Joint, bone, spine : revue du rhumatisme
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Letter Case Reports
Epidural venous enlargements presenting with lumboradiculopathy.
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Comparative Study
Misleading abstract conclusions in randomized controlled trials in rheumatology: comparison of the abstract conclusions and the results section.
Readers of scientific articles often read only the abstract and its conclusions because of lack of time or of access to the full-length articles. ⋯ Almost one-quarter of these RCT in rheumatology had misleading conclusions in the abstract, especially those with negative results.
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Many medications have been evaluated for the treatment of nonspecific low back pain. The only medications proven to be more effective than a placebo in chronic low back pain are nonsteroidal antiinflammatory drugs (NSAIDs), the acetaminophen-tramadol combination, antidepressants other than selective serotonin reuptake inhibitors, and some types of spinal applications of glucocorticoids or local anesthetics. However, the efficacy of these drugs in inducing pain relief is limited, and NSAIDs are the only drugs that also improve function. ⋯ In addition, treatment effects vary dramatically across studies. One factor in this variability is the heterogeneity of patient populations. To improve the uniformity of patient populations enrolled in therapeutic trials, the selection criteria should take into account the nociceptive, dysfunctional, and possible neuropathic components of the pain syndrome.
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Randomized Controlled Trial
Are the results of multiple drilling and alendronate for osteonecrosis of the femoral head better than those of multiple drilling? A pilot study.
The treatment of osteonecrosis of the femoral head (ONFH) remains controversial. A recently proposed treatment is multiple drilling core decompression combined with systemic alendronate as a femoral head-preserving procedure for ONFH. However, it is not known whether alendronate enhances the risk of collapse. We wondered whether the combined procedure could delay or prevent progression of ONFH compared to multiple drilling alone. ⋯ Multiple small-diameter drilling core decompression combined with systemic alendronate administration can reduce pain and delay progression of early-stage ONFH. Even in Ficat IIA and III hips, some benefit was obtained from this approach at least delay in the need for THA.
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To assess the validity of the two self-report questionnaires RAPID3 and RADAI5 for measuring the activity of rheumatoid arthritis (RA) in everyday practice, comparatively to the DAS28, CDAI, and SDAI. To determine cutoffs for flare detection based on patients' and physicians' opinions. ⋯ These results confirm the validity of the RAPID3 and RADAI5 self-report questionnaires and support their widespread use in everyday practice in patients with RA. The self-report questionnaire scores correlate with the composite activity index values and allow the detection of activity peaks or flares.