Prevalence and Incidence of Arthralgia
Arthralgia Prevalence: Book Excerpts
- Causes and incidence - Rheumatoid arthritis
- Causes and incidence - Juvenile rheumatoid arthritis
- Causes and incidence - Septic arthritis
- III. Epidemiology and Incidence of Spinal Epidural Abscess - Back, Joint, and Extremity Pain - Case 5-1 2-Year-Old Boy
- III. Epidemiology - Back, Joint, and Extremity Pain - Case 5-2 2-Year-Old Boy
- III. Incidence and Epidemiology of Slipped Capital Femoral Epiphysis - Back, Joint, and Extremity Pain - Case 5-3 14-Year-Old Boy
- III. Incidence and Epidemiology of Crohn's Disease. - Back, Joint, and Extremity Pain - Case 5-4 16-Year-Old Girl
- III. Incidence and Epidemiology - Back, Joint, and Extremity Pain - Case 5-6 9-Year-Old Boy
Prevalence/Incidence of Arthralgia: Online Medical Books
16 MEDICAL BOOKS ONLINE!
Review excerpts from medical books online, free, without registration,
for more information about the prevalence and/or incidence of Arthralgia.
Rheumatoid arthritis:
Causes and incidence
(Professional Guide to Diseases (Eighth Edition))
RA occurs worldwide, striking three times more females than males. Although it can occur at any age, it begins most often between ages 25 and 55. This disease affects more than 7 million people in the United States alone.
What causes the chronic inflammation characteristic of RA isn’t known, but various theories point to infectious, genetic, and endocrine factors. Currently, it’s believed that a genetically susceptible individual develops abnormal or altered immunoglobulin (Ig) G antibodies when exposed to an antigen. This altered IgG antibody isn’t recognized as “self,” and the individual forms an antibody against it — an antibody known as RF. By aggregating into complexes, RF generates inflammation. Eventually, cartilage damage by inflammation triggers additional immune responses, including activation of complement. This in turn attracts polymorphonuclear leukocytes and stimulates release of inflammatory mediators, which enhance joint destruction.
Much more is known about the pathogenesis of RA than about its causes. If unarrested, the inflammatory process within the joints occurs in four stages. First, synovitis develops from congestion and edema of the synovial membrane and joint capsule. Formation of pannus — thickened layers of granulation tissue — marks the second stage’s onset. Pannus covers and invades cartilage and eventually destroys the joint capsule and bone. Progression to the third stage is characterized by fibrous ankylosis — fibrous invasion of the pannus and scar formation that occludes the joint space. Bone atrophy and malalignment cause visible deformities and disrupt the articulation of opposing bones, causing muscle atrophy and imbalance and, possibly, partial dislocations or subluxations. In the fourth stage, fibrous tissue calcifies, resulting in bony ankylosis and total immobility.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Juvenile rheumatoid arthritis:
Causes and incidence
(Professional Guide to Diseases (Eighth Edition))
The cause of JRA remains puzzling. Research continues to test several theories, such as those linking the disease to genetic factors or to an abnormal immune response. Viral or bacterial (particularly streptococcal) infection, trauma, and emotional stress may be precipitating factors, but their relationship to JRA remains unclear.
Considered the major chronic rheumatic disorder of childhood, JRA affects an estimated 150,000 to 250,000 children in the United States; overall incidence is twice as high in females, with variation among the types of JRA.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Septic arthritis:
Causes and incidence
(Professional Guide to Diseases (Eighth Edition))
In most cases of septic arthritis, bacteria spread from a primary site of infection — usually in adjacent bone or soft tissue — through the bloodstream to the joint. Common infecting organisms in children are group B Streptococcus and Haemophilus influenzae. Adults are usually infected by Staphylococcus, Streptococcus (pneumonia), and group B Streptococcus, whereas chronic septic arthritis is caused by Mycobacterium tuberculosis and Candida albicans.
Various factors can predispose a person to septic arthritis. Any concurrent bacterial infection (of the genitourinary or the upper respiratory tract, for example) or serious chronic illness (such as malignancy, renal failure, rheumatoid arthritis, systemic lupus erythematosus, diabetes, or cirrhosis) heightens susceptibility. Consequently, elderly people and those who abuse I.V. drugs run a higher risk of developing septic arthritis. Of course, diseases that depress the immune system and immunosuppressive therapy increase susceptibility. Other predisposing factors include recent articular trauma, joint arthroscopy or other surgery, intra-articular injections, and local joint abnormalities.
Septic arthritis may be seen at any age in children, but it occurs most often in children younger than age 3. It’s uncommon from age 3 until adolescence, at which time the incidence increases again.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Back, Joint, and Extremity Pain - Case 5-1: 2-Year-Old Boy:
III. Epidemiology and Incidence of Spinal Epidural Abscess
(Pediatric Complaints and Diagnostic Dilemmas)
Spinal epidural abscesses occur rarely in children. Auletta and John reported an
incidence of 0.6 per 10,000 hospital admissions. Most patients are boys that
were previously healthy, but predisposing factors include sickle cell disease
(SCD), hematologic malignancy, and spinal surgery. Spinal epidural abscess
occasionally complicates serial lumbar puncture and varicella infection.
Staphylococcus aureus causes more than two-thirds of cases but infections due to group A Streptococcus, group B Streptococcus, Salmonella species, Escherichia coli, and Pseudomonas aeruginosa have also been reported. Rare fungal causes include Candida species and Aspergillus flavus. Mycobacterium tuberculosis may be seen more commonly in areas with a high prevalence of tuberculosis.
The infection is usually acquired by hematogenous spread and occasionally by
direct extension from an adjacent site of infection. Associated osteomyelitis
is present in approximately 50% of patients. In the study by Auletta and John,
seven of eight children with spinal epidural abscess had an associated psoas or
paraspinal abscess.
» READ BOOK EXCERPT ONLINE »
Source: Pediatric Complaints and Diagnostic Dilemmas, 2003
Back, Joint, and Extremity Pain - Case 5-2: 2-Year-Old Boy:
III. Epidemiology
(Pediatric Complaints and Diagnostic Dilemmas)
Leukemia results from malignant transformation and clonal expansion of
hematopoietic cells that have stopped at a particular stage of differentiation
and are unable to progress to more mature forms. Leukemias are divided into
acute and chronic subtypes and are further classified on the basis of leukemic
cell morphology into lymphocytic leukemias (lymphoid lineage cell
proliferation) and nonlymphocytic leukemias (granulocyte, monocyte,
erythrocyte, or platelet lineage cell proliferation). Acute leukemias
constitute more than 95% of all childhood leukemias and are subdivided into
acute lymphocytic leukemia (ALL) and acute nonlymphocytic leukemia, also known
as acute myelogenous leukemia (AML). The following discussion focuses on ALL.
ALL, the most common pediatric malignancy, accounts for approximately 25% of all
childhood cancers and 75% of all childhood leukemias. Most children are
diagnosed between 2 and 5 years of age. In the United States, the incidence of
ALL is higher in whites than in blacks and in boys than in girls. Genetic
factors also affect the risk of ALL. ALL develops in siblings of children with
ALL two to four times more often than in unrelated children. The concordance of
ALL in monozygotic twins is approximately 25%. Children with chromosomal
abnormalities, including trisomy 21, and syndromes characterized by chromosomal
fragility, such as Bloom
's syndrome and Fanconi anemia, also have a substantially higher risk of
leukemia.
» READ BOOK EXCERPT ONLINE »
Source: Pediatric Complaints and Diagnostic Dilemmas, 2003
Back, Joint, and Extremity Pain - Case 5-3: 14-Year-Old Boy:
III. Incidence and Epidemiology of Slipped Capital Femoral Epiphysis
(Pediatric Complaints and Diagnostic Dilemmas)
The term SCFE refers to displacement of the femoral head relative to the femoral neck through
the physis (growth plate). This displacement results from either cumulative
normal stresses acting on a weakened physis or the effect of an acute traumatic
event on a normal or previously weakened physis. SCFE occurs with an annual
incidence of 2 to 3 cases per 100,000 persons. It typically develops during the
adolescent growth spurt, occurring in boys 10 to 16 years of age and girls 10
to 13 years of age. The incidence is approximately 2.5 times greater in boys
than in girls. The incidence is also higher in African-Americans than in
Caucasians. Obesity is a clear predisposing factor. One-half to two-thirds of
children with SCFE have weight-for-height profiles greater than the 95th
percentile. Obesity may contribute by creating increased shear forces across
the weakened physis during ambulation. Underlying endocrine or metabolic
disorders that delay skeletal maturation, such as primary or secondary
hypothyroidism, panhypopituitarism, or hypogonadism, should be suspected in
children who are outside the typical age or weight range for SCFE. In this
case, the corticosteroids the patient received at 10 years of age were not
thought to be a contributing factor in the development of SCFE.
» READ BOOK EXCERPT ONLINE »
Source: Pediatric Complaints and Diagnostic Dilemmas, 2003
Back, Joint, and Extremity Pain - Case 5-4: 16-Year-Old Girl:
III. Incidence and Epidemiology of Crohn's Disease.
(Pediatric Complaints and Diagnostic Dilemmas)
Crohn's disease, a major form of chronic intestinal inflammation, can segmentally
involve any part of the gastrointestinal tract, from the esophagus to the
colon. The inflammation involves the terminal portion of the ileum in
approximately 90% of cases. Inflammation occurs in the ileum and colon together
in 60% of cases, and the upper portion of the gastrointestinal tract is
involved in approximately 30% of cases. In contrast, inflammation in ulcerative
colitis begins in the rectum and extends continuously into the colon but does
not involve more proximal portions of the gastrointestinal tract. Isolated
colonic involvement occurs in 10% of cases of Crohn
's disease, making distinction from ulcerative colitis difficult in some cases.
The prevalence of Crohn's disease in North America ranges from 26 to 198 cases per 100,000 persons, with
higher rates occurring in the more northern latitudes. Crohn
's disease is most common among Caucasians and least common among Hispanics and
Asian-Americans. Peak incidence occurs in young adulthood, and a second,
smaller peak occurs during the sixth decade of life. Approximately 15% of
patients with Crohn
's disease are diagnosed during childhood. The etiology of Crohn's disease is not known but probably involves a combination of environmental,
genetic, and immunoregulatory factors. When the diagnosis of either Crohn
's disease or ulcerative colitis is made, the likelihood of finding inflammatory
bowel disease in a first-degree relative is 10% to 25%.
» READ BOOK EXCERPT ONLINE »
Source: Pediatric Complaints and Diagnostic Dilemmas, 2003
Back, Joint, and Extremity Pain - Case 5-6: 9-Year-Old Boy:
III. Incidence and Epidemiology
(Pediatric Complaints and Diagnostic Dilemmas)
Although ARF was common in the United States until the 1960s, its incidence
decreased in the 1970s in developed nations. Regional outbreaks occurred
throughout the United States in the 1980s and 1990s, and this resurgence may be
related to the increased prevalence of strains of GABHS that are thought to be
more
“rheumatogenic.” Populations at greatest risk for ARF mirror the populations with increased
incidence of GABHS pharyngitis: children age 5 to 15 years, and older
individuals living in close quarters (e.g., military recruits). In developing
countries and in the United States before 1970, poorer socioeconomic
communities had higher rates of GABHS pharyngitis and ARF. However, over the
last two decades of the 20th century, outbreaks of ARF in the United States
have occurred predominantly in suburban and rural middle-class communities and
among military recruits.
» READ BOOK EXCERPT ONLINE »
Source: Pediatric Complaints and Diagnostic Dilemmas, 2003
About prevalence and incidence statistics:
The term 'prevalence' of Arthralgia usually refers to the estimated population
of people who are managing Arthralgia at any given time.
The term 'incidence' of Arthralgia refers to the annual diagnosis rate,
or the number of new cases of Arthralgia diagnosed each year.
Hence, these two statistics types can differ:
a short-lived disease like flu can have high annual incidence but low prevalence,
but a life-long disease like diabetes has a low annual incidence but high prevalence.
For more information see about prevalence and incidence statistics.
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