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Study of inflammatory osteoarthrosis and diabetes mellitus
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Abstracts
Presence of fibromyalgia in osteoarthritis patients in a general r h e u m a t o l o g y practice THOMAS J. ROMANO
Medical Park, Wheeling, WV, U.S.A. F i b r o m y a l g i a s y n d r o m e (FS) a n d o s t e o a r t h r i t i s (OA) are common r h e u m a t o l o g i c conditions. The c o i n c i d e n c e of both FS and OA is t h e s u b j e c t of this study. A l l OA p a t i e n t s seen in 1991 in a p r i v a t e g e n e r a l r h e u m a t o l o g y p r a c t i c e were e v a l u a t e d for t h e presence of FS employing e s t a b l i s h e d ACR c r i t e r i a (Arthritis Rheum 1990; 33: 2). There were 362 OA p a t i e n t s (105 males a n d 257 females), m e a n age 60.82 y e a r s (range 27-93 years). The m e a n age of males was 58.65 y e a r s (range 27-82 years) and of females was 61.39 y e a r s (range 29-93 years)~ Forty-two males (40%) and 142 females (55% with OA also fulfilled c r i t e r i a for FS. The m e a n age of females
with OA a n d FS (61.37 years) was n o t s i g n i f i c a n t l y different from t h a t of females with OA b u t n o t F S (61.42 years). However, t h e males w i t h OA a n d F S were signific a n t l y y o u n g e r t h a n those w i t h o u t F S (54.29 y e a r s vs 61.56 years, P _< 0.005). Of t h e 20 male OA p a t i e n t s u n d e r 50 years, 17 h a d FS, w h e r e a s of t h e 85 m a l e OA p a t i e n t s over 50 years, 25 h a d FS, a n d 60 did not. T h e r e was no c o r r e l t i o n b e t w e e n t h e site of OA a n d Whether a p a t i e n t h a d o r did n o t h a v e FS. K n o w i n g t h a t an OA p a t i e n t has F S c a n be v a l u a b l e since t r e a t m e n t of such a p a t i e n t differs from t h a t of a p u r e OA patient.
Dry eye syndrome in nodal generalized osteoarthritis (NGOA) M. REGAN, C. HUGKULSTONE, S. VERNON AND M. DOHERTY
Rheumatology and Ophthalmology Units, Nottingham, U.K. It has been s u g g e s t e d t h a t N G O A has an a u t o i m m u n e component. Deficient t e a r p r o d u c t i o n is a s s o c i a t e d with a u t o i m m u n e disease a n d a n i n c r e a s e d frequency of dry eyes in NGOA would be f u r t h e r i n d i r e c t evidence of an a u t o i m m u n e aetiology. T h r e e tests of t e a r film i n t e g r i t y were u n d e r t a k e n on 48 N G O A patients; 43 p a t i e n t s with non-nodal large j o i n t OA (LJOA); and 49 non-OA c o n t r o l s (all female; m e a n ages 65, 66, 66 years, respectively). The tests were: S c h i r m e r ' s test ( s t a n d a r d strips); Rose B e n g a l conjunctival s t a i n i n g p a t t e r n graded using a slit lamp; a n d t e a r film break-up time after fluorescein was instilled. Symptoms s u g g e s t i n g d r y eyes were elicited after the
tests were performed. P a t i e n t s were r a n d o m i z e d as to w h i c h eye was e x a m i n e d a n d the o p h t h a l m o l o g i s t b l i n d e d to the diagnosis. Symptoms of d r y eyes were more common in N G O A ( P < 0.02) a n d L J O A ( P < 0.05) groups compared to non-OA subjects. No differences were observed in tests. Symptoms are recognized to be a m o r e sensitive indic a t o r t h a n c u r r e n t l y a v a i l a b l e c l i n i c a l tests for d r y eyes. T h o u g h open to a l t e r n a t i v e i n t e r p r e t a t i o n , this first r e p o r t of a h i g h e r frequency of symptoms in NGOA, and to a lesser e x t e n t LJOA, s u p p o r t s t h e p o s s i b i l i t y of e x t r a - a r t i c u l a r a b n o r m a l i t y in some OA subjects.
Study of inflammatory osteoarthrosis and diabetes mellitus F. RIVAS SANTIRSO*, J. REVILLA JOAI~EZ~ AND J. BORRACHI~RO*
*Cruz Roja Espa~ola y Cdtedra de ReumatologEa Universidad Complutense de Madrid, tServicio de Endopcrinologfa de la Seguridad Social, Segovia, Spain We have studied t h e c l i n i c a l and r a d i o l o g i c a l c h a r a c t e r istics of 85 p a t i e n t s with a diagnosis of d i a b e t e s m e l l i t u s and who showed signs a s s o c i a t e d with o s t e o a r t h r o s i s u s u a l l y a s s o c i a t e d w i t h inflammation. Seventy-one (83.5%) were i n s u l i n dependents, 14 (16.4%) were noninsulin dependent, d u r a t i o n of diabetes was a t l e a s t 10 years. Age r a n g e d from 50-65 y e a r s (34 M : 5 1 F ) . The clinical symptoms i n c l u d e d an a b r u p t and p a i n f u l onset with signs of inflammation. Radiologic studies showed
signs of o s t e o a r t h r o s i s as well as bone c h a n g e s with s u b c h o n d r a l cysts. L a b o r a t o r y tests i n c l u d e d n e g a t i v e r h e u m a t o i d factor and a mild i n c r e a s e in s e d i m e n t a t i o n rate, (25-40 mm). The purpose of the p r e s e n t s t u d y was to d e t e r m i n e the c l i n i c a l and r a d i o l o g i c aspects of d i a b e t e s mellitus a n d o s t e o a r t h r i t i s and to show t h e r e l a t i o n and frequency b e t w e e n inflammatory o s t e o a r t h r o s i s and diabetes mellitus.
Abstracts
Presence of fibromyalgia in osteoarthritis patients in a general r h e u m a t o l o g y practice THOMAS J. ROMANO
Medical Park, Wheeling, WV, U.S.A. F i b r o m y a l g i a s y n d r o m e (FS) a n d o s t e o a r t h r i t i s (OA) are common r h e u m a t o l o g i c conditions. The c o i n c i d e n c e of both FS and OA is t h e s u b j e c t of this study. A l l OA p a t i e n t s seen in 1991 in a p r i v a t e g e n e r a l r h e u m a t o l o g y p r a c t i c e were e v a l u a t e d for t h e presence of FS employing e s t a b l i s h e d ACR c r i t e r i a (Arthritis Rheum 1990; 33: 2). There were 362 OA p a t i e n t s (105 males a n d 257 females), m e a n age 60.82 y e a r s (range 27-93 years). The m e a n age of males was 58.65 y e a r s (range 27-82 years) and of females was 61.39 y e a r s (range 29-93 years)~ Forty-two males (40%) and 142 females (55% with OA also fulfilled c r i t e r i a for FS. The m e a n age of females
with OA a n d FS (61.37 years) was n o t s i g n i f i c a n t l y different from t h a t of females with OA b u t n o t F S (61.42 years). However, t h e males w i t h OA a n d F S were signific a n t l y y o u n g e r t h a n those w i t h o u t F S (54.29 y e a r s vs 61.56 years, P _< 0.005). Of t h e 20 male OA p a t i e n t s u n d e r 50 years, 17 h a d FS, w h e r e a s of t h e 85 m a l e OA p a t i e n t s over 50 years, 25 h a d FS, a n d 60 did not. T h e r e was no c o r r e l t i o n b e t w e e n t h e site of OA a n d Whether a p a t i e n t h a d o r did n o t h a v e FS. K n o w i n g t h a t an OA p a t i e n t has F S c a n be v a l u a b l e since t r e a t m e n t of such a p a t i e n t differs from t h a t of a p u r e OA patient.
Dry eye syndrome in nodal generalized osteoarthritis (NGOA) M. REGAN, C. HUGKULSTONE, S. VERNON AND M. DOHERTY
Rheumatology and Ophthalmology Units, Nottingham, U.K. It has been s u g g e s t e d t h a t N G O A has an a u t o i m m u n e component. Deficient t e a r p r o d u c t i o n is a s s o c i a t e d with a u t o i m m u n e disease a n d a n i n c r e a s e d frequency of dry eyes in NGOA would be f u r t h e r i n d i r e c t evidence of an a u t o i m m u n e aetiology. T h r e e tests of t e a r film i n t e g r i t y were u n d e r t a k e n on 48 N G O A patients; 43 p a t i e n t s with non-nodal large j o i n t OA (LJOA); and 49 non-OA c o n t r o l s (all female; m e a n ages 65, 66, 66 years, respectively). The tests were: S c h i r m e r ' s test ( s t a n d a r d strips); Rose B e n g a l conjunctival s t a i n i n g p a t t e r n graded using a slit lamp; a n d t e a r film break-up time after fluorescein was instilled. Symptoms s u g g e s t i n g d r y eyes were elicited after the
tests were performed. P a t i e n t s were r a n d o m i z e d as to w h i c h eye was e x a m i n e d a n d the o p h t h a l m o l o g i s t b l i n d e d to the diagnosis. Symptoms of d r y eyes were more common in N G O A ( P < 0.02) a n d L J O A ( P < 0.05) groups compared to non-OA subjects. No differences were observed in tests. Symptoms are recognized to be a m o r e sensitive indic a t o r t h a n c u r r e n t l y a v a i l a b l e c l i n i c a l tests for d r y eyes. T h o u g h open to a l t e r n a t i v e i n t e r p r e t a t i o n , this first r e p o r t of a h i g h e r frequency of symptoms in NGOA, and to a lesser e x t e n t LJOA, s u p p o r t s t h e p o s s i b i l i t y of e x t r a - a r t i c u l a r a b n o r m a l i t y in some OA subjects.
Study of inflammatory osteoarthrosis and diabetes mellitus F. RIVAS SANTIRSO*, J. REVILLA JOAI~EZ~ AND J. BORRACHI~RO*
*Cruz Roja Espa~ola y Cdtedra de ReumatologEa Universidad Complutense de Madrid, tServicio de Endopcrinologfa de la Seguridad Social, Segovia, Spain We have studied t h e c l i n i c a l and r a d i o l o g i c a l c h a r a c t e r istics of 85 p a t i e n t s with a diagnosis of d i a b e t e s m e l l i t u s and who showed signs a s s o c i a t e d with o s t e o a r t h r o s i s u s u a l l y a s s o c i a t e d w i t h inflammation. Seventy-one (83.5%) were i n s u l i n dependents, 14 (16.4%) were noninsulin dependent, d u r a t i o n of diabetes was a t l e a s t 10 years. Age r a n g e d from 50-65 y e a r s (34 M : 5 1 F ) . The clinical symptoms i n c l u d e d an a b r u p t and p a i n f u l onset with signs of inflammation. Radiologic studies showed
signs of o s t e o a r t h r o s i s as well as bone c h a n g e s with s u b c h o n d r a l cysts. L a b o r a t o r y tests i n c l u d e d n e g a t i v e r h e u m a t o i d factor and a mild i n c r e a s e in s e d i m e n t a t i o n rate, (25-40 mm). The purpose of the p r e s e n t s t u d y was to d e t e r m i n e the c l i n i c a l and r a d i o l o g i c aspects of d i a b e t e s mellitus a n d o s t e o a r t h r i t i s and to show t h e r e l a t i o n and frequency b e t w e e n inflammatory o s t e o a r t h r o s i s and diabetes mellitus.