[Prevalence, comorbidity and interdisciplinary treatment of rheumatoid arthritis - Insurance data on outpatient and inpatient care in Baden-Württemberg]. / Prävalenz, Komorbidität und interdisziplinäre Versorgung der Rheumatoiden Arthritis ­ Versicherungsdaten zur ambulanten und stationären Versorgung in Baden-Württemberg.

BACKGROUND: Rheumatoid arthritis (RA) has an increased number of comorbidities compared with the general population. OBJECTIVE: Study aim was to collect epidemiological data on prevalence, incidence and comorbidities of RA as well as utilization of outpatient and inpatient care services. MATERIAL AND METHODS: In an age and gender-adjusted case control study, a total of 3.4 million patients insured by the AOK Baden-Württemberg were analysed with respect to visits to physicians, prevalence, incidence and comorbidities of RA. The study was based on out- and inpatient diagnoses from 2013. RESULTS: The RA prevalence was 0.64% (n = 26,919), the incidence was 0.04%. Patients with RA have significant more comorbidities in almost all diagnosis groups, especially in musculoskeletal and cardiovascular diseases, compared to a control group (n = 181,209). 22.8% of RA patients had not contacted an internist rheumatologist, orthopedist or orthopedic surgeon. Biological disease-modifying anti-rheumatic drugs (DMARDs) were almost exclusively prescribed by internist rheumatologists, while conventional DMARDs were equally prescribed by general practitioners and rheumatologists. Of the RA patients 32.6% were hospitalized at least once a year and were nearly twice as frequently inpatient as the control group. CONCLUSION: RA patients need more in- and outpatient healthcare services and suffer significantly more often from comorbidities. The general practitioner is the most frequently visited physician. Other consulted physicians are rheumatologists, ophthalmologists, orthopedists/orthopedic surgeons and internists not specialized in rheumatology. The study highlights the need to create consensus treatment algorithms and maintain a close interdisciplinary and intersectoral cooperation and communication.

[Quantification and visualization of the influence of pelvic tilt upon measurement of acetabular inclination and anteversion]. / Quantifizierung und Visualisierung des Einflusses der Beckenkippung auf die Messung von Pfanneninklination und -anteversion.

AIM: The indication of acetabular inclination and anteversion not only depends on definition but also on a correctly aligned patient. Determination of anteversion and inclination according to Sven-Johannsson and Visser were simulated with 3D calculations. The influence of pelvic tilt in relation to the frontal plane was evaluated and visualized. METHOD: With 3D calculations of planar X-ray photographs for artificial hip cups the normal vector of the acetabular cup was used to calculate anteversion and inclination. RESULTS: The main axis of the projected acetabular rim is equally suited to determine the cup orientation as the normal vector of the cup plane. Pelvic tilt of about 10 degrees causes measuring errors of about 8 degrees when measured with conventionally used techniques. CONCLUSION: For the correct determination of cup orientation pelvic tilt in relation to the frontal plane has to be accounted for.