418 hips examined) to 52.7% in 2013–2014 (5,598 hips examined). In order to answer the question of whether early treatment of DDH has better outcomes, the acetabulum maturation was studied in 93 type III hips. The statistical analysis showed a strong dependency (P < 0.001) between the alpha-angle gain and the age at which treatment was started. The first 2 weeks of life is the optimum time for early diagnosis and treatment; after 6 weeks of life, treatment is less effective and the results are less predictable. Furthermore, the role of the labrum and its morphological changes was analyzed in 86 unstable dysplastic hips (13 type D, 49 type III and 24 type IV) in patients with an average age of 53 days (range 1–134 days) at DDH diagnosis and the beginning of treatment. The labrum was never inverted and underwent a statistically significant increase in echogenicity and dimensions with a frequency of 97% and 96% respectively, suggesting the labrum’s stabilizing role. Abnormal findings such as in achondroplasia, cleidocranial dysplasia, other rare osteochondrodysplasias and in coxa vara are underlined. Uncommon findings such as incomplete acetabular bony rim and eccentric position of the femoral head nucleus are also described.
[Names] => Maurizio De Pellegrin ... Nicola Guindani [Doi] => 10.37349/emd.2024.00040 [Published] => April 10, 2024 [Viewed] => 166 [Downloaded] => 15 [Subject] => Review [Year] => 2024 [CiteUrl] => https://api.crossref.org/works/10.37349/emd.2024.00040 [Inline] => 1 [Type] => 0 [Issue] => [Topic] => 267 [TitleAbbr] => Explor Musculoskeletal Dis. [Pages] => 2024;2:116–129 [Recommend] => 0 [Keywords] => Hip, ultrasound, screening, developmental dysplasia of the hip, Ortolani, osteochondrodysplasias, labrum, femoral head nucleus [DetailTitle] => Baby Hip Sonography Worldwide: Experience, Results, and Recommendations [DetailUrl] => https://www.explorationpub.com/Journals/emd/Special_Issues/267 [Id] => 100740 [ris] => https://www.explorationpub.com/uploads/Article/A100740/789c2f382ad30a2570c245afe504ce43.ris [bib] => https://www.explorationpub.com/uploads/Article/A100740/e9a1e3feb19d8433fd9345c3cd6aad66.bib [ens] => [Cited] => 0 [Cited_Time] => [CitethisArticle] => De Pellegrin M, Fracassetti D, Marcucci L, Guindani N. Hip sonography: thirty-four years of experience in Italy. Explor Musculoskeletal Dis. 2024;2:116–29. https://doi.org/10.37349/emd.2024.00040 [Jindex] => 0 [CName] => [CEmail] => [Ris_Time] => 2024-03-28 03:55:56 [Bib_Time] => 2024-03-28 03:55:56 [KeysWordContens] => Hip sonography: thirty-four years of experience in Italy, Hip, ultrasound, screening, developmental dysplasia of the hip, Ortolani, osteochondrodysplasias, labrum, femoral head nucleus, This paper provides a review of the years of experience of hip sonography since the first ultrasound (US) course in Italy in 1987. Clinical and US findings were correlated in 1,000 newborns examined consecutively in a study in 1991. Developmental dysplasia of the hip (DDH) was present even in the absence of clinical signs, including the Ortolani sign. The percentage of US diagnosis of DDH in newborns was 2.8%, while instability according to the Ortolani test was present in 0.75%. After recommendations from the American Academy of Pediatrics against universal US screening, early diagnosis decreased from 74.4% in the period 1992–2002 (43,418 hips examined) to 52.7% in 2013–2014 (5,598 hips examined). In order to answer the question of whether early treatment of DDH has better outcomes, the acetabulum maturation was studied in 93 type III hips. The statistical analysis showed a strong dependency (P < 0.001) between the alpha-angle gain and the age at which treatment was started. The first 2 weeks of life is the optimum time for early diagnosis and treatment; after 6 weeks of life, treatment is less effective and the results are less predictable. Furthermore, the role of the labrum and its morphological changes was analyzed in 86 unstable dysplastic hips (13 type D, 49 type III and 24 type IV) in patients with an average age of 53 days (range 1–134 days) at DDH diagnosis and the beginning of treatment. The labrum was never inverted and underwent a statistically significant increase in echogenicity and dimensions with a frequency of 97% and 96% respectively, suggesting the labrum’s stabilizing role. Abnormal findings such as in achondroplasia, cleidocranial dysplasia, other rare osteochondrodysplasias and in coxa vara are underlined. Uncommon findings such as incomplete acetabular bony rim and eccentric position of the femoral head nucleus are also described. ,Maurizio De Pellegrin ... Nicola Guindani [PublishedText] => Published [IsEdit] => 0 [AccountId] => 22 [Zh] => 1 ) [40] => Array ( [ArticleId] => 1198 [Create_Time] => 2024-04-17 [zipUrl] => https://www.explorationpub.com/uploads/zip/202404/20240417014408.zip [xmlUrl] => https://www.explorationpub.com/uploads/Article/A100741/100741.xml [pdfUrl] => https://www.explorationpub.com/uploads/Article/A100741/100741.pdf [coverUrl] => https://www.explorationpub.com/uploads/Article/A100741/100741_cover.png [JournalsId] => 9 [Title] => Hip sonography in Hungary [Abstract] => The diagnosis of hip dysplasia has developed very differently in different countries over the last few decades. The development and current situation in Hungary is described in this paper. The Ortol [AbstractComplete] =>The diagnosis of hip dysplasia has developed very differently in different countries over the last few decades. The development and current situation in Hungary is described in this paper. The Ortolani test is still the gold standard for clinical examination in most regions. Hip sonography is not officially established and is only used occasionally. However, thanks to private initiatives, more and more orthopaedic surgeons are now familiarising themselves with this method and the first courses are being held in accordance with International Interdisciplinary Consensus Committee on DDH Evaluation (ICODE) guidelines. A regional screening with Graf hip sonography was carried out in Szeged. The results of the evaluation impressively demonstrate the efficiency of this method.
[Names] => Beat Dubs [Doi] => 10.37349/emd.2024.00041 [Published] => April 17, 2024 [Viewed] => 102 [Downloaded] => 6 [Subject] => Perspective [Year] => 2024 [CiteUrl] => https://api.crossref.org/works/10.37349/emd.2024.00041 [Inline] => 1 [Type] => 0 [Issue] => [Topic] => 267 [TitleAbbr] => Explor Musculoskeletal Dis. [Pages] => 2024;2:130–132 [Recommend] => 0 [Keywords] => Hungary, hip, sonography, Graf, dysplasia [DetailTitle] => Baby Hip Sonography Worldwide: Experience, Results, and Recommendations [DetailUrl] => https://www.explorationpub.com/Journals/emd/Special_Issues/267 [Id] => 100741 [ris] => https://www.explorationpub.com/uploads/Article/A100741/f180f70248677e50ef0d97ea209b782a.ris [bib] => https://www.explorationpub.com/uploads/Article/A100741/87585a7d835156c4f80ae3403492bb5e.bib [ens] => [Cited] => 0 [Cited_Time] => [CitethisArticle] => Dubs B. Hip sonography in Hungary. Explor Musculoskeletal Dis. 2024;2:130–2. https://doi.org/10.37349/emd.2024.00041 [Jindex] => 0 [CName] => [CEmail] => [Ris_Time] => 2024-03-28 07:25:21 [Bib_Time] => 2024-03-28 07:25:21 [KeysWordContens] => Hip sonography in Hungary, Hungary, hip, sonography, Graf, dysplasia, The diagnosis of hip dysplasia has developed very differently in different countries over the last few decades. The development and current situation in Hungary is described in this paper. The Ortolani test is still the gold standard for clinical examination in most regions. Hip sonography is not officially established and is only used occasionally. However, thanks to private initiatives, more and more orthopaedic surgeons are now familiarising themselves with this method and the first courses are being held in accordance with International Interdisciplinary Consensus Committee on DDH Evaluation (ICODE) guidelines. A regional screening with Graf hip sonography was carried out in Szeged. The results of the evaluation impressively demonstrate the efficiency of this method. ,Beat Dubs [PublishedText] => Published [IsEdit] => 0 [AccountId] => 76 [Zh] => 1 ) [41] => Array ( [ArticleId] => 1237 [Create_Time] => 2024-04-17 [zipUrl] => https://www.explorationpub.com/uploads/zip/202404/20240424073138.zip [xmlUrl] => https://www.explorationpub.com/uploads/Article/A100742/100742.xml [pdfUrl] => https://www.explorationpub.com/uploads/Article/A100742/100742.pdf [coverUrl] => https://www.explorationpub.com/uploads/Article/A100742/100742_cover.png [JournalsId] => 9 [Title] => Teleteaching in paediatric rheumatology: an Asia Pacific League of Associations for Rheumatology experience [Abstract] => Aim: To evaluate the reach and potential effectiveness of teleteaching of health providers in paediatric rheumatology by observing the pattern of sessions, attendance, and attendees’ feedback i [AbstractComplete] =>To evaluate the reach and potential effectiveness of teleteaching of health providers in paediatric rheumatology by observing the pattern of sessions, attendance, and attendees’ feedback in paediatric rheumatology teleteaching sessions across the Asia Pacific region. These were conducted by the Asia Pacific League of Associations for Rheumatology (APLAR) Paediatric Rheumatology Special Interest Group (Paeds Rheum SIG) as an APLAR academy activity.
A retrospective, descriptive analysis of electronic records of synchronous telehealth sessions held between July 2021 to July 2023. These followed three formats: case-based webinars, single topic modular online course, and a hybrid one-day short course. The topics of sessions, attendees’ registration details, specifically primary area of practice/specialty, geographic location, and their satisfaction as per feedback forms were noted.
Case-based webinars had an average attendance of 200 per webinar: majority adult rheumatologists, paediatric rheumatologists (PRs), or paediatricians. The modular course consisted of nine sessions with an average of 63 participants per session. Specialties comprised PRs, adult rheumatologists with immunologists, and general paediatricians. The one-day hybrid course had over 600 attendees. Attendees were adult rheumatologists, general physicians, paediatricians, and PRs. Although the majority (79.3%) of attendees from these sessions were from APLAR member nation organisations (MNOs), a significant percentage (20.7%) were from non-APLAR MNOs and even non-Asia Pacific regions. The attendees’ feedback for all three formats showed a high level of satisfaction with case-based webinars being most favoured.
Teleteaching in paediatric rheumatology has the potential to fulfill the dire need for improved expertise of health professionals managing children with rheumatic diseases. Case-based, interactive sessions of shorter duration and a blended hybrid format may garner the most attendance and best learning outcomes.