An unusual case of weight loss in a patient with refractory rheumatoid arthritis.

We describe a case of metastatic malignant melanoma with no primary cutaneous lesion presenting as weight loss in a man with refractory, seropositive rheumatoid arthritis (RA). The patient had undergone multiple investigations previously and the case highlights the importance of repeat assessment in elderly patients presenting with unexplained weight loss.

Important determinants of self-efficacy in patients with chronic musculoskeletal pain.

Objective: To define the presenting characteristics of a population of patients with chronic musculoskeletal pain seen in a tertiary rheumatology clinic, and to investigate which factors are associated with self-efficacy in these patients.

Methods: Data were collected prospectively for 196 patients who attended the clinic for the first time between October 2000 and August 2002. The primary outcome measure was self-efficacy, measured using the Pain Self-Efficacy Questionnaire.