Secondary OA Research Articles

Atlanto-odontoid osteoarthritis in rheumatoid arthritis: dynamic CT findings.

We analyzed the CT appearances of degenerative change in the atlanto-odontoid joint (AOJ) in patients with rheumatoid arthritis (RA) and evaluated the effect of these changes on atlanto-axial joint (AAJ) rotation by dynamic CT. This revealed that 9 patients (24%) treated with methotrexate had degenerative features in the AOJ. The ratio of AAJ rotation to the total rotation of the cervical spine was significantly higher in normal subjects (54 +/- 3%) than in patients (38 +/- 12%). The degree of AAJ rotation was significantly lower in the patient group with degenerative features in the AOJ (20.9 +/- 8.4 degrees ) than in patients without degenerative features (28.5 +/- 7.4 degrees ). RA patients with a history of longstanding disease and treatment with antirheumatic drugs may develop AO OA. Although secondary OA was described as healing phenomena in the joints of RA patients, it can limit rotation in the AAJ and cause suboccipital neck pain. A regular check-up of the AAJ and AOJ by means of dynamic CT in all RA patients is proposed to avoid possible antirheumatic drug complications.

Clinical epidemiology of hip and knee joint arthroses: an overview of the results of the "Ulm Osteoarthrosis Study"

To summarize the strategy of patient recruitment, applied methods and published results within the Ulm Osteoarthritis Study, a multicenter cross-sectional survey of patients with advanced hip and knee osteoarthritis. 420 patients with hip OA and 398 patients with knee OA scheduled for unilateral total joint replacement in four hospitals in the southwestern part of Germany underwent detailed clinical investigations and a standardized interview in addition to radiographic analyses of ipsilateral and contralateral hip or knee joint and both hands. Odds ratios and 95% confidence intervals for the association of different possible risk factors with OA patterns (unilateral, bilateral and generalized OA) were calculated with logistic regression, adjusting for potential confounders. In 41.7% of patients with hip OA and 33.4% of patients with knee OA, an underlying pathological condition allowed a classification as secondary OA. 82.1% of patients with hip and 87.4% of patients with knee OA had bilateral disease. Generalized OA (GOA) was found in 19.3 and 34.9%, respectively (after adjustment for different age and sex distribution in the two patient groups; however, this difference was not any more significant). A positive association could be observed between hypercholesterolemia and GOA in knee OA patients as well as between serum uric acid and GOA in hip OA patients. Obesity and overweight were associated with bilateral knee OA, but not bilateral hip OA nor GOA. Our innovative study design allows the non-invasive investigation of patient subgroups with established disease and a testing of relevant hypotheses in an appropriate setting. The data add to the evidence regarding the independent role of different systemic risk factors for OA. In an ongoing study the natural course of the disease of the contralateral, unoperated joint is currently being investigated in all recruited patients.

Recent information about Hip dysplasia

Dogs suffering from HD have a genetic background, but the releasing factors are many. Two of the most important are overnutrition and overexercising, especially in the young puppy. Radiography can give an estimate of the degree of secondary OA, and by evaluating the laxity in the hip joints at an early age, it seems to be possible to predict the chances for later development of OA. The eradication program has to be instituted in such a way that only the best dogs are accepted into breeding programs. It seems to be more efficient to eradicate the genetic part of the etiology by creating a breeding index by means of evaluating the offspring of the male dogs.

Pathologic conditions of the pisiform and pisotriquetral joint

In eight of sixteen patients with symptomatic pisotriquetral joints the pisiform was excised. A detailed study allowed correlation of the etiologic factors with the pathologic diagnosis. In a similar fashion pathologic-etiologic data were retrieved from 216 cases identified from the world literature and organized into the following four pathologic groups: primary OA (2.3%), secondary OA (48.4%), other arthritides (4.7%), and flexor carpi ulnaris enthesopathy (44.6%). The most common causes were acute and chronic trauma and instability. On the basis of these data, we hypothesized that loss of integrity to the surrounding retinacular structures of the pisiform may lead to instability and thus dysfunction of the joint.