PubMed · 12981382
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F A SPELLMAN. 1952. Report on arthritis program.. https://pubmed.ncbi.nlm.nih.gov/12981382/
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In the past three decades, radiofrequency neurotomy (RFN) has been established as a safe and effective treatment for facet and sacroiliac arthropathy. However, early reports of deafferentation pain syndromes and motor deficit with the application of radiofrequency lesions to other neural structures effectively halted further development of this technology for other applications until recent years. Pulsed radiofrequency neurotomy (PRFN) represents the most recent advance in radiofrequency technology in clinical practice. PRFN allows for application of radiofrequency current at markedly lower tissue temperatures, thereby minimizing the risk of adverse events. The initial clinical data on PRFN demonstrate response rates similar to conventional high temperature RFN lesions for facet and sacroiliac arthropathy and a host of other chronic pain disorders.
PURPOSE OF REVIEW: Hemochromatosis is a common autosomal recessive condition characterized by increased iron absorption and tissue deposition. Recognition of this condition is important because phlebotomy can be life saving. This review examines recent studies of articular manifestations in hemochromatosis and the frequency of hemochromatosis genes in the general population and in selected patients with various types of arthritis. RECENT FINDINGS: Genetic mutations in the HFE gene are present in most patients with hemochromatosis. Several studies have shown a higher frequency of homozygous or heterozygous HFE mutations in individuals with various types of arthritis compared with unselected populations. Although important, the lack of characterization of arthritis in the controls of these studies limits their impact. One recent study compared arthritis symptoms in individuals with HFE mutations, newly identified through a large screening program, with individuals lacking such mutations from the same population. Individuals with hemochromatosis genotypes reported a higher frequency of some arthritis symptoms than did controls. Although these differences were not statistically significant, the low number of individuals with hemochromatosis genotypes limited the statistical power of this study. SUMMARY: Arthritis symptoms are common in individuals with hemochromatosis and can have a significant impact on their quality of life. Although the genetic defect associated with hemochromatosis is common in whites, the frequency with which these genotypes cause clinical disease remains unclear. More detailed study of arthritis symptoms and signs over time in individuals with and without mutations in the HFE gene is necessary to determine the contribution of HFE genes to arthritis in the population.
Measures of health-related quality of life, which assess patients' symptoms, their functioning, and their satisfaction with their health status, have received increased attention. Quality-of-life measures specifically developed for patients with rheumatoid arthritis and ankylosing spondylitis have been reported, and generic quality-of-life measures have been validated in patients with diverse rheumatic diseases. Although many studies have assessed the psychometric properties of health status measures, few studies have focused on the interpretation and meaning of questionnaire results. New measures should identify the unique role they occupy in patient assessment.