Index A variability, 233 Abatacept, 67 classification criteria Absolute fracture risk model (FRAX), 242 clinical, 232 Acetaminophen, 62, 75 laboratary, 232 aCL ELISA tests, 233 clinical and subclinical atherosclerosis, 20 Acupuncture, 54 features, 231 Acute gouty arthritis therapy, 209 morbidity and mortality, 232–233 Acute pseudogout precipitators, elderly, 216 Anti-TNF agents Aerobic exercise, 109, 125, 126, 128, 261 adalimumab, 164 AION, 226 efficacy, 164 Alcoholic myopathy, 270 etanercept, 164 Amyloid myopathy, 269–270 infliximab, 165 Anakinra, 67 safety, 164 Analgesics, 52–53 Anti-TNF alpha agents, 66–67 ANCA-associated renal vasculitis Anti-TNFa(alpha) therapy, 37 age indicator, 202 Apoptosis, 4 cyclophosphamide dose, 202 APS. See Antiphospholipid syndrome (APS) diagnosis, 32 Arthritis-specific federal policy initiatives morbidity and mortality determinant, 201 CDC Arthritis Program, 97 therapy, 32 Healthy People 2010, 96 Angiotensin converting enzyme (ACE), 262 The National Arthritis Action Plan, 96–97 Ankylosing Spondylitis (AS), 109–110 National Arthritis Act of 1974, 95–96 atherosclerosis, 20–21 National Arthritis Plan of 1976, 95–96 clinical features, 104 National Institute of Arthritis, 96 inspiratory muscle training, 110 Arthrocentesis pathology, 110 corticosteroids, 113–114 physical therapy interventions, 104 elbow sacroilitis, 110 joint effusion, 118 self-management, 110 olecranon bursa injection, 118 Anticonvulsants, 52 tennis elbow injection, 118 Antidepressants, 51–52 foot Antimalarials ankle injection (tibio-talar), 121 clinical pharmacology, 154 metatarsophalangeal joint injection, 122 efficacy, 154–155 Morton’s neuroma, 122 safety, 155 plantar fasciitis injection, 121 Antineutrophil cytoplasmic antibodies, 198 posterior tibialis tendon sheath injection, 121–122 Antiphospholipid (aPL) antibodies hip, 120 diseases, 233–234 hyaluronates, 114 elderly, 234–236 indications, 113 Antiphospholipid syndrome (APS) knee injection, 120–121 aCL antibodies, prevalence local anesthetics, 114 aCL ELISA tests, 233 post injection care, 116 Louisville reference standards, 233 precautions and contraindications, 115 venous thromboembolism, 233 shoulder aPL antibodies, prevalence acromioclavicular joint (ACJ) injection, 117 autoimmune diseases, 233 biceps tendon injection, 117–118 elderly, 234–236 glenohumeral joint injection, 116 non-parametric tests, 233 subacromial-subdeltoid (SA-AD) bursal injection, 116–117 SLE patients, 233 suprascapular nerve block, 117 transient ischemic attacks and strokes, 233 side effects and complications, 114–115 Y. Nakasato and R.L. Yung (eds.), Geriatric Rheumatology: A Comprehensive Approach, 293 DOI 10.1007/978-1-4419-5792-4, © Springer Science+Business Media, LLC 2011 294 Index Arthrocentesis (cont.) anatomy and physiology, 11 technical considerations, 115–116 fracture healing, 12–13 wrist and hand remodeling, 241 carpal tunnel injection, 118–119 resorption, 241 De Quervain’s tenosynovitis injection, 120 senile osteoporosis, 11–12 first carpometacarpal (CMC) joint, 119 Bone mineral density (BMD), 179 ganglion, 119 Bone remodeling, 241 metcarpophalangeal and proximal interphalangeal Bone resorption, 241 joints injection, 119 Boost test, 39 trigger finger injection, 119–120 Bracing or splinting, 77 Arthroplasty, 82 BRMs. See Biologic response modifiers (BRMs) Atherosclerosis ankylosing spondylitis, 20–21 antiphospholipid syndrome (APS), 20 C ASCVD, epidemiology of, 19–20 Calcium-containing crystal-associated arthropathies. See Calcium atheroma, 17 pyrophosphate dihydrate (CPPD) deposition disease clinical implications, preventive strategies Calcium pyrophosphate dihydrate (CPPD) antimalarial agents, 22 deposition disease biological therapies, 22 and BCP pathogenesis, 218–219 corticosteroids, 21 clinical spectrum, 214–215 methotrexate, 22 diagnosis mycophenolate mofetil, 22 characteristic rhomboid shape demonstration, 216 NSAIDs and COX–2 inhibitors, 21 MSKUS, 216–217 statins, 21–22 epidemiology, 213 pathologic mechanisms, SLE and RA, 18–19 osteoarthritis and, 215 primary systemic vasculitis, 21 treatment psoriasis and psoriatic arthritis, 20 acute pseudogout attack management, 217 shared disease mechanisms, 17–18 biologic therapy, 218 systemic sclerosis, 21 colchicine or corticosteroids, 218 Atherosclerotic cardiovascular disease (ASCVD) dietary calcium, 218 endothelial dysfunction, 18 hydroxychloroquine or methotrexate, 218 epidemiology magnesium, 218 RA and ASCVD mortality, 19 NSAIDs, 217 SLE and ASCVD mortality, 19 probenecid, 218 subclinical atherosclerosis in SLE and RA, 19–20 Cataracts, medium-and small-vessel vasculitis, 203–204 pathologic mechanisms, 18–19 Cevimeline, 290 Autoimmunity, 290 Chloroquine, 66 Azathioprine, 66 Churg-Strauss syndrome (CSS), 200 CNS angiitis diagnosis, 32–33 B therapy, 33 Barthels Index, 88 Cognitive-behavioral therapy (CBT), 53 Basic calcium phosphate (BCP) diseases Colchicine, 209, 270 and CPPD pathogenesis, 219–220 Comorbid psychiatric disorders, 53 Milwaukee shoulder syndrome, 219 Complementary and alternative medicine (CAM) practices, 77 B cells, 6 Corticosteroids, 21, 270 Biologic response modifiers (BRMs), 159–167 CPPD. See Calcium pyrophosphate dihydrate (CPPD) deposition abatacept, 166 disease anakinra, 166–167 Cryotherapy, 76 cancer, older RA patient, 163–164 Crystal arthropathies, 179 other safety concerns, 164 Crystal induced inflammation, 220 rituximab, 167 Cyclooxygenase–2 (COX–2) inhibitors, 21 TNF-a(alpha) action, 159 Cyclophosphamide, 282, 290 TNF inhibiting agents, older RA patient, 163 Cyclosporin, 66, 289–290 Biomechanic factors knee laxity, 180 LLI, 180–181 D proprioception, 181 Degenerative lumbar spinal stenosis (LSS) Bisphosphonate therapy classification, 102 males, 242 definition, 102 osteonecrosis of jaw, 244 pathophysiology, 103 BMD. See Bone mineral density (BMD) physical examination findings and interventions Bone Maine lumbar spine study, 105 age-related changes sensory and proprioceptive changes, 102 cytokines, 12 therapeutic exercise, 104–105 GH-IGF axis, 12 Dendritic cells (DC), 6 vitamin D, 14–15 Depot corticosteroid crystals, 221 Index 295 Dermatomyositis (DM) differential diagnosis autoantibodies, 265, 266 ESR and C-reactive protein (CRP), 146 diagnosis, 265 pro-inflammatory cytokine pattern, 146 incidence rates, 265 radiographic evaluation, 146 malignancy, 266–267 seropositive patients, 146 Deyo-Charlson Comorbidity Index, 211 serum rheumatoid factor (RF), 146 Disease-modifying anti-rheumatic drug (DMARD) inflammatory arthritis, 145 antimalarials symptoms, 145 clinical pharmacology, 154 treatment, 147–149 efficacy, 154–155 Electrical stimulation, 76 safety, 155 Enzyme-linked immunosorbent assay (ELISA), 233 anti-TNF agents Eosinophilic fasciitis (EF), 279 adalimumab, 164 Exercise, 110 efficacy, 164 aerobic, 109, 125, 126, 128 etanercept, 164 characterization, 125 infliximab, 165 definition, 125 safety, 164 degenerative LSS, 104 biologic response modifiers and fall prevention, 243–244 abatacept, 166 interventions, 98, 107 anakinra, 166–167 muscle strengthening, 126, 128 cancer, older RA patient, 163–164 nursing home patient, 77 other safety concerns, 164 range-of-motion, 102 rituximab, 167 sarcopenia, 261 TNF-a(alpha) action, 159 stabilization and closed chain, 102 TNF inhibiting agents, older RA patient, 163 Eye dryness. See Xeropthalmia introduction, 151–152 Ezetimibe, 270 leflunomide clinical pharmacology, 155 efficacy, 156 F safety, 156 Facioscapulohumeral dystrophy, 267 methotrexate Febuxostat, 210 clinical pharmacology, 156–157 Fibrates, 270 efficacy, 157 Fibric acid derivatives, 270 safety, 157–158 Fibromyalgia syndrome (FMS) physiologic changes with aging chronic pain assessment, 46–47 pharmacodynamics, 153–154 classification criteria, 45 pharmacokinetics, 152–153 clinical presentation, 47 sulfasalazine definition and epidemiology, 45–46 clinical pharmacology, 158 differential diagnosis, 48, 49 efficacy, 158 pain processing and analgesia, 46 safety, 158–159 pathogenesis, 46 Disease modifying anti-rheumatic drugs (DMARDs), 147 physical examination, 47–48 azathioprine, 66 prevalence, 45 chloroquine, 66 signs and symptoms, 47 cyclosporine, 66 treatment hydroxychloroquine, 66 analgesics, 52–53 leflunomide, 65–66 anticonvulsants, 52 methotrexate, 65 antidepressants, 51–52 sulfasalazine, 66 comorbid psychiatric disorders, 53 Drug-induced myopathy non-pharmacological management, 53–54 alcoholic myopathy, 270 Fluoxetine, 52 colchicine, 270 Fracture healing, 12–13 corticosteroids, 270 Fragility fracture, osteoporosis, 241 lipid lowering agents, 270 Frailty and Injuries: Cooperative Studies of Intervention Techniques statin drugs, 270–271 (FICSIT) studies, 126 Duloxetine, 52 G E Gadolinium, 279 Elderly onset rheumatoid arthritis GCA. See Giant cell arteritis (GCA) aging factors, 147 Geriatric Depression Scale, 88 characterization, 145 Geriatric gout management clinical features accurate diagnosis, 209 de novo development, 145 acute gouty arthritis therapy, 209 disease duration, 146 in elderly patients physical examination, 146 drug adherence rates, 210 vs.YORA, 146 health care costs, 211 296 Index Geriatric gout management (cont.) T-cell migration, 5 hyperuricemia treatment Th1 and Th2 responses, 5 allopurinol, 210 Th17 cells, 5 febuxostat, 210 vaccine efficacy, elder patients, 7 serum urate level, 209–210 Immunosenescence, 7 Geriatric rheumatology adaptive immunity definition, 86 B-cells, 253–254 future aspects, 89–90 Gavazzi and Krause postulate, 254 Gerontorheumatology outpatient service (GOS) memory T-cells, 253 aims