Objective: To compare the prevalence of self reported, physician diagnosed osteoarthritis (OA) of the hip in ex-professional footballers with that in age matched controls in the general public. Method: A questionnaire was sent to the 92 football league and premiership managers to assess the prevalence of OA of various joints. The prevalence of OA of the hip in those managers that were ex-professional footballers was assessed. Radiographic controls were obtained and used to assess the prevalence of OA of the hip in the general population. The results of the two groups were compared statistically using χ 2 tabulation. Results: Seventy four (80%) of the managers responded to the questionnaire. Nine of the 68 ex-professional footballers who replied had OA of the hip, and six of these had undergone a total of eight total hip replacements. Of the 18 managers who did not respond, 12 were known to be ex-professionals. In the control group of 136, two had OA of the hip. The two groups differed significantly (p<0.001). The odds ratio for OA of the hip was 10.2 (95% confidence interval 2.1 to 48.8). Conclusion:The ex-professional footballers had a significantly higher prevalence of OA of the hip than an age matched group of radiographic controls. V arious studies have shown an increased prevalence of osteoarthritis (OA) of the subtalar joints, 1 2 knees, 3-6 and spine 7 in ex-professional footballers. OA of the hip has also been shown to be more common in groups of footballers.3 6 More recently, a questionnaire study of 515 footballers showed the prevalence of OA of the hip to be 14% of the respondents.8 Unfortunately this study had a poor response rate (55%). No studies, to our knowledge, have related previous injuries to reported OA of the hips.We are undertaking a clinical study of ex-professional footballers, and this paper is a report of part of the pilot study. MATERIALS AND METHODSThe managers of the 92 league and premiership football clubs in England and Wales were selected as a study group for the pilot investigation. Eighty of them, at the time, were ex-professional footballers, most being 35-55 years of age. In January 2000, a questionnaire was sent to the managers asking for basic personal details, details of their playing career, any serious injuries sustained, and proven degenerative joint disease. For the purpose of the study, serious injuries were described as injuries that had necessitated more than one month out of the team, and "proven degenerative disease" was defined as arthritis that had been diagnosed by a doctor from a radiograph. After 28 days, a second questionnaire was sent to those mangers who had not responded.Two age and sex matched controls were enrolled for each respondent. The age matches for the subjects were tightly controlled such that no control was more than three months older or younger than the subject. These were obtained from radiographs taken as part of barium enema investigations, where the hip joint is visualised incidentally. Barium enemas were chosen because the pelvic part of...

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Since the turn of the millennium, the epidemiology of Clostridium difficile infection (CDI) has continued to challenge. Over the last decade there has been a growing awareness that improvements to surveillance are needed. The increasing rate of CDI and emergence of ribotype 027 precipitated the implementation of mandatory national surveillance of CDI in the UK. Changes in clinical presentation, severity of disease, descriptions of new risk factors and the occurrence of outbreaks all emphasised the importance of early diagnosis and surveillance.However a lack of consensus on case definitions, clinical guidelines and optimal laboratory diagnostics across Europe has lead to the underestimation of CDI and impeded comparison between countries. These inconsistencies have prevented the true burden of disease from being appreciated.Acceptance that a multi-country surveillance programme and optimised diagnostic strategies are required not only to detect and control CDI in Europe, but for a better understanding of the epidemiology, has built the foundations for a more robust, unified surveillance. The concerted efforts of the European Centre for Disease Prevention and Control (ECDC) CDI networks, has lead to the development of an over-arching long-term CDI surveillance strategy for 2014-2020. Fulfilment of the ECDC priorities and targets will no doubt be challenging and will require significant investment however the hope is that both a national and Europe-wide picture of CDI will finally be realised.

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