Volume 5, Number 2

Alexander Bennett MRCP MSc Specialist Registrar, Rheumatology; Laura Coates MRCP Specialist Registrar, Rheumatology; Helena Marzo-Ortega MRCP Consultant Rheumatologist, Chapel Allerton Hospital, Leeds

Ankylosing spondylitis (AS) is a chronic progressive inflammatory disorder that affects the axial skeleton and peripheral joints and is considered the prototype of the spondyloarthropathies (SpAs). It is common, with a prevalence of up to 1.4%, and typically affects young patients in the second and third decades of life.

Andrew Bamji FRCP President, British Society for Rheumatology

Paul Emery began his editorial for the summer 2007 issue, ‘This is a critical period for the interaction between primary and secondary care,’ and he is right. The last ten years of this Labour government have produced more funding for the NHS than ever before, and yet there has been increasing disillusionment, even despair, among doctors on both sides of the fence that has been erected to separate hospitals from the community.

Paul Emery, Editor

In this issue of Rheumatology in practice we address a number of the areas that are currently of contention in the field.

At the 2007 annual congress of the European League Against Rheumatism (EULAR), data from a study at the Karolinska Institute, Sweden, showed that women receive anti-tumour necrosis factor drugs at a higher perceived level of disease activity and when reporting more severe pain than men. Lead researcher Ronald van Vollenhoven commented, 'Our study does not show a gender bias as such, but does indicate that physicians to some extent "discount" the subjective measures of disease activity'.

Hayley Faries Medical student; Helen Foster MD MBBS (Hons) FRCP FRCPCH Cert Med Ed Professor, Paediatric Rheumatology, Newcastle University

The last few decades have seen huge changes in the management of juvenile idiopathic arthritis (JIA). For most children with JIA – with prompt referral to specialist teams and access to appropriate care – remission without functional limitation is an expected outcome.

Kimme Hyrich MD PhD FRCPC Clinical Lecturer in Rheumatology; Deborah Symmons MD FRCP Professor in Rheumatology and Musculoskeletal Epidemiology, The University of Manchester

A registry involves the systematic follow-up of a population defined by a common factor – for example, a disease or exposure to a particular therapy – to study specific outcomes. The study design is known as a longitudinal observational study. In rheumatology, patient registries have provided us with valuable information on the 'real-world' outcomes (that is, those outside clinical trials) among patients living with rheumatic diseases.

Jackie Hill RN PhD MPhil FRCN arc Senior Lecturer in Rheumatology Nursing, Co-director, Academic and Clinical Unit for Musculoskeletal Nursing, University of Leeds, Chapel Allerton Hospital

Nurses have long been considered essential members of the rheumatology team, but it was not until the 1980s that the role of specialist nurse began to evolve. It was at this time that many of the drug treatments and management of inflammatory rheumatic diseases became increasingly complex, and it was realised that with specialist training, nurses could provide specialist services in the multidisciplinary team.