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Postmortem examination revealed antitrochanteric degeneration in turkeys (8 male, 2 female) and broiler type chickens (5 male, 1 female). Antitrochanteric degeneration was detected in birds aged 20 weeks or older but histological examination identified lesions in others with grossly normal antitrochanters. Normal and abnormal antitrochanteric development was studied in male, skeletally immature, turkeys and broilers. Differential subchondral bone growth occurred, with relatively delayed ilial bone development. As a result, hyaline cartilage was retained dorsally and persisted even in adult birds. Retained hyaline, and in younger birds growth plate, cartilage was prone to osteochondrosis. When cartilage flap formation involved fissures traversing retained hyaline cartilage, the term osteochondrosis dissecans was appropriate. In other cases of antitrochanteric degeneration, changes typical of osteoarthrosis were present with, in some instances, no evidence of pre-existing osteochondrosis. Certain sites of antitrochanteric cartilage may be susceptible to fatigue failure in these cases.
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PMID:Further studies of degenerative hip disease; antitrochanteric degeneration in turkeys and broiler type chickens. 397 5

Three experimental questionnaires were compared with the Influence of Rheumatic Diseases on Health and Lifestyle (IRGL) questionnaire, a Dutch version of the Arthritis Impact Measurement Scales. Sixty-two patients with osteoarthritis (OA) and 35 patients with rheumatoid arthritis (RA), all of whom underwent hip arthroplasty, completed the study. Results showed that visual analogue scales for pain, stiffness, fatigue, and anxiety were strongly correlated with a number of the IRGL scales. Patient preference scales were sensitive to change and provided additional information on aspects of the patients' quality of life (QOL) that were felt to be important by the patients themselves. The questionnaire on performance in various roles in life was insensitive to change. In existing questionnaires, there is an attempt to represent the concept of QOL in terms of its most important aspects. Such realizations of the concept of QOL are not entirely suitable for application in clinical trials. The IRGL is overly complex, and its sometimes comprehensive scales do not deal with the possible effects of treatment. Neither of these properties is conducive to sensitivity to change. Visual analogue scales reduce the complexity. A simpler representation of QOL that can evaluate aspects relevant to treatment is recommended.
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PMID:Quality of life assessment: a comparison of four questionnaires: for measuring improvements after total hip replacement. 774 39

Overuse is the primary culprit in most running injuries, with biomechanical factors playing a much smaller role. A review of some of the most common and recalcitrant injuries in adults and adolescents is presented. Discussion of the pathophysiology of tendon injuries, stress fractures of the lower extremities, and apophysitis in adolescents is undertaken, and treatment strategies are proposed. Additionally, non-musculoskeletal events that may be related to a musculoskeletal injury such as exercise-associated amenorrhea and chronic fatigue or depression are reviewed. That running may promulgate osteoarthritis is still controversial. Most studies are limited by their retrospective design. However, the preponderance of data gives insufficient credence to the idea of osteoarthritis as a complication of long-distance running. With regard to treatment, nonsteroidal anti-inflammatory drugs appear to play little or no effective role in the management of running injuries.
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PMID:Running injuries. 802 68

Skeletal abnormalities of eight patients with Satoyoshi's syndrome, a rare condition of unknown etiology characterized by progressive muscle spasms, alopecia, and diarrhea, were studied radiographically. Various skeletal changes were observed including metaphyseal lesions, slipping of multiple epiphyses, cystic lesions, acroosteolysis and osteolysis, bone fragmentation at tendinous insertions, fatigue fractures, and early osteoarthrosis. This wide range of lesions is likely to be due to repeated injuries to the growth plates, epiphyses, and tendon attachments in the growing skeleton caused by recurrent vigorous muscle spasms.
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PMID:Skeletal abnormalities in Satoyoshi's syndrome: a radiographic study of eight cases. 837 59

A prospective pre- and postoperative general health/quality-of-life factor comparison, using the Rand SF-36 Health Status Questionnaire (TyPE Specification, Quality Quest [Health Outcomes Institute, Minneapolis, MN]), was carried out on a consecutive series of patients with diagnosed osteoarthritis undergoing total hip and knee arthroplasty between March 1991 and March 1994. Study groups consisted of 85 total hip arthroplasty patients, 93 total knee arthroplasty patients, and 65 single-stage bilateral total knee arthroplasty patients, all treated at the same specialty hospital, under the care of three senior orthopaedic surgeons. The average patient age was 69 years. Significant improvements in quality-of-life measures including physical functioning, social functioning, role functioning/physical problem, role functioning/emotional problem, mental health, energy/fatigue, pain, and change in health were noted in all hip and knee arthroplasty patients 6 months, 1 year, and 2 years after surgery (P < .05). There appeared to be no significant differences in quality-of-life measures between hip and knee arthroplasty patients. Results therefore indicate that total hip and knee arthroplasty significantly improve the functional status and quality of life among patients suffering from osteoarthritis.
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PMID:Comparative outcomes of total joint arthroplasty. 874 54

Seven cadaveric feet were studied to determine the distribution of the contact area of the talonavicular joint. Feet were loaded axially with soft tissue structures intact and after sectioning of static elements that support the arch. Bony displacement was monitored with a magnetic tracking device, and joint contact was determined from proximity calculations of digitized joint surfaces. With physiologic loading of the intact foot, the number of regions in contact increased. In the unstable foot, there was a shift in contact distribution toward more dorsal and central regions of the navicular bone. This is consistent with the clinical observation that fatigue fractures, acute fractures, and nonunion of navicular fractures occur often in the central navicular body. The alteration in contact characteristics in unstable feet is also consistent with the observation that osteoarthrosis of the hindfoot joints occurs commonly with long-standing arch instability or pes planus deformity.
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PMID:Contact features of the talonavicular joint of the foot. 899 89

The carpus and metacarpus of 40 horses which were free from lameness and 40 horses with lameness associated with the metacarpophalangeal joint or more distal limb were examined radiographically (Group A). The opacity of the proximal third of the third metacarpal bone was regular, with a uniform trabecular pattern. Osseous cyst-like lesions (OCLLs) were identified in the radial carpal bone (1), the ulnar carpal bone (2), the second carpal bone (15) and the fourth carpal bone (1). Thirty-one of 638 horses (4.8 percent) with forelimb lameness had pain localised to the proximal metacarpal region using local anaesthesia (Group B). All these horses were examined radiographically and an ultrasonographic examination was performed in seven. No definitive diagnosis was reached in 16 horses, seven of which had an OCLL in one of the carpal bones or the second metacarpal bone. One horse had, in addition to a poorly defined lucent area in the second carpal bone, radiographic evidence of degenerative joint disease of the carpometacarpal joint and an hypoechoic lesion in the accessory ligament of the deep digital flexor tendon. One horse had an hypoechoic lesion in the proximal part of the suspensory ligament. Abnormalities of the trabecular structure of the third metacarpal bone were identified in 13 horses. In 11 of these there was a vertically orientated lucent line, usually surrounded by sclerotic bone. These lucent lines may represent fatigue fractures seen end on. In one horse an horizontal lucent line was seen. One of these 13 horses also had a lesion in the proximal part of the suspensory ligament. Ten of the 13 (77 per cent) horses with presumed fractures of the third metacarpal bone recovered completely, whereas only eight of the 16 (50 per cent) horses in which no definitive diagnosis was reached returned to their former function.
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PMID:Some observations on lameness associated with pain in the proximal metacarpal region. 907 62

The knee joint position sense of a control group of healthy women was compared with that of women diagnosed as having severe osteoarthritis (OA) of the knee. Movements monitored were multi-joint when weightbearing on one leg. All subjects completed two angle rematching tests on two separate test occasions, and the criterion and reproduction angles which lay in the range of 15-45 degrees knee flexion were recorded photographically on each occasion. The results showed that the OA group performed the rematching tests with less accuracy than the controls (p < 0.05). Additionally, the OA group displayed significantly higher average flexion error magnitudes than the controls. These results suggest that joint position sense is less accurate and may be systematically distorted during multi-joint movements of the affected legs of a high proportion of women with severe knee OA. They further suggest that to improve their functional performance, patients with knee OA probably require a carefully constructed sensorimotor rehabilitation programme in which pain, effusion and fatigue are minimised.
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PMID:Further evidence of impaired position sense in knee osteoarthritis. 923 29

Arthritis is one of the most common chronic illnesses managed in primary care. Osteoarthritis and rheumatoid arthritis are two common types the provider must distinguish between in terms of diagnosis and treatment. Osteoarthritis, the most common form, typically occurs in people more than 60 years of age and involves cartilage destruction. Signs and symptoms are local and include cool, bony joints and arthralgia that worsens with weight bearing. Treatment includes acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), exercise, and joint arthroplasty in severe cases. Rheumatoid arthritis is a systemic disease that results in symmetrical joint inflammation along with constitutional symptoms such as fatigue and depression. Current treatment recommendations include early use of disease modifying anti-rheumatic drugs along with NSAIDs. The key to arthritis management is early diagnosis and treatment to prevent further joint destruction and maximize functional ability.
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PMID:A comparison of osteoarthritis and rheumatoid arthritis: diagnosis and treatment. 931 63

This study examined the relationship of pain coping strategies to osteoarthritis patients' ratings of self-efficacy and to spouses' ratings of the patients' self-efficacy. Subjects, 130 individuals having osteoarthritis of the knees and persistent knee pain, completed a pain coping strategies measure (the Coping Strategies Questionnaire), a measure of self-efficacy (the Arthritis Self-Efficacy Scale), and a measure of pain (the McGill Pain Questionnaire). Two sets of regression analyses were conducted, one examining the degree to which pain coping strategies predicted patients' self-efficacy ratings, and the other examining the degree to which coping strategies predicted spouses' ratings of the patients' self-efficacy. Several pain coping strategies were found to predict a significant proportion of variance in patients' ratings of self-efficacy: (i) ignoring pain sensations was related to higher self-efficacy for pain; (ii) coping self statements were related to higher self-efficacy for controlling other arthritis symptoms (e.g., fatigue or mood symptoms: and (iii) catastrophizing was related to lower self-efficacy for pain, and self-efficacy for other arthritis symptoms. Pain coping strategies were also found to predict a significant proportion of variance in spouses' ratings of the patients' self-efficacy. Specifically: (i) diverting attention was related to lower spousal ratings of self-efficacy for pain; (ii) praying or hoping was related to lower spousal ratings of self-efficacy for function; and (iii) catastrophizing was related to lower spousal ratings of self-efficacy for control of fatigue or mood symptoms. The findings regarding coping strategies were particularly interesting in that they were obtained even after controlling for pain intensity and demographic variables. The pain coping strategies identified are potentially important targets for cognitive-behavioral assessment and treatment efforts. Interventions designed to increase the use of adaptive pain coping strategies and decrease the use of maladaptive pain coping strategies could enhance self-efficacy, reduce pain, and improve the physical and psychological functioning of individuals having osteoarthritis.
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PMID:Pain coping strategies that predict patients' and spouses' ratings of patients' self-efficacy. 941 5


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