Best Practice & Research in Clinical Rheumatology最新文献

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Novel therapies in Sjögren's disease: A systematic review of the literature. Sjögren病的新疗法:文献系统综述
IF 4.5 2区 医学
Best Practice & Research in Clinical Rheumatology Pub Date : 2025-07-07 DOI: 10.1016/j.berh.2025.102084
Cristina Pelkas, Kyle B Franke, Fabien B Vincent, Maureen Rischmueller
{"title":"Novel therapies in Sjögren's disease: A systematic review of the literature.","authors":"Cristina Pelkas, Kyle B Franke, Fabien B Vincent, Maureen Rischmueller","doi":"10.1016/j.berh.2025.102084","DOIUrl":"https://doi.org/10.1016/j.berh.2025.102084","url":null,"abstract":"<p><p>Sjögren's disease (SjD) is a chronic systemic autoimmune disorder that primarily involves lymphocytic infiltration of exocrine glands, with frequent extra-glandular manifestations. Historically, treatment options for SjD have been limited to alleviating symptoms, rather than treating the underlying cause or preventing disease progression. Furthermore, past clinical trials of therapies such as rituximab failed to demonstrate improvement in symptoms or disease activity. Recently, novel therapeutic strategies targeting underlying disease pathogenesis - including transcription factors, circulating RNA, and B and T cell activity - herald a paradigm shift. Given the complexities of diagnosis, clinical assessment and treatment in SjD, improved clinical trial design with enhanced patient stratification, greater inclusivity and better outcome measures are paramount in evaluating new therapeutics. This systematic review aims to provide a comprehensive overview of recent SjD therapeutic advances, assess trial inclusivity with respect to sex/gender and ethnicity, critically examine negative pivotal trials and highlight promising directions for future research.</p>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":" ","pages":"102084"},"PeriodicalIF":4.5,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592802","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}
引用次数: 0
Integrating handheld ultrasound in rheumatology: A review of benefits and drawbacks. 集成手持式超声在风湿病学:优点和缺点的回顾。
IF 4.5 2区 医学
Best Practice & Research in Clinical Rheumatology Pub Date : 2025-06-25 DOI: 10.1016/j.berh.2025.102085
Ricardo Sabido-Sauri, Lihi Eder, Paul Emery, Sibel Zehra Aydin
{"title":"Integrating handheld ultrasound in rheumatology: A review of benefits and drawbacks.","authors":"Ricardo Sabido-Sauri, Lihi Eder, Paul Emery, Sibel Zehra Aydin","doi":"10.1016/j.berh.2025.102085","DOIUrl":"https://doi.org/10.1016/j.berh.2025.102085","url":null,"abstract":"<p><p>Musculoskeletal ultrasound is a key tool in rheumatology for diagnosing and managing inflammatory arthritis. Traditional ultrasound systems, while effective, can be cumbersome and costly, limiting their use in many clinical settings. Handheld ultrasound (HHUS) devices, which are portable, affordable, and user-friendly, have emerged as a promising alternative. This review explores the role of HHUS in rheumatology, specifically evaluating its impact on diagnostic accuracy, ease of use, and utility in screening for inflammatory arthritis. The review also addresses key challenges, such as image quality, storage and data security, and the potential for integrating artificial intelligence to improve device performance. We compare HHUS devices to cart-based ultrasound machines, discuss their advantages and limitations, and examine the potential for widespread adoption. Our findings suggest that HHUS devices can effectively support musculoskeletal assessments and offer significant benefits in resource-limited settings. However, proper training, standardized protocols, and continued technological advancements are essential for optimizing their use in clinical practice.</p>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":" ","pages":"102085"},"PeriodicalIF":4.5,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509293","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}
引用次数: 0
Clinical utility of ultrasound and MRI in rheumatoid arthritis: An expert review. 超声和MRI在类风湿关节炎中的临床应用:专家综述。
IF 4.5 2区 医学
Best Practice & Research in Clinical Rheumatology Pub Date : 2025-05-14 DOI: 10.1016/j.berh.2025.102072
David A Kellner, Nicolette T Morris, Stephanie M Lee, Joshua F Baker, Philip Chu, Veena K Ranganath, Gurjit S Kaeley, Howard H Yang
{"title":"Clinical utility of ultrasound and MRI in rheumatoid arthritis: An expert review.","authors":"David A Kellner, Nicolette T Morris, Stephanie M Lee, Joshua F Baker, Philip Chu, Veena K Ranganath, Gurjit S Kaeley, Howard H Yang","doi":"10.1016/j.berh.2025.102072","DOIUrl":"https://doi.org/10.1016/j.berh.2025.102072","url":null,"abstract":"<p><p>Musculoskeletal ultrasound (MSUS) and magnetic resonance imaging (MRI) are advanced imaging techniques that are increasingly important in the diagnosis and management of rheumatoid arthritis (RA) and have significantly enhanced the rheumatologist's ability to assess RA disease activity and progression. This review serves as a five-year update to our previous publication on the contemporary role of imaging in RA, emphasizing the continued importance of MSUS and MRI in clinical practice and their expanding utility. The review examines the role of MSUS in diagnosing RA, differentiating RA from mimickers, scoring systems and quality control measures, novel longitudinal approaches to disease monitoring, and patient populations that may benefit most from MSUS. It also examines the role of MRI in diagnosing pre-clinical and early RA, disease activity monitoring, research and clinical trials, and development of alternative scoring approaches utilizing artificial intelligence. Finally, the role of MRI in RA diagnosis and management is summarized, and selected practice points offer key tips for integrating MSUS and MRI into clinical practice.</p>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":" ","pages":"102072"},"PeriodicalIF":4.5,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081934","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}
引用次数: 0
Best practice in rheumatology new developments in ultrasound and MRI imaging of pediatric rheumatic diseases. 风湿病的最佳实践:儿童风湿病超声和MRI成像的新发展。
IF 4.5 2区 医学
Best Practice & Research in Clinical Rheumatology Pub Date : 2025-05-07 DOI: 10.1016/j.berh.2025.102069
Johannes Roth, Clara Malattia
{"title":"Best practice in rheumatology new developments in ultrasound and MRI imaging of pediatric rheumatic diseases.","authors":"Johannes Roth, Clara Malattia","doi":"10.1016/j.berh.2025.102069","DOIUrl":"https://doi.org/10.1016/j.berh.2025.102069","url":null,"abstract":"<p><p>The evidence base for ultrasound and MRI imaging in pediatric rheumatic diseases continues to grow, enabling the routine clinical use of the two techniques that complement each other. Ultrasound imaging has a superior spatial resolution, the ability to assess several joints at the same time without sedation and provides very detailed assessments of important structures like the entheses. MRI has advantages in the assessment of osteochondral damage and certain anatomic regions like the temporomandibular joint (TMJ) and the axial skeleton. Significant progress in the standardization of image acquisition and quantification of findings allows the utilisation of both techniques as an outcome measure. This will improve the standard of care in pediatric rheumatic diseases where objective measurements of disease activity are urgently needed. Finally, the integration of artificial intelligence (AI) represents a groundbreaking development in the field and potential applications will be discussed.</p>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":" ","pages":"102069"},"PeriodicalIF":4.5,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995039","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}
引用次数: 0
Imaging for inflammatory neuropathies. 炎性神经病变的影像学检查。
IF 4.5 2区 医学
Best Practice & Research in Clinical Rheumatology Pub Date : 2025-05-02 DOI: 10.1016/j.berh.2025.102066
Federico Zaottini, Federico Pistoia, Riccardo Picasso, Marta Macciò, Giovanni Marcenaro, Marina Grandis, Luana Benedetti, Carlo Martinoli
{"title":"Imaging for inflammatory neuropathies.","authors":"Federico Zaottini, Federico Pistoia, Riccardo Picasso, Marta Macciò, Giovanni Marcenaro, Marina Grandis, Luana Benedetti, Carlo Martinoli","doi":"10.1016/j.berh.2025.102066","DOIUrl":"https://doi.org/10.1016/j.berh.2025.102066","url":null,"abstract":"<p><p>Inflammatory neuropathies comprise a heterogeneous group of conditions united by inflammation-mediated damage to peripheral nerves and their vasa nervorum. Although classification, diagnosis and management are largely based on clinical features, electrodiagnostic and laboratory examinations, imaging studies play an important supporting role. Ultrasound and MRI are the two modalities used for imaging peripheral nerves. The two techniques differ in the clinical context of application, the information provided and the diagnostic performance. This narrative review aims to provide guidance on when and how to use ultrasound or MRI in patients with inflammatory neuropathies, highlighting their respective strengths and pitfalls, and how to combine these imaging modalities to enhance their usefulness in the diagnostic-therapeutic management of these far from rare conditions.</p>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":" ","pages":"102066"},"PeriodicalIF":4.5,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990968","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}
引用次数: 0
Tropical pyomyositis 热带pyomyositis。
IF 4.5 2区 医学
Best Practice & Research in Clinical Rheumatology Pub Date : 2025-05-01 DOI: 10.1016/j.berh.2025.102041
Praveen Kumar Tirlangi , Anjely Sebastian , Mukhyaprana Prabhu M
{"title":"Tropical pyomyositis","authors":"Praveen Kumar Tirlangi ,&nbsp;Anjely Sebastian ,&nbsp;Mukhyaprana Prabhu M","doi":"10.1016/j.berh.2025.102041","DOIUrl":"10.1016/j.berh.2025.102041","url":null,"abstract":"<div><div>Tropical pyomyositis is a serious infectious disease characterised by the formation of abscesses in the skeletal muscles and is primarily caused by <em>Staphylococcus aureus</em>, with an increasing incidence in non-tropical regions. The disease primarily affects men and young adults, often following minor trauma, with an increasing incidence in immunocompromised individuals. Immunocompromised hosts are more likely to be affected by Gram-negative organisms, <em>Mycobacterium tuberculosis</em>, opportunistic infections such as fungal pathogens, non-tuberculous mycobacteria, and <em>Nocardia</em> species. Diagnosis is complicated by non-specific symptoms and the low yield of blood cultures, so imaging studies such as Magnetic Resonance Imaging (MRI) are required for accurate identification. Treatment focuses on controlling the source through drainage, tailored antibiotic therapy, and supportive care, especially in patients with complications such as multi-organ dysfunction. Given the complex clinical manifestations, heightened awareness and a collaborative approach to education and resource provision are critical to improving outcomes in patients with tropical pyomyositis.</div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"39 2","pages":"Article 102041"},"PeriodicalIF":4.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460536","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}
引用次数: 0
Correspondence on “Epidemiology of rheumatic diseases in tropical populations” by Goyal & Santhanam Goyal & Santhanam关于“热带人群中风湿病流行病学”的通信。
IF 4.5 2区 医学
Best Practice & Research in Clinical Rheumatology Pub Date : 2025-05-01 DOI: 10.1016/j.berh.2025.102073
Benoit Suzon , Aurore Abel , Emmanuelle Sylvestre , Andre Cabie , Arthur Felix , Fabienne Louis-Sidney
{"title":"Correspondence on “Epidemiology of rheumatic diseases in tropical populations” by Goyal & Santhanam","authors":"Benoit Suzon ,&nbsp;Aurore Abel ,&nbsp;Emmanuelle Sylvestre ,&nbsp;Andre Cabie ,&nbsp;Arthur Felix ,&nbsp;Fabienne Louis-Sidney","doi":"10.1016/j.berh.2025.102073","DOIUrl":"10.1016/j.berh.2025.102073","url":null,"abstract":"","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"39 2","pages":"Article 102073"},"PeriodicalIF":4.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144133262","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}
引用次数: 0
Access to rheumatologic care in tropical regions: Barriers and solutions 热带地区风湿病治疗的可及性:障碍和解决办法。
IF 4.5 2区 医学
Best Practice & Research in Clinical Rheumatology Pub Date : 2025-05-01 DOI: 10.1016/j.berh.2025.102052
Keerthi Talari , Himanshu Pathak , Neeraj Jain , Vinod Ravindran
{"title":"Access to rheumatologic care in tropical regions: Barriers and solutions","authors":"Keerthi Talari ,&nbsp;Himanshu Pathak ,&nbsp;Neeraj Jain ,&nbsp;Vinod Ravindran","doi":"10.1016/j.berh.2025.102052","DOIUrl":"10.1016/j.berh.2025.102052","url":null,"abstract":"<div><div>Due to systemic, cultural, and economic barriers, tropical regions face unique challenges in delivering rheumatologic care. This review outlines key obstacles such as disjointed healthcare systems, shortage of trained manpower in rheumatology, limited diagnostic tools, treatment barriers, lack of multidisciplinary care and cultural barriers in tropical countries. These barriers lead to delays in diagnosis, disease progression, disability, and poor quality of life. This chapter discusses actionable solutions such as building healthcare infrastructure, healthcare policy changes, expanding rheumatology training programs, leveraging telemedicine, and fostering community-driven awareness initiatives with examples. By tackling these challenges directly, access to rheumatologic care can be improved, making it more widely available to people, regardless of their location within tropical countries.</div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"39 2","pages":"Article 102052"},"PeriodicalIF":4.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568617","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}
引用次数: 0
Arthritis related to parasitic infections 关节炎与寄生虫感染有关。
IF 4.5 2区 医学
Best Practice & Research in Clinical Rheumatology Pub Date : 2025-05-01 DOI: 10.1016/j.berh.2025.102062
Shaheed Ahmed , Jasmin Raja
{"title":"Arthritis related to parasitic infections","authors":"Shaheed Ahmed ,&nbsp;Jasmin Raja","doi":"10.1016/j.berh.2025.102062","DOIUrl":"10.1016/j.berh.2025.102062","url":null,"abstract":"<div><div>Various parasitic infections can manifest with symptoms resembling inflammatory rheumatic diseases. Parasitic arthritis is uncommon, and the literature concerning rheumatic manifestations of specific parasitic infections tends to be limited to case reports. Despite its rarity, parasitic infections should always be included in the differential diagnosis of rheumatic presentations when there is a history of risk factors, particularly in patients from endemic regions and in atypical rheumatic presentations. Specific treatment of the parasitic infection often leads to significant improvement or resolution of symptoms. This account discusses various parasites that have been reported to be associated with arthritis and other related musculoskeletal manifestations.</div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"39 2","pages":"Article 102062"},"PeriodicalIF":4.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042886","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}
引用次数: 0
Chikungunya and other viral arthritis 基孔肯雅和其他病毒性关节炎。
IF 4.5 2区 医学
Best Practice & Research in Clinical Rheumatology Pub Date : 2025-05-01 DOI: 10.1016/j.berh.2025.102068
Arvind Chopra , Anuradha Venugopalan
{"title":"Chikungunya and other viral arthritis","authors":"Arvind Chopra ,&nbsp;Anuradha Venugopalan","doi":"10.1016/j.berh.2025.102068","DOIUrl":"10.1016/j.berh.2025.102068","url":null,"abstract":"<div><div>Several viruses cause acute and chronic arthritis. Millions of people suffered from Chikungunya(CHIK) during the recent epidemics/outbreaks in Asia, Africa and the Americas. Almost 20–40 % failed to recover completely and suffered from chronic pain and arthritis sequel. A wide spectrum of clinical phenotypic arthritis was described. Non-specific arthralgias(NSA) and soft tissue pains were predominant although inflammatory arthritis (mostly undifferentiated)(IA-U) was substantial. Specifically, rheumatoid arthritis(RA) and spondyloarthritis(SpA) like disorders were described. The frequency of biomarkers such as rheumatoid factor(RF) was low. Arthritis was mostly non-erosive in population studies. Abnormal immune mechanisms and persistent specific CHIK virus (CHIKV) IgM and IgG antibodies were shown. The etiopathogenetic evidence was divided between intense joint tissue inflammation due to prolonged virus persistence and abnormal autoimmune mechanisms. There was no specific therapy. The symptomatic management was often combined with an empirical use of disease modifying anti rheumatoid drugs and steroids. Substantial research is required to address knowledge gaps and unravel evidence-based medicine.</div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"39 2","pages":"Article 102068"},"PeriodicalIF":4.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059311","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}
引用次数: 0
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