Volume 7, Number 4

Brian Hazleman MA MB FRCP Honorary Consultant in Rheumatology, Addenbrooke’s Hospital, Cambridge

The comedian and TV personality Lee Hurst has lived with ankylosing spondylitis (AS) for over 20 years. Here, he talks to Brian Hazleman about how it has affected his life and work – currently focused on Lee Hurst’s Comedy Club in east London – his coping mechanisms, and his opinions on the treatment available, while Dr Hazleman provides a clinical perspective.

Devesh Mewar BChir MB MRCP Consultant in Rheumatology, Royal Liverpool University Hospital, Liverpool; Gerry Wilson MB PhD FRCP DCH Professor of Rheumatology, University of Sheffield, Royal Hallamshire Hospital, Sheffield

The past ten years have seen major advances in the management of individuals with rheumatoid arthritis (RA). High-quality controlled trials have established the efficacy of conventional disease-modifying antirheumatic drugs (DMARDs) such as methotrexate, as well as an increasing range of newer biologic agents.

Claire Wenham BMBS MRCP Clinical Research Fellow, NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds; Philip Conaghan MB BS PhD FRACP FRCP Professor of Musculoskeletal Medicine, NIHR Leeds Musculoskeletal Biomedical Research Unit and Section of Musculoskeletal Disease, Leeds Institute of Molecular Medicine, University of Leeds

In February 2008, the National Institute for Health and Clinical Excellence (NICE) issued a comprehensive guide to the care and management of osteoarthritis (OA) in adults. In this article, the authors will draw out the key points from these recommendations with a view to updating front-line clinicians and highlighting areas of potential change in practice.

Jason Seewoodhary BSc(Hons) MBBCh(Hons) MRCP(UK) Specialist Registrar in Rheumatology and General Medicine; Sarah M Keidel BM BCh(Oxon) MA(Oxon) MRCP(UK) Specialist Registrar in Rheumatology and General Medicine; Sally E Edmonds MBBS MD FRCP(UK) Consultant Rheumatologist, Department of Rheumatology, Stoke Mandeville Hospital, Aylesbury

Osteoporosis is a disorder characterised by low bone mass and microarchitectural deterioration, with a resulting increase in bone fragility and susceptibility to fracture. It is a very important public health issue, because of the high morbidity and mortality of people with fractures. The incidence of osteoporosis-related fractures is increasing and this constitutes a major public health problem.

Thomas Rider MBBS BCS F1 Doctor in General Medicine; Kelsey M Jordan MBChB MRCP(UK) Consultant Rheumatologist, Brighton and Sussex University Hospitals Trust

Gout is one of the oldest recognised diseases, first identified by the Egyptians in 2640 BC. Hippocrates later described the disease as ‘arthritis of the rich’, due to its association with rich foods and excessive alcohol. Currently, gout has a prevalence of 1.4% in the UK; this does not appear to be rising, unlike in many other countries around the world.

Paul Emery, Editor

Can medicines be too successful? This question can be raised with the case of the therapy for gout. The availability of highly successful and specific treatment with allopurinol relegated interest in gout to a very low level for many years.