{"id":"https://openalex.org/W4367309528","doi":"https://doi.org/10.1007/s00198-023-06749-z","title":"Reducing diagnostic delay in hypophosphatasia: a case series of 14 patients presenting to general rheumatology","display_name":"Reducing diagnostic delay in hypophosphatasia: a case series of 14 patients presenting to general rheumatology","publication_year":2023,"publication_date":"2023-04-28","ids":{"openalex":"https://openalex.org/W4367309528","doi":"https://doi.org/10.1007/s00198-023-06749-z","pmid":"https://pubmed.ncbi.nlm.nih.gov/37118032","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/10427523"},"language":"en","primary_location":{"id":"doi:10.1007/s00198-023-06749-z","doi":"https://doi.org/10.1007/s00198-023-06749-z","is_oa":true,"landing_page_url":"https://doi.org/10.1007/s00198-023-06749-z","pdf_url":"https://link.springer.com/content/pdf/10.1007/s00198-023-06749-z.pdf","source":{"id":"https://openalex.org/S170889201","display_name":"Osteoporosis International","issn_l":"0937-941X","issn":["0937-941X","1433-2965"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-b","jufo-2","ki-jl-1","medline","norway-1","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310319900","host_organization_name":"Springer Science+Business Media","host_organization_lineage":["https://openalex.org/P4310319900","https://openalex.org/P4310319965"],"host_organization_lineage_names":["Springer Science+Business Media","Springer Nature"],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Osteoporosis International","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","pubmed"],"open_access":{"is_oa":true,"oa_status":"hybrid","oa_url":"https://link.springer.com/content/pdf/10.1007/s00198-023-06749-z.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5086243534","display_name":"Muhammad Atif Rauf","orcid":"https://orcid.org/0000-0002-7660-2951","observed_orcids":["https://orcid.org/0000-0002-7660-2951"]},"institutions":[{"id":"https://openalex.org/I165862685","display_name":"St George's, University of London","ror":"https://ror.org/040f08y74","country_code":"GB","type":"education","lineage":["https://openalex.org/I124357947","https://openalex.org/I165862685","https://openalex.org/I4401726869"]}],"countries":["GB"],"is_corresponding":true,"raw_author_name":"Muhammad A. Rauf","raw_affiliation_strings":["Department of Medicine, St. George's University of London, Cranmer Terrace, London, SW17, 0RE, UK. m.rauf3@nhs.net","Department of Medicine, St. George's University of London, Cranmer Terrace, London, SW17, 0RE, UK"],"raw_orcid":"https://orcid.org/0000-0002-7660-2951","affiliations":[{"raw_affiliation_string":"Department of Medicine, St. George's University of London, Cranmer Terrace, London, SW17, 0RE, UK. m.rauf3@nhs.net","institution_ids":["https://openalex.org/I165862685"]},{"raw_affiliation_string":"Department of Medicine, St. George's University of London, Cranmer Terrace, London, SW17, 0RE, UK","institution_ids":["https://openalex.org/I165862685"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5006706215","display_name":"Jalpa Kotecha","orcid":"https://orcid.org/0000-0001-6267-122X","observed_orcids":["https://orcid.org/0000-0001-6267-122X"]},"institutions":[{"id":"https://openalex.org/I4210153400","display_name":"King's College Hospital","ror":"https://ror.org/044nptt90","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I4210111135","https://openalex.org/I4210153400"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"Jalpa Kotecha","raw_affiliation_strings":["Weston Education Centre, King's College Hospital, London, UK"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Weston Education Centre, King's College Hospital, London, UK","institution_ids":["https://openalex.org/I4210153400"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5108256815","display_name":"Katie Moss","orcid":"https://orcid.org/0000-0002-1944-8302","observed_orcids":["https://orcid.org/0000-0002-1944-8302"]},"institutions":[{"id":"https://openalex.org/I2801196673","display_name":"St George\u2019s University Hospitals NHS Foundation Trust","ror":"https://ror.org/039zedc16","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I2801196673"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"Katie Moss","raw_affiliation_strings":["Department of Rheumatology, St. George's University Hospitals NHS Foundation Trust, London, UK"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Rheumatology, St. George's University Hospitals NHS Foundation Trust, London, UK","institution_ids":["https://openalex.org/I2801196673"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":3,"corresponding_author_ids":["https://openalex.org/A5086243534"],"corresponding_institution_ids":["https://openalex.org/I165862685"],"apc_list":{"value":4590,"currency":"USD","value_usd":4590},"apc_paid":{"value":4590,"currency":"USD","value_usd":4590},"fwci":2.8776,"has_fulltext":true,"cited_by_count":17,"citation_normalized_percentile":{"value":0.918026,"is_in_top_1_percent":false,"is_in_top_10_percent":true},"cited_by_percentile_year":{"min":96,"max":99},"biblio":{"volume":"34","issue":"9","first_page":"1647","last_page":"1652"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T13453","display_name":"Alkaline Phosphatase Research Studies","score":0.9740999937057495,"subfield":{"id":"https://openalex.org/subfields/2712","display_name":"Endocrinology, Diabetes and Metabolism"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T13453","display_name":"Alkaline Phosphatase Research Studies","score":0.9740999937057495,"subfield":{"id":"https://openalex.org/subfields/2712","display_name":"Endocrinology, Diabetes and Metabolism"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10516","display_name":"Parathyroid Disorders and Treatments","score":0.015200000256299973,"subfield":{"id":"https://openalex.org/subfields/2727","display_name":"Nephrology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12924","display_name":"Dermatological and Skeletal Disorders","score":0.001500000013038516,"subfield":{"id":"https://openalex.org/subfields/1311","display_name":"Genetics"},"field":{"id":"https://openalex.org/fields/13","display_name":"Biochemistry, Genetics and Molecular Biology"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/hypophosphatasia","display_name":"hypophosphatasia","score":1.0},{"id":"https://openalex.org/keywords/delayed-diagnosis","display_name":"delayed diagnosis","score":0.996999979019165},{"id":"https://openalex.org/keywords/musculoskeletal-pain","display_name":"musculoskeletal pain","score":0.8009999990463257},{"id":"https://openalex.org/keywords/rheumatology-referral","display_name":"rheumatology referral","score":0.6620000004768372},{"id":"https://openalex.org/keywords/calcium-pyrophosphate-deposition-disease","display_name":"calcium pyrophosphate deposition disease","score":0.8790000081062317},{"id":"https://openalex.org/keywords/osteoarthritis","display_name":"osteoarthritis","score":0.875},{"id":"https://openalex.org/keywords/psoriatic-arthritis","display_name":"psoriatic arthritis","score":0.8939999938011169},{"id":"https://openalex.org/keywords/spondyloarthritis","display_name":"spondyloarthritis","score":0.8529999852180481},{"id":"https://openalex.org/keywords/enthesitis","display_name":"enthesitis","score":0.8920000195503235},{"id":"https://openalex.org/keywords/fracture-history","display_name":"fracture history","score":0.6119999885559082},{"id":"https://openalex.org/keywords/dental-diseases","display_name":"dental diseases","score":0.5569999814033508},{"id":"https://openalex.org/keywords/metabolic-bone-disease","display_name":"metabolic bone disease","score":0.7699999809265137}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9614256620407104},{"id":"https://openalex.org/C198451711","wikidata":"https://www.wikidata.org/wiki/Q327657","display_name":"Rheumatology","level":2,"score":0.8560140132904053},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.6887277364730835},{"id":"https://openalex.org/C2777831278","wikidata":"https://www.wikidata.org/wiki/Q540571","display_name":"Fibromyalgia","level":2,"score":0.5591861605644226},{"id":"https://openalex.org/C2778471162","wikidata":"https://www.wikidata.org/wiki/Q1313510","display_name":"Hypophosphatasia","level":4,"score":0.5564640760421753},{"id":"https://openalex.org/C2776541429","wikidata":"https://www.wikidata.org/wiki/Q165328","display_name":"Osteoporosis","level":2,"score":0.5115433931350708},{"id":"https://openalex.org/C2780062341","wikidata":"https://www.wikidata.org/wiki/Q645363","display_name":"Bursitis","level":2,"score":0.5110369920730591},{"id":"https://openalex.org/C68312169","wikidata":"https://www.wikidata.org/wiki/Q216685","display_name":"Orthopedic surgery","level":2,"score":0.49500101804733276},{"id":"https://openalex.org/C2776661782","wikidata":"https://www.wikidata.org/wiki/Q52848","display_name":"Spondyloarthropathy","level":3,"score":0.464652955532074},{"id":"https://openalex.org/C2776164576","wikidata":"https://www.wikidata.org/wiki/Q62736","display_name":"Osteoarthritis","level":3,"score":0.4173929989337921},{"id":"https://openalex.org/C2780175798","wikidata":"https://www.wikidata.org/wiki/Q1478321","display_name":"Spinal stenosis","level":3,"score":0.4132267236709595},{"id":"https://openalex.org/C2777077863","wikidata":"https://www.wikidata.org/wiki/Q170990","display_name":"Arthritis","level":2,"score":0.38768038153648376},{"id":"https://openalex.org/C1862650","wikidata":"https://www.wikidata.org/wiki/Q186005","display_name":"Physical therapy","level":1,"score":0.3749900758266449},{"id":"https://openalex.org/C187212893","wikidata":"https://www.wikidata.org/wiki/Q123028","display_name":"Pediatrics","level":1,"score":0.3606198728084564},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.2810593843460083},{"id":"https://openalex.org/C142724271","wikidata":"https://www.wikidata.org/wiki/Q7208","display_name":"Pathology","level":1,"score":0.15945640206336975},{"id":"https://openalex.org/C160160445","wikidata":"https://www.wikidata.org/wiki/Q24769688","display_name":"Alkaline phosphatase","level":3,"score":0.07758024334907532},{"id":"https://openalex.org/C44575665","wikidata":"https://www.wikidata.org/wiki/Q1293405","display_name":"Lumbar","level":2,"score":0.06609475612640381},{"id":"https://openalex.org/C55493867","wikidata":"https://www.wikidata.org/wiki/Q7094","display_name":"Biochemistry","level":1,"score":0.0},{"id":"https://openalex.org/C181199279","wikidata":"https://www.wikidata.org/wiki/Q8047","display_name":"Enzyme","level":2,"score":0.0},{"id":"https://openalex.org/C204787440","wikidata":"https://www.wikidata.org/wiki/Q188504","display_name":"Alternative medicine","level":2,"score":0.0},{"id":"https://openalex.org/C185592680","wikidata":"https://www.wikidata.org/wiki/Q2329","display_name":"Chemistry","level":0,"score":0.0}],"mesh":[{"descriptor_ui":"D000469","descriptor_name":"Alkaline Phosphatase","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D001851","descriptor_name":"Bone Diseases, Metabolic","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D005260","descriptor_name":"Female","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D007014","descriptor_name":"Hypophosphatasia","qualifier_ui":"Q000150","qualifier_name":"complications","is_major_topic":true},{"descriptor_ui":"D007014","descriptor_name":"Hypophosphatasia","qualifier_ui":"Q000175","qualifier_name":"diagnosis","is_major_topic":true},{"descriptor_ui":"D008297","descriptor_name":"Male","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008875","descriptor_name":"Middle Aged","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D010003","descriptor_name":"Osteoarthritis","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D012189","descriptor_name":"Retrospective Studies","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D012219","descriptor_name":"Rheumatology","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D015535","descriptor_name":"Arthritis, Psoriatic","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D050723","descriptor_name":"Fractures, Bone","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D057210","descriptor_name":"Delayed Diagnosis","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D059352","descriptor_name":"Musculoskeletal Pain","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true}],"locations_count":3,"locations":[{"id":"doi:10.1007/s00198-023-06749-z","doi":"https://doi.org/10.1007/s00198-023-06749-z","is_oa":true,"landing_page_url":"https://doi.org/10.1007/s00198-023-06749-z","pdf_url":"https://link.springer.com/content/pdf/10.1007/s00198-023-06749-z.pdf","source":{"id":"https://openalex.org/S170889201","display_name":"Osteoporosis International","issn_l":"0937-941X","issn":["0937-941X","1433-2965"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-b","jufo-2","ki-jl-1","medline","norway-1","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310319900","host_organization_name":"Springer Science+Business Media","host_organization_lineage":["https://openalex.org/P4310319900","https://openalex.org/P4310319965"],"host_organization_lineage_names":["Springer Science+Business Media","Springer Nature"],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Osteoporosis International","raw_type":"journal-article"},{"id":"pmh:oai:pubmedcentral.nih.gov:10427523","doi":null,"is_oa":true,"landing_page_url":"https://www.ncbi.nlm.nih.gov/pmc/articles/10427523","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC10427523/pdf/198_2023_Article_6749.pdf","source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Osteoporos Int","raw_type":"Text"},{"id":"pmid:37118032","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/37118032","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA","raw_type":"Journal Article"}],"best_oa_location":{"id":"doi:10.1007/s00198-023-06749-z","doi":"https://doi.org/10.1007/s00198-023-06749-z","is_oa":true,"landing_page_url":"https://doi.org/10.1007/s00198-023-06749-z","pdf_url":"https://link.springer.com/content/pdf/10.1007/s00198-023-06749-z.pdf","source":{"id":"https://openalex.org/S170889201","display_name":"Osteoporosis International","issn_l":"0937-941X","issn":["0937-941X","1433-2965"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-b","jufo-2","ki-jl-1","medline","norway-1","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310319900","host_organization_name":"Springer Science+Business Media","host_organization_lineage":["https://openalex.org/P4310319900","https://openalex.org/P4310319965"],"host_organization_lineage_names":["Springer Science+Business Media","Springer Nature"],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Osteoporosis International","raw_type":"journal-article"},"sustainable_development_goals":[{"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3","score":0.98580002784729}],"study_designs":[{"display_name":"Observational Study","id":"https://openalex.org/study-designs/observational-study"}],"awards":[],"funders":[],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W4367309528.pdf","grobid_xml":"https://content.openalex.org/works/W4367309528.grobid-xml"},"referenced_works_count":20,"referenced_works":["https://openalex.org/W1561133221","https://openalex.org/W2039133694","https://openalex.org/W2040669016","https://openalex.org/W2042977564","https://openalex.org/W2083873386","https://openalex.org/W2107554167","https://openalex.org/W2147592355","https://openalex.org/W2280954766","https://openalex.org/W2325927107","https://openalex.org/W2470366316","https://openalex.org/W2518941021","https://openalex.org/W2619913215","https://openalex.org/W2775666899","https://openalex.org/W2905259247","https://openalex.org/W2924411106","https://openalex.org/W2947712313","https://openalex.org/W3011905850","https://openalex.org/W3046946812","https://openalex.org/W3082464335","https://openalex.org/W3087960330"],"related_works":["https://openalex.org/W3158234124","https://openalex.org/W2936341280","https://openalex.org/W4379800184","https://openalex.org/W3164346523","https://openalex.org/W4399482588","https://openalex.org/W3164636722","https://openalex.org/W4395076925","https://openalex.org/W2890590061","https://openalex.org/W4212773402","https://openalex.org/W4312334286"],"abstract_inverted_index":{"OBJECTIVES:":[0],"Hypophosphatasia":[1],"(HPP)":[2],"is":[3,19,26,233],"a":[4,20,184,229,265,280,299],"rare":[5,243],"genetic":[6],"metabolic":[7,284],"bone":[8,188,285],"disease":[9,306],"that":[10,65,76],"can":[11,66,220],"cause":[12],"chronic":[13],"pain":[14,80,139,166,251],"and":[15,39,53,89,112,210,227,259],"fractures.":[16],"Its":[17],"hallmark":[18],"persistently":[21,230],"low":[22,231],"serum":[23],"ALP.":[24],"HPP":[25,219,253,290],"now":[27],"recognised":[28],"by":[29],"many":[30],"osteoporosis":[31],"specialists,":[32,35],"but":[33,122],"other":[34,247],"such":[36],"as":[37],"rheumatologists":[38],"primary":[40],"care":[41],"physicians,":[42],"may":[43,236],"be":[44],"less":[45],"aware":[46],"of":[47,118,130,142,156,171,181,186,197,199,204,241,267,289,304],"this":[48,68,235,242],"condition,":[49],"causing":[50],"diagnostic":[51,97,239],"delay":[52,98,240],"possible":[54],"harm":[55],"to":[56,62,81,147,174,222,246],"these":[57],"patients.":[58,143],"Our":[59],"objective":[60],"was":[61,99,136,145,167,254,273,291],"highlight":[63],"features":[64],"reduce":[67,237],"delay.":[69],"METHODS:":[70],"We":[71],"retrospectively":[72],"analysed":[73],"14":[74],"patients":[75,103,172,182,200,212,268,297],"presented":[77],"with":[78,93,114,127,218,224,263,283,298],"musculoskeletal":[79,225,250],"general":[82],"rheumatology":[83,223],"clinic":[84],"at":[85],"St.":[86],"George's":[87],"Hospital":[88],"were":[90,125],"subsequently":[91],"diagnosed":[92],"HPP.":[94],"RESULTS:":[95],"Median":[96],"13":[100],"years.":[101,132],"All":[102,121],"had":[104,183,192,201,208,214],"an":[105],"ALP":[106,117,232],"below":[107],"reference":[108],"range":[109],"for":[110],"age":[111,129],"gender,":[113],"lowest":[115],"mean":[116],"16":[119],"IU/L.":[120],"one":[123],"patient":[124,207],"women":[126],"median":[128],"51":[131],"Most":[133],"common":[134],"presentation":[135],"peripheral":[137,257],"joint":[138],"in":[140,154,159,163,169,252,256,260,276,295],"85.7%":[141],"This":[144],"due":[146,173],"early-onset":[148],"CPPD":[149],"(calcium":[150],"pyrophosphate":[151],"deposition":[152],"disease)":[153],"71.4%":[155],"patients,":[157,249],"osteoarthritis":[158,175],"50%,":[160],"or":[161,176,301,307],"bursitis":[162],"50%.":[164],"Axial":[165],"reported":[168],"64%":[170],"spinal":[177],"stenosis.":[178],"Fifty":[179,190],"percent":[180,191],"history":[185,303],"long":[187,278],"pain.":[189],"previous":[193],"fracture(s).":[194],"A":[195],"total":[196],"28.6%":[198],"psoriatic":[202,270],"arthritis,":[203],"which":[205],"1":[206],"spondyloarthropathy,":[209],"4":[211],"also":[213,274,292],"enthesitis.":[215],"CONCLUSION:":[216],"Patients":[217],"present":[221],"pain,":[226],"if":[228],"confirmed,":[234],"the":[238,261,277],"disease.":[244,286],"Similar":[245],"rheumatologic":[248],"noted":[255,275],"joints":[258],"spine":[262],"almost":[264],"third":[266],"having":[269],"arthritis.":[271,308],"Pain":[272],"bones,":[279],"feature":[281],"consistent":[282],"The":[287],"diagnosis":[288],"more":[293],"likely":[294],"those":[296],"personal":[300],"family":[302],"dental":[305]},"counts_by_year":[{"year":2026,"cited_by_count":6},{"year":2025,"cited_by_count":7},{"year":2024,"cited_by_count":4}],"updated_date":"2026-11-12T12:28:57.059296","created_date":"2023-04-29T00:00:00"}