Planning a treatment program for the patient with rheumatoid arthritis.
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Biomedical subjects
Publications and source records attributed to J G Mayne.
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The diagnosis and the treatment of rheumatic diseases in older people pose special problems. Degenerative joint disease, almost universally present in the elderly, may not be the basis for the newly developing rheumatic symptoms. Systemic inflammatory disease may be confused with malignancy or it may be an initial manifestation of malignancy. Some drugs used to control central-nervous-system or cardiovascular disease may produce painful rheumatic syndromes. Results of laboratory tests used in the diagnosis of rheumatic diseases may be altered by other nonrheumatic disorders in older people. Papers in this symposium will explore these concepts in greater detail.
Older people often complain of back pain, but it usually is not a major complaint except in the presence of serious disease such as malignancy, compression fractures from osteoporosis, or disc-space infections. When back pain is a serious symptom in the elderly patient, the physician should look beyond the obvious evidences of degenerative joint disease for these other more serious conditions. Satisfactory examination of the back does not require an undue amount of time. It is important that it be done systematically. Simple, rapid, and adequate procedures are described.
As a means of evaluating the effect of each presentation at a national medical conference and of the meeting as a whole, the scheduled lecturers were asked to supply the testers with several questions that summarized the most important points of their talks. Audience participants at the meeting were given tests drawn from these questions--one test before the beginning of the meeting, and another at the end. The results were compared for the answers to each lecturer's 3-question group, and for the complete tests. All scores were better at the end than at the beginning of each lecture. A follow-up survey of the attitudes of participants showed a positive reaction to the use of such testing at future meetings.
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