Smoking has an adverse effect on disease progression in patients with RA. An association was also observed between smoking and those RF types that predispose to RA and have the highest diagnostic specificity for this disease.
Objectives-To study the impact of articular hypermobility on the clinical and radiological features of hand osteoarthritis (OA) and to investigate whether hand osteoarthritis associated with hypermobility should be considered a separate subset of hand OA. and nine (p < 0-001) respectively. Patients with hypermobility features were characterised clinically and radiologically by fewer and less severely involved interphalangeal joints. Radiologically, two fairly distinct subsets could be identified: Severe interphalangeal OA in which the prevalence of hypermobility was similar to controls, and patients with predominant involvement of the first carpometacarpal joint (CMC 1), most of whom had evidence of hypermobility. Conclusion-A causal relation exists between articular hypermobility and development of thumb base OA, and hypermobility associated hand OA constitutes a definite clinical and radiological subset of hand OA. In the clinical setting, the easily applied hypermobility criterion of passive dorsiflexion ofthe fifth finger >900 is useful in identifying most patients with hand OA and hypermobility. (Ann Rheum Dis 1996; 55: 540-543) Osteoarthritis (OA) is a very heterogeneous condition, representing a common pathway from many causes. It is likely that further understanding of the pathophysiological mechanisms of OA will lead to a division into definite subsets.
MethodsBenign articular hypermobility has been implicated in the development of OA, particularly of spine and knee joints, 1-3 and we have recently shown that articular hypermobility is related to the severity and disability of clinical thumb base OA in a mixed group of patients with hand OA.4
Intraarticular ganglion cysts arising from the cruciate ligaments are rare. Only 9 cases have been described in the literature (2, 4-6, 8-10, 13, 14). Only in one case was the diagnosis suggested before operation by the appearance on MR imaging (4). We report a case of a patient presenting with a bone erosion in the proximal tibial epiphysis caused by an intraarticular ganglion cyst arising from the anterior cruciate ligament.
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