Non-inflammatory Joint Diseases Research Articles

The effect of aquatherapy on pain intensity and performance in patients with osteoarthritis.

Osteoarthritis (OA) is a noninflammatory joint disease. If OA of the knee causes pain, decreased muscle strength and joint stiffness, exercise therapy is one of the most effective treatments for the disease. The aim of the present study was to evaluate the effect of aquatherapy on pain intensity and performance in women with OA with the assumption that it causes weightlessness. This is a quasiexperimental study. The sample size included 60 people who were randomly divided into experimental and control groups. The visual analogue scale was used to assess pain and timed up and go test (TUG), 30 Second Sit to Stand Test (30-S-CS), and 40-meter fast-paced walk test (40 MW) were used to assess performance. Data analysis was carried out using SPSS ver. 22. The results of the present study showed a decrease in pain intensity from moderate to mild intensity. Also, physical performance dimensions in patients with OA were improved, so that the average TUG increased from 14.06 to 8.8 s. The average S-CS frequency increased from 4.86 to 8.4 s and 90 MW decreased from the average 93.43 to 72.66 s. Lower limb muscle strength, and physical performance can be improved and pain intensity can be reduced in patients with OA by performing aquatherapy three times a week for 8 weeks.

A review on Janusandhigata Vata

Janusandhigata Vata is explained in concise form in our Samhitha. The symptoms includes Vatapoorna-Dritisparsha, Sandhi Shotha, Prasarana Acuchanayo Vedana, Atopa, Sandhi Hanti. Various treatment modalities have been employed such as Bahya and Abhyantara Snehana, Basti Prayoga, Upanaha, Agnikarma, Bandhana, Unmardana. Aetiology and symptomology of Sandhigata Vata mentioned in Samhitha, mimics with the symptoms of osteoarthritis of contemporary science. Osteoarthritis is defined as a non-inflammatory degenerative joint disease marked by degeneration of articular cartilage, accompanied by pain and stiffness of joints. When left untreated this disease makes the person crippled and dependent on others for attending normal daily activities.

The role of CD14 and CSF1R in osteoarthritis and gastritis.

Osteoarthritis (OA) is a non-inflammatory degenerative joint disease that mainly involves articular cartilage damage and involves the whole joint tissue. Gastritis is a common stomach disorder, typically referring to inflammation or lesions of the gastric mucosa. However, the relationship between CD14 and colony stimulating factor-1 receptor (CSF1R) and these 2 diseases is not yet clear. OA datasets GSE46750, GSE82107 and gastritis datasets GSE54043 profiles were downloaded from gene expression omnibus databases generated by GPL10558 and GPL570.The R package limma was used to screen differentially expressed genes (DEGs). Weighted gene co-expression network analysis was performed. The construction and analysis of protein-protein interaction network, functional enrichment analysis, gene set enrichment analysis and comparative toxicogenomics database analysis were performed. TargetScan was used to screen miRNAs regulating central DEGs. A total of 568 DEGs were identified. According to the gene ontology (GO) and biological processes analysis, they were mainly enriched in ATP metabolism negative regulation, toll-like receptor TLR1:TLR2 signaling pathway, and intracellular transport. The enrichment terms for OA and gastritis were similar to the GO and Kyoto encyclopedia of gene and genome enrichment terms of DEGs, mainly enriched in ATP metabolism negative regulation, secretion granules, transmembrane receptor protein kinase activity, cytokine-cytokine receptor interaction, Toll-like receptor signaling pathway, MAPK signaling pathway, and TGF-β signaling pathway. In the Metascape enrichment projects, GO enrichment projects showed functions related to cell-cell receptor interaction, cell secretion, and growth. Two core genes were identified through the construction and analysis of the protein-protein interaction network. The core genes (CD14 and CSF1R) exhibited high expression in OA and gastritis samples and low expression in normal samples. Comparative toxicogenomics database analysis revealed associations between core genes (CD14 and CSF1R) and diseases such as OA, osteoporosis, gastritis, juvenile arthritis, diarrhea, and inflammation. CD14 and CSF1R are highly expressed in OA and gastritis, making them potential therapeutic targets for both diseases.

COL3A1, COL5A1 and COL6A2 serve as potential molecular biomarkers for osteoarthritis based on weighted gene co‑expression network analysis bioinformatics analysis.

Osteoarthritis (OA) is a non-inflammatory degenerative joint disease, characterized by joint pain and stiffness. The prevalence of OA increases with age. However, the relationship between biomarkers [collagen type III α1 (COL3A1), COL5A1, COL6A2, COL12A1] and OA remains unclear. The OA subchondral bone dataset GSE51588 was downloaded from the GEO database, and the differentially expressed genes (DEGs) were screened. Weighted gene co-expression network analysis was performed, and a protein-protein interaction network was constructed and further analyzed using Cytoscape and STRING. Functional enrichment analysis was performed using Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis, and then Gene Set Enrichment Analysis (GSEA) was used to formulate the molecular functions and pathways based on the results of GO and KEGG analyses. Comparative Toxicogenomics Database and TargetScan were used to identify the hub-gene-related diseases and the microRNAs that regulated the central hub genes. Immunohistochemical staining was performed to confirm the expression of related proteins in OA and non-OA tissue samples. A total of 1,679 DEGs were identified. GO analysis showed that the DEGs were primarily enriched in the process of 'immune system', 'extracellular region', 'secretory granule', 'collagen-containing extracellular matrix', 'ECM-receptor, glycosaminoglycan binding' and 'systemic lupus erythematosus'. The results of GSEA were similar to those of GO and KEGG enrichment terms for DEGs. A total of 25 important modules were generated, and two core gene clusters and seven core genes were obtained (COL6A2, COL5A2, COL12A1, COL5A1, COL6A1, LUM and COL3A1). Core genes were expressed differentially between OA subchondral bone and normal tissue samples. The expression levels of COL3A1, COL5A1 and COL6A2 in OA subchondral bone tissue were higher compared with those in normal tissues, but COL12A1 expression was not significantly increased; all stained markers were highly expressed in surrounding tissues of immunohistochemical staining. In conclusion, COL3A1, COL5A1 and COL6A2 may be potential molecular biomarkers for OA.

Role of Cell Count of Synovial Fluid in Diagnosis of Joint Disease Compared to Gross Analysis

Joint effusion is a common clinical problem throughout the world. Synovial fluid analysis is one of the most important diagnostic tests to differentiate various inflammatory and non-inflammatory joint diseases. Gross examination and cell count of synovial fluid are two important test modalities. A comparison of performances of the tests would enable us to emphasize on the diagnostic procedures for better outcomes. A total of 105 cases were included in this study, performances of the tests such as accuracy, sensitivity, specificity, positive and negative predictive values of each test modality were calculated for comparison. Joint effusions were diagnosed as 19 rheumatoid arthritis, 12 non- inflammatory, 15 inflammatory, 14 infective, 7 tubercular, 4 traumatic, 6 osteoarthritis, 5 crystal induced arthritis, 6 non- specific arthritis and 8 normal cases. Accuracy, sensitivity, specificity, PPV and NPV of cell count were 76.19%, 72.72%, 94.11%, 98.46% and 40% respectively and accuracy, sensitivity, specificity, PPV and NPV of gross examination were 71.42%, 68.18%, 88.23%, 96.77% and 34.88% respectively. The individual parameters of synovial fluid study overlaps among each other test modalities and a combination of test procedures would yield better performances for diagnosis.

Long-term Follow-up of 254 Ceramic Coated Implant (CCI) Evolution Total Ankle Replacements.

The ceramic coated implant (CCI) Evolution was a third-generation implant design used in approximately 2000 total ankle replacements (TARs) between 2003 and 2016. Because this implant was abandoned, long-term follow-up studies are lacking. All patients undergoing TAR using a CCI prosthesis between 2004 and 2012 were included for analysis. Preoperatively the tibiotalar alignment was measured, and postoperatively the patients were followed up clinically, with radiographs and by questionnaire. The primary outcome was implant survival at 10 years of follow-up. Implant survival was also compared for (1) inflammatory joint disease vs noninflammatory joint disease and (2) preoperative tibiotalar neutral vs varus or valgus alignment. The secondary outcomes were complications, reoperations, and function (assessed by patient-reported outcome measures). Two hundred fifty-four TARs were performed in 237 patients. Two hundred twelve additional procedures were performed to achieve stable ankles. At 10-year follow-up, the survival was 67.5%, with an average time to revision of 4.5 years. The 10-year survival of the inflammatory joint disease group was 76.8% and of the noninflammatory joint group 63.1% (P = .44). In 248 TARs, the preoperative tibiotalar alignment was measured; (62% neutral, 25% varus, and 13% valgus), these showed 10-year survival rates of 74.7%, 48.2%, and 68.9% respectively (P = .07). The complication rate was 54%; 37% of patients underwent reoperation. At a mean of 8.5 years, postoperative satisfaction scored an average of 7.0 (SD 2.26) on a 0- to 10-point numeric rating scale. The mean Foot and Ankle Ability Measure sports subscore was 24.7, the mean Foot and Ankle Outcome Score (FAOS) sports subscore was 42.8, and the mean 36-Item Short Form Health Survey score was 40.0. Regarding daily activities, the mean FAOS was 81.0. This is currently the sole study reporting the long-term results of the CCI prosthesis. The survival and functional outcomes were inferior to other third-generation mobile-bearing ankle implants.

Metabolic reprogramming of synovial fibroblasts in osteoarthritis by inhibition of pathologically overexpressed pyruvate dehydrogenase kinases

Osteoarthritis (OA) is the most common degenerative joint disease and a major cause of age-related disability worldwide, mainly due to pain, the disease's main symptom. Although OA was initially classified as a non-inflammatory joint disease, recent attention has been drawn to the importance of synovitis and fibroblast-like synoviocytes (FLS) in the pathogenesis of OA. FLS can be divided into two major populations: thymus cell antigen 1 (THY1)- FLS are currently classified as quiescent cells and assumed to destroy bone and cartilage, whereas THY1+ FLS are invasively proliferative cells that drive synovitis. Both THY1- and THY1+ FLS share many characteristics with fibroblast-like progenitors – mesenchymal stromal cells (MSC). However, it remains unclear whether synovitis-induced metabolic changes exist in FLS from OA patients and whether metabolic differences may provide a mechanistic basis for the identification of approaches to precisely convert the pathologically proliferative synovitis-driven FLS phenotype into a healthy one. To identify novel pathological mechanisms of the perpetuation and manifestation of OA, we analyzed metabolic, proteomic, and functional characteristics of THY1+ FLS from patients with OA. Proteome data and pathway analysis revealed that an elevated expression of pyruvate dehydrogenase kinase (PDK) 3 was characteristic of proliferative THY1+ FLS from patients with OA. These FLS also had the highest podoplanin (PDPN) expression and localized to the sublining but also the lining layer in OA synovium in contrast to the synovium of ligament trauma patients. Inhibition of PDKs reprogrammed metabolism from glycolysis towards oxidative phosphorylation and reduced FLS proliferation and inflammatory cytokine secretion. This study provides new mechanistic insights into the importance of FLS metabolism in the pathogenesis of OA. Given the selective overexpression of PDK3 in OA synovium and its restricted distribution in synovial tissue from ligament trauma patients and MSC, PDKs may represent attractive selective metabolic targets for OA treatment. Moreover, targeting PDKs does not affect cells in a homeostatic, oxidative state. Our data provide an evidence-based rationale for the idea that inhibition of PDKs could restore the healthy THY1+ FLS phenotype. This approach may mitigate the progression of OA and thereby fundamentally change the clinical management of OA from the treatment of symptoms to addressing causes.

Alpha-defensins determination in different types of synovial fluid and parallel collected serum samples by ELISA

The study aims were to verify the serum (S) and synovial fluid (SF) reference intervals (RIs) for human neutrophil defensins (HNP1-3); measure S and SF defensin concentrations in different types of SF, including non-inflammatory, inflammatory non-pyogenic, inflammatory pyogenic, and hemorrhagic; and to compare the HNP1-3 concentrations in SF and S with those of other inflammatory biomarkers. SF and S samples were collected from 92 patients. HNP1-3 concentrations were determined using enzyme-linked immunosorbent assays; glucose, lactate, interleukin-6, and procalcitonin using an automatic analyzer; and presepsin using a Pathfast system. There were 61 non-inflammatory, 11 inflammatory non-pyogenic, 11 inflammatory pyogenic, and 9 hemorrhagic SF. Non-inflammatory SF was divided into non-inflammatory normal and non-inflammatory osteoarthritis. The former was used to estimate the HNP1-3 RI in SF and S. The estimated HNP1-3 RIs of SF and S were 12.47-437.42 mg/L and 5.45-44.75 µg/L, respectively. HNP1-3 differed significantly between S and SF and individual groups of SF (P<0.001 and P=0.001, respectively). There were significant relationships between SF HNP1-3 and S HNP1-3 (P<0.001), S C-reactive protein (P<0.001), and S interleukin-6 (P=0.007), and between SF HNP1-3 and SF C-reactive protein (P=0.004) and SF interleukin-6 (P<0.001). The highest kappa coefficient was between SF HNP1-3 and SF interleukin-6 (κ=0.507). We validated the SF HNP1-3 diagnostic kit and demonstrated that SF and S HNP1-3 are promising biomarkers for distinguishing inflammatory from non-inflammatory joint diseases.

Cartilagem articular, patogênese e tratamento da osteoartrite

A osteoartrite caracteriza-se por dor e claudicação, sendo considerada processo não específico, mais sim uma sequela comum a várias formas de lesão articular, com envolvimento de fatores biológicos e mecânicos. Desta forma, o objetivo da presente revisão foi discorrer sobre alguns aspectos da cartilagem articular (generalidades, histogênese), patogênese da osteoartrite, bem como algumas possibilidades de tratamentos intra-articulares para a osteoatrite. A cartilagem articular, juntamente com o líquido sinovial, têm papel mecânico importante nas articulações diartrodiais. Os condrócitos estão entre os principais componentes da cartilagem articular e são apontados como células altamente diferenciadas com capacidade limitada de proliferação e migração. O outro componente é a matriz extracelular constituída de colágeno tipo II, proteoglicanos, proteínas não colagenosas, glicoproteínas, água e eletrólitos. A osteoartrite é classificada como doença articular não inflamatória, com múltiplas interações bioquímicas e biomecânicas. Todos os componentes da articulação podem ser comprometidos, porém a cartilagem é considerada o tecido alvo. A afecção pode ser classificada como primária, que ocorre predominantemente em animais idosos, e secundária, decorrente de doenças que afetam a articulação e as estruturas de suporte. Entre os tratamentos intra-articulares para a osteoartrite estão a viscossuplementação com ácido hialurônico, o uso de corticosteroides, e a combinação de ácido hialurônico e corticosteroides. Contudo, há ainda várias controvérsias quanto à eficácia.

Long-term Follow-up Results of Buechel-Pappas Ankle Arthroplasty.

Total ankle replacement (TAR) is gaining popularity as a treatment option for ankle osteoarthritis. Long-term implant survival is a critical outcome to determine the success of the TAR implant. The Buechel-Pappas (BP) implant is a second-generation mobile bearing implant. The aim of this study was to analyze the BP implant survivorship at 10-year follow-up, make a subanalysis between patient groups, and evaluate long-term functional outcomes. Data of 86 patients who received 101 BP implants between 1993 and 2010 were obtained from a prospectively documented database. Subanalyses were done for patients diagnosed with inflammatory joint disease and noninflammatory joint disease, and patients with preoperative tibiotalar neutral and nonneutral alignment. A Kaplan-Meier curve was used for survival analysis. Long-term functional outcomes were assessed with the following patient-reported outcome measures: Foot and Ankle Outcome Score (FAOS), Foot and Ankle Ability Measure (FAAM), Short Form-36 (SF-36) Stand Version 2.0 Health Survey and 3 anchor questions. The survival rate of the BP implant at 10 years was 86% (95% confidence interval, 78%-93%). A total of 31 patients (36%) required 55 reoperations, and in 13 patients (15%) a revision procedure was performed. In this series, no significant difference in 10-year survival rate was found between neither the inflammatory joint disease and noninflammatory joint disease group ( P = .47), nor the tibiotalar neutral and nonneutral alignment group ( P = .16). At a mean follow-up of 16.8 years for 21 patients, the mean FAOS activities of daily living (ADL) and FAAM ADL subscale scores were 75/100 and 56/100 points. The mean physical component summary (PCS) and mental component summary (MCS) of the SF-36 were 34/100 and 51/100 points, respectively. A survival rate of 86% was found at 10-year follow-up for the Buechel-Pappas implant. Our series demonstrated no significant difference in 10-year survival rates between the 2 patient subgroups. Long-term results of the various functional outcomes varied between poor and moderate. Level II, prospective cohort study.

Fluorescence optical imaging in pediatric patients with inflammatory and non-inflammatory joint diseases: a comparative study with ultrasonography

BackgroundValid detection of arthritis is essential in differential diagnosis of joint pain. Indocyanin green (ICG)-enhanced fluorescence optical imaging (FOI) is a new imaging method that visualizes inflammation in wrist and finger joints. Objectives of this study were to compare FOI with ultrasonography (US, by gray-scale (GS) and power Doppler (PD)) and clinical examination (CE) and to estimate the predictive power of FOI for discrimination between inflammatory and non-inflammatory juvenile joint diseases.MethodsFOI and GSUS/PDUS were performed in both hands of 76 patients with joint pain (53 with juvenile idiopathic arthritis (JIA), 23 with non-inflammatory joint diseases). Inflammation was graded by a semiquantitative score (grades 0–3) for each imaging method. Joints were defined clinically active if swollen or tender with limited range of motion. Sensitivity and specificity of FOI in three phases dependent on ICG enhancement (P1–P3) were analyzed with CE and GSUS/PDUS as reference.ResultsFor JIA patients, FOI had an overall sensitivity of 67.3%/72.0% and a specificity of 65.0%/58.8% with GSUS/PDUS as reference; specificity was highest in P3 (GSUS 94.3%/PDUS 91.7%). FOI was more sensitive for detecting clinically active joints than GSUS/PDUS (75.2% vs 57.3%/32.5%). In patients with non-inflammatory joint diseases both FOI and US showed positive (i.e., pathological) findings (25% and 14% of joints). The predictive value for discrimination between inflammatory and non-inflammatory joint diseases was 0.79 for FOI and 0.80/0.85 for GSUS/PDUS.ConclusionsDependent on the phase evaluated, FOI had moderate to good agreement with CE and US. Both imaging methods revealed limitations and should be interpreted cautiously. FOI may provide an additional diagnostic method in pediatric rheumatology.Trial registrationDeutsches Register Klinischer Studien DRKS00012572. Registered 31 July 2017.

In arthritis the Doppler based degree of hypervascularisation shows a positive correlation with synovial leukocyte count and distinguishes joints with leukocytes greater and less than 5/nL

ObjectivesPower Doppler ultrasound is used to assess joint vascularity in acute arthritis. PDUS signals have been correlated with synovial histology and bone deterioration. Little is known about the correlation between power Doppler signals and synovial white blood count. In our study, we analyzed power Doppler signals in inflammatory joint diseases including gout, calcium pyrophosphate deposition disease, rheumatoid arthritis, spondyloarthritis and others and correlated power Doppler signals with synovial white blood count and with serologic markers of inflammation. MethodsWe retrospectively evaluated 194 patients with arthritis. All patients underwent joint sonography, power Doppler ultrasound, synovial fluid analysis and blood examination of C-reactive protein and erythrocyte sedimentation rate. Correlation analyses (Spearman and Pearson), Chi2 test, t-tests, a unifactorial ANOVA and regression analyses were applied. Results and conclusionsHypervascularisation in power Doppler was most prominent in gout and calcium pyrophosphate deposition disease. Spondyloarthritis and non-inflammatory joint diseases presented with low degrees of hypervascularisation. Mean synovial white blood count did not differ significantly between crystal-related arthritides, rheumatoid arthritis, spondyloarthritis or other inflammatory joint diseases. There was a positive but weak correlation between power Doppler signals and synovial white blood count (P<0.001, rs=0.283), erythrocyte sedimentation rate (P<0.001, rs=0.387) and C-reactive protein (P<0.001, rs=0.373) over all diagnoses. This was especially relevant in rheumatoid arthritis (P<0.01, rs=0.479). Power Doppler degrees 0 and 1 were able to predict synovial leukocytes<5/nL, degrees 2 and 3 predict leukocytes⿥5/nL (P<0.001).

Intraindividual changes of dipeptidyl peptidase-IV in peripheral blood of patients with rheumatoid arthritis are associated with the disease activity.

BackgroundDipeptidyl peptidase-IV (DPP-IV) is suggested to contribute to the pathogenesis of several autoimmune diseases. The aim of this study was to evaluate the association of DPP-IV presence in blood plasma and mononuclear cells with the disease activity in rheumatoid arthritis (RA).MethodsPatients with active RA (n = 27) were examined at the study enrolment and a follow-up examination was performed after the regression of the joint effusions and at least 6 months after the first investigation. The control group comprised patients with a noninflammatory joint disease, i.e. osteoarthritis (OA; n = 15). The DPP-IV-like enzymatic activity was measured by a kinetic fluorimetric method, the concentration of DPP-IV in the blood plasma was determined using ELISA and the expression of DPP-IV in leukocytes was assayed by flow cytometry.ResultsBlood plasma DPP-IV-like enzymatic activity (median ± SD 220.15 ± 83.6 pkat/mL in RA vs. 376.9 ± 144.9 pkat/mL in OA, p < 0.001) and concentrations (median ± SD 465.1 ± 215.6 ng/mL in RA vs. 953.3 ± 368.4 ng/mL in OA, p < 0.001) were lower in patients with active RA compared to OA. In RA patients, the blood plasma DPP-IV-like enzymatic activity negatively correlated with the CRP concentration (r = −0.39, p = 0.044). No significant differences were observed in the DPP-IV-like enzymatic activity and DPP-IV expression in blood mononuclear cells between the RA and OA groups. At follow-up, 18 RA patients had a less active disease as demonstrated by an improved DAS28 score. In this group, comparison of the entry and the follow-up values in individual patients revealed an increase of the blood plasma DPP-IV-like enzymatic activity (median ± SD 141 ± 46 % of the patient’s entry values, p = 0.011) and DPP-IV concentration (median ± SD 168 ± 25 %, of the patient’s entry values, p = 0.033). In contrast to the blood plasma, the DPP-IV expression in blood mononuclear cells was reduced in these patients as evidenced by a decrease in the cell surface DPP-IV-like enzymatic activity as well as the median fluorescence intensity of DPP-IV staining in lymphocytes (median ± SD 66 ± 56 %, p = 0.018 and 63 ± 31 % of the patient’s entry values, p = 0.005, respectively).ConclusionsThe association between RA activity and the changes in blood plasma and blood mononuclear cell DPP-IV in individual patients supports the possible relationship of DPP-IV to RA pathophysiology.

Inflammatory joint disease in cats: diagnostic approach and treatment.

Osteoarthritis, a degenerative non-inflammatory joint disease, is common in cats, usually causing gradual changes in behavior and lifestyle rather than severe lameness. Inflammatory arthritis occurs much less frequently and is nearly always associated with debilitating lameness. It may have an infectious or immune-mediated cause - but, unlike the canine disease, is much more likely to be infectious in origin. Cats with inflammatory joint disease are presented for evaluation of lethargy, anorexia, reluctance to walk or fever. Synovial fluid collection and analysis is required to confirm joint inflammation, but this is a procedure many veterinarians are not comfortable performing in cats. Once inflammatory arthritis is confirmed, extensive testing is required to diagnose infectious causes and determine appropriate treatment. Immune-mediated polyarthritis can be treated with immunosuppressive drugs only after all infectious possibilities are eliminated. Radiographs are used to characterize the arthritis as erosive or nonerosive, but radiographic changes in cats are often subtle compared with those described in canine rheumatoid-like arthritis. This review, aimed at all veterinarians who treat cats, describes the general clinical approach to feline joint disease, the collection and analysis of synovial fluid, and the diagnosis and management of inflammatory joint diseases affecting cats. The diagnostic approach to an unusual case of erosive polyarthritis is discussed in the Case Notes. To date, the veterinary literature on inflammatory joint disease in cats has been limited to older reviews of immune-mediated disorders and multiple single case reports or small case series describing infectious disorders. This article offers a current comprehensive review of these disorders.

A1.9 Pilot work towards discovery of novel diagnostic biomarker for rheumatoid arthritis using combinations of chemokine receptor expression on peripheral blood cell-subsets

Background and ObjectivesRheumatoid Arthritis (RA) is an autoimmune inflammatory joint disease resulting in joint damage and functional loss. Management is centred on early intervention, proven to prevent disabling joint damage...

Pain Survey in Rheumatology Outpatient Clinics in Taiwan

Objective: For this study, a pain survey was conducted in the rheumatology outpatient department (OPD) of eight medical centers in Taiwan to determine the prevalence and characteristics of pain in a Taiwanese rheumatology patient population. Methods: Multi-center pain survey was conducted among Taiwanese patients in rheumatology OPDs. Eight medical centers in Taiwan were enrolled from July to September in 2009 to recruit participants. Using a well-designed and validated pain survey questionnaire that was uploaded to touch-screen computers, all questions were answered by the patients themselves and checked by physicians. Results: In all, 8,549 patients were recruited from 8 medical centers in the northern, central and southern regions; 62% (5,316)) of patients had pain, and among them, more than 70% were suffering from moderate to severe pain (VAS ＞4). Chronic pain with duration of more than three months was found in 64% of the with-pain patients. The most common diseases in this pain survey were rheumatoid arthritis (RA, 24.2%), osteoarthritis (OA, 11.2%), systemic lupus erythematosus (SLE, 15.3%), gout (11.9%), ankylosing spondylitis (AS, 8.2%) and other autoimmune diseases (AID, 12.6%). Of the 5,316 patients with pain, females were predominant (64%). The overall average visual analogue scale (VAS) score was 4.76. The prevalence of pain was increased with age. In Taiwan, the highest pain prevalence (68%), but lowest average VAS (4.5), was observed in the central region. In contrast, the highest average VAS (5.33) was found in the southern region. Severe pain was significant in inflammatory and non-inflammatory joint diseases and in fibromyalgia syndrome, compared with SLE or AID. Conclusion: The pain survey revealed that 62% of Taiwanese patients had chronic rheumatic pain and most of them with moderate to severe pain had received pain management. The pain might have resulted from the inadequate or insufficient treatment. The reason for the differences in pain prevalence and severity in different areas of Taiwan remains unknown and further study is needed.

OP0074 Clinical study: Frequency and manifestations of joint disease in HIV-infected patients

BackgroundThe frequency of joint manifestation in HIV-infected patients is unknown. Some reports suggest that musculoskeletal pain in HIV-infected patients is substantially increased with a prevalence of up to 50% of...

SAT0405 The specificity of ultrasound power doppler (USPD) for the diagnosis of inflammatory joint disease

BackgroundNumerous studies have clearly demonstrated that USPD examination of joints is more sensitive than clinical physical examination for the detection of synovitis. Further studies are required, however, to determine how...

FRI0506 The diagnostic utility of musculoskeletal ultrasound in early arthritis – a probabilistic (bayesian) approach

BackgroundWhile musculoskeletal ultrasound examination (MSUS) is used increasingly in the work-up of patients with inflammatory joint disease, the exact diagnostic utility has not been established.ObjectivesTo quantify the diagnostic utility of...

SAT0317 Identification of Osteoarthritis Patients with Chronic Tissue Inflammation Whom may Benefit from Anti-Inflammatory Treatment

BackgroundOsteoarthritis (OA) is described as a non-inflammatory joint disease. It is now evident that a subset of patients has chronic tissue inflammation. C-reactive protein (CRP) has shown limited use in...