scholarly journals An unusual cause of forefoot pain: diagnosis and discussion

2009 ◽  
Vol 38 (8) ◽  
pp. 831-832
Author(s):  
Alper Deveci ◽  
Onder M. Delialioglu ◽  
Bulent Daglar ◽  
Sahap C. Tunç ◽  
Barıs Birinci ◽  
...  
Keyword(s):  
Forefoot Pain ◽  
Pain Diagnosis

scholarly journals Temporomandibular disorders in patients with early rheumatoid arthritis and at-risk individuals in the Dutch population: a cross-sectional study

RMD Open ◽  
2021 ◽  
Vol 7 (1) ◽  
pp. e001485
Author(s):  
Johanna M Kroese ◽  
Catherine M C Volgenant ◽  
Wim Crielaard ◽  
Bruno Loos ◽  
Dirkjan van Schaardenburg ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
At Risk ◽  
Early Rheumatoid Arthritis ◽  
Temporomandibular Disorders ◽  
Self Report ◽  
Joint Disease ◽  
Control Group ◽  
Healthy Controls ◽  
Cross Sectional ◽  
Pain Diagnosis

ObjectiveTo evaluate the prevalence of temporomandibular disorders (TMD) in patients with early rheumatoid arthritis (ERA) and individuals at-risk of RA.Methods150 participants were recruited in three groups (50 per group): (1) patients with ERA (2010 EULAR criteria) (2) at-risk individuals and (3) healthy controls. All participants were tested for seropositivity of rheumatoid factor and anticitrullinated protein antibodies. A possible TMD diagnosis was determined according to the standardised and validated diagnostic criteria for TMD (DC/TMD) in five categories: myalgia, arthralgia, articular disc displacement, degenerative joint disease and headache attributed to TMD. Results were tested for the prevalence of TMD (all categories combined) and TMD pain (myalgia and/or arthralgia). To investigate a possible role for bruxism, a probable sleep and/or awake bruxism diagnosis was determined based on self-report and several clinical features.ResultsThe prevalence of any TMD diagnosis did not differ between the three groups. However, at-risk individuals more often had a TMD-pain diagnosis than healthy controls (p=0.046). No such difference was found between the ERA group and the control group. However, within the ERA group, seronegative patients had a TMD-pain diagnosis more often than seropositive patients (4/12 (33%) vs 3/38 (8%), p=0.048). Participants with a TMD-pain diagnosis were more often diagnosed with probable sleep bruxism than those without a TMD-pain diagnosis.ConclusionThe prevalence of TMD pain is increased in individuals at-risk of RA and seronegative ERA patients, and is associated with bruxism signs and symptoms. These results suggest that health professionals should be alert to TMD pain in these groups.

Multiple neuromas coexisting with rheumatoid synovitis and a rheumatoid nodule

2000 ◽  
Vol 90 (5) ◽  
pp. 252-255 ◽  
Author(s):  
LA Zielaskowski ◽  
SJ Kruljac ◽  
JJ DiStazio ◽  
S Bastacky
Keyword(s):  
Rare Case ◽  
Relevant Literature ◽  
Rheumatoid Nodule ◽  
Morton’S Neuroma ◽  
Forefoot Pain ◽  
Rheumatoid Nodules ◽  
Morton's Neuroma ◽  
The Many

The authors present a rare case of multiple intermetatarsal neuromas coexisting with rheumatoid synovitis and a rheumatoid nodule. A brief review of rheumatoid nodules as a source of forefoot pain and a review of the relevant literature are provided. A rheumatoid nodule is just one of the many diagnoses that must be considered when one encounters pedal symptoms similar to those associated with Morton's neuroma.

scholarly journals Conservative Treatment for Primary Metatarsalgia

2021 ◽  
Vol 2 (1) ◽  
pp. 22-25
Author(s):  
Kentaro Amaha
Keyword(s):  
Surgical Treatment ◽  
Pressure Reduction ◽  
Front Part ◽  
Forefoot Pain ◽  
Metatarsal Bones ◽  
Plantar Aspect ◽  
Common Causes ◽  
Inflammatory Drugs ◽  
Treatment Pressure ◽  
Shoe Inserts

Metatarsalgia is one of the most common causes of forefoot pain, and it is characterized by pain in the front part of the foot under the head of the metatarsal bones. Primary metatarsalgia is idiopathic, but it has been suggested to be related to forefoot plantar compression. Because of the various causes of metatarsalgia, there is the need to thoroughly consider the etiology of metatarsalgia to find novel, effective, and conservative treatments for metatarsalgia to avoid surgical treatment. Pressure reduction or redistribution can be achieved using toe exercise, flat shoe inserts, metatarsal pads, custom-molded inserts, and rockerbars. There was no need for one treatment. If toe function was poor, toe exercises were recommended. If dorsiflexion of the ankle joint was limited, the Achilles tendon was stretched. If the pain was localized to the plantar aspect of the 2nd MTP, a decompression insole was applied. If the pain was limited to the plantar aspect of the 2nd MTP, a decompression insole was worn. If swelling occurred, anti-inflammatory drugs were indicated to reduce inflammation. The combination of the two was appropriate for this condition. Toe exercises can improve balance and are worth trying. An in-depth understanding of the various etiologies of metatarsal and toe deformities is essential for successful treatment.

scholarly journals Chronic pain diagnoses and opioid dispensings among individuals with serious mental illness

2019 ◽  
Author(s):  
Ashli Owen-Smith ◽  
Christine Stewart ◽  
Musu M. Sesay ◽  
Sheryl M. Strasser ◽  
Bobbi Jo Yarborough ◽  
...  
Keyword(s):  
Mental Health ◽  
Chronic Pain ◽  
Mental Illness ◽  
Healthcare Utilization ◽  
Serious Mental Illness ◽  
Research Network ◽  
Prescription Opioid ◽  
Medical Comorbidities ◽  
Pain Diagnosis ◽  
Opioid Medications

Abstract Background Individuals with major depressive disorder (MDD) and bipolar disorder (BD) have particularly high rates of chronic non-cancer pain (CNCP) and are also more likely to receive prescription opioids for their pain. However, there have been no known studies published to date that have examined opioid treatment patterns among individuals with schizophrenia. Methods Using electronic medical record data across 13 Mental Health Research Network sites, individuals with diagnoses of MDD (N=65,750), BD (N=38,117) or schizophrenia or schizoaffective disorder (N=12,916) were identified and matched on age, sex and Medicare status to controls with no documented mental illness. CNCP diagnoses and prescription opioid medication dispensings were extracted for the matched samples. Multivariate analyses were conducted to evaluate (1) the odds of receiving a pain-related diagnosis and (2) the odds of receiving opioids, by separate mental illness diagnosis category compared with matched controls, controlling for age, sex, Medicare status, race/ethnicity, income, medical comorbidities, healthcare utilization and chronic pain diagnoses. Results Multivariable models indicated that having a MDD (OR=1.90; 95% CI=1.85–1.95) or BD (OR=1.71; 95% CI=1.66–1.77) diagnosis was associated with increased odds of a CNCP diagnosis after controlling for age, sex, race, income, medical comorbidities and healthcare utilization. By contrast, having a schizophrenia diagnosis was associated with decreased odds of receiving a chronic pain diagnosis (OR=0.86; 95% CI=0.82– 0.90). Having a MDD (OR=2.59; 95% CI=2.44–2.75) or BD (OR=2.12; 95% CI=1.97–2.28) diagnosis was associated with increased odds of receiving chronic opioid medications, even after controlling for age, sex, race, income, medical comorbidities, healthcare utilization and chronic pain diagnosis; having a schizophrenia diagnosis was not associated with receiving chronic opioid medications. Conclusions Individuals with serious mental illness, who are most at risk for developing opioid-related problems, continue to be prescribed opioids more often than their peers without mental illness. Healthcare providers need to be especially conservative in prescribing opioids – or avoid opioid therapy altogether – for this population. Mental health clinicians may be particularly well-suited to lead pain assessment and management efforts for these patients.

Suggests More Tests for Chest Pain Diagnosis

PEDIATRICS ◽  
1978 ◽  
Vol 61 (1) ◽  
pp. 143-144
Author(s):  
Michael F. Elmore ◽  
Glen A. Lehman
Keyword(s):  
Chest Pain ◽  
Physical Examination ◽  
Pediatric Patients ◽  
Laboratory Studies ◽  
Psychiatric Interview ◽  
X Ray ◽  
Pain Diagnosis ◽  
Chest X Ray ◽  
Pain Characteristics ◽  
Diagnostic Work

Driscoll et al. (Pediatrics 57:648, May 1976) reported a series of 43 patients with chest pain evaluated by history and physical examination, psychiatric interview, screening laboratory studies, ECG, and chest x-ray film. No organic cause was identified in 45% of patients, and various psychiatric aspects of the pain were discussed. The history obtained from pediatric patients is often suboptimal, and specific pain characteristics and associations cannot be defined. We therefore propose that more vigorous diagnostic work-ups are necessary before chest pain can be classed as "idiopathic."

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