CDC Releases New Data on Childhood Arthritis

A recent study from the Centers for Disease Control and Prevention (CDC) estimates that 294,000 US children under the age of 18 have been diagnosed with arthritis or another rheumatologic condition.

The new study provides for the first time a national data? based estimate of the number of children diagnosed with arthritis and related rheumatic conditions across the country and within each state. This creates a benchmark to measure future shifts in occurrence. For the research, the CDC along with other organizations began a review of options on how to estimate the number of children with arthritis and related conditions and also what conditions should be included.

In addition to providing these improved national estimates, the study also provides estimates for each state. The calculations of childhood arthritis?related diagnosis show a state-bystate range from 500 children in Wyoming to 38,000 children in California. Data also indicate that children diagnosed with arthritis and other rheumatologic conditions account for approximately 827,000 physician visits a year, including an average of 83,000 emergency department visits

Joint Problems Greater for Postmenopausal Women

Joint issues, including arthritis, may be a risk for postmenopausal women with breast cancer who are receiving endocrine treatment, reported researchers in the September 2008 issue of The Lancet Oncology.

The researchers found that previous use of hormone replacement therapy (HRT), hormone-receptor positivity, previous chemotherapy, obesity, and treatment with anastrozole (an aromatase inhibitor) all raised the odds of these women developing joint problems. These increased risks seem to be associated with a considerable drop in estrogen levels the patients experience during endocrine treatment.

The findings stem from a trial comparing the use of either an aromatase inhibitor or tamoxifen in 9000 postmenopausal women with breast cancer. Joint symptoms were reported in 41% of women who had previously used HRT; 39% of women who received chemotherapy also reported significantly more joint symptoms; and the more obese a woman was the more apt she had joint issues.

OA on the Rise

A new study, reported in the September 2008 issue of Arthritis Care & Research, found that 45% of adults will develop knee osteoarthritis (OA)—painful arthritis of the knee. The findings are based on data from 3068 individuals aged 45 and older in North Carolina.

For the study, the patients were interviewed and given an examination that included x-ray images of the knee. The study results showed that obese individuals had a higher risk due to the extra weight putting more stress on the knee joint. Whereas 35% of normal weight individuals were diagnosed with OA of the knee, 65% of obese individuals developed it, along with 44% of overweight people.

"Simply put, people who keep their weight within the normal range are much less likely to develop symptomatic knee osteoarthritis as they get older, and thus much less likely to face the need for major surgical procedures such as knee replacement surgery," said researcher Joanne Jordan, MD.

Furthermore, a report by an agency of the US Department of Health and Human Services showed that hospitalizations due to OA increased to 735,000 in 2006 from 322,000 in 1993, mostly attributed to an increase in knee replacement operations.

Updated Guidelines for Seasonal Allergies Available

"The Diagnosis and Management of Rhinitis: An Updated Practice Parameter"—the new guidelines for diagnosing and treating allergic rhinitis are now available for download at www.aaaai.org/professionals. The objective of the guidelines "is to improve the care of patients with all types of rhinitis, with an emphasis on allergic rhinitis," said Chief Editor Dana V. Wallace, MD, FAAAAI. Featured in the August 2008 issue of the Journal of Allergy and Clinical Immunology, the parameter offers discussion points on recent developments in the treatment of allergic rhinitis. They include:

• Recognize comorbidities, such as asthma, sinusitis, and sleep apnea, and testing pulmonary function in these patients
• Use of nonsedating antihistamines during pregnancy
• Medications released in the past 10 years

The parameter also introduces for the first time a classification of episodic allergic rhinitis. Episodic cases are those that are neither seasonal nor perennial, but rather those that are triggered by sporadic exposure to an allergen and therefore require a modified treatment plan.

F A S T   F A C T: One in 250 US children has some form of arthritis.