How to investigate: Suspected systemic rheumatic diseases in patients presenting with muscle complaints

Workplace barriers among people with rheumatic and chronic back pain: Results from the work experience survey for rheumatic conditions

BACKGROUND

The Work Experience Survey for Rheumatic Conditions (WES-RC) is a prominent feature of an evidence-based intervention to prevent premature job loss among people with arthritis. The WES-RC is used to identify client perceived barriers related to work performance. The degree to which people with arthritis and rheumatic conditions report barriers on the WES-RC has not been reported.

OBJECTIVE

The purpose of this study was to characterize the barriers reported on the WES-RC.

METHODS

Data from participants who completed the WES-RC in the Work It study trial were included (N = 143). Descriptive statistics were used to characterize the sample and the frequency with which barriers on the WES-RC were reported. Responses to the top three bothersome barriers to study participants were summed.

RESULTS

The mean age of the sample was 50.3 years; 73% were female, and 66% white. All WES-RC items were checked as a barrier by at least two participants; less than 10 participants checked 34 items. Barriers in the 'getting ready for work and traveling to and from, or for work' domain, were frequently reported. The most bothersome barriers were 'standing or being on feet too long' and 'prolonged sitting'.

CONCLUSION

The WES-RC is a self-reported checklist that captures a wide breadth of work-related barriers that could be experienced by people with arthritis who are currently employed.

Novel Muscle Imaging in Inflammatory Rheumatic Diseases-A Focus on Ultrasound Shear Wave Elastography and Quantitative MRI

In recent years, imaging has played an increasing role in the clinical management of patients with rheumatic diseases with respect to aiding diagnosis, guiding therapy and monitoring disease progression. These roles have been underpinned by research which has enhanced our understanding of disease pathogenesis and pathophysiology of rheumatology conditions, in addition to their key role in outcome measurement in clinical trials. However, compared to joints, imaging research of muscles is less established, despite the fact that muscle symptoms are very common and debilitating in many rheumatic diseases. Recently, it has been shown that even though patients with rheumatoid arthritis may achieve clinical remission, defined by asymptomatic joints, many remain affected by lingering constitutional systemic symptoms like fatigue, tiredness, weakness and myalgia, which may be attributed to changes in the muscles. Recent improvements in imaging technology, coupled with an increasing clinical interest, has started to ignite new interest in the area. This perspective discusses the rationale for using imaging, particularly ultrasound and MRI, for investigating muscle pathology involved in common inflammatory rheumatic diseases. The muscles associated with rheumatic diseases can be affected in many ways, including myositis-an inflammatory muscle condition, and myopathy secondary to medications, such as glucocorticoids. In addition to non-invasive visual assessment of muscles in these conditions, novel imaging techniques like shear wave elastography and quantitative MRI can provide further useful information regarding the physiological and biomechanical status of the muscle.