[Cartilage ageing and treatment possibilities]

Osteoarthritis is the disease connected with aging which is characterised by progressive degeneration of all elements building the joint but also influencing the muscles constituting motor unit with the affected joint. The effective and unified therapy has not been yet introduced despite the broad multi-site studies concentrating on metabolic pathways responsible for the development of the disease. The reason of which is probably its multifactorial aetiology. The treatment methods are based on decreasing of cartilage destruction activity, retardation of proinflammatory factors activity and fighting with pain. Physiotherapy, movement rehabilitation, painkillers, anti-inflammatory drugs, glucosamine sulphates and hyaluronic acids are used as therapeutic strategies. The methods recently introduced are platelet rich plasma concentrates and stem cells injected directly into the affected joint. The aim of this review article was the presentation of differential therapeutic options offered to patients in different stages of osteoarthritis.

[Diagnosis of lower limb pain in a diabetic patient]

By presenting this clinical case, we aim at discussing the diagnosis between arteriopathy, neuropathy and osteoarticular pathology in a patient with type 2 diabetes who complains of lower limb pain. We emphasize the role of a global medical approach based upon anamnesis and clinical exam, which should contribute to select the most helpful paraclinical investigations.

[Risk factors analysis for low back pain in patients with multiple sclerosis]

OBJECTIVE

To investigate musculoskeletal disorders and risk factors of low back pain in multiple sclerosis (MS) patients.

METHODS

In this study, patients in our hospital with confirmed MS with an expanded disabilitystatus scale (EDSS) score between 4 to 7 were selected. Data of MS history, pain, musculoskeletal disorders, muscle strength and spasticity in lower limbs were collected.

RESULTS

Among 190 patients, there were 61 males and 129 females, with an average age of(54.9±9.2) years old. The mean disease duration was(19.3±9.9) years, and the median EDSS score was 6. Forty-two patients were relapsing-remitting type, 45 patients were primary progressive type, and 93 patients were secondary progressive type. The most common musculoskeletal disorders were described as follows:knee osteoarthritis (15 cases), claw toe (13 cases) and genu recurvatum (12 cases). Seventy-nine patients with prevalence low back pain was higher than in patients with a progressive type(secondary: OR=2.958, P=0.007 9, primary(OR=2.629, P=0.039 8) and in patients who had a visual dysfunction at EDSS score(OR=1.411, P=0.012 4). The prevalence was reduced in male patients(OR=0.306, P=0.001 4).

CONCLUSIONS

The progressive type of MS and visual dysfunction increased the risk of low back pain in these patients.