[Various manifestations of calcium pyrophosphate-associated arthritis]. / De diverse uitingen van calciumpyrofosfaat-artritis.

In calcium pyrophosphate (CPP)-associated arthritis, deposits of calcium pyrophosphate lead to acute attacks of painful joint inflammation. The disease may present with signs of systemic inflammation such as fever, mimicking an infectious disease. Early recognition and treatment of this disease can prevent overdiagnosis and joint damage. In this article we describe three different patient cases of CPP-associated arthritis. The diversity of clinical presentation in CPP-associated arthritis can be of interest to different medical specialties who will occasionally encounter them in daily practice.

Poor psychological health status among patients with inflammatory rheumatic diseases and osteoarthritis in multidisciplinary rehabilitation: need for a routine psychological assessment.

PURPOSE: To examine psychological health status among patients with inflammatory rheumatic diseases (i.e. rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis) and osteoarthritis in multidisciplinary rehabilitation, and to describe changes in psychological distress, illness cognitions, and pain coping from pre- to post-treatment. METHOD: Eighty-nine patients referred to multidisciplinary rehabilitation completed a set of questionnaires to assess pain (AIMS2-SF), physical functioning (AIMS2-SF), psychological distress (IRGL), illness cognitions (ICQ) and pain coping (PCI) at pre- and post-treatment. Changes in physical functioning, pain, and psychological health status were determined. On the basis of the cut-off scores of psychological distress, distressed, and non-distressed patients were compared on physical and psychological outcomes. RESULTS: Psychological distress was found in 64% of the study sample. In addition, high levels of helplessness and worrying, low levels of acceptance, and moderate levels of physical functioning were found. After treatment, positive changes in pain, psychological distress, and illness cognitions were observed. However, 69% (29/42) of the distressed patients at baseline still experienced elevated levels of psychological distress and maladaptive cognitions. CONCLUSIONS: Psychological distress and maladaptive illness cognitions are important characteristics of this study sample, and psychological distress remains high after rehabilitation. More attention should be given to the appropriate assessment and treatment of psychological distress within multidisciplinary rehabilitation.