Ideal for shoulder surgeons who want to upgrade their skills to the next level, this practical, step-by-step text presents the latest cutting-edge management strategies and science aimed at shoulder preservation surgery. Highlighting four main areas - the overhead athlete, shoulder instability, glenohumeral arthritis, and the rotator cuff - these innovative techniques focus on the maintenance of the native shoulder joint. Chapters open with an introduction to the clinical problem, followed by misgivings related to open surgery or arthroplasty as treatment strategies. A rationale for the arthroscopic treatment is then presented, along with an in-depth description of the technique itself as well as preliminary results. Techniques presented include posterior capsule release for the overhead athlete, arthroscopic Latarjet for instability, the CAM procedure for glenohumeral arthritis, biological augmentation for rotator cuff repair. A fifth section covers post-operative care and return-to-play considerations. With contributions from many of the top thinkers and surgeons of the shoulder, Elite Techniques in Shoulder Arthroscopy brings these exciting new management strategies to the fore with the aim of elevating them to more common practice for orthopedic surgeons and sports medicine specialists.

This volume is a state-of-the art resource on the recent advances and clinical management of NSAIDs and aspirin. The text provides a thorough overview of NSAIDS and aspirin, reviewing such topics as pharmacology and mechanisms, clinical effects, and the safety and efficacy of these drugs. It also focuses on the effect of the drugs on the cardiovascular system and in the prevention of GI cancer. Practical recommendations for a safe prescription of NSAIDs are also included. Written by experts in the field, NSAIDs and Aspirin: Recent Advances and Implications for Clinical Management is a comprehensive text of great value to gastroenterologists, rheumatologists, cardiologists, oncologists, orthopedists, trauma and internal medicine specialists.

Rheumatology in Practice offers chapters which are organised and built around anatomical and regional syndromes, so reinforcing the evidence-based approach. As readers progress through the text they are given more demanding and challenging questions, encouraging them to use their diagnostic skills to identify the main syndromes and the underlying diseases responsible for the disorders in question. The text is lavishly illustrated in full colour, with detailed photos of patient examinations, complemented by radiographs and full colour line illustrations. The text also benefits from the use of summaries using coloured boxing to identify key points in diagnosis and management. Written by two of the most respected clinicians in the discipline, this book will be essential reading for rheumatologists in practice and training.

Recent research, which Bone- Metabolic Function and Modulators expands on, has added new support to the idea that bone not only serves as a support system, but also functions as an integrating organ, with a significant regulatory role for lipid and energy metabolism. Links between physical activity and the skeleton are also becoming increasingly clear. This fully illustrated volume contains up-to-date information on the metabolic role of the skeleton and what this can mean for the treatment of metabolic as well as skeletal and auditory diseases. Bone- Metabolic Function and Modulators is of particular interest to clinician scientists, clinical and basic bone researchers, orthopedists, endocrinologists, internists, dentists, nurse practitioners, medical and dental residents and physiotherapists as well as students of the musculoskeletal system. Bone- Metabolic Function and Modulators is the seventh volume in the series Topics in Bone Biology, edited by Felix Bronner and Mary C. Farach-Carson. Other titles in this series:- Bone Formation Bone Resorption Engineering of Functional Skeletal Tissues Bone and Osteoarthritis Bone and Cancer Bone and Development Bone- Metabolic Function and Modulators is of particular interest to clinician scientists, clinical and basic bone researchers, orthopedists, endocrinologists, internists, dentists, nurse practitioners, medical and dental residents and physiotherapists as well as students of the musculoskeletal system. Bone- Metabolic Function and Modulators is the seventh volume in the series Topics in Bone Biology, edited by Felix Bronner and Mary C. Farach-Carson. Other titles in this series:- Bone Formation Bone Resorption Engineering of Functional Skeletal Tissues Bone and Osteoarthritis Bone and Cancer Bone and Development Bone- Metabolic Function and Modulators is of particular interest to clinician scientists, clinical and basic bone researchers, orthopedists, endocrinologists, internists, dentists, nurse practitioners, medical and dental residents and physiotherapists as well as students of the musculoskeletal system. Bone- Metabolic Function and Modulators is the seventh volume in the series Topics in Bone Biology, edited by Felix Bronner and Mary C. Farach-Carson. Other titles in this series:- Bone Formation Bone Resorption Engineering of Functional Skeletal Tissues Bone and Osteoarthritis Bone and Cancer Bone and Development

This dictionary provides a comprehensive list of the terms and definitions commonly used in clinical rheumatology and osteology, and the new edition has been extended to include more than 50 additional entries. The book contains systematic descriptions relating to diseases of the locomotor apparatus, including osteoporosis, and important laboratory findings; special reference is made to the immunological parameters, which are essential for correct definition of rheumatologic disorders. Another focus is the general principles of pharmacological treatment, including biologicals and modern therapy. Information is also provided on individual disorders in the field of mineral metabolism and metabolic osteopathies and basic issues in rheumatic surgery. General entries are included from the fields of physical medicine and physiotherapy, including a system of functional assessment. The Dictionary of Rheumatology will be of value for medical students and all who are training in this specialty.

Autoimmune disorders of the skin remain an enigma for many clinicians and scientists not familiar with these mostly severe and chronic diseases. The book provides an overview and the latest information on the broad spectrum of cutaneous autoimmune disorders for clinicians, scientists and practitioners in dermatology, medicine, rheumatology, ENT, pediatrics and ophthalmology. The book is unique since it presents the state-of-the-art knowledge on pathophysiology, clinical diagnosis and management of these disorders provided by the world experts in the field. The primary intention is to broaden the understanding of the pathophysiology of cutaneous autoimmune disorders and to provide a practical guide to how to identify and handle these conditions. The book is illustrated with many tables, illustrative figures and clinical color photographs. The third edition has been thoroughly updated and extended by chapters on paraneoplastic cutaneous syndromes, atopic dermatitis and autoimmunity and Skin manifestations of rheumatic diseases.

Back pain is the commonest form of rheumatism and it is estimated to affect between 65% and 80% of populations sampled. The costs of back pain-related medical care and disability compensation make it one of society's most significant non-lethal medical conditions. Whilst mortality is low, its morbidity is high, inconvenience great, and economic burden massive. The actual symptom of back pain is one of the commonest and most perplexing encountered in medical practice. A proper understanding of what it means is crucial for further medical advance. However, the field of back pain research probably has more experts than any other. Anybody who has back pain will, as often as not, expound views on all matters concerning causation and expectations. Indeed, it is not for a lack of ideas that this field of investigation has failed to make progress. A respected senior investigator advised me early on that patients could not even tell which side their pain was on. It was only many years later that I discovered why. Though the initial incident or accident would seem important to the patient and to the researcher, it is remarkable how little it helps distinguish patterns of back pain. Tests of inappropriate behaviour in the past have been widely disseminated and yet even the originators have said that they cannot be sure of the implications of positive non-organic test findings. This book will show that these 'indicators' are not what they seem to be. In many cases, it is difficult to tell which level in the lumbar spine the pain comes from, and thus treatments such as injections or operation, may be given at the wrong level, let alone the wrong side. Though the various forms of back pain treatment seem to help some patients, when these same treatments are subjected to randomised controlled trials, the evidence for efficacy seems to all but vanish. With all these difficulties and uncertainties, it can be seen why low back pain presents one of the most fallible fields of healthcare. This book indicates that there are ways of dealing with the majority of these problems. Many of the answers from the research conducted were most unexpected. The reader is also advised that the scientific approach cannot deliver hard and fast answers to all contemporary questions in such a wide field and much has depended on the choice of problems to study. Whilst the tests used to distinguish the patterns in this study have their limitations, and whilst there is, as yet, only limited evidence as to the underlying pathology for the patterns recognised, it is felt that some of the other patterns identified are descriptive of diagnoses that are generally accepted. If the answers that are put forward appear to change the direction of understanding, it is hoped that you, the reader, will be able to carry the enquiry further when you see patients, advise treatment or even experience back pain yourself!

Nutritional Influences on Bone Health presents a collection of papers from the 8th International Symposium on Nutritional Aspects of Osteoporosis, the primary forum for and only regular meeting exclusively devoted to the topic of nutritional influences on bone health. The outcome is a fusion of the most current and up-to-date research in this area. Key themes include the permeation of the Western diet across the globe, calcium, vitamin D and acid-base balance. Written by authorities on the impact of nutrition on bone health, Nutritional Influences on Bone Health brings the reader the emerging trends, new messages and the latest scientific data in the field, to inform future research and clinical practice. This comprehensive, well researched volume is an essential reference for professionals in the field of bone health and nutrition.

Review of Rheumatology is a synopsis of key areas of interest, making for an indispensable quick reference work. The material included reviews basic musculoskeletal anatomy, immunology, genetics, major rheumatic diseases and their pathophysiology, and major rheumatic therapeutics, as well as a unique chapter on the emerging autoinflammatory diseases. Review of Rheumatology is a clear and concise review book written in an outline format. This book is a quick and easily accessible reference not only for those preparing for the rheumatology board exams, but it also serves as a succinct reference for all health care workers interested in the field of rheumatology.

A comprehensive reference and practical guide on the technology and application of ultrasound to the musculoskeletal system. It is organized into two main sections. The first is devoted to general aspects, while the second provides a systematic overview of the applications of musculoskeletal ultrasound in different areas of the body. Ultrasound scans are correlated with drawings, photographs, images obtained using other modalities, and anatomic specimens. There is a generous complement of high-quality illustrations based on high-end equipment. This book will acquaint beginners with the basics of musculoskeletal ultrasound, while more advanced sonologists and sonographers will learn new skills, means of avoiding pitfalls, and ways of effectively relating the ultrasound study to the clinical background.

This book provides an updated overview of agammaglobulinemia, a rare form of primary immunodeficiency which is considered the prototype of the congenital humoral defects, and which is characterized by the absence of peripheral B cells and very low serum immunoglobulin levels. The book opens by discussing the highly orchestrated early B cell development in the bone marrow and the genes involved based on both human and animal models. The pathogenesis and clinical presentation of X-linked agammaglobulinemia, caused by mutations in the BTK (Bruton's tyrosine kinase) gene, are then presented in detail, followed by descriptions of the clinical manifestations and molecular basis of the less frequent autosomal recessive and autosomal dominant forms of agammaglobulinemia. Patients' management in terms of respiratory complications, gammaglobulin replacement therapy and the potential value of novel experimental therapeutic strategies are discussed. The book's closing chapters offer a comprehensive and updated description of mutations in the BTK gene, and the expression and function of BTK in cells other than B cells.

This book is dedicated to our readers with the intention of providing an informative exposition of the myositis syndromes. It is also presented in the hope that perhaps it may serve to inspire and stimulate discussion and research into these disabling disorders. Included are descriptions of clinical features, differential diagnosis, pathogenetic mechanisms, and approaches to therapy. Current concepts of classi- cation and diagnostic techniques are also presented. The production staff at Humana Springer, especially Ms. F. Louie and Ms. C. Walsh, have been instrumental and invaluable in allowing this work to see the light of day. Above all, the scholarly essays of the contributing authors are acknowledged with gratitude. They have given this volume its character and existence. New York, NY Lawrence J. Kagen v Contents Preface ...v Contributors ...ix 1 Evaluation of the Patient ...1 Lawrence J. Kagen 2 Classification of Idiopathic Inflammatory Myopathies ...15 Frederick W. Miller 3 The Inflammatory Milieu: Cells and Cytokines...29 Ann M. Reed and Thomas A. Griffin 4 Juvenile Dermatomyositis: An Update on Clinical and Laboratory Findings ...55 Lauren M. Pachman 5 Inclusion Body Myositis ...87 Lawrence J. Kagen 6 The Role of Muscle Biopsy in the Diagnosis of Inflammatory Myopathy ...95 Sakir Humayun Gultekin 7 Electromyography ...1 1 1 Hans L. Carlson 8 Magnetic Resonance Imaging of Myopathies and Myositis ...127 Carolyn M. Sofka 9 Ultrasound in the Evaluation of the Inflammatory Myopathies ...147 Ronald S. Adler and Giovanna Garofalo vii viii Contents 10 Serological Findings ...165 Ira N.

This handbook is an in-depth and comprehensive guide for the treatment and management of patients with juvenile idiopathic arthritis. The handbook provides an informative review of the disease looking at the epidemiology, etiology and pathogenesis, issues of diagnosis and classification, consequences and complications, general treatment aspects, as well as both non pharmacologic and pharmacologic therapy whilst considering the future outlook for patients with juvenile idiopathic arthritis. Juvenile idiopathic arthritis is the most common type of arthritis found in children and adolescents, affecting about 1 in 1,000 children. It is a chronic disease which causes inflammation, pain and swelling of the affected joints and can affect joints in any part of the body. This Handbook provides an unbiased, informative discussion of the current and emerging treatments in this field.

With hundreds of question and answer items and bite-sized chunks of information that can be read and processed easily, reviewing for the pediatric board exams - or just brushing up in your spare time - has never been easier. Pediatric Tricky Topics, Volume 1: A Practically Painless Review includes review items in pediatric orthopedics, trauma, environmental medicine, toxicology, rheumatology, and neurology topics, among others. The Q&A format allows for self-testing or study with a partner or a group and is practical and accessible enough to dip into during a few minutes of downtime at the hospital or office, and as such it is suitable for those studying for the pediatric board exam, practicing physicians brushing up their skills, and any busy clinician who wants to learn more about these topics while on the go.

Understanding the key components of the diagnosis, assessment and management of inflammatory arthritis patients is essential to improving patient care. This book aims to cover these areas. It places inflammatory arthritis into a historical context; deals with the epidemiology, pathology, clinical assessment and investigation of inflammatory arthritis patients and provides a comprehensive overview of currently available treatment options. It provides insight into stratified medicine, an area of emerging importance in the management of heterogeneous diseases like RA. Finally, it provides an overview of what treatments strategies are in development.

This practical text provides a clinical overview of the etiology, diagnosis and treatment for fibromyalgia. Current evidence-based treatments and guidelines are emphasized along with lifestyle modification suggestions for the patient. Also included is a review of current literature, research and emerging developments on this prevalent pain syndrome. A range of healthcare specialties, including pain management, rheumatology, neurology, internal medicine and family practice, will find this comprehensive guide to be a valuable resource to their routine treatment of fibromyalgia and improve patient's quality of life.

Ibuprofen is one of the most successful drugs used worldwide for the treatment of mild to moderate pain and various inflammatory conditions. Over the past 40 years, ibuprofen has been proven to be as safe or even safer and also as effective as the established non-steroidal anti-inflammatory drugs (NSAIDs) and the coxibs. This well-written book reviews the pharmacology, clinical uses and the various adverse effects of Ibuprofen, the disposition and unique modes of action in relation to clinical effects of the drug as well as various formulations. The use of combinations with other drugs (e.g. paracetamol, codeine, caffeine) are critically assessed and the impact of natural products and Chinese Medicines on the safety of ibuprofen.

This next volume in our established series proposes to systematically review the basic science and clinical knowledge of the role of free radicals and antioxidants, collectively known as "oxidative stress", in the pathology of arthritis and other joint diseases. It will describe the most current diagnostic tools , laboratory methods and technology, to suggest ways of prevention and treatment and to emphasize the concept of the bench-to-bedside approach. The book will also provide specific coverage on emerging technology and medical applications including discussions of biomarkers and antioxidants as therapeutic agents and several more relevant aspects. In addition, the book will promote the concept of using biomarkers representative of oxidative stress reactions and free radical damage , as well as describe the effect of antioxidants in treating disease in clinical trials. The content will be valuable to researchers studying the development of arthritis/joint disease, and clinicians treating patients with these diagnoses.

Both scientifically and socially the Vlth International Symposium on Amyloidosis, August 5 - 8, 1990 in Oslo was a great success. There were three and a half intensive days. It started with the Opening Ceremony, particularly highlighted with the Norway-Norway multi media show by David Cochron, and ended with a visit to the Edvard Munch museuro and the Farewell Salmon Dinner on the evening of August 8 (not to forget the "happy birthday" song for Dorothea Zucker-Franklin at the breakfast table the following morning). In between was the intellectual penetration into the science of amyloidosis and amyloid proteins, and a deepening of many friendships among young and old "amyloidologists", together with some of the cultural and historical features of Oslo and Norway. Among the numerous Ietters of thanks and gratitude that we have received, the senior organizer of the previous meeting, Takashi lsobe said it briefly and eloquently: "You have overwhelmed us, you have performed a drama with joy and cheer, you have hosted so nicely with lovely secretariat, you have arranged impressive hospitality in every respect, you certainly did for all of us" Now we are left with the proceedings book for the three coming years until the next symposium in Kingston, Canada, which will be organized by Drs. Robert Kisilevsky and Thomas Muckle from the Department of Pathology at Queens University in 1993. The scientific contributions herein cover all the sessions of the meeting.

Classification of the carpal injuries helps us to understand the relationship between them. The growing interest in this field has been advanced by recent imaging techniques. Therapeutic advice and treatment are still not completely defined, even by the most renowned specialists. There is still room for new concepts.

This edition of the companion volumes Muscle Pain: Understanding the Mech- isms and Muscle Pain: Diagnosis and Treatment is essential reading for those interested in clinical approaches to acute and chronic pain conditions involving muscle tissues and in the mechanisms underlying these conditions. The volumes cover a very important topic in pain medicine, since muscle pain is very common and can often be dif?cult to diagnose and treat effectively. Furthermore, chronic pain involving muscle and other components of the musculoskeletal system increases with age, such that it is a common complaint of those of us who are middle-aged or older. Indeed, as changing population demographics in "west- nized" countries result in higher proportions of the population living longer and being middle-aged and elderly, chronic muscle pain will likely become even more of a health problem. In the case of acute muscle pain, this can often be very intense, and in the short term can limit or modify the use of components of the musculoskeletal system associated with the sensitive muscle. Chronic muscle pain can also be intense, as well as unpleasant and disabling, and it is in many cases the over-riding symptom of most musculoskeletal disorders that are associated with long-term deleterious changes in musculoskeletal function.

This edition of the companion volumes Muscle Pain: Understanding the Mech- isms and Muscle Pain: Diagnosis and Treatment is essential reading for those interested in clinical approaches to acute and chronic pain conditions involving muscle tissues and in the mechanisms underlying these conditions. The volumes cover a very important topic in pain medicine, since muscle pain is very common and can often be dif?cult to diagnose and treat effectively. Furthermore, chronic pain involving muscle and other components of the musculoskeletal system increases with age, such that it is a common complaint of those of us who are middle-aged or older. Indeed, as changing population demographics in "west- nized" countries result in higher proportions of the population living longer and being middle-aged and elderly, chronic muscle pain will likely become even more of a health problem. In the case of acute muscle pain, this can often be very intense, and in the short term can limit or modify the use of components of the musculoskeletal system associated with the sensitive muscle. Chronic muscle pain can also be intense, as well as unpleasant and disabling, and it is in many cases the over-riding symptom of most musculoskeletal disorders that are associated with long-term deleterious changes in musculoskeletal function.

The physiology of man is a complex subject. Unfortunately the regulation of temperature in the human body is not always well explained in textbooks. Many conference proceedings on the subject have been produced that give excellent detail on research topics. However, the subject matter is rarely presented as a composite whole. New technology has broadened the scope of methods available for studying body temperature. Thermography in particular has made it possible to record in real time the temperature distribution of large areas of the body surface. Modem image processing methods permit dynamic studies to be carried out and detailed analyses made retrospectively-a tremendous advance over the complex and slow techniques formerly used by physiologists. Yet although the associa tion between disease and temperature is as old as medicine itself, beyond the implicit faith in the clinical mercury thermometer, other measuring techniques are finding a slow acceptance. This book is designed to put into perspective the critical factors that make up "body temperature. " Body temperature cannot be viewed as a static entity but rather must be seen as a dynamic process. An understanding of this phenomenon is important to all who use thermal imaging and measuring techniques in clinical medi cine. These methods have, in recent years, brought engineers, physi cists, technicians, and clinicians together. Inevitably, however, there v vi Preface are gaps and overlaps in technology and understanding.

The assessment and management of rheumatic diseases is challenging and many doctors are not confident of their abilities in this area. Those who want to rapidly learn the essentials of modern clinical rheumatology will find all the practical advice and information they need in this text. Written for senior house officers and residents in general (internal) medicine, health professionals in rheumatology, primary care doctors and medical students will also find it useful: Up-to-date information about new therapies Essentials of common and uncommon rheumatic diseases listed Practical advice on selecting appropriate tests, drug prescribing and patient information Patient-centred approach to management Useful rheumatology websites listed All you need in one handy pocket-sized resource