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Synovium front cover

Issue 28 (Autumn 2009)

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After the controversial NICE back pain guidelines which led to a significant increase in comments to the Synovium mailbox we return to less contentious topics. In this issue we feature three of our favourite Cinderellas, subjects that get less attention than their prevalence and impact deserve – osteoarthritis of the knee, gout and chronic pain. The outlook for patients with chronic pain is particularly grim, as you will read below. One possible benefit, if the NICE guidelines are implemented, might be earlier and improved access to multidisciplinary interventions for this very needy group of patients. I do hope that doesn't sound like a campaign issue – campaigning is not in Synovium's remit!

Adrian Dunbar, Medical Editor

Knees up!

Knee pain is one of the commonest musculoskeletal symptoms presenting in primary care. Osteoarthritis of the knee joint is often (but not always) associated with knee pain. Obesity is a major risk factor for both knee pain and osteoarthritis of the knee.

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The summer of gout

In a study published in Annals of the Rheumatic Diseases surveillance data gathered by the Royal College of General Practitioners Research and Surveillance Centre in Birmingham was used to plot the incidence and prevalence of gout between 1994 and 2007.

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Allopurinol saves lives

It is known that hyperuricaemia and gout are associated with increased incidence of premature death largely due to cardiovascular disease. A recent study from the USA suggests that allopurinol may prevent this increased risk.

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Hand osteoarthritis and vascular disease

An interesting population-based study of ageing in the elderly population of Reykjavik has demonstrated that there is a positive and linear relationship between the severity of hand osteoarthritis and atherosclerotic disease.

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Pain – it puts years on you!

We have previously reported evidence indicating hat patients with chronic pain have increased risk of mortality with increased risk of cancer and cardiovascular disease. It gets worse.

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Beer up ladies!

A Spanish study involving 1697 healthy women found that those reporting regular beer consumption had higher bone densities than those who did not – or than those reporting wine consumption.

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