Clinical Rheumatology最新文献

{"title":"Reply to Sener et al.: Cardiovascular risk according to biological agent exposure in patients with ankylosing spondylitis: A nationwide population-based study.","authors":"Oh Chan Kwon, Min-Chan Park","doi":"10.1007/s10067-025-07389-w","DOIUrl":"https://doi.org/10.1007/s10067-025-07389-w","url":null,"abstract":"","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Partnership with minority ethnic communities is crucial to tackling health inequalities in rheumatology: lessons from Rochester, New York, US.","authors":"Kanta Kumar, Edith Williams, Allen Anandrajah, Lisa Roberts, Shirish Dubey, Arumugam Moorthy, Ade Adebajo","doi":"10.1007/s10067-025-07404-0","DOIUrl":"https://doi.org/10.1007/s10067-025-07404-0","url":null,"abstract":"","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phase angle: a novel application of bioelectrical impedance technology in osteoarthritis screening and diagnosis.","authors":"Minghua Xian, Yuan Yan, Jinpeng Lin, Guoli Huang, Kele Xie, Dongyu Zeng, Liping Li, Yu Zhang","doi":"10.1007/s10067-025-07349-4","DOIUrl":"https://doi.org/10.1007/s10067-025-07349-4","url":null,"abstract":"<p><p>Bioelectrical impedance technology (EBI) offers a non-invasive, cost-effective method for body composition assessment, showing promise in diagnosing and managing musculoskeletal disorders, particularly osteoarthritis (OA). OA is a major global health concern, notably affecting the knee and hip joints. Conventional imaging techniques like X-rays and MRI have limitations in early detection, as they cannot capture microscopic cartilage changes. Phase angle (PhA), an essential EBI parameter, is widely applied in evaluating sarcopenia, tumors, and body fluids, and is increasingly valuable in OA research. PhA reflects cellular health through cell membrane impedance, with studies showing that lower PhA levels correlate with OA severity and predict OA-related degeneration, supporting its role in early screening. Additionally, EBI holds potential for monitoring OA progression and evaluating treatment efficacy. This review summarizes recent advances in OA diagnosis with EBI, focusing on the applications of PhA and other bioimpedance parameters in screening, monitoring, and evaluation. Through systematic analysis, this review provides theoretical support for EBI's clinical use, highlighting its potential in OA prevention, diagnosis, and intervention. With continued technological progress, EBI is poised to become a critical tool in OA management, particularly for early diagnosis and personalized treatment.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A narrative review of multidisciplinary rehabilitation in juvenile idiopathic arthritis.","authors":"Eduardo Cifuentes-Silva, Mauricio Inostroza-Mondaca, Claudio Cabello-Verrugio, Manuel Retamal-Espinoza, Jorge Cancino-Jiménez","doi":"10.1007/s10067-025-07407-x","DOIUrl":"https://doi.org/10.1007/s10067-025-07407-x","url":null,"abstract":"<p><p>Juvenile idiopathic arthritis (JIA) is a chronic condition affecting children, marked by persistent joint inflammation driven by innate and adaptive immune responses involving macrophages and T and B lymphocytes. These responses promote tissue damage and inflammation via elevated pro-inflammatory cytokines, while anti-inflammatory cytokines are also present, but without a clear linear relationship. JIA can result in long-term physical disabilities, making a multidisciplinary rehabilitation approach essential to enhance patients' quality of life. This approach includes a collaborative team addressing pain reduction, joint and muscle function improvement, and patient autonomy. Key interventions involve physical therapy to maintain and enhance joint mobility and muscle strength. Evidence suggests that physical exercise may modulate immune responses and pro-inflammatory cascades, critical in JIA pathogenesis. However, further studies are required to determine the most effective exercise protocols for this population and their specific immunomodulatory benefits. A narrative literature review was conducted using PubMed (2014-2024) with the terms \"juvenile idiopathic arthritis,\" \"rehabilitation,\" and \"exercise,\" supplemented by references from systematic reviews and meta-analyses, and additional historical data from Google Scholar. The search yielded 52 relevant articles, primarily involving pediatric subjects under 18 years. These studies highlight the multifaceted benefits of multidisciplinary management in JIA, including improved physical and functional outcomes. Despite promising evidence, further research is warranted to refine exercise protocols tailored to JIA, ensuring optimal therapeutic impact on inflammation and disease progression.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasonographic findings and differential diagnosis of acute calcific periarthritis in hands.","authors":"Li Chen, Jie Chen, Yudong Kong, Xiaoxian Xiong, Tao Ying, Bing Hu, Yuanyi Zheng","doi":"10.1007/s10067-025-07371-6","DOIUrl":"https://doi.org/10.1007/s10067-025-07371-6","url":null,"abstract":"<p><strong>Objectives: </strong>To explore the feasibility of using high-frequency ultrasound for the diagnosis and differential diagnosis of acute calcific periarthritis (ACP).</p><p><strong>Method: </strong>A total of 35 ACP patients in Group A and 38 gouty patients in Group B underwent ultrasound examination. All the ultrasound images were observed and analysed, and the sizes of the tophi and calcifications in the hands were measured. The differences in ultrasound features between Group A and Group B were examined. A t test was used to determine significant differences in size between ACP calcifications and gouty tophi.</p><p><strong>Results: </strong>The mean size of the tophus (9.54 ± 5.51 mm) was significantly larger than that of the ACP calcification (4.3 ± 1.51 mm). The double contour sign, bone erosion and synovitis were present in Group B (gout) but not in Group A (ACP). The calcification in all patients in Group A was almost completely resolved at the 1-month follow-up, as confirmed by ultrasound examination.</p><p><strong>Conclusions: </strong>High-frequency ultrasound appears to be a useful diagnostic tool for identifying ACP and can reduce the use of unnecessary diagnostic tests, invasive procedures, inappropriate medications and surgery. Key Points • High-frequency ultrasound effectively differentiates between acute calcific periarthritis (ACP) and gout by identifying distinct ultrasound features. • This study revealed that the size of the tophus in gout patients was significantly larger than the calcification size in ACP patients. • Unique ultrasound signs, such as the double contour sign and bone erosion, were present in gout patients but absent in ACP patients, aiding in accurate diagnosis. • Follow-up ultrasound examinations revealed significant resolution of calcifications in ACP patients, reinforcing the utility of the tool in monitoring disease progression.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The ultrasonographic spectrum of toe dactylitis in psoriatic arthritis: a descriptive analysis.","authors":"Garifallia Sakellariou, Nicolò Girolimetto, Ilaria Tinazzi, Marco Canzoni, Georgios Filippou, Alberto Batticciotto, Niccolò Possemato, Pierluigi Macchioni, Orazio De Lucia, Christian Dejaco, Luca Idolazzi, Carmelo Pirri, Annamaria Iagnocco","doi":"10.1007/s10067-025-07395-y","DOIUrl":"https://doi.org/10.1007/s10067-025-07395-y","url":null,"abstract":"<p><strong>Introduction: </strong>Dactylitis is a hallmark of psoriatic arthritis (PsA). While its assessment is clinical, recently musculoskeletal ultrasonography (MSUS) has been applied to its monitoring. However, the evidence on MSUS application for toe dactylitis is limited. The aim of this study is to characterize the ultrasonographic features of toe dactylitis in PsA.</p><p><strong>Method: </strong>Patients with PsA and painful toe dactylitis were retrospectively identified from clinical records. Demographic and clinical variables were analyzed. Ultrasound images of the affected toe, allowing the assessment of grey scale (GS) and power Doppler (PD) were collected, to evaluate tenosynovitis, soft tissue oedema (STO), synovitis of metatarsophalangeal (MTP), proximal and distal interphalangeal (PIP, DIP) joints (all graded 0-3), and peritendonitis (PTI) at the MTP and PIP (graded 0-1). Clinical and ultrasonographic features were analyzed through descriptive statistics.</p><p><strong>Results: </strong>The study included 26 patients (30 toes) of which 9 (34.5%) females, with mean (sd) age of 46.8 (11.73). All but one patient had an oligoarticular phenotype. Tenosynovitis was the most frequent lesion, with GS abnormalities in 27/30 toes (90%) and PD in 25/30 (83.3%). STO was common (GS in 28/30 (93.33%) toes and PD in 20/30 (66.66%)). Synovitis was less common (63.33%, 46.66% and 33.33% of MTPs, PIPs and DIPs, respectively), while PTI was uncommon, with no patient presenting with PD.</p><p><strong>Conclusions: </strong>Ultrasound showed different elementary lesions in toe dactylitis confirming the complexity of this manifestation also at foot. These findings represent a first step toward the development of further imaging studies assessing toe dactylitis in PsA. Key Points • Tenosynovitis and soft tissue oedema were the most common ultrasonographic elementary lesion in acute toe dactylitis in psoriatic arthritis. • Synovitis was less frequent and peritendonitis was very uncommon. • Musculoskeletal ultrasound confirms the presence of multiple lesions in painful toe dactylitis, confirming the complexity of this manifestation.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simplifying ANCA-associated vasculitis classification with ANCA specificity: a retrospective analysis.","authors":"Lina Zhang, Jing Zhang, Jing Xu, Qian Guo, Yadan Zou, Xuewu Zhang, Kuanting Wang, Lianjie Shi, Shengguang Li","doi":"10.1007/s10067-025-07397-w","DOIUrl":"https://doi.org/10.1007/s10067-025-07397-w","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the utility of ANCA specificity as a primary criterion for classifying AAV subtypes to simplify the diagnostic process without compromising accuracy.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted involving 310 patients diagnosed with AAV between January 2015 and December 2023 across three tertiary care centers affiliated with Peking University. Patients were reclassified using three methods: the European Medicines Agency (EMA) algorithm, the 2022 American College of Rheumatology/European Alliance of Associations for Rheumatology (ACR/EULAR) criteria, and ANCA specificity-based classification. Concordance between classification systems was assessed using Cohen's kappa coefficients.</p><p><strong>Results: </strong>ANCA specificity-based classification demonstrated substantial to almost perfect agreement with the 2022 ACR/EULAR criteria for MPA/MPO-AAV (kappa = 0.806) and GPA/PR3-AAV (kappa = 0.663). Many patients initially classified as GPA under the EMA algorithm were reclassified as MPA when using ANCA specificity. EGPA classification remained consistent across all methods (kappa = 0.725 between EMA and ACR/EULAR), suggesting that ANCA specificity is less critical for EGPA. The use of ANCA specificity simplified the classification process, aligning closely with the underlying pathophysiology of AAV subtypes.</p><p><strong>Conclusion: </strong>ANCA specificity serves as a valuable adjunct in the classification of AAV, particularly for distinguishing between MPA and GPA. Utilizing ANCA serotypes can simplify the diagnostic process, potentially facilitating earlier diagnosis and targeted treatment. For EGPA, traditional classification criteria remain effective. Incorporating ANCA specificity into clinical practice may enhance diagnostic accuracy and improve patient outcomes in AAV management. Key Points • ANCA-based classification aligns strongly with the 2022 ACR/EULAR criteria for MPA and GPA, providing a simplified diagnostic approach. • Adopting this approach can streamline the classification process, reduce invasive procedures, and enable earlier diagnosis while maintaining high concordance with established systems.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Human epididymis secretory protein 4 in idiopathic inflammatory myopathy-associated interstitial lung disease.","authors":"Liubing Li, Runzhao Li, Hongji Zhu, Huiya Xu, Hongxia Tan, Hongxu Xu, Min Liu, Fen Wang, Laisheng Li, Qiong Shi, Jianbo Liang","doi":"10.1007/s10067-025-07391-2","DOIUrl":"https://doi.org/10.1007/s10067-025-07391-2","url":null,"abstract":"<p><strong>Objective: </strong>The current study assessed the level of serum HE4 in patients with IIM to evaluate its feasibility in diagnosing IIM-ILD, as well as determined the association between HE4 and demographic, clinical, and laboratory characteristics of IIM patients.</p><p><strong>Methods: </strong>Sera and clinical data were collected from 139 patients with IIMs and 135 healthy controls. We compared the clinical parameters between the high and low HE4 groups, and the relationship between HE4 levels and clinical parameters was determined. Moreover, the expression of HE4 in the lung tissue was accessed.</p><p><strong>Results: </strong>HE4 level was significantly higher in the serum of IIM patients than in the controls (median 69.3 versus 33.5 μg/L, P < 0.001). Patients in the high HE4 group had higher ferritin (median 559 versus 83.7 μg/L, P = 0.006), frequencies of ILD(94.4% versus 56.1%, P < 0.001) and anti-Jo-1 autoantibodies (25.5% versus 5.7%, P = 0.018) compared with the low HE4 group. The immunohistochemical staining of HE4 in lung tissues was positive in IIM-ILD and negative in controls.</p><p><strong>Conclusion: </strong>Our findings suggested that serum HE4 might be a clinically useful biomarker for IIM-ILD. Key Points • Patients with IIMs, particularly those with IIM-ILD, had high serum levels of HE4. • Patients with high HE4 levels demonstrated a high prevalence of anti-Jo-1 autoantibodies. • Patients with IIM-ILD showed significant expression of HE4 within the lung tissue.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fever of unknown origin in B-cell depleted patients: Have you considered Neoehrlichiosis?","authors":"Lea-Kristin Nagler, Marc Schmalzing, Nora Isberner, Christoph Schoen, Michael Gernert","doi":"10.1007/s10067-025-07394-z","DOIUrl":"https://doi.org/10.1007/s10067-025-07394-z","url":null,"abstract":"","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mendelian randomization and mediation analysis reveal the role of immune cell subsets in the causal pathways between blood cell perturbation responses and rheumatoid arthritis.","authors":"Feng Li, Dehai Xian, Kaiwen Yang","doi":"10.1007/s10067-025-07387-y","DOIUrl":"https://doi.org/10.1007/s10067-025-07387-y","url":null,"abstract":"<p><strong>Background: </strong>Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by complex immune interactions. Elucidating the causal relationships between blood cell perturbations, immune cell subsets, and RA can provide valuable insights into its pathogenesis.</p><p><strong>Methods: </strong>This study employed bidirectional two-sample Mendelian Randomization (MR) to explore the causal effects of blood cell perturbations on RA risk, with a focus on immune cell mediation. Genetic data from large-scale Genome-Wide Association Studies (GWAS) were utilized to select instrumental variables (IVs) for exposure, mediator, and outcome. Inverse Variance Weighted (IVW) analysis was applied, supplemented by sensitivity tests. Mediation analysis was conducted to assess the indirect effects mediated by immune cells.</p><p><strong>Results: </strong>Significant causal associations were identified between perturbations in reticulocytes, monocytes, and lymphocytes and specific immune cell subsets, including CD3 + CD39 + regulatory T cells (Tregs) and CD45RA + terminally differentiated CD8 + T cells (CD45RA + TD CD8 + cells). Erythropoiesis perturbation was associated with a reduced RA risk, while perturbations in monocytes and lymphocytes were found to facilitate RA progression through immune-mediated mechanisms.</p><p><strong>Conclusion: </strong>This study underscores the pivotal role of immune cell subsets in mediating the effects of blood cell perturbations on RA development. These findings suggest that targeting immune cell-mediated pathways, particularly those involving Tregs and CD8 + T cells, can provide new therapeutic strategies for RA management. Key Points • Causal Relationships: Mendelian randomization (MR) analysis identified significant causal relationships between specific blood cell disturbances (e.g., reticulocytes, monocytes, and lymphocytes) and rheumatoid arthritis (RA). • Role of Immune Cells: CD3 + CD39 + regulatory T cells (Tregs) and CD45RA + Terminally Differentiated CD8 + T cells (CD45RA + TD CD8 + cells) mediate the association between blood cell disturbances and RA. • Protective Role of Reticulocytes: Reticulocyte disturbances under potassium chloride (KCl) conditions are negatively associated with RA, potentially protecting joints from inflammatory damage by reducing oxidative stress. • Protective Role of Non-Classical Monocytes: Baseline disturbances in monocyte median side scatter are negatively associated with RA, suggesting non-classical monocytes may reduce RA-related inflammation. • Positive Association of Lymphocyte Disturbances with RA: Lymphocyte side scatter standard deviation under colchicine disturbances shows a significant positive association with RA, indicating abnormal T cell activation may exacerbate RA progression.AQ.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143613784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}