P86: Dynamic joint stiffness of the ankle in rheumatoid arthritis postmenopausal women fallers and non-fallers

Objective.To investigate the effect of rheumatoid arthritis (RA) on volumetric bone mineral density (vBMD) and bone geometry in postmenopausal women treated with bisphosphonates.Methods.Fifty-three postmenopausal women with RA and 87 control subjects, comparable in terms of age, body mass index, and years since menopause, underwent peripheral quantitative computed tomography (pQCT) of the nondominant tibia.Results.At 4% (trabecular site), trabecular bone mineral content (BMC) and vBMD (p < 0.001) were lower in the RA group, while trabecular area was comparable. At 38% (cortical site), cortical BMC (p < 0.01), area (p < 0.05), and thickness (p < 0.001) were lower in the RA group, whereas vBMD was comparable. Endosteal circumference was higher (p < 0.05), whereas periosteal circumference was comparable, indicating cancellization of cortical bone. In the RA group, muscle area was lower (p < 0.001), while at 14% polar stress strength index was significantly lower (p < 0.01) in patients with RA, indicating impairment of bone mechanical properties.Conclusion.RA is associated with negative effects on both cortical and cancellous bone in postmenopausal women treated with bisphosphonates. Cortical geometric properties are also adversely affected mainly by increased endosteal circumference, whereas trabecular geometric properties are generally preserved.

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High incidence of vertebral and non-vertebral fractures in the OSTRA cohort study: a 5-year follow-up study in postmenopausal women with rheumatoid arthritis

Osteoporosis International ◽

10.1007/s00198-010-1517-6 ◽

2011 ◽

Vol 22 (9) ◽

pp. 2413-2419 ◽

Cited By ~ 42

Author(s):

M. Vis ◽

E. A. Haavardsholm ◽

P. Bøyesen ◽

G. Haugeberg ◽

T. Uhlig ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Cohort Study ◽

Postmenopausal Women ◽

Vertebral Fractures ◽

Follow Up Study ◽

High Incidence

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Physical Therapy in Rheumatoid Arthritis

Acta Balneologica ◽

10.36740/abal202102101 ◽

2021 ◽

Vol 63 (2) ◽

pp. 81-87

Author(s):

Włodzisław Kuliński ◽

Jakub Skuza

Keyword(s):

Quality Of Life ◽

Rheumatoid Arthritis ◽

Physical Therapy ◽

Joint Stiffness ◽

Light Therapy ◽

Well Being ◽

Magnetic Field Therapy ◽

Field Therapy ◽

Global Population

Introduction: Rheumatoid arthritis (RA) is a chronic and progressive inflammatory process resulting in the destruction of articular and periarticular tissues and leading to the development of functional impairment, permanent deformities and disability. RA affects approximately 1% of the global population and is more common in women than men. Aim: To assess the effects of physical therapy in RA patients. Material and Methods: The study assessed 21 patients with stage III/IV RA. They were managed with physical therapy, including thermotherapy, electrotherapy, laser therapy, magnetic field therapy and light therapy. The data collected in the study were statistically analysed. Results: After treatment, all study patients showed pain reduction, improved well-being, reduced duration of morning joint stiffness, improved ranges of motion in the joints and a better quality of life. Conclusions: 1. Rheumatoid arthritis is a difficult clinical and social problem. 2. The physical therapy used in the study reduced the pain experienced by the patients and the duration of morning joint stiffness and improved the ranges of motion and quality of life. 3. Physical therapy and rehabilitation constitute the main method of treatment of this disorder.

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Disease activity assessment in rheumatoid arthritis

Oxford Textbook of Rheumatoid Arthritis ◽

10.1093/med/9780198831433.003.0015 ◽

2020 ◽

pp. 161-168

Author(s):

Josef Smolen

Keyword(s):

Rheumatoid Arthritis ◽

Disease Activity ◽

Joint Pain ◽

Joint Stiffness ◽

Treat To Target ◽

Therapeutic Decision ◽

Activity Assessment ◽

Disease Modifying ◽

Therapeutic Decision Making ◽

Disease Activity Assessment

The major clinical hallmarks of rheumatoid arthritis (RA) are articular swelling, joint pain, and morning joint stiffness. Disease activity assessment is pivotal when following patients with RA throughout the course of their disease, and especially when assessing improvement or deterioration upon institution of the necessary therapies. To prevent an adverse outcome, it is essential to diagnose the disease early and to start treatment with disease-modifying antirheumatic drugs (DMARDs) immediately after diagnosis. Adhering to the treat-to-target approach, which is a central strategy irrespective of the type of treatment available and the therapy applied, requires consistency in using validated composite measures of disease activity. Rather than a mere matter of using specific therapies, it is also a matter of using tools for disease activity assessment to guide therapeutic decision-making. This enables offering and achieving the best possible outcomes for RA patients.

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Aromatase inhibitor-induced joint symptom in patients with breast cancer

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.11070 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 11070-11070 ◽

Cited By ~ 1

Author(s):

Y. Yamamoto ◽

T. Kawasoe ◽

M. Ibusuki ◽

K. Kai ◽

S. Tomita ◽

...

Keyword(s):

Breast Cancer ◽

Aromatase Inhibitor ◽

Postmenopausal Women ◽

Joint Stiffness ◽

Onset Time ◽

Initial Symptom ◽

Joint Symptom ◽

Joint Symptoms ◽

Er Positive ◽

Positive Breast Cancer

11070 Background: Aromatase inhibitor (AI) are superior to tamoxifen (TAM) for postmenopausal women with estrogen receptor (ER)-positive breast cancer. Toxic profiles are different between AI and TAM. The frequency of bone fracture and joint symptom are high in AI compared with TAM. However, there is little report concerning a detailed joint symptom. Methods: From January 2002 to March 2006, 120 postmenopausal women with ER-positive breast cancer were treated with anastrozole 1mg or exemestane 25mg daily at our hospital. We studied retrospectively the incidence, onset, type, sites, grade, and change of joint symptom. We also investigated the incidence of discontinuation due to joint symptoms and correlation between patient’s characteristics and joint symptoms. Results: Median follow-up time is 590 days and median age is 63 years old. Forty-seven (39.1%) of 120 patients complained of joint symptom. Median onset time of the symptom was 90 days of starting AI. All cases with the symptom complained of joint stiffness and 33 (70.2%) of 47 patients with the symptom have joint pain. In decreasing order, the most commonly affected sites were hand, knee, wrist, ankle, shoulder and elbow. The joint symptom was mostly grade 1/2, and most symptom ware resolved with exercise. Most common feature is morning digital stiffness like initial symptom of rheumatoid arthritis. Some patients experienced severe joint symptom. Subsequently, 15 (12.5%) patients had to discontinue AI because of the severe symptom. Discontinuation of AI led to improvement of symptoms, and patients received TAM in stead of AI also led to resolution of symptoms. AI-induced joint symptom was significantly correlated with young age, prior chemotherapy and switching from TAM to AI. Conclusions: Most AI-induced joint symptom is modest, and this symptom can lead to resolution with exercise. However, some patients lead to discontinue AI because of AI-induced severe joint symptom. We should inform patients treated with AI about AI- induced joint symptom and observe patient’s symptom in detail because severe joint symptom can prevent maintenance of quality of life and compliance. No significant financial relationships to disclose.

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