Best Practice & Research in Clinical Rheumatology最新文献_第10页

Synovial fluid analysis: Relevance for daily clinical practice 滑膜液分析：与日常临床实践的相关性

IF 5.2 2区医学

Best Practice & Research in Clinical Rheumatology Pub Date : 2023-03-01 DOI: 10.1016/j.berh.2023.101848

Francesca Oliviero , Brian F. Mandell

引用次数: 0

Seeing is believing: Smart use of musculoskeletal ultrasound in rheumatology practice 眼见为实：在风湿病学实践中巧妙使用肌肉骨骼超声波

IF 5.2 2区医学

Best Practice & Research in Clinical Rheumatology Pub Date : 2023-03-01 DOI: 10.1016/j.berh.2023.101850

Sahil Koppikar , Pamela Diaz , Gurjit S. Kaeley , Lihi Eder

引用次数: 1

Vascular ultrasound in rheumatology practice 风湿病学实践中的血管超声

IF 5.2 2区医学

Best Practice & Research in Clinical Rheumatology Pub Date : 2023-03-01 DOI: 10.1016/j.berh.2023.101847

Wolfgang A. Schmidt

{"title":"Vascular ultrasound in rheumatology practice","authors":"Wolfgang A. Schmidt","doi":"10.1016/j.berh.2023.101847","DOIUrl":"10.1016/j.berh.2023.101847","url":null,"abstract":"<div>Rheumatologists are increasingly using vascular ultrasound. Several guidelines now recommend ultrasound as the first diagnostic modality in giant cell arteritis (GCA). The German curriculum for rheumatology training has recently included ultrasound for the acute diagnosis of vasculitis.Recent studies have shown that ultrasound of temporal, axillary, subclavian, and vertebral arteries has sensitivities and specificities of >90%.Vascular ultrasound detects subclinical GCA in approximately 20% of patients with “pure” polymyalgia rheumatica. GCA fast-track clinics might regularly include these patients.A new score based on the intima-media thickness of the temporal and axillary arteries allows the monitoring of structural changes with treatment. The score decreases faster for the temporal arteries than it does for the axillary arteries.Measuring the diameter of the ascending aorta and the aortic arch might become a fast and cost-effective tool for the long-term monitoring of aortic aneurysms in extracranial GCA.Vascular ultrasound also has a role for Takayasu arteritis, thrombosis, Behçet's syndrome, and Raynaud's phenomenon.</div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":null,"pages":null},"PeriodicalIF":5.2,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10137738","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: 1

Arthrocentesis and soft tissue aspiration and injection 关节穿刺术、软组织抽吸和注射

IF 5.2 2区医学

Best Practice & Research in Clinical Rheumatology Pub Date : 2023-03-01 DOI: 10.1016/j.berh.2023.101853

Michael Toprover, Nicole Leung, Michael H. Pillinger

{"title":"Arthrocentesis and soft tissue aspiration and injection","authors":"Michael Toprover, Nicole Leung, Michael H. Pillinger","doi":"10.1016/j.berh.2023.101853","DOIUrl":"10.1016/j.berh.2023.101853","url":null,"abstract":"<div>Accessing a joint with a needle (arthrocentesis) to extract synovial fluid is a skill intrinsic to the rheumatologist's praxis. Joint aspirations are essential for diagnosing or excluding septic joints, are the gold standard for diagnosing acute crystal arthritis, and can provide valuable information about the nature of other forms of arthritis. In appropriate settings, injecting medications into joints can provide rapid, temporary, or even prolonged relief of pain and swelling and can provide a window of relief until other treatment modalities (anti-inflammatories, immunomodulators, and physical therapy) can enforce durable responses. Soft tissue aspirations (e.g., of bursae) and soft tissue injections (of bursae, tendons, trigger points, and areas of nerve compression) can provide similar relief, earning the practitioner the gratitude of the patient. Here, we provide a primary on joint and soft tissue aspiration and injection, including indications for and against procedures, preparing for procedures, and approaches to specific musculoskeletal structures.</div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":null,"pages":null},"PeriodicalIF":5.2,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9888439","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

Management of Takayasu arteritis 高安动脉炎的治疗

IF 5.2 2区医学

Best Practice & Research in Clinical Rheumatology Pub Date : 2023-03-01 DOI: 10.1016/j.berh.2023.101826

Durga Prasanna Misra , Kritika Singh , Upendra Rathore , Chengappa G. Kavadichanda , Manish Ora , Neeraj Jain , Vikas Agarwal

{"title":"Management of Takayasu arteritis","authors":"Durga Prasanna Misra , Kritika Singh , Upendra Rathore , Chengappa G. Kavadichanda , Manish Ora , Neeraj Jain , Vikas Agarwal","doi":"10.1016/j.berh.2023.101826","DOIUrl":"10.1016/j.berh.2023.101826","url":null,"abstract":"<div>This review overviews the challenges in the assessment of disease activity, damage, and therapy of Takayasu arteritis (TAK). Recently developed disease activity scores for TAK are more useful for follow-up visits and require validation of cut-offs for active disease. A validated damage score for TAK is lacking. Computed tomography angiography (CTA), magnetic resonance angiography (MRA), and ultrasound enable the evaluation of vascular anatomy and arterial wall characteristics of TAK. 18-fluorodeoxyglucose (18-FDG) positron emission tomography (PET) visualizes arterial wall metabolic activity and complements the information provided by circulating C-reactive protein (CRP) levels. ESR and CRP alone moderately reflect TAK disease activity. TAK is corticosteroid-responsive but relapses upon tapering corticosteroids. Conventional synthetic disease-modifying anti-rheumatic drugs (DMARDs) are the first-line maintenance agents, and tumor necrosis factor-alpha inhibitors, tocilizumab, or tofacitinib are second-line agents for TAK. Revascularization procedures for TAK should be used judiciously during periods of inactive disease.</div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":null,"pages":null},"PeriodicalIF":5.2,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9904514","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: 9

Recent advances in the treatment of giant cell arteritis 治疗巨细胞动脉炎的最新进展

IF 5.2 2区医学

Best Practice & Research in Clinical Rheumatology Pub Date : 2023-03-01 DOI: 10.1016/j.berh.2023.101830

Jason M. Springer , Tanaz A. Kermani

{"title":"Recent advances in the treatment of giant cell arteritis","authors":"Jason M. Springer , Tanaz A. Kermani","doi":"10.1016/j.berh.2023.101830","DOIUrl":"10.1016/j.berh.2023.101830","url":null,"abstract":"<div>Giant cell arteritis (GCA) is a systemic, granulomatous, large-vessel vasculitis that affects individuals over the age of 50 years. Morbidity from disease includes cranial manifestations which can cause irreversible blindness, while extra-cranial manifestations can cause vascular damage with large-artery stenosis, occlusions, aortitis, aneurysms, and dissections. Glucocorticoids while efficacious are associated with significant adverse effects. Furthermore, despite treatment with glucocorticoids, relapses are common. An understanding of the pathogenesis of GCA has led to the discovery of tocilizumab as an efficacious steroid-sparing therapy while additional therapeutic targets affecting different inflammatory pathways are under investigation. Surgical treatment may be indicated in cases of refractory ischemia or aortic complications but data on surgical outcomes are limited. Despite the recent advances, many unmet needs exist, including the identification of patients or subsets of GCA who would benefit from earlier initiation of adjunctive therapies, patients who may warrant long-term immunosuppression and medications that sustain permanent remission. The impact of medications like tocilizumab on long-term outcomes, including the development of aortic aneurysms and vascular damage also warrants investigation.</div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":null,"pages":null},"PeriodicalIF":5.2,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9999596","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

Nailfold capillaroscopy 甲襞毛细血管镜检查

IF 5.2 2区医学

Best Practice & Research in Clinical Rheumatology Pub Date : 2023-03-01 DOI: 10.1016/j.berh.2023.101849

Vanessa Smith , Claudia Ickinger , Elvis Hysa , Marcus Snow , Tracy Frech , Alberto Sulli , Maurizio Cutolo

{"title":"Nailfold capillaroscopy","authors":"Vanessa Smith , Claudia Ickinger , Elvis Hysa , Marcus Snow , Tracy Frech , Alberto Sulli , Maurizio Cutolo","doi":"10.1016/j.berh.2023.101849","DOIUrl":"10.1016/j.berh.2023.101849","url":null,"abstract":"<div>Nailfold capillaroscopy is a safe and well-established method for the assessment of structural alterations of the microcirculation. It is a crucial tool in the investigation and monitoring of patients presenting with Raynaud's phenomenon. Detection of the characteristic “scleroderma pattern” on capillaroscopy may indicate an underlying rheumatic disease, particularly systemic sclerosis (SSc). Herein, we highlight the practical aspects of videocapillaroscopy, including image acquisition and analysis, with mention of dermoscopy. Special emphasis is placed on standardized use of terminology to describe capillary characteristics. Systematic evaluation of images in discerning the normal from the abnormal using the validated European Alliance of Associations for Rheumatology (EULAR) Study Group consensus reporting framework is paramount. In addition to the relevance of capillaroscopy in the (very) early diagnosis of SSc, its emerging predictive value (especially capillary loss) for new organ involvement and disease progression is underscored. We further provide capillaroscopic findings in selected other rheumatic diseases.</div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":null,"pages":null},"PeriodicalIF":5.2,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1521694223000359/pdfft?md5=f48f713e2065154c41476c9acce52822&pid=1-s2.0-S1521694223000359-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10137742","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}

引用次数: 2

Advanced molecular imaging in large-vessel vasculitis: Adopting FDG-PET into a clinical workflow 大血管炎的高级分子成像：将 FDG-PET 纳入临床工作流程

IF 5.2 2区医学

Best Practice & Research in Clinical Rheumatology Pub Date : 2023-03-01 DOI: 10.1016/j.berh.2023.101856

Mark A. Ahlman , Peter C. Grayson

引用次数: 1

Preface to practical procedures how to do 实用程序前言如何做到

IF 5.2 2区医学

Best Practice & Research in Clinical Rheumatology Pub Date : 2023-03-01 DOI: 10.1016/j.berh.2023.101854

Kenneth S. O'Rourke, Mitsumasa Kishimoto

引用次数: 0

Relapsing polychondritis: Best Practice & Clinical Rheumatology 复发性多软骨炎：最佳实践与临床风湿病。

IF 5.2 2区医学

Best Practice & Research in Clinical Rheumatology Pub Date : 2023-03-01 DOI: 10.1016/j.berh.2023.101867

Phillip Mertz , Joshua Sparks , Dale Kobrin , Sandra Amara Ogbonnaya , Ecem Sevim , Clement Michet , Laurent Arnaud , Marcela Ferrada

{"title":"Relapsing polychondritis: Best Practice & Clinical Rheumatology","authors":"Phillip Mertz , Joshua Sparks , Dale Kobrin , Sandra Amara Ogbonnaya , Ecem Sevim , Clement Michet , Laurent Arnaud , Marcela Ferrada","doi":"10.1016/j.berh.2023.101867","DOIUrl":"10.1016/j.berh.2023.101867","url":null,"abstract":"<div>Relapsing polychondritis (RP) is an uncommon inflammatory disorder that predominantly targets cartilaginous structures. The disease frequently affects the nose, ears, airways, and joints, but it can also impact organs that aren't primarily cartilage-based, such as blood vessels, skin, inner ear, and eyes. Given its infrequent occurrence and recurrent symptoms, patients often experience delays in proper diagnosis. Lately, based on the organs involved, the disease's diverse manifestations have been categorized into specific clinical groups, based on the most likely organ involvement including auricular, nasal, pulmonary, and musculoskeletal. More recently the discovery of a new disease, called (Vacuoles, E1 enzyme, X-linked, Autoinflammatory, Somatic) VEXAS syndrome, due to mutations in UBA1 gene, identified the cause of 8 % of the patients with a clinical diagnosis of RP. VEXAS is likely the cause of a previously described “hematologic subgroup” in RP. This discovery is proof of concept that RP is likely more than one disease (Beck et al., Dec 31 2020; Ferrada et al., 2021).People diagnosed with RP face numerous hurdles, with the quality of their lives and overall prognosis being affected. Diagnosing the condition is particularly challenging due to its fluctuating symptoms, the absence of specific markers, and the lack of universally recognized classification criteria. For a correct diagnosis, it's imperative for healthcare professionals to identify its unique clinical patterns. Moreover, there are no approved metrics to gauge the disease's severity, complicating patient management.This review seeks to equip clinicians with pertinent insights to better diagnose and attend to these complex patients.</div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":null,"pages":null},"PeriodicalIF":5.2,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41240699","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