Pattern of arthralgia in an urban community in Southwestern Nigeria

Background: Arthritis is a common presentation among Nigerians, most especially in the elderly population. Easy access to over-the-counter drugs, paucity of data, and non-orthodox medical practice have underscored the need to examine the magnitude of the problem toward morbidity reduction risk factors. The objective of the study was to determine the pattern of arthralgia in Osogbo community in Southwestern Nigeria.Materials and Methods: This was a descriptive cross-sectional study  conducted between September 2010 and August 2011. Respondents were serially recruited as they presented to the randomly selected healthcare facilities. Interviewer administered questionnaires, and modified checklist were used for collecting clients information, physical examination, X-ray, and laboratory results. Data were analyzed using the SPSS software.Results: A total of 90 cases were screened, with a male to female ratio of 1:1.5 and age range of 50-59 years. Females were more affected among the studied respondents, and this was statistically significant (p < 0.05). About half (48.9%) used non-steroidal anti-inflammatory drugs (NSAID) for the pain, while about 17.8% used traditional herbs. Osteoarthritis of the knee was the most common radiological finding, constituting about 86.7% of the 30 respondents that had X-ray done. Only one case tested positive to rheumatoid factor in high-dilution titer. Notable complication of arthralgia in this study was loss of time off work in 46.6% of the respondents.Conclusion: Arthralgia of the knee joint was most common in the studied area, followed by that of hip and the ankle. Weight reduction strategies and prompt diagnosis and treatment were advocated. Since about half of the respondents used NSAID, the use of enteric-coated NSAID tablets would go a long way to minimize the unwanted side effects of NSAID, notably peptic ulceration and erosion.Keywords: Arthralgia, pattern, urban communit

Rationale, design and protocol of a longitudinal study assessing the effect of total knee arthroplasty on habitual physical activity and sedentary behavior in adults with osteoarthritis

Background: Physical activity levels are decreased and sedentary behaviour levels are increased in patients with knee osteoarthritis (OA). However, previous studies have shown that following total knee arthroplasty (TKA), objectively measured physical activity levels do not change compared to before the surgery. Very few studies have objectively assessed sedentary behaviour following TKA. This study aims to assess patterns of objective habitual physical activity and sedentary behaviour in patients with knee OA and to determine whether these change following TKA. Methods: Patients diagnosed with knee osteoarthritis and scheduled for unilateral primary total knee arthroplasty will be recruited from the Orthopaedic Division at the Charlotte Maxeke Johannesburg Academic Hospital. Eligible participants will have assessments completed one week before the scheduled arthroplasty, six weeks, and six months post-operatively. The primary outcomes are habitual physical activity and sedentary behaviour which will be measured using accelerometry (Actigraph GTX3+ and activPal monitors) at the specific time points. The secondary outcomes will be improvements in osteoarthritis-specific quality of life measures using the following questionnaires: Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Knee injury and Osteoarthritis Outcome Score (KOOS), Oxford Knee Score (OKS), Knee Society Clinical Rating System (KSS), UCLA activity index; subjective pain scores, and self reported sleep quality.Discussion: The present study will contribute to the field of musculoskeletal health by providing a rich detailed description of the patterns of accumulation of physical activity and sedentary behaviour in patients with knee OA. These data will contribute to existing knowledge using an objective measurement for the assessment of functional ability after total knee arthroplasty. Although studies have used accelerometry to measure physical activity in knee OA patients, the data provided thus far have not delved into the detailed patterns of how and when physical activity is accumulated before and after TKA. Accurate assessment of physical activity is important for physical activity interventions that target special populations

Iatrogenic Digital Gangrene: Report of a Case

OBJECTIVE: The rationale of this report is to highlight warning signals and to suggest methods of minimizing the severity of the gangrene. METHOD: A 20 year old male developed gangrene of the right thumb, index and middle fingers following what was suspected to be an accidental intra-arterial injection of ketamine as an anaesthetic agent. RESULTS: Dry gangrene of the right thumb, index and middle fingers and of the right thenar eminence CONCLUSION: During administration of any intravenous drug (including and especially anaesthetic agent), aspiration of bright red blood should alert the doctor that an artery has been cannulated. Pulsation (if elicited) along the vessel concerned should be confirmatory, and such injection discontinued. Nig Jnl Orthopaedics & Trauma Vol.2(2) 2003: 134-13