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Larsen SB, Søgaard SB, Nielsen MB, Torp-Pedersen ST. Diagnostic Considerations of Intermetatarsal Bursitis: A Systematic Review. Diagnostics (Basel) 2023; 13:diagnostics13020211. [PMID: 36673020 PMCID: PMC9857655 DOI: 10.3390/diagnostics13020211] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/02/2023] [Accepted: 01/03/2023] [Indexed: 01/09/2023] Open
Abstract
Intermetatarsal bursitis (IMB) is an inflammation of the intermetatarsal bursas. The condition causes forefoot pain with symptoms similar to those of Morton's neuroma (MN). Some studies suggest that IMB is a contributing factor to the development of MN, while others describe the condition as a differential diagnosis. Among patients with rheumatic diseases, IMB is frequent, but the scope is yet to be understood. The aim of this paper was to investigate the diagnostic considerations of IMB and its role in metatarsalgia by a systematic review approach. We identified studies about IMB by searching the electronic databases Pubmed, Embase, Cochrane Library, and Web of Science in September 2022. Of 1362 titles, 28 met the inclusion criteria. They were subdivided according to topic: anatomical studies (n = 3), studies of patients with metatarsalgia (n = 10), and studies of patients with rheumatic diseases (n = 15). We conclude that IMB should be considered a cause of pain in patients with metatarsalgia and patients with rheumatic diseases. For patients presenting with spreading toes/V-sign, IMB should be a diagnostic consideration. Future diagnostic studies about MN should take care to apply a protocol that is able to differ IMB from MN, to achieve a better understanding of their respective role in forefoot pain.
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Affiliation(s)
- Sif Binder Larsen
- Department of Diagnostic Radiology, Rigshospitalet, 2100 Copenhagen, Denmark
- Correspondence: ; Tel.: +45-21457551
| | - Stinne Byrholdt Søgaard
- Department of Diagnostic Radiology, Rigshospitalet, 2100 Copenhagen, Denmark
- Department of Biomedical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
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Alkady EA, Abdelaziz MM, Abdelwahed D, Mahran SA. Falls in Rheumatoid Patients: Does Ankle and Foot Ultrasonography have a Predictive Role? A Single-blind Study. AKTUEL RHEUMATOL 2021. [DOI: 10.1055/a-1353-4415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
ABSTRACT
Background Rheumatoid arthritis (RA) patients have a higher prevalence of falls compared with the healthy population. Several risk factors of falls in RA have been postulated, including high disease activity, low balance, muscle weakness and non-treatment with biologics.
Aim of the work We investigated our hypothesis that the sonographically detected ankle and foot changes in RA patients can predict falls in this population. To our knowledge, no previous study had investigated this before.
Methods In a total of 101 RA patients, we performed assessments of disease activity, disability level, gait speed, balance status, clinical examination of ankle and foot and an MSUS assessment of the ankle and foot joints and tendons as possible risk factors of falls.
Results The Berg balance test had the highest fall-predicting power (71.3%), followed by a gait speed test and restricted range of motion (ROM) of the Rt. subtalar joint, each with a predictive power of 70.3%. Of the sonographic findings, erosion of the first metatarsophalangeal (MTP) joint was the most accurate fall predictor, followed by erosion of the talonavicular joint and tenosynovitis of the ankle dorsal flexors with an area under the curve of 0.656, 0.642 and 0.614, respectively.
Conclusion The use of the MSUS as an adjunct objective method for predicting falls in RA patients has not been studied before. It was found that clinical foot and balance testing was a superior and easier way of predicting falls in RA patients than using ultrasonography.
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Affiliation(s)
- Eman A.M. Alkady
- Department of Rheumatology, Rehabilitation and Physical Medicine, Assiut University Faculty of Medicine, Assiut, Egypt
| | - Marwa Mahmoud Abdelaziz
- Department of Rheumatology, Rehabilitation and Physical Medicine, Assiut University Faculty of Medicine, Assiut, Egypt
| | - Dalia Abdelwahed
- Department of Rheumatology, Rehabilitation and Physical Medicine, Assiut University Faculty of Medicine, Assiut, Egypt
| | - Safaa A. Mahran
- Department of Rheumatology, Rehabilitation and Physical Medicine, Assiut University Faculty of Medicine, Assiut, Egypt
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Hammer HB, Kvien TK, Terslev L. Intermetatarsal bursitis is frequent in patients with established rheumatoid arthritis and is associated with anti-cyclic citrullinated peptide and rheumatoid factor. RMD Open 2019; 5:e001076. [PMID: 31673423 PMCID: PMC6803004 DOI: 10.1136/rmdopen-2019-001076] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 09/18/2019] [Accepted: 10/02/2019] [Indexed: 12/01/2022] Open
Affiliation(s)
| | - Tore K Kvien
- Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - L Terslev
- Center for Rheumatology and Spine Disease, Rigshospitalet Glostrup, Copenhagen, Denmark
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Pehlivan Y, Orucoglu N, Pehlivan S, Kimyon G, Zengin O, Kucuk A, Sahin A, Tomas N, Oksuz MF, Kisacik B, Akar S, Onat AM, Dalkilic E. Patients' concerns regarding biological agents in rheumatology. Int J Rheum Dis 2018; 21:1219-1226. [PMID: 29879318 DOI: 10.1111/1756-185x.13319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The potential side effects of biological agents may increase the anxiety levels of patients and influence not only their desire to use these therapies but also their concordance to treatment. This study aimed to determine the level and prevalence of drug-related concern in patients treated with biological agents and to acquire additional information regarding the related causes. MATERIALS AND METHODS A total of 1134 patients who were using biological agents for at least 3 months with a diagnosis of rheumatic diseases were enrolled. General anxiety levels were evaluated using the State-Trait Anxiety Inventory (STAI). RESULTS The most common cause for drug-related concerns was the potential side effects of the drugs (59.5%). Among the potential side effects, cancer risk was the most common cause for concern (40.1%), followed by the risk of tuberculosis activation (30.7%). Anxiety levels were higher in patients who experienced side effects than in other patients, and this difference was statistically significant (P < 0.05). STAI trait and state scores were moderately correlated with anxiety levels related to the drug (P < 0.001). CONCLUSION Anxiety related to biological agents may significantly affect the patients' anxiety levels. Awareness regarding the patients' concerns and expectations related to the drug is important to ensure drug adherence and concordance to treatment.
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Affiliation(s)
- Yavuz Pehlivan
- Department of Rheumatology, School of Medicine, Uludag University, Bursa, Turkey
| | - Nurdan Orucoglu
- Department of Rheumatology, School of Medicine, Uludag University, Bursa, Turkey
| | - Seda Pehlivan
- Department of Nursing, Health Science Faculty, Uludag University, Bursa, Turkey
| | - Gezmis Kimyon
- Department of Rheumatology, School of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Orhan Zengin
- Department of Rheumatology, School of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Adem Kucuk
- Department of Rheumatology, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Ali Sahin
- Department of Rheumatology, School of Medicine, Cumhuriyet University, Sivas, Turkey
| | - Nazmiye Tomas
- Department of Rheumatology, School of Medicine, İzmir Katip Celebi University, İzmir, Turkey
| | - Mustafa Ferhat Oksuz
- Department of Rheumatology, School of Medicine, Uludag University, Bursa, Turkey
| | - Bunyamin Kisacik
- Department of Rheumatology, School of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Servet Akar
- Department of Rheumatology, School of Medicine, İzmir Katip Celebi University, İzmir, Turkey
| | - Ahmet Mesut Onat
- Department of Rheumatology, School of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Ediz Dalkilic
- Department of Rheumatology, School of Medicine, Uludag University, Bursa, Turkey
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Mehasseb DF, Korayem HK, Tayel MY, Afifi AH, El-Tawab SS, Ibrahim AM. Pattern of forefoot bursae in patients with rheumatoid arthritis and its effect on foot functions. EGYPTIAN RHEUMATOLOGY AND REHABILITATION 2018. [DOI: 10.4103/err.err_24_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Sanders L, Donovan-Hall M, Borthwick A, Bowen CJ. Experiences of mobility for people living with rheumatoid arthritis who are receiving biologic drug therapy: implications for podiatry services. J Foot Ankle Res 2017; 10:14. [PMID: 28331550 PMCID: PMC5356260 DOI: 10.1186/s13047-017-0195-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 03/06/2017] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Despite significant advancements in new treatment modalities for rheumatoid arthritis with biological therapies, foot complications remain a disabling and common feature of the disease. In this study the aim was to explore and describe the personal experiences of people with rheumatoid arthritis in receipt of biologic treatments in a bid to understand the impact of this form of medication on their mobility. METHODS An interpretative phenomenological analysis (IPA) was undertaken to explore in depth the individual experience of rheumatoid disease through personal accounts of the patient journey spanning both 'before' and 'after' the instigation of biologic therapy. A purposive sampling strategy was adopted and in-depth semi structured interviews used to facilitate rich, detailed interview data exploring the lived experiences of individuals undertaking biological therapy and the changes to mobility experienced as a result. Thematic analysis was employed with an IPA framework to identify key meanings, and report patterns within the data. RESULTS Five people with rheumatoid arthritis participated in the study. The mean disease duration was 20.2 years (range: 6 -32) and all were being treated with biologic therapies. Four key themes emerged from the data: 1) Life before biologic treatment, depicted in accounts as a negative experience characterised by painful and disabling symptoms and feelings of hopelessness. 2) Life with biologic treatment, often experienced as a life changing transition, restoring function and mobility and offering renewed hope. 3) Sense of self, in which the impact of rheumatoid disease and the subsequent changes arising from biologic therapy reveal a profound impact on feelings of personal identity both pre and post biologic therapy; an effect of footwear on self-image emerges as a dominant sub theme; 4) Unmet footcare needs were evident in the patient narrative, where the unrelenting if diminished impact of foot pain on mobility was viewed in the context of problematic access to foot health services. CONCLUSION Whilst the findings from this study mirror those within the existing literature, which report improvements in physical function related to biological therapy, foot problems clearly remained an unremitting feature of life for patients with rheumatoid disease, even when in receipt of biologics.
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Affiliation(s)
- Lucy Sanders
- Faculty of Health Sciences, University of Southampton, Highfield Campus Building 45, University Road, Southampton, Hampshire SO17 1BJ UK
| | - Margaret Donovan-Hall
- Faculty of Health Sciences, University of Southampton, Highfield Campus Building 45, University Road, Southampton, Hampshire SO17 1BJ UK
| | - Alan Borthwick
- Faculty of Health Sciences, University of Southampton, Highfield Campus Building 45, University Road, Southampton, Hampshire SO17 1BJ UK
| | - Catherine J Bowen
- Faculty of Health Sciences, University of Southampton, Highfield Campus Building 45, University Road, Southampton, Hampshire SO17 1BJ UK.,NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK
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van der Zwaard BC, Terwee CB, Roddy E, Terluin B, van der Horst HE, Elders PJM. Evaluation of the measurement properties of the Manchester foot pain and disability index. BMC Musculoskelet Disord 2014; 15:276. [PMID: 25115354 PMCID: PMC4244846 DOI: 10.1186/1471-2474-15-276] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2013] [Accepted: 07/17/2014] [Indexed: 11/28/2022] Open
Abstract
Background The Manchester Foot Pain and Disability Index (MFPDI, 19 items) was developed to measure functional limitations, pain and appearance for patients with foot pain and is frequently used in both observational studies and randomised controlled trials. A Dutch version of the MFPDI was developed. The aims of this study were to evaluate all the measurement properties for the Dutch version of the MFPDI and to evaluate comparability to the original version. Method The MFPDI was translated into Dutch using a forward/backward translation process. The dimensionality was evaluated using exploratory and confirmatory factor analysis. Measurement properties were evaluated per subscale according to the COSMIN taxonomy consisting of: reliability (internal consistency, test-retest reliability and measurement error), validity (structural validity, content validity and cross-cultural validity comparing the Dutch version to the English version) responsiveness and interpretation. Results The questionnaire consists of three scales, measuring foot function, foot pain and perception. The reliability of the foot function scale is acceptable (Cronbach’s α > 0.7, ICC = 0.7, SEM = 2.2 on 0-18 scale). The construct validity of the function and pain scale was confirmed and only the pain scale contains one item with differential item functioning (DIF). The responsiveness of the function and pain scale is moderate when compared to anchor questions. Conclusion Results using the Dutch MFPDI version can be compared to results using the original version. The foot function sub-scale (items 1-9) is a reliable and valid sub-scale. This study indicates that the use of the MFPDI as a longitudinal instrument might be problematic for measuring change in musculoskeletal foot pain due to moderate responsiveness.
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Affiliation(s)
- Babette C van der Zwaard
- EMGO + Institute for health and care research, Department of general practice and elderly care medicine, VU University Medical Centre, Amsterdam, The Netherlands.
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Hooper L, Bowen CJ, Gates L, Culliford D, Arden NK, Edwards CJ. Comparative Distribution of Ultrasound-Detectable Forefoot Bursae in Patients With Osteoarthritis and Rheumatoid Arthritis. Arthritis Care Res (Hoboken) 2014. [DOI: 10.1002/acr.22217] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Lindsey Hooper
- University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, and University of Oxford, NIHR Musculoskeletal Biomedical Research Unit; Oxford UK
| | - Catherine J. Bowen
- University Hospital Southampton NHS Foundation Trust, Southampton, and University of Oxford, NIHR Musculoskeletal Biomedical Research Unit; Oxford UK
| | - Lucy Gates
- University Hospital Southampton NHS Foundation Trust and University of Southampton; Southampton UK
| | - David Culliford
- University of Southampton, Southampton, and University of Oxford, NIHR Musculoskeletal Biomedical Research Unit; Oxford UK
| | - Nigel K. Arden
- University of Southampton, Southampton, and University of Oxford, NIHR Musculoskeletal Biomedical Research Unit; Oxford UK
| | - Christopher J. Edwards
- University Hospital Southampton NHS Foundation Trust and University of Southampton; Southampton UK
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Gijon-Nogueron G, Ndosi M, Luque-Suarez A, Alcacer-Pitarch B, Munuera PV, Garrow A, Redmond AC. Cross-cultural adaptation and validation of the Manchester Foot Pain and Disability Index into Spanish. Qual Life Res 2013; 23:571-9. [PMID: 23975380 DOI: 10.1007/s11136-013-0507-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE The Manchester Foot Pain and Disability Index (MFPDI) is a self-assessment 19-item questionnaire developed in the UK to measure foot pain and disability. This study aimed at conducting cross-cultural adaptation and validation of the MFPDI for use in Spain. METHODS Principles of good practice for the translation and cultural adaptation process for patient-reported outcomes measures were followed in the MFPDI adaptation into Spanish. The cross-cultural validation involved Rasch analysis of pooled data sets from Spain and the UK. RESULTS Spanish data set comprised 338 patients, five used in the adaptation phase and 333 in the cross-cultural validation phase, mean age (SD) = 55.2 (16.7) and 248 (74.5 %) were female. A UK data set (n = 682) added in the cross-cultural validation phase; mean age (SD) = 51.6 (15.2 %) and 416 (61.0 %) were female. A preliminary analysis of the 17-item MFPDI revealed significant local dependency of items causing significant deviation from the Rasch model. Grouping all items into testlets and re-analysing the MFPDI as a 3-testlet scale resulted in an adequate fit to the Rasch model, χ (2) (df) = 15.945 (12), p = 0.194, excellent reliability and unidimensionality. Lack of cross-cultural invariance was evident on the functional and personal appearance testlets. Splitting the affected testlets discounted the cross-cultural bias and satisfied requirements of the Rasch model. Subsequently, the MFPDI was calibrated into interval-level scales, fully adjusted to allow parametric analyses and cross-cultural data comparisons when required. CONCLUSIONS Rasch analysis has confirmed that the MFPDI is a robust 3-subscale measure of foot pain, function and appearance in both its English and Spanish versions.
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Naidoo S, Bowen C, Arden N, Redmond A. Training the next generation of clinical researchers: evaluation of a graduate podiatrist research internship in rheumatology. J Foot Ankle Res 2013; 6:15. [PMID: 23590884 PMCID: PMC3637456 DOI: 10.1186/1757-1146-6-15] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Accepted: 04/10/2013] [Indexed: 11/30/2022] Open
Abstract
Background The aim of this study was to evaluate the effectiveness of the Arthritis Research UK funded graduate internship scheme for podiatrists and to explore the experiences of interns and mentors. Methods Nine new graduates completed the internship programme (July 2006–June 2010); six interns and two mentors participated in this study. The study was conducted in three phases. Phase 1: quantitative survey of career and research outcomes for interns. Phase 2 and 3: qualitative asynchronous interviews through email to explore the experiences of interns and mentors. Interpretive phenomenological analysis (IPA) of coded transcripts identified recurring themes. Results Research outputs included ten peer reviewed publications with authorial contributions from interns, 23 conference abstract presentations and one subsequent ‘Jewel in the Crown’ award at the British Society for Rheumatology Conference. Career progression includes two National Institute for Health research (NIHR) PhD fellowships, two Arthritis Research UK PhD fellowships, one NIHR Master of Research fellowship and one specialist rheumatology clinical post. Two interns are members of NIHR and professional body committees. Seven important themes arose from the qualitative phases: perceptions of the internship pre-application; internship values; maximising personal and professional development; psychosocial components of the internship; the role of mentoring and networking; access to research career pathways; perceptions of future developments for the internship programme. The role of mentorship and the peer support network have had benefits that have persisted beyond the formal period of the scheme. Conclusions The internship model appears to have been perceived to have been valuable to the interns’ careers and may have contributed significantly to the broader building of capacity in clinical research in foot and ankle rheumatology. We believe the model has potential to be transferable across health disciplines and on national and international scales.
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Affiliation(s)
- Serena Naidoo
- Advanced Clinical and Expert Practice, Centre for Innovation and Leadership in Health Sciences, Faculty of Health Sciences, University of Southampton, Southampton SO17 1BJ, UK.
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Shi M, Wang A, Prescott D, Waterhouse CCM, Zhang S, McDougall JJ, Sharkey KA, McKay DM. Infection with an intestinal helminth parasite reduces Freund's complete adjuvant-induced monoarthritis in mice. ACTA ACUST UNITED AC 2011; 63:434-44. [PMID: 20967852 DOI: 10.1002/art.30098] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Assessment of infection with helminth parasites in murine models of disease could identify antiinflammatory mechanisms that translate into treatments for arthritic disease. The aim of this study was to test the ability of infection with the tapeworm Hymenolepis diminuta to ameliorate Freund's complete adjuvant (CFA)-induced monoarthritis in mice. METHODS Mice received CFA with or without H diminuta, and knee swelling, pain, and measures of inflammation were assessed. RESULTS Injection of CFA resulted in rapid (within 24 hours) and sustained (lasting 20 days) knee swelling, a decreased pain threshold, increased blood flow to the knee, and increased production of tumor necrosis factor α and interleukin-12p40 (IL-12p40). In mice that were infected with H diminuta 8 days prior to receiving CFA, the severity of arthritis was reduced as assessed by these indices of inflammation and infection 2 days after CFA injection and resulted in more rapid resolution of knee swelling. This antiarthritic effect required a viable infection and was dependent on adaptive immunity, because infection with H diminuta did not protect mice lacking T cells and B cells or the IL-4 receptor α chain from CFA-induced inflammation. Interleukin-10 was of prime importance in the antiarthritic effect, because IL-10-knockout mice were not protected by infection, the antiarthritic effect was ablated by use of neutralizing IL-10 antibodies, and transfer of CD4+ cells from infected wild-type mice but not IL-10-knockout mice significantly reduced CFA-induced knee swelling. CONCLUSION In mice, the adaptive immune response to infection with H diminuta involves mobilization of IL-10, which has the concomitant advantage of dampening the innate immune responses that drive CFA-induced joint inflammation.
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