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Objectives: There is a paucity of qualitative research exploring the patient experience of living with a meniscal tear, vital to effective patient management. The aim of this study was to explore the experiences and expectations of treatment of patients aged 18-55 years with a meniscal tear of the knee., Design: Qualitative study involving semistructured interviews., Setting: Participants were selected from nine secondary care centres in England., Participants: 10 participants diagnosed with a meniscal tear were recruited from the Meniscal Tear Outcome cohort study using a purposive sampling strategy until data saturation was achieved. Semistructured interviews were conducted between April and May 2021 and thematic analysis was used to identify key patient experiences., Results: Themes identified relate to the broad areas of symptoms, clinical consultation and experience of treatment. Meniscal tears have a profound impact on pain and many patients experience effects on their family and financial life in addition to physical symptoms. Participants expected most of their management to occur in secondary care and most thought surgery would be a definitive treatment, while they believed the effectiveness of physiotherapy could not be guaranteed as it would not fix the physical tear., Conclusion: This study is one of the first to explore patient experiences of a meniscal tear and their perceptions of treatment options. Patient experiences and perceptions are important for clinicians to understand in order to provide the best possible care. It is important to elicit these experiences, listen to the patient, discuss their perspectives and build these experiences and expectations into clinical care., Trial Registration Number: ISRCTN11534691., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY. Published by BMJ Group.)

Objective: To compare body composition between patients with psoriatic disease (PsD), including cutaneous psoriasis (PsO) and psoriatic arthritis (PsA), and controls, and to explore associations between disease activity and measures of function and metabolic derangement., Methods: Body composition was assessed by air displacement plethysmography (ADP) and MRI-derived fat segmentation using an automated pipeline (FatSegNet). Function was assessed by Health Assessment Questionnaire (HAQ) and metabolic status by fasting lipid profile, insulin and adiponectin. Active and inactive PsO and PsA were defined by body surface area (BSA) and Psoriasis Area Severity Index (PASI) and minimal disease activity (MDA), respectively., Results: Thirty patients (median disease duration 15 years; median age 52 years) and 30 BMI-matched controls were enrolled. Compared with controls, all MRI-derived body composition parameters-whole-body volume, subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT), abdominal adipose tissue (AAT), VAT/AAT and VAT/SAT-were higher in the PsD group, specifically, those with active disease. Body mass, body fat, whole-body volume and whole-body VAT were correlated with higher triglycerides, cholesterol:HDL (high-density lipoprotein), insulin resistance and lower adiponectin as well as higher HAQ and lower MDA., Conclusions: In this pilot study, patients with PsD revealed excessive total adipose tissue and a greater volume of metabolically unfavourable ectopic fat, including VAT, compared with BMI-matched controls, which also correlated with HAQ, disease activity and overall dysmetabolism. We also provide the first evidence in patients with PsD for the clinical application of FatSegNet: a novel, automated and rapid deep learning pipeline for providing accurate MRI-based measurement of fat segmentation. Our findings suggest the need for a more integrated approach to the management of PsD, which considers both the metabolic and inflammatory burden of disease. More specifically, visceral fat is a surrogate marker of uncontrolled PsD and may be an important future target for both pharmacological and lifestyle interventions., (© 2023. The Author(s).)