1
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Rothschild B, Haeusler M. Possible vertebral brucellosis infection in a Neanderthal. Sci Rep 2021; 11:19846. [PMID: 34615929 PMCID: PMC8494896 DOI: 10.1038/s41598-021-99289-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 09/23/2021] [Indexed: 12/02/2022] Open
Abstract
The La Chapelle-aux-Saints 1 skeleton of an old (>60-year-old) male Neanderthal is renowned for the advanced osteoarthritis of its spinal column and hip joint, and their implications for posture and lifestyle in these Mid- to Late Pleistocene humans. Reassessment of the pathologic lesions reveals erosions at multiple non-contiguous vertebrae and reactive bone formation extending far beyond the left hip joint, which suggests the additional diagnosis of brucellosis. This implies the earliest secure evidence of this zoonotic disease in hominin evolution. Brucellosis might have been transmitted via butchering or eating raw meat and is well compatible with the range of prey animals documented for Neanderthals. The associated infertility could have represented an important aspect of health in these late archaic humans.
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Affiliation(s)
- Bruce Rothschild
- Department of Vertebrate Paleontology, Carnegie Museum, 4400 Forbes Ave, Pittsburgh, PA, 15213, USA
- Indiana University Health, Muncie, IN, 47303, USA
| | - Martin Haeusler
- Institute of Evolutionary Medicine, University of Zürich, Winterthurerstr. 190, 8057, Zurich, Switzerland.
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2
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Wang S, Wang X, Teng X, Li S, Zhang H, Shan Z, Li Y. Lumbar Scheuermann's disease found in a patient with osteogenesis imperfecta (OI) caused by a heterozygous mutation in COL1A2 (c.4048G > A): a case report. BMC Musculoskelet Disord 2021; 22:525. [PMID: 34098919 PMCID: PMC8185920 DOI: 10.1186/s12891-021-04401-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 05/26/2021] [Indexed: 11/26/2022] Open
Abstract
Background Osteogenesis imperfecta (OI) is a heterogeneous connective tissue disorder characterized by increased bone fragility and a series of extraskeletal manifestations. Approximately 90 % of OI cases are caused by type I collagen variants encoded by the collagen type I alpha 1 (COL1A1) or type I alpha 2 (COL1A2) gene. Lumbar Scheuermann’s disease is an atypical type of Scheuermann’s disease accompanied by Schmorl’s nodes and irregular endplates but without pronounced kyphosis. Although the etiology of Scheuermann’s disease is unclear, genetic and environmental factors are likely. Case presentation Here, we report a 32-year-old male patient who experienced multiple brittle fractures. Gene sequencing revealed a heterozygous mutation, c.4048G > A (p.G1350S), in the COL1A2 gene, and the patient was diagnosed with OI. Magnetic resonance imaging of his thoracolumbar spine revealed multiple Schmorl’s nodes. Conclusions This is the first reported case of OI coexisting with the spinal presentation of Scheuermann’s disease. It is speculated that the COL1A2 gene mutation might be an underlying novel genetic cause of Scheuermann’s disease. In conclusion, this case demonstrates the relationship between Scheuermann’s disease and OI for the first time and enriches the genotype-phenotype spectrum of OI.
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Affiliation(s)
- Shiwei Wang
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, Shenyang, P. R. China
| | - Xiaoli Wang
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, Shenyang, P. R. China
| | - Xiaochun Teng
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, Shenyang, P. R. China
| | - Songbai Li
- Department of Radiology, The First Hospital of China Medical University, Shenyang, P. R. China
| | - Hanyi Zhang
- Department of Radiology, The First Hospital of China Medical University, Shenyang, P. R. China
| | - Zhongyan Shan
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, Shenyang, P. R. China
| | - Yushu Li
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, Shenyang, P. R. China.
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3
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Guiot A, Estublier C, Gaude M, Szulc P, Chapurlat R. Relationship between diffuse idiopathic skeletal hyperostosis and fragility vertebral fracture: a prospective study in older men. Rheumatology (Oxford) 2021; 60:2197-2205. [PMID: 33200181 DOI: 10.1093/rheumatology/keaa517] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 07/09/2020] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To analyse the risk of incident vertebral and non-vertebral fracture in men with DISH. METHODS In 782 men ages 50-85 years, DISH was diagnosed using Resnick's criteria. In men followed prospectively for 7.5 years, a radiographic incident vertebral fracture was defined by a decrease of ≥20% or ≥4mm in any vertebral height vs baseline. Self-reported incident non-vertebral fractures were confirmed by medical records. RESULTS Men with DISH had higher BMD at the lumbar spine (P < 0.05), but not at other skeletal sites. After adjustment for confounders including disc space narrowing (DSN) and endplate irregularity, the risk of vertebral fracture was higher in men with DISH vs men without DISH [10/164 (6.1%) vs 16/597 (2.7%), P < 0.05; odds ratio (OR) 2.89 (95% CI 1.15, 7.28), P < 0.05]. DISH and low spine BMD were each associated with a higher vertebral fracture risk. The vertebral fracture risk was higher in men who had both DISH and severe DSN. DISH and endplate irregularities (EIs) were each associated with higher vertebral fracture risk. DISH, DSN and EIs define the intervertebral space dysfunction, which was associated with higher vertebral fracture risk [OR 3.99 (95% CI 1.45, 10.98), P < 0.01]. Intervertebral space dysfunction improved the vertebral fracture prediction (ΔAUC = +0.111, P < 0.05), mainly in men with higher spine BMD (>0.9 g/cm2; ΔAUC = +0.189, P < 0.001). DISH was not associated with the risk of non-vertebral fracture. CONCLUSION DISH is associated with higher vertebral fracture risk, independently of other risk factors. Assessment of the intervertebral space dysfunction components may improve the vertebral fracture prediction in older men.
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Affiliation(s)
- Anaïs Guiot
- Service de Rhumatologie, Hôpital Edouard Herriot, Pavillon F, Lyon.,Faculté de Médecine, Université Claude Bernard Lyon 1
| | - Charline Estublier
- INSERM UMR 1033, Hôpital Edouard Herriot, Pavillon F, Lyon.,Service de Rhumatologie, Hôpital Lyon Sud, Pierre-Bénite, France
| | - Marine Gaude
- Service de Rhumatologie, Hôpital Edouard Herriot, Pavillon F, Lyon.,Faculté de Médecine, Université Claude Bernard Lyon 1
| | - Pawel Szulc
- INSERM UMR 1033, Hôpital Edouard Herriot, Pavillon F, Lyon
| | - Roland Chapurlat
- Service de Rhumatologie, Hôpital Edouard Herriot, Pavillon F, Lyon.,Faculté de Médecine, Université Claude Bernard Lyon 1.,INSERM UMR 1033, Hôpital Edouard Herriot, Pavillon F, Lyon
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4
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Carlson BB, Salzmann SN, Shirahata T, Ortiz Miller C, Carrino JA, Yang J, Reisener MJ, Sama AA, Cammisa FP, Girardi FP, Hughes AP. Prevalence of osteoporosis and osteopenia diagnosed using quantitative CT in 296 consecutive lumbar fusion patients. Neurosurg Focus 2020; 49:E5. [PMID: 32738803 DOI: 10.3171/2020.5.focus20241] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 05/13/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Osteoporosis is a metabolic bone disease that increases the risk for fragility fractures. Screening and diagnosis can be achieved by measuring bone mineral density (BMD) using quantitative CT tomography (QCT) in the lumbar spine. QCT-derived BMD measurements can be used to diagnose osteopenia or osteoporosis based on American College of Radiology (ACR) thresholds. Many reports exist regarding the disease prevalence in asymptomatic and disease-specific populations; however, osteoporosis/osteopenia prevalence rates in lumbar spine fusion patients without fracture have not been reported. The purpose of this study was to define osteoporosis and osteopenia prevalence in lumbar fusion patients using QCT. METHODS A retrospective review of prospective data was performed. All patients undergoing lumbar fusion surgery who had preoperative fine-cut CT scans were eligible. QCT-derived BMD measurements were performed at L1 and L2. The L1-2 average BMD was used to classify patients as having normal findings, osteopenia, or osteoporosis based on ACR criteria. Disease prevalence was calculated. Subgroup analyses based on age, sex, ethnicity, and history of abnormal BMD were performed. Differences between categorical groups were calculated with Fisher's exact test. RESULTS Overall, 296 consecutive patients (55.4% female) were studied. The mean age was 63 years (range 21-89 years). There were 248 (83.8%) patients with ages ≥ 50 years. No previous clinical history of abnormal BMD was seen in 212 (71.6%) patients. Osteopenia was present in 129 (43.6%) patients and osteoporosis in 44 (14.9%). There were no prevalence differences between sex or race. Patients ≥ 50 years of age had a significantly higher frequency of osteopenia/osteoporosis than those who were < 50 years of age. CONCLUSIONS In 296 consecutive patients undergoing lumbar fusion surgery, the prevalence of osteoporosis was 14.9% and that for osteopenia was 43.6% diagnosed by QCT. This is the first report of osteoporosis disease prevalence in lumbar fusion patients without vertebral fragility fractures diagnosed by QCT.
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Affiliation(s)
- Brandon B Carlson
- 1Marc A. Asher, MD, Comprehensive Spine Center, University of Kansas Medical Center, Kansas City, Kansas
| | | | | | | | - John A Carrino
- 3Department of Radiology and Imaging, Hospital for Special Surgery, New York; and
| | - Jingyan Yang
- 2Spine Care Institute and.,4Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
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Aboudiab M, Grados F, Batteux B, Henry-Desailly I, Fardellone P, Goëb V. Vertebral fracture assessment (VFA) in patients over 50 years of age with a non-severe peripheral fracture. Osteoporos Int 2020; 31:1477-1486. [PMID: 32266434 DOI: 10.1007/s00198-020-05400-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 03/23/2020] [Indexed: 12/28/2022]
Abstract
UNLABELLED The prevalence of unknown vertebral fractures evaluated by systematic vertebral fracture assessment (VFA) was 21% in patients over 50 years of age who suffered from a recent low-trauma non-severe peripheral fracture. The outcome of VFA resulted in changes in the management of osteoporosis. INTRODUCTION The aim of this study was to evaluate the utility of VFA in detecting vertebral fractures (VFs) in patients over 50 years of age, who suffered from a recent low-trauma non-severe peripheral fracture. METHODS This was an observational, single-center, cross-sectional study conducted in patients over 50 years of age, who presented a recent low-trauma non-severe peripheral fracture and were identified by the Fracture Liaison Service (FLS) of Amiens University Hospital between December 2017 and March 2019. VFA was interpreted by two trained rheumatologists providing a consensual reading using Genant semi-quantitative assessment. RESULTS Of the 359 eligible patients, 114 patients (31.8%) were included (mean age 65.6 ± 8.4 years; 89.5% female). Twenty-four patients (21%) had one or more VF diagnosed by VFA. The total number of VF diagnosed by VFA was 30: 20 VF (66.7%) grade 1, 7 VF (23.3%) grade 2, and 3 VF (10%) grade 3. Among the 24 patients with at least one prevalent VF diagnosed by VFA, 18 patients had an osteoporosis medication adaptation after the VFA results (16 osteoporosis medication initiation and 2 treatment intensification), and 6 patients would have had an osteoporosis medication even without the VFA results (66.7% versus 33.3% respectively, p < 0.001). Of the 51 patients receiving an osteoporosis medication after DXA and VFA, 18 patients (35.3%) had a change in the management of osteoporosis after knowing the outcome of VFA. All the VFs diagnosed by VFA were unknown before. We did not evidence any threshold (age, T-score, height loss) below which no VF was detected. CONCLUSIONS Our study demonstrates the usefulness of systematic VFA to detect prevalent VF in patients over 50 years of age who suffer from a recent non-severe peripheral fracture.
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Affiliation(s)
- M Aboudiab
- Department of Rheumatology, Amiens University Hospital, Amiens, France.
| | - F Grados
- Department of Rheumatology, Amiens University Hospital, Amiens, France
| | - B Batteux
- Department of Pharmacology, Amiens University Hospital, Amiens, France
| | - I Henry-Desailly
- Department of Rheumatology, Amiens University Hospital, Amiens, France
| | - P Fardellone
- Department of Rheumatology, Amiens University Hospital, Amiens, France
| | - V Goëb
- Department of Rheumatology, Amiens University Hospital, Amiens, France
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6
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Lawan A, Leung A, Battié MC. Vertebral endplate defects: nomenclature, classification and measurement methods: a scoping review. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2020; 29:1397-1409. [DOI: 10.1007/s00586-020-06378-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 01/25/2020] [Accepted: 03/14/2020] [Indexed: 01/29/2023]
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7
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Ristolainen L, Kettunen JA, Danielson H, Heliövaara M, Schlenzka D. Magnetic resonance imaging findings of the lumbar spine, back symptoms and physical function among male adult patients with Scheuermann's disease. J Orthop 2020; 21:69-74. [PMID: 32139999 DOI: 10.1016/j.jor.2020.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 02/02/2020] [Indexed: 10/25/2022] Open
Abstract
Background There are only a few studies on untreated Scheuermann's disease and magnetic resonance imaging (MRI) findings in the lumbar spine. The primary aim of this study was to clarify lumbar MRI findings in patients with Scheuermann's disease and to compare with subjects without diagnosed spine disease. Methods Twenty-two male adult Scheuermann's patients (mean age 64.7 years (Standard Deviation [SD] 6.4) and 26 males (mean age 59.7 years [SD 7.4]) from a national health survey were included in this study. From MR images, the dimensions of the vertebral bodies, intervertebral discs and the dural sac were measured. Spondylolisthesis, Modic changes (MC), high intensity zone values (HIZ), and Schmorl's nodes were registered from both groups as well as self-reported data concerning general health, quality of life, and back pain symptoms. Results Significantly more patients with Scheuermann's disease had at least one MC compared to the controls at the level L1/L2 (Odds Ratio [OR] 21.11, 95% Confidence Interval [95% CI] 2.31-192.96), at the level L3/L4 (OR 13.62, 95% CI 1.41-131.26), and at the level L5/S1 (OR 6.11, 95% CI 1.50-24.83). Patients had significantly more Schmorl's nodes compared to the controls (64% vs. 8%, p < 0.001). The area of the dura sac (L3/L4) was larger (mean 201 mm2 vs. 152 mm2, p = 0.017) in the patients compared to controls. At level L1/L2 patients had higher disc than controls (mean 7.9 mm vs. 6.8 mm, p = 0.038). After adjusting for age patients had more commonly constant back pain (OR 9.4, 95% CI 1.56-56.97), and difficulties in walking up one floor without resting (OR 9.8, 95% CI 1.01-95.34) than controls. Conclusions Schmorl's nodes and Modic changes on lumbar MRI, back pain and physical function restrictions seem to be more prevalent among patients with Scheuermann's disease than in the general population.
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Affiliation(s)
- Leena Ristolainen
- Orton Orthopaedic Hospital, Helsinki, Finland, Tenholantie 10, PL 29, 00281, Helsinki, Finland
| | - Jyrki A Kettunen
- Arcada, University of Applied Sciences, Jan-Magnus Janssonin aukio 1, 00560, Helsinki, Finland
| | - Heidi Danielson
- Orton Orthopaedic Hospital, Helsinki, Finland, Tenholantie 10, PL 29, 00281, Helsinki, Finland
| | - Markku Heliövaara
- National Institute for Health and Welfare, Helsinki, Finland, Mannerheimintie 166, PL 30, 00271, Helsinki, Finland
| | - Dietrich Schlenzka
- Research Institute Orton, Helsinki, Finland, Tenholantie 10, PL 29, 00281, Helsinki, Finland
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8
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Urrutia J, Narvaez F, Besa P, Meissner-Haecker A, Rios C, Piza C. Scheuermann's disease in patients 15-40 years old: A study to determine its prevalence and its relationship with age and sex using chest radiographs as screening tool. J Orthop Sci 2019; 24:776-779. [PMID: 30685093 DOI: 10.1016/j.jos.2018.12.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 12/25/2018] [Accepted: 12/27/2018] [Indexed: 01/24/2023]
Abstract
BACKGROUND There is insufficient knowledge of the epidemiology of Scheuermann's disease. The data available comes from estimations from young adults with obvious deformity, from studies evaluating children who may not have developed the deformity yet, or from older populations who can develop vertebral wedging secondary to other causes. We aimed to determine the prevalence of Scheuermann's disease in patients 15-40 years old using plain chest radiographs as a screening tool. METHODS We evaluated 454 patients aged 15-40 years old studied using standing plain chest radiographs. We measured thoracic kyphosis from T5 to T12; using the intraclass correlation coefficient (ICC), we determined inter- and intra-observer agreement. To determine the prevalence of Scheuermann's disease we used the Sorensen criteria. We performed a correlation analysis of thoracic kyphosis and age, and a linear regression to determine the impact of age and sex on the kyphosis angle. RESULTS The prevalence of Scheuermann's disease was 2.2% (0.9-3.5%). The prevalence was not different in females (1.4%) and males (2.8%), p = 0.36. Inter-and intra-observer agreements were excellent: ICC = 0.93 (0.84-0.97) and 0.97 (0.95-0.98). There was a small positive correlation of kyphosis angle with age (r = 0.110; p = 0.019). Linear regression revealed that age (ß = 0.138; p = 0.019) was an independent predictor of kyphosis angle, but sex was not (ß-coefficient = 0.007; p = 0.994). CONCLUSION We found a prevalence of Scheuermann's disease of 2.2%, without significant differences between males and females. Age independently influenced the kyphosis angle; sex did not. This study allows a better understanding of the epidemiology of Scheuermann's disease.
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Affiliation(s)
- Julio Urrutia
- Department of Orthopaedic Surgery, School of Medicine, Pontificia, Universidad Catolica de Chile, Chile.
| | - Felipe Narvaez
- Department of Orthopaedic Surgery, School of Medicine, Pontificia, Universidad Catolica de Chile, Chile
| | - Pablo Besa
- Department of Orthopaedic Surgery, School of Medicine, Pontificia, Universidad Catolica de Chile, Chile
| | - Arturo Meissner-Haecker
- Department of Orthopaedic Surgery, School of Medicine, Pontificia, Universidad Catolica de Chile, Chile
| | - Clemente Rios
- Department of Orthopaedic Surgery, School of Medicine, Pontificia, Universidad Catolica de Chile, Chile
| | - Cristobal Piza
- Department of Orthopaedic Surgery, School of Medicine, Pontificia, Universidad Catolica de Chile, Chile
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9
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Gaudé M, Chapurlat R, Pialat JB, Szulc P. Long term prognosis of Scheuermann's disease: The association with fragility fracture - The MINOS cohort. Bone 2018; 117:116-122. [PMID: 30244156 DOI: 10.1016/j.bone.2018.09.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 09/07/2018] [Accepted: 09/18/2018] [Indexed: 11/28/2022]
Abstract
The aim was to assess the association of Scheuermann's disease (SCD) with fracture risk (vertebral, peripheral) and bone mineral density (BMD) in older men. SCD was assessed on the baseline lateral spine radiographs using the Berlin criteria in 766 men aged 50-85. We evaluated the association of SCD and its diagnostic criteria with incident fracture (vertebral over 7.5 years, peripheral over 10 years) and BMD (baseline). SCD prevalence was 25.2%. SCD and its criteria showed inconsistent associations with BMD at different skeletal sites. Eighty-four men had incident fractures. After adjustment for age, weight, spine BMD, prevalent vertebral fractures, prior falls and score of disc space narrowing due to osteoarthritis (DSN-OA), SCD was not associated with vertebral fracture risk. Vertebral endplate irregularities (EI), one of its diagnostic criteria, were associated with higher vertebral fracture risk (OR = 3.26, 95% CI: 1.34-7.94, p < 0.01). Vertebral fracture risk was higher in men with EI and low spine BMD vs. men without these characteristics (OR = 12.84, 95% CI: 3.12-52.83, p < 0.005). EI was associated with higher vertebral fracture risk in men without severe DSN-OA and without prevalent vertebral fractures. Peripheral fracture risk was lower in men with SCD (HR = 0.39, 95% CI: 0.18-0.83, p < 0.02) and EI. Peripheral fracture risk was higher in men without SCD who had low femoral neck BMD vs. men with SCD and normal BMD (HR = 4.68, 95% CI: 1.09-20.03, p < 0.05). In conclusion, EI were associated with high vertebral fracture risk. SCD and EI were associated with lower peripheral fracture risk. The associations of SCD and its criteria with BMD were inconsistent.
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Affiliation(s)
- Marine Gaudé
- INSERM UMR 1033, University of Lyon, Lyon, France; Department of Rheumatology, Hospices Civils de Lyon, Hôpital Edouard Herriot, Lyon, France
| | - Roland Chapurlat
- INSERM UMR 1033, University of Lyon, Lyon, France; Department of Rheumatology, Hospices Civils de Lyon, Hôpital Edouard Herriot, Lyon, France
| | - Jean-Baptiste Pialat
- INSERM UMR 1033, University of Lyon, Lyon, France; Department of Radiology, Hospices Civils de Lyon, Hôpital Edouard Herriot, Lyon, France
| | - Pawel Szulc
- INSERM UMR 1033, University of Lyon, Lyon, France.
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10
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Oei L, Koromani F, Breda SJ, Schousboe JT, Clark EM, van Meurs JB, Ikram MA, Waarsing JH, van Rooij FJ, Zillikens MC, Krestin GP, Oei EH, Rivadeneira F. Osteoporotic Vertebral Fracture Prevalence Varies Widely Between Qualitative and Quantitative Radiological Assessment Methods: The Rotterdam Study. J Bone Miner Res 2018; 33:560-568. [PMID: 28719143 DOI: 10.1002/jbmr.3220] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 07/07/2017] [Accepted: 07/13/2017] [Indexed: 12/29/2022]
Abstract
Accurate diagnosis of vertebral osteoporotic fractures is crucial for the identification of individuals at high risk of future fractures. Different methods for radiological assessment of vertebral fractures exist, but a gold standard is lacking. The aim of our study was to estimate statistical measures of agreement and prevalence of osteoporotic vertebral fractures in the population-based Rotterdam Study, across two assessment methods. The quantitative morphometry assisted by SpineAnalyzer® (QM SA) method evaluates vertebral height loss that affects vertebral shape whereas the algorithm-based qualitative (ABQ) method judges endplate integrity and includes guidelines for the differentiation of vertebral fracture and nonfracture deformities. Cross-sectional radiographs were assessed for 7582 participants aged 45 to 95 years. With QM SA, the prevalence was 14.2% (95% CI, 13.4% to 15.0%), compared to 4.0% (95% CI, 3.6% to 4.5%) with ABQ. Inter-method agreement according to kappa (κ) was 0.24. The highest agreement between methods was among females (κ = 0.31), participants age >80 years (κ = 0.40), and at the L1 level (κ = 0.40). With ABQ, most fractures were found at the thoracolumbar junction (T12 -L1 ) followed by the T7 -T8 level, whereas with QM SA, most deformities were in the mid thoracic (T7 -T8 ) and lower thoracic spine (T11 -T12 ), with similar number of fractures in both peaks. Excluding mild QM SA deformities (grade 1 with QM) from the analysis increased, the agreement between the methods from κ = 0.24 to 0.40, whereas reexamining mild deformities based on endplate depression increased agreement from κ = 0.24 to 0.50 (p <0.001). Vertebral fracture prevalence differs significantly between QM SA and ABQ; reexamining QM mild deformities based on endplate depression would increase the agreement between methods. More widespread and consistent application of an optimal method may improve clinical care. © 2017 American Society for Bone and Mineral Research.
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Affiliation(s)
- Ling Oei
- Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - Fjorda Koromani
- Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands.,Department of Radiology, Erasmus MC, Rotterdam, The Netherlands
| | - Stephan J Breda
- Department of Radiology, Erasmus MC, Rotterdam, The Netherlands
| | - John T Schousboe
- Park Nicollet Clinic and HealthPartners Institute, HealthPartners, Inc., Minneapolis, MN, USA
| | - Emma M Clark
- Musculoskeletal Research Unit, School of Clinical Science, University of Bristol, Southmead Hospital, Bristol, UK
| | | | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - Jan H Waarsing
- Department of Orthopedics, Erasmus MC, Rotterdam, The Netherlands
| | | | - Maria C Zillikens
- Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | | | - Edwin Hg Oei
- Department of Radiology, Erasmus MC, Rotterdam, The Netherlands
| | - Fernando Rivadeneira
- Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
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Halanski MA, Hildahl B, Amundson LA, Leiferman E, Gendron-Fitzpatrick A, Chaudhary R, Hartwig-Stokes HM, McCabe R, Lenhart R, Chin M, Birstler J, Crenshaw TD. Maternal Diets Deficient in Vitamin D Increase the Risk of Kyphosis in Offspring: A Novel Kyphotic Porcine Model. J Bone Joint Surg Am 2018; 100:406-415. [PMID: 29509618 PMCID: PMC6818982 DOI: 10.2106/jbjs.17.00182] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND The purpose of this study was to explore the role of perinatal vitamin-D intake on the development and characterization of hyperkyphosis in a porcine model. METHODS The spines of 16 pigs were assessed at 9, 13, and 17 weeks of age with radiography and at 17 weeks with computed tomography (CT), magnetic resonance imaging (MRI), histology, and bone-density testing. An additional 169 pigs exposed to 1 of 3 maternal dietary vitamin-D levels from conception through the entire lactation period were fed 1 of 4 nursery diets supplying different levels of vitamin D, calcium, and phosphorus. When the animals were 13 weeks of age, upright lateral spinal radiography was performed with use of a custom porcine lift and sagittal Cobb angles were measured in triplicate to determine the degree of kyphosis in each pig. RESULTS The experimental animals had significantly greater kyphotic sagittal Cobb angles at all time points when compared with the control animals. These hyperkyphotic deformities demonstrated no significant differences in Hounsfield units, contained a slightly lower ash content (46.7% ± 1.1% compared with 50.9% ± 1.6%; p < 0.001), and demonstrated more physeal irregularities. Linear mixed model analysis of the measured kyphosis demonstrated that maternal diet had a greater effect on sagittal Cobb angle than did nursery diet and that postnatal supplementation did not completely eliminate the risk of hyperkyphosis. CONCLUSIONS Maternal diets deficient in vitamin D increased the development of hyperkyphosis in offspring in this model. CLINICAL RELEVANCE This study demonstrates that decreased maternal dietary vitamin-D intake during pregnancy increases the risk of spinal deformity in offspring. In addition, these data show the feasibility of generating a large-animal spinal-deformity model through dietary manipulation alone.
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Affiliation(s)
- Matthew A. Halanski
- Departments of Orthopedics and Rehabilitation (M.A.H., B.H., E.L., R.C., H.M.H.-S., R.M., and R.L.) and Animal Sciences (L.A.A. and T.D.C.), Comparative Pathology Laboratory (A.G.-F.), and Department of Biostatistics and Medical Informatics (J.B.), University of Wisconsin-Madison, Madison, Wisconsin,E-mail address for M.A. Halanski:
| | - Blake Hildahl
- Departments of Orthopedics and Rehabilitation (M.A.H., B.H., E.L., R.C., H.M.H.-S., R.M., and R.L.) and Animal Sciences (L.A.A. and T.D.C.), Comparative Pathology Laboratory (A.G.-F.), and Department of Biostatistics and Medical Informatics (J.B.), University of Wisconsin-Madison, Madison, Wisconsin
| | - Laura A. Amundson
- Departments of Orthopedics and Rehabilitation (M.A.H., B.H., E.L., R.C., H.M.H.-S., R.M., and R.L.) and Animal Sciences (L.A.A. and T.D.C.), Comparative Pathology Laboratory (A.G.-F.), and Department of Biostatistics and Medical Informatics (J.B.), University of Wisconsin-Madison, Madison, Wisconsin
| | - Ellen Leiferman
- Departments of Orthopedics and Rehabilitation (M.A.H., B.H., E.L., R.C., H.M.H.-S., R.M., and R.L.) and Animal Sciences (L.A.A. and T.D.C.), Comparative Pathology Laboratory (A.G.-F.), and Department of Biostatistics and Medical Informatics (J.B.), University of Wisconsin-Madison, Madison, Wisconsin
| | - Annette Gendron-Fitzpatrick
- Departments of Orthopedics and Rehabilitation (M.A.H., B.H., E.L., R.C., H.M.H.-S., R.M., and R.L.) and Animal Sciences (L.A.A. and T.D.C.), Comparative Pathology Laboratory (A.G.-F.), and Department of Biostatistics and Medical Informatics (J.B.), University of Wisconsin-Madison, Madison, Wisconsin
| | - Rajeev Chaudhary
- Departments of Orthopedics and Rehabilitation (M.A.H., B.H., E.L., R.C., H.M.H.-S., R.M., and R.L.) and Animal Sciences (L.A.A. and T.D.C.), Comparative Pathology Laboratory (A.G.-F.), and Department of Biostatistics and Medical Informatics (J.B.), University of Wisconsin-Madison, Madison, Wisconsin
| | - Heather M. Hartwig-Stokes
- Departments of Orthopedics and Rehabilitation (M.A.H., B.H., E.L., R.C., H.M.H.-S., R.M., and R.L.) and Animal Sciences (L.A.A. and T.D.C.), Comparative Pathology Laboratory (A.G.-F.), and Department of Biostatistics and Medical Informatics (J.B.), University of Wisconsin-Madison, Madison, Wisconsin
| | - Ronald McCabe
- Departments of Orthopedics and Rehabilitation (M.A.H., B.H., E.L., R.C., H.M.H.-S., R.M., and R.L.) and Animal Sciences (L.A.A. and T.D.C.), Comparative Pathology Laboratory (A.G.-F.), and Department of Biostatistics and Medical Informatics (J.B.), University of Wisconsin-Madison, Madison, Wisconsin
| | - Rachel Lenhart
- Departments of Orthopedics and Rehabilitation (M.A.H., B.H., E.L., R.C., H.M.H.-S., R.M., and R.L.) and Animal Sciences (L.A.A. and T.D.C.), Comparative Pathology Laboratory (A.G.-F.), and Department of Biostatistics and Medical Informatics (J.B.), University of Wisconsin-Madison, Madison, Wisconsin
| | - Matthew Chin
- Geisinger Wyoming Valley Medical Center, Wilkes-Barre, Pennsylvania
| | - Jennifer Birstler
- Departments of Orthopedics and Rehabilitation (M.A.H., B.H., E.L., R.C., H.M.H.-S., R.M., and R.L.) and Animal Sciences (L.A.A. and T.D.C.), Comparative Pathology Laboratory (A.G.-F.), and Department of Biostatistics and Medical Informatics (J.B.), University of Wisconsin-Madison, Madison, Wisconsin
| | - Thomas D. Crenshaw
- Departments of Orthopedics and Rehabilitation (M.A.H., B.H., E.L., R.C., H.M.H.-S., R.M., and R.L.) and Animal Sciences (L.A.A. and T.D.C.), Comparative Pathology Laboratory (A.G.-F.), and Department of Biostatistics and Medical Informatics (J.B.), University of Wisconsin-Madison, Madison, Wisconsin,Swine Research and Teaching Center, Arlington, Wisconsin,E-mail address for T.D. Crenshaw:
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12
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Armbrecht G, Felsenberg D, Ganswindt M, Lunt M, Kaptoge SK, Abendroth K, Aroso Dias A, Bhalla AK, Cannata Andia J, Dequeker J, Eastell R, Hoszowski K, Lyritis G, Masaryk P, van Meurs J, Miazgowski T, Nuti R, Poór G, Redlund-Johnell I, Reid DM, Schatz H, Todd CJ, Woolf AD, Rivadeneira F, Javaid MK, Cooper C, Silman AJ, O'Neill TW, Reeve J. Degenerative inter-vertebral disc disease osteochondrosis intervertebralis in Europe: prevalence, geographic variation and radiological correlates in men and women aged 50 and over. Rheumatology (Oxford) 2017; 56:1189-1199. [PMID: 28398504 PMCID: PMC5582627 DOI: 10.1093/rheumatology/kex040] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Indexed: 11/14/2022] Open
Abstract
Objectives To assess the prevalences across Europe of radiological indices of degenerative inter-vertebral disc disease (DDD); and to quantify their associations with, age, sex, physical anthropometry, areal BMD (aBMD) and change in aBMD with time. Methods In the population-based European Prospective Osteoporosis Study, 27 age-stratified samples of men and women from across the continent aged 50+ years had standardized lateral radiographs of the lumbar and thoracic spine to evaluate the severity of DDD, using the Kellgren-Lawrence (KL) scale. Measurements of anterior, mid-body and posterior vertebral heights on all assessed vertebrae from T4 to L4 were used to generate indices of end-plate curvature. Results Images from 10 132 participants (56% female, mean age 63.9 years) passed quality checks. Overall, 47% of men and women had DDD grade 3 or more in the lumbar spine and 36% in both thoracic and lumbar spine. Risk ratios for DDD grades 3 and 4, adjusted for age and anthropometric determinants, varied across a three-fold range between centres, yet prevalences were highly correlated in men and women. DDD was associated with flattened, non-ovoid inter-vertebral disc spaces. KL grade 4 and loss of inter-vertebral disc space were associated with higher spine aBMD. Conclusion KL grades 3 and 4 are often used clinically to categorize radiological DDD. Highly variable European prevalences of radiologically defined DDD grades 3+ along with the large effects of age may have growing and geographically unequal health and economic impacts as the population ages. These data encourage further studies of potential genetic and environmental causes.
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Affiliation(s)
- Gabriele Armbrecht
- Department of Radiology and Nuclear Medicine, Free University, Berlin, Germany
| | - Dieter Felsenberg
- Department of Radiology and Nuclear Medicine, Free University, Berlin, Germany
| | - Melanie Ganswindt
- Department of Radiology and Nuclear Medicine, Free University, Berlin, Germany
| | - Mark Lunt
- NIHR Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, & Arthritis Research UK Centre for Epidemiology, Manchester, University of Manchester
| | - Stephen K Kaptoge
- Department of Public Health and Primary Care, Strangeways Research Laboratory, Cambridge, UK
| | | | | | - Ashok K Bhalla
- Rheumatology, Royal National Hospital for Rheumatic Diseases, Bath, UK
| | | | - Jan Dequeker
- Rheumatology, University Hospital, Leuven, Belgium
| | - Richard Eastell
- Mellanby Centre for Bone Research, University of Sheffield, Sheffield, UK
| | | | - George Lyritis
- Laboratory for the Research of Musculoskeletal System, University of Athens, Athens, Greece
| | - Pavol Masaryk
- Rheumatology, Institute of Rheumatic Diseases, Piestany, Slovakia
| | - Joyce van Meurs
- Department of Epidemiology and Department of Internal Medicine, Erasmus University, Rotterdam, Netherlands
| | - Tomasz Miazgowski
- Department of Hypertension and Internal Medicine, Pomeranian Medical University, Szczecin, Poland
| | - Ranuccio Nuti
- Institute of Clinical Medicine, University of Siena, Siena, Italy
| | - Gyula Poór
- 1st Department of Rheumatology and Metabolic Osteology, National Institute of Rheumatology and Physiotherapy, Budapest, Hungary
| | | | - David M Reid
- School of Medicine, Medical Science and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Helmut Schatz
- Rheumatology, Med Klinik & Polyklinik, Bochum, Germany
| | - Christopher J Todd
- School of Health Sciences, The University of Manchester, Oxford Road, Manchester
| | - Anthony D Woolf
- Institute of Health Care Research, Peninsula College of Medicine and Dentistry, Universities of Exeter and Plymouth, Royal Cornwall Hospital, Truro
| | - Fernando Rivadeneira
- Department of Epidemiology and Department of Internal Medicine, Erasmus University, Rotterdam, Netherlands
| | - Muhammad K Javaid
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, NIHR Musculo-skeletal Biomedical Research Unit, Botnar Research Centre, Oxford, UK
| | - Cyrus Cooper
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, NIHR Musculo-skeletal Biomedical Research Unit, Botnar Research Centre, Oxford, UK
| | - Alan J Silman
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, NIHR Musculo-skeletal Biomedical Research Unit, Botnar Research Centre, Oxford, UK
| | - Terence W O'Neill
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, NIHR Musculo-skeletal Biomedical Research Unit, Botnar Research Centre, Oxford, UK
| | - Jonathan Reeve
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, NIHR Musculo-skeletal Biomedical Research Unit, Botnar Research Centre, Oxford, UK
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13
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Oei L, Koromani F, Rivadeneira F, Zillikens MC, Oei EHG. Quantitative imaging methods in osteoporosis. Quant Imaging Med Surg 2016; 6:680-698. [PMID: 28090446 DOI: 10.21037/qims.2016.12.13] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Osteoporosis is characterized by a decreased bone mass and quality resulting in an increased fracture risk. Quantitative imaging methods are critical in the diagnosis and follow-up of treatment effects in osteoporosis. Prior radiographic vertebral fractures and bone mineral density (BMD) as a quantitative parameter derived from dual-energy X-ray absorptiometry (DXA) are among the strongest known predictors of future osteoporotic fractures. Therefore, current clinical decision making relies heavily on accurate assessment of these imaging features. Further, novel quantitative techniques are being developed to appraise additional characteristics of osteoporosis including three-dimensional bone architecture with quantitative computed tomography (QCT). Dedicated high-resolution (HR) CT equipment is available to enhance image quality. At the other end of the spectrum, by utilizing post-processing techniques such as the trabecular bone score (TBS) information on three-dimensional architecture can be derived from DXA images. Further developments in magnetic resonance imaging (MRI) seem promising to not only capture bone micro-architecture but also characterize processes at the molecular level. This review provides an overview of various quantitative imaging techniques based on different radiological modalities utilized in clinical osteoporosis care and research.
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Affiliation(s)
- Ling Oei
- Department of Internal Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands; Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Fjorda Koromani
- Department of Internal Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands; Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Fernando Rivadeneira
- Department of Internal Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands; Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - M Carola Zillikens
- Department of Internal Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Edwin H G Oei
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
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14
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Briot K, Fechtenbaum J, Roux C. Clinical Relevance of Vertebral Fractures in Men. J Bone Miner Res 2016; 31:1497-9. [PMID: 27381556 DOI: 10.1002/jbmr.2906] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 06/28/2016] [Accepted: 07/03/2016] [Indexed: 11/08/2022]
Affiliation(s)
- Karine Briot
- Epidemiology and Biostatistics Sorbonne Paris Cité Research Center, INSERM U1153, Paris, France.,Paris Descartes University, Department of Rheumatology, Cochin Hospital, Paris, France
| | - Jacques Fechtenbaum
- Epidemiology and Biostatistics Sorbonne Paris Cité Research Center, INSERM U1153, Paris, France.,Paris Descartes University, Department of Rheumatology, Cochin Hospital, Paris, France
| | - Christian Roux
- Epidemiology and Biostatistics Sorbonne Paris Cité Research Center, INSERM U1153, Paris, France.,Paris Descartes University, Department of Rheumatology, Cochin Hospital, Paris, France
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