Rheumatology in practice - 2008

Comment: Recognising the burden of arthritis
Paul Emery
pp 3-3
Arthritis affects large numbers of people: more than 7.5 million people in England have the disease. The financial and operational burden on the NHS is substantial. The direct cost is £5.5 billion. Prescription costs are £34 million, and hip and knee replacements are £4–5 million. One in five of the adult population see their GP for arthritis or a related condition.

Osteoarthritis: ‘programming’ by the early environment
Susie Earl, Cyrus Cooper and Nigel Arden
pp 4-7
Osteoarthritis (OA) is the most common form of arthritis in Western populations. It is the single most important cause of disability in older adults. OA of the knee, the principal joint affected, is diagnosed in 10% of the UK population older than 55 and results in disabling knee symptoms for 10% of them.

What’s new in psoriasis?
Semina Seraj and Christopher T Ritchlin
pp 8-10
Psoriasis has been the subject of intense interest since it was first described in ancient times. While mild disease is quite common, a significant fraction of patients suffer from moderateto- severe skin involvement, which can have a profound negative impact on self-image and quality of life (QoL).

Exercise and arthritis
Zuzana de Jong, Jet Veldhuijzen van Zanten and George Kitas
pp 11-14
Rheumatoid arthritis (RA) is a chronic destructive disease, which classically involves small joints of the hands and feet. In long-standing disease, larger joints such as knees, hips, ankles, shoulders and elbows, as well as the internal organs (heart, lungs and kidneys) may become involved. Systemic symptoms may be prominently present and subsequently patients complain of lack of energy, tiredness and depressive feelings.

Case study: A rheumatological cause of dyspnoea in a young woman
Karen Douglas and George Kitas
pp 14-15
A 29-year-old student nurse was admitted with a rapid onset of breathlessness accompanied by central, non-radiating chest pain at rest. She denied any cough, productive sputum, haemoptysis or orthopnoea. She and her husband had joined a gym 18 months previously, and while he became fitter she became dyspnoeic. Her symptoms had accelerated rapidly in the past fortnight. Her weight was stable and she had no risk factors for venous thrombosis.

Connective tissue diseases: who and when to refer
Graham Hughes
pp 16-19
There are three major connective tissue diseases which are seen in every general practice. These are lupus, Sjögren’s syndrome and Hughes syndrome (the antiphospholipid syndrome).

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ISSN 1366-6541 (Print) ISSN 2052-3130 (Online)