Egyptian Rheumatologist最新文献

{"title":"Assessment of the efficacy of beam irradiation in breast cancer patients with knee osteoarthritis","authors":"Dina F. El-Essawi ,&nbsp;Ibrahim Elzawahry ,&nbsp;Manal R. Mohammed ,&nbsp;Asmaa Zohry ,&nbsp;Hany William","doi":"10.1016/j.ejr.2025.10.003","DOIUrl":"10.1016/j.ejr.2025.10.003","url":null,"abstract":"<div><h3>Background</h3><div>Knee osteoarthritis (OA) causes pain, stiffness, and reduced mobility, significantly impairing quality of life. Low-dose radiotherapy (LDRT) has emerged as a potential treatment due to its anti-inflammatory and immunomodulatory effects, but its efficacy in specific populations, such as breast cancer survivors, remains under studied.</div></div><div><h3>Aim of the work</h3><div>To evaluate the effectiveness and safety of LDRT in female breast cancer survivors with knee OA (grades II and III), focusing on pain relief, inflammation, joint function, and genotoxicity.</div></div><div><h3>Patients and methods</h3><div>Out of an initial 36 patients, 20 (aged 45–65) were divided into two groups: Group I received 0.5 Gy LDRT three times weekly for two weeks, while Group II received 0.5 Gy twice weekly for three weeks. Outcomes were assessed using the Western Ontario and McMaster Universities Arthritis (WOMAC) index, erythrocyte sedimentation rate (ESR), genotoxicity tests (Micronucleus and Comet assays), and magnetic resonance imaging (MRI) for cartilage thickness and joint space.</div></div><div><h3>Results</h3><div>Both the LDRT regimens significantly improved WOMAC, reduced pain, stiffness, and enhanced joint function. Inflammatory markers showed a non-significant decline, suggesting mild anti-inflammatory effects. Genotoxicity tests indicated minimal DNA damage, particularly in Group II, confirming safety. MRI revealed improved cartilage thickness and morphology without significant joint effusion changes. The two dosing schedules were comparable.</div></div><div><h3>Conclusion</h3><div>LDRT, particularly 0.5 Gy twice weekly for three weeks, is an effective and safer treatment for knee OA in breast cancer survivors, providing symptoms relief and cartilage improvement with low toxicity. Further large-scale trials are needed to refine protocols and confirm optimal dosing.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"48 1","pages":"Pages 16-21"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145271303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of systemic lupus erythematosus on cardiovascular health in young adults","authors":"Noha H. Shedid ,&nbsp;Hanan M. Farouk ,&nbsp;Reem A. Habib ,&nbsp;Amr E. Mahdy","doi":"10.1016/j.ejr.2025.10.007","DOIUrl":"10.1016/j.ejr.2025.10.007","url":null,"abstract":"<div><h3>Aim of the work</h3><div>To evaluate cardiovascular (CV) characteristics of young adult patients with systemic lupus erythematosus (SLE) and their potential association with disease-related features.</div></div><div><h3>Patients and methods</h3><div>This study included 60 adult SLE patients &lt;45 years old and 30 healthy controls matched for age and gender. The demographic and clinical characteristics were recorded and laboratory data including lipid profile, high sensitivity C-reactive protein (hs-CRP) and anticardiolipin antibodies were measured. The SLE Disease Activity Index 2000 (SLEDAI-2K) and Systemic Lupus International Collaborating Clinics damage index (SDI) score were assessed. Echocardiography and carotid ultrasound (US) were performed.</div></div><div><h3>Results</h3><div>The 60 patients were 42 females and 12 males (F:M 4:1). Their mean age was 32.3±7.6 years and disease duration 9.1±4.7 years. Carotid US abnormalities were present in 8 (13.3%). Echocardiographic abnormalities (n=39, 65%) particularly valve and left ventricular dysfunction as well as mean carotid intima-media thickness (CIMT) were significantly higher in patients compared to control (p&lt;0.001). SLE patients with abnormal carotid ultrasound had higher age, disease duration (both p&lt;0.001), triglycerides (p=0.03), fasting blood glucose (p=0.005), SDI (p=0.02), steroid dose (p=0.004) and duration (p&lt;0.001). CIMT significantly correlated with disease duration (r=0.46, p&lt;0.001), steroids cumulative dose (r=0.38, p=0.003) and steroids duration (r=0.41, p&lt;0.001). Disease duration was an independent risk factor affecting CIMT (r=0.12, p&lt;0.001).</div></div><div><h3>Conclusion</h3><div>Young patients with SLE have an increased risk of premature CV disease that is linked to traditional and lupus-related risk factors. Implementation of early CV screening and preventive strategies is essential to decrease the incidence of CV morbidity and mortality.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"48 1","pages":"Pages 22-27"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145271302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of miR-23b and miR-326 expression in rheumatoid arthritis patients","authors":"Asmaa S. Sholkamy ,&nbsp;Enas H. Mahmoud ,&nbsp;Asmaa Kamal ,&nbsp;Emily S. Mikhael ,&nbsp;Noha M. Abdel Baki","doi":"10.1016/j.ejr.2025.10.004","DOIUrl":"10.1016/j.ejr.2025.10.004","url":null,"abstract":"<div><h3>Aim of the work</h3><div>To study serum levels of microribonucleic acids (microRNA-23b and microRNA-326) and to evaluate their potential use as biomarkers in rheumatoid arthritis (RA), their relation with the clinical features and disease activity.</div></div><div><h3>Patients and methods</h3><div>Seventy RA patients recruited from the rheumatology department, Kasr Al-Ainy University Hospitals and fifteen matched controls were studied. 35 patients with established RA and another 35 with early disease were included. Serum expression levels of microRNA-23b and microRNA-326 were evaluated via real-time polymerase chain reaction (PCR). Disease activity score (DAS28) was assessed.</div></div><div><h3>Results</h3><div>Patients were 65 females (92.9 %) and 5 males (7.1 %)(F:M 10.8:1) with mean age 39.4 ± 9.3 years and DAS28 4.45 <strong>±</strong> 0.92. Rheumatoid factor was positive in 29 (41.4 %). Steroids were received by 25 (35.7 %) and disease modifying anti-rheumatic drugs by 53 (75.7 %). The median value of microRNA-23b fold change (FC) as well as the microRNA-326 FC were found to be lower in the serum of RA patients than in controls with no significant difference (p = 0.661 and p = 0.612 respectively). No significant difference was found in expression levels of microRNA-23b and microRNA-326 between early and established RA patients (p = 0.545 and p = 0.125). Levels were comparable according to the gender for miR-23b (p = 0.34) and miR-326 (p = 0.78). Significant correlation was found between urea and both microRNA-326 and microRNA-23b in patients (r = 0.296, p = 0.013 and r = 0.48, p = 0.003 respectively).</div></div><div><h3>Conclusion</h3><div>The microRNA-23b and microRNA-326 expressions are not significantly associated with RA pathogenesis, clinical features or disease activity. However, miR-23b and miR-326 may be involved in the pathogenesis of kidney disorders.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"48 1","pages":"Pages 44-49"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145326521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Idiopathic inflammatory myositis: Clinical, laboratory and therapeutic insights from a retrospective case series","authors":"Samar Tharwat ,&nbsp;Adel M Elsayed ,&nbsp;Sherin MH Hamza ,&nbsp;Mohammed A Teama ,&nbsp;Dina A Shahin ,&nbsp;Safaa A Hussein","doi":"10.1016/j.ejr.2025.10.011","DOIUrl":"10.1016/j.ejr.2025.10.011","url":null,"abstract":"<div><h3>Aim</h3><div><em>of the work:</em> This study aimed to characterize the clinical, laboratory, radiological, and therapeutic profiles of idiopathic inflammatory myopathies (IIMs) patients in an Egyptian cohort to enhance understanding and management of these conditions. <em>Patients and methods:</em> A retrospective case series was conducted on 99 IIM patients; 42 polymyositis (PM), 33 dermatomyositis (DM), 19 overlap syndrome, 5 cancer-associated myositis recruited from Mansoura Rheumatology and Immunology Unit (March 2023– January 2025). Data included demographics, clinical features, laboratory results, magnetic resonance imaging (MRI), and electromyography (EMG), and treatments. <em>Results:</em> The cohort was predominantly female (83.8 %), with a mean age of 36.6 years. Most patients (83.8 %) experienced diagnostic delays of less than 2 years. Proximal muscle weakness was present in 74.7 % of cases. In the DM patients, Gottron papules are the most common (∼70 %), followed by erythema (∼60 %), heliotrope rash (∼50 %), and the V sign (∼45 %). DM and overlap groups exhibited more frequent fever (48.5 % and 47.4 %, p = 0.006) and sclerodactyly was confined to overlap syndrome (15.8 %, p = 0.002). Overlap syndrome patients had higher arthritis frequency (68.4 %, p &lt; 0.001). Laboratory analysis showed significantly lower creatine phosphokinase (CPK) levels in overlap syndrome (p = 0.001). MRI and EMG findings corroborated myopathic changes in most cases. Corticosteroids were the main therapy (76.8 %), with dexamethasone more frequently used in overlap and DM groups (p = 0.026). <em>Conclusion:</em> Idiopathic inflammatory myopathies manifests predominantly in females, typically with subacute proximal muscle weakness and systemic symptoms. Distinct clinical and therapeutic profiles were observed among PM, DM, and overlap syndromes, with overlap syndromes featuring higher arthritis rates.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"48 1","pages":"Pages 61-66"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145466860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peripheral joint manifestations in patients with ulcerative colitis from the middle east: systematic review and meta-analysis","authors":"Abdulaziz S. Alshahrani","doi":"10.1016/j.ejr.2025.11.002","DOIUrl":"10.1016/j.ejr.2025.11.002","url":null,"abstract":"<div><h3>Background</h3><div>Ulcerative colitis (UC) is an inflammatory bowel disease and a chronic gastrointestinal disorder with extraintestinal manifestations commonly involving the peripheral joints and contributing to patients’ morbidity.</div></div><div><h3>Aim of the work</h3><div>This study aimed to systematically analyze the prevalence of peripheral joint manifestations among patients with UC in the Middle East, providing insights into regional variations and potential clinical implications.</div></div><div><h3>Patients and methods</h3><div>A comprehensive search was performed in electronic databases for studies on the prevalence of peripheral joint manifestations in patients with UC in Middle Eastern countries. Twelve studies involving 2086 patients with UC were selected for quantitative synthesis. Random-effects <em>meta</em>-analysis was performed, and the prevalence of peripheral joint manifestations was calculated.</div></div><div><h3>Results</h3><div>The overall prevalence of peripheral joint manifestations in Middle Eastern patients with UC was 18 % (95 % CI: 12 %–24 %). The prevalence rates ranged from 3.2 % to 52.3 %. A symmetrical funnel plot indicated the absence of significant publication bias. Heterogeneity among the studies was substantial (I² = 95 %). Regional variations among the findings were observed, with Saudi Arabian studies reporting relatively higher prevalence rates than studies from Kuwait and Turkey. Gender disparities were noted but were not consistent across all the studies.</div></div><div><h3>Conclusions</h3><div>This <em>meta</em>-analysis reveals that peripheral joint manifestations are common extraintestinal complications in Middle Eastern patients with UC. Recognizing regional differences and gender disparities is essential for healthcare providers in the region. Further research is needed to explore the underlying factors and improve patient care. The findings contribute to a good understanding of the clinical burden of UC in the Middle East.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"48 1","pages":"Pages 71-76"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145526244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fundamental skills and knowledge to optimize Nursing-led care for autoimmune rheumatic diseases in geriatric patients: Rheumatology-Nursing perspective","authors":"Eman Harraz ,&nbsp;Inshrah Roshdy ,&nbsp;Elsayed Satour ,&nbsp;Khalid Alhusseiny ,&nbsp;Ohud Abukammas ,&nbsp;Samar Tharwat ,&nbsp;Yasser Ragab ,&nbsp;Farida Yasser ,&nbsp;Yasser Emad","doi":"10.1016/j.ejr.2025.11.003","DOIUrl":"10.1016/j.ejr.2025.11.003","url":null,"abstract":"<div><h3>Background</h3><div>Efforts should focus on enhancing rheumatology nurse-led care (NLC) to better meet the evolving needs of geriatric patients with rheumatic diseases (RDs) and improve their outcomes.</div></div><div><h3>Aim of the work</h3><div>The current review aimed to provide an overview of NLC in rheumatology, with an emphasis on rheumatic disorders that often afflict the elderly. Prevalent RDs in elderly including late onset rheumatoid arthritis (RA) (LORA), polymyalgia rheumatica (PMR), osteoarthritis (OA), gout and pseudogout were added as comprehensive educational components.</div></div><div><h3>Review of literature</h3><div><em>Search strategy</em>: The Web of Science, Scopus, and Medline/PubMed databases were explored, without time-restrictions, using the following search phrases; EULAR NLC, rheumatology NLC, rheumatology nurse specialists and RDs in geriatrics. Special emphasis was considered for NLC in the common RDs affecting the elderly: LORA, PMR, OA and gout/pseudogout. English-language articles deemed pertinent to the review topic were included. The search revealed 19 papers pertaining to NLC in RA, chronic inflammatory arthritis (CIA) and others that address educational aspects to enhance NLC in rheumatology as well as one article focused on NLC in PMR, four articles related to NLC in knee and hand OA, and another four related to NLC in gout.</div></div><div><h3>Conclusion</h3><div>Rheumatology NLC and nursing clinics in rheumatology (NCR) compose a beneficial and valuable addition to the management of RDs, particularly in vulnerable geriatric patients. In addition to the principal physician-led care, NLC provides a supplementary potential advantage that supports optimal management, patient education, care satisfaction, quick access to care, medication adherence, and tracking drug adverse effects.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"48 1","pages":"Pages 77-89"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145623502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Liver fibrosis assessment in rheumatoid arthritis patients on long-term methotrexate therapy using hepatic fibroScan (transient elastography)","authors":"Nermeen Samy ,&nbsp;Dalia Fayez ,&nbsp;Emad Kelada ,&nbsp;Dalia Mostafa Mohamed Sdik ,&nbsp;Nouran M. Elshahat ,&nbsp;Maha Ahmed El-Serwi","doi":"10.1016/j.ejr.2026.01.001","DOIUrl":"10.1016/j.ejr.2026.01.001","url":null,"abstract":"<div><h3>Aim of the work</h3><div>To assess liver stiffness (LS) and fibrosis in rheumatoid arthritis (RA) patients receiving long-term methotrexate (MTX) therapy using FibroScan (transient elastography).</div></div><div><h3>Patients and methods</h3><div>Sixty RA patients treated with uninterrupted weekly MTX for a minimum of five years were enrolled. Clinical evaluation, liver function tests, aspartate aminotransferase (AST)-to-platelet ratio index (APRI), abdominal ultrasonography, and FibroScan were performed. The disease activity score (DAS28) was assessed. Patients with obesity, diabetes, hyperlipidemia, alcohol consumption and those with liver diseases or nonalcoholic fatty liver disease (NAFLD) were excluded.</div></div><div><h3>Results</h3><div>Patients were predominantly females (85 %), had mean age of 39.5 ± 9.9 years, disease duration 8.2 ± 4.5 years and mean body mass index of 24.4 ± 1.97.The mean DAS28 was 3.64 ± 1.34. The weekly MTX dose ranged from 12.5–25 mg, with a mean duration of 7.8 ± 4 years and mean cumulative dose of 6728 ± 3948.4 mg. All patients exhibited normal AST, alanine trasnferase (ALT), AST/ALT, APRI and abdominal ultrasound findings. Regarding fibroscan, the mean controlled attenuation parameter (CAP) score was 170.4 ± 38.79 dB/m, corresponding to steatosis grade 0 (S0). Fifty-six (93.3 %) patients demonstrated fibrosis grade 0 (F0), while four (6.7 %) had mild, non-significant fibrosis (F1). No significant differences were noted among F0 and F1 groups in demographic, clinical, or laboratory parameters, or in MTX duration or cumulative dose.</div></div><div><h3>Conclusion</h3><div>Long-term MTX therapy, in the absence of metabolic risk factors, did not significantly contribute to hepatic fibrosis in RA patients, supporting its favorable hepatic safety profile. Transient elastography may be most beneficial for monitoring high-risk patients with metabolic comorbidities.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"48 1","pages":"Pages 95-99"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gout with co-existing rosacea in a diabetic male: Expanding the clinical association","authors":"Hamad Alfahaad ,&nbsp;Fayeh Asiri ,&nbsp;Hamza Alshehri ,&nbsp;Bakhaitan Alumer ,&nbsp;Soliman Alsaiari","doi":"10.1016/j.ejr.2025.10.008","DOIUrl":"10.1016/j.ejr.2025.10.008","url":null,"abstract":"<div><h3>Aim of the work</h3><div>To shed light on the co-existence of rosacea with gout as a possible dermatologic association in the context of diabetes in an elderly male.</div></div><div><h3>Case presentation</h3><div>A 66-year-old Saudi male known diabetic on oral hypoglycemic agents for more than 10 years and a history of gouty arthritis receiving colchicine during attacks and is on regular allopurinol, presented with a facial lesion misdiagnosed initially as cutaneous leishmaniasis and did not respond to treatment for 2 years. The patient presented to the dermatology clinic at Khamis Mushayt Hospital and was further investigated. The skin lesions were well-defined pinkish nodules infiltrated with telangiectasia and pustules involving the malar area, dorsum of nose, nasolabial folds with positive apple jelly diascopy. Concurrently, the left foot showed an erythematous swelling over the 1st metatarsophalangeal (MTP) joint. Differential diagnosis included rosacea, systemic lupus erythematosus and sarcoidosis. Laboratory investigations were within normal ranges except for an increased hemoglobin A1C (9 %) and SUA (10.1 mg/dl). Skin biopsy histopathology revealed an image compatible with rosacea. Co-management with the rheumatologist provided colchicines (0.5 mg thrice daily until the gouty attack resolves, as well as avoidance of triggers including spicy food, using sunscreen, doxycycline 100 mg/day and metronidazole gel for the rosacea.</div></div><div><h3>Conclusion</h3><div>The present case confirms a relationship between gout and rosacea occurring in an elderly male with diabetes. Awareness of such cases by dermatologists is crucial due to the challenges of similar clinical presentations to other rheumatic diseases such as SLE.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"48 1","pages":"Pages 7-10"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145247954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Doppler ultrasonography on small joints of hands and feet to assess subclinical affection in patients with psoriasis","authors":"Safaa A. Hussein,&nbsp;Dalia Fayez Mohamed,&nbsp;Amina Badr Eldin,&nbsp;Noran O. El-Azizi,&nbsp;Maha Shokry Mohamed,&nbsp;Elham S. Mohamed","doi":"10.1016/j.ejr.2025.10.010","DOIUrl":"10.1016/j.ejr.2025.10.010","url":null,"abstract":"<div><h3>Aim of the work</h3><div>To evaluate the frequency and distribution of subclinical synovitis, tenosynovitis and enthesitis using musculoskeletal ultrasound (MSUS) in psoriasis patients without clinical musculoskeletal affection, and to identify its predicting factors.</div></div><div><h3>Patients and methods</h3><div>70 patients with psoriasis were studied. Psoriasis Area and Severity Index (PASI) was assessed. High-resolution MSUS assessment of the wrists, small hand joints; metacarpophalangeal (MCP), proximal interphalangeal (PIP), distal interphalangeal (DIP), ankles, small foot joints; metatarsophalangeal (MTP), PIP and DIP joints. All joints were examined for synovial proliferation, effusion, erosions and osteophytes. Extensor and flexor wrist tendons were evaluated for tenosynovitis. Flexor and extensor digitorum tendons were assessed for tenosynovitis/tendinitis. Achilles tendon and plantar fascia were examined for enthesitis.</div></div><div><h3>Results</h3><div>The 70 patients mean age was 38.2 ± 13.62 years; were 38 males, 32 females. Positive MSUS findings were detected in 74.28 % of patients; synovitis in 71.43 %, enthesitis in 60 %, and 17.14 % had tenosynovitis. Age, female distribution, body mass index (BMI), disease duration, PASI score, and erythrocyte sedimentation rate were significantly higher in psoriatic patients with positive MSUS abnormalities. Female gender, BMI &gt; 25 kg/m², smoking, PASI &gt; 5, methotrexate treatment, and topical steroid therapy were significant predictors for positive MSUS findings.</div></div><div><h3>Conclusion</h3><div>Subclinical synovitis, enthesitis, and tenosynovitis detected by ultrasound are frequent findings in psoriasis patients without clinical musculoskeletal manifestations. MSUS is a valuable, simple, and non-invasive tool in the early detection of subclinical inflammatory findings in psoriatic patients, especially in the presence of female gender, high BMI, smoking and high PASI as potential predictors of positive MSUS abnormalities.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"48 1","pages":"Pages 55-60"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145365249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of vascular involvement in polymyalgia rheumatica (PMR) patients by duplex ultrasound","authors":"Passant N. El-Husseiny ,&nbsp;Marwa H. Niazy ,&nbsp;Sama A. Anwar ,&nbsp;Amira A. Shahin","doi":"10.1016/j.ejr.2025.09.002","DOIUrl":"10.1016/j.ejr.2025.09.002","url":null,"abstract":"<div><h3>Aim of the work</h3><div>To assess the vascular involvement consistent with giant cell arteritis (GCA) in polymyalgia rheumatica (PMR) patients by duplex ultrasound (US).</div></div><div><h3>Patients and methods</h3><div>Twenty PMR patients and 20 matched healthy controls were recruited. Vascular duplex was performed for: common carotid artery (CCA), extracranial part of internal carotid artery (ICA), external carotid artery (ECA), superficial temporal artery (STA), frontal and occipital arteries. Vessels were considered abnormal if Outcome Measures in Rheumatology (OMERACT) definitions for GCA were found; or if intima media thickness (IMT) exceeded respective cut-off values: <strong>≥</strong>0.4 mm for STA, frontal and occipital arteries, ≥1mm for CCA, ECA and ICA.</div></div><div><h3>Results</h3><div>Included PMR patients were females, with mean ages of 56.5 ± 4.5 years. Vascular findings suggestive of GCA by duplex US were found in 14/20 PMR patients (70 %)(sonography pathological group), and subclinical vasculitis was reported in 10/14 PMR patients (71.4 %). The STA was affected in 85.7 %, occipital in 71.4 %, frontal in 64.3 %, ECA 35.7 %, CCA 28.6 % and ICA 28.6 %. Overlap pattern (cranial and extra-cranial) was observed in 8/14 PMR patients (57.1 %); while cranial pattern in 42.9 % and none had isolated extra-cranial affection. Halo sign, stenosis and occlusion were detected in none of PMR patients. Significantly longer duration of the current steroid therapy was found in sonography pathological group (16 ± 9.95 months) versus pure PMR patients (2 ± 1.4 months)(p = 0.03).</div></div><div><h3>Conclusion</h3><div>Subclinical vascular involvement suggestive of GCA has been depicted in the studied PMR patients, implying that sonographic assessment of group set of vessels by vascular duplex is warranted in PMR.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"48 1","pages":"Pages 1-6"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145247953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}