Association Between Self-Reported Spinal Morning Stiffness and Radiographic Evidence of Lumbar Disk Degeneration in Participants of the Cohort Hip and Cohort Knee (CHECK) Study.

Background: Low back pain (LBP) is very common and is a main cause of limited activity and work absence. Patients with LBP may also report spinal morning stiffness; this symptom could be useful for identifying subgroups with signs and symptoms related to spinal osteoarthritis.

Objective: This study investigated whether an association exists between reported spinal morning stiffness and radiographic evidence of lumbar disk degeneration (LDD) in people with LBP and a history of pain of the hip and/or knee.

Natural History of Back Pain in Older Adults over Five Years.

Introduction: Back pain is a prevalent health problem. Research often focuses on adults. Evidence on the long-term course of back pain in older patients is limited.

Prognostic factors for progression of osteoarthritis of the hip: a systematic review.

Background: Predicting which patients with hip osteoarthritis are more likely to show disease progression is important for healthcare professionals. Therefore, the aim of this review was to assess which factors are predictive of progression in patients with hip osteoarthritis.

Methods: A literature search was made up until 14 March 2019.

Predicting no return to sports after three months in patients with traumatic knee complaints in general practice by combining patient characteristics, trauma characteristics and knee complaints.

It remains unclear to what extent patients with traumatic knee complaints aged 18-45 years seen in general practice experience difficulties with return to sports. This study aims to determine the proportion of patients with a knee trauma that return to sports at six weeks and three months follow-up. Also examined were associations between no return to sports and baseline patient/trauma characteristics, knee complaints and MR (magnetic resonance) findings, as well as the additive value of MR findings.

Does MRI add value in general practice for patients with traumatic knee complaints? A 1-year randomised controlled trial.

Objective: To determine whether referral to MRI by the general practitioner (GP) is non-inferior to usual care (no access to MRI by GPs) in patients with traumatic knee complaints regarding knee-related daily function.

Methods: This was a multicentre, non-inferiority randomised controlled trial with 1-year follow-up. GPs invited eligible patients during or after their consultation.

Daily Pain Measurements and Retrospective Pain Measurements in Hip Osteoarthritis Patients With Intermittent Pain.

Objective: To examine the value of daily pain measurements in patients with hip osteoarthritis (OA), and whether the reliability of retrospective measurements was lower in patients with intermittent pain than in patients with more constant pain.

Methods: We used data from a randomized controlled trial that investigated the effectiveness of general practitioner care plus exercise therapy in 203 patients with hip OA. During the first 6 weeks, patients scored their pain each day.

The association between pro-inflammatory biomarkers and nonspecific low back pain: a systematic review.

Background Context: About 85% of the patients with low back pain seeking medical care have nonspecific low back pain (NsLBP), implying that no definitive cause can be identified. Nonspecific low back pain is defined as low back pain and disability which cannot be linked to an underlying pathology, such as cancer, spinal osteomyelitis, fracture, spinal stenosis, cauda equine, ankylosing spondylitis, and visceral-referred pain. Many pain conditions are linked with elevated serum levels of pro-inflammatory biomarkers.

Discontinuation of the PACE Plus trial: problems in patient recruitment in general practice.

Background: The PACE Plus trial was a multi-center, double-blinded, superiority randomized controlled trial (RCT) conducted in patients from Dutch general practice to investigate the efficacy of paracetamol and NSAIDs in acute non-specific low back pain (LBP). Because insufficient numbers of patients could be recruited (only four out of the required 800 patients could be recruited over a period of 6 months), the trial was prematurely terminated in February 2017, 6 months after the start of recruitment. This article aims to transparently communicate the discontinuation of PACE Plus and to make recommendations for future studies.

General Practitioners Referring Adults to MR Imaging for Knee Pain: A Randomized Controlled Trial to Assess Cost-effectiveness.

Purpose To determine the cost-effectiveness of early referral by the general practitioner for magnetic resonance (MR) imaging compared with usual care alone in patients aged 18-45 years with traumatic knee symptoms. Materials and Methods Cost-utility analysis was performed parallel to a prospective multicenter randomized controlled trial in Dutch general practice. A total of 356 patients with traumatic knee symptoms were included from November 2012 to December 2015 (mean age, 33 years ± 8 [standard deviation]; 222 men [62%]).

No association between low bone quality and back pain in older adults: A cohort study.

Background: It is unclear whether bone quality associates with severity and prognosis of back pain.

Objectives: To investigate the association between bone quality and back pain severity at baseline, and whether low bone quality is a prognostic factor for persistent back pain in patients aged over 55 years at 1-year follow-up.

Methods: In this prospective cohort study persistent back pain was defined as a decrease in the back pain severity score of less than 30% at 1-year follow-up compared with baseline score or as a back pain severity score greater than 1 (0-10: 0 = no pain) Low bone quality was categorized as a T-score, calculated using a stiffness index by quantitative ultrasound of the heel, of 2.

Intramuscular glucocorticoid injection versus placebo injection in hip osteoarthritis: a 12-week blinded randomised controlled trial.

Objectives: Guidelines recommend intra-articular glucocorticoid injection in patients with painful hip osteoarthritis. However, intra-articular hip injection is an invasive procedure. The efficacy of systemic glucocorticoid treatment for pain reduction in hip osteoarthritis is unknown.

Post-traumatic knee MRI findings and associations with patient, trauma, and clinical characteristics: a subgroup analysis in primary care in the Netherlands.

Background: The added value of magnetic resonance imaging (MRI) in primary care is still being debated. A high diagnostic yield can be expected in young and active patients with post-traumatic knee complaints.

Aim: To determine the frequency of MRI abnormalities in young and active patients (aged 18-45 years) and the associations with patient, trauma, and clinical characteristics.

Discontinuation of a randomised controlled trial in general practice due to unsuccessful patient recruitment.

Background: A randomised controlled trial (RCT) in general practice, recruiting incident patients with (sub)acute sciatica, was discontinued because of insufficient recruitment.

Aim: To describe factors that influenced the recruitment process and ultimately led to discontinuation of this trial, and to enable others to learn from this experience.

Design & Setting: A pragmatic RCT was designed to compare two pain medication prescription strategies for treatment of (sub)acute sciatica in general practice.

Effectiveness and cost-effectiveness of duloxetine added to usual care for patients with chronic pain due to hip or knee osteoarthritis: protocol of a pragmatic open-label cluster randomised trial (the DUO trial).

Introduction: Osteoarthritis (OA) is a highly prevalent painful condition of the musculoskeletal system. The effectiveness of current analgesic options has proven to be limited and improved analgesic treatment is needed. Several randomised placebo-controlled trials have now demonstrated the efficacy of duloxetine, an antidepressant with a centrally acting effect, in the treatment of OA pain.

The Association Between Self-reported Low Back Pain and Radiographic Lumbar Disc Degeneration of the Cohort Hip and Cohort Knee (CHECK) Study.

Study Design: Cross-sectional study, nested in a prospective cohort (Cohort Hip and Knee, CHECK).

Objective: Low back pain (LBP) is very common and the main cause of activity limitations and work absence throughout the world. Although lumbar disc degeneration (LDD) is suggested as a cause of LBP, this association remains debatable.

Efficacy of paracetamol, diclofenac and advice for acute low back pain in general practice: design of a randomized controlled trial (PACE Plus).

Background: Low back pain is common and associated with a considerable burden to patients and society. There is uncertainty regarding the relative benefit of paracetamol and diclofenac and regarding the additional effect of pain medication compared with advice only in patients with acute low back pain. This trial will assess the effectiveness of paracetamol, diclofenac and placebo for acute low back pain over a period of 4 weeks.

Back Complaints in the Elders in Brazil and the Netherlands: a cross-sectional comparison.

Background: although back pain is most prevalent in older adults, there is a paucity of studies investigating back pain in older people. Our objective was to characterize and compare Brazilian and Dutch older adults presenting to primary care with a new episode of back pain. We also aimed to investigate whether socio-demographic characteristics were associated with pain severity and disability.

Knee osteoarthritis in traumatic knee symptoms in general practice: 6-year cohort study.

Aim: To identify degenerative knee abnormalities using MRI and radiography 6 years after knee trauma, their relation with persistent knee symptoms and baseline prognostic factors.

Methods: Adults (18-65 years) with incident traumatic knee symptoms visiting their general practitioner were followed up for 6 years and underwent baseline MRI and 6-year follow-up MRI and radiography. Logistic regression was used to analyse associations between various degenerative abnormalities on 6-year MRI and radiography, persistent knee symptoms and baseline prognostic factors for knee osteoarthritis (OA) on 6-year MRI.

Defining trajectories in older adults with back pain presenting in general practice.

Background: although back pain is a frequently recurring disorder, the course of back pain remains uncertain. Therefore, this study aimed to identify different trajectories in older adults with back pain who presented in general practice and to determine which baseline characteristics are associated with these trajectories.

Methods: the BACE study is a prospective cohort study including 675 patients (aged >55 years) with back pain who consulted a general practitioner; patients were followed for 3 years.

Management of Symptomatic Cervical Disk Herniation: A Survey Among Dutch Neurosurgeons.

Study Design: A questionnaire survey.

Objective: To assess the preferred surgical technique, the optimal timing of surgery, and the expectations of different surgical techniques of neurosurgeons in the Netherlands, regarding patients with cervical disc herniation (CDH).

Summary Of Background Data: To treat CDH, multiple surgical techniques are performed.

Effectiveness of exercise therapy for meniscal lesions in adults: A systematic review and meta-analysis.

Objectives: This study evaluated the effectiveness of exercise therapy in patients with meniscal lesions.

Design: Systematic review and meta-analysis.

Methods: Nine databases were searched up to July 2015, including EMBASE and Medline OvidSP.

The added prognostic value of MRI findings for recovery in patients with low back pain in primary care: a 1-year follow-up cohort study.

Purpose: Information on the prognostic value of MRI findings in low back pain patients in primary care is lacking. The objective of this study is to investigate the added prognostic value of baseline MRI findings over known prognostic factors for recovery at 12-month follow-up in patients with low back pain referred to MRI by their general practitioner.

Methods: Patients referred by their general practitioner for MRI of the lumbar spine were recruited at the MRI Center.

Prevalence of spinal pathology in patients presenting for lumbar MRI as referred from general practice.

Background: The use of magnetic resonance imaging (MRI) as initial imaging for back pain has increased in general practice. However, few data are available on the characteristics of these referred patients. The objective of this study was to describe the baseline characteristics and MRI findings of patients presenting for a lumbar MRI examination as referred by their GP.

Six-year course and prognosis of traumatic knee symptoms in general practice: Cohort study.

Background: Traumatic knee symptoms are frequently seen, however, evidence about the course and prognostic factors are scarce.

Objectives: To describe the one and six-year course of traumatic knee symptoms presenting in general practice, and to identify prognostic factors for persistent knee symptoms.

Methods: Adolescents (≥12 years) and adults with traumatic knee symptoms (n = 328) from general practice were followed for six years with self-report questionnaires and physical examination.