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Query: UMLS:C0003873 (rheumatoid arthritis)
 53,068 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We studied the pain, Stanford Health Assessment Questionnaire functional disability, pain/disability ratio, and psychological scores in 1,522 patients with rheumatic disease with 7 distinct disorders. Individual differences between patients were more striking than differences among diagnostic groups. Patients with rheumatoid arthritis (RA) had the greatest disability, least pain, lowest pain/disability ratio, and least abnormal psychological scores. Highest pain and psychological distress was noted in low back pain, neck pain, and fibromyalgia (axial disorders). Disability in activities of daily living was as high in fibromyalgia as in RA, but low in axial skeletal disorders. There appears to be a continuum for disability that begins with axial but not articular disease (neck and back pain) and ends with multiple articular and periarticular involvement (RA and fibromyalgia).
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PMID:Pain, disability, and pain/disability relationships in seven rheumatic disorders: a study of 1,522 patients. 183 15

In 24,964 employees of a shoe factory a retrospective analysis of the work incapacity on account of diseases of the locomotor system was made. On account of these diseases in the course of the calendar year 11.7% of the employees were unable to work and these diseases accounted for 19.5% of the sickness days. The largest number of work incapacities was in March and November. The mean period of work incapacity was 21.4 days. The shortest work incapacity was recorded in patients suffering from gout (13.2 days) and the longest one in patients with rheumatoid arthritis (125.4 days). The most frequent cause of work incapacity was back pain (62.2%), extraarticular rheumatism (17.4%) and osteoarthritis of the joints of the extremities (7.2%). Two hundred-sixty-four patients had in-patient treatment (9%). The greatest proportion of patients were hospitalized on account of back pain (54.9%). The mean period of hospitalization was 17.3 days. Between different factory medical officers relatively great differences in the number and length of granted work incapacity were found. The investigation revealed the importance of diseases of the locomotor system in the investigated shoe factory and the need to investigate the influence of the working environment and occupation on clinical manifestations of affections of the locomotor system.
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PMID:[Disease of the locomotor system in a shoe factory]. 214 Jul 14

Many factors are known to play a role in the pathogenesis of generalized tendomyopathy (GTM), or fibromyalgia. While the secondary forms develop along with known diseases, particularly rheumatoid arthritis, the cause of primary GTM is often not well understood. The fact that this disorder usually appears first at a single site, e.g., as low-back pain or cervical syndrome in which poor posture or malformation of the spine can be observed, gives rise to the theory that local changes in the spine or the joints are particular underlying causes of the initial manifestation. As the disorder becomes generalized, however, psychological causes predominate. Psychosocial factors in particular seem to further the process of generalization. Therapy can take many forms. Above all, it calls for an understanding attitude on the part of the managing physician and, whenever, possible, elimination of likely causal factors. Analgesics and antiinflammatories are often inadequate; antidepressants and neuroleptics provide more effective relief. Moreover, intensive physiotherapy and psychotherapy are necessary. GTM in many cases is resistant to treatment despite intensive management, although it often subsides naturally after age 60. Recognizing GTM is of great importance in order to initiate appropriate treatment promptly, avoid incorrect diagnoses and their consequences, e.g., repeat surgery, and to prevent premature disability.
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PMID:[Generalized tendomyopathy. II: Pathogenesis and therapy]. 218 26

Generalized tendomyopathy (GTM), or fibromyalgia, is a disorder characterized by diffuse pain in the musculoskeletal apparatus which usually begins at a single site, e.g., as low-back pain or cervical syndrome, and develops into generalized pain over months or years. It is accompanied by increased tenderness at characteristic tender points, although the pain threshold on the whole is reduced. In addition to the main symptoms (pain in the musculoskeletal system, tenderness at the tender points), autonomic and functional symptoms are almost invariably present and are often accompanied by pathological psychological findings such as neuroses and depression. To date, no reliable laboratory parameters or pathognomonic histological findings have been identified. The disorder affects primarily women, beginning around the age of 35 and reaching its peak during or after the menopause. It also affects young people and those over age 60, although it is much less common in these cases. Secondary forms are observed particularly in rheumatoid arthritis. The differential diagnosis must first distinguish primary GTM from the secondary forms. There must also be further differentiation between internal and psychiatric disorders and primary GTM. This can be achieved in many cases by careful clinical diagnosis, although a more complete examination is sometimes required.
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PMID:[Generalized tendomyopathy. I: Clinical aspects, follow-up and differential diagnosis]. 218 25

We measured the levels of alpha 2-macroglobulin (alpha 2M)-proteinase complexes in the plasma of 18 patients with classic rheumatoid arthritis, 11 age-matched patients with noninflammatory back pain and osteoarthritis, and 8 healthy volunteers. In contrast with previous reports, we found no evidence of alpha 2 M-proteinase complexes in the plasma samples from individuals in any of the groups. In our assays, all activity that might have been the result of the presence of such complexes in the plasma samples proved instead to be an artifact attributable to contamination of the anti-alpha 2M antibody immobilized on the AffiGel solid phase with a trypsin-like proteinase. When the contaminating activity was eliminated by pretreatment of the antibody with 1 mM diisopropyl fluorophosphate, no degradation of substrate was detected with any of the plasma samples. However, the ability of the solid-phase assay to detect and quantitate alpha 2M-proteinase complexes when they are present was confirmed in control experiments with plasma samples to which performed alpha 2M-trypsin complexes had been added, or in which alpha 2M-kallikrein complexes had been generated by activation of Hageman factor (coagulation factor XII). We therefore conclude that neither normal plasma nor that from rheumatoid arthritis patients contains measurable amounts of alpha 2M-proteinase complexes.
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PMID:Plasma from rheumatoid arthritis patients does not contain abnormally high levels of alpha 2-macroglobulin-proteinase complexes. 244 46

An observation method for assessing chronic pain in back pain and rheumatoid arthritis has been developed during the last decade in the U.S.A. This study examined the validity and reliability of the method for a non-chronic back pain population from another culture. Two trained observers recorded pain behaviors displayed by 61 Swedish subjects during a 10 min, videorecorded, standardized sequence of maneuvers. Subjects were asked to make ratings of their pain intensity, depression, helplessness and disability level. A physical examination was performed by an orthopedist to obtain objective medical information about the subjects. Results showed that interrater as well as test-retest reliability were satisfactory. Correlations between pain behavior and other measures of pain, e.g., intensity ratings, medication intake, and spinal mobility, were statistically significant but somewhat lower than expected. The results indicate that the behavioral observation method provides reliable and valid information about non-chronic back pain among Swedish females. However, some modifications in the standardized sequence of maneuvers and the definitions of pain behaviors may be necessary to improve the utility of the method in this population.
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PMID:Validation of an observation method of pain assessment in non-chronic back pain. 253 39

Among bone and joint diseases, frequent causes of disability include (a) fractures from falls and osteoporosis, (b) osteoarthritis of hips, knees, and lumbar spine, (c) painful feet, (d) back pain, and (e) intractable rheumatoid arthritis. Risk factors for falling may arise from factors intrinsic to the patient and from hazards in the environment. The prevention and management of osteoporosis are controversial. Most experts endorse the use of estrogens in postmenopausal women and the need for continuing physical activity, particularly walking, in both elderly men and women. To preserve independent living, conservative management of osteoarthritis of hip, knee, and low back consists of properly balancing rest, non-weight-bearing exercises, and the use of walking aids. In rheumatoid arthritis, the clinician should emphasize (a) exercises to maintain range of motion and (b) muscle strength, both to prevent flexion contractures and to maintain the ability to carry on activities of daily living.
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PMID:Preventive aspects of mobility and functional disability. 253 6

The purpose of cognitive-behavioral therapy is to teach individuals the skills necessary to control pain and disability as well as to believe that they can successfully employ these skills. Cognitive-behavioral therapy has been used successfully in patients with back pain and rheumatoid arthritis and represents a potentially effective intervention for patients with primary fibromyalgia. This article describes cognitive-behavioral treatment procedures, presents 2 experimental designs that may be used in randomized, controlled clinical trials of cognitive-behavioral therapy in patients with primary fibromyalgia and identifies the methodological features that should be included in the trials.
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PMID:Cognitive-behavioral therapy for primary fibromyalgia. 269 72

The authors report a case of spine involvement in a severe case of rheumatoid arthritis treated with corticosteroids. First, the patient developed acute back pain, related to costovertebral joints arthritis at levels T9-T10. Then, neck pain and cord involvement yielded to diagnosis of cervical interapophyseal joints arthritis; there was a C5-C6 subluxation which necessitated surgical treatment. The conjunction of these two rheumatoid localizations is an uncommon feature. Study by the CT scan is valuable when rheumatoid arthritis of the spine is suspected. Lower cervical spine subluxation, even severe, may be well tolerated. Surgery is necessary when there is medullary involvement.
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PMID:Thoracic and lower cervical spine involvement in a case of rheumatoid arthritis. 277 85

The prevalence of back and joint complaints and of rheumatoid arthritis (RA), chondrocalcinosis (CC) and osteoarthritis (OA) was studied in three representative population subsamples aged 70, 75 and 79 years. The prevalence of back pain was 38% and of joint complaints 40%, both significantly higher in females. The prevalence of RA was not significantly different between the age groups. Chondrocalcinosis increased with age in females. Radiographic and clinical OA of knees was less prevalent with increasing age. Symptoms of wrist and finger OA occurred in 1-4% of females but not males. Enlargement of DIP joints occurred in 50% of females and 25% males. Radiographic OA of first MCP joints was more prevalent with age in males but not females. Obesity correlated with radiographic OA of knees in females. Clinical and radiographic OA of fingers and knees did not correlate with previous strenuous occupations.
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PMID:Joint disorders at ages 70, 75 and 79 years--a cross-sectional comparison. 294 52


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