Arthritis Watch

CDC Releases New Data on Childhood Arthritis

A recent study from the Centers for Disease Control andPrevention (CDC) estimates that 294,000 US children underthe age of 18 have been diagnosed with arthritis or anotherrheumatologic condition.

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

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

Joint Problems Greater for Postmenopausal Women

Joint issues, including arthritis, may bea risk for postmenopausal women withbreast cancer who are receiving endocrinetreatment, reported researchers inthe September 2008 issue of The LancetOncology.

The researchers found that previoususe of hormone replacement therapy(HRT), hormone-receptor positivity, previouschemotherapy, obesity, and treatmentwith anastrozole (an aromataseinhibitor) all raised the odds of thesewomen developing joint problems. Theseincreased risks seem to be associatedwith a considerable drop in estrogenlevels the patients experience duringendocrine treatment.

The findings stem from a trial comparingthe use of either an aromatase inhibitoror tamoxifen in 9000 postmenopausalwomen with breast cancer. Joint symptomswere reported in 41% of womenwho had previously used HRT; 39% ofwomen who received chemotherapy alsoreported significantly more joint symptoms;and the more obese a woman wasthe more apt she had joint issues.

OA on the Rise

A new study, reported in the September 2008 issue of ArthritisCare & Research, found that 45% of adults will develop kneeosteoarthritis (OA)—painful arthritis of the knee. The findingsare based on data from 3068 individuals aged 45 and older inNorth Carolina.

For the study, the patients were interviewed and given anexamination that included x-ray images of the knee. The studyresults showed that obese individuals had a higher risk due tothe extra weight putting more stress on the knee joint. Whereas35% of normal weight individuals were diagnosed with OA ofthe knee, 65% of obese individuals developed it, along with 44%of overweight people.

"Simply put, people who keep their weight within the normalrange are much less likely to develop symptomatic kneeosteoarthritis as they get older, and thus much less likely toface the need for major surgical procedures such as kneereplacement surgery," said researcher Joanne Jordan, MD.

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

Updated Guidelinesfor Seasonal AllergiesAvailable

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

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

The parameter also introduces for the first time a classificationof episodic allergic rhinitis. Episodic cases are those thatare neither seasonal nor perennial, but rather those that aretriggered by sporadic exposure to an allergen and thereforerequire a modified treatment plan.

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