Differentiating Rheumatoid Arthritis Related Musculoskeletal Pain in Patients With Concurrent Sickle Cell Disease: A Case Series and Literature Review
Bibliographic record
Abstract
Rheumatoid arthritis (RA) can occur concurrently in patients with sickle cell disease (SCD). Both conditions can have similar musculoskeletal symptoms during painful exacerbations. SCD tends to be frequently labelled as the causative factor of painful events by both patients and providers alike. It is important to distinguish between these two conditions causing painful exacerbations to guide treatment plans. Our review of literature showed that the concurrent presentation of RA and SCD is not well described. We present a case series of eight patients with concurrent RA and SCD. We conducted a retrospective review of their charts to make observations about differences in musculoskeletal symptoms, biomarkers and radiological changes. Generally, RA affects smaller joints compared to SCD which affects larger joints. Radiological differences include bone infarcts and avascular necrosis in SCD versus erosive arthritis in RA. In terms of biomarkers, we are better guided using C-reactive protein (CRP) in conjunction with lactate dehydrogenase (LDH). Our case series demonstrates certain indicators which help make a clearer distinction between the two usually painful conditions. J Med Cases. 2016;7(8):334-340 doi: http://dx.doi.org/10.14740/jmc2602e
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.007 | 0.005 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".