Can magnetic resonance imaging differentiate undifferentiated arthritis?

A high sensitivity for the detection of inflammatory and destructive changes in inflammatory joint diseases makes magnetic resonance imaging potentially useful for assigning specific diagnoses, such as rheumatoid arthritis and psoriatic arthritis in arthritides, that remain undifferentiated after conventional clinical, biochemical and radiographic examinations. With recent data as the starting point, the present paper describes the current knowledge on magnetic resonance imaging in the differential diagnosis of undifferentiated arthritis

Prevalence of Rheumatoid Arthritis in the Southern Part of Denmark

The aim of the present study was to estimate the prevalence of rheumatoid arthritis in the southern part of Denmark. Using a screening questionnaire, telephone interview, register data, and a clinical examination cases were ascertained from a random sample of 4995 individuals over the age of 15. As case definition we used the original and modified 1987 American College of Rheumatology classification criteria. The overall point prevalence was 0.26% (95% confidence interval: 0.13-0.39) in the total sample and 0.35% (95% confidence interval: 0.17-0.52) among the responders; the cumulative prevalence was 0.75% (95% confidence interval: 0.52-0.97) in the total sample and 0.92% (95% confidence interval: 0.62-1.21) among the responders

The two faces of user involvement: Everyday life and local context

In most developed countries, healthcare systems are increasingly faced with political demands to involve users in the planning and development of their services. This article reports findings from an ethnographic fieldwork that investigated an inter-organizational project involving user representation. The project was set up to develop an educational programme for people with rheumatoid arthritis (RA). By investigating user representatives’ experiences, our aim was to bring to light more general determinants and conditions of user involvement in health services. Drawing on an analytical framework within everyday life sociology, the analysis explored the dual concept of “conditions and conditionality”, metaphorically described in this article as “the two faces of user involvement”. From one perspective, everyday life experiences – living with RA, encounters with the health system and professional identities and work life – conditioned user representatives’ participation in the project. From another perspective, the local institutional context and interactions within the project framework conditioned the way in which users are involved. The ways in which these conditions changed over time are described, in relation to the specific spatial, temporal and social developments in both the everyday lives of the user representatives and in the local project

The two faces of user involvement: Everyday life and local context

In most developed countries, healthcare systems are increasingly faced with political demands to involve users in the planning and development of their services. This article reports findings from an ethnographic fieldwork that investigated an inter-organizational project involving user representation. The project was set up to develop an educational programme for people with rheumatoid arthritis (RA). By investigating user representatives’ experiences, our aim was to bring to light more general determinants and conditions of user involvement in health services. Drawing on an analytical framework within everyday life sociology, the analysis explored the dual concept of “conditions and conditionality”, metaphorically described in this article as “the two faces of user involvement”. From one perspective, everyday life experiences – living with RA, encounters with the health system and professional identities and work life – conditioned user representatives’ participation in the project. From another perspective, the local institutional context and interactions within the project framework conditioned the way in which users are involved. The ways in which these conditions changed over time are described, in relation to the specific spatial, temporal and social developments in both the everyday lives of the user representatives and in the local project

CRP genotype and haplotype associations with serum C-reactive protein level and DAS28 in untreated early rheumatoid arthritis patients

INTRODUCTION: Single-nucleotide polymorphisms (SNPs) in the CRP gene are implicated in the regulation of the constitutional C-reactive protein (CRP) expression and its response to proinflammatory stimuli. Previous reports suggest that these effects may have an impact on clinical decision-making tools based on CRP, such as the Disease Activity Score in 28 joints (DAS28). We aimed to investigate the possible association between seven CRP SNPs, their haplotypes and the serum levels of CRP, as well as DAS28 scores, in two cohorts of untreated active early rheumatoid arthritis (RA) patients followed during their initial treatment. METHODS: Overall, 315 patients with RA from two randomized controlled trials (the CIMESTRA and OPERA trials) who were naïve to disease-modifying antirheumatic drugs and steroids with disease durations less than 6 months were included. Seven CRP SNPs were investigated: rs11265257, rs1130864, rs1205, rs1800947, rs2808632, rs3093077 and rs876538. The genotype and haplotype associations with CRP and DAS28 levels were evaluated using linear regression analysis adjusted for age, sex and treatment. RESULTS: The minor allele of rs1205 C > T was associated with decreased CRP levels at baseline (P = 0.03), with the TT genotype having a 50% reduction in CRP from 16.7 to 8.4 mg/L (P = 0.005) compared to homozygosity of the major allele, but no association was observed at year 1 (P = 0.38). The common H2 haplotype, characterized by the T allele of rs1205, was associated with a 26% reduction in CRP at baseline (P = 0.043), although no effect was observed at year 1 (P = 0.466). No other SNP or haplotype was associated with CRP at baseline or at year 1 (P ≥0.09). We observed no associations between SNPs or haplotypes and DAS28 scores at baseline or at year 1 (P ≥0.10). CONCLUSION: CRP genotype and haplotype were only marginally associated with serum CRP levels and had no association with the DAS28 score. This study shows that DAS28, the core parameter for inflammatory activity in RA, can be used for clinical decision-making without adjustment for CRP gene variants. TRIAL REGISTRATION: The OPERA study is registered at Clinicaltrials.gov (NCT00660647). The CIMESTRA study is not listed in a clinical trials registry, because patients were included between October 1999 and October 2002. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13075-014-0475-3) contains supplementary material, which is available to authorized users