Knee pain

The miscellaneous drugp are used to treat a variety of musculoskeletal disorders. Ffenicillamine, methotrexate (MTX), and hydroxychloroquine are used to treat rheumatoid arthritis in patients who have had an insufficient therapeutic response to or are intolerant of other antirheumatic drugp such as the sailcylates and NSAIDs. The Summary Drug Table Drug s Used to Tream Musculoskeletal Disorders provides additional information about these and other drug s. One compound, hylan G-F 20, listed in the Summary Drug Table is not used for rheumatoid arthritis, but rather, for osteoarthritis knee pain. It is a viscous, elastic... 

Several formulations of hyaluronan are available for the treatment of knee pain in patients with OA who are unresponsive to other measures. Administration typically consists of... 

For knee OA, a patient must have knee pain and radiographic osteophytes in addition to one or more of the following (1) age greater than 50 years, (2) morning stiffness of 30 minutes or less duration, or (3) crepitus on motion, (4) bony enlargement, (6) bony tenderness, or (7) palpable joint warmth. 

A 17-year-old woman with cystic fibrosis is evaluated for knee pain. On review of systems, she also notes persistent bleeding from cuts in her skin and bleeding of her gums after brushing her teeth. Physical examination is remarkable for an obviously swollen right knee that is tender with limited range of motion. Fluid drained from the knee is bloody (hemarthrosis). Her complete blood count is normal, but prothrombin time is elevated. 

A 52-year-old woman with a history of eczema and heavy alcohol use begins taking ibuprofen to control hip and knee pain due to osteoarthritis. Over... 

Braham, B. Dawson, B. Goodman, C. The effect of glucosamine supplementation on people experiencing regular knee pain. Br. J. Sports Med. 2003, 57 (1), 45-55. 

Severe bone pain, previously reported in ciclosporin-treated patients (SED-14, 1291), also occurred as a possible consequence of tacrolimus treatment in a 50-year-old woman (86). Bilateral knee pain occurred within 2 months after renal transplantation and bone scintigraphy showed increased uptake in both knees. Calcitonin was ineffective, and she improved only after the dose of tacrolimus was reduced. 

Altman and Marcussen evaluated 247 patients with osteoarthritis and moderate to severe knee pain in a randomized, double-blind, placebo-controlled, multicenter, parallel-group, 6-week study. The results of their investigation revealed small but statistically insignificant benefits of ginger over placebo (6). 

Altman RD, Marcussen KC. Effects of ginger extract on knee pain in patients with osteoarthritis. Arthritis Rheum 2001 44(11) 2531-2538. 

Amin S, Niu J, Guermazi A, et al. Cigarette smoking and the risk for cartilage loss and knee pain in men with knee osteoarthritis. Ann Rheum Dis 2007 66(1) 18-22. 

One should not underestimate the power ol the placebo effect—that is, the tendency to perceive improvement in a subject who believes that he or she is receiving a potentially beneficial treatment. In a study of arthroscopic surgical treatment for knee pain, for example, subjects who were led to be-ieve that they had received surgery through the use of videotapes and other means showed the same level of improvement, on average, as subjects who were actually operated on. 

A recent randomized, placebo-controlled, double-blind study showed that intra-articular triamcinolone 40 mg every 3 months was superior to placebo in alleviating knee pain and stiffness due to OA... 

Slipped capital femoral epiphysis (SCFE)—Increased width of the femoral plate observed during GH treatment resulting in hip or knee pain. 

Example Advil 600 mg po q 6 h prm for mild to moderate knee pain. 

L9. Lohmander, L. S., Dahlberg, L., Eyre, D., Lark, M., Thonar, E. J., and Ryd, L., Longitudinal and cross-sectional variability in markers of joint metabolism in patients with knee pain and articular cartilage abnormafities. Osteoarthritis Cartilage 6,351-361... 

Cuendet, M. and Pezzuto, J.M., The role of cyclooxygenase and lipoxygenase in cancer chemoprevention. Drug Metabol Drug Interact, 2000 17(1 ) 109-157. Altman, R.D. and Marcussen, K.C., Effects of a ginger extract on knee pain in patients with osteoarthritis. Arthritis Rheum, 2001 Nov 44(ll) 2531-2538. 

Smith, A.J., Lloyd, D.G., and Wood, D.J., Pre-surgery knee joint loading patterns during walking predict the presence and severity of anterior knee pain after total knee arthroplasty, /. Orthop. Res., 22,260,2004. 

Jarvela T, Paakkala T, Kannus P et al (2004) Ultrasonographic and power Doppler evaluation of the patellar tendon ten years after harvesting its central third for reconstruction of the anterior cruciate ligament comparison of patients without or with anterior knee pain. Am J Sports Med 32(1) 39 6... 

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