Reduced quadriceps muscle functional performance in knee osteoarthritis

Reduced quadriceps strength is an early finding in subjects with knee osteoarthritis [OA]. The strength of flexor and extensor muscles of the knee joint was assessed with isokinetic dynamometry in patients with tibiofemoral and patellofemoral knee OA. To study the relationship of muscle strength with the severity of tibiofemoral and patellofemoral OA of the knee joint using functional performance isokinetic testing. This was to determine the role of reduced functional performance in quadriceps strength in knee osteoarthritis. The study was performed on 30 patients: [16 females and 14 males]. In the TFOA group the age was 48.8+4.47. In the 30 patients patellofemoral OA group, the age was 30.14+4.68. Isokinetic dynamometry testing of the quadriceps and hamstring muscles. The strength and functional isokinetic performance was found to be decreased in both groups more in TFOA than patellofemoral OA. Reduced functional performance of the lower extremity is an early predictor than radiographic changes of osteoarthritis, mainly osteophytes, in TFOA than in patellofemoral OA patients. This suggests that in chronic knee pain, the functional performance is important for evaluating knee osteoarthritis, perhaps more so than radiography

Association between rheumatoid arthritis activity and atherosclerosis

We assessed atherosclerosis as a risk factor in rheumatoid arthritis [RA] patients who experience excess atherosclerosis and cardiovascular risk. They were compared with osteoarthritis [OA] patients as a control group. The severity of atherosclerosis remains to be determined through carotid intima-media thickness [IMT] as a reflector for systemic atherosclerosis. The study was performed on 30 RA patients without history of cardiovascular accidents. The severity of carotid atherosclerosis was evaluated with the mean max IMT, i.e., mean of the maximal wall thickness at carotid segments. Serum level of IL-18 was measured in both RA and OA groups. Erythrocyte sedimentation rate [ESR] and C-reactive protein [CRP] were used to measure systemic inflammation. The relationship of the carotid artery IMT with inflammatory markers was examined in RA versus OA as a control. IL-18 concentration was higher in RA versus OA and it positively correlated with IMT, p<0.05. Lipid profile was also higher in RA than OA and positively correlated with CRP, ESR and IL -18 serum level hyperlipidemia and body mass index [BMI], p<0, 05, We demonstrated an association between higher serum IL-18 level and atherosclerotic risk factors. Increased liability of atherosclerosis has the link between IL-18 and atherosclerosis. So, inflammation and cardiovascular risk factors interact to enhanced atherosclerosis in RA patients. Our findings need more evaluation in large study groups with cardiovascular risk profiles

electromyographic assessment of F-wave in carpal tunnel syndrome: correlation study with MRI carpus and cervical spine

In this study we have analyzed the effect C.T.S. of focal median nerve injury carpal tunnel syndrome [CT] on F wave. We have determined the F wave parameters in C.T.S. patients and evaluate the relationship between F wave and severity of injury of CT and MRI finding of the wrist and cervical spine finding. The study was conducted on all patients[104] referred from out-patients clinic in the same hospital to electrophysiologic examination in Rheumatology, Physical Medicine and Rehabilitation Dep. and Radiology department, Al Hussein University Hospital as clinical assessed as a carpal tunnel syndrome, Standard electro diagnostic study was made on all of them bilaterally. MRI of carpal tunnel and cervical spine done for selected patients with C.T. S. According to F wave parameters, patients were divided into three groups, absent F-wave, abnormally prolonged F-wave and normal F-wave. According to electrophysiological testing results, the patients were grouped into mild, moderate or severe C.T.S. Absent F wave was presented in 8 hands [7.7%], prolonged latency in 9 hands [8.6%] and normal F wave in 87 of 104 hands [83.7%]. the mean F wave latency were statistically different between the C.T.S. patients and the normal values [CI 95%, p<0.0001]. Also, the entire F wave latencies were significantly prolonged in the severely injured group [p=0.0001]. F wave determination could show injury to proximal and also severe injury to distal parts of median nerve and especially axonal injury. According to abnormalities of this test the surgical release of nerve for prevention of irreversible changes must be considered. Results of our study supported the adding of F wave parameters study to standardize electrophysiological evaluation of C.T.S

Tissue plasminogen and plasminogen activator inhibitor-1 serum level in osteoarthritis and rheumatoid arthritis patients

The activity of tissue plasminogen activator [t-PA] and plasminogen activator inhibitor-1 [PAI-1] in the plasma of 40 rheumatoid arthritis [RA] patients [Gl] and 10 osteoarthritis [OA] patients [G2] was measured. Group I mean age was 40.95 +/- 3.57 and the duration of disease was 91.65 +/- 37.93 weeks. Group II mean age was 50.87 +/- 5.39 and the duration of disease was 77.43 +/- 12.75 weeks. Ten apparently healthy subjects were examined as a control group [G3]. Their mean age was 25.44 +/- 10.45. The relationship between plasma t-PA and PAI-1 and their correlation with disease activity were studied in patients with rheumatoid arthritis [RA=G1] and [OA=G2], and control group a comparative study group showed that, RA Gl increased t-PA and PAI-1 activity, in comparison with OA patients and control group. In addition, there was an imbalance between plasminogen activator inhibitor-type 1 [PAI-1] and t-PA in RA than OA patient or control. These results show an alteration of the PAI-1/t-PA system in RA, which increases with disease activity. This alteration may play a role in joint destruction in RA