Muscle stiffness in rheumatoid arthritis is not altered or associated with muscle weakness: a shear wave elastography study

Objective: To investigate muscle stiffness and strength in rheumatoid arthritis patients compared to healthy controls. Methods: A sample of 80 RA patients from three discrete groups: 1-newly diagnosed treatment-naïve RA (n = 29), 2-active RA for at least 1 year (n = 18) and 3-in remission RA for at least 1 year (n = 33), was compared to 40 healthy controls. Shear wave velocity (SWV) was measured using shear wave elastography as a surrogate for tissue stiffness in multiple muscles. All participants performed isometric grip strength, timed get-up-and-go test, 30-sec chair stand test and isokinetic knee extension/flexion(60°/sec). The difference in SWV amongst the groups was tested using one-way ANOVA, and the correlation between SWV and muscle strength results were calculated using Pearson's coefficients. Results: The mean age ± SD was 61.2 ± 12.8 for RA patients and 61.5 ± 10.5 years for controls. SWV was not significantly different amongst the groups on all muscles (p > 0.05). In comparison to controls, the new and active RA groups showed a significantly lower isokinetic strength by -29%(p = 0.013) and -28%(p = 0.040), fewer chair stands by -28%(p = 0.001) and -44%(p  0.05). Conclusions: Significant muscle weakness was demonstrated in patients with RA disease. However, muscle stiffness was normal and not associated with muscle strength

The prevalence of temporo mandibular joint in degenerative disease

Rezumat Articulaţia temporomandibulară (ATM), prin poziţie şi funcţie se integrează sistemului stomatognat (SSG), iar prin morfologie se aliniază sistemului articular general; aceste elemente fac ca patologia ATM să înregistreze numeroase aspecte, conturate şi înţelese mai bine în ultima perioadă prin elocvenţa metodelor imagistice. Scopul lucrării: identificarea prevalenţei afectării ATM în bolile reumatismale degenerative. Material şi metodă: studiu prospectiv pe 42 pacienţi cu artroză (OA), generalizată sau localizată la nivelul articulaţiilor mari (şold, genunchi), definitş conform ACR, şi un lot martor alcătuit din 33 bolnavi cu alte afecţiuni. Pacienţii au fost spitalizaţi în Clinica Reumatologie a Spitalului Clinic de Recuperare Iaşi, Romania în perioada 01.01.2005—31.07.2006. Rezultate şi discuţii: prevalenţa simptomatologiei ATM a înregistrat următoarele: durerea articulară, semn dominant, în 92.86% cazuri; durerea musculară frecvent la nivelul muşchiului maseter (71.43%) şi pterigoidian intern (47.62%); contractură musculară la nivelul muşchiului temporal (83.33%). Concluzii: simptomatologia afectării ATM trebuie corect apreciată şi corelată cu modificările imagistice locale, modificările la nivelul întregului SSG sau modificări articulare axiale şi periferice, în vederea stabilirii etiologiei şi terapiei optime.Summary Recent advances in imaging techniques of temporo-mandibular joint (TMJ) result in a better understanding of TMJ pathology, taking into account that TMJ is included in both stomatognatic and articular system Objectives: to identify the prevalence of TMJ involvement in degenerative rheumatic disorders. Material and methods: prospective study on 42 patients with either generalized or localized (hip, knee) osteoarthritis (OA), defined according to ACR criteria, and 33 controllers. Patients were hospitalized in Rheumatology Department, Rehabilitation Hospital, Iasi, Romania during 01.01.2005—31.07.2006. Results: the prevalence of TMJ symptoms registered the following: articular pain, commonly reported, in 92.86% cases; muscular pain frequently in both maseter (71.43%) and internal pterigoidian (47.62%) muscles; muscular contracture in temporal muscle (83.33%). Conclusions: both correct assessment of TMJ involvement and identification of potential relationship between TMJ symptoms and imagistic details are necessary in order to establish etiology and optimal management of TMJ pathology