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joint stiffness in rheumatoid arthritis

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  • joint stiffness in rheumatoid arthritis

    I think I can resolve the issues raised by Mark Swanepol and Geoffrey
    Walsh. Our group found no apparent increase in joint stiffness in RA
    despite what the patients were telling us. I thought at the time that
    it might be perceived stiffness due to aberrant mechanoreceptor
    activity and I did in fact proceed to look at vibration thresholds
    (as a surrogate for proprioception) in this group - no abnormalities
    (Helliwell Clinical Rheumatology 1994 13:51-53).
    Measuring the passive mechanical properties of joints in vivo is
    complicated by the structures which impact on and control joint
    movement and about 50% of stiffness in the metacarpophalangeal joint
    at mid range is due to forearm muscles. Unfortunately muscular
    wasting occurs in RA (Helliwell Annals of Rheumatic Diseases 1994
    53:726-728) so that when comparing joint stiffness between RA and
    normals you have to correct for the decreased contribution of muscle
    - once this is done people with RA are found to have increased
    stiffness (Helliwell, Smeathers, Wright. Proc Institute Mech
    Engineers 1994 208:223-228). So joint stiffness in RA is not an
    enigma after all and it may be used to test the efficacy of
    treatments in this group (Helliwell Annals of Rheumatic Diseases
    1997 56:71-73). Incidentally a group from Holland looked at the
    relationship between weather and joint stiffness. They measured
    mechanical joint stiffness over aperiod of time and correlated
    changes with barometric pressure - see Rasker et al Scandinavian
    Journal of Rheumatology 1986 15:27-36.
    Philip Helliwell, Senior Lecturer in Rheumatology,
    Rheumatology and Rehabilitation Research Unit,
    36, Clarendon Road, LEEDS, LS2 9NZ, UK
    Tel: +44 113 2334935 Fax: +44 113 2445533

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