Objectives: Morning stiffness (MS) is characteristic of RA and associates with markers of systemic and local inflammation in RA patients. In patients with arthralgia, MS is a cardinal symptom to recognize arthralgia at-risk for RA development [i.e. clinically suspect arthralgia (CSA)]. In CSA, MS is also assumed to reflect inflammation, but this has never been studied. Therefore we aimed to study whether MS in CSA patients is associated with systemic and subclinical joint inflammation.
Methods: A total of 575 patients presenting with CSA underwent laboratory investigations and contrast-enhanced 1.5 T MRI of the hand and forefoot (scored according to the Rheumatoid Arthritis MRI Score method). Associations of MS (duration ≥60 min) with the presence of subclinical joint inflammation (synovitis, tenosynovitis and osteitis) and increased CRP (≥5 mg/l) were determined with logistic regression. Additionally, the effect of MS duration (≥30, ≥60 and ≥120 min) was studied.
Results: A total of 195 (34%) CSA patients experienced MS. These patients more often had subclinical synovitis [34% vs 21%; odds ratio (OR) 1.95 (95% CI 1.32, 2.87)], subclinical tenosynovitis [36% vs 26%; OR 1.59 (95% CI 1.10, 2.31)] and increased CRP [31% vs 19%; OR 1.93 (95% CI 1.30, 2.88)] than patients without MS. In multivariable analyses, subclinical synovitis [OR 1.77 (95% CI 1.16, 2.69)] and CRP [OR 1.78 (95% CI 1.17-2.69)] remained independently associated with MS. In CSA patients who later developed RA, and thus in retrospect were 'pre-RA' at the time of CSA, MS was more strongly associated with subclinical synovitis [OR 2.56 (95% CI 1.04, 6.52)] and CRP [OR 3.86 (95% CI 1.45, 10.24)]. Furthermore, associations increased with longer MS durations.
Conclusion: Inflammation associates with MS in the CSA phase that preceded clinical arthritis. These results increase our understanding of MS when assessing arthralgia in clinical practice.
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http://dx.doi.org/10.1093/rheumatology/keab651 | DOI Listing |
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Swine coccidiosis is a host-specific protozoan disease caused by Cystoisospora suis and various Eimeria species, leading to diarrhea or subclinical signs in pigs. In this study, 3296 fecal samples from 55 farms across six provinces in China were collected and examined to determine the prevalence and molecular characteristics of swine coccidia. The single oocyst isolation technique (SOIT) and molecular characterization identified nine coccidian species, with an overall infection prevalence of 13.
View Article and Find Full Text PDFJ Oral Facial Pain Headache
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Department of Experimental Dentistry, Wroclaw Medical University, 50-425 Wroclaw, Poland.
Temporomandibular disorders (TMD) comprise a group of conditions affecting the masticatory muscles, the temporomandibular joints and associated structures, often manifesting as orofacial pain and functional limitations of the mandible. Central sensitization (CS) is gaining increasing attention in research focused on pain syndromes and somatization, playing a significant role in the pain experience. This study investigates the prevalence of CS and somatization among TMD patients, analyzing their relationships with TMD diagnoses and the intensity of chronic masticatory muscle pain (MMP).
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