A Narrative Review on Avulsion Fractures of the Upper and Lower Limbs.
Authors: Vannabouathong C, Ayeni OR, Bhandari M Abstract Avulsion fractures compromise function and movement at the affected joint. If left untreated, it can lead to deformity, nonunion, malunion, pain, and disability. The purpose of this review was to identify and describe the epidemiology and available treatment options for common avulsion fractures of the upper and lower extremities. Current evidence suggests that optimal treatment is dependent on the severity of the fracture. Conservative efforts generally include casting or splinting with a period of immobilization. Surgery is typically indicated for more seve...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - November 20, 2018 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Patient Discomfort and Resident Confidence After Knee Intra-articular Injection Simulation Training: A Randomized Control Trial Study.
This study aims to evaluate whether targeted simulation model training in residency can increase residents' comfort level in performing intra-articular knee injections and decrease the pain of the procedure, as reported by patients injected. Residents were randomized into intervention and control groups. The comfort level of the residents as well as the pain levels from the procedures, as reported by patients, was recorded. The mean comfort level for the intervention group was 1.2, compared with that in the control group, which was 2.13; P value was .047. The mean pain level in the intervention group was 1.8, whereas in th...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - July 19, 2018 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Influence of HLA-B27 Subtypes on Ankylosing Spondylitis Phenotype: Comment on the Article by Akassou et al.
Authors: Fallahi S PMID: 30013411 [PubMed] (Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders)
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - July 19, 2018 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Short-Term Outcomes in Treatment of Knee Osteoarthritis With 4 Bone Marrow Concentrate Injections.
Conclusions: These results are promising, and additional research with a larger sample size and longer follow-up is needed to further examine the treatment effectiveness of multiple BMC injections for knee osteoarthritis. PMID: 29977117 [PubMed] (Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders)
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - July 8, 2018 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Safety and Predictive Factors of Short-Term Efficacy of a Single Injection of Mannitol-Modified Cross-Linked Hyaluronic Acid in Patients with Trapeziometacarpal Osteoarthritis. Results of a Multicentre Prospective Open-Label Pilot Study (INSTINCT Trial).
Authors: Dauvissat J, Rizzo C, Lellouche H, Porterie J, Melac-Ducamp S, Locquet V, Travers V, Maillet B, Conrozier T Abstract Purpose: To assess safety and search predictive factors of efficacy of a single intra-articular injection of a mannitol-modified hyaluronic acid (HA) viscosupplement, in patients having trapeziometacarpal (TMC) osteoarthritis (OA). Methods: Patients with symptomatic TMC OA, not adequately relieved by analgesic therapy and/or by the use of a thumb splint, were included in a 3-month prospective multicentre open-label trial. All underwent plain radiographs with the Kapandji incidences allow...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - July 8, 2018 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Retrocalcaneal Bursitis Precedes or Accompanies Achilles Tendon Enthesitis in the Early Phase of Rheumatoid Arthritis.
Authors: Suzuki T, Hidaka Y, Seri Y Abstract The consecutive reports and stored images of ultrasound examinations for 100 symptomatic ankles of 74 patients with rheumatoid arthritis (RA) were reviewed for the presence or absence of retrocalcaneal bursitis (RCB) and Achilles tendon enthesitis (ATE). The ankles were classified into 4 categories based on the presence or absence of RCB or ATE. The number of RCB(-)/ATE(-), RCB(+)/ATE(-), RCB(+)/ATE(+), and RCB(-)/ATE(+) ankles was 62, 16, 12, and 10, respectively. When classifying patients into early RA and established RA, the percentage of RCB(-)/ATE(+) ankles with ear...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - June 15, 2018 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

A Pooled Analysis of Two Multicenter, Randomized Controlled Trials of a Single Intra-articular Injection of Gel-200 for Treatment of Osteoarthritis of the Knee.
Conclusion: This integrated analysis demonstrated the efficacy of a single intra-articular injection of Gel-200 compared with PBS for treatment of osteoarthritis of the knee over 26 weeks without major safety concerns. Trial Registration: NCT00449696 and NCT00450112. PMID: 29780263 [PubMed] (Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders)
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - May 23, 2018 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Late Presentation of Infected Silicone Granulomas in the Lower Limb.
Conclusions: Microorganisms can induce immune-mediated hypersensitivity and are believed to be the trigger for delayed activation of a quiescent foreign body to a granulomatous reaction. The substantial time delay between injection and reaction must be recognised and may be attributable to atypical microorganisms or biofilm formation. Previous antibiotic use can affect expedient microbiological diagnosis and treatment requires close collaboration with microbiologists. It is important that clinicians are aware of these important complications which are becoming more common with increased use of filler augmentation. PMID...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - March 9, 2018 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

An Observational 1-Month Trial on the Efficacy and Safety of Promerim for Improving Knee Joint.
This study was conducted to evaluate the efficacy and tolerability of the oral intake of promerim in the elimination of acute pain and discomfort associated with knee osteoarthritis (OA). Methods: Single-center, 1-month, prospective, observational clinical trial. A total of 92 patients not older than 70 years were included. Patients were offered to use 720-mg promerim for the first 15 days after admission after breakfast and then 360 mg for the second 15 days. All patients were analyzed with the visual analog scale (VAS) for pain, which ranges from 0 to 10, and the Western Ontario and McMast...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - February 27, 2018 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Osteoarthritis and the Complement Cascade.
Authors: Silawal S, Triebel J, Bertsch T, Schulze-Tanzil G Abstract Accumulating evidence demonstrates that complement activation is involved in the pathogenesis of osteoarthritis (OA). However, the intimate complement regulation and cross talk with other signaling pathways in joint-associated tissues remain incompletely understood. Recent insights are summarized and discussed here, to put together a more comprehensive picture of complement involvement in OA pathogenesis. Complement is regulated by several catabolic and inflammatory mediators playing a key role in OA. It seems to be involved in many processes obser...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - February 14, 2018 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

A Preliminary Evaluation of the Ability of Keratotic Tissue to Act as a Prognostic Indicator of Hip Fracture Risk.
The objective of this study was to investigate the potential of a prospective test for hip fracture based on spectroscopic analysis of nail tissue. Archived toenail samples from post-menopausal women aged 50 to 63 years in the Nurses' Health Study were obtained and analysed by Raman spectroscopy. Nails were matched case-controls sourced from 161 women; 82 who underwent a hip fracture up to 20 years after nail collection and 81 age-matched controls. A number of clinical risk factors (CRFs) from the Fracture Risk Assessment (FRAX) tool had been assessed at toenail collection. Using 80% of the spectra, models we...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - January 28, 2018 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Total Knee Arthroplasty: Does Day of Surgery Matter?
Authors: Malik AT, Khan S, Ali A, Mufarrih SH, Noordin S Abstract Introduction: There has been an influx of research studies aimed at identifying all factors that contribute to minimizing cost and maximizing postoperative care after total knee arthroplasty (TKA). Length of stay (LOS) has been defined as a significant factor that contributes to increased burden. We aimed at looking whether day of surgery has any significant effect on the LOS and postoperative complications following total knee arthroplasty (TKA). Materials and methods: Retrospective cohort study done at the Aga Khan University Hospital, Pakistan...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - January 28, 2018 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

The Protein Tyrosine Phosphatase Nonreceptor 22 (PTPN22) R620W Functional Polymorphism in Psoriasis.
Authors: Bin Huraib G, Al Harthi F, Arfin M, Rizvi S, Al-Asmari A Abstract Background: Psoriasis is a complex autoimmune disease caused by the interaction of genetic and environmental factors. PTPN22 gene polymorphism has been reported to affect psoriasis susceptibility; however, no data are available for Middle Eastern populations. Objective: The aim of this study was to investigate the association of PTPN22 (1858C/T) R620W polymorphism with psoriasis in a Saudi cohort. Methods: Saudi subjects (n = 306) including patients with psoriasis (n = 106) and matched controls (n =...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - January 20, 2018 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Does HLA-B27 Status Influence Ankylosing Spondylitis Phenotype?
Authors: Akassou A, Bakri Y Abstract The association of HLA-B27 with ankylosing spondylitis (AS) remains as one of the intriguing models that could exist between a molecule and human disease in medicine. Although it was reported in 1973, its contribution to AS and related spondyloarthritis continues to be a major challenge for scientific community. It is important to understand its etiopathogenic mechanism and its functions in these diseases. Although the diagnostic and prognostic roles of HLA-B27 in AS are still debated, there is an increasing interest for HLA-B27-based effects especially in HLA-B27(+) patients wi...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - January 19, 2018 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Medial Pivot in Total Knee Arthroplasty: Literature Review and Our First Experience.
Discussion and conclusions: Medial Congruent insert showed good to excellent clinical results at 1-year FU. Range of motion and subjective outcomes were satisfying and comparable with results obtained in literature using traditional TKA design. PMID: 29326531 [PubMed] (Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders)
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - January 13, 2018 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Rheological Properties of Commercially Available Hyaluronic Acid Products in the United States for the Treatment of Osteoarthritis Knee Pain.
Conclusions: Due to the differences in rheological properties between IA-HA products, the universal assessment of these products as a class may not be appropriate. Instead, it may be more appropriate to assess each product individually. Future research should aim to link these differences in rheological properties to the differences in clinical efficacy seen across these IA-HA products. PMID: 29326532 [PubMed] (Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders)
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - January 13, 2018 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Proliferative Synovitis of the Shoulder Bursae is a Key Feature for Discriminating Elderly Onset Rheumatoid Arthritis Mimicking Polymyalgia Rheumatica From Polymyalgia Rheumatica.
Authors: Suzuki T, Yoshida R, Hidaka Y, Seri Y Abstract Semiquantitative scoring for subacromial bursa (SAB), subdeltoid bursa (SDB), and subcoracoid bursa by both gray-scale (GS) and power Doppler (PD) ultrasonography was performed in 15 patients with polymyalgia rheumatica (PMR) (72.6 ± 7.7 years old) and 15 patients with elderly onset rheumatoid arthritis with PMR-like onset (pm-EORA) (70.7 ± 7.0 years old) before starting treatment. The GS grades of SAB were significantly higher in the shoulders with pm-EORA than in the shoulders with PMR. The GS and PD sc...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - December 17, 2017 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Efficacy of Intra-articular Injection of a Newly Developed Plasma Rich in Growth Factor (PRGF) Versus Hyaluronic Acid on Pain and Function of Patients with Knee Osteoarthritis: A Single-Blinded Randomized Clinical Trial.
CONCLUSIONS: In 6 months follow up, our newly developed PRGF and HA, both are effective options to decrease pain and improvement of function in patients with symptomatic mild to moderate knee osteoarthritis. PMID: 29051707 [PubMed] (Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders)
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - October 21, 2017 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Feasibility of the Atlas Unicompartmental Knee System Load Absorber in Improving Pain Relief and Function in Patients Needing Unloading of the Medial Compartment of the Knee: 1-Year Follow-Up of a Prospective, Multicenter, Single-Arm Pilot Study (PHANTOM High Flex Trial).
This study highlights the potential benefit of a joint unloading device in the management of young patients with medial knee OA. The trial is still ongoing and another analysis is planned at 24 months. PMID: 28989290 [PubMed] (Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders)
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - October 11, 2017 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Patient Preferences Regarding Surgical Interventions for Knee Osteoarthritis.
Authors: Moorman CT, Kirwan T, Share J, Vannabouathong C Abstract Surgical interventions for knee osteoarthritis (OA) have markedly different procedure attributes and may have dramatic differences in patient desirability. A total of 323 patients with knee OA were included in a dual response, choice-based conjoint analysis to identify the relative preference of 9 different procedure attributes. A model was also developed to simulate how patients might respond if presented with the real-world knee OA procedures, based on conservative assumptions regarding their attributes. The "amount of cutting and removal of t...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - October 5, 2017 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Magnetic Resonance Imaging of the Axial Skeleton in Patients With Spondyloarthritis: Distribution Pattern of Inflammatory and Structural Lesions.
Authors: Hoffstetter P, Al Suwaidi MH, Joist A, Benditz A, Fleck M, Stroszczynski C, Dornia C Abstract PURPOSE: Spondyloarthritis is a chronic inflammatory disorder of the musculoskeletal system driven by systemic enthesitis and typically involving the axial skeleton, ie, the spine and the sacroiliac joints. The purpose of this study was to assess the distribution pattern of inflammatory and structural magnetic resonance imaging (MRI) findings in spondyloarthritis. METHODS: Retrospective study of 193 patients with axial spondyloarthritis who received MRI of the spine and the sacroiliac joints. We quantitatively...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - September 13, 2017 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Hypokalemic Paralysis: A Hidden Card of Several Autoimmune Diseases.
We report a case of a lupic patient who presented rapidly progressive quadriparesis in the context of active renal disease. Research revealed severe refractory hypokalemia, metabolic acidosis, and alkaline urine suggestive of dRTA. We diagnosed Sjögren's syndrome based on sicca symptoms, an abnormal salivary glands' nuclear scan and the presence of anti-Ro/SSA and anti-La/SSB. In addition, the finding of thyroid peroxidase, thyroglobulin antibodies, and hypothyroidism led us to the diagnosis of Hashimoto thyroiditis. Due to the active renal involvement on the context of systemic lupus erythematosus and Sjögren's ...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - August 26, 2017 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

The Disease-Modifying Effects of Hyaluronan in the Osteoarthritic Disease State.
The objectives of this article are to (1) describe the etiology and pathophysiology of OA including both what is known about the genetics and biochemistry, (2) describe the role of HA on disease progression, (3) detail the antinociceptive and anti-inflammatory actions of HA in OA, and (4) present evidence of disease-modifying effects of HA in the preservation and restoration of the extracellular matrix. These data support that HA is not only just a simple device used for viscosupplementation but also a biologically active molecule that can affect the physiology of articular cartilage. PMID: 28839448 [PubMed] (Source: C...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - August 26, 2017 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Comparison of the 3 Different Injection Techniques Used in a Randomized Controlled Study Evaluating a Cross-Linked Sodium Hyaluronate Combined With Triamcinolone Hexacetonide (Cingal) for Osteoarthritis of the Knee: A Subgroup Analysis.
In this study, injections were administered by 1 of 3 approaches; however, there is currently no consensus on which, if any, of these techniques produce a more favorable outcome. To provide additional insight on this topic, the results of the previous trial were reanalyzed to determine whether (1) the effect of Cingal was significant within each injection technique and (2) pain reductions were similar between injection techniques across all treatment groups. Greater pain reductions with Cingal up to 3 weeks were only significant in the anteromedial subgroup. Across all therapies, both the anteromedial and anterolate...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - August 26, 2017 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Oral Anaerobic Bacteria in the Etiology of Ankylosing Spondylitis.
Authors: Ö─črendik M Abstract Ankylosing spondylitis (AS) is associated with periodontitis. Anti-Porphyromonas gingivalis and anti-Prevotella intermedia antibody titers were higher in patients with spondyloarthritis than in healthy people. Sulfasalazine is an effective antibiotic treatment for AS. Moxifloxacin and rifamycin were also found to be significantly effective. The etiology hypothesis suggests that oral anaerobic bacteria such as Porphyromonas spp and Prevotella spp contribute to the disease. These bacteria have been identified in AS, and we will discuss their pathogenic properties with respect to our...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - June 25, 2017 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Cost-Utility of a Single-Injection Combined Corticosteroid-Hyaluronic Acid Formulation vs a 2-Injection Regimen of Sequential Corticosteroid and Hyaluronic Acid Injections.
Authors: Belzile EL, Deakon RT, Vannabouathong C, Bhandari M, Lamontagne M, McCormack R Abstract Research has shown early and sustained relief with a combination therapy of a corticosteroid (CS) and hyaluronic acid (HA) in knee osteoarthritis (OA) patients. This can be administered via a single injection containing both products or as separate injections. The former may be more expensive when considering only product cost, but the latter incurs the additional costs and time of a second procedure. The purpose of this study was to compare the cost-utility of the single injection with the 2-injection regimen. The resu...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - June 25, 2017 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Subacromial Anesthetics Increase Proprioceptive Deficit in the Shoulder and Elbow in Patients With Subacromial Impingement Syndrome.
Authors: Ettinger LR, Shapiro M, Karduna A Abstract Shoulder proprioception gives information regarding arm joint position and movement direction. Several studies have investigated shoulder proprioceptive acuity in patients with subacromial impingement syndrome (SIS); however, differences in protocols and between-subjects designs have limited scientific inferences regarding proprioception and SIS. We aimed to determine within-subject differences in shoulder and elbow proprioceptive acuity in 17 patients with stage 2 SIS following treatment of a local anesthetic injection. In addition, we used 17 healthy, age-, sex-...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - June 25, 2017 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

A Double-Blind, Active-Controlled Clinical Trial of Sodium Bicarbonate and Calcium Gluconate in the Treatment of Bilateral Osteoarthritis of the Knee.
Authors: Caamaño MDC, García-Padilla S, Duarte-Vázquez MÁ, González-Romero KE, Rosado JL Abstract OBJECTIVE: To evaluate the effect of intra-articular injections of sodium bicarbonate with a single (SBCG1) or double dose (SBCG2) of calcium gluconate administered monthly compared with methylprednisolone (MP) for treatment of knee osteoarthritis. METHODS: A 3-month, randomized, double-blind clinical trial with patients diagnosed with knee osteoarthritis (OA). The outcome variables were the Western Ontario-McMaster University Osteoarthritis Index (WOMAC) and the Lequesne function...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - May 5, 2017 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Early Results of Minimally Invasive Percutaneous Plate Osteosynthesis for Fractures of the Distal Tibia: A Retrospective Case Series and Review of the Literature.
We report on our early experience using this technique over a 1-year period with 14 such injuries that were treated by a locking compression plate via minimally invasive surgery. The surgical reduction was excellent in most of the cases and all fractures healed uneventfully. One superficial infection and a wound slough were the only complications recorded. The mean follow-up was at 15 months, and all patients were satisfied with a mean ankle-hindfoot score of 84. Early results of such management are very encouraging. PMID: 28469487 [PubMed - in process] (Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders)
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - May 5, 2017 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Ultrasound-Diagnosed Tibia Stress Fracture: A Case Report.
We present the case of a young female distance runner with left shin pain. Plain radiography was unremarkable. Ultrasound showed focal hyperechoic elevation of the periosteum with irregularity over the distal tibia and increased flow on Doppler. These findings were consistent with a distal tibia stress fracture and confirmed by MRI. Examination of our case will highlight the utility of considering an ultrasound for diagnosis of tibial stress fracture. PMID: 28469488 [PubMed - in process] (Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders)
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - May 5, 2017 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Sternocostoclavicular Hyperostosis: An Insufficiently Recognized Clinical Entity.
Authors: Sugase T, Akimoto T, Kanazawa H, Kotoda A, Nagata D Abstract A 79-year-old male chronic hemodialysis patient with no history of central venous catheterization was referred to our hospital with progressive swelling of the left upper limb ipsilateral to a forearm arteriovenous fistula. Radiological assessments revealed marked hyperostosis in the ribs, sternum, and clavicles with well-developed ossification of the sternocostoclavicular ligaments. Such characteristic structural abnormalities and our failure to identify the left subclavian vein with contrast material despite the abundant dilated collaterals in ...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - May 5, 2017 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Correction to "Macroscopical, Histological, and In Vitro Characterization of Nonosteoarthritic Versus Osteoarthritic Hip Joint Cartilage".
Correction to "Macroscopical, Histological, and In Vitro Characterization of Nonosteoarthritic Versus Osteoarthritic Hip Joint Cartilage". Clin Med Insights Arthritis Musculoskelet Disord. 2016;9:201 Authors: Badendick J, Godkin O, Kohl B, Meier C, Jagielski M, Huang Z, Arens S, Schneider T, Schulze-Tanzil G Abstract [This corrects the article DOI: 10.4137/CMAMD.S29844.]. PMID: 28008294 [PubMed] (Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders)
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - December 24, 2016 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Relationship Between Lymph Node Volume and Pain Following Certolizumab Therapy for Rheumatoid Arthritis Flare: A Pilot Study.
CONCLUSION: RA patients with the smallest change in LN volume during anti-tumor necrosis factor (anti-TNF) therapy experienced the greatest pain relief in symptomatic knee joints. Moreover, the remarkably linear inverse correlation between LN volume and joint pain observed in this small clinical pilot provides initial evidence to support the concept that dynamic changes in draining LN volume are a biomarker of clinical response to therapy in RA. PMID: 28008295 [PubMed] (Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders)
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - December 24, 2016 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Patellofemoral Joint Arthroplasty: Our Experience in Isolated Patellofemoral and Bicompartmental Arthritic Knees.
CONCLUSION: We are going toward a new attitude in which partial osteoarthritic changes could be treated with partial resurfacing prosthetic solutions such as unicompartmental, bi-unicompartmental or PFR alone, or unicompartmental combined, which respects the cruciates and achieves maximal bone preservation, which is vital, particularly, for young patients. PMID: 27891054 [PubMed - in process] (Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders)
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - November 30, 2016 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Imaging Guidance Improves the Results of Viscosupplementation with HANOX-M-XL in Patients with Ankle Osteoarthritis: Results of a Clinical Survey in 50 Patients Treated in Daily Practice.
CONCLUSION: This preliminary study suggests that the use of imaging guidance significantly optimizes the success rate of ankle viscosupplementation. No safety concern was observed. LEVEL OF EVIDENCE: III. PMID: 27891055 [PubMed - in process] (Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders)
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - November 30, 2016 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Rate of Proven Rheumatic Diseases in a Large Collective of Referrals to an Outpatient Rheumatology Clinic Under Routine Conditions.
Authors: Feuchtenberger M, Nigg AP, Kraus MR, Schäfer A Abstract The prognostic significance of early diagnosis and therapeutic intervention in inflammatory rheumatic diseases has been well documented. However, a shortage of rheumatologists often impedes this approach in clinical practice. Therefore, it is of importance to identify those patients referred for diagnosis who would benefit most from a specialist's care. We applied a telephone-based triage for appointment allocation during routine care. This retrospective, monocentric analysis evaluated the efficacy of our triage to identify patients with rheumati...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - October 12, 2016 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Standardized Follow-up of Patients with Symptomatic Knee Osteoarthritis Treated with a Single Intra-articular Injection of a Combination of Cross-Linked Hyaluronic Acid and Mannitol.
CONCLUSION: Treatment with one injection of 4.4 mL HAnox-M-XL is effective to alleviate KOA symptoms over six months, without safety concern. Controlled trials are needed to confirm these pilot data. PMID: 27688712 [PubMed - in process] (Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders)
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - October 1, 2016 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Genetic Association of HLA-A*26, -A*31, and -B*51 with Behcet's Disease in Saudi Patients.
CONCLUSION: This study suggests that HLA-A*26, -A*31, and -B*51 are associated with susceptibility risk to BD, while HLA-B*15 may be protective in Saudi patients. However, larger scale studies are needed to confirm these findings. PMID: 27547040 [PubMed] (Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders)
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - August 24, 2016 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Reliability of a Proposed Ultrasonographic Grading Scale for Severity of Primary Knee Osteoarthritis.
CONCLUSIONS: US can reliably detect the severity of KOA. Good agreement was found between the proposed US grading scale and K&L grading scale. The proposed US grading scale is simple and reliable. PMID: 27478389 [PubMed] (Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders)
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - August 3, 2016 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Raman Spectroscopic Analysis of Fingernail Clippings Can Help Differentiate Between Postmenopausal Women Who Have and Have Not Suffered a Fracture.
The objective was to build a prediction algorithm for fracture using data from four sites (known as the calibration set) and test its performance using data from the other two sites (known as the validation set). Results from the validation set showed that a novel algorithm, combining spectroscopy data with clinical data, provided area under the curve (AUC) of 74% compared to an AUC of 60% from a reduced QFracture score (a clinically accepted risk calculator) and 61% from the dual-energy X-ray absorptiometry T-score, which is in current use for the diagnosis of osteoporosis. Raman spectroscopy should be investigated furthe...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - July 20, 2016 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

A Systematic Review of Dextrose Prolotherapy for Chronic Musculoskeletal Pain.
CONCLUSION: Use of dextrose prolotherapy is supported for treatment of tendinopathies, knee and finger joint OA, and spinal/pelvic pain due to ligament dysfunction. Efficacy in acute pain, as first-line therapy, and in myofascial pain cannot be determined from the literature. PMID: 27429562 [PubMed - as supplied by publisher] (Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders)
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - July 20, 2016 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Effects of Nasal Calcitonin vs. Oral Gabapentin on Pain and Symptoms of Lumbar Spinal Stenosis: A Clinical Trial Study.
Authors: Haddadi K, Asadian L, Isazade A Abstract Lumbar spinal stenosis (LSS) is a chronic and prevalent disease that occurs in 10.8% of the general population, mostly in old age. We designed the first clinical trial study to compare the effects of administering the nasal salmon calcitonin spray and gabapentin in patients with LSS. In this clinical trial, 90 patients with symptoms of neurogenic claudication and magnetic resonance imaging-proven LSS were randomly assigned to nasal salmon calcitonin, gabapentin, or placebo treatments for eight weeks (30 participants in each group). This was followed by a washout per...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - July 12, 2016 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Case Study: Giant Cell Arteritis with Vertebral Artery Stenosis.
Authors: Daniel Chomlak R, Ghazanfari F, Datta M Abstract In giant cell arteritis (GCA), involvement of the vertebral arteries is rare with reported rates of 3%-4% for ischemic events secondary to vertebral artery stenosis or occlusion for those patients with GCA. This case study describes a patient who initially presented with acute onset of vertigo but was also found to have transient, side-alternating upper limb neurological findings. While initial imaging showed no vascular abnormalities, it was not until GCA was eventually confirmed with a temporal artery biopsy that the initial scans were shown to have bilate...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - June 11, 2016 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Differences Regarding Branded HA in Italy, Part 2: Data from Clinical Studies on Knee, Hip, Shoulder, Ankle, Temporomandibular Joint, Vertebral Facets, and Carpometacarpal Joint.
CONCLUSIONS: There are only a few products with some evidences, while the majority of products remain without proof. Clinicians and regulators should request postmarketing studies from pharmaceuticals to corroborate with that reported in the leaflet and to gather more data, allowing the clinicians to choose the adequate product for the patient. PMID: 27279754 [PubMed] (Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders)
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - June 11, 2016 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Apolipoprotein E Gene Polymorphisms in Saudi Patients with Systemic Lupus Erythematosus.
Authors: Al-Rayes H, Huraib G, Julkhuf S, Arfin M, Tariq M, Al-Asmari A Abstract Apolipoprotein E (APOE) is a glycosylated protein with multiple biological properties. APOE gene polymorphism plays a central role in lipid metabolism and has recently been suggested to regulate inflammation. Our objective is to evaluate whether APOE polymorphism affects susceptibility to SLE. APOE genotyping was performed using ApoE StripAssay™ kit. Results indicated significantly higher frequencies of allele ε4 and genotype ε3/ε4 and lower frequencies of allele ε3 and genotype ε3/&epsilon...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - June 5, 2016 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Differences among Branded Hyaluronic Acids in Italy, Part 1: Data from In Vitro and Animal Studies and Instructions for Use.
CONCLUSIONS: Data on HAs deriving from in vitro and in vivo studies are scarce and relate to only a small percentage of products marketed in Italy. Many indications and contraindications are arbitrarily reported in Italian HA leaflets without the support of scientific evidence. Larger and brand-specific studies are necessary and should be reported in the leaflets to guide clinicians in making an appropriate choice regarding HA-based IA therapy. PMID: 27257398 [PubMed] (Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders)
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - June 5, 2016 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Genetic Contribution to the Development of Radiographic Knee Osteoarthritis in a Population Presenting with Nonacute Knee Symptoms a Decade Earlier.
This study examined the contribution of the osteoarthritis (OA) susceptibility genes ASPN, GDF5, DIO2, and the 7q22 region to the development of radiographic knee OA in patients with a mean age of 40.6 ± 7.9 years (standard deviation) and who suffered from nonacute knee complaints a decade earlier. Dose-response associations of four single nucleotide polymorphisms(SNPs) in the susceptibility genes were determined by comparing 36 patients who showed the development of OA on radiographs (Kellgren and Lawrence score ≥1) with 88 patients having normal cartilage with no development of OA on radiographs. Multivariate l...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - May 10, 2016 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Macroscopical, Histological, and In Vitro Characterization of Nonosteoarthritic Versus Osteoarthritic Hip Joint Cartilage.
Authors: Badendick J, Godkin O, Kohl B, Meier C, Jagielski M, Huang Z, Arens S, Schneider T, Schulze-Tanzil G Abstract Osteoarthritis (OA) might affect chondrocyte culture characteristics and complement expression. Therefore, this study addressed the interrelation between macroscopical and microscopical structure, complement expression, and chondrocyte culture characteristics in non-OA and OA cartilage. Femoral head cartilage samples harvested from patients with femoral neck fractures (FNFs) and OA were analyzed for macroscopical alterations using an in-house scoring system, graded histologically (Mankin score), an...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - May 10, 2016 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Hip Fracture Types in Canadian Men and Women Change Differently with Age: A Population-Level Analysis.
Authors: Crilly RG, Kloseck M, Mequanint S Abstract BACKGROUND: We have previously reported a gender difference in the occurrence of hip fracture type with age in our local population. In the current report, we have explored this phenomenon in a Canadian population using five years of data from a national administrative database. We have compared community-dwelling and institutionalized individuals to determine if frailty is important and has a differential effect on the type of hip fracture experienced. METHODS: Hospitalization records from 2005 to 2009, in which the most responsible diagnosis, that is the dia...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - May 10, 2016 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research

Analysis of Mitogen-Activated Protein Kinases in Bone and Cartilage of Patients with Rheumatoid Arthritis Treated with Abatacept.
Authors: Kanbe K, Oh K, Chiba J, Inoue Y, Taguchi M, Yabuki A Abstract The aim of this study was to analyze the histological changes related to mitogen-activated protein (MAP) kinases in bone and cartilage treated with abatacept for rheumatoid arthritis (RA). A total of 20 patients of bone and cartilage were assessed: 10 abatacept with methotrexate (MTX)-treated RA patients were compared with 10 MTX-treated RA patients (control). The histology of bone and cartilage was observed by staining with hematoxylin and eosin and analyzed immunohistochemically for the expression of tumor necrosis factor-α, interleukin-...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - April 24, 2016 Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research