Journal of Rheumatology最新文献

{"title":"Validation of Handheld Ultrasound Devices for Point of Care Use in Rheumatology Study- Focus on Synovitis, Doppler Activity, Erosions, and Tendon Lesions.","authors":"Seyyid Bilal Acikgoz, Ummugulsum Gazel, Suharsh Shah, Rohan Apurva Machhar, Patrick Leclerc, Marie Maguin, Gurjit S Kaeley, Lihi Eder, Sibel Zehra Aydin","doi":"10.3899/jrheum.2026-0288","DOIUrl":"https://doi.org/10.3899/jrheum.2026-0288","url":null,"abstract":"<p><strong>Objective: </strong>Ultrasonography (US) is essential in rheumatology, but conventional systems are costly and not easily portable. Handheld US offers affordable, portable options, yet their diagnostic validity in Psoriatic Arthritis (PsA) is unclear. This study assessed the concurrent validity of handheld US devices in PsA by evaluating agreement with a gold-standard scanner in detecting elementary lesions.</p><p><strong>Methods: </strong>PsA patients meeting Classification Criteria for PsA and presenting ≥ tender and swollen joint underwent same-day US with handheld (Clarius-HD3 L20/L15) and gold-standard (GE Logiq E9/E10) systems using a standardized protocol. A blinded assessor scored anonymized images for synovitis, Doppler signals, erosions, and tendon/tenosynovitis based on OMERACT definitions. Inter-device agreement was analyzed using Cohen's kappa (lesion detection), weighted kappa (lesion scoring), and intraclass correlation (ICC) per patient.</p><p><strong>Results: </strong>Thirty patients were included. Between devices, agreement for detecting synovitis was moderate (κ = 0.46-0.50). For Doppler activity, moderate agreement was found with Clarius-L15 (κ = 0.42) and fair agreement with Clarius-L20 (κ = 0.37). Erosions showed moderate-to-substantial agreement (κ for L15= 0.57, L20= 0.62), whereas tendon inflammation had no-fair (κ for L15=0.16, -0.05). Per-patient agreement showed poor (Global OMERACT-EULAR Synovitis Score - GLOESS) and moderate agreement (Doppler) for L15, and good (GLOESS) and moderate (Doppler) agreement for L20, when compared with the gold-standard device.</p><p><strong>Conclusion: </strong>Handheld US devices demonstrated moderate agreement with high-end scanners in identifying and grading synovitis and erosions, suggesting promising potential for clinical application. However, sensitivity for Doppler activity and tendon lesions remains lower, emphasizing the need for continued optimization and validation.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978558","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":"Unity Through Rheumatic Diseases: A Youth-Led Model of Community, Connection, and Change.","authors":"Natasha Trehan, Brianne Chou, Maggie Douglas, Isabel Dukes, Yaneisy-Nynoska Tremblay, Nicholas Blanchette, Nadia Luca, Mark Matsos, Yan Yeung, Reine Hodroj, Andrea Ou-Hingwan, Natalia Trehan, Zac Spinosa, Michelle Batthish, Andrea Knight, Rae Yeung, Deborah A Marshall, Cheryl Barnabe, Cristina Montoya, Cheryl Crow","doi":"10.3899/jrheum.2026-0017","DOIUrl":"https://doi.org/10.3899/jrheum.2026-0017","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978597","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":"Hantavirus Infection as a Mimic of Rheumatic Disease: A Selective Diagnostic Approach.","authors":"Francesco Caso, Luisa Costa, Raffaele Scarpa, Roberto Giacomelli, Piero Ruscitti","doi":"10.3899/jrheum.2026-0485","DOIUrl":"https://doi.org/10.3899/jrheum.2026-0485","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978622","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":"What Defines an MRI Considered Indicative of Axial Spondyloarthritis in the Sacroiliac Joints: A Systematic Literature Review.","authors":"Mohamad Bittar, Majid Chalian, Natalya Horbal, Liron Caplan, Maureen Dubreuil, Parham Pezeshk, Rachael Stovall, Janice Y Kung, Lianne S Gensler, Atul Deodhar, Robert G W Lambert, Walter P Maksymowych","doi":"10.3899/jrheum.2026-0011","DOIUrl":"https://doi.org/10.3899/jrheum.2026-0011","url":null,"abstract":"<p><strong>Objective: </strong>To systematically review the literature to support guidance defining MRI criteria of sacroiliac joint (SIJ) involvement indicative of axial spondyloarthritis (axSpA) for classification.</p><p><strong>Methods: </strong>The primary question for the SLR was 'Which MRI lesion, or combination of lesions, in the SIJ is most sensitive and specific for an MRI considered indicative of axSpA'. Three additional questions addressed an endpoint of clinician diagnosis of axSpA and the extent and location of the lesion(s). The SLR included all studies from January 2017 through October 2025, and 5 databases (Scopus, Web of Science Core Collection, Ovid MEDLINE, Ovid Embase, and Cochrane Library (via Wiley)) were searched. Data extraction and risk of bias assessment was done independently by three reviewers.</p><p><strong>Results: </strong>Searches returned 1871 unique results, of which 30 were selected for full review and data extraction. Only 2 reports described 'MRI global indicative of axSpA' as reference criterion and only 5 assessed MRI lesion definitions in an inception cohort study design. The quantitative component for bone marrow edema (BME) of the ASAS 2009/2016 MRI definitions lacked specificity. BME in <4 SIJ quadrants was seen in anterior SIJ slices of peripartum women, and healthy individuals. Erosion and fat lesion were uncommon (<5%) in healthy individuals and disorders that mimic axSpA. BME adjacent to erosion and/or fat lesion was highly specific for axSpA. The quantitative cut-offs of active and structural lesions are derived from a single inception cohort, which would require future studies for external validation.</p><p><strong>Conclusion: </strong>These results reinforce the need to revise previously reported definitions of a positive MRI indicative of axSpA towards more stringent cut-offs that detail the extent and location of MRI lesions.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978587","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":"Bioelectric Phase Angle and Appendicular Skeletal Muscle Mass in Rheumatoid Arthritis: Association With Disease Activity, Impact of Disease, and Functional Disability.","authors":"Sofia Charneca, Catarina Costa, João Vasques, Margarida Ferro, Elisabete Carolino, Joana Martins-Martinho, Ana Margarida Duarte-Monteiro, Eduardo Dourado, Joaquim Polido-Pereira, João Eurico Fonseca, Catarina Sousa Guerreiro","doi":"10.3899/jrheum.2026-0072","DOIUrl":"10.3899/jrheum.2026-0072","url":null,"abstract":"<p><strong>Objective: </strong>Adverse changes in body composition are increasingly being recognized in patients with rheumatoid arthritis (RA). This study aimed to explore the relationship between RA disease activity, disease impact, and functional disability with bioelectrical phase angle (PhA) and appendicular skeletal muscle mass index (ASMI).</p><p><strong>Methods: </strong>Patients with RA were recruited at a tertiary hospital in Portugal. The Disease Activity Score in 28 joints based on erythrocyte sedimentation rate and C-reactive protein (DAS28-ESR and DAS28-CRP, respectively) were used to assess disease activity. The impact of disease and functional status were evaluated using the Rheumatoid Arthritis Impact of Disease (RAID) questionnaire and the Health Assessment Questionnaire (HAQ), respectively. Body composition was measured by bioelectrical impedance analysis (BIA). PhA was stratified into tertiles, and ASMI was classified according to the European Working Group on Sarcopenia in Older People 2 criteria.</p><p><strong>Results: </strong>A total of 104 patients with RA were included (74% female; mean age 60.9 [SD 9.6] years). RAID scores were significantly lower in patients in the highest PhA tertile (PhA-T3) than in those in the lower PhA tertiles (PhA-T2 and PhA-T1, <i>P</i> = 0.001 and <i>P</i> < 0.001, respectively). HAQ scores were significantly lower in patients in the highest PhA tertile (PhA-T3) than in those in the lowest PhA tertile (PhA-T1, <i>P</i> < 0.001). Median DAS28-ESR and DAS28-CRP were lower among patients with higher PhA, but the difference did not reach statistical significance (<i>P</i> = 0.07 and <i>P</i> = 0.16, respectively). No differences were found among the ASMI groups in DAS28-ESR (<i>P</i> = 0.62), DAS28-CRP (<i>P</i> = 0.97), RAID (<i>P</i> = 0.30), or HAQ (<i>P</i> = 0.51) scores.</p><p><strong>Conclusion: </strong>A lower PhA was associated with greater disease impact and greater significant functional disability in patients with RA.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654973","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. Schock et al reply.","authors":"Bettina C Schock, Rosa I Rodríguez Viera, Steven O'Reilly, Nazia Chaudhuri","doi":"10.3899/jrheum.2026-0657","DOIUrl":"https://doi.org/10.3899/jrheum.2026-0657","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978575","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":"Transition From Systemic Sclerosis to Interstitial Lung Disease: Methodological Considerations.","authors":"Shiying Fang, Yafei Ren, Yuhong Shi","doi":"10.3899/jrheum.2026-0253","DOIUrl":"https://doi.org/10.3899/jrheum.2026-0253","url":null,"abstract":"<p><p>We have read with great interest the article by Rodríguez Viera and colleagues¹ employing a systematic review approach to identify soluble mediators in bronchoalveolar lavage fluid (BALF) that are differentially expressed between patients with systemic sclerosis (SSc)-associated interstitial lung disease (SSc-ILD) and those with SSc alone. The study underscores the central role of pulmonary epithelium-fibroblast interactions in driving the transition from SSc to SSc-ILD.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978584","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":"Multidimensional Complexities of Rheumatoid Arthritis Care.","authors":"Pedro Santos-Moreno","doi":"10.3899/jrheum.2026-0801","DOIUrl":"https://doi.org/10.3899/jrheum.2026-0801","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978595","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":"A Case of Refractory Adult-Onset Still Disease With Macrophage Activation Syndrome and Pulmonary Alveolar Proteinosis.","authors":"Jiachen Li, Yangyang Xie, Jianping Guo, Xue Li, Limin Ren","doi":"10.3899/jrheum.2025-1038","DOIUrl":"10.3899/jrheum.2025-1038","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"1047-1049"},"PeriodicalIF":3.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202936","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":"Do Not Throw Out the Radiographs! Radiographic Disease Severity as a Prognostic Biomarker for the Onset of Frequent Knee Pain.","authors":"Grace H Lo, Nathan Ji, Julieann C Patarini, Timothy E McAlindon, Charles B Eaton, Jeffrey B Driban","doi":"10.3899/jrheum.2026-0129","DOIUrl":"10.3899/jrheum.2026-0129","url":null,"abstract":"<p><strong>Objective: </strong>To enable interventions aimed at preventing the onset of frequent knee osteoarthritis (OA) symptoms and their sequelae, effective screening methods are required. Conventional radiographs are accessible and inexpensive; consequently, they have the potential to identify those at high risk of developing symptoms. Thus, we aimed to determine whether radiographic severity is prognostic of frequent symptoms at 12- and 48-month follow-up visits.</p><p><strong>Methods: </strong>We studied knees from participants of the Osteoarthritis Initiative without frequent symptoms at the baseline visit. Posteroanterior semiflexed knee radiographs were obtained at the baseline visit and scored for Kellgren-Lawrence (KL) grade (0-4). Frequent knee symptoms were defined by self-report at baseline, month 12, and month 48 follow-up visits. We conducted knee-based logistic regression, using generalized estimating equations to account for correlation between knees within a person, to assess if baseline KL grade was associated with incident frequent symptoms (at 12 and 48 months).</p><p><strong>Results: </strong>The study included 5653 knees (3407 participants). The incidence of frequent symptoms at 12 months by baseline KL grades were 12.4% (KL 0), 15.6% (KL 1), 18.6% (KL 2), 24.7% (KL 3), and 37.2% (KL 4). Relative to KL 0, the odds of frequent knee symptoms at 12 months were elevated for KL 1 (odds ratio [OR] 1.30, 95% CI 1.05-1.61), KL 2 (OR 1.61, 95% CI 1.32-1.96), KL 3 (OR 2.31, 95% CI 1.82-2.92), and KL 4 (OR 4.18, 95% CI 2.69-6.48). The results at 48 months were similar.</p><p><strong>Conclusion: </strong>Radiographic OA severity should be considered a potential prognostic biomarker to identify individuals at high risk of developing knee symptoms.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"1025-1027"},"PeriodicalIF":3.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13274960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147950007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}