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Background: Some guidelines recommend splinting for base-of-thumb osteoarthritis, despite lack of evidence of efficacy. Objective: To assess the efficacy and acceptability of a splint for base-of-thumb osteoarthritis. Design: Multicenter, randomized trial. Randomization was computer-generated, and allocation was concealed by faxing centralized treatment assignment to investigators at the time of enrollment. Patients and investigators were not blinded to assignment, and patients self-reported outcomes. Setting: 2 tertiary care hospitals in France. Patients: 112 patients (101 women) with base-of-thumb osteoarthritis. Intervention: Custom-made neoprene splint (n = 57) or usual care (n = 55). Measurements: Primary outcome was change in pain level assessed on a visual analogue scale (VAS) (range, 0 to 100 mm) from baseline to 1 month. Secondary outcomes were change in measures of hand disability at 1 month and change in pain level and measures of disability at 12 months. Tolerance and adherence with the splint were recorded. Results: At 1 month, no difference in change occurred in pain level from baseline in the intervention and control groups (adjusted mean change, -10.1 vs. -10.7; between-group difference, 0.6 [95% CI, -7.9 to 9.1]; P = 0.89). Disability was assessed by the Cochin Hand Function Scale score (range, 0 to 90) or patient-perceived disability (VAS, 0 to 100 mm). At 12 months, change in pain from baseline was greater in the intervention group than in the control group (adjusted mean change, -22.2 vs. -7.9; between-group difference, -14.3 [CI, -23.4 to -5.2]; P = 0.002). The Cochin Hand Function Scale score was -1.9 versus 4.3 (between-group difference, -6.3 [CI, -10.9 to -1.7]; P = 0.008) and patient-perceived disability was -11.6 versus 1.5 (between-group difference, -13.1 [CI, -21.8 to -4.4]; P = 0.003). At 12 months, 86% of the intervention group had worn the splint for more than 5 nights a week, and no adverse effects were observed. Limitation: Patients, health care providers, and outcome assessors were not blinded. Conclusion: For patients with base-of-thumb osteoarthritis, wearing a splint had no effect on pain at 1 month but improved pain and disability at 12 months. Primary Funding Source: Programme Hospitalier de Recherche Clinique National.

WHEN ADDRESSING arthritis in cats, we presume similarities to arthritis in dogs, interpreting radiographs and clinical signs with canine differential diagnoses in mind. And we develop therapies based on how [...]

The first of two articles describes the main characteristics and risk factors of osteoarthritis, the most common cause of disability in the UK Helen Boreham Heberden's nodes - firm knobbly [...]

Osteoarthritis (OA) is a progressive condition that causes significant disability and impairment. In 2005, arthritis affected nearly 60% of Americans aged 65 years and older. The American College of Rheumatology, the American Geriatrics Society, and the American Pain Society have published guidelines on management of mild to moderate OA. These organizations advocate use of a comprehensive management program, which includes nonpharmacologic modalities (eg, education, use of assistive devices) as the cornerstone of therapy and pharmacologic intervention, such as over-the-counter or prescription analgesia, in patients needing pain relief. The purpose of this article is to outline a comprehensive management program for patients with an established diagnosis of mild to moderate OA of the hip or knee, which can be initiated by primary care providers and then collaboratively maintained by the patient and healthcare practitioners. Strategies to improve patient compliance with the program are described so that maximum benefit can be derived from the comprehensive approach. Keywords: Osteoarthritis, pain management, analgesia, Table of Contents Abstract Introduction Role Of Activity In Osteoarthritis Management And Prevention Influence Of Nutrition On Osteoarthritis Drug Therapy For Relief Of Osteoarthritis Pain Benefits Of A Comprehensive Approach [...]

Dislocation or subluxation of scaphotrapezial joint is occasionally seen in patients with degenerative osteoarthritis or the other forms of arthritis. However, traumatic dislocation or subluxation of this joint is extremely rare because of strong ligamenteous complex. Complete dislocation of greater multangular (trapezoid bone) is especially observed via a harsh trauma. Here, a complete dislocation of multangular occurred with self-mutilating trauma is presented as well. Keywords: Complete, dislocation, dorsoradial, trapezium, Table of Contents Abstract Introduction Case Report Discussion References The study was performed at the 1st Orthopaedics and Traumatology Clinics of Ankara Training and Education Hospital. Introduction Hand injuries are [...]

Table of Contents Abstract Introduction Observation 1 Observation 2 Discussion References Abstract Introduction: The shoulder is an exceptional location for osteoarticular tuberculosis particularly in children. We are reporting two observations [...]

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/S0002-9343(97)89541-1 Byline: Chester V. Oddis Abstract: Osteoarthritis (OA) is the most common rheumatologic disease, afflicting tens of millions of U.S. citizens. It is not an inevitable consequence of aging; rather, it is a degenerative process acquired because of metabolic, mechanical, genetic, and other influences. It is characterized by progressive loss of cartilage and bony overgrowth. Because cartilage is not innervated, the pain of OA arises from secondary effects, such as joint capsule distention, stretching of periosteal nerve endings, and, possibly, synovial inflammation. Psychologic factors, including stress and depression, may influence the perception of pain by OA patients. The risk of OA apparently is not increased by normal joint use, but persons who participate in competitive sports or who play with abnormal or injured joints are at increased risk. Obesity increases OA risk, and weight loss has been found to decrease it. Some forms of premature OA appear to be inherited. The objective diagnosis of OA is made on the basis of radiography. However, many individuals with radiographic evidence of OA are asymptomatic in the affected joint. It is essential to ensure that pain in the affected joint is attributable to OA and not another cause. The management of OA should include physical medicine measures such as heat or cold therapy and oftenneglected environmental measures, such as reducing chair height and using shoe orthotics. Therapeutic exercise is beneficial for many patients and includes an initial warmup with range of motion, muscle strengthening, and aerobic activity (such as swimming). A major question in the pharmacologic management of OA is whether nonsteroidal antiinflammatory drugs (NSAIDs) are superior to analgesics in terms of symptomatic relief; studies indicate that they are not. The question is relevant because of the adverse effects of NSAID use, particularly in the elderly population. Author Affiliation: From the Division of Rheumatology and Clinical Immunology, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA

I have nothing to live for." Helen spoke softly. A bright and articulate woman at 86, this was the first time in 20 years that I had heard these words [...]

The Case Dolores was 66, a plain-spoken and direct woman who loved to raise rhododendrons and drive her Miata sports convertible. She had chosen homeopathy for treatment, because she reacted [...]

PARIS -- Tanezumab, a novel inhibitor of nerve growth factor, significantly eased knee pain in patients with moderately severe osteoarthritis, according to the findings of a large, phase II, double-blind [...]

SAN FRANCISCO -- Magnetic resonance imaging is often ordered before patients are referred for total knee arthroplasty, yet MRI confers minimal or no benefit, compared with taking weight-bearing and skyline [...]

PRAGUE -- Intra-articular injections of autologous conditioned serum reduced the symptoms of knee osteoarthritis significantly more than did either saline or hyaluronan injections in the first controlled clinical trial of [...]

CHICAGO -- Intraarticular hyaluronan injections immediately after shoulder arthroscopy reduce postoperative pain and analgesia use, Lennard Funk, M.D., reported in a poster presentation at the 2004 World Congress on Osteoarthritis. [...]

CHICAGO -- The association between knee pain and the presence of pathologic features varies by the different compartments of the knee, Kathryn Wildy, M.D., reported at the 2004 World Congress [...]

BERLIN -- a portrait is emerging of the osteoarthritis patient at risk for rapid disease progression, Tim D. Spector, M.D., said at the annual European Congress of Rheumatology. Getting a [...]