Reduction in long-term functional disability in rheumatoid arthritis from 1977 to 1998:a longitudinal study of 3035 patients

Abstract Background In well-controlled rheumatoid arthritis (RA) without significant joint damage, a substantial proportion of patients complain of persistent pain. Previous studies have identified different pain phenotypes in RA, in which non-nociceptive pain phenotypes are associated with higher concurrent disease activity scores. In this longitudinal study, we explored associations between pain phenotypes and long-term disease activity outcome in RA patients. Secondly, we explored whether pain phenotype is associated with comorbid conditions. Methods One hundred eighty established RA patients were classified with a nociceptive (61%) or a non-nociceptive (39%) pain phenotype, based on their responses to the painDETECT-questionnaire. Two years of clinical follow-up data on disease activity outcomes were collected. Information on comorbid diseases was derived from electronic patient files. Results Patients with a non-nociceptive pain phenotype showed higher mean disease activity scores (DAS28, 2.57; 95% CI, 2.37–2.77 vs. 2.11; 95% CI, 1.94–2.27; p < 0.001) and a twofold lower chance of achieving sustained DAS28 remission (OR = 0.49; 95% CI, 0.26–0.92; p = 0.020). Only the tender joint count and patient global health significantly differed between the pain phenotype groups. Patients with a non-nociceptive pain phenotype had more often been diagnosed with concurrent fibromyalgia (9.9% vs. 0.9%; p = 0.007) and other pain-associated comorbid diseases (52.1% vs. 35.8%; p = 0.030) compared with patients with a nociceptive pain phenotype. Conclusion This longitudinal study showed consistently worse long-term disease activity outcomes in RA patients with a non-nociceptive pain phenotype which appeared to be mainly due to differences in the subjective components of the disease activity score. Trial registration The DREAM cohort study is registered in the Netherlands Trial Register: NTR578.

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Juvenile rheumatoid arthritis associated with uveitis in a 4-year-old girl

Paediatrica Indonesiana ◽

10.14238/pi46.2.2006.87-92 ◽

2016 ◽

Vol 46 (2) ◽

pp. 87

Author(s):

Made Sukmawati ◽

Hendra Santoso ◽

Niti Susila

Keyword(s):

Rheumatoid Arthritis ◽

Rheumatic Disease ◽

Juvenile Rheumatoid Arthritis ◽

Functional Disability ◽

Benign Disease ◽

Disease Remission

The variability of the disease may explain mis-conceptions that JRA is usually a benign disease. Acohort study in which 506 subjects during the periodof 1970-1999 found that approximately one-third ofJRA patients achieve disease remission. The visualcomplications are also important in determining theoutcome. Functional disability is common and can belong-lasting. Recognizing JRA symptoms earlier areimportant to prevent mortality, disability, and long-term complications. Although JRA is the most com-mon rheumatic disease in children, many doctors arenot familiar with this disease. The purpose of thispaper is to report a case of juvenile rheumatoid ar-thritis associated with uveitis in a 4-year, 8-month-old girl.

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Erosive rheumatoid arthritis in a young patient with mirror hand

BMJ Case Reports ◽

10.1136/bcr-2018-227739 ◽

2019 ◽

Vol 12 (2) ◽

pp. bcr-2018-227739

Author(s):

Ali Sibtain Farooq Sheikh ◽

Ernest Wong

Keyword(s):

Rheumatoid Arthritis ◽

Congenital Anomaly ◽

Early Diagnosis ◽

Young Patient ◽

Young Woman ◽

Functional Disability ◽

Significant Degree ◽

Muscles Of The Hand ◽

Intrinsic Muscles

Mirror hand is a congenital anomaly characterised by duplication of the ulnar ray, resulting in polydactyly and functional disability of the hand. It can cause arthralgias and weakness in intrinsic muscles of the hand. We present a young woman who had a surgically corrected mirror hand and subsequently developed aggressive rheumatoid arthritis, which increased her limitations to a significant degree. Early diagnosis and treatment in such cases is very important to prevent long-term disability.

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