ABSTRACT
We reexamined 19 shoulder hemiarthroplasties in patients with rheumatoid arthritis after a mean of 8 (1-17) years. For the evaluation, we used the Constant and Murley score and routine radiographs. At the follow-up examination, 12 of the 19 shoulders showed little, if any, pain. In 7 shoulders the pain was moderate and no patient had severe pain. The range of motion was not improved. In 7/18 shoulders proximal subluxation of the head of the humeral prosthesis and in 9/15 shoulders, progression of the glenoid erosion were seen. The increase in glenoid erosion and the postoperative pain were not correlated. Hemiarthroplasty of the shoulder effectively relieves the pain in rheumatoid patients and this seems long-lasting.
Subject(s)
Arthritis, Rheumatoid/surgery , Joint Prosthesis , Shoulder Joint/surgery , Aged , Arthritis, Rheumatoid/physiopathology , Arthritis, Rheumatoid/rehabilitation , Disability Evaluation , Disease Progression , Female , Follow-Up Studies , Humans , Joint Prosthesis/adverse effects , Male , Middle Aged , Pain Measurement , Pain, Postoperative/etiology , Pain, Postoperative/physiopathology , Pain, Postoperative/therapy , Prosthesis Failure , Radiography , Range of Motion, Articular , Retrospective Studies , Shoulder Joint/diagnostic imaging , Shoulder Joint/physiopathology , Time FactorsABSTRACT
OBJECTIVE: To find out if the C reactive protein concentration is of any value in the diagnosis of acute appendicitis, either alone or in combination with other laboratory tests. DESIGN: Open study. SETTING: Drechtsteden Hospital, Dordrecht, and Spaarne Hospital, Heemstede, The Netherlands. SUBJECTS: 209 consecutive patients admitted with suspected appendicitis. MAIN OUTCOME MEASURES: Correlation of C reactive protein concentration with age, sex, body temperature, duration of abdominal pain, anorexia, nausea, vomiting, white cell count, neutrophil count, erythrocyte sedimentation rate, and histological appearance of the appendix. RESULTS: 125 patients of the 209 patients had their appendixes removed, and of these 101 had histologically confirmed appendicitis: A C reactive protein concentration of > or = 6 mg/1 alone had a sensitivity of 87% and a specificity of 50%. When the selected variables were subjected to multivariate analysis the most important, in decreasing order, were white blood cell count, female sex, and C reactive protein concentration. Combining the variables was of no additional value. CONCLUSION: measurement of the C reactive protein concentration can increase the accuracy in the diagnosis of acute appendicitis.
