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Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies01:22

Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies

The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...

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Preliminary Study on Acupuncture Combined with Grain-sized Moxibustion for Treating Rheumatoid Arthritis with Finger Joint Pain
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Patient-reported outcomes in polymyalgia rheumatica.

Eric L Matteson1, Hilal Maradit-Kremers, Marco A Cimmino

  • 1Department of Internal Medicine, Division of Rheumatology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. matteson.eric@mayo.edu

The Journal of Rheumatology
|March 17, 2012
PubMed
Summary

Patient-reported outcomes and inflammatory markers effectively track polymyalgia rheumatica (PMR) disease activity. A core set of pain, function, and inflammatory measures is recommended for clinical practice and trials.

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Area of Science:

  • Rheumatology
  • Clinical Medicine
  • Outcome Measurement

Background:

  • Polymyalgia rheumatica (PMR) is a common inflammatory condition affecting older adults.
  • Assessing disease activity and treatment response in PMR is crucial for effective management.
  • Standardized outcome measures are needed to evaluate disease course and treatment efficacy.

Purpose of the Study:

  • To prospectively evaluate the disease course in new-onset polymyalgia rheumatica (PMR).
  • To assess the performance of clinical, patient-reported outcome (PRO), and musculoskeletal ultrasound measures in PMR.
  • To identify optimal outcome measures for clinical practice and trials in PMR.

Main Methods:

  • Prospective study of 85 new-onset PMR patients treated with gradually tapered prednisone.
  • Data collection included physical exams, inflammatory markers (CRP/ESR), and PRO measures (VAS).
  • Musculoskeletal ultrasound was performed at baseline and 26 weeks; treatment response defined as 70% VAS improvement.

Main Results:

  • At baseline, 77% reported hip pain, and 100% had elevated inflammatory markers.
  • Ultrasound revealed shoulder findings in 84% and hip/shoulder findings in 32%.
  • 73% achieved treatment response by week 4, correlated with other VAS improvements; baseline ultrasound findings predicted response.

Conclusions:

  • Patient-reported outcome (PRO) measures and inflammatory markers are effective for assessing PMR disease activity.
  • A core set of outcome measures including PROs for pain/function and an inflammatory marker is recommended.
  • These measures can enhance clinical practice and improve the design of PMR clinical trials.