Decrease in handgrip strength in rheumatoid arthritis (RA): is there a sex-related difference?

Rheumatoid arthritis occurs two to three times more often in women than in men and it has been less studied in men. The results of gender influence on clinical course of the disease are contradictory. The aim of this study is to determine the difference in handgrip strength between female and male RA patients in comparison to healthy individuals. The study included 100 RA patients and 100 healthy individuals (50% were male in both groups). Handgrip strength was measured in both hands using a dynamometer. A two-way ANCOVA was used to analyse the data and age was included in the study as covariate. The results show that both male and female RA patients have lower handgrip strength compared to healthy individuals. The analysis of gender and disease interaction has shown that male RA patients have lower handgrip strength than female RA patients in comparison with the healthy group, age adjusted. This interaction is evident and statistically significant in both right hand (F 1, 195) = 14.62; p < 0.01) and left hand (F 1, 195) = 20.54; p < 0.01). The common-language effect size has shown that there is 92% (right hand) and 93% (left hand) chance that male individual will have stronger handgrip than his female counterpart. In RA patients, there is 77% chance for both hands that male will have stronger handgrip. Men and women with RA have significantly lower handgrip strength compared to healthy individuals and the difference is more pronounced in men which was not previously observed in the literature.

[Musculoskeletal ultrasound in rheumatology--current status and future perspectives]. / Muskuloskeletni ultrazvuk u reumatologiji--sadasnje stanje i potencijalna primjena u buducnosti.

In the last ten years we are whitnesses of fast development of ultrasound in rheumatology clinical practice and research. The main problem is general perception that US can be highly subjective. Since 2004 an international collaborative group of ultrasound experts known as the OMERACT Ultrasound Task Force has worked to address the metric qualities of ultrasound in RA and other arthritides, according to criteria specified by the OMERACT filter. The same group has worked since 2000 in the EULAR setting for promoting training and educational issues. Part of this group is now promoting the standardized use of ultrasound at a practical international level: the TUI initiative (Targeted ultrasound initiative). One of the main goals of TUI initiative is standardisation and formal assessment of musculoskeletal ultrasound.

[Role of diagnostic ultrasound in assessment of disease activity in rheumatoid arthritis]. / Dijagnosticki ultrazvuk u procjeni upalne aktivnosti u reumatoidnom artritisu.

Since biologics have been introduced for the treatment of rheumatoid arthritis a need for reliable imaging modality to assess treatment efficacy have been opened. In the last years through technological advances diagnostic ultrasound has become highly sensitive and specific method for detection of inflammatory and destructive changes in rheumatoid arthritis. Thus, high resolution ultrasound enhanced by power Doppler has been recognized in clinical studies and in every day work as useful method for assessment of disease activity. Here we give special interest in application of diagnostic ultrasound enhanced by power Doppler for assessment of inflammatory activity, therapeutic decision and monitoring to attain remission in rheumatoid arthritis patients.

[Late diagnosis of intraarticular osteoid osteoma treated as hip osteoarthritis--case report and review of the literature]. / Kasna dijagnoza intraartikularno smjestenog osteoid osteoma lijecenog kao osteoartritis kuka - prikaz bolesnika i pregled literature.

A 34-year old men with left hip pain caused by intraarticular osteoid osteoma localized in the left femoral head is described. He was treated as a hip osteoarthritis for one year before the accurate diagnosis was established. Magnetic resonance imaging showed lesion indicating osteoid osteoma. Accurate diagnosis was established based on typical appearance of the osteoid osteoma on the computed tomography (CT). Osteoid osteoma rarely occures after 30 years of age and intraarticular locallisation is uncommon. This case report pinpoints the importance of careful analysis of monoarticular pain in order to avoid the possibile misdiagnosis of osteoid osteoma especially in young adult with an isolated osteoarthritis feature on the conventional radiography and normal laboratory findings. CT is specific and sensitive imaging modality for diagnosis of osteoid osteoma.

[HLA-DRB1 gene distribution in Croatian arthritis patients]. / Raspodjela HLA-DRB1 gena u hrvatskih bolesnika s artritisom.

Genetic association between particular HLA-DRB1 genes and severity of rheumatoid arthritis (RA) has been documented in various clinical investigations. Susceptible alleles are *0401, *0404, *0405, *0408, *0101, *1001, *1402. According to the Shared epitope hypothesis presence of these alleles were considered as poor prognostic sign. The aim was to investigate HLA-DRB1 distribution in Croatian arthritis patients. Group of 90 patients with non-specific joint arthritis, non-erosive RA and erosive RA were typed for DRB1 alleles by PCR-SSP method. Susceptible alleles were identified in 58 (64.44 %) patients. The most frequent genes were DRB1 *0101 (43.33 %), *0401 (17.77 %), *0404 (10 %). 9 out of 58 DRB1* positive patients had 2 susceptible alleles, and the rest (49 patients) had only one susceptible allele. The patients with non-specific joint arthritis and non-erosive RA will bee closely followed for more destructive disease course in DRB1* positive patients.