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Sentence: The severity of the condition varies, with some patients experiencing joint pain without any objective findings, others showing clear signs of arthritis on physical assessment and with diagnostic imaging, and some developing a chronic erosive synovitis where the fluid in the joints, and the joint capsule is irrevocably damaged.

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Sentence: Bilateral agreements are one way of securing specialised training, but such formal agreements may not even be needed to take advantage of existing opportunities.