[Rheumatology emergencies in general practice].

In rheumatology there may occur emergencies especially in the field of inflammable diseases, the sudden occlusion of the central retinal artery in temporal arteritis as an example. Such incidents are rare. The general practitioner is more often confronted with not necessarily threatening, but very painful and function obstructing acute cases.

Spondylodiscitis caused by viridans streptococci: three cases and a review of the literature.

Three cases of spondylodiscitis caused by viridans streptococci were observed within the course of 1 month. Although streptococci have been reported as the third most frequent cause of spondylodiscitis after staphylococci and gram-negative bacteria, alpha-haemolytic streptococci are rarely seen. The three patients presented with symptoms of low back pain; they felt well and did not have a fever or chills.

Longitudinal study of Lyme borreliosis in a high risk population in Switzerland.

Orienteers from all parts of Switzerland (n = 416) were included in a longitudinal study for Lyme borreliosis. In spring 1986, the seroprevalence was 28.1%.

Longterm survey (7 years) in a population at risk for Lyme borreliosis: what happens to the seropositive individuals?

In 1986, a 26% seroprevalence of IgG- anti-Borrelia burgdorferi antibodies was observed among 950 orienteers and the incidence of new clinical infections was 0.8%. In 1993, a total of 305 seropositive orienteers were reexamined.

Diffuse idiopathic skeletal hyperostosis (DISH) of the elbow: a cause of elbow pain? A controlled study.

Elbow pain is a common complaint and elbow hyperostosis a frequent radiological condition. However, little is known about the association between the clinical and radiological findings. To evaluate the relationship between spinal and extraspinal hyperostotic features and the clinical relevance of elbow hyperostosis we have performed the first controlled, double-blinded study of 85 hospitalized probands, 33 with and 52 without thoracospinal hyperostosis on lateral chest X-ray.

Diet and fatty acids: can fish substitute for fish oil?

As fish oil has been shown to be beneficial in rheumatoid arthritis and in psoriasis, we examined whether a diet rich in fish has a similar effect on membrane and plasma lipids as a dietary fish oil supplement. Volunteers recruited by 2 rheumatology units in Switzerland formed three parallel groups eating respective diets during 2 months: a normal diet without fish; a normal diet including 700 g fish per week; a normal diet without fish but with additional fish oil (7.5 g daily).

The prevalence and incidence of clinical and asymptomatic Lyme borreliosis in a population at risk.

A past history of clinical Lyme borreliosis and the 6-month incidence of clinical and asymptomatic Lyme borreliosis was studied prospectively in a high-risk population. In the spring, blood samples were drawn from 950 Swiss orienteers, who also answered a questionnaire. IgG anti-Borrelia burgdorferi antibodies were detected by ELISA.

Diffuse idiopathic skeletal hyperostosis (DISH) of the shoulder: a cause of shoulder pain?

Shoulder pain is a common complaint and shoulder hyperostosis a frequent radiological condition. However, little is known about the association between the clinical and radiological findings. To evaluate the clinical relevance of shoulder hyperostosis we performed a controlled, blind study of 99 hospitalized probands with and without thoracospinal hyperostosis on lateral chest X-rays.

Pelvic manifestations of diffuse idiopathic skeletal hyperostosis (DISH): are they clinically relevant?

This is a cross-sectional, case-controlled study on the clinical relevance of diffuse idiopathic skeletal hyperostosis (DISH) in relation to the pelvic girdle. Thirty-two rheumatology patients with DISH were compared with 35 dermatology control subjects in respect to the clinical parameters pain and passive hip joint motion in a standardized manner. There were no significant differences between the two groups, indicating no major clinical relevance of DISH in the pelvic region.

Knee effusion and reflex inhibition of the quadriceps. A bar to effective retraining.

In order to investigate the difficulty of quadriceps training in the presence of an effusion into the knee we examined 13 patients with chronic effusions by recording isometric muscle strength. Maximal strength was markedly lower in the presence of an effusion, and aspiration of the effusion produced a 13.6% increase in strength (p less than 0.

[Pelvic and skeletal hyperostosis (diffuse idiopathic skeletal hyperostosis, Forestier disease)].

Diffuse idiopathic skeletal hyperostosis (DISH) is characterized by, among other things, spinal and extraspinal manifestations. Two studies on the prevalence and clinical significance of hyperostotic spurs and ectopic ossifications in the pelvic area are presented. Spinal DISH seems to be a risk factor for the development of ectopic ossification, particularly in the postoperative course after total hip arthroplasty.

Ectopic ossification following total hip arthroplasty: is diffuse idiopathic skeletal hyperostosis a risk factor?

Total hip arthroplasty may be followed by ectopic bone formation. An increased frequency has been suspected in patients with diffuse idiopathic skeletal hyperostosis (DISH). In 204 patients we found that, of the 38 subjects with pre-existing DISH, 29% developed postoperative ossification compared with only 10% in those without DISH (p less than 0.

Dysphagia caused by diffuse idiopathic skeletal hyperostosis.

Diffuse idiopathic skeletal hyperostosis (DISH) of the spine is often a hazardous radiological finding. Dysphagia, caused by ossification of the anterior longitudinal ligament, may be one of the most important clinical symptoms disturbing the patient. Diagnosis is done by esophagogram, and cervical decompression restores esophageal function.

[Prevalence of Lyme borreliosis in a Swiss population at risk].

The epidemiology of "Lyme borreliosis" in Europe and the significance of positive antibody titers against Borrelia burgdorferi is not well known. Since "orienteering", a competitive cross country sport with a map and a compass, usually in forests, elevates the risk of being bitten by ticks and infected by B. burgdorferi, nearly 1000 orienteerers were included in a prospective study.

Occurrence of spinal pain syndromes in a group of apparently healthy and physically fit sportsmen (orienteers).

The prevalence of three spine-related pain syndromes was assessed in 739 apparently healthy leisure-time sportsmen (orienteers). The three syndromes were (i) low back pain or stiffness, (ii) thoracic inter-scapular back pain or stiffness, and (iii) frontal chest pain or discomfort. The mean age of the sportsmen was 32.

[Reasonable and unreasonable indications for physiotherapy of the locomotor system].

The wide variety of techniques currently available in physiotherapy may appear confusing to the prescribing physician who must select methods which are both of proven efficiency and economical. A primary requisite is knowledge of the aims and possibilities of physiotherapy, thus allowing a decision as to whether or not physiotherapy is in fact indicated. Two examples, "thermotherapy" and "back school", demonstrate how, with minimum investment of time and expense, patients can be taught effective measures for the treatment and prevention of certain pain syndromes of the locomotor system.