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The Chronic Osteoarthritis Management Initiative (COAMI)

Dr. Joanne Jordan, COAMI Chair, worked with colleagues to prepare the U.S.Bone and Joint Initiative (USBJI)/COAMI annotated bibliography of guidelines and recommendations on the management of OA. An extensive literature review and rigorous screening process yielded several areas where current recommendations and guidelines offer general consensus: education and self-management, exercise and weight loss, use of assistive devices, alternative/complementary approaches, surgical interventions, and pharmacologic interventions.

The Findings of the Annotated Bibliography of Clinical Outcomes on the Management of Osteoarthritis team also included TARC team members Kirsten Nyrop, PhD; Amanda Nelson, MD, MSCR; Yvonne Golightly, PT, MS, PhD; Adam Goode, PT, DPT, PhD; and Leigh Callahan, PhD.  Dr. Nelson was the first author of the manuscript.  Kelli Allen, PhD, currently at Duke, was also on the team.

A systematic review of recommendations and guidelines for the management of osteoarthritis: The Chronic Osteoarthritis Management Initiative of the U.S. Bone and Joint Initiative.  Nelson AE, Allen KD, Golightly YM, Goode AP, Jordan JM.  Semin Arthritis Rheum. 2013 Dec 4. pii: S0049-0172(13)00258-8. doi: 10.1016/j.semarthrit.2013.11.012. [Epub ahead of print]

Access the abstract: 

Summary Recommendations from a Systematic Review of Recommendations and Guidelines for the Management of OA

  • Provide or refer patients to self-management programs.
  • Provide education, regular contact to promote self-care, joint protection strategies, and individualized treatment plans.
  • Advise patients to engage in low-impact aerobic exercise and, if overweight, to lose weight.
  • Consider range of motion, flexibility, endurance, and strengthening exercises, exercise combined with manual therapy, and PT/OT referral.
  • Recommend walking aids and assistive devices to improve Activities of Daily Living (ADLs).
  • Discuss thermal modalities for hand, knee and hip OA.
  • Joint replacement is recommended for appropriate patients.
  • Arthroscopy with debridement is not indicated for symptomatic OA.
  • Pharmacologic management of OA
  • Intra-articular therapy

Click here to view the COAMI Care Model in it's entirety

Dr. Mary Anne Dooley Retires

Dr. Mary Anne Dooley, Associate Professor of Medicine, is retiring from the UNC Health Care System at the end of February after 23 years of devoted service to our patients, our referring physicians, the UNC School of Medicine, and the people of North Carolina.  She has cared for many of our patients over the years, especially those with Systemic Lupus Erythematosus (SLE), vasculitis, and other autoimmune conditions. In addition to patient care, Dr. Dooley and her research team have led many clinical trials to find better and more advanced treatment options for autoimmune conditions, particularly for lupus and lupus nephritis.

Dr. Dooley received her medical education here at UNC, where she held the prestigious Holderness Fellowship, and also completed a Masters degree in Public Health.  She then completed her internship, residency and chief residency in Internal Medicine at the University of Massachusetts before returning to North Carolina for a fellowship in Rheumatology and Immunology at Duke University Medical Center.

She joined the faculty at UNC in Rheumatology and Immunology in 1991 and has had an impressive career here, wearing many hats in the Division and in the UNC Thurston Arthritis Research Center.  She expanded the Sanford Rheumatology Outreach Clinic and served as Clinic Director for our UNC Rheumatology Clinic for many years, launching and overseeing a huge expansion in our Infusion Clinic.  She also served as Acting Division Chief of the Division for four years.

Dr. Dooley is an internationally recognized expert and has been a vital contributor to, and leader in, many national and international lupus initiatives, including the Systemic Lupus International Collaborating Clinics (SLICC) and the Lupus Clinical Trials Consortium.  Her seminal paper in Kidney International in 1997 was one of the first to cast doubt on the efficacy of cyclophosphamide for lupus nephritis in African Americans in the South.  Most recently, her paper in the New England Journal of Medicine in 2011 detailed the superiority of mycophenolate mofetil over azathioprine in maintaining remission in lupus nephritis.

Dr. Dooley has taught countless medical students, residents, and Rheumatology and Nephrology fellows, and cared for hundreds on patients with SLE.  We deeply appreciate the contributions Dr. Dooley has made to our Division and Center.  We are grateful that we have had the opportunity to provide exceptional medical care to all of our patients and look forward to continuing to care for all of Dr. Dooley's patients in the future.

Please do not hesitate to contact Ms. Tammy Bradsher, Administrative Support Supervisor, Rheumatology Clinic, at telephone number (919) 957-6554, if you have any questions. 

Please join us in thanking Dr. Dooley for her many years of service and wishing her the very best in the future. 


Dr. Nelson receives certification in Musculoskeletal Ultrasound

amanda_nelson.pngDr. Amanda Nelson has received certification in Musculoskeletal Ultrasound in Rheumatology through the American College of Rheumatology RhMSUS program.  This certification requires extensive training, practice, and successful completion of a comprehensive examination.  Dr. Nelson previously completed the Train-the Trainer program through USSONAR (Ultrasound School of North American Rheumatologists) and the ACR.  She was a speaker and small group mentor for the Duke Musculoskeletal Ultrasound in Rheumatology Training course in 2013, and now serves as a mentor for the USSONAR online training program.  She provides didactic and hands-on training in musculoskeletal ultrasound for our Rheumatology fellows, and staffs a half-day ultrasound clinic at the Farrington Road Rheumatology clinic site.

2013 American College of Rheumatology Conference - San Diego, CA

Numerous faculty and staff of the Thurston Arthritis Research Center attended the Annual American College of Rheumatology (ACR) Conference in San Diego, California October 25 - 30.

Call to Action on Walking sent to the Surgeon General

The OA Action Alliance, with partner organization Thurston Arthritis Research Center, submits a Call to Action on Walking to the Surgeon General.

A special Osteoarthritis and Cartilage issue on pain in osteoarthritis

The September 2013 special issue of OAC on Pain in Osteoarthritis has come out. This issue incorporates articles from basic science, pre-clinical animal models, to clinical OA, clinical trials, and policy. It was guest-edited by our own Dr. Joanne Jordan, and Richard Gracely, PhD in the UNC School of Dentistry.

Additional media coverage of the MCRC grant

You can also check out the announcement of the Multidisciplinary Clinical Research Center (MCRC) grant on these media outlet websites:

Welcome our new faculty member, Saira Sheikh, MD

We are pleased to have Saira Sheikh, M.D. on our team as a clinical Assistant Professor in the Division of Rheumatology, Allergy and Immunology, and as a member of the Thurston Arthritis Research Center.

Dr. Sheikh (right) enjoying a little downtime at Rock the Joint, the center's fundraiser, this past June. Pictured with Dr. Sheikh from left to right, Dr. Jen Rogers and Dr. Joanne Jordan .
Dr. Sheikh has been part of our family as a clinical Fellow in Rheumatology and in Allergy/Immunology for the past three years, and her dual training and experience enables her to provide excellent patient care in both the Rheumatology and Allergy clinics.  In addition to caring for patients in both of our clinics, she has expanded our research clinical trial programs into adult Allergy and in Rheumatology.

"I am thrilled to join the faculty at UNC and the Thurston Arthritis Research Center. I look forward to continuing the advancement of the center's mission by providing state-of-the-art care to our patients and constantly striving to bring new and innovative treatment approaches to our patients. As a clinical immunologist with dual training in Allergy, Immunology & Rheumatology, I am privileged to have the opportunity to take care of patients with a wide range of allergic, immunologic and rheumatologic diseases. "

When she isn't working, Dr. Sheikh loves spending time with her husband and four year old son.  As a family, they travel around the world and are always looking for new places to visit and explore.

Please join us in giving a warm welcome to Dr. Sheikh!

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