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  1. Fulltext The past and current updates on diagnostic aspects of osteoarthritis
    Tan WM, Lau SF, Ajat M, Mansor R, Abd-Rani PAM, Ng AMH, et al.
    Jurnal Veterinar Malaysia, 2017;29(1):7-12.
    MyJurnal
    Osteoarthritis (OA) is a progressive joint disease leading to the destruction of joint structures, which in turn causes severe and chronic pain to the patient. Since OA is a troubling and disruptive disease, numerous researches have been done into diagnosing this disease, both in the early and the late stages of the disease. Diagnostic modalities such as radiography, computed-tomography (CT), micro-computed tomography (µ-CT), and magnetic resonance imaging (MRI) have been used in OA research. Not only that, more advance measurements and criteria have been established to standardize OA research. Currently, the OA research has been delving into proteomic studies to search for potential disease biomarkers. Biomarkers such as urinary C-terminal telopeptide of collagen type 2 (uCTX-II) and cartilage oligometric protein (COMP) have shown potential to be both diagnostic and prognostic biomarkers. For this review paper, the developments in diagnostic modalities are discussed focusing more on proteomic and biomarker studies.
    Matched MeSH terms: Arthralgia
  2. Fulltext Using Design of Experiments Methods for Assessing Peak Contact Pressure to Material Properties of Soft Tissue in Human Knee
    Bahraminasab M, Jahan A, Sahari B, Arumugam M, Shamsborhan M, Hassan MR
    J Med Eng, 2013;2013:891759.
    PMID: 27006925 DOI: 10.1155/2013/891759
    Contact pressure in the knee joint is a key element in the mechanisms of knee pain and osteoarthritis. Assessing the contact pressure in tibiofemoral joint is a challenging mechanical problem due to uncertainty in material properties. In this study, a sensitivity analysis of tibiofemoral peak contact pressure to the material properties of the soft tissue was carried out through fractional factorial and Box-Behnken designs. The cartilage was modeled as linear elastic material, and in addition to its elastic modulus, interaction effects of soft tissue material properties were added compared to previous research. The results indicated that elastic modulus of the cartilage is the most effective factor. Interaction effects of axial/radial modulus with elastic modulus of cartilage, circumferential and axial/radial moduli of meniscus were other influential factors. Furthermore this study showed how design of experiment methods can help designers to reduce the number of finite element analyses and to better interpret the results.
    Matched MeSH terms: Arthralgia
  3. Fulltext Anti-gout potential of Malaysian medicinal plants
    Abu Bakar FI, Abu Bakar MF, Rahmat A, Abdullah N, Sabran SF, Endrini S
    Front Pharmacol, 2018;9:261.
    PMID: 29628890 DOI: 10.3389/fphar.2018.00261
    Gout is a type of arthritis that causes painful inflammation in one or more joints. In gout, elevation of uric acid in the blood triggers the formation of crystals, causing joint pain. Malaysia is a mega-biodiversity country that is rich in medicinal plants species. Therefore, its flora might offer promising therapies for gout. This article aims to systematically review the anti-gout potential of Malaysian medicinal plants. Articles on gout published from 2000 to 2017 were identified using PubMed, Scopus, ScienceDirect, and Google Scholar with the following keyword search terms: "gout," "medicinal plants," "Malaysia," "epidemiology," "in vitro," and "in vivo." In this study, 85 plants were identified as possessing anti-gout activity. These plants had higher percentages of xanthine oxidase inhibitory activity (>85%); specifically, the Momordica charantia, Chrysanthemum indicum, Cinnamomum cassia, Kaempferia galanga, Artemisia vulgaris, and Morinda elliptica had the highest values, due to their diverse natural bioactive compounds, which include flavonoids, phenolics, tannin, coumarins, luteolin, and apigenin. This review summarizes the anti-gout potential of Malaysian medicinal plants but the mechanisms, active compounds, pharmacokinetics, bioavailability, and safety of the plants still remain to be elucidated.
    Matched MeSH terms: Arthralgia
  4. The effects of Momordica charantia (bitter melon) supplementation in patients with primary knee osteoarthritis: A single-blinded, randomized controlled trial
    Soo May L, Sanip Z, Ahmed Shokri A, Abdul Kadir A, Md Lazin MR
    Complement Ther Clin Pract, 2018 Aug;32:181-186.
    PMID: 30057048 DOI: 10.1016/j.ctcp.2018.06.012
    BACKGROUND: Osteoarthritis is a common problem affecting the joints in the elderly, caused disability and consequently decrease the quality of life. The conservative treatment includes the usage of analgesia, but the use of herbal medicine is growing. Momordica charantia or bitter melon has been widely described to have anti-diabetic and anti-inflammatory effects. However, its effect on reducing pain in primary knee osteoarthritis is not well studied. We aim to determine the effects of Momordica charantia in reducing pain among primary knee osteoarthritis patients.
    MATERIALS AND METHODS: Thirty-eight and thirty-seven primary knee osteoarthritis patients underwent 3 months of Momordica charantia and placebo supplementation respectively. Three 500 mg per capsule of Momordica charantia were taken thrice daily. Rescue analgesia was allowed as needed. Pain and symptoms throughout the Momordica charantia supplementation period were assessed using Knee Injury and Osteoarthritis Outcome Score and EQ-5D-3L Health questionnaire, while rescue analgesia intake throughout the period of supplementation was measured using analgesic score.
    RESULTS: After 3 months supplementation period, body weight, body mass index, and fasting blood glucose reduced significantly in the Momordica charantia group. There were also significant improvements in Knee Injury and Osteoarthritis Outcome Score subscales and EQ-5D-3L dimension score, and reduction in analgesic score. The placebo group had also shown significant improvements in certain Knee Injury and Osteoarthritis Outcome Score subscales and EQ-5D-3L dimension score, but with increased of the analgesic score.
    CONCLUSION: Momordica charantia supplementation offers a safe alternative to reducing pain and improving symptoms among the primary knee osteoarthritis patients while reducing the need for analgesia consumption. These beneficial effects can be seen as early as 3 months of supplementation.
    Study site: Orthopaedic clinic, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia
    Matched MeSH terms: Arthralgia
  5. An 11-year-old girl presenting with chronic knee pain: a case report with diagnostic dilemma
    Maj MK, Ar AH, Faisal SA, Ahmad J, Das S
    Acta Medica (Hradec Kralove), 2010;53(4):247-9.
    PMID: 21400986
    Discoid meniscus is the commonest anatomical aberration of the knee joint, among rare cases such as bilateral separated lateral meniscus, accessory lateral meniscus, partial deficiency of the lateral meniscus and double-layered lateral meniscus. An 11-year-old girl presented with history of chronic pain in her right knee for the last 6 months. The problem disturbed her involvement in the sport activities at school. Clinical examination revealed a clicking sensation on knee extension with lateral joint line tenderness. Magnetic resonance imaging (MRI) of her right knee showed torn posterior horn of lateral meniscus. Arthroscopy examination revealed a discoid meniscus with absence posterior horn. Posterior horn deficient discoid meniscus is a rare form of a congenital meniscus anomaly. We as clinicians believe that the abnormal shaped meniscus may pose a diagnostic challenge clinically and radiologically. Presentation of this case may be beneficial for orthopaedicians in their daily clinical practice.
    Matched MeSH terms: Arthralgia/etiology*
  6. Reliability and sensitivity of radiographic measures of hip dysplasia in childhood Charcot-Marie-Tooth disease
    Dwan LN, Gibbons P, Jamil K, Little D, Birke O, Menezes MP, et al.
    Hip Int, 2023 Mar;33(2):323-331.
    PMID: 34180253 DOI: 10.1177/11207000211027591
    BACKGROUND: Hip dysplasia is a lack of femoral head coverage and disruption of hip and acetabular alignment and congruency, with severity ranging from mild subluxation in nascent at-risk hips to complete dislocation. Presentation of hip dysplasia in neuromuscular conditions can be sub-clinical or associated with a limp with or without hip pain, abductor and flexor weakness and reduced hip range of motion. Untreated hip dysplasia leads to early onset osteoarthritis requiring hip arthroplasty in early adulthood. Hip dysplasia occurs in 6-20% of children with Charcot-Marie-Tooth disease, however little is known about the reliability and sensitivity of detection on plain film pelvic radiographs.

    METHODS: 14 common measures of hip dysplasia on anteroposterior pelvis radiographs were independently assessed by 2 orthopaedic specialists in 30 ambulant children with Charcot-Marie-Tooth disease. Hip health was also categorised based on clinical impression to assess the sensitivity of radiographic measures to identify hip dysplasia status.

    RESULTS: 8 measures (acetabular index, head width, lateral centre-edge angle, lateral uncoverage, medial joint width, migration percentage, neck shaft angle, triradiate status) exhibited 'excellent' reliability between clinical evaluators. 5 of the 30 patients (17%) were identified as having nascent hip dysplasia. Reliable radiographic measures that significantly distinguished between nascent hip dysplasia and healthy hips were acetabular index, lateral centre edge angle, medial joint width and migration percentage.

    CONCLUSIONS: We have identified a subset of reliable and sensitive radiographic hip measures in children with Charcot-Marie-Tooth disease to prioritise during hip screening to mitigate the deleterious effects of hip dysplasia, pain and disability in adulthood.

    Matched MeSH terms: Arthralgia/surgery
  7. Clinical and radiological features of imported chikungunya fever in Japan: a study of six cases at the National Center for Global Health and Medicine
    Mizuno Y, Kato Y, Takeshita N, Ujiie M, Kobayashi T, Kanagawa S, et al.
    J Infect Chemother, 2011 Jun;17(3):419-23.
    PMID: 20862507 DOI: 10.1007/s10156-010-0124-y
    Chikungunya fever (CHIKF) is currently distributed in Africa and in South and Southeast Asia; outbreaks have occurred periodically in the region over the past 50 years. After a large outbreak had occurred in countries in the western Indian Ocean region in 2005, several countries reported cases of CHIKF from travelers who had visited affected areas. In Japan, there have been only 15 cases of CHIKF patients so far, according to the National Institute of Infectious Diseases. Therefore, to evaluate the clinical and radiological features associated with the disease, we describe 6 imported cases of CHIKF. All of the patients had had prolonged arthralgia on admission to our hospital, and diagnosis was confirmed with specific antibodies by using an IgM-capture enzyme-linked immunoassay and a plaque reduction neutralizing antibody assay. Magnetic resonance imaging (MRI) of one patient revealed erosive arthritis and tenosynovitis during the convalescence stage. Clinicians should be aware of the late consequences of infection by the chikungunya virus (CHIKV) and recognize the possible association of subacute and chronic arthritis features. In addition, competent vectors of CHIKV, Aedes aegypti, can now be found in many temperate areas of the eastern and western hemispheres, including Japan. This fact raises concern that the virus could be introduced and become established in these areas. This necessitates an increased awareness of the disease, because imported cases are likely to contribute to the spread of CHIKV infection wherever the competent mosquito vectors are distributed.
    Matched MeSH terms: Arthralgia/diagnosis; Arthralgia/epidemiology; Arthralgia/virology
  8. Does acupuncture improve pain and function in people with hip osteoarthritis? A Cochrane Review summary with commentary
    Chan SC, Patrick Engkasan J
    Int J Rheum Dis, 2020 Dec;23(12):1741-1743.
    PMID: 33118670 DOI: 10.1111/1756-185X.13948
    Matched MeSH terms: Arthralgia/etiology; Arthralgia/physiopathology; Arthralgia/therapy*
  9. Fulltext Ethnic differences in the prevalence of knee pain among adults of a community in a cross-sectional study
    Chia YC, Beh HC, Ng CJ, Teng CL, Hanafi NS, Choo WY, et al.
    BMJ Open, 2016 12 01;6(12):e011925.
    PMID: 27909033 DOI: 10.1136/bmjopen-2016-011925
    OBJECTIVE: To determine the prevalence of knee pain among 3 major ethnic groups in Malaysia. By identifying high-risk groups, preventive measures can be targeted at these populations.

    DESIGN AND SETTING: A cross-sectional survey was carried out in rural and urban areas in a state in Malaysia. Secondary schools were randomly selected and used as sampling units.

    PARTICIPANTS: Adults aged ≥18 years old were invited to answer a self-administered questionnaire on pain experienced over the previous 6 months. Out of 9300 questionnaires distributed, 5206 were returned and 150 participants who did not fall into the 3 ethnic groups were excluded, yielding a total of 5056 questionnaires for analysis. 58.2% (n=2926) were women. 50% (n=2512) were Malays, 41.4% (n=2079) were Chinese and 8.6% (n=434) were Indians.

    RESULTS: 21.1% (n=1069) had knee pain during the previous 6 months. More Indians (31.8%) experienced knee pain compared with Malays (24.3%) and Chinese (15%) (p<0.001). The odds of Indian women reporting knee pain was twofold higher compared with Malay women. There was a rising trend in the prevalence of knee pain with increasing age (p<0.001). The association between age and knee pain appeared to be stronger in women than men. 68.1% of Indians used analgesia for knee pain while 75.4% of Malays and 52.1% of Chinese did so (p<0.001). The most common analgesic used for knee pain across all groups was topical medicated oil (43.7%).

    CONCLUSIONS: The prevalence of knee pain in adults was more common in Indian women and older women age groups and Chinese men had the lowest prevalence of knee pain. Further studies should investigate the reasons for these differences.

    Matched MeSH terms: Arthralgia/drug therapy; Arthralgia/ethnology*; Arthralgia/epidemiology
  10. Fulltext Rheumatoid arthritis: refractory to infliximab, a tumor necrosis factor inhibitor
    Solehan HM, Said MS, Shaharir S, Rajalingham S
    J Clin Med Res, 2011 Oct;3(5):270-4.
    PMID: 22383918 DOI: 10.4021/jocmr630w
    Rheumatoid arthritis is one of the commonest autoimmune diseases. It is a chronic, progressive, systemic inflammatory disorder affecting the synovial joints and typically producing symmetrical arthritis. If left untreated, it leads to joint destruction and thus deformity and disability.In the recent years, advances in molecular biology have led to a variety of new treatment approaches to rheumatoid arthritis and other systemic inflammatory diseases associated with autoimmunity. Anti tumor necrosis factor (TNF) agents are emerging in the frontline management of rheumatoid arthritis (RA) in the current era of biological treatment. We presented a 46-year-old Chinese female with a history of seropositive RA for the past 22 years refractory and intolerant to multiple medications including sulphasalazine (SSZ), leflunomide, hydroxychloroquine (HCQ) and methotrexate (MTX), thus infliximab, a tumor necrosis factor (TNF) inhibitor was initiated. However, despite receiving 6 cycles of infliximab therapy, she still complained of persistent disabled multiple joint pain and swelling. This report will discuss about rheumatoid arthritis, which is refractory to infliximab (a TNF inhibitor) and its alternative.
    Matched MeSH terms: Arthralgia
  11. Oversized acetabular socket causing groin pain after total hip arthroplasty
    Abbas AA, Kim YJ, Song EK, Yoon TR
    J Arthroplasty, 2009 Oct;24(7):1144.e5-8.
    PMID: 18848418 DOI: 10.1016/j.arth.2008.09.008
    The causes of groin pain after total hip arthroplasty are numerous, and the condition itself is disabling. Therefore, it is imperative that the cause of the pain is identified and managed appropriately. We report a case where the patient had groin pain after total hip arthroplasty as a result of an oversized cementless acetabular component, which caused a breach in the anterior wall of the acetabulum. The anterior wall of the acetabulum was reconstructed with femoral head allograft, and the patient has been symptom free since.
    Matched MeSH terms: Arthralgia/diagnosis*; Arthralgia/etiology*
  12. Combined effects of knee brace, laterally wedged insoles and toe-in gait on knee adduction moment and balance in moderate medial knee osteoarthritis patients
    Khan SJ, Khan SS, Usman J, Mokhtar AH, Abu Osman NA
    Gait Posture, 2018 03;61:243-249.
    PMID: 29413792 DOI: 10.1016/j.gaitpost.2018.01.024
    OBJECTIVE: To test the hypothesis that toe-in gait (TI) will further reduce first peak (Knee Adduction Moment) KAM and decrease balance when combined with a knee brace (KB) and laterally wedged insoles (LWI) in medial knee osteoarthritis (kOA) patients.
    PARTICIPANTS: Twenty patients with bilateral symptomatic medial kOA.
    INTERVENTIONS: 4-point leverage-based KB, full-length LWI with 5° inclination and toe-in gait (TI).
    MAIN OUTCOME MEASURES: First and second peak knee adduction moment (fKAM and sKAM respectively), balance and pain.
    METHODS: The fKAM and sKAM were determined from 3-dimensional gait analysis with six randomized conditions: (1) N (without any intervention), (2) KB, (3) KB + TI, (4) LWI, (5) LWI + TI, (6) KB + LWI + TI. Balance was assessed by Biodex Balance System using three stability settings, (i) Static (ii) Moderate dynamic setting for fall risk (FR12) and (iii) High dynamic setting for fall risk (FR8).
    RESULTS: The reduction in fKAM and sKAM was greatest (19.75% and 12%) when TI was combined with KB and LWI respectively. No change in balance was observed when TI combined with KB, and LWI and when used concurrently with both the orthosis at static and FR12 conditions. Significant balance reduction was found at FR8 for KB + TI (22.22%), and KB + LWI + TI (35.71%). Pain increased significantly for KB (258%), KB + TI (305%), LWI + TI (210%) and KB + LWI + TI (316%). LWI showed no effect on pain.
    CONCLUSIONS: There is a synergistic effect of TI when combined with KB and LWI concurrently in sKAM reduction. However, the concurrent use of TI, KB and LWI decreases balance and pain as assessed on a highly dynamic platform.
    Study site: Department of Sports Medicine, University of Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
    Matched MeSH terms: Arthralgia/physiopathology; Arthralgia/rehabilitation*
  13. Pain relief for reduction of acute anterior shoulder dislocations: a prospective randomized study comparing intravenous sedation with intra-articular lidocaine
    Cheok CY, Mohamad JA, Ahmad TS
    J Orthop Trauma, 2011 Jan;25(1):5-10.
    PMID: 21164304 DOI: 10.1097/BOT.0b013e3181d3d338
    The aim was to compare the effectiveness of intra-articular lidocaine (IAL) versus intravenous Demerol and Diazepam (IVS) in reduction of acute anterior shoulder dislocation.
    Matched MeSH terms: Arthralgia/diagnosis; Arthralgia/drug therapy*; Arthralgia/etiology
  14. Fulltext Multicentric reticulohistiocytosis in a Malaysian Chinese lady: a case report and review of literature
    Yap FBB
    Dermatol. Online J., 2009;15(1):2.
    PMID: 19281707
    A 36-year-old Malaysian woman with erosive arthritis presented with multiple asymptomatic skin colored papulonodules on the hands, elbows, knees, ears, and feet; many macules, papules, and plaques were photodistributed. Progressive, erosive arthritis began about 18 months after the onset of skin involvement. Initially the patient was diagnosed to have dermatomyositis due to her skin findings, but later proved to have multicentric reticulohistiocytosis based on the typical histopathological features of histiocytic multinucleated giant cells with eosinophilic ground glass cytoplasm on skin biopsy. Workup for associated diseases including malignancies was negative. Her skin lesions and joint pain responded to treatment with methotrexate and prednisolone.
    Matched MeSH terms: Arthralgia
  15. Fulltext The diagnostic conundrum: neuropsychiatry manifestation of systemic lupus erythematosus
    Panirselvam RR, Ramly SS, Harun NA
    Malaysian Journal of Psychiatry, 2016;25(1):80-85.
    MyJurnal
    Systemic lupus erythematosus (SLE) is a debilitating and chronic autoimmune disease which strikes insidiously. The disease currently has a prevalence of 43/ 100 000 individuals in Malaysia. The presentation of the disease is varied resulting in delay in diagnosis and onset of complications prior to management. The disease commonly presents as joint pain and cutaneous manifestations. Neuropsychiatric presentation accounts for 24% of symptoms during onset of illness. This case report highlights that we encountered a patient who presented with neuropsychiatric manifestations, whereby the patient was managed for the psychiatric symptoms prior to the organic diagnosis being made.
    Matched MeSH terms: Arthralgia
  16. Fulltext The impact of digital healthcare systems on pain and body function in patients with knee joint pain: a systematic review and meta-analysis
    Guo L, Li S, Xie S, Bian L, Shaharudin S
    Sci Rep, 2024 Feb 09;14(1):3310.
    PMID: 38331984 DOI: 10.1038/s41598-024-53853-z
    The digital healthcare (DH) system has recently emerged as an advanced rehabilitation approach that promotes rehabilitation training based on virtual reality (VR) and augmented reality (AR). The purpose of this meta-analysis study is to review and assess the impact of DH systems on pain and physical function among patients diagnosed with knee joint pain. Between January 2003 and September 2023, studies that met the listed inclusion criteria were gathered from Scopus, PubMed, Web of Science, and EBSCO databases. The analysis of standardized mean difference (SMD) was carried out with 95% confidence interval (95% CI) (PROSPERO registration number: CRD42023462538). Eight research papers were selected, which collectively involved 194 males and 279 females. The meta-analysis outcomes revealed that DH intervention significantly improved balance (SMD, 0.41 [0.12, 0.69], p 
    Matched MeSH terms: Arthralgia
  17. Fulltext Effects of isometric training and R.I.C.E. treatment on the arm muscle performance of swimmers with elbow pain
    Li W, Hadizadeh M, Yusof A, Naharudin MN
    Sci Rep, 2024 Feb 27;14(1):4736.
    PMID: 38413632 DOI: 10.1038/s41598-024-54789-0
    The effects of IT and R.I.C.E. treatment on arm muscle performance in overhead athletes with elbow pain (EP) have been partially validated. However, there is a lack of research evidence regarding the efficacy of these two methods on arm muscle performance among swimmers with EP. The aim of this study was to investigate the trends and differences in the effects of IT and R.I.C.E. treatment on arm muscle performance among swimmers with EP. The main outcomes were the time effects and group effects of interventions on muscle voluntary contraction (MVC). Sixty elite freestyle swimmers from Tianjin, China, voluntarily participated in the study and completed a 10-week intervention program. Swimmers with EP in the IT group showed a positive trend in MVC, with an approximately 2% increase, whereas the MVC of subjects in the R.I.C.E. treatment group and control group decreased by approximately 4% and 5%, respectively. In comparison, the effects of the IT intervention on the MVC of the triceps and brachioradialis muscles in swimmers with EP were significant (p = 0.042 
    Matched MeSH terms: Arthralgia
  18. Tibia vara and slipped upper femoral epiphysis: is there an association?
    Jamil K, Abdul Rashid AH, Ibrahim S
    J Pediatr Orthop B, 2015 Jan;24(1):46-9.
    PMID: 25192368 DOI: 10.1097/BPB.0000000000000101
    Tibia vara and slipped upper femoral epiphysis (SUFE) share a common risk factor, but their relationship is unclear. In both conditions, the patients are usually obese. To the best of our knowledge, there have been only two previous reports in the literature that have described the occurrence of tibia vara and SUFE in three patients. We report a child who was treated for bilateral tibia vara at the age of 3 years and subsequently developed a SUFE at the age of 13 years.
    Matched MeSH terms: Arthralgia/etiology
  19. Vitamin D deficiency is associated with ethnicity and knee pain in a multi-ethnic South-East Asian nation: Results from Malaysian Elders Longitudinal Research (MELoR)
    Mat S, Jaafar MH, Sockalingam S, Raja J, Kamaruzzaman SB, Chin AV, et al.
    Int J Rheum Dis, 2018 May;21(5):930-936.
    PMID: 29611292 DOI: 10.1111/1756-185X.13279
    AIM: To determine the association between vitamin D and knee pain among participants of the Malaysian Elders Longitudinal Research (MELoR) study.

    METHOD: This was a cross-sectional study from the MELoR study consisting of a representative group of 1011 community-dwelling older persons (57% female), mean age 86.5 (54-94) years; 313 were Malays, 367 Chinese and 330 Indians. Participants were asked if they had knee pain. Levels of serum 25-hydroxy cholecalciferol (25-[OH]D), an indicator of vitamin D status, were measured using routine laboratory techniques.

    RESULTS: In unadjusted analysis, presence of knee pain was significantly associated with vitamin D deficiency (odds ratio [OR] 1.42; 95% confidence interval (CI) 1.08-1.85, P 0.011). Vitamin D levels were significantly associated with ethnicity differences where Malays (OR 7.08; 95% CI 4.94-10.15) and Indians (OR 6.10; 95% CI 4.28-9.71) have lower levels of vitamin D compared to Chinese. Subsequent multivariate analysis revealed that the association between vitamin D deficiency and knee pain was confounded by ethnic differences.

    CONCLUSION: A previous study suggested that vitamin D deficiency was associated with knee pain. This relationship was reproduced in our study, but we further established that the association was explained by ethnic variations. As vitamin D status is dependent on skin tone, diet and sunlight exposure, which are all effected by ethnicity, future studies are now required to determine whether a true relationship exists between vitamin D and knee pain.
    Matched MeSH terms: Arthralgia/diagnosis; Arthralgia/ethnology*
  20. Fulltext Musculoskeletal pain in Malaysia: a COPCORD survey
    Veerapen K, Wigley RD, Valkenburg H
    J Rheumatol, 2007 Jan;34(1):207-13.
    PMID: 17216688
    Objective. To assess the nature and extent of rheumatic complaints in a semirural area in a multiracial (Malay, Indian, Chinese) community in Malaysia using the Community Oriented Program for the Control of Rheumatic Diseases (COPCORD) protocol initiated by ILAR and the WHO.
    Methods. All members of a community of 2700 persons over the age of 15 years were offered a questionnaire based interview in Phase 1 of the study. Those with rheumatic complaints (pain in the last 1 week) were invited for a physical examination by a rheumatologist in Phase 2.
    Results. In total, 2594 (96%) persons agreed to a questionnaire based interview. Of those interviewed, 21.1% had a current rheumatic complaint. The pain rate was higher in women (23.8%) than in men (17.8%). Chinese men had the lowest age-standardized pain rate (9.9%), while Indian women had the highest rate (28.4%). In the study population, 14.4% complained of pain in the joints and/or musculoskeletal pain and 11.6% had low back pain. The knee was responsible for 64.8% of all complaints pertaining to the joints, and more than half those examined with knee pain had clinical evidence of osteoarthritis (OA). The complaint rate increased with age, up to 53.4% in the group age > 65 years. The major disability encountered was the inability to squat (3.1%). Fibromyalgia, soft tissue lesions, and localized OA of the knees were the main clinical diagnoses. Inflammatory arthritis was uncommon. Both Western and traditional sources of healthcare were used, often together. Self-medication was common (58.8%).
    Conclusion. Knee and back pain are the main rheumatic complaints in Malaysia, with complaint rates differing according to race and gender.
    Matched MeSH terms: Arthralgia/ethnology*; Arthralgia/epidemiology*
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