Zeitschrift fur Rheumatologie最新文献

{"title":"[Synovial chondromatosis : Results from the histopathological arthritis register of the German Society for Orthopedic Rheumatology].","authors":"Stella Kriegsmann, Veit Krenn, Martin Liebisch","doi":"10.1007/s00393-024-01569-w","DOIUrl":"https://doi.org/10.1007/s00393-024-01569-w","url":null,"abstract":"<p><strong>Background: </strong>Synovial chondromatosis, or osteochondromatosis, is a rare benign disorder that occurs in joints, tendon sheaths, or bursae, characterized by cartilage proliferations of varying sizes and shapes, often with ossifications. In this study the prevalence, sensitivity, gender predominance, differential diagnoses, and primary localization of synovial chondromatosis are analyzed within the Histopathological Arthritis Registry of the German Society for Orthopedic Rheumatology.</p><p><strong>Methods: </strong>All cases of patients diagnosed with \"synovial chondromatosis\" from the Histopathological Arthritis Registry of the German Society for Orthopedic Rheumatology were retrospectively examined, covering the period from 1 January 2018, to 31 December 2022.</p><p><strong>Results: </strong>Between 1 January 2018, and 31 December 2022, there were 14 cases of synovial chondromatosis out of a total of 13,222 cases in the Histopathological Arthritis Register of the German Society for Orthopedic Rheumatology. The available data include primary localization, and age and gender of the patients. Among the 13,222 cases in the Histopathological Arthritis Register of the German Society for Orthopedic Rheumatology, 14 were histopathologically confirmed as synovial chondromatosis. This resulted in a prevalence of 0.1% or 1.13 per 1,000 cases. The correct clinical presumptive diagnosis was made in 5 cases, yielding a sensitivity of 35.7%, 95% confidence interval (CI) 12.8% to 64.9%.</p><p><strong>Discussion: </strong>Differential diagnoses for this condition include pigmented villonodular synovitis, tenosynovial giant cell tumor, and chondrosarcoma. Synovial chondromatosis frequently occurs in large joints such as the knee, hip, and the temporomandibular joint. A peak incidence is described in the fifth decade of life. However, the disorder can also occur in children. For the first time, the study was able to provide data for Germany based on a large sample. Additionally, initial statements regarding the prevalence and sensitivity of synovial chondromatosis could be made. The aim of this work is to raise awareness of this very rare disease to enable faster and more efficient diagnosis. The study also highlights the importance of histopathology in the diagnosis of synovial chondromatosis.</p>","PeriodicalId":23834,"journal":{"name":"Zeitschrift fur Rheumatologie","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355181","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":"YouTube as a source of information on reactive arthritis: a quality analysis.","authors":"Muhammet Limon, Dilek Tezcan","doi":"10.1007/s00393-024-01571-2","DOIUrl":"https://doi.org/10.1007/s00393-024-01571-2","url":null,"abstract":"<p><strong>Objective: </strong>YouTube is often used by patients and healthcare professionals to obtain medical information. Reactive arthritis (ReA) is a type of inflammatory arthritis triggered by infection, usually in the genitourinary or gastrointestinal tract. However, the accuracy and quality of ReA-related information on YouTube are not fully known. This study aimed to assess the reliability and quality of YouTube videos pertaining to ReA.</p><p><strong>Materials and methods: </strong>A YouTube search was performed on August 1, 2023, using the keywords \"reactive arthritis,\" \"Reiter's disease,\" and \"Reiter's syndrome.\" The number of days since upload; the number of views, likes, and comments; and the duration of videos were recorded. The modified DISCERN tool (mDISCERN) and the global quality scale (GQS) were used to evaluate the reliability and quality of the videos. Two physicians independently classified videos as low, moderate, or high quality and rated them on a five-point GQS (1 = poor quality, 5 = excellent quality). The source of videos was also noted.</p><p><strong>Results: </strong>Of the 180 videos screened, 68 met the inclusion criteria. The most common topic (61, 89.7%) was \"ReA overview.\" Among the 68 videos analyzed, the main source of uploads was physicians 45 (66.2%), and 66 (97%) were categorized as useful. Around half of the YouTube videos about ReA were of high quality (33, 48.5%) according to the GQS. Upon comparing videos uploaded by rheumatologists, non-rheumatology healthcare professionals, and independent users, significant differences were found in mDISCERN and GQS but not in the number of views, likes, and comments or duration. Upon comparing high-, moderate-, and low-quality videos, significant differences were found in the number of views, likes, and comments; duration; and in mDISCERN and GQS.</p><p><strong>Conclusion: </strong>YouTube is a source of information on ReA of variable quality, with wide viewership and the potential to influence patients' knowledge and behavior. Our results showed that most YouTube videos on ReA were of high quality. Videos presented by physicians had higher quality. YouTube should consider avoiding low-quality videos by using validity scales such as mDISCERN and GQS.</p>","PeriodicalId":23834,"journal":{"name":"Zeitschrift fur Rheumatologie","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355183","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":"[Vasculitic involvement of the skeletal muscle and the peripheral nervous system: clinical and neuropathologic perspective].","authors":"Nikolas Ruffer, Felix Kleefeld, Marie-Therese Holzer, Martin Krusche, Ina Kötter, Udo Schneider, Werner Stenzel","doi":"10.1007/s00393-024-01567-y","DOIUrl":"https://doi.org/10.1007/s00393-024-01567-y","url":null,"abstract":"<p><p>The peripheral nervous system is a classic target organ in systemic vasculitis. In addition, the skeletal muscle can also be affected. Myalgia, muscle weakness and sensory deficits are typical signs, which can lead to severe functional limitations and impaired of quality of life. Vasculitic involvement of the skeletal muscle (vasculitic myopathy [VM]) and peripheral nerves (vasculitic neuropathy [VN]) occurs predominantly in polyarteritis nodosa and small-vessel vasculitis. VM presents with elevated markers of inflammation and is typically characterized by immobilizing myalgia with normal creatine kinase activity and diffuse or patchy areas of hyperintensity on T2-weighted MRI (\"MRI myositis without myositis\"). In VN, sensor motor deficits predominantly affect the lower extremity in the area supplied by several peripheral nerves (e.g., mononeuritis multiplex) with acute to subacute history. The histopathological examination of nerve and muscle biopsies is the gold standard for the diagnosis of vasculitic manifestations and has a significant impact on the therapeutic approach.</p>","PeriodicalId":23834,"journal":{"name":"Zeitschrift fur Rheumatologie","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308654","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":"[News on the treatment of large vessel vasculitis].","authors":"Nils Venhoff, Markus Zeisbrich","doi":"10.1007/s00393-024-01563-2","DOIUrl":"https://doi.org/10.1007/s00393-024-01563-2","url":null,"abstract":"<p><p>Large vessel vasculitis, such as giant cell arteritis (GCA) and Takayasu arteritis (TAK) are primarily manifested on large and medium-sized arteries. While GCA mainly affects older people after the 6th decade of life onwards, TAK mainly affects young women under the age of 40 years. Glucocorticoids (GC) are still the standard treatment for both diseases. Refractory courses and relapses in particular often lead to long-term treatment with high cumulative doses of GC, which can lead to increased morbidity and mortality. To date, only the interleukin 6 (IL-6) receptor blocker tocilizumab has been approved for the treatment of GCA. The data on methotrexate and other conventional immunosuppressants are incomplete and in some cases contradictory. The early use of steroid-sparing immunosuppressants is recommended for TAK, although the number of randomized placebo-controlled trials is limited and no steroid-sparing treatment has yet been approved for TAK. For both diseases there is still a great need for modern and safe steroid-sparing treatment that effectively treats vasculitis, prevents damage and enables adequate disease monitoring. This article provides an overview of the current study situation and possible future treatment options for GCA and TAK.</p>","PeriodicalId":23834,"journal":{"name":"Zeitschrift fur Rheumatologie","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296731","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":"[Effects of a multimodal inpatient treatment for patients with fibromyalgia syndrome at the Rhineland-Palatinate Acute Rheumatology Center].","authors":"Konstantinos Triantafyllias, Veronika Balaklytska, Charlotte Sauer, Matthias Dreher, Andreas Schwarting","doi":"10.1007/s00393-024-01568-x","DOIUrl":"https://doi.org/10.1007/s00393-024-01568-x","url":null,"abstract":"<p><strong>Introduction: </strong>Fibromyalgia syndrome (FMS) is a complex condition that is often refractory to therapy and is associated with impaired quality of life. In some studies, multimodal rheumatological treatment has been shown to be an effective therapy option for patients with systemic-inflammatory and degenerative rheumatic diseases. However, the effects of this therapeutic approach have not been sufficiently investigated in patients with FMS. Therefore, the aim of this study was to examine the effect of a concise 9‑ to 10-day inpatient multimodal fibromyalgia treatment (MFT) using patient-reported outcomes in a German cohort.</p><p><strong>Methods: </strong>The effects of MFT were assessed using visual analog scales (VAS) for pain (P) and subjective disease activity (DA), questionnaires measuring everyday functional capacity (Health Assessment Questionnaire [HAQ], Funktions-Fragebogen-Hannover [FFbH, Hannover Functional Ability Questionnaire]), and pharmacotherapy at three time points (Visit 1: beginning of multimodal therapy, Visit 2: end of MFT, and Visit 3: 3 months after Visit 2).</p><p><strong>Results: </strong>Sixty-one patients were enrolled in the study at the Rhineland-Palatinate Acute Rheumatology Center. Under MFT, a significant improvement in VAS (P) and VAS (DA) was observed between the start and end of treatment (Visit 2 versus Visit 1: median decrease from 7 to 5, p < 0.001, for both VAS [P] and VAS [DA]). Additionally, comparison of the other two assessment points showed a change in VAS (P) (Visit 3 versus Visit 1: median decrease from 7 to 6, p = 0.041, and Visit 3 versus Visit 2: median increase from 5 to 6, p = 0.004). However, there were no significant differences in FFbH and HAQ parameters among the three visits. Examination of the subgroup of patients whose medication therapy was not intensified during hospitalization also showed significant improvements in VAS (P) and VAS (DA) between the start and end of MFB (Visit 2 versus Visit 1: median decrease from 7 to 4, p < 0.001, for VAS [P] and median decrease from 6.25 to 4, p = 0.002, for VAS [DA]).</p><p><strong>Conclusion: </strong>These findings indicate a demonstrable benefit to patients of MFT regarding both pain and subjective disease activity. Furthermore, pain relief was even observed 3 months after the end of therapy. This shows the high value of this therapeutic approach to treating patients with FMS.</p>","PeriodicalId":23834,"journal":{"name":"Zeitschrift fur Rheumatologie","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296728","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":"[News on the imaging of large vessel vasculitis].","authors":"Valentin S Schäfer, Simon M Petzinna, Wolfgang A Schmidt","doi":"10.1007/s00393-024-01565-0","DOIUrl":"https://doi.org/10.1007/s00393-024-01565-0","url":null,"abstract":"<p><p>Large vessel vasculitis, including giant cell arteritis (GCA) and Takayasu arteritis (TAK), are autoimmune diseases primarily affecting the aorta and its branches. GCA is the most common primary vasculitis. Inflammatory changes in the vessel walls can cause serious complications such as amaurosis, stroke, and aortic dissection and rupture. Imaging techniques have become an integral part for the diagnosis and monitoring of large vessel vasculitis, allowing for effective disease monitoring. GCA and TAK exhibit similar patterns of vascular distribution. However, the temporal arteries are never involved in TAK, and axillary arteritis occurs more frequently in GCA. In most centers, ultrasound of the temporal and axillary arteries has replaced temporal artery biopsy as the primary diagnostic tool for GCA. In addition to ultrasound, magnetic resonance imaging (MRI), computed tomography (CT), and [¹⁸F]-FDG (fluorodeoxyglucose) positron emission tomography-computed tomography (PET) are important, particularly for visualizing the aorta. Moreover, PET-CT is now also capable of assessing the temporal arteries, although it is not yet widely available. In polymyalgia rheumatica (PMR), ultrasound of the shoulder and hip regions is part of the ACR/EULAR classification criteria. MRI allows detailed visualization of additional inflammatory extraarticular manifestations, showing characteristic inflammatory lesions in entheses, tendons, and ligaments. [¹⁸F]-FDG-PET-CT also enables the visualization of musculoskeletal inflammation, especially in the shoulder and hip regions, as well as paravertebral areas. Ultrasound can detect subclinical GCA in up to 23% of patients with PMR, which should be treated like GCA. Technological innovations such as new radiotracers and improved MRI imaging could further enhance the diagnosis and monitoring of large vessel vasculitis and PMR, thus playing a crucial role in improving the prognosis through faster initiation of therapy.</p>","PeriodicalId":23834,"journal":{"name":"Zeitschrift fur Rheumatologie","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296730","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":"[Digital health applications-What we should know as rheumatologists].","authors":"Johannes Knitza, Martin Krusche, Gamal Chehab, Christof Specker, Jutta G Richter","doi":"10.1007/s00393-024-01570-3","DOIUrl":"https://doi.org/10.1007/s00393-024-01570-3","url":null,"abstract":"<p><p>Digital health applications (DHAs) are revolutionising patient care by improving access to evidence-based therapy and promoting active self-management. The continuously growing number of DHAs enables patients to act more independently through digital support. The budget-neutral prescription and cost coverage by statutory health insurance companies reduce financial barriers for practitioners and patients. Initial studies show that DHAs can be used successfully to treat comorbidities and rheumatic diseases. Several DHAs for inflammatory rheumatic diseases are at an advanced stage of development. The identification of suitable patients and support through shared decision making are crucial for successful implementation. Challenges remain in adherence and acceptance of the applications. This article provides an overview of prescription in clinical routine, initial data and experiences from the reality of rheumatology care, and reports on current developments.</p>","PeriodicalId":23834,"journal":{"name":"Zeitschrift fur Rheumatologie","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296727","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":"Nachruf auf Herrn Professor Dr. sc. med. Wolfgang Keitel.","authors":"Eugen Feist, Karsten Beyer, Carlo Weimann","doi":"10.1007/s00393-024-01561-4","DOIUrl":"https://doi.org/10.1007/s00393-024-01561-4","url":null,"abstract":"","PeriodicalId":23834,"journal":{"name":"Zeitschrift fur Rheumatologie","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126843","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":"Looking back on 51 years of the Carol Nachman Prize in Rheumatology-significance for the field of spondyloarthritis research.","authors":"Jürgen Braun, Joachim Sieper, Elisabeth Märker-Hermann","doi":"10.1007/s00393-024-01496-w","DOIUrl":"10.1007/s00393-024-01496-w","url":null,"abstract":"<p><p>The city and casino of Wiesbaden, capital of the German state Hessen, have endowed the Carol Nachman Prize to promote research work in the field of rheumatology since 1972. The prize, endowed with 37,500 €, is the second highest medical award in Germany and serves to promote clinical, therapeutic, and experimental research work in the field of rheumatology. In June 2022, the 50-year anniversary was celebrated. In the symposium preceding the award ceremony, an overview was given on the significance of spondyloarthritis for the work of the awardees in the past 30 years. This overview has now been put together to inform the interested community of the work performed, including the opinion of the awardees regarding what they consider to be their most important contribution.</p>","PeriodicalId":23834,"journal":{"name":"Zeitschrift fur Rheumatologie","volume":" ","pages":"563-574"},"PeriodicalIF":0.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11442482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141306991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Procedures of complementary medicine in rheumatology].","authors":"Gernot Keyßer, Inna Frohne, Olaf Schultz, Monika Reuß-Borst, Oliver Sander, Alexander Pfeil","doi":"10.1007/s00393-024-01524-9","DOIUrl":"10.1007/s00393-024-01524-9","url":null,"abstract":"<p><p>Patients with diseases of the musculoskeletal system are confronted with a large quantity of treatment offers based on methods of complementary medicine. Despite a considerable number of publications on this topic, the scientific evidence is still poor. This article focuses on Ayurvedic medicine (AM), traditional Chinese medicine (TCM), mind-body medicine and homeopathy. These procedures have a longstanding tradition of practice and each claims to have its own theoretical concept; however, the application in the field of rheumatology can only be recommended either for specific entities or, in the case of homeopathy, not at all. In addition, this article summarizes the evidence for dietary recommendations, nutritional supplements and herbal medicine in rheumatology. The latter topics are frequently discussed in the popular press and are a much-debated issue between physicians and patients; however, clear-cut recommendations for the application on a scientific basis are the exception and mainly consist of the endorsement to adhere to the principles of a Mediterranean diet.</p>","PeriodicalId":23834,"journal":{"name":"Zeitschrift fur Rheumatologie","volume":" ","pages":"549-561"},"PeriodicalIF":0.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141459626","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}