Search

Objective: Osteoarthritis (OA) of the knee is found to be one of the commonest rheumatic disorders. For prevention of knee OA, the risk factors for this condition should first be identified., Methods: A population sample of 2188 adults aged 35 - 64 years, living in 6-story buildings without elevators, was surveyed from April to August 2005 in the urban of Taiyuan region, north China. Protocol of APLAR-COPCORD Core Questionnaire for identification of risk factors for knee OA was implemented. The positive respondents were examined simultaneously by rheumatologists. Lateral and anterior-posterior non-weight-bearing knee radiographs were arranged. Variables such as sex, age, body mass index (BMI), waist circumference, education level, and smoking et al, were included in binary logistic regression model for further analysis., Results: Prevalence rate of knee pain and knee OA was 13.6% and 10.9% respectively, significantly higher than that in Shantou--in south of China and similar with Beijing--in north of China. Both of these prevalence was significantly higher in women than that in men (18.3% vs. 8.7% and 15.1% vs. 6.3%), and with a tendency of being increased with age. The prevalence rate of knee OA was increased more obviously in people after 40 years old in women and after 45 years old in men. BMI in knee OA group was significantly higher than that in non-knee OA group. Binary logistic regression revealed that age, sex, and BMI were significantly associated with knee OA. Whereas there were no significant association between the other factors such as climbing stairs, waist circumference, time length of occupation service, education level, smoking, as well as religious belief and knee OA., Conclusions: Geography, aging (aged > 40 years in woman and > 45 years in man, respectively), female, and overweight (BMI > or = 24 kg/m(2)) might be the associated risk factors of knee OA. No association between climbing stairs and knee OA was found. Prevention of knee OA should be initiated before the middle-aged, especially in female. Controlling body weight and avoiding obesity are important in preventing knee OA.

Objective: To study the pathological features of sacroiliitis, aiming at improving the early diagnosis of ankylosing spondylitis (AS)., Methods: CT guided needle biopsy of sacroiliac joint (SIJ) was performed in 96 cases of spondyloarthropathy (SpA) patients with 3 autopsy materials of non-SpA sacroiliac joints serving as control. Pathological features were studied by two independent observers. Clinical data were collected and analyzed., Results: No pathological change was noticed in the control group. Among the 96 cases of SpA, pathological changes were found in 76 cases, including bone marrow inflammation, pannus formation, subchondral bony plate destruction, cartilage degeneration/erosion, synovitis, and enthesitis. The aforementioned first 4 findings were present in 45 cases of grade 0/I CT sacroiliitis. In the synovial specimens obtained, synovitis was seen in some cases of grade I and all of >/= grade II CT sacroiliitis,while no inflammatory change was noticed in all cases of grade 0 CT sacroiliitis. Frequency rate of cartilage erosion and ossification in grade 0/I CT sacroiliitis was the lowest in comparison with the other groups. Moreover, in cases of grade 0/I CT sacroiliitis, cartilage erosion only present at the bony plate side, while the joint cavity side was not affected. The inflammatory index was significantly lower in cases of grade IV CT sacroiliitis than that in the other groups. Enthesitis only presented in some cases of >/= grade II CT sacroiliitis. Among the 65 undifferentiated spondyloarthropathy patients, 45 were diagnosed as AS after SIJ pathological examination. The mean disease duration of these 45 cases was significantly shorter than that in cases of >/= grade II CT sacroiliitis., Conclusions: Inflammatory changes of SIJ did exist in cases of the < grade II CT sacroiliitis. Sacroiliitis probably initiated with bone marrow inflammation, followed by pannus formation, subchondral bony plate destruction, and cartilage degeneration/erosion, eventually leading to fibrosis, ossification and joint fusion. Synovitis and enthesitis were not the very early changes of sacroiliitis. Pathological examination was beneficial to the early diagnosis and differential diagnosis of ankylosing spondylitis.

3 cases of seronegative synovitis syndrome were reported. Two elderly women and one man presented with symmetrical polysynovitis of acute onset involving most of their appendicular joints and flexor digitorum tendons associated with pitting edema of the dorsum of both hands and both feet. Rheumatoid factor was absent from serum samples in all and no radiologically evident erosions developed. All the three patients had a benign course and the disease resolved completely within 2-18 months after the onset. None had deformities, erosions and/or relapse after being followed for 22-34 months. Literatures on this syndrome were reviewed.