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Abstract
Osteoarthritis (OA) most commonly affects knee joints, and the next most commonly affected sites are the hands and hips. Three distinct hand OA phenotypes have been described: erosive hand OA (EHOA), nodal hand OA - also known as non-erosive hand OA (non-EHOA) - and first carpometacarpal joint OA. EHOA predominantly affects women and is the most aggressive form of hand OA, characterized by a severe clinical onset and progression, leading to joint damage, disability and reduction of quality of life. Clinical signs of inflammation associated with EHOA include the acute onset of pain, swelling and redness. Moreover, EHOA is characterized by radiographic features such as central erosion, saw-tooth and gull-wing lesions and, rarely, ankylosis. The aim of this Review is to report the latest findings on epidemiology, clinical features, pathology and aetiopathogenesis, biomarkers, imaging modalities and treatments for EHOA. The ongoing development of new hand OA classification criteria should facilitate standardization between studies.
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Favero M, Hoxha A, Frallonardo P, Ortolan A, Lorenzin M, Felicetti M, Belluzzi E, Doria A, Ramonda R. Efficacy and Safety of Ultrasound-Guided Intra-articular Glucocorticoid Injection in Erosive Hand Osteoarthritis. PAIN MEDICINE 2021; 22:1229-1232. [PMID: 32914191 DOI: 10.1093/pm/pnaa261] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 05/19/2020] [Accepted: 07/07/2020] [Indexed: 11/13/2022]
Affiliation(s)
- Marta Favero
- Rheumatology Unit, Department of Medicine-DIMED, University-Hospital of Padova, Padova, Italy
| | - Ariela Hoxha
- Rheumatology Unit, Department of Medicine-DIMED, University-Hospital of Padova, Padova, Italy.,Internal Medicine Unit, Department of Medicine, San Bortolo Hospital, Vicenza, Italy
| | - Paola Frallonardo
- Rheumatology Unit, Department of Medicine-DIMED, University-Hospital of Padova, Padova, Italy
| | - Augusta Ortolan
- Rheumatology Unit, Department of Medicine-DIMED, University-Hospital of Padova, Padova, Italy
| | - Mariagrazia Lorenzin
- Rheumatology Unit, Department of Medicine-DIMED, University-Hospital of Padova, Padova, Italy
| | - Mara Felicetti
- Rheumatology Unit, Department of Medicine-DIMED, University-Hospital of Padova, Padova, Italy
| | - Elisa Belluzzi
- Rheumatology Unit, Department of Medicine-DIMED, University-Hospital of Padova, Padova, Italy
| | - Andrea Doria
- Rheumatology Unit, Department of Medicine-DIMED, University-Hospital of Padova, Padova, Italy
| | - Roberta Ramonda
- Rheumatology Unit, Department of Medicine-DIMED, University-Hospital of Padova, Padova, Italy
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Kondo M, Murakawa Y, Honda M, Moriyama M. Remission with tocilizumab in a patient with erosive hand osteoarthritis. Scand J Rheumatol 2021; 50:485-487. [PMID: 33729085 DOI: 10.1080/03009742.2020.1867238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- M Kondo
- Department of Rheumatology, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - Y Murakawa
- Department of Rheumatology, Shimane University Faculty of Medicine, Izumo, Shimane, Japan.,Department of General Treatment Center for Intractable Diseases, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - M Honda
- Department of Rheumatology, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - M Moriyama
- Department of Rheumatology, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
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Lane JCE, Craig RS, Rees JL, Gardiner MD, Shaw AV, Spiteri M, Kuo R, Dean BF, Green J, Prieto-Alhambra D, Furniss D. Low rate of subsequent surgery and serious complications following intra-articular steroid injection for base of thumb osteoarthritis: national cohort analysis. Rheumatology (Oxford) 2021; 60:4262-4271. [PMID: 33410485 PMCID: PMC8410003 DOI: 10.1093/rheumatology/keaa925] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 12/08/2020] [Indexed: 11/12/2022] Open
Abstract
Objectives Intra-articular steroid injection is commonly used to treat base of thumb osteoarthritis (BTOA), despite a lack of large-scale data on safety and effectiveness. We estimate the incidence of serious complications and further procedures following BTOA injection, including the risk of post-operative serious surgical site infection for subsequent operative intervention. Methods Hospital Episode Statistics data linked to mortality records from 1 April 1998 to 31 March 2017 were used to identify all BTOA injections undertaken in adults in the National Health Service secondary care in England. Patients were followed up longitudinally until death or 31 March 2017. A multivariable regression with a Fine and Gray model adjusting for the competing risk of mortality in addition to age, sex and socioeconomic deprivation was used to identify factors associated with progression to further procedure. Secondary outcomes included serious complications after injection and subsequent surgical site infection. Results A total of 19 120 primary injections were performed during the 19-year period in 18 356 patients. Of these 76.5% were female; mean age 62 years (s.d. 10.6); 50.48% underwent further procedure; 22.40% underwent surgery. Median time to further intervention was 412 days (IQR 110–1945). Female sex was associated with increased risk of proceeding to surgery. Serious complication rate following injection was 0.04% (0.01–0.08) within 90 days. Of those proceeding to surgery 0.16% (0.06–0.34) presented with a wound infection within 30 days and 90 days, compared with an overall post-operative wound infection rate of 0.03% (0.02–0.05). Conclusions Very low rates of serious complications were identified following BTOA injections performed in secondary care; only one in five patients proceeded to subsequent surgery. Clinical trial registration clinicaltrials.gov, https://www.clinicaltrials.gov, NCT03573765
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Affiliation(s)
- Jennifer C E Lane
- Oxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Nuffield Orthopaedic Centre, University of Oxford, Oxford
| | - Richard S Craig
- Oxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Nuffield Orthopaedic Centre, University of Oxford, Oxford
| | - Jonathan L Rees
- Oxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Nuffield Orthopaedic Centre, University of Oxford, Oxford
| | | | - Abigail V Shaw
- Oxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Nuffield Orthopaedic Centre, University of Oxford, Oxford
| | - Michelle Spiteri
- Department of Hand Surgery, Nuffield Orthopaedic Centre, Windmill Road
| | - Rachel Kuo
- Oxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Nuffield Orthopaedic Centre, University of Oxford, Oxford
| | - Benjamin F Dean
- Oxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Nuffield Orthopaedic Centre, University of Oxford, Oxford.,Department of Hand Surgery, Nuffield Orthopaedic Centre, Windmill Road
| | - Jane Green
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford
| | - Daniel Prieto-Alhambra
- Oxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Nuffield Orthopaedic Centre, University of Oxford, Oxford
| | - Dominic Furniss
- Oxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Nuffield Orthopaedic Centre, University of Oxford, Oxford.,Department of Plastic and Reconstructive Surgery, Nuffield Orthopaedic Centre, Universiy of Oxford, Oxford, UK
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Almansa Ruiz JC, Kirberger RM, Steenkamp G. Temporomandibular joint injections in dogs with temporomandibular joint pain: 11 cases (2015-2019). J Small Anim Pract 2020; 62:33-41. [PMID: 33145802 DOI: 10.1111/jsap.13251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 09/20/2020] [Accepted: 09/28/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To describe and evaluate the clinical application of temporomandibular joint injections using betamethasone and ropivacaine in German Shepherd dogs suffering from non-odontogenic orofacial pain due to temporomandibular dysplasia and/or osteoarthritis. MATERIALS AND METHODS Outcomes in dogs presented with clinical signs of non-odontogenic orofacial pain associated to temporomandibular joint dysplasia and/or arthritis and treated with a temporomandibular joint injection were retrospectively-prospectively evaluated. RESULTS The overall clinical signs free period ranged between 25 to 1579 days, with an average of 461 days. The clinical signs free period for temporomandibular joint osteoarthritis scores 1, 2 and 3 were on average 659 days (180-1579 days), 134 days (42-355 days) and 723 days (25-1377 days), respectively. Similarly the temporomandibular dysplasia scores 1, 2 and 3 were on average 306 days (26-1579 days), 1377 days and 669 days (25-1429 days) respectively. Those dogs in which only one side was injected the clinical signs free period average was 639 days (25-1578 days), compared with dogs in which both temporomandibular joints were injected showing a clinical signs free period average of 378 days (42-1377 days). CLINICAL SIGNIFICANCE The temporomandibular joint injection technique proved to be feasible with a decent outcome in dogs suffering from non-odontogenic orofacial pain associated with temporomandibular joint osteoarthritis and/or dysplasia. Further randomised studies are required to confirm the effectiveness of this intervention.
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Affiliation(s)
- J C Almansa Ruiz
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Old Soutpan Rd, Onderstepoort, Pretoria, 0110, South Africa
| | - R M Kirberger
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Old Soutpan Rd, Onderstepoort, Pretoria, 0110, South Africa
| | - G Steenkamp
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Old Soutpan Rd, Onderstepoort, Pretoria, 0110, South Africa
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