Zeitschrift fur Rheumatologie最新文献

{"title":"[Ectopic calcification of the knee joint].","authors":"Elina Hahn, Iman Khalili, Veit Krenn, Wolfgang Rüther, Andreas Niemeier","doi":"10.1007/s00393-025-01659-3","DOIUrl":"https://doi.org/10.1007/s00393-025-01659-3","url":null,"abstract":"<p><p>An 81-year-old man presented with progressive tumorous swelling of the infrapatellar region of the left knee joint. X‑ray imaging was suggestive of bursosynovial chondromatosis or ectopic calcification. Histopathological examination of the resected tissue combined with laboratory findings of renal insufficiency and secondary hyperparathyroidism led to the diagnosis of tumoral calcinosis, which is a rare subentity of ectopic calcification.</p>","PeriodicalId":23834,"journal":{"name":"Zeitschrift fur Rheumatologie","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Innovative treatments in rheumatology].","authors":"Abhinav Singla, Christof Iking-Konert, Carolin Kellersmann, Dimitrios Mougiakakos, Eugen Feist","doi":"10.1007/s00393-025-01658-4","DOIUrl":"https://doi.org/10.1007/s00393-025-01658-4","url":null,"abstract":"<p><p>Systemic rheumatic diseases represent a heterogeneous group of conditions associated with significant morbidity and substantial healthcare burden. Their clinical course varies widely and is influenced by genetic, immunologic, and environmental factors. Despite advances in pharmacotherapy, conventional immunomodulatory and immunosuppressive treatments often remain insufficiently effective or lose efficacy over time. The identification of novel molecular targets is crucial to enable more precise and effective therapies. Advances in understanding pathogenic signaling pathways have led to the development of innovative therapeutic agents. This review highlights current and emerging molecular and cell-based therapies that are either recently approved or in clinical development, with a special focus on their mechanisms of action and potential to support personalized treatment approaches in rheumatic diseases.</p>","PeriodicalId":23834,"journal":{"name":"Zeitschrift fur Rheumatologie","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Lipoma arborescens of both knees in a woman with seronegative rheumatoid arthritis].","authors":"Iman Khalili, Elina Hahn, Christof Iking-Konert, Wolfgang Rüther, Andreas Niemeier","doi":"10.1007/s00393-025-01663-7","DOIUrl":"https://doi.org/10.1007/s00393-025-01663-7","url":null,"abstract":"","PeriodicalId":23834,"journal":{"name":"Zeitschrift fur Rheumatologie","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Rotator cuff lesion-Is cuff repair indicated in patients with rheumatic diseases?]","authors":"Ulrich Bechler, Jan Hubert, Julius Rosenfeld, Eva Goedecke, Frank Timo Beil","doi":"10.1007/s00393-025-01648-6","DOIUrl":"https://doi.org/10.1007/s00393-025-01648-6","url":null,"abstract":"<p><p>Rheumatic diseases, particularly in the context of rheumatoid arthritis (RA), frequently affect the shoulder joint and lead to lesions of the rotator cuffs, which are associated with chronic pain and restricted movement. Systemic inflammation endangers the integrity of the rotator cuff, while pharmacotherapy can impair tissue repair; however, the function of rotator cuffs is decisive for the selection of diagnostic and therapeutic measures. In cases of failure of conservative treatment surgical reconstruction represents an option in order to relieve pain and restore the biomechanical function. However, the decision for surgical treatment in RA patients is complex due to increased risks of complications, such as delayed healing, infections and re-rupture. This article examines the benefits and probability of success of the surgical reconstruction of rotator cuffs in the context of rheumatic diseases and should form a foundation for making clinical decisions and treatment recommendations.</p>","PeriodicalId":23834,"journal":{"name":"Zeitschrift fur Rheumatologie","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Decision-making process between plate osteosynthesis vs. endoprosthesis in proximal humerus fractures of the rheumatoid arthritis shoulder].","authors":"Christoph Biehl, Anna-Catarina Meyer, Maren Seidl, Christian Heiß, Markus Rupp, Thaqif El Khassawna","doi":"10.1007/s00393-025-01656-6","DOIUrl":"https://doi.org/10.1007/s00393-025-01656-6","url":null,"abstract":"<p><p>The shoulder joint is involved in a high percentage of rheumatoid arthritis (RA) cases. At the same time, patients with RA develop osteoporosis at an early stage, which significantly increases the risk of fracture. In recent years, joint-preserving procedures with stable-angle implants have become available for individuals with low disease activity and good medication control. However, this approach is dependent on the fracture morphology and, if not adequately addressed, is associated with a high rate of revision surgery. In rotator cuff reconstruction, recent data show encouraging results regarding regenerative capacity, which does not necessarily indicate immediate reverse shoulder arthroplasty. Follow-up treatment must consider delayed osseous healing.</p>","PeriodicalId":23834,"journal":{"name":"Zeitschrift fur Rheumatologie","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Rheumatic shoulder joints in childhood].","authors":"Daniel Windschall, Hartmut Bork, Faekah Gohar, Anna Maier","doi":"10.1007/s00393-025-01654-8","DOIUrl":"https://doi.org/10.1007/s00393-025-01654-8","url":null,"abstract":"<p><p>Although the knee joint in children and adolescents is most frequently affected in cases of juvenile idiopathic arthritis (JIA), shoulder joint arthritis is only present in a small proportion of JIA patients at disease onset. Shoulder joint involvement is more frequently seen in polyarthritis or chronic JIA, which if not considered and left untreated can lead to substantial joint immobility and with a destructive course. In addition to the clinical examination, imaging methods help to verify an early involvement of the shoulder joint and imaging can also provide important information in a treat to target concept. The treatment of pediatric omarthritis is very often guided by the treatment algorithm for the appropriate JIA category. In this respect, in addition to local steroid injections, medications such as methotrexate, biologicals and also Janus kinase (JAK) inhibitors are used. In addition to the pharmacotherapy, physiotherapy also plays an important role.</p>","PeriodicalId":23834,"journal":{"name":"Zeitschrift fur Rheumatologie","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Articular and periarticular tumors : Important diagnoses in rheumatology and orthopedic rheumatology].","authors":"Veit Krenn, Andreas Niemeier, Caroline Liewen-Kugel","doi":"10.1007/s00393-025-01650-y","DOIUrl":"https://doi.org/10.1007/s00393-025-01650-y","url":null,"abstract":"<p><p>This review article presents the histopathological differential diagnostics of malignant and benign joint tumors as well as pseudotumors of the joints and the peri-implant tissue. Methodologically, these integrative diagnostics are based on conventional standard staining procedures, on immunohistochemical analyses of formalin-fixed and paraffin-embedded (FFPE) tissues and also on molecular diagnostic procedures, which can be particularly useful in the diagnosis of benign and malignant joint tumors. For joint tumors S100, smooth muscle (SM) actin, cluster of differentiation (CD) 68, CD34, signal transducer and activator of transcription (STAT) 6, clusterin, mucin 4 (Muc-4), beta-catenin and mouse double minute 2 homolog (MDM2) fluorescence in situ hybridization (FISH) are recommended. For the differential diagnostic typing of periarticular carcinoma metastases cytokeratin (CK, AE1/AE3), CK8, p63, thyroid transcription factor (TTF)-1, thyroglobin (TGB), prostate-specific antigen (PSA), androgen receptor, GATA, CD56, chromogranin, caudal type homeobox (CDX) 2, special AT-rich sequence-binding protein 2 (SATB2), spalt like transcription factor 4 (SALL4), estrogen and progesterone receptors, CD45LCA, CD30, CD79a and S100 are recommended. Necrosis, pronounced inflammatory infiltration and reparative inflammatory changes can make histopathological classification difficult. Therefore, the correlation with clinical, microbiological and radiological imaging data may be necessary in the sense of interdisciplinary integrative diagnostics. In the case of histopathological findings that reveal questionable representativeness, the report should definitely refer to the need for clinical or radiological control as well as the need for a second biopsy.</p>","PeriodicalId":23834,"journal":{"name":"Zeitschrift fur Rheumatologie","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Annual report 2025 from the National Database of the Regional Collaborative Rheumatology Centers in Germany].","authors":"Katinka Albrecht, Katja Thiele, Tobias Alexander, Martin Aringer, Jacqueline Detert, Thorsten Eidner, Martin Feuchtenberger, Jörg Henes, Kirsten Karberg, Uta Kiltz, Benjamin Köhler, Andreas Krause, Jutta G Richter, Susanna Späthling-Mestekemper, Mirko Steinmüller, Silke Zinke, Anja Strangfeld, Johanna Callhoff","doi":"10.1007/s00393-025-01646-8","DOIUrl":"https://doi.org/10.1007/s00393-025-01646-8","url":null,"abstract":"<p><strong>Background: </strong>Data of patients with inflammatory rheumatic diseases are annually recorded within the National Database of the German Collaborative Rheumatology Centers.</p><p><strong>Methods: </strong>For rheumatoid arthritis (RA), psoriatic arthritis (PsA), axial spondylarthritis (axSpA), systemic lupus erythematosus (SLE), systemic sclerosis (SSc), Sjögren's syndrome (SjS), idiopathic inflammatory myositis (IIM), polymyalgia rheumatica (PMR), giant cell arteritis (GCA), ANCA-associated vasculitis (AAV), Behçet's disease (BD), adult onset Still's disease (AOSD) and autoinflammatory diseases (AID) data are reported from 2023. Information includes physician-reported disease activity on a numeric rating scale (NRS) of 0-10, treatment and patient-reported outcomes. For selected diagnoses, developments from 2010 to 2023 are presented regarding physicians' assessments of disease activity and treatment.</p><p><strong>Results: </strong>A total of 13,884 patients were documented from 14 rheumatology centers, most frequently with RA (5734), PsA (1741) and axSpA (1494). The mean age ranged from 45 years (BD) to 73 years (GCA) and the median disease duration ranged from 3 years (PMR) to 16 years (axSpA). Disease activity was predominantly low, with 6% (BD) to 15% (axSpA) rated moderate to high (> 4 on the NMR) by rheumatologists. Biological disease-modifying antirheumatic drugs (bDMARD) were most frequently prescribed for axSpA (65%), AOSD (58%), PsA (53%) and GCA (41%). Tumor necrosis factor (TNF) inhibitors were frequently used in axSpA (53%), BD (30%) and PsA (28%), interleukin (IL)-1 inhibitors in AOSD (51%) and AID (50%), IL-6Ri in GCA (38%), IL17i in PsA (17%) and rituximab in AAV (29%). Higher levels of pain, fatigue, sleep disturbances and reduced well-being were reported by patients with IIM, SSc, axSpA and AID. Among those younger than 65 years, 58% (SSc) to 77% (axSpA) were employed. The percentage of early retirement due to rheumatic diseases was 5% (AOSD) to 18% (AAV). Since 2010 the development in the proportion of patients in remission or with very low disease activity (NRS 0-1) has increased across all diagnoses. In terms of treatment there has been an increase in b/tsDMARDs and a decrease in glucocorticoids for various diagnoses.</p><p><strong>Conclusion: </strong>The results show the diversity of inflammatory rheumatic diagnoses and the continuously growing range of treatment in rheumatology along with good disease control in many patients.</p>","PeriodicalId":23834,"journal":{"name":"Zeitschrift fur Rheumatologie","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Infections during joint replacement under immunomodulatory treatment].","authors":"Stefan Rehart, Ole Schickedanz, Benedikt Wickler","doi":"10.1007/s00393-025-01643-x","DOIUrl":"10.1007/s00393-025-01643-x","url":null,"abstract":"<p><p>Artificial joint replacement, particularly of the hip and knee joints, has become an established treatment option for degenerative and systemic inflammatory joint diseases in Germany; however, with the increasing number of endoprosthetic procedures, the risk of postoperative complications, particularly periprosthetic infections (PPI), also increases. These infections can lead to severe consequences, such as prolonged healing times, redo surgery and functional impairments. Patients with rheumatic diseases and immunosuppressive treatment have a particularly high risk for PPI, as the immune response is severely impaired by medications, such as corticosteroids, disease-modifying antirheumatic drugs (DMARD) and biologics. Preoperative measures, such as a thorough anamnesis and adjustment of the immunosuppressive treatment, are crucial to minimize the risk of infections. Diagnosing a PPI in immunosuppressed patients can be challenging as typical symptoms are often less pronounced. In cases of a suspected infection, an early diagnostic work-up and individualized treatment are required, which may include both antibiotic treatment and surgical interventions. An interdisciplinary management involving rheumatologists, orthopedic (rheumatologic) surgeons and infectious disease specialists is essential for successful treatment. Preventive strategies and targeted perioperative risk management can help to reduce the occurrence of PPI and ensure the long-term health of patients.</p>","PeriodicalId":23834,"journal":{"name":"Zeitschrift fur Rheumatologie","volume":" ","pages":"295-301"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mitteilungen der DGRh - Veranstaltungen der Rheumaakademie.","authors":"","doi":"10.1007/s00393-025-01651-x","DOIUrl":"https://doi.org/10.1007/s00393-025-01651-x","url":null,"abstract":"","PeriodicalId":23834,"journal":{"name":"Zeitschrift fur Rheumatologie","volume":"84 4","pages":"339"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}