Degenerative joint disease among populations in Wensleydale, England and Jamaica

Influence of meteorological elements on balance control and pain in patients with symptomatic knee osteoarthritis

This study aimed to determine if pain and balance control are related to meteorological modifications in patients with knee osteoarthritis (OA). One hundred and thirteen patients with knee OA (mean age = 65 ± 9 years old, 78 women) participated in this study. Static posturography was performed, sway area covered and sway path traveled by the center of foot pressure being recorded under six standing postural conditions that combine three visual situations (eyes open, eyes closed, vision altered) with two platform situations (firm and foam supports). Knee pain score was assessed using a visual analog scale. Balance control and pain measurements recorded in the morning were correlated with the meteorological data. Morning and daily values for temperature, precipitation, sunshine, height of rain in 1 h, wind speed, humidity, and atmospheric pressure were obtained from the nearest data collecting weather station. The relationship between postural control, pain, and weather variations were assessed for each patient on a given day with multiple linear regressions. A decrease of postural stability was observed when atmospheric pressure and maximum humidity decreased in the morning (p < 0.05) and when atmospheric pressure decreased within a day (p < 0.05). Patient's knee pain was more enhanced when it is warmer in the morning (p < 0.05) and when it is wetter and warmer within a day (p < 0.05). The relationship between weather, pain, and postural control can help patients and health professionals to better manage daily activities.

A systematic search and narrative review of radiographic definitions of hand osteoarthritis in population-based studies

OBJECTIVE

Currently there is no agreed "gold standard" definition of radiographic hand osteoarthritis (RHOA) for use in epidemiological studies. We therefore undertook a systematic search and narrative review of community-based epidemiological studies of hand osteoarthritis (OA) to identify (1) grading systems used, (2) definitions of radiographic OA for individual joints and (3) definitions of overall RHOA.

METHODS

The following electronic databases were searched: Medline, Embase, Science Citation Index and Ageline (inception to Dec 2006). The search strategy combined terms for "hand" and specific joint sites, OA and radiography. Inclusion and exclusion criteria were applied. Data were extracted from each paper covering: hand joints studied, grading system used, definitions applied for OA at individual joints and overall RHOA.

RESULTS

Titles and abstracts of 829 publications were reviewed and the full texts of 399 papers were obtained. One hundred fifty-two met the inclusion criteria and 24 additional papers identified from screening references. Kellgren and Lawrence (K&L) was the most frequently applied grading system used in 80% (n=141) of studies. In 71 studies defining OA at the individual joint level 69 (97%) used a definition of K&L grade > or = 2. Only 53 publications defined overall RHOA, using 21 different definitions based on five grading systems.

CONCLUSION

The K&L scheme remains the most frequently used grading system. There is a consistency in defining OA in a single hand joint as K&L grade > or = 2. However, there are substantial variations in the definitions of overall RHOA in epidemiological studies.

Osteoarthritis of the peripheral joints

Osteoarthritis (OA) is a complex process affecting many different joint areas in the body. From a pathophysiological point of view some features are crucial for the diagnosis, such as cartilage fibrillation and thinning, subchondral sclerosis and the presence of osteophytes. From a clinical perspective, OA is the most prevalent rheumatic joint disorder, causing pain and stiffness of the joints and, for the individual, impaired function and health status. The aim of this chapter is to present current knowledge of definitions of OA, its presence in different populations and in different joint areas (the back excluded). Furthermore, methods of diagnosing and delineating clinically relevant forms of OA, now and in the future, are presented as well as current knowledge of the risk factors for developing and the factors for preventing OA.

Influence of weather on osteoarthritics

This exploratory study examined the effects of selected weather variables on pain and pain-related stress in osteoarthritic subjects. Urban and rural dwelling arthritics who perceived that weather made their symptoms worse and those who did not were surveyed. Some persons with osteoarthritis in urban Chicago were more weather sensitive than their rural counterparts in Grand Forks, North Dakota. Multiple regression analysis showed that precipitation affected degree of pain for urban subjects who identified weather as a pain-generating factor; barometric pressure, relative humidity and sunshine were significant factors influencing pain-related stress. Wind speed correlated with pain and pain-related stress; relative humidity and precipitation correlated with pain-related stress for urban subjects who did not perceive weather as a problem. Specific weather variables were not identified as affecting rural subjects' pain. However, temperature and barometric pressure affected degree of pain-related stress in rural subjects who perceived weather as a problem. Subtle differences between Chicago urban and Grand Forks rural climates are reflected in arthritic subjects' degree of pain and their perception of pain-related stress.

Osteoarthrosis in a rural South African Negro population

The prevalence and distribution of osteoarthrosis has been studied in a South African Negro population. One or more joints were affected in 60% of the males and 48% of the females, compared with a prevalence of 55% in males and 63% in females in a comparable English population. Multiple osteoarthrosis was significantly less common in the African than in the English population, the difference here being greatest in females. Clinical Heberden's nodes were also very infrequent in the African population. However, the Tswana males had significantly more osteoarthrosis of the metacarpophalangeal and proximal interphalangeal joints than was encountered in English males. This is attributed to the traumatic effect of hard manual work which is carried on into old age among most African populations.