UPFRONT | News and events NEW FINDINGS RESEARCH Finger joint enlargements may be linked to knee osteoarthritis arthritis. “The presence of He-berden’s nodes in a physical examination is associated with a distinct pattern of worsening of osteoarthri-tis-related structural damage in the knee joint,” said leading author Dr. Arya Haj-Mirza-ian, of the Johns Hopkins University School of Medi-cine. “These exploratory re-sults have motivated us to initiate more focused investi-gations to further characterize the nodal osteoarthritis phe-notype and tailor specific treatments for patients in fu-ture trials,” added senior au-thor Dr. Shadpour Demehri. — WILEY Space missions have lasting effects on spinal muscles Astronauts who spend several months on the Inter-national Space Station have significant reductions in the size and density of paraspi-nal muscles of the trunk af-ter returning to Earth, re-ports a study in Spine. Some changes in muscle composition are still present up to four years after long-duration spaceflight, according to the new re-search by Katelyn Burkhart, MS, of Massachusetts Insti-tute of Technology and col-leagues. They write, “Space-flight-induced changes in paraspinal muscle morphol-ogy may contribute to back pain commonly reported in astronauts.” The researchers analyzed computed tomography (CT) scans of the lumbar spine in 17 astronauts and cosmonauts who flew mis-sions on the International Space Station. Scans ob-tained before and after missions were analyzed to determine changes in the size and composition of the paraspinal muscles. Average time in space was six months. The CT scans showed reductions in the size of paraspinal muscles after spaceflight. For individual muscles, muscle size de-creased by 4.6 to 8.8 per cent. In follow-up scans performed one year later, size returned at least to nor-mal for all muscles. The scans also showed significant increases in the amount of fatty tissue pres-ent in the paraspinal mus-cles. Accordingly, the astro-nauts’ muscle density, which is inversely related to fat content, decreased by 5.9 to 8.8 per cent. For most mus-cles, composition returned to normal by one year. However, for two muscles – the quadratus lumborum and psoas muscles – fat con-tent remained above pre-flight values even two to four years after the astronaut re-turned from space. Changes in muscle size and composition varied between individuals. For some muscles, changes in size were at least partly re-lated to the amount and type of exercise the astro-nauts performed while in zero gravity: either resist-ance exercise or cycling. In-flight exercise did not seem to affect changes in muscle density. Previous studies of astro-nauts have linked spaceflight to muscle atrophy, especially of the muscles that maintain posture and stability while upright on Earth in normal gravity. Many astronauts experience low back pain during and immediately af-ter space missions, and they appear to be at increased risk of spinal disc herniation. The results show that muscle size returns to nor-mal upon Earth recovery, but that some changes in muscle composition – par-ticularly increased fatty infil-tration – may persist for at least a few years. Some of the paraspinal muscle changes seem to be affected by exercise, sug-gesting possible approaches to preventing the adverse effects of prolonged spaceflight on spinal health and functioning. —Wolters Kluwer Health Heberden’s nodes (HNs) are bony enlargements of the finger joints that are readily detectable in a routine physi-cal exam and are considered hallmarks of osteoarthritis. A new Arthritis & Rheumatology study found that the presence of HNs may also indicate structural damage associated with knee osteoarthritis. In the study of 395 patients with HN and 188 without, there were significant associa-tions between the presence of HN and imaging measures of knee osteoarthritis. The authors noted that additional studies are needed to better understand the mechanisms behind the link between HN and knee osteo-NUMBER CRUNCH The pharmacare talk The Broadbent Institute has released a report outlining two possible ways the country can achieve single-payer pharmacare. 731K of employers would support a national drug plan The number of attempts to establish a national pharmacare plan in the last 73 years www.canadianchiropractor.ca the number of Canadians who have had to borrow money to pay for prescription medication 9 1/4 of all (current) prescription drug costs are covered by private insurance February 2019 Canadian Chiropractor 9
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