71 research outputs found
Complex Regional Pain Syndromes in The Rheumatology Clinic
No full textThe differential diagnosis of complex regional pain syndrome (CRPS) type I is wide and includes almost any other cause of regional pain (Table 1). There may be a history of trauma, including surgery, preceding the onset of symptoms, and other causes of localized pain include fracture and ligamentous injury. In view of this, fracture should be considered as a differential diagnosis. However, the two may coexist, usually with CRPS type I developing as a complication of fracture but, if a fracture is present, this must be diagnosed so that correct management may be instituted. As CRPS type I often involves a joint, the diagnosis of septic arthritis and other causes of a monoarthritis should be considered. Vascular disease may also present as regional pain associated with colour change and, as a consequence, some patients with CRPS type I present initially to vascular surgeons
Early remission is associated with improved survival in patients with inflammatory polyarthritis: Results from the Norfolk Arthritis Register
No full textObjectives: This study aimed to evaluate whether the early achievement of clinical remission influences overall survival in an inception cohort of patients with inflammatory polyarthritis (IP). Methods: Consecutive early IP patients, recruited to a primary care based inception cohort from 1990 to 1994 and from 2000 to 2004 were eligible for this study. Remission was defined as absence of clinically detectable joint inflammation on a 51-joint count. In sensitivity analyses, less stringent de finitions of remission were used, based on 28-joint counts. Remission was assessed at 1, 2 and 3 years after baseline. All patients were flagged with the national death register. Censoring was set at 1 May 2011. The effect of remission on mortality was analysed using the Cox proportional hazard regression model, and presented as HRs and 95% CIs. Results: A total of 1251 patients were included in the analyses. Having been in remission at least once within the first 3 years of follow-up was associated with a significantly lower risk of death: HR 0.72 (95% CI 0.55 to 0.94). Patients who were in remission 1 year after the baseline assessments and had persistent remission over time had the greatest reduction in mortality risk compared with patients who never achieved remission within the first 3 years of follow-up: HR 0.58 (95% CI 0.37 to 0.91). Remission according to less stringent definitions was associated with progressively lower protective effect. Conclusions: Early and sustained remission is associated with decreased all-cause mortality in patients with IP. This result supports clinical remission as the target in the management of IP
208. RITUXIMAB AND LATE-ONSET NEUTROPENIA: A RETROSPECTIVE ANALYSIS OF RITUXIMAB-TREATED ADULT RHEUMATOID ARTHRITIS PATIENTS IN A TEACHING HOSPITAL
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