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This paper examines and summarizes data on knee osteoarthritis (AO) in Community Oriented Program For Control Of Rheumatic Disorders (COPCORD) publications. A literature search was made through PubMed, Google, Proceedings of Asia-Pacific League of Associations for Rheumatology (APLAR) congresses, and Abstracts from APLAR congresses. Data were compiled to examine the prevalence of knee OA and knee pain, sex ratio, urban/rural differences and other risk factors. Data on knee pain and OA were available in a total of 36 COPCORD publications. The pooled prevalence of knee OA was 7.9% in adults above the age of 15 years. It was more common in women. Overweight, squatting and cycling appeared to be modifiable risk factors for knee OA. OA of the knee is the commonest rheumatic disease in studied communities. Further research is needed for identification of its modifiable risk factors and development of strategies for reduction of the community burden of this malady.

IntroductionDespite the profound burden of disease, a strategic global response to optimise musculoskeletal (MSK) health and guide national-level health systems strengthening priorities remains absent. Auspiced by the Global Alliance for Musculoskeletal Health (G-MUSC), we aimed to empirically derive requisite priorities and components of a strategic response to guide global and national-level action on MSK health.MethodsDesign: mixed-methods, three-phase design.Phase 1: qualitative study with international key informants (KIs), including patient representatives and people with lived experience. KIs characterised the contemporary landscape for MSK health and priorities for a global strategic response.Phase 2: scoping review of national health policies to identify contemporary MSK policy trends and foci.Phase 3: informed by phases 1–2, was a global eDelphi where multisectoral panellists rated and iterated a framework of priorities and detailed components/actions.ResultsPhase 1: 31 KIs representing 25 organisations were sampled from 20 countries (40% low and middle income (LMIC)). Inductively derived themes were used to construct a logic model to underpin latter phases, consisting of five guiding principles, eight strategic priority areas and seven accelerators for action.Phase 2: of the 165 documents identified, 41 (24.8%) from 22 countries (88% high-income countries) and 2 regions met the inclusion criteria. Eight overarching policy themes, supported by 47 subthemes, were derived, aligning closely with the logic model.Phase 3: 674 panellists from 72 countries (46% LMICs) participated in round 1 and 439 (65%) in round 2 of the eDelphi. Fifty-nine components were retained with 10 (17%) identified as essential for health systems. 97.6% and 94.8% agreed or strongly agreed the framework was valuable and credible, respectively, for health systems strengthening.ConclusionAn empirically derived framework, co-designed and strongly supported by multisectoral stakeholders, can now be used as a blueprint for global and country-level responses to improve MSK health and prioritise system strengthening initiatives.

Aim:  To estimate the incidence of musculoskeletal pain and rheumatic disorders in a Bangladeshi rural community. Methods:  This study was conducted in six villages near Dhaka from January 2001 to June 2002. Door‐to‐door case finding by interviewers was followed by interviewing and examination of positive respondents by trained doctors. The respondents with inflammatory arthropathies were reviewed 5 years later, in December 2006. Results:  Four hundred and forty‐one (M = 163, F = 278) out of 2685 adults (M = 1324, F = 1361) developed new musculoskeletal pain yielding an incidence rates of 10.9/100 person‐years (PY) (M = 8.2, F = 13.6). The incidence was highest in the 35–44‐year age group in both genders. It was highest in housewives, followed by weavers and cultivators. The spine (7.5/100 PY) was the most common affected part followed by knees (6.5), shoulder (6.2) and neck (6.2). The most common cause of new musculoskeletal pain was non‐specific low back pain, followed by fibromyalgia and knee osteoarthritis. Forty‐one subjects (M = 17, F = 24) developed inflammatory joint or spinal pain (1000/100,000 PY). The incidence of rheumatoid arthritis, combined spondyloarthropothies, ankylosing spondylitis, reactive arthropathy and psoriatic arthritis were 120 (M = 101, F = 147), 150 (M = 252, F = 49), 75 (M = 151, F = 0), 50 (M = 101, F = 0) and 25 (M = 0, F = 49) per 100,000 PY, respectively. Thirty‐one cases had undiagnosed arthropathies (770/100,000 PY). Seven were unavailable in December, 2006 and one died. The remaining 23 were symptom‐free. Conclusions:  The incidence of musculoskeletal pain and rheumatic disorders is considerable in this Bangladeshi rural community. Common incident disorders are non‐specific low back pain, fibromyalgia and osteoarthritis of knees. Inflammatory arthropathies are not common. The majority of undiagnosed arthopathies undergo spontaneous lasting remission.

Low-dose MTX appears to be as effective as CQ in patients with articular and cutaneous manifestations of SLE, having an acceptable toxicity profile. Results of this prospective study need to be confirmed in a larger study.