Rheumatology 2002; 41: 118
© 2002 British Society for Rheumatology
Robin Goodfellow
Guten Tag. Robin is feeling sore. Some while ago an orthopaedic colleague (yes, the one who goes to the opera while Robin shovels horse-dung) amused him with a tale of medical assistance he rendered on the ski slope, only to discover his patient telling the tale of how fortunate he had been to have an osteopath in his party. Well, let me tell you that rheumatologists are not immune from such misconceptions. Robin's son reported that he had been asked by a schoolfriend what I did—a request prompted by forgotten knowledge, for he continued ‘I think it begins with an R. That's right, he's a reflexologist, isn't he?’ Almost the same number of letters, I suppose, but Robin's acquaintance with the sole is confined to testing plantar responses and sticking the odd needle into a heel in a strictly steroidal sort of way. Reflexology, I ask you. My foot.
|
Back pain patients are helped by being given advice and information, according to Little et al. ( Spine 2001;26:2065–72[Medline]). This might at first sight be one for Robin's Journal of Unsurprising Results, but an important point is made—that if the verbal advice differs significantly from that in a booklet then the beneficial effects of either alone may be negated.
Robin has a new Web tip for UK readers; the OVID site now has full text access to a large number of journals which you can access from work or home if you have the right passwords. Go to http://gateway.ovid.com for details and see your librarian to get your access codes.
Inhaled steroids may induce excess bone loss in pre-menopausal women
(
Israel et al., New Engl J Med 2001;345:941–7
We all inject tendon lesions, so perhaps should read the review by Speed
(
Br Med J 2001;323:382–6
A commentary by Doherty
(
Lancet 2001;358:775–6[ISI][Medline])
looks at risk factors for the progression of osteoarthritis (OA) of the knee, pointing out that in the elderly, disability from it is as great as that of cardiac disease (where's the NSF then, Robin cries again). Quoting Sharma et al.
(
J Am Med Assoc 2001;286:188–95
How should we treat lupus nephritis, asks Lewis in an editorial
(
Ann Intern Med 2001;135:296–8
Trying to read the tea leaves in rheumatoid arthritis (RA) is a much-researched topic, as all physicians would like to prognosticate. Combe et al. ( Arthritis Rheum 2001;44:1736–43[Medline]) conducted a ‘multiparameter’ study (Question: what's the difference between a parameter and a variable? Can we get it right please?) which concludes that some factors may matter (ESR, IgM RF positivity, pain score, baseline and total radiologic score and HLA-DRB1*4). Others do not, which might save on tests, I suppose.
Pentoxifylline has been used (not very successfully) in the management of peripheral vascular disease for decades, but a study on joint prosthesis loosening has some interesting undertones. TNF-
is very important in the genesis of particle-induced osteolysis, and it appears that pentoxifylline is a potent TNF- inhibitor
(
Pollice et al., J Bone Joint Surg 2001;83A:1057–61).
Anyone used it in RA yet? I thought not. Remember you read it here first.
Robin is always titillated by the unusual (as an example, there was a radiograph of knee OA in a book by Frank Dudley Hart, which showed a calcified guinea-worm: one of those fascinating, but gratuitous images illustrating no particular point), so he was delighted by the graphic image of leeches used in the management of knee pain
(
Michalsen et al., Ann Rheum Dis 2001;60:986
CiteULike 
Connotea 
Del.icio.us What's this?
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||