Musculoskeletal Abnormalities https://greenmedinfo.com/taxonomy/term/3371/all en Aromatase inhibitors can induce an arthralgia syndrome. https://greenmedinfo.com/article/aromatase-inhibitors-can-induce-arthralgia-syndrome PMID:  J Clin Oncol. 2008 Jul 1;26(19):3147-52. Epub 2008 May 12. PMID: 18474874 Abstract Title:  Prospective study to assess short-term intra-articular and tenosynovial changes in the aromatase inhibitor-associated arthralgia syndrome. Abstract:  PURPOSE: Arthralgia is an adverse class effect of aromatase inhibitors (AIs). To date, its exact mechanism remains unclear. The purpose of this study was to investigate the changes in clinical rheumatologic features and magnetic resonance imaging (MRI) of hands and wrists in AI and tamoxifen users.PATIENTS AND METHODS: This is a prospective single-center study including 17 consecutive postmenopausal patients with early breast cancer receiving either tamoxifen (n = 5) or an AI (n = 12). At baseline and after 6 months, patients filled in a rheumatologic history questionnaire and a rheumatologic examination including a grip strength test was done. At the same time points, MRI of both hands and wrists was performed. The primary end point was tenosynovial changes from baseline on MRI. Secondary end points were changes from baseline for morning stiffness, grip strength, and intra-articular fluid on MRI. Wilcoxon signed ranks was used to test changes from baseline and the Spearman correlation coefficient to assess the association between rheumatologic and MRI changes from baseline.RESULTS: At 6 months, patients on AI had a decrease in grip strength (P = .0049) and an increase in tenosynovial changes (P = .0010). The decrease in grip strength correlated well with the tenosynovial changes on MRI (P = .0074). Only minor changes were seen in patients on tamoxifen. AI users reported worsening of morning stiffness and showed an increase in intra-articular fluid on MRI.CONCLUSION: The functional impairment of hands in the AI-associated arthralgia syndrome is characterized by tenosynovial changes on MRI correlating with a significant decrease in hand grip strength. https://greenmedinfo.com/article/aromatase-inhibitors-can-induce-arthralgia-syndrome#comments Arthralgia Breast Cancer Drug-Induced Toxicity Musculoskeletal Abnormalities Rheumatic Diseases Aromatase Inhibitor Drugs Drug: Tamoxifen Human Study Fri, 14 Jan 2011 23:19:31 +0000 greenmedinfo 60182 at https://greenmedinfo.com Bony Protrusions in Young Adults: Are Cellphones to Blame? https://greenmedinfo.com/blog/bony-protrusions-young-adults-are-cellphones-blame <div class="copyright">This article is copyrighted by GreenMedInfo LLC, 2020<br/><strong><a href="/greenmedinfocom-re-post-guidelines">Visit our Re-post guidelines</a></strong></div><p class="rtecenter"><img alt="" src="//cdn.greenmedinfo.com/sites/default/files/ckeditor/blank.justin/images/Bony_Protrusions_in_Young_Adults_Are_Cell_Phones_to_Blame-GreenMedInfo.jpg" style="width: 600px; height: 315px;" /></p> <p><span style="font-size:18px;"><strong><em>While cellphone use has raised concerns about health implications before, research suggests that cellphones may be causing prominent bony projections to grow in the back of young adult heads</em></strong></span></p><p><a href="https://greenmedinfo.com/blog/bony-protrusions-young-adults-are-cellphones-blame" target="_blank">read more</a></p> https://greenmedinfo.com/blog/bony-protrusions-young-adults-are-cellphones-blame#comments Alcohol Toxicity Musculoskeletal Abnormalities Obesity Osteoarthritis Tobacco Toxicity Health Guide: Corruption in Science bone health electromagnetic field exposure technology Sat, 09 May 2020 20:57:06 +0000 GMI Research Group 220066 at https://greenmedinfo.com Clinically relevant musculoskeletal symptoms develop in women treated with aromatase inhibitors, leading to treatment discontinuation in a substantial percentage of these patients. https://greenmedinfo.com/article/clinically-relevant-musculoskeletal-symptoms-develop-women-treated-aromatase-i PMID:  Cancer. 2010 Sep 15;116(18):4360-7. PMID: 20549827 Abstract Title:  A prospective study of aromatase inhibitor-associated musculoskeletal symptoms and abnormalities on serial high-resolution wrist ultrasonography. Abstract:  BACKGROUND: Nearly half of women treated with aromatase inhibitors (AI) develop AI-associated musculoskeletal symptoms (AIMSS) such as arthralgias, but to the authors&#039; knowledge the etiology is unclear. The upper extremities are frequently affected, especially the wrists, hands, and fingers. AI use may also increase the risk of developing carpal tunnel syndrome. Tendon sheath fluid and tenosynovial changes have been demonstrated by imaging symptomatic patients who were treated with AIs. The authors hypothesized that these abnormalities are correlated with AIMSS.METHODS: Thirty consecutive patients in whom adjuvant therapy with letrozole or exemestane was initiated on a prospective clinical trial enrolled in a pilot study evaluating tendon and joint abnormalities at baseline and after 3 months of AI therapy. Patients underwent high-resolution ultrasonography of the wrists bilaterally and completed the Health Assessment Questionnaire (HAQ) and pain Visual Analog Scale (VAS). AIMSS were defined as an increase in the HAQ or VAS score during AI therapy that exceeded a predefined cutoff.RESULTS: Twenty-five patients completed both the baseline and 3-month assessments. During the first 12 months of AI therapy, 15 patients developed AIMSS, and 13 discontinued therapy because of musculoskeletal symptoms. There was a trend toward an association between the presence of tendon sheath abnormalities on wrist ultrasound at baseline and the development of AIMSS (P = .06).CONCLUSIONS: Clinically relevant musculoskeletal symptoms develop in women treated with AIs, leading to treatment discontinuation in a substantial percentage of these patients. However, in the current study, patient-reported symptoms were not found to be associated with changes visible on wrist ultrasonography. https://greenmedinfo.com/article/clinically-relevant-musculoskeletal-symptoms-develop-women-treated-aromatase-i#comments Drug-Induced Toxicity Musculoskeletal Abnormalities Exemestane Letrozole (trade name Femera) Human Study Fri, 14 Jan 2011 22:57:57 +0000 greenmedinfo 60178 at https://greenmedinfo.com Musculoskeletal complaints are exceedingly common (71.5%) in those receiving long-term (6 months or longer) aromatase inhibitor therapy. https://greenmedinfo.com/article/musculoskeletal-complaints-are-exceedingly-common-715-those-receiving-long-ter PMID:  Breast Cancer Res Treat. 2010 Feb;120(1):127-34. Epub 2009 Dec 25. PMID: 20035381 Abstract Title:  Effect of a switch of aromatase inhibitors on musculoskeletal symptoms in postmenopausal women with hormone-receptor-positive breast cancer: the ATOLL (articular tolerance of letrozole) study. Abstract:  The objective of the present study was to evaluate the effect of the switch of aromatase inhibitors (AIs) on musculoskeletal symptoms in postmenopausal women with hormone-receptor-positive breast cancer. This was a 6-month, prospective, non-randomized, multicenter study. Patients who had discontinued anastrozole due to musculoskeletal symptoms were eligible to participate in this study, and received letrozole, which was initiated 1 month after anastrozole discontinuation. Musculoskeletal symptoms were systematically assessed for severity, location of the symptoms, presence of swelling and of morning stiffness by the oncologist patients when patients stopped taking their anastrozole, 1 month after the discontinuation of anastrozole, and 1, 3, and 6 months after initiating the letrozole therapy. The primary endpoint was the percentage of patients who discontinued letrozole due to the severe musculoskeletal symptoms. After switching from anastrozole therapy, and at the end of the 6-month letrozole treatment, 128 (71.5%) out of 179 patients (61.3 +/- 8.4 years) continued with letrozole. Fifty-one patients (28.5%) discontinued treatment due to severe joint pain. At the end of the 6-month, 116 patients (73.9%) had arthralgia, 33 (21.0%) myalgia, 25 (15.9%) arthritis, 22 (14.0%) tendinitis, and 20 (12.7%) polyalgic syndrome. Bivariate analysis of the factors associated with letrozole discontinuation showed that the duration of a prior anastrozole treatment was a significant predictor (P = 0.04). This study shows that in patients intolerant to one AI, switching to another agent allows a higher proportion of patients to continue the therapy and maximize hormonal adjuvant therapy and disease outcome benefits. https://greenmedinfo.com/article/musculoskeletal-complaints-are-exceedingly-common-715-those-receiving-long-ter#comments Arthralgia Arthritis Breast Cancer Drug-Induced Toxicity Musculoskeletal Abnormalities Myalgias Polymyalgia Rheumatica Tendinitis Arimidex Aromatase Inhibitor Drugs Letrozole (trade name Femera) Human Study Fri, 14 Jan 2011 23:12:59 +0000 greenmedinfo 60181 at https://greenmedinfo.com Musculoskeletal pains in breast cancer patients under third generation AIs can be severe, debilitating and are associated with tenosynovial and joint changes. https://greenmedinfo.com/article/musculoskeletal-pains-breast-cancer-patients-under-third-generation-ais-can-be PMID:  Breast Cancer Res Treat. 2007 Jul;104(1):87-91. Epub 2006 Oct 24. PMID: 17061044 Abstract Title:  Debilitating musculoskeletal pain and stiffness with letrozole and exemestane: associated tenosynovial changes on magnetic resonance imaging. Abstract:  OBJECTIVE: Arthralgia, skeletal and muscle pain have been reported in postmenopausal women under treatment with third generation aromatase inhibitors (AIs). However, the pathogenesis and anatomic correlate of musculoskeletal pains have not been thoroughly evaluated. Moreover, the impact of AI-induced musculoskeletal symptoms on normal daily functioning needs to be further explored.PATIENTS AND METHODS: We examined 12 consecutive non-metastatic breast cancer patients who reported severe musculoskeletal pain under a third generation AI; 11 were on letrozole and 1 on exemestane. Clinical rheumatological examination and serum biochemistry were performed. Radiological evaluation of the hand/wrist joints were performed using ultrasound (US) and/or magnetic resonance imaging (MRI).RESULTS: The most common reported symptom was severe early morning stiffness and hand/wrist pain causing impaired ability to completely close/stretch the hand/fingers and to perform daily activities and work-related skills. Six patients had to discontinue treatment due to severe symptoms. Trigger finger and carpal tunnel syndrome were the most frequently reported clinical signs. US showed fluid in the tendon sheath surrounding the digital flexor tendons. On MRI, an enhancement and thickening of the tendon sheath was a constant finding in all 12 patients.CONCLUSIONS: Musculoskeletal pains in breast cancer patients under third generation AIs can be severe, debilitating, and can limit compliance. Characteristic tenosynovial, and in some patients joint changes on US and MRI were observed in this series and have not been reported before. https://greenmedinfo.com/article/musculoskeletal-pains-breast-cancer-patients-under-third-generation-ais-can-be#comments Breast Cancer: Recovery Musculoskeletal Abnormalities Aromatase Inhibitor Drugs Exemestane Letrozole (trade name Femera) Human Study Fri, 14 Jan 2011 23:04:23 +0000 greenmedinfo 60179 at https://greenmedinfo.com