Large Joint Osteoarthritis Research Articles

Relationship Between Vertebral Intraosseous Pressure, pH, PO2, pCO2, and Magnetic Resonance Imaging Signal Inhomogeneity in Patients with Back Pain

The cause of back pain in many patients in unknown. The pain experienced by patients with osteoarthritis of large joints has been associated with intraosseous abnormalities of elevated pressure, venous dilatations, and abnormalities of pH, pCO2, and pO2. Magnetic resonance imaging demonstrates an abnormal signal in the vertebral bodies of some patients with degenerative disc disease. The intraosseous pressure as well as the intraosseous pH, pO2, and pCO2 in a group of patients undergoing anterior spine surgery was studied, and the results were correlated to the preoperative magnetic resonance imaging appearance. Vertebral bodies with an abnormal magnetic resonance imaging signal had pressures 55% higher than vertebral bodies with a homogeneous signal; they also had significantly decreased pH and increased pCO2. Bodies with Type I changes had pressures 73% higher than those with a normal signal. No differences in pO2 were identified. These findings suggest that abnormalities of intraosseous pressure or blood gas concentrations may be related to mechanisms of pain production in some patients with back pain. These abnormalities can be identified by magnetic resonance imaging. Further investigation is needed to determine if therapeutic manipulation of these variables can be effective in relieving axial spinal pain.

Reflex Therapy in the Complex of Restorative Treatment of Traumatological and Orthopedic Patients

A number of authors have shown the possibility of using reflexotherapy in the complex of means of rehabilitation of patients with traumatological and orthopedic profile.
 We analyzed a ten-year experience of using reflexotherapy in the complex of rehabilitation treatment of 196 patients with consequences of limb fractures and 187 patients with osteoarthritis of large joints. Among them there were 56% men and 44% women at the age of 21 to 67 years old.

The lumbar facet arthrosis syndrome. Clinical presentation and articular surface changes.

We describe a lumbar facet syndrome in which disabling symptoms are associated with normal or near-normal plain radiographs. Local spinal fusion relieved symptoms in 12 patients; the excised facet joint surfaces showed some of the histological changes seen in chondromalacia patellae and in osteoarthritis of other large joints. The most frequent change was focal full-thickness cartilage necrosis or loss of cartilage with exposure of subchondral bone, but osteophyte formation was remarkably absent in all specimens. We suggest that there are both clinical and histological similarities between the facet arthrosis syndrome and chondromalacia patellae. Facet arthrosis may be a relatively important cause of intractable back pain in young and middle-aged adults.

Medical History: Arthritis in Saxon and mediaeval skeletons

Examination of 400 Saxon, Romano-British, and mediaeval skeletons from seven archaeological excavations in the west of England showed an unexpectedly high incidence of osteoarthritis and osteophytosis. Three skeletons had evidence of an erosive peripheral arthritis-one with probable gout, one probable psoriatic arthropathy, and one with possible rheumatoid arthritis. The pattern and types of rheumatic disease, and the resultant disability, were apparently different. An exuberant form of large joint osteoarthritis was common and rheumatoid arthritis and similar diseases rare.