Showing papers by "Cyrus Cooper published in 1994"

Occupational activity and osteoarthritis of the knee

Abstract: OBJECTIVES--To test the hypothesis that specific occupational physical activities are risk factors for knee osteoarthritis (OA). METHODS--A population-based case-control study of knee osteoarthritis was carried out in which 109 men and women with painful, radiographically confirmed knee OA were compared with 218 age and sex matched controls who had not suffered knee pain and had normal radiographs. Information collected included a lifetime occupational history and details of specific workplace physical activities. RESULTS--After adjustment for obesity and Heberden's nodes, the risk of knee OA was significantly elevated in subjects whose main job entailed more than 30 minutes per day squatting (OR 6.9, 95% CI 1.8-26.4) or kneeling (OR 3.4, 95% CI 1.3-9.1), or climbing more than ten flights of stairs per day (OR 2.7, 95% CI 1.2-6.1). The increase in risk associated with kneeling or squatting appeared to be more marked in subjects whose jobs entailed heavy lifting, but the size of the study did not permit precise delineation of any such interaction. CONCLUSIONS--These data suggest that prolonged or repeated knee bending is a risk factor for knee OA, and that risk may be higher in jobs which entail both knee bending and mechanical loading.

Fracture risk in patients with ankylosing spondylitis: a population based study.

Abstract: Objective. To assess the risk of fructures among patients with ankylosing spondylitis (AS). Methods. A population based cohort study compared fracture incidence in an inception cohort of 158 Rochester, Minnesota residents newly diagnosed with AS between 1935 and 1989 with expected rates from the same community. Results. In 2,398 person-years of observation, there was no increase in the risk of limb fractures, but there was a pronounced increase in the risk of thoracolumbar compression fractures (standardized morbidity ratio=7.6; 95% CI, 4.3-12.6) among those with AS. Conclusion. These data point to the importance of measures aimed at maintaining axinl skeletal status in patients with AS

Defining osteoarthritis of the hand for epidemiological studies: the Chingford Study.

Abstract: OBJECTIVES--To explore the relative merits of clinical and radiological examination in defining hand osteoarthritis (OA) for epidemiological purposes. METHODS--A total of 976 women aged 45-64 years were selected from the general population and underwent a structured interview, clinical examination of the hand joints and radiography of the hands and knees. The inter-relationship of the clinical and radiological findings was examined, and also the association of each with hand symptoms and the presence of knee OA. RESULTS--Clinical and radiographic signs of hand OA generally correlated with each other, and each was associated with hand symptoms to a similar degree. When analysed in combination, they were only marginally better at predicting symptoms than when tested individually. However, when they were examined in relation to radiographic features of knee OA, there was a significantly stronger association with radiographic features of hand OA than with clinical features. CONCLUSIONS--Hand radiology provides a better overall assessment of osteoarthritis than physical examination of the interphalangeal joints or carpo-metacarpal joint; in situations where radiology is not available clinical examination is a viable substitute.