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Best Practice & Research in Clinical Rheumatology最新文献

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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 Epub Date: 2025-03-04 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
RE: Response to Goyal & Santhanam best practice & research clinical rheumatology 回复：对Goyal和Santhanam临床风湿病最佳实践和研究的回应。
IF 4.5 2区 医学
Best Practice & Research in Clinical Rheumatology Pub Date : 2025-05-01 Epub Date: 2025-05-15 DOI: 10.1016/j.berh.2025.102074
Mohit Goyal , Sham Santhanam
{"title":"RE: Response to Goyal & Santhanam best practice & research clinical rheumatology","authors":"Mohit Goyal ,&nbsp;Sham Santhanam","doi":"10.1016/j.berh.2025.102074","DOIUrl":"10.1016/j.berh.2025.102074","url":null,"abstract":"","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"39 2","pages":"Article 102074"},"PeriodicalIF":4.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144087009","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 Epub Date: 2025-05-12 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
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 Epub Date: 2025-04-15 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
Fungal arthritis 真菌关节炎。
IF 4.5 2区 医学
Best Practice & Research in Clinical Rheumatology Pub Date : 2025-05-01 Epub Date: 2025-03-13 DOI: 10.1016/j.berh.2025.102058
Ying Xi Kong , Kok Ooi Kong
{"title":"Fungal arthritis","authors":"Ying Xi Kong ,&nbsp;Kok Ooi Kong","doi":"10.1016/j.berh.2025.102058","DOIUrl":"10.1016/j.berh.2025.102058","url":null,"abstract":"<div><div>Fungal arthritis is a rare infection with a global distribution that affects neonates, the elderly, and immunocompromised individuals, resulting in severe outcomes. It presents a challenge for healthcare professionals due to its rarity, lack of characteristic features, and difficulty isolating and identifying responsible organisms. Studies on their pathophysiology and treatment have been limited, and evidence-based treatment options are lacking. The pathogens infect through direct inoculation, extension from adjacent infective foci, or distant dissemination via the bloodstream. Typically, it manifests as either monoarthritis or oligoarthritis, with the knee joint being the most common target. Systemic disease is often absent, while pulmonary and cutaneous diseases are the most frequent extra-articular manifestations. Diagnosis frequently necessitates the direct visualisation of the organism in specimens and cultures of synovial fluid and membranes. A combination of medical (antifungal) and surgical treatments is often required.</div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"39 2","pages":"Article 102058"},"PeriodicalIF":4.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630978","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
Musculoskeletal manifestations in leprosy 麻风病的肌肉骨骼表现。
IF 4.5 2区 医学
Best Practice & Research in Clinical Rheumatology Pub Date : 2025-05-01 Epub Date: 2025-02-05 DOI: 10.1016/j.berh.2025.102039
Vitor Alves Cruz , Anna Carolina Faria Moreira Gomes Tavares , Andréa Monteiro de Araújo , Maria Stella Cochrane Feitosa , Joana Starling de Carvalho , Ciro Martins Gomes , Viviane Angelina de Souza , Licia Maria Henrique da Mota
{"title":"Musculoskeletal manifestations in leprosy","authors":"Vitor Alves Cruz ,&nbsp;Anna Carolina Faria Moreira Gomes Tavares ,&nbsp;Andréa Monteiro de Araújo ,&nbsp;Maria Stella Cochrane Feitosa ,&nbsp;Joana Starling de Carvalho ,&nbsp;Ciro Martins Gomes ,&nbsp;Viviane Angelina de Souza ,&nbsp;Licia Maria Henrique da Mota","doi":"10.1016/j.berh.2025.102039","DOIUrl":"10.1016/j.berh.2025.102039","url":null,"abstract":"<div><div>Leprosy, a chronic infectious disease caused by <em>Mycobacterium leprae</em> and <em>Mycobacterium lepromatosis</em>, primarily targets the skin and peripheral nerves, frequently leading to dermatological, neurological, and musculoskeletal complications. This review highlights the spectrum of musculoskeletal manifestations in leprosy, including acute arthritis during Type 2 reactions, chronic arthritis mimicking autoimmune diseases like rheumatoid arthritis, and neuropathic arthropathy. These manifestations underscore the complex interplay of inflammatory and immune mechanisms. Acute arthritis often involves both small and large joints, while chronic forms may present diagnostic challenges due to their resemblance to other inflammatory arthritides. Clinical management centers on multidrug therapy (MDT) for infection control, complemented by immunosuppressive or anti-inflammatory agents for reactional episodes. Recent advancements, such as biologics and synthetic immunosuppressants, have demonstrated efficacy in refractory cases, offering new therapeutic avenues. Heightened clinician awareness is essential for timely diagnosis and integrated management, particularly in endemic regions, to mitigate long-term disabilities and improve patient outcomes.</div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"39 2","pages":"Article 102039"},"PeriodicalIF":4.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366503","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
Rheumatic manifestations of HIV/AIDS HIV/AIDS的风湿病表现。
IF 4.5 2区 医学
Best Practice & Research in Clinical Rheumatology Pub Date : 2025-05-01 Epub Date: 2025-05-15 DOI: 10.1016/j.berh.2025.102071
Aishwarya Gopal , Augustine Jose , Bharat Kumar Singh , Paul T. Antony , Molly Mary Thabah
{"title":"Rheumatic manifestations of HIV/AIDS","authors":"Aishwarya Gopal ,&nbsp;Augustine Jose ,&nbsp;Bharat Kumar Singh ,&nbsp;Paul T. Antony ,&nbsp;Molly Mary Thabah","doi":"10.1016/j.berh.2025.102071","DOIUrl":"10.1016/j.berh.2025.102071","url":null,"abstract":"<div><div>Rheumatic manifestations of HIV infection encompass a wide spectrum of disorders, arising from direct viral effects, immune dysregulation, opportunistic infections, or antiretroviral therapy (ART)-induced complications. These manifestations can occur at any stage of HIV, and include arthralgia, HIV-associated arthritis, spondyloarthropathies (SpA), inflammatory myopathies, vasculitides, and opportunistic musculoskeletal infections. Arthralgia is common and self-limiting, whereas HIV-associated arthritis mimics rheumatoid arthritis. SpA, particularly reactive arthritis, psoriatic arthritis, and undifferentiated forms, often present atypically in HIV, with pathogenesis linked to immune dysfunction rather than HLA-B27. Inflammatory myopathies, including polymyositis and inclusion body myositis, exhibit distinct clinical features, often necessitating cautious immunomodulatory treatment. Opportunistic infections, such as septic arthritis and pyomyositis, are more frequent with advanced immunosuppression. The advent of HAART has modified the prevalence and presentation of these disorders, with immune reconstitution inflammatory syndrome (IRIS) emerging as a new challenge. Management strategies require balancing disease control with minimizing immunosuppressive risks.</div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"39 2","pages":"Article 102071"},"PeriodicalIF":4.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081935","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
Acute rheumatic fever and Post-streptococcal reactive arthritis 急性风湿热和链球菌后反应性关节炎。
IF 4.5 2区 医学
Best Practice & Research in Clinical Rheumatology Pub Date : 2025-05-01 Epub Date: 2025-05-08 DOI: 10.1016/j.berh.2025.102067
Suma Balan, Manyam Prudhvi Krishna, Anand Sasidharan, C.B Mithun
{"title":"Acute rheumatic fever and Post-streptococcal reactive arthritis","authors":"Suma Balan,&nbsp;Manyam Prudhvi Krishna,&nbsp;Anand Sasidharan,&nbsp;C.B Mithun","doi":"10.1016/j.berh.2025.102067","DOIUrl":"10.1016/j.berh.2025.102067","url":null,"abstract":"<div><div>Acute rheumatic fever (ARF) and poststreptococcal reactive arthritis (PSRA) represent two distinct but related poststreptococcal conditions, both arising from an autoimmune response following Group A streptococcal (GAS) infection, typically pharyngitis. Although both illnesses have a shared trigger, their clinical presentations and long-term consequences differ markedly. ARF, a systemic inflammatory disorder, can impact several organs, particularly the heart, potentially resulting in chronic rheumatic heart disease with irreversible valve damage. The cornerstone of ARF treatment includes Streptococcus eradication therapy, symptom management, and secondary prophylaxis to prevent recurrence. In contrast, PSRA primarily presents as non-infectious, nonmigratory, persistent arthritis without carditis and generally resolves without lasting sequelae. Distinguishing PSRA from ARF is crucial for appropriate management and to avoid unnecessary long-term antibiotic prophylaxis. This review focuses on the key clinical features and diagnostic approaches for ARF and PSRA, along with an overview of their management strategies.</div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"39 2","pages":"Article 102067"},"PeriodicalIF":4.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056922","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
Musculoskeletal manifestations in Tuberculosis 肺结核的肌肉骨骼表现。
IF 4.5 2区 医学
Best Practice & Research in Clinical Rheumatology Pub Date : 2025-05-01 Epub Date: 2025-03-14 DOI: 10.1016/j.berh.2025.102057
Ramaswamy Subramanian, Shiva Prasad, Mahabaleshwar Mamadapur
{"title":"Musculoskeletal manifestations in Tuberculosis","authors":"Ramaswamy Subramanian,&nbsp;Shiva Prasad,&nbsp;Mahabaleshwar Mamadapur","doi":"10.1016/j.berh.2025.102057","DOIUrl":"10.1016/j.berh.2025.102057","url":null,"abstract":"<div><div>Musculoskeletal Tuberculosis (TB) affects the bones, joints and soft tissues and accounts for 1–3 % of TB cases worldwide. The onset of symptoms is usually insidious and nonspecific. It may lead to irreversible joint damage, deformities or neurological manifestations necessitating surgical and rehabilitative corrections due to delayed diagnosis and prolonged latency in the initiation of definitive medical treatment. The axial skeleton, particularly the thoracic and lumbar regions, is the most commonly involved site, followed by the hips and knees in peripheral joints. Given the rising prevalence of TB in developing countries and the emergence of drug-resistant strains, understanding musculoskeletal TB's pathophysiology, clinical manifestations, and management strategies remains critical for improving patient outcomes. In addition, non-tuberculous mycobacterial infections, para-infectious manifestation, and achieving adequate disease control in a setting of immune-mediated inflammatory disorders pose significant diagnostic and therapeutic challenges.</div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"39 2","pages":"Article 102057"},"PeriodicalIF":4.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634778","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
Emerging insights in tropical rheumatology: Challenges, clinical manifestations, and recent advances 热带风湿病的新见解：挑战、临床表现和最新进展。
IF 4.5 2区 医学
Best Practice & Research in Clinical Rheumatology Pub Date : 2025-05-01 DOI: 10.1016/j.berh.2025.102070
A.B. Maharaj , V. Ravindran
{"title":"Emerging insights in tropical rheumatology: Challenges, clinical manifestations, and recent advances","authors":"A.B. Maharaj ,&nbsp;V. Ravindran","doi":"10.1016/j.berh.2025.102070","DOIUrl":"10.1016/j.berh.2025.102070","url":null,"abstract":"","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"39 2","pages":"Article 102070"},"PeriodicalIF":4.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064816","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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