https://www.oarsijournal.com/article/S1063-4584(12)00987-9/pdf

Osteoarthritis as a disease of mechanics

Femoroacetabular impingement (FAI) is an increasingly recognized cause of hip pain. It is best defined as a pathologic mechanical process by which morphologic abnormalities of the acetabulum and/or femur combined with vigorous hip motion lead to repetitive collisions that damage the soft-tissue structures within the joint itself. Based on cross-sectional studies in which FAI morphology was studied before the presence of radiographic osteoarthritis (OA), and on prevalence studies in younger, asymptomatic persons, it is clear that FAI and its morphologic risk factors are common in young adult hips and predispose to the later development of OA in certain patients. Longitudinal studies also support the assertion that, in middle-aged adults, the presence of cam deformities at baseline substantially increases the risk of developing OA and the need for total hip arthroplasty. More long-term data are needed to better define the natural history of pincer deformities as well as FAI in younger cohorts.

Femoroacetabular impingement: defining the condition and its role in the pathophysiology of osteoarthritis.

https://www.oarsijournal.com/article/S1063-4584(12)00708-X/pdf

The lifetime risk of total hip and knee arthroplasty: results from the UK general practice research database.

The effect of vitamin D supplementation on knee osteoarthritis, the VIDEO study: a randomised controlled trial.

Introduction
Increasing evidence indicates that features suggestive of neuropathic pain may also be present in patients with common rheumatic conditions. The objective of this study was to examine neuropathic-like pain symptoms and associated factors in patients with rheumatoid arthritis. 

Methods
We used the painDETECT screening tool to identify possible or likely neuropathic pain in 159 outpatients with rheumatoid arthritis. Patients additionally completed other self-reported measures, while clinical measures were assessed to calculate the 28-joint Disease Activity Score. Univariate analyses and multivariable logistic regression were used to identify factors associated with neuropathic pain features. 

Results
According to the painDETECT, 27 patients (17.0 %) were classified as having likely neuropathic pain and 34 patients (21.4 %) as having possible neuropathic pain. Besides reporting more severe pain, patients with likely or possible neuropathic pain were more likely to meet the diagnostic criteria for fibromyalgia, to use analgesics, and to have more tender joints and a worse physical and mental health status as measured by the 36-item Short-Form health survey. In multivariable analysis, physical (P < 0.001) and mental health status (P = 0.006) remained significantly associated with neuropathic pain features, even after controlling for pain severity. 

Conclusions
These findings suggest that a sizeable proportion of patients with relatively well-controlled rheumatoid arthritis report symptoms suggestive of neuropathic pain. Neuropathic-like pain symptoms are independently associated with worse self-reported physical and mental health.

/pdf/neuropathic-like-pain-features-and-cross-sectional-v5rvfu0gps.pdf

M K Javaid

Papers

The association between hip morpholgy and 19-year risk of osteoarthritis in the hip

Joint space narrowing over 5 years predicts future knee replacements up to 15 years later

Evaluation of calcaneal ultrasound and DXA to assess the risk of corticosteroid osteoporosis

The natural history of knee pain in a prospective longitudinal population-based cohort: identifying important patient phenotypes

The natural history of knee pain in a prospective longitudinal population-based cohort: how does pain change over time?