Clinical Features Of Osteoarthritis Research Articles

FEATURES OF THE CLINICAL COURSE OF OSTEOARTHRITIS IN COMBINATION WITH DIABETES MELLITUS.

The aim: To examine the features of the clinical course of osteoarthritis in combination with type 2 diabetes on the background of obesity and hypertension. Materials and methods: 116 patients who were in the inpatient stage of treatment in the rheumatology department of the Chernivtsi Regional Clinical Hospital during 2015-2017 were examined. The epidemiological and clinical features of osteoarthritis in patients with type 2 diabetes mellitus were also analyzed. Results: It was found that the course of osteoarthritis is extremely severe with limited range of motion in the joints, their deformation and significant deteri¬oration of functional capacity, duration of pain, periodic prolonged exacerbations, the predominance of knee and hip injuries (64.8%) and 14.8 persons - small joints. This showed the progression and generalization of processes in various joints, aggravation of the course and prognosis of osteoarthritis, especially in women. Their prevalence was registered at II radiological stage (59.27% and 74.0%, respectively). Conclusions: The authors emphasize that such a clinical course indicates the worst prognosis. This multimorbidity of diseases requires treatment, observation and consultation with a traumatologist, rheumatologist and endocrinologist, due to the multisystem approach to the treatment and rehabilitation of such patients with an emphasis on individual clinical features (including gender) and the course of comorbidities or syndromes.

Increased Ratio of CD14++CD80+ Cells/CD14++CD163+ Cells in the Infrapatellar Fat Pad of End-Stage Arthropathy Patients.

ObjectivesThis study sought to identify the ratio of M1/M2 cells in the infrapatellar fat pads (IFP) and subcutaneous fat tissues (SC) of osteoarthritis (OA) and rheumatoid arthritis (RA) patients. The clinical features of OA and RA patients treated with or without biological disease-modifying anti-rheumatic drugs (bDMARDs) were also assessed.MethodsIFP and SC were collected from patients with OA and RA who are undergoing total knee arthroplasty (TKA). CD14-positive cells were then isolated from these samples. Flow cytometry was used to determine the number of CD14++CD80+ cells and CD14++CD163+ cells. The expression levels of lipid transcription factors, such as sterol regulatory element-binding protein 1 (SREBP1) and liver X receptor alpha (LXRA), and inflammatory cytokines were also evaluated.ResultsTwenty OA patients and 22 RA patients were enrolled in this study. Ten of the RA patients (45.4%) received bDAMRDs before TKA. On average, a fivefold increase in the number of CD14-positive cells and lower expression levels of SREBP1C and LXRA were observed in OA IFP relative to OA SC; however, these results were not obtained from the RA samples. The median ratio of CD14++CD80+ cells/CD14++CD163+ cells of OA IFP was 0.87 (0.76–1.09, interquartile range), which is higher to that of OA SC with a lower ratio (p = 0.05835).ConclusionsThe quantity and quality of CD14-positive cells differed between IFP and SC in arthropathy patients. To our knowledge, this is the first study to characterize the ratio of M1/M2 cells in the IFP and SC of end-stage OA and RA patients. The increased ratio of CD14++CD80+ cells/CD14++CD163+ cells in the IFP from patients with OA and RA treated with bDMARDs indicated that inflammation was localized in the IFP. As adipose tissue-derived innate immune cells were revealed as one of the targets for regulating inflammation, further analysis of these cells in the IFP may reveal new therapeutic strategies for inflammatory joint diseases.

Multivariable logistic and linear regression models for identification of clinically useful biomarkers for osteoarthritis

Osteoarthritis (OA) is the most common chronic degenerative joint disease which causes substantial joint pain, deformity and loss of activities of daily living. Currently, there are over 500 million OA cases worldwide, and there is an urgent need to identify biomarkers for early detection, and monitoring disease progression in patients without obvious radiographic damage to the joint. We have used regression modelling to describe the association of 19 of the currently available biomarkers (predictors) with key radiographic and clinical features of OA (outcomes) in one of the largest and best characterised OA cohort (NIH Osteoarthritis Initiative). We demonstrate that of the 19 currently available biomarkers only 4 (serum Coll2-1 NO2, CS846, COMP and urinary CTXII) were consistently associated with established radiographic and/or clinical features of OA. These biomarkers are independent of one another and provide additional predictive power over, and above established predictors of OA such as age, gender, BMI and race. We also show that that urinary CTXII had the strongest and consistent associations with clinical symptoms of OA as well as radiographic evidence of joint damage. Accordingly, urinary CTXII may aid in early diagnosis of OA in symptomatic patients without radiographic evidence of OA.

OSTEOARTHRITIS IN WOMEN: ARE THERE ANY DIFFERENCES? Review

Relevance. Female gender is known to be a major risk factor for osteoarthritis (OA). In addition, women with OA are characterized by some differences in the context of etiopathogenesis, clinical course and prognosis, and the question of clarifying the causes of these differences remains relevant.
 Objective: to review the literature data on the epidemiological, etiopathogenic and clinical features of OA in women, as well as the peculiarities of treatment and prognosis based on gender.
 Materials and methods. Analysis of scientific publications in the international electronic scientometric database PubMed using keywords "osteoarthritis", "women", "gender", "estrogens" over the period 1989-2019 years.
 Results. The incidence of OA is on average almost twice as high among women compared with men. Smoking, alcohol and heavy exercise are significant risk factors of OA for men, while the role of genetic factors is more significant for women. High concentrations of estradiol in women are associated with a lower degree of cartilage destruction, less significant productive synovitis and a lower rate of total arthroplasty. Women with knee OA are characterized by significantly higher pain intensity during walking and knee extension. The strength of quadriceps femoris muscle is significantly lower in women than in men, regardless of the severity of OA. Women with OA are characterized by a higher concentration of C-reactive protein, which is associated with a larger number of painful joints. Women are more likely than men to take non-steroidal anti-inflammatory drugs and use topical agents. The frequency of total arthroplasty among women is much higher, but early rehabilitation after it is relatively more favorable than in men.
 Conclusions. Sex hormones, genetic factors, lower extremity muscle strength, anatomical and kinematic features of the knee joints play an important role in the etiopathogenesis of OA in women. Women with OA are characterized by more intense and diffuse character of pain, more significant functional impairments compared to men.

Clinical features of osteoarthritis in patients with metabolic syndrome

To estimate clinical and laboratory parameters in patients with osteoarthritis (OA) and in those with OA and metabolic syndrome (MS). 164 patients with OA were examined and divided into 2 groups of 82 people: a study group (patients with MS) and a control one (those without MS). OA was defined according to the diagnostic criteria described by R.D. Althmann (1995). MS was identified based on the criteria developed by the International Diabetes Federation (2005). The location of affected and swollen joints was determined according to the Richie index; the intensity of pain syndrome was measured by a visual analogue scale at rest and on movement; the WOMAC and Lequesne indexes were estimated in the patients. Erythrocyte sedimentation rate and C-reactive protein and tumor necrosis factor-α levels were determined from laboratory data. In the MS group, the frequency of joint injuries at various sites, the prevalence of synovitis, and the intensity of pain and inflammation were significantly higher than in the non-MS group. The negative impact of MS on the clinical picture of OA can be inferred by the findings.

THU0568 Effectiveness of Educational Programs for Knee and Hip Osteoarthritis Pain and Quality of Life in Primary Care Patients

BackgroundKnee and hip joints are the two most prevalent sites of osteoarthritis (OA). Pain and functional limitations are the two major factors influencing the quality of life in patients with...

An emerging player in knee osteoarthritis: the infrapatellar fat pad

The role of inflammation in the development, progression, and clinical features of osteoarthritis has become an area of intense research in recent years. This led to the recognition of synovitis as an important source of inflammation in the joint and indicated that synovitis is intimately associated with pain and osteoarthritis progression. In this review, we discuss another emerging source of inflammation that could play a role in disease development/progression: the infrapatellar fat pad (IFP). The aim of this review is to offer a comprehensive view of the pathology of IFP as obtained from magnetic resonance studies, along with its characterization at both the cellular and the molecular level. Furthermore, we discuss the possible function of this organ in the pathological processes in the knee by summarizing the knowledge regarding the interactions between IFP and other joint tissues and discussing the pro- versus anti-inflammatory functions this tissue could have. We hope that this review will offer an overview of all published data regarding the IFP and will indicate novel directions for future research.

Cross-sectional study of the prevalence and clinical features of osteoarthritis in 100 cats

To assess clinical signs and relevance of osteoarthritis (OA) in cats, the radiographic prevalence of OA in the appendicular skeleton of 100 client-owned cats (≥ 6 years old) was assessed. Possible associations between radiographic OA, clinical locomotor system examination, and owner-perceived behavioural changes were evaluated. OA was most prevalent in the shoulders, elbows, hips and tarsal joints with 61% of cats having OA in at least one joint and 48% in more than one joint. Overall, clinical examination of the larger peripheral joints had the highest sensitivity and specificity for radiographic OA. Regression analysis showed age to be related to OA (P = 0.002), as were decreased mobility and grooming (P = 0.008), although there was a correlation with age. Finally, increased inappropriate elimination was associated with OA (P = 0.046). It was concluded that the prevalence of OA in cats is strikingly high and increases with age. OA in cats seems to be associated with behavioural changes.

Osteoarthritis of the Knee: Association between Clinical Features and MR Imaging Findings

To prospectively evaluate the association between clinical features and structural abnormalities found at magnetic resonance (MR) imaging in patients with osteoarthritis (OA) of the knee. The study was approved by the institutional medical ethics review board. Written informed consent was obtained from each patient. MR images of the knee were obtained from 205 (42 [20%] men, 163 [80%] women; median age, 60 years; range, 43-77 years) patients in whom symptomatic OA at multiple joint sites was diagnosed. MR images were analyzed for various abnormalities of OA. All patients were interviewed concerning pain and stiffness in the knee that was imaged. Odds ratios (ORs) with 99% confidence intervals (CIs) were used to determine the association between the imaging findings and clinical features of OA. A large joint effusion was associated with pain (OR, 9.99; 99% CI: 1.28, 149) and stiffness (OR, 4.67; 99% CI: 1.26, 26.1). The presence of an osteophyte in the patellofemoral compartment (OR, 2.25; 99% CI: 1.06, 4.77) was associated with pain. All other imaging findings, including focal or diffuse cartilaginous abnormalities, subchondral cysts, bone marrow edema, subluxation of the meniscus, meniscal tears, or Baker cysts, were not associated with symptoms. Findings of this study indicate that only two associations exist between clinical symptoms and structural findings found on MR images in patients with OA of the knee.

Some Clinical Features of Osteoarthritis of the Hip Joint in Adult Dogs in Kenya

Clinical examination of forty German shepherd dogs with hindlimb lameness was conducted. The severity of lameness was classified as normal conformation, mild lameness or severe lameness attributable to the hindlimb and assigned numerical scores 1, 2 or 3 respectively. Thirty three percent (33 %) were clinically normal, 19 % had mild lameness while 48 % had severe and debilitating lameness. These observations were verified by radiographic examination of affected hip joints. Five dogs were severely affected with hindlimb lameness also had decubital wounds on the dorsal aspect of the paws of the hindlimb. Although some animals were clinically normal, ventrodorsal pelvic radiographs revealed severe osteoarthritis. Clinical and radiographic examination of adult dogs is useful in diagnosis of orthopaedic disease. This improves diagnostic accuracy and assists in determining the prognosis for appropriate medical or surgical therapy and advice on control breeding of affected dogs. The Kenya Veterinarian Vol. 29 2005: pp. 126-129

Angiotensin converting enzyme gene polymorphism in Korean patients with primary knee osteoarthritis.

Angiotensin converting enzyme (ACE) plays an important role in the physiology of vasculature, blood pressure and inflammation. ACE gene, known to have insertion/deletion (I/D) polymorphism, has been widely investigated in its relation with cardiovascular and neurodegenerative diseases and longevity. ACE gene polymorphism in an inflammation associated osteoarthritis (OA) patients is not known. Here we have investigated ACE gene polymorphism in 142 Korean primary knee OA patients and 135 healthy volunteers to establish any clinical correlates between ACE polymorphism and knee osteoarthritis. Clinical parameters such as disease onset age, Kellgren-Lawrence grade and Lequesne's functional index provided additional analysis of the relationship of ACE polymorphism and clinical features of OA. Early onset OA showed significantly higher allele frequency and carriage rate of I than late onset OA. Radiographically severe and functionally poor OA showed higher carriage rate of I allele than radiographically mild and functionally good OA, respectively. This study first reports ACE gene polymorphism to be a risk factor for early onset, severe form primary knee OA.

Clinical features of osteoarthritis, diffuse idiopathic skeletal hyperostosis, and hypermobility syndromes

In 1990, there were signs of a renewed interest in clinical studies about several aspects of osteoarthritis. The work-up of classic data and the use of new information from epidemiologic surveys as well as careful radiographic monitoring of selected groups of patients have brought us broader views on the general course of the condition. In addition, the biochemical disturbances underlying certain types of early degenerative arthritis that could help us to understand some of the mechanisms that may be operative in osteoarthritis have been disclosed. Finally, a few pieces of new information have been incorporated into the knowledge of diffuse idiopathic skeletal hyperostosis and the hypermobility syndrome.

Design and Conduct of Clinical Trials in Osteoarthritis

Clinical features of osteoarthritis (OA) require that general recommendations for the design and conduct of clinical trials be modified in order to apply these concepts to clinical trials in OA. A format has been devised for design of clinical trials in OA. In order to assess the applicability of this format, it has been compared to a published clinical trial: chondroprotective agents versus standard treatment of OA of the knee. The published study appeared reliably designed and conducted in a manner that provided an answer to most of the questions posed. The study appears to form a sound basis for additional studies.

8 - Clinical Features of Osteoarthritis in the Elderly

Osteoarthritis (OA), the commonest form of arthritis, is an important cause of chronic morbidity. Assessment of patients with OA can be improved by the recognition of several patterns with which this disorder can present. When these patterns are delineated by a careful history, physical examination, appropriate radiographs and laboratory tests, it often leads to a more precise diagnosis and ultimately better management of these patients. The standard classification of primary and secondary OA, while useful, should be expanded to include clinically relevant patterns of disease.

Osteoarthritis

The clinical features of osteoarthritis provide little support for the traditional view of the disease as a wear-and-tear phenomenon of aging. In many cases osteoarthritis consists of a polyarthritis with mildly inflammatory features, such as stiffness, effusions, and hot Heberden's nodes. The finding of biochemical abnormalities of cartilage throws new light on this enormously important disease and suggests the possibility of more effective therapy.