Arthritis http://www.hindawi.com The latest articles from Hindawi Publishing Corporation © 2014 , Hindawi Publishing Corporation . All rights reserved. Progression of Gene Expression Changes following a Mechanical Injury to Articular Cartilage as a Model of Early Stage Osteoarthritis Sun, 16 Nov 2014 09:25:59 +0000 http://www.hindawi.com/journals/arthritis/2014/371426/ An impact injury model of early stage osteoarthritis (OA) progression was developed using a mechanical insult to an articular cartilage surface to evaluate differential gene expression changes over time and treatment. Porcine patellae with intact cartilage surfaces were randomized to one of three treatments: nonimpacted control, axial impaction (2000 N), or a shear impaction (500 N axial, with tangential displacement to induce shear forces). After impact, the patellae were returned to culture for 0, 3, 7, or 14 days. At the appropriate time point, RNA was extracted from full-thickness cartilage slices at the impact site. Quantitative real-time PCR was used to evaluate differential gene expression for 18 OA related genes from four categories: cartilage matrix, degradative enzymes and inhibitors, inflammatory response and signaling, and cell apoptosis. The shear impacted specimens were compared to the axial impacted specimens and showed that shear specimens more highly expressed type I collagen (Col1a1) at the early time points. In addition, there was generally elevated expression of degradative enzymes, inflammatory response genes, and apoptosis markers at the early time points. These changes suggest that the more physiologically relevant shear loading may initially be more damaging to the cartilage and induces more repair efforts after loading. R. S. McCulloch, M. S. Ashwell, C. Maltecca, A. T. O'Nan, and P. L. Mente Copyright © 2014 R. S. McCulloch et al. All rights reserved. Evaluation of Antiarthritic Potential of Methanolic Extract of Gentiana kurroo Royle Thu, 06 Nov 2014 11:45:38 +0000 http://www.hindawi.com/journals/arthritis/2014/810615/ Rheumatoid arthritis is a systemic disorder which involves the activation of immune system against the self-tissues. The main targets of this disease are the joints. Being systemic the development of this disease involves different mechanisms and thus the exact cause of this disease remains unknown. Although different drugs have been developed, none has been found to be the cure for this disease. In the current study the rat carrageenin paw was used as a model for acute inflammation and mycobacterium induced adjuvant arthritic model was used for exploring the antiarthritic potential of methanolic extract of Gentiana kurroo. In this study the different extracts tested showed less inhibition of acute inflammation than methanolic extract. The methanolic extract was further used in different doses and the anti-inflammatory efficacy was found to be dose dependent. The results obtained were significant with the control and the standard groups. In the arthritic model the methanolic extract showed decrease in the paw volume of arthritic animals and also in the arthritic symptoms. Again the results obtained were found to be significantly dose dependent. From the results obtained it can be concluded that this extract may serve as a source of drug against the rheumatoid arthritis. Khan Mubashir, Bashir A. Ganai, Khalid Ghazanfar, and Seema Akbar Copyright © 2014 Khan Mubashir et al. All rights reserved. Short Term Recovery of Function following Total Knee Arthroplasty: A Randomised Study of the Medial Parapatellar and Midvastus Approaches Wed, 01 Oct 2014 00:00:00 +0000 http://www.hindawi.com/journals/arthritis/2014/173857/ This pilot double blind randomised controlled study aimed to investigate whether the midvastus (MV) approach without patellar eversion in total knee arthroplasty (TKA) resulted in improved recovery of function compared to the medial parapatellar (MP) approach. Patients were randomly allocated to either the MV approach or the MP approach. Achievements of inpatient mobility milestones were recorded. Knee kinematics, muscle strength, Timed Up and Go, WOMAC, and daily step count were assessed before and up to six months after surgery. Cohen’s effect size was calculated to inform the sample size in future trials. Twenty-eight participants (16 males, 12 females) participated. Patient mobility milestones such as straight leg raise were achieved on average 1.3 days (95% CI −3.4 to 0.7, ) earlier in the MV group. Knee extensor strength at 6 weeks after surgery was higher (95% CI −0.38 to 0.61, ) in the MV group. No trends for differences between the groups were observed in knee kinematics, TUG, WOMAC, or step count. Our results suggest a short term advantage in the first 6 weeks after surgery of the MV approach over the MP approach, but a larger study is required to confirm these findings. This trial is registered with NCT056445. Richard W. Nutton, Frazer A. Wade, Fiona J. Coutts, and Marietta L. van der Linden Copyright © 2014 Richard W. Nutton et al. All rights reserved. Psychometric Properties of the 8-Item English Arthritis Self-Efficacy Scale in a Diverse Sample Thu, 21 Aug 2014 11:13:13 +0000 http://www.hindawi.com/journals/arthritis/2014/385256/ Arthritis self-efficacy is important for successful disease management. This study examined psychometric properties of the 8-item English version of the Arthritis Self-Efficacy Scale (ASES-8) and differences in ASES-8 scores across sample subgroups. In 401 participants with self-reported doctor-diagnosed arthritis, exploratory factor analysis and tests of internal consistency were conducted. Concurrent validity was examined by associating ASES-8 scores with disease-specific, psychosocial, functional, and behavioral measures expected to be related to arthritis self-efficacy. All analyses were conducted for the full sample and within subgroups (gender, race, age, education, and weight status). Exploratory factor analysis for the entire sample and in all 12 subgroups demonstrated a one factor solution (factor loadings: 0.61 to 0.89). Internal consistency was high for measures of Cronbach’s alpha (0.87 to 0.94), omega (0.87 to 0.93), and greatest lower bound (0.90 to 0.95). ASES-8 scores were significantly correlated with all measures assessed , demonstrating concurrent validity. Those with a high school education or greater had higher ASES-8 scores than those with less than a high school education ; no other subgroup differences were found. The ASES-8 is a valid and reliable tool to measure arthritis self-efficacy efficiently and thereby reduce participant burden in research studies. Sara Wilcox, Danielle E. Schoffman, Marsha Dowda, and Patricia A. Sharpe Copyright © 2014 Sara Wilcox et al. All rights reserved. Individual and Community Socioeconomic Status: Impact on Mental Health in Individuals with Arthritis Mon, 04 Aug 2014 00:00:00 +0000 http://www.hindawi.com/journals/arthritis/2014/256498/ To examine the impact of individual and community socioeconomic status (SES) measures on mental health outcomes in individuals with arthritis, participants with self-reported arthritis completed a telephone survey assessing health status, health attitudes and beliefs, and sociodemographic variables. Regression analyses adjusting for race, gender, BMI, comorbidities, and age were performed to determine the impact of individual and community level SES on mental health outcomes (i.e., Medical Outcomes Study SF-12v2 mental health component, the Centers for Disease Control and Prevention Health-Related Quality of Life Healthy Days Measure, Center for Epidemiological Studies Depression [CES-D] scale). When entered singly, lower education and income, nonmanagerial occupation, non-homeownership, and medium and high community poverty were all significantly associated with poorer mental health outcomes. Income, however, was more strongly associated with the outcomes in comparison to the other SES variables. In a model including all SES measures simultaneously, income was significantly associated with each outcome variable. Lower levels of individual and community SES showed most consistent statistical significance in association with CES-D scores. Results suggest that both individual and community level SES are associated with mental health status in people with arthritis. It is imperative to consider how interventions focused on multilevel SES factors may influence existing disparities. Chivon A. Mingo, Kathryn R. Martin, Jack Shreffler, Britta Schoster, and Leigh F. Callahan Copyright © 2014 Chivon A. Mingo et al. All rights reserved. Zingiber officinale: A Potential Plant against Rheumatoid Arthritis Tue, 27 May 2014 06:18:17 +0000 http://www.hindawi.com/journals/arthritis/2014/159089/ Rheumatoid arthritis (RA) is an autoimmune disease particularly affecting elderly people which leads to massive bone destruction with consequent inflammation, pain, and debility. Allopathic medicine can provide only symptomatic relief. However, Zingiber officinale is a plant belonging to the Zingiberaceae family, which has traditionally been used for treatment of RA in alternative medicines of many countries. Many of the phytochemical constituents of the rhizomes of this plant have therapeutic benefits including amelioration of RA. This review attempts to list those phytochemical constituents with their reported mechanisms of action. It is concluded that these phytochemicals can form the basis of discovery of new drugs, which not only can provide symptomatic relief but also may provide total relief from RA by stopping RA-induced bone destruction. As the development of RA is a complex process, further research should be continued towards elucidating the molecular details leading to RA and drugs that can stop or reverse these processes by phytoconstituents of ginger. Abdullah Al-Nahain, Rownak Jahan, and Mohammed Rahmatullah Copyright © 2014 Abdullah Al-Nahain et al. All rights reserved. Weight Status and Differences in Mobility Performance, Pain Symptoms, and Physical Activity in Older, Knee Osteoarthritis Patients Sun, 25 May 2014 12:57:52 +0000 http://www.hindawi.com/journals/arthritis/2014/375909/ Knee osteoarthritis (OA) is a leading cause of functional disability among American adults. Obesity is a strong independent risk factor for OA. While research emphasizes the role of obesity in the OA-physical function relationship, the extent to which weight status impacts salient physical, health, and pain measures in older, knee OA patients is not well delineated. The primary aim of this study was to assess differences in mobility performance (stair climb and 400-meter walk), mobility-related self-efficacy, pain symptoms (WOMAC), and measures of accelerometer-determined physical activity (PA) as a function of weight status. Analysis of covariance was conducted to examine differences on the dependent variables. Obese class III patients were outperformed by their counterparts on nearly every measure of mobility, mobility-related self-efficacy, and the assessment of pain symptoms. These outcomes did not differ among other weight comparisons. Normal weight subjects outperformed classes I, II, and III counterparts on most measures of PA (engagement in moderate or greater PA and total weekly steps). Additionally, overweight participants outperformed obese class II participants and obese class I participants outperformed obese classes II and III participants on total weekly steps. Collectively, these findings underscore the meaningful differences observed in relevant OA outcomes as a function of increasing levels of body weight. Matthew J. Garver, Brian C. Focht, Justin Dials, Mark Rose, Alexander R. Lucas, Steven T. Devor, Charles F. Emery, Kevin V. Hackshaw, and W. Jack Rejeski Copyright © 2014 Matthew J. Garver et al. All rights reserved. Fibroblast-Like Synoviocytes Induce Calcium Mineral Formation and Deposition Tue, 20 May 2014 12:37:22 +0000 http://www.hindawi.com/journals/arthritis/2014/812678/ Calcium crystals are present in the synovial fluid of 65%–100% patients with osteoarthritis (OA) and 20%–39% patients with rheumatoid arthritis (RA). This study sought to investigate the role of fibroblast-like synoviocytes (FLSs) in calcium mineral formation. We found that numerous genes classified in the biomineral formation process, including bone gamma-carboxyglutamate (gla) protein/osteocalcin, runt-related transcription factor 2, ankylosis progressive homolog, and parathyroid hormone-like hormone, were differentially expressed in the OA and RA FLSs. Calcium deposits were detected in FLSs cultured in regular medium in the presence of ATP and FLSs cultured in chondrogenesis medium in the absence of ATP. More calcium minerals were deposited in the cultures of OA FLSs than in the cultures of RA FLSs. Examination of the micromass stained with nonaqueous alcoholic eosin indicated the presence of birefringent crystals. Phosphocitrate inhibited the OA FLSs-mediated calcium mineral deposition. These findings together suggest that OA FLSs are not passive bystanders but are active players in the pathological calcification process occurring in OA and that potential calcification stimuli for OA FLSs-mediated calcium deposition include ATP and certain unidentified differentiation-inducing factor(s). The OA FLSs-mediated pathological calcification process is a valid target for the development of disease-modifying drug for OA therapy. Yubo Sun, David R. Mauerhan, Atiya M. Franklin, Natalia Zinchenko, Harry James Norton, Edward N. Hanley Jr., and Helen E. Gruber Copyright © 2014 Yubo Sun et al. All rights reserved. Quantitative Gait Analysis Detects Significant Differences in Movement between Osteoarthritic and Nonosteoarthritic Guinea Pig Strains before and after Treatment with Flunixin Meglumine Mon, 19 May 2014 07:21:29 +0000 http://www.hindawi.com/journals/arthritis/2014/503519/ A computer-aided gait analysis system was used to contrast two guinea pig strains with differing propensity for osteoarthritis (OA), with/without administration of a nonsteroidal anti-inflammatory drug. Walking speed and static/dynamic gait parameters were determined at baseline. Flunixin meglumine was given and animals were evaluated 4, 24, and 72 hours after treatment. Body weight was compared using unpaired -tests. Knee joints were histologically evaluated using species-specific criteria; indices were analyzed using one-way ANOVA, Kruskal-Wallis test, followed by Dunn’s multiple comparisons. A generalized linear model followed by Tukey’s posttests juxtaposed gait parameters; walking speed was a covariate for other outcome measures. Body weight was not different between strains; OA-prone animals demonstrated more progressive chondropathy. At baseline, OA-prone animals had slower walking speeds, narrower hind limb bases of support, shorter stride lengths, and slower limb swing speeds relative to OA-resistant animals. These differences were not detected 4 or 24 hours after treatment. By 72 hours, OA-prone animals had returned to baseline values. These findings indicate a distinct voluntary gait pattern in a rodent model of bilateral primary OA, modification of which may allow rapid screening of novel therapies. Flunixin meglumine temporarily permitted OA-prone animals to move in a manner that was analogous to OA-resistant animals. K. S. Santangelo, A. C. Kaeding, S. A. Baker, and A. L. Bertone Copyright © 2014 K. S. Santangelo et al. All rights reserved. Treatment of Nongout Joint Deposition Diseases: An Update Thu, 08 May 2014 12:44:44 +0000 http://www.hindawi.com/journals/arthritis/2014/375202/ This update develops the actual therapeutic options in the management of the joint involvement of calcium pyrophosphate deposition disease (CPPD), basic calcium phosphate (BCP) deposition disease, hemochromatosis (HH), ochronosis, oxalosis, and Wilson’s disease. Conventional pharmaceutical treatment provides benefits for most diseases. Anti-interleukine-1 (IL-1) treatment could provide similar results in CPPD than in gout flares. There is only limited evidence about the efficacy of preventive long-term colchicine intake, methotrexate, and hydroxychloroquine in chronic CPPD. Needle aspiration and lavage have satisfactory short and midterm results in BCP. Extracorporeal shockwave therapy has also proved its efficacy for high-doses regimes. Phlebotomy does not seem to have shown real efficacy on joint involvement in HH so far. Iron chelators’ effects have not been assessed on joint involvement either, while IL-1 blockade may prove useful. NSAIDs have limited efficacy on joint involvement of oxalosis, while colchicine and steroids have not been assessed either. The use of nitisinone for ochronotic arthropathy is still much debated, but it could provide beneficial effects on joint involvement. The effects of copper chelators have not been assessed either in the joint involvement of Wilson’s disease. NSAIDs should be avoided because of the liver affection they may worsen. Tristan Pascart, Pascal Richette, and René-Marc Flipo Copyright © 2014 Tristan Pascart et al. All rights reserved. Productivity Improvements in Hip and Knee Surgery Thu, 20 Feb 2014 07:48:11 +0000 http://www.hindawi.com/journals/arthritis/2014/615784/ Productivity improvements that occur as technologies become widely used are not well documented. This study measured secular trends over 1998–2010 in productivity of hip and knee procedures gauged in terms of changes in physical function and pain after versus before surgery. We used data from the Health and Retirement Study. Health outcomes from surgery were measured by 6 physical functioning scales and 2 pain indicators. We used propensity score matching to obtain nonsurgery control groups. Not only were there substantial improvements in physical functioning and pain reduction after receipt of these procedures in all years, but also we documented improvements in health outcomes over time. Largest improvements were for reductions in numbers of Activity and Instrumental Activity of Daily Living limitations for knee procedures. Frank A. Sloan, Linda K. George, and Linyan Hu Copyright © 2014 Frank A. Sloan et al. All rights reserved. A Technique of Predicting Radiographic Joint Line and Posterior Femoral Condylar Offset of the Knee Tue, 11 Feb 2014 09:17:58 +0000 http://www.hindawi.com/journals/arthritis/2014/121069/ Purpose. To describe a reliable method of predicting native joint line and posterior condylar offset (PCO) using true lateral digital radiographs of the distal femur. Methods. PCO was measured relative to a line drawn parallel to the posterior cortex of the distal femur and the joint line was measured from the posterior condylar flare to the articular surface. A ratio was then calculated for these measurements relative to the width of the femur at the level of the flare. Two independent observers measured PCO and joint line ratio for 105 radiographs of the different knees and one repeated these measurements after one week. Results. There was a significant correlation between the width of the femoral diaphysis at the level of the posterior condylar flare with joint line () and PCO (). Joint line and PCO could be predicted within 4 mm and 2 mm, respectively, using the identified ratio between the width of the femoral diaphysis at the level of the posterior condylar flare with measured joint line and PCO. The inter- () and intra- () observer reliability for these ratios were high. Conclusion. These ratios could be used to predict the native joint line and PCO. Nicholas D. Clement, David F. Hamilton, and Richard Burnett Copyright © 2014 Nicholas D. Clement et al. All rights reserved. Glucosamine for Osteoarthritis: Biological Effects, Clinical Efficacy, and Safety on Glucose Metabolism Tue, 11 Feb 2014 00:00:00 +0000 http://www.hindawi.com/journals/arthritis/2014/432463/ Osteoarthritis is a chronic degenerative disorder that currently represents one of the main causes of disability within the elderly population and an important presenting complaint overall. The pathophysiologic basis of osteoarthritis entails a complex group of interactions among biochemical and mechanical factors that have been better characterized in light of a recent spike in research on the subject. This has led to an ongoing search for ideal therapeutic management schemes for these patients, where glucosamine is one of the most frequently used alternatives worldwide due to their chondroprotective properties and their long-term effects. Its use in the treatment of osteoarthritis is well established; yet despite being considered effective by many research groups, controversy surrounds their true effectiveness. This situation stems from several methodological aspects which hinder appropriate data analysis and comparison in this context, particularly regarding objectives and target variables. Similar difficulties surround the assessment of the potential ability of glucosamine formulations to alter glucose metabolism. Nevertheless, evidence supporting diabetogenesis by glucosamine remains scarce in humans, and to date, this association should be considered only a theoretical possibility. Juan Salazar, Luis Bello, Mervin Chávez, Roberto Añez, Joselyn Rojas, and Valmore Bermúdez Copyright © 2014 Juan Salazar et al. All rights reserved. The Good Life: Assessing the Relative Importance of Physical, Psychological, and Self-Efficacy Statuses on Quality of Well-Being in Osteoarthritis Patients Wed, 25 Dec 2013 16:01:13 +0000 http://www.hindawi.com/journals/arthritis/2013/914216/ Background and Purpose. The purpose of the present study was to examine the interrelationships among physical dysfunction, self-efficacy, psychological distress, exercise, and quality of well-being for people with osteoarthritis. It was predicted that exercise would mediate the relationships between physical dysfunction, self-efficacy, psychological distress, and quality of well-being. Methods. Participants were 363 individuals with osteoarthritis who were 60 years of age or older. Data were collected from the baseline assessment period prior to participating in a social support and education intervention. A series of structural equation models was used to test the predicted relationships among the variables. Results. Exercise did not predict quality of well-being and was not related to self-efficacy or psychological distress; it was significantly related to physical dysfunction. When exercise was removed from the model, quality of life was significantly related to self-efficacy, physical dysfunction, and psychological distress. Conclusions. Engagement in exercise was directly related to physical functioning, but none of the other latent variables. Alternatively, treatment focused on self-efficacy and psychological distress might be the most effective way to improve quality of well-being. Charles Van Liew, Maya S. Santoro, Arielle K. Chalfant, Soujanya Gade, Danielle L. Casteel, Mitsuo Tomita, and Terry A. Cronan Copyright © 2013 Charles Van Liew et al. All rights reserved. Application of a Simple In-House PCR-SSP Technique for HLA-B* 27 Typing in Spondyloarthritis Patients Thu, 19 Dec 2013 13:42:28 +0000 http://www.hindawi.com/journals/arthritis/2013/504109/ Background. Microlymphocytotoxicity (MLCT) and flowcytometry (FC) are the conventional serological methods to detect HLA-B* 27. Due to some disadvantages in these methods, most of the HLA laboratories have now switched over to molecular methods. Molecular techniques based on commercial kits are expensive; as such many laboratories with limited funds in developing countries cannot afford these techniques. Aims. Our main aim was to standardize a simple inexpensive in-house PCR-SSP technique for HLA-B* 27 typing. Materials and Methods. Sequence Specific primers were designed to amplify all the subtypes of B* 27 using IMGT-HLA sequence database. Accuracy was checked by retyping of 90 PCR-SSOP typed controls. Results. The presence of 149 bp specific band with control band on 2% agarose gel showed B* 27 positivity. No discrepancies were found when compared with PCR-SSOP results. The frequency of HLA-B* 27 was found to be significantly increased (68.75% versus 4.40%, O.R 46.909: value ) among 700 SpA patients as compared to controls. Clinically, 54% of patients had polyarticular arthritis with SI joints involvement (68%) and restricted spine flexion (60%). Conclusion. In-house PCR-SSP technique is very simple and inexpensive technique to detect B* 27 allele, which was strongly associated with SpA patients from Western India. Devraj J. Parasannanavar, Anjali Rajadhyaksha, and Kanjaksha Ghosh Copyright © 2013 Devraj J. Parasannanavar et al. All rights reserved. Association of Body Mass Index with Physical Function and Health-Related Quality of Life in Adults with Arthritis Thu, 12 Dec 2013 11:49:12 +0000 http://www.hindawi.com/journals/arthritis/2013/190868/ Arthritis and obesity, both highly prevalent, contribute greatly to the burden of disability in US adults. We examined whether body mass index (BMI) was associated with physical function and health-related quality of life (HRQOL) measures among adults with arthritis and other rheumatic conditions. We assessed objectively measured BMI and physical functioning (six-minute walk, chair stand, seated reach, walking velocity, hand grip) and self-reported HRQOL (depression, stiffness, pain, fatigue, disability, quality of life-mental, and quality of life, physical) were assessed. Self-reported age, gender, race, physical activity, and arthritis medication use (covariates) were also assessed. Unadjusted and adjusted linear regression models examined the association between BMI and objective measures of functioning and self-reported measures of HRQOL. BMI was significantly associated with all functional () and HRQOL measures () in the unadjusted models. Associations between BMI and all functional measures () and most HRQOL measures remained significant in the adjusted models (); depression and quality of life, physical, were not significant. The present analysis of a range of HRQOL and objective measures of physical function demonstrates the debilitating effects of the combination of overweight and arthritis and other rheumatic conditions. Future research should focus on developing effective group and self-management programs for weight loss for people with arthritis and other rheumatic conditions (registered on clinicaltrials.gov: NCT01172327). Danielle E. Schoffman, Sara Wilcox, and Meghan Baruth Copyright © 2013 Danielle E. Schoffman et al. All rights reserved. Capillaroscopy in Psoriatic and Rheumatoid Arthritis: A Useful Tool for Differential Diagnosis Thu, 12 Dec 2013 11:22:43 +0000 http://www.hindawi.com/journals/arthritis/2013/957480/ Impairment of capillaries permeability and changes of microcirculation are associated with inflammatory arthritis. In order to demonstrate microvascular differences between psoriatic arthritis (PsA) and rheumatoid arthritis (RA) we analyzed capillaroscopic abnormalities such as megacapillaries, haemorrhages, ramifications, and avascular areas in patients affected by these two rheumatic disorders. Moreover to identify specific capillaroscopy patterns we analyzed the following parameters: venous limb diameter, arterial limb diameter, capillary loop diameter, amplitude of the capillary loop, linear density of capillaries (on 2 mm), and number of twisted capillaries (on 4 mm). Through a comparative morphometric analysis of capillaroscopy, our study demonstrated the presence of specific microvascular differences between PsA and RA providing an additional diagnostic tool for the differential diagnosis. We also suggest that capillaries structural abnormalities might reflect endothelial injury due to systemic inflammation during chronic arthritis. Dario Graceffa, Beatrice Amorosi, Elisa Maiani, Claudio Bonifati, Maria Sole Chimenti, Roberto Perricone, and Aldo Di Carlo Copyright © 2013 Dario Graceffa et al. All rights reserved. Defects in Tendon, Ligament, and Enthesis in Response to Genetic Alterations in Key Proteoglycans and Glycoproteins: A Review Sun, 10 Nov 2013 13:31:19 +0000 http://www.hindawi.com/journals/arthritis/2013/154812/ This review summarizes the genetic alterations and knockdown approaches published in the literature to assess the role of key proteoglycans and glycoproteins in the structural development, function, and repair of tendon, ligament, and enthesis. The information was collected from (i) genetically altered mice, (ii) in vitro knockdown studies, (iii) genetic variants predisposition to injury, and (iv) human genetic diseases. The genes reviewed are for small leucine-rich proteoglycans (lumican, fibromodulin, biglycan, decorin, and asporin); dermatan sulfate epimerase (Dse) that alters structure of glycosaminoglycan and hence the function of small leucine-rich proteoglycans by converting glucuronic to iduronic acid; matricellular proteins (thrombospondin 2, secreted phosphoprotein 1 (Spp1), secreted protein acidic and rich in cysteine (Sparc), periostin, and tenascin X) including human tenascin C variants; and others, such as tenomodulin, leukocyte cell derived chemotaxin 1 (chondromodulin-I, ChM-I), CD44 antigen (Cd44), lubricin (Prg4), and aggrecan degrading gene, a disintegrin-like and metallopeptidase (reprolysin type) with thrombospondin type 1 motif, 5 (Adamts5). Understanding these genes represents drug targets for disrupting pathological mechanisms that lead to tendinopathy, ligamentopathy, enthesopathy, enthesitis and tendon/ligament injury, that is, osteoarthritis and ankylosing spondylitis. Subhash C. Juneja and Christian Veillette Copyright © 2013 Subhash C. Juneja and Christian Veillette. All rights reserved. Association of Self-Efficacy and Outcome Expectations with Physical Activity in Adults with Arthritis Thu, 24 Oct 2013 11:14:11 +0000 http://www.hindawi.com/journals/arthritis/2013/621396/ Background and Purpose. The purpose of this study is to determine whether higher baseline levels of (a) self-efficacy for physical activity, (b) self-efficacy for arthritis self-management, and (c) outcome expectations for exercise are associated with higher physical activity levels following an exercise intervention for adults with arthritis. Methods. A secondary analysis of the intervention cohort () within a randomized controlled trial of the People with Arthritis Can Exercise program was performed. Multiple linear regression evaluated the relationship between physical activity at a time point three months after the completion of an exercise intervention and three main explanatory variables. Results. After controlling for baseline physical activity, neither self-efficacy for arthritis self-management nor outcome expectations for exercise related to three-month physical activity levels. There was a relationship between three-month physical activity and self-efficacy for physical activity. Conclusions. Future research is needed to evaluate the ability of self-efficacy-enhancing programs to increase physical activity in adults with arthritis. Thelma J. Mielenz, Kathryn L. Kubiak-Rizzone, Kimberly J. Alvarez, Patrick R. Hlavacek, Janet K. Freburger, Carol Giuliani, Vicki S. Mercer, and Leigh F. Callahan Copyright © 2013 Thelma J. Mielenz et al. All rights reserved. Physical Functioning, Perceived Disability, and Depressive Symptoms in Adults with Arthritis Thu, 05 Sep 2013 08:41:01 +0000 http://www.hindawi.com/journals/arthritis/2013/525761/ This study investigated how physical functioning and perceived disability are related to depressive symptoms in adults with arthritis (). Participants self-reported depressive symptoms and disability. Objective measures of physical functioning included the 30-second chair stand test, 6-minute walk test, gait speed, balance, grip strength, and the seated reach test. Separate quantile regression models tested associations between each functional measure and depressive symptoms, controlling for age, gender, race, BMI, self-reported health status, and arthritis medication use. The association between perceived disability and depressive symptoms was also tested. Participants averaged years; 85.8% were women; 64.3% were white. Lower distance in the 6-minute walk test, fewer chair stands, slower gait speed, and greater perceived disability were associated with greater depressive symptoms in unadjusted models (). Fewer chair stands and greater perceived disability were associated with more depressive symptoms in adjusted models (). Balance, grip strength, and seated reach were not related to depressive symptoms. The perception of being disabled was more strongly associated with depressive symptoms than reduced physical functioning. To reduce the risk of depression in arthritic populations, it may be critical to not only address physical symptoms but also to emphasize coping skills and arthritis self-efficacy. Katie Becofsky, Meghan Baruth, and Sara Wilcox Copyright © 2013 Katie Becofsky et al. All rights reserved. Diagnosis and Progression of Sacroiliitis in Repeated Sacroiliac Joint Computed Tomography Tue, 03 Sep 2013 09:12:19 +0000 http://www.hindawi.com/journals/arthritis/2013/659487/ Objective. To assess the clinical utility of repeat sacroiliac joint computed tomography (CT) in sacroiliitis by assessing the proportion of patients changing from normal to pathologic at CT and to which degree there is progression of established sacroiliitis at repeat CT. Methods. In a retrospective analysis of 334 patients (median age 34 years) with symptoms suggestive of inflammatory back pain, CT had been performed twice, in 47 of these thrice, and in eight patients four times. The studies were scored as normal, equivocal, unilateral sacroiliitis, or bilateral sacroiliitis. Results. There was no change in 331 of 389 repeat examinations. Ten patients (3.0%) had progressed from normal or equivocal to unilateral or bilateral sacroiliitis. Of 43 cases with sacroiliitis on the first study, 36 (83.7%) progressed markedly. Two normal cases had changed to equivocal. Eight equivocal cases were classified as normal on the repeat study. In further two patients, only small changes within the scoring grade equivocal were detected. Conclusions. CT is a valuable examination for diagnosis of sacroiliitis, but a repeated examination detects only a few additional cases of sacroiliitis. Most cases with already established sacroiliitis showed progression of disease. Mats Geijer, Gro Gadeholt Göthlin, and Jan H. Göthlin Copyright © 2013 Mats Geijer et al. All rights reserved. No Association between FCγR3B Copy Number Variation and Susceptibility to Biopsy-Proven Giant Cell Arteritis Tue, 20 Aug 2013 10:47:27 +0000 http://www.hindawi.com/journals/arthritis/2013/514914/ Objective. To determine the relationship between FCGR3B gene copy number variation (CNV) and biopsy proven giant cell arteritis (GCA). Methods. FCGR3B CNV was determined in 139 Australian biopsy proven GCA patients and 162 population matched controls, using a duplex qPCR assay and RNase P as the reference gene. Copy number was determined using Copy Caller software (v.1.0, Applied Biosystems, USA). CNV genotypes were classified into 3 groups (<2, 2, 3+) for analysis purposes, and analysis was performed using logistic regression. Results. All GCA patients had a positive temporal artery biopsy, and the most common presenting symptoms were visual disturbance and temporal headache. The mean age of patients at biopsy was 74 years (range 51–94) and 88/139 (63%) were female. The frequency of low (<2) FCGR3B copy number was comparable between GCA patients (%) and controls (%), as was the frequency of high (3+) FCGR3B copy number (15/130 (10.8%) in GCA patients versus 13/162 (8.0%) in controls). Overall there was no evidence that FCGR3B CNV frequencies differed between GCA patients and controls (, , ). Conclusion. FCGR3B CNV is not associated with GCA; however, replicate studies are required. Emma Dunstan, Sue Lester, Rachel Black, Maureen Rischmueller, Helen Chan, Alex W. Hewitt, and Catherine L. Hill Copyright © 2013 Emma Dunstan et al. All rights reserved. Differences in Mammalian Target of Rapamycin Gene Expression in the Peripheral Blood and Articular Cartilages of Osteoarthritic Patients and Disease Activity Tue, 25 Jun 2013 10:40:05 +0000 http://www.hindawi.com/journals/arthritis/2013/461486/ The gene expression of mTOR, autophagy-related ULK1, caspase 3, CDK-inhibitor p21, and TNFα was measured in the peripheral blood of osteoarthritic (OA) patients at different stages of the disease aiming to establish a gene expression profile that might indicate the activity of the disease and joint destruction. Whole blood of 65 OA outpatients, 27 end-stage OA patients, 27 healthy volunteers, and knee articular cartilages of 28 end-stage OA patients and 26 healthy subjects were examined. OA outpatients were subjected to clinical testing, ultrasonography, and radiographic and WOMAC scoring. Protein levels of p70-S6K, p21, and caspase 3 were quantified by ELISA. Gene expression was measured using real-time RT-PCR. Upregulation of mTOR gene expression was observed in PBMCs of 42 OA outpatients (“High mTOR expression subset”) and in PBMCs and articular cartilages of all end-stage OA patients. A positive correlation between mTOR gene expression in PBMCs and cartilage was observed in the end-stage OA patients. 23 OA outpatients in the “Low mTOR expression subset” exhibited significantly lower mTOR gene expression in PBMCs compared to healthy controls. These “Low mTOR” subset subjects experienced significantly more pain upon walking, and standing and increased total joint stiffness versus “High mTOR” subset, while the latter more often exhibited synovitis. The protein concentrations of p70-S6K, p21, and caspase 3 in PBMCs were significantly lower in the “Low” subset versus “High” subset and end-stage subjects. Increases in the expression of mTOR in PBMCs of OA patients are related to disease activity, being associated with synovitis more than with pain. Elena V. Tchetina, A. Robin Poole, Elena M. Zaitseva, Eugeniya P. Sharapova, Natalya G. Kashevarova, Elena A. Taskina, Liudmila I. Alekseeva, Liudmila A. Semyonova, Svetlana I. Glukhova, Alexandr N. Kuzin, Maxim A. Makarov, and Sergey A. Makarov Copyright © 2013 Elena V. Tchetina et al. All rights reserved. Retrospective Cohort Study of the Prevalence of Lumbosacral Transitional Vertebra in a Wide and Well-Represented Population Mon, 24 Jun 2013 11:37:02 +0000 http://www.hindawi.com/journals/arthritis/2013/461425/ Purpose. The aim of this study is to determine the prevalence of lumbosacral transitional vertebra (LSTV) in a well-represented general population. Methods. For a retrospective cohort study, abdominal radiographs of adult subjects were queried with clear visibility of the vertebral body articulation of the last rib, all lumbar transverse processes, and complete sacral wings. Exclusion criteria included any radiologic evidence of previous lumbosacral surgery that would block our view. A total of 6200 abdominal films were reviewed, and 3607 were identified as being suitable for the measurement of the desired parameters. Results. A total of 3607 subjects were identified as eligible for the study, and 683 (18.9%) were classified as positive for a lumbosacral transitional vertebra. The prevalence of sacralization and lumbarization was found as 17.2% and 1.7%, respectively. The average age at the time of the study was years (18–86 years). Conclusions. As a result of different opinions, LSTV retains its controversial status. Our prevalence study of the general population will provide assistance for resolution of the controversy. Prevalence studies of the general population with a wide participation will shed light on comparative studies. Demet Uçar, Bekir Yavuz Uçar, Yahya Coşar, Kurtuluş Emrem, Gürkan Gümüşsuyu, Serhat Mutlu, Burcu Mutlu, Mehmet Akif Çaçan, Yılmaz Mertsoy, and Hatice Gümüş Copyright © 2013 Demet Uçar et al. All rights reserved. Primary and Posttraumatic Arthritis of the Elbow Mon, 27 May 2013 14:16:07 +0000 http://www.hindawi.com/journals/arthritis/2013/473259/ Whether degenerative joint disease of the elbow may be the result of primary or posttraumatic etiologies, arthritis of the elbow commonly leads to pain, loss of motion, and functional disability. A detailed history and focused physical examination, in combination with imaging modalities, can help localize the origin of symptoms and help direct treatment. Although nonoperative treatment is the initial therapy for arthritis of the elbow, surgical interventions may provide substantial relief to the appropriately selected patient. Debdut Biswas, Robert W. Wysocki, and Mark S. Cohen Copyright © 2013 Debdut Biswas et al. All rights reserved. Determination of the Diagnostic Values of Asymmetric Dimethylarginine as an Indicator for Evaluation of the Endothelial Dysfunction in Patients with Rheumatoid Arthritis Wed, 15 May 2013 13:51:51 +0000 http://www.hindawi.com/journals/arthritis/2013/818037/ Introduction. To compare the diagnostic values of laboratory variables, to present evaluations of the diagnostic test for asymmetric dimethyl arginine (ADMA), rheumatoid factor (RF), C-reactive protein (CRP), and DAS28 index, and to define the effect of untreated rheumatoid arthritis on endothelial function. In order to determine whether ADMA changes depending on the disease evolution, ADMA was used as an indicator for endothelial dysfunction. Methods. Using an ELISA technology of DLD-Diagnostika-GMBH for the detection of ADMA, the samples of serum and urine have been examined in 70 participants (35 RA who were not treated, 35 healthy controls). RF was defined with the test for agglutination (Latex RF test) in the same participants. Results. Out of 35 examined patients with RA, RF appeared in 17 patients (sensitivity of the test, 51.42%). In 20 of the 35 examined patients with RA, we found the presence of ADMA (sensitivity of the test, 57.14%). Anti-CCP antibody was present in 24 examined patients with RA (sensitivity of the test, 68.57%). Conclusion. ADMA has equal or very similar sensitivity and specificity to RF in untreated RA (sensitivity of 57.14% versus 48.57%, specificity of 88.57% versus 91.42%) in the detection of asymptomatic endothelial dysfunction in untreated RA. Dejan Spasovski, Arif Latifi, Bashkim Osmani, Svetlana Krstevska-Balkanov, Irena Kafedizska, Maja Slaninka-Micevska, Beti Dejanova, Sonja Alabakovska, and Trajan Balkanov Copyright © 2013 Dejan Spasovski et al. All rights reserved. Rheumatoid Arthritis in Minorities Tue, 14 May 2013 11:18:53 +0000 http://www.hindawi.com/journals/arthritis/2013/256493/ Juan-Manuel Anaya, Adriana Rojas-Villarraga, Rubén Darío Mantilla, and Claudio Galarza-Maldonado Copyright © 2013 Juan-Manuel Anaya et al. All rights reserved. Comment on “The Effects of Bariatric Surgery Weight Loss on Knee Pain in Patients with Osteoarthritis of the Knee” Wed, 24 Apr 2013 16:12:18 +0000 http://www.hindawi.com/journals/arthritis/2013/517803/ Janice Lin, Manish Parikh, and Jonathan Samuels Copyright © 2013 Janice Lin et al. All rights reserved. Two Single-Nucleotide Polymorphisms in ADAM12 Gene Are Associated with Early and Late Radiographic Knee Osteoarthritis in Estonian Population Thu, 28 Mar 2013 13:56:40 +0000 http://www.hindawi.com/journals/arthritis/2013/878126/ Objectives. To investigate associations of selected single-nucleotide polymorphisms (SNPs) in ADAM12 gene with radiographic knee osteoarthritis (rKOA) in Estonian population. Methods. The rs3740199, rs1871054, rs1278279, and rs1044122 SNPs in ADAM12 gene were genotyped in 438 subjects (303 women) from population-based cohort, aged 32 to 57 (mean 45.4). The rKOA features were evaluated in the tibiofemoral joint (TFJ) and patellofemoral joint. Results. The early rKOA was found in 51.4% of investigated subjects (72% women) and 12.3% of participants (63% women) had advanced stage of diseases. The A allele of synonymous SNP rs1044122 was associated with early rKOA in TFJ, predominantly with the presence of osteophytes in females (OR 1.57; 95% CI 1.08–2.29, ). The C allele of intron polymorphism rs1871054 carried risk for advanced rKOA, mostly to osteophyte formation in TFJ in males (OR 3.03; 95% CI 1.11–7.53, ). Also the CCAA haplotype of ADAM12 was associated with osteophytosis, again mostly in TFJ in males (). For rs3740199 and rs1278279, no statistically significant associations were observed. Conclusion.  ADAM12 gene variants are related to rKOA risk during the early and late stages of diseases. The genetic risk seems to be predominantly associated with the appearance of osteophytes—a marker of bone remodelling and neochondrogenesis. Irina Kerna, Kalle Kisand, Ann E. Tamm, Jaanika Kumm, and Agu O. Tamm Copyright © 2013 Irina Kerna et al. All rights reserved. Imaging Appearances in Gout Mon, 25 Mar 2013 13:34:55 +0000 http://www.hindawi.com/journals/arthritis/2013/673401/ Gout is an ancient disease. Last decade has brought about significant advancement in imaging technology and real scientific growth in the understanding of the pathophysiology of gout, leading to the availability of multiple effective noninvasive diagnostic imaging options for gout and treatment options fighting inflammation and controlling urate levels. Despite this, gout is still being sub-optimally treated, often by nonspecialists. Increased awareness of optimal treatment options and an increasing role of ultrasound and dual energy computed tomography (DECT) in the diagnosis and management of gout are expected to transform the management of gout and limit its morbidity. DECT gives an accurate assessment of the distribution of the deposited monosodium urate (MSU) crystals in gout and quantifies them. The presence of a combination of the ultrasound findings of an effusion, tophus, erosion and the double contour sign in conjunction with clinical presentation may be able to obviate the need for intervention and joint aspiration in a certain case population for the diagnosis of gout. The purpose of this paper is to review imaging appearances of gout and its clinical applications. Gandikota Girish, David M. Melville, Gurjit S. Kaeley, Catherine J. Brandon, Janak R. Goyal, Jon A. Jacobson, and David A. Jamadar Copyright © 2013 Gandikota Girish et al. All rights reserved.