Journal of Rheumatology最新文献

{"title":"Deep Learning-Based Comparison of Knee Minimum Joint Space Width in Patients with Rheumatoid Arthritis and Osteoarthritis Before Total Knee Arthroplasty.","authors":"Miguel M Girod, Monty Khela, Sami Saniei, Kellen L Mulford, Cassondra A Hulshizer, Elizabeth J Atkinson, Cody C Wyles, John M Davis, Gavin A McKenzie, Cynthia S Crowson","doi":"10.3899/jrheum.2025-0951","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0951","url":null,"abstract":"<p><strong>Objective: </strong>While osteoarthritis (OA) and rheumatoid arthritis (RA) can necessitate total knee arthroplasty (TKA), the mechanisms and radiographic patterns of joint space narrowing (JSN) differ. Deep learning (DL) enables compartment-specific measurement of minimum joint space width (mJSW). This study compared JSN patterns between patients with RA and OA undergoing TKA and evaluated associations between mJSW and RA disease activity.</p><p><strong>Methods: </strong>In this retrospective study, 409 RA patients undergoing TKA (2000-2021) were age- and sex-matched with OA patients. A validated DL model quantified medial and lateral mJSW from AP knee radiographs at two time points: early (>2 years before TKA) and late (≤2 years before TKA). The rate of JSN was calculated in 302 patients with paired radiographs. Mixed-effects models adjusted for BMI and alignment. RA disease activity, serology, and medications were recorded.</p><p><strong>Results: </strong>RA demonstrated narrower lateral mJSW than OA at the late time point (5.6 vs. 7.0 mm, P<0.01), with comparable medial values. RA exhibited uniform bicompartmental JSN, whereas OA patients showed medial narrowing. RA had a faster mean lateral ΔmJSW (0.11 mm/year; P = 0.01), while OA had a faster mean medial ΔmJSW (0.21 mm/year; P<0.001). Longer RA duration and higher inflammatory markers were negatively associated with lateral mJSW. Seronegative RA showed faster lateral ΔmJSW in the surgical knee than seropositive patients (0.12 vs 0.06 mm/year; P = 0.03).</p><p><strong>Conclusion: </strong>Patients with RA demonstrated diffuse, symmetric cartilage loss contrasting with medialpredominant narrowing in patients with OA. Automated DL-based measurement enables scalable, compartment-specific assessment of compartment-specific patterns of joint degeneration.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regional Trends and Patterns of Axial Spondyloarthritis in Latin America: A Study from the ESPALDA Registry (2019-2024).","authors":"Cristian Mesa-Pedraza, Rodrigo Nicolás García-Salinas, Fernando Sommerfleck, Wilson Bautista-Molano, Guillermo Arturo Guaracha Basañez, Julio César Casasola Vargas, Daniel Fernández-Ávila, Diego Vila, María Lorena Brance, Jossiell Then Báez, Francisco Zevallos Miranda, Lysseth Macías Oviedo, Marilú Mestanza Peralta, Daisy Yelena Sánchez Cantos, Lyn Chinchay, Patricia Melgarejo, Ángel Alejandro Castillo Ortiz, Gimena Gómez, Leandro Grabiel Ferreyra Garrot, Dora Liliana Candia Zúñiga, Gustavo Medina, María Fernanda Egüez Del Pozo, Einer Sánchez Prado, Daniel Palleiro, John Londoño","doi":"10.3899/jrheum.2025-1266","DOIUrl":"https://doi.org/10.3899/jrheum.2025-1266","url":null,"abstract":"<p><strong>Objective: </strong>To compare demographic, clinical, functional, and therapeutic characteristics of patients with axial spondyloarthritis (axSpA) across three Latin American regions using data from the ESPALDA registry between January 2019 and December 2024.</p><p><strong>Methods: </strong>This cross-sectional study included 418 patients diagnosed with axSpA who fulfilled ASAS classification criteria. Participants were recruited from three regions: Northern (Mexico), Andean (Colombia, Ecuador, Peru, Venezuela), and Southern (Argentina, Chile, Paraguay, Uruguay). Collected data included demographic features, HLA-B27 status, extra-articular manifestations, disease activity, radiographic damage, and treatments.</p><p><strong>Results: </strong>The Northern region showed the highest prevalence of HLA-B27 (81%) and uveitis (36.3%), along with lower frequencies of peripheral involvement and fewer patients with MRI sacroiliitis (12.9%) (all p ≤ 0.003). In contrast, the Southern region reported a later onset of inflammatory back pain (median 39 vs. 22 years; p = 0.01), higher BASFI scores (median 4.6 vs. 2.87; p = 0.004), and a lower response to NSAIDs (59.8% vs. >77%; p = 0.001). Use of biologic DMARDs was lowest in the Northern region (34.4%) compared with the Andean (58.2%) and Southern (53.9%) regions (p ≤ 0.002 for North vs. others). The median diagnostic delay was 40.9 months (IQR 21-120), with no significant regional differences.</p><p><strong>Conclusion: </strong>Two clinical phenotypes of axSpA appear to exist in Latin America: a predominantly axial, HLA-B27-positive phenotype in the Northern region, and a second phenotype in the Andean and Southern regions characterized by greater peripheral involvement and, in the South, later symptom onset and worse functional status.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Crohn Disease, Takayasu Arteritis, and Thrombophlebitis: Is There Underlying Behçet Disease? Genetic Clues and the Complex Role of Infliximab.","authors":"Jiang Yunxia, Dai Xiaoliang","doi":"10.3899/jrheum.2025-1182","DOIUrl":"https://doi.org/10.3899/jrheum.2025-1182","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unilateral Versus Bilateral Ultrasound of the Hands in Patients With Clinically Suspect Arthralgia: What Is the Difference? A Longitudinal Study.","authors":"Anna M P Boeren, Edwin H G Oei, A Willemze, Pascal H P de Jong, Annette H M van der Helm-van Mil, Elise van Mulligen","doi":"10.3899/jrheum.2025-0373","DOIUrl":"10.3899/jrheum.2025-0373","url":null,"abstract":"<p><strong>Objective: </strong>In clinically suspect arthralgia (CSA), ultrasound (US) can be used to detect subclinical joint inflammation, which is a known predictor for progression to clinically apparent inflammatory arthritis (IA). Although most US protocols include both hands, a more efficient, unilateral US approach is also sufficient but has never been investigated. Therefore, we described US findings for 1 hand and both hands in patients with CSA and investigated if a US protocol that includes 1 hand is as predictive as a protocol with 2 hands.</p><p><strong>Methods: </strong>Two cohorts of patients with CSA underwent bilateral US. Subclinical synovitis and tenosynovitis (grayscale ≥ 2 and/or power Doppler ≥ 1) in 1 hand and both hands were described per hand and joint. Additionally, we analyzed the association between IA development and US positivity.</p><p><strong>Results: </strong>In total, 320 patients with CSA were studied. In cohort 1, 23% of patients had bilateral US-detected subclinical (teno)synovitis, 20% in the dominant hand only, and 10% in the nondominant hand only. In cohort 2, 10% had bilateral involvement, 12% in the dominant hand only, and 8% in the nondominant hand only. US of the dominant hand predicted IA development almost equally as US of both hands, with hazard ratios (HRs) of 2.8 (95% CI 1.3-6.0) for both hands and 2.6 (95% CI 1.3-5.3) for the dominant hand in cohort 1. In cohort 2, HRs were comparable.</p><p><strong>Conclusion: </strong>US-detected subclinical (teno)synovitis in patients with CSA is partly bilateral and partly unilateral. Predictive values for IA development are comparable. To reduce scanning time in clinical practice, clinicians could consider scanning 1 hand instead of both hands in patients with CSA.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Am I Lost?","authors":"Ripudaman Singh","doi":"10.3899/jrheum.2025-1299","DOIUrl":"10.3899/jrheum.2025-1299","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"575"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Normalizing Uricemia in Psoriatic Arthritis: A Hypothetical Reduction of Atherosclerotic Plaque Burden.","authors":"Rubén Queiro, Marta Loredo, Estefanía Pardo, Ignacio Braña","doi":"10.3899/jrheum.2025-0992","DOIUrl":"10.3899/jrheum.2025-0992","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"580-581"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel <i>DNASE2</i> Variants Linked With Neonatal Acute Liver Failure and Monogenic Systemic Lupus Erythematosus.","authors":"Melissa C Misztal, Tapas Mukherjee, Madeline Couse, Dilan Dissanayake, Daniela Dominguez, Samuel A Killackey, Andrea Knight, Deborah M Levy, Lawrence Ng, Vicky L Ng, Tara A Paton, Michelle Spivak, Dana J Philpott, Linda T Hiraki","doi":"10.3899/jrheum.2025-1111","DOIUrl":"https://doi.org/10.3899/jrheum.2025-1111","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiological Characteristics of Psoriatic Disease in Peru from 2016 to 2023.","authors":"Milton Rodriguez-Zuniga, Natalie Torres-Panduro, David Jumpa-Armas","doi":"10.3899/jrheum.2026-0061","DOIUrl":"https://doi.org/10.3899/jrheum.2026-0061","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to estimate the incidence rate of psoriatic disease (psoriasis [PSO] and psoriatic arthritis [PSA]), both crude and age- and sex-standardized from the Peruvian healthcare system.</p><p><strong>Methods: </strong>A secondary data analysis was conducted using nationwide records (2016-2023) from the National Health Superintendence (SUSALUD), encompassing both public and private sectors. Incidence rates were calculated per 100,000 person-years (py).</p><p><strong>Results: </strong>Evaluating 195,866 PSO and 6,786 PSA cases, the overall incidence rates were 102.99 (95% CI 102.54-103.45) and 3.57 (95% CI 3.48-3.65) per 100,000py, respectively. Both conditions displayed increasing trends from 2016 to 2023. PSO incidence peaked in adults ≥65 years (300.46) and showed male predominance (130.04 vs. 76.94 in females). Conversely, PSA demonstrated a bimodal age distribution with an early peak at 40-44 years and a later, higher peak at 60-64 years, while maintaining a balanced sex distribution. Regional disparities were prominent; Lima-Callao reported the highest rates, whereas the Macro Central region recorded the lowest.</p><p><strong>Conclusion: </strong>PSO and PSA incidence rates are rising in Peru, presenting notable demographic and regional variations. The lower incidence in the Andean macro-regions may reflect a combination of healthcare access barriers and a protective genetic profile inherent to Native American ancestry. These findings emphasize the need for improved public health policies to address the growing demand for psoriatic care.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dr. Yamaguchi et al reply.","authors":"Sadanobu Yamaguchi, Masaru Kawamura, Rie Shirayama, Takayuki Hoshina","doi":"10.3899/jrheum.2026-0317","DOIUrl":"https://doi.org/10.3899/jrheum.2026-0317","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Patient Self-Administered Inflammatory Arthritis Detection Study.","authors":"Norma K Biln, Nick Bansback, Charlyn Black, Kam Shojania, Daphne Guh, Mark J Harrison","doi":"10.3899/jrheum.2025-0428","DOIUrl":"10.3899/jrheum.2025-0428","url":null,"abstract":"<p><strong>Objective: </strong>Early diagnosis and treat-to-target strategies improve outcomes for patients with inflammatory arthritis (IA). One approach for reducing diagnostic delay is using standardized patient-completed questionnaires to support referral decisions. This study evaluated the discriminatory referral performance of 2 validated questionnaires in newly referred rheumatology patients in British Columbia, Canada.</p><p><strong>Methods: </strong>Patients completed the Early Inflammatory Arthritis Questionnaire (EIAQ) and Case Finding Axial Spondyloarthritis (CaFaSpA) questionnaire. Predictive scores for IA were calculated using existing algorithms and compared to the reference standard of their rheumatologist diagnosis. Discriminative performance was tested using the area under the receiver-operating characteristics curve (AUC), and diagnostic performance was tested using metrics, including sensitivity and specificity. Exploratory regression models were used to predict IA with different combinations of questionnaire questions.</p><p><strong>Results: </strong>Of 92 participants, 30 (33%) had time-sensitive IA (TS-IA), 35 (38%) other IA, and 27 (29%) non-IA. Time from referral to rheumatologist visits for patients with TS-IA was 44 days (IQR 28-83), 69 (IQR 40-102) for \"other IA,\" 65 (IQR 34-99) for \"non-IA,\" and was longer for women (+ 9 days) and in nonmetropolitan areas (+ 16 days). Only 7 patients had axial spondyloarthritis, precluding discriminative analysis of the CaFaSpA. The EIAQ had an AUC of 0.59 (95% CI 0.49-0.68), sensitivity of 33% (95% CI 19-51%), and specificity of 84% (95% CI 73-91); alternate algorithms based on EIAQ and CaFaSpA questions delivered AUCs up to 0.80 (95% CI 0.68-0.90).</p><p><strong>Conclusion: </strong>The results support the utility and feasibility of routine collection of EIAQ and CaFaSpA questionnaires for discriminating patients with IA from those with non-IA.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"529-536"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145656268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}