Best Practice & Research in Clinical Rheumatology最新文献

{"title":"Interstitial lung disease imaging for autoimmune diseases.","authors":"John P Lichtenberger, Sean Hagaman, Wesley Jong, Sydney Yee, Darwish Alabyad, Nadeem Kandalaft","doi":"10.1016/j.berh.2025.102065","DOIUrl":"https://doi.org/10.1016/j.berh.2025.102065","url":null,"abstract":"<p><p>Imaging plays a central role in the diagnosis and surveillance of patients with rheumatic diseases complicated by lung disease. This lung disease ranges from acute lung injury to chronic, diffuse lung disease attributed to their underlying autoimmune condition. Whether screening for lung disease or evaluating respiratory symptoms in patients with rheumatic diseases, chest radiography and computed tomography remain the most common and important diagnostic imaging tests. MRI remains an evolving modality for the evaluation of lung disease, but it is an important test in evaluating vascular disease or involvement of the heart and chest wall. This work aims to illustrate the role of diagnostic imaging in interstitial lung disease and other thoracic manifestations of autoimmune disease.</p>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":" ","pages":"102065"},"PeriodicalIF":4.5,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049691","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":"Update of imaging in the assessment of axial spondyloarthritis.","authors":"Natalya Horbal, Krystel Aouad, Xenofon Baraliakos, Nelly Ziade, Walter P Maksymowych","doi":"10.1016/j.berh.2025.102064","DOIUrl":"https://doi.org/10.1016/j.berh.2025.102064","url":null,"abstract":"<p><p>This update addresses new developments in imaging of axial spondyloarthritis from the past 5 years. These have focused mostly on enhanced CT and MRI-based technologies that bring greater precision to the assessment of both inflammatory and structural lesions in the sacroiliac joint. An international consensus has recommended a 4-sequence MRI for routine diagnostic evaluation of the sacroiliac joint aimed at depicting the location and extent of inflammation as well as an erosion-sensitive sequence for structural damage. The latter include high resolution thin slice sequences that accentuate the interface between subchondral bone and the overlying cartilage and joint space as well as synthetic CT, a deep learning-based technique that transforms certain MRI sequences into images resembling CT. Algorithms based on deep learning derived from plain radiographic, CT, and MRI datasets are increasingly more accurate at identifying sacroiliitis and individual lesions observed on images of the sacroiliac joints and spine.</p>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":" ","pages":"102064"},"PeriodicalIF":4.5,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025638","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":"Imaging of crystal-induced arthropathies in 2025.","authors":"Silvia Sirotti, Tristan Pascart, Ralf Thiele, Georgios Filippou","doi":"10.1016/j.berh.2025.102063","DOIUrl":"https://doi.org/10.1016/j.berh.2025.102063","url":null,"abstract":"<p><p>In recent years, imaging has become an essential tool in the assessment of crystal-induced arthropathies (CIAs), including gout, calcium pyrophosphate deposition disease, and basic calcium phosphate crystal deposition. Advances in imaging have improved diagnosis and disease monitoring, leading to its integration into classification criteria and clinical guidelines. Ultrasound (US), conventional radiography (CR), and dual-energy computed tomography (DECT) each offer unique advantages. US is a widely accessible, cost-effective, and dynamic tool, while DECT provides crystal-specific images, aiding particularly in gout diagnosis. CR, though less sensitive to early crystal deposition, remains valuable for evaluating structural damage and chronic changes. Despite these advances, challenges remain. The specificity and sensitivity of imaging findings need further validation, and the clinical relevance of certain imaging features is debated. This review summarizes recent developments, highlights key strengths, and discusses unresolved issues, emphasizing areas where future research is needed to optimize imaging use in CIAs.</p>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":" ","pages":"102063"},"PeriodicalIF":4.5,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008126","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":"Imaging in the diagnosis and management of peripheral psoriatic arthritis: Update and recent advances.","authors":"Ashish J Mathew, Alan L Zhou, Mikkel Østergaard, Sahil Koppikar","doi":"10.1016/j.berh.2025.102061","DOIUrl":"https://doi.org/10.1016/j.berh.2025.102061","url":null,"abstract":"<p><p>Psoriatic arthritis is an immune-mediated inflammatory disease characterized by inflammatory and structural changes in multiple clinical domains, including peripheral and axial arthritis, enthesitis, and dactylitis. Early diagnosis and initiation of targeted therapies in patients with PsA lead to a better quality of life. Conventional radiography continues to be the most frequently used imaging modality in routine care, given its easy accessibility and low cost. Advanced imaging techniques, such as ultrasound and magnetic resonance imaging, with their ability to assess both inflammatory and structural pathologies simultaneously, have facilitated a better understanding of disease pathogenesis, early diagnosis leading to early initiation of therapy, sensitive outcome measurement in clinical trials, and close monitoring of the disease process, enabling practical switching of therapies. Novel imaging techniques still seeking broad applicability have demonstrated encouraging results but require further testing before clinical use. This review focuses on the progress in imaging techniques for peripheral psoriatic disease.</p>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":" ","pages":"102061"},"PeriodicalIF":4.5,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797089","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":"Update in imaging for large vessel vasculitis.","authors":"Berit D Nielsen, Luca Seitz, Wolfgang A Schmidt","doi":"10.1016/j.berh.2025.102060","DOIUrl":"https://doi.org/10.1016/j.berh.2025.102060","url":null,"abstract":"<p><p>Diagnostic imaging is recommended to confirm suspected giant cell arteritis (GCA) or Takayasu arteritis (TAK), and may, in the follow-up of these patients, be used to assess vascular damage. Ultrasound, magnetic resonance imaging (MRI) and 18F-Fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography (PET)/computed tomography (CT) can all visualise inflammation in vascular regions affected. Ultrasound and MRI are recommended first line diagnostic test in GCA and TAK, respectively, but local expertise, availability and potential differential diagnoses are important prerequisites for the choice of imaging modality. Ultrasound, MR- and CT-angiography may also be used to assess morphologic changes. Further research is necessary on the role of imaging for monitoring disease activity and guide treatment decisions. Advantages and limitations apply to all modalities separately. This review will discuss the pros and cons, the application and pitfalls of each of these imaging modalities in the diagnosis and management of GCA and TAK.</p>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":" ","pages":"102060"},"PeriodicalIF":4.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781891","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":"Imaging in sarcoid disease.","authors":"Sherief Ghozy, Jonathan W Revels, Aakanksha Sriwastwa, Lily L Wang, Jennifer S Weaver, Sherry S Wang","doi":"10.1016/j.berh.2025.102054","DOIUrl":"https://doi.org/10.1016/j.berh.2025.102054","url":null,"abstract":"<p><p>Sarcoidosis is a complex multisystem inflammatory disease characterized by noncaseating granulomas and variable clinical manifestations, most commonly affecting the lungs, skin, heart, and nervous system. Imaging is central in its diagnosis, staging, and management, providing essential insights into organ involvement and disease activity. Pulmonary manifestations remain the hallmark, with modalities such as high-resolution chest computed tomography (CT) and chest radiography offering critical diagnostic clues. Imaging techniques, including Fluorodeoxyglucose Positron Emission Tomography (FDG-PET) and cardiac magnetic resonance imaging, are invaluable for identifying cardiac and systemic involvement, including cutaneous and musculoskeletal, while abdominal MRI and ultrasound help delineate hepatic and splenic manifestations. Neurosarcoidosis requires MRI for precise evaluation, supplemented by FDG-PET to guide biopsy and monitor treatment response. This chapter synthesizes the imaging features of sarcoidosis across organ systems, emphasizing practical approaches to diagnosis and management while identifying key areas for future research.</p>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":" ","pages":"102054"},"PeriodicalIF":4.5,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630980","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":"Practical utilization of sonography for the assessment of muscle diseases in rheumatology.","authors":"Takeshi Yoshida, Jemima Albayda","doi":"10.1016/j.berh.2025.102055","DOIUrl":"https://doi.org/10.1016/j.berh.2025.102055","url":null,"abstract":"<p><p>Muscular manifestations are common complaints encountered in daily rheumatology practice. Magnetic resonance imaging and electromyography are employed to evaluate muscular manifestations associated with myositis and other rheumatologic diseases, but both have limitations that hinder their universal applicability. Ultrasound, on the other hand, has been increasingly used given its utility as a point-of-care tool. There is increasing data that show it is a safe and sensitive tool for screening for myositis. Changes in ultrasound images differ between acute and chronic myositis, and echo intensity has been shown to correlate with muscle strength as well as the number of inflammatory cell infiltrates observed in histopathological analysis. Additionally, it can evaluate non-inflammatory muscular conditions, such as muscular dystrophy, sarcopenia, and certain neurologic disorders that mimic myositis. Despite its potential, its use in clinical practice remains limited due to a lack of physician experience and challenges associated with standardizing and optimizing muscle assessment. This review provides updated knowledge on muscle ultrasound as a practical imaging modality for the evaluation of myositis and other rheumatologic diseases. It discusses settings, techniques, and different assessment methods that will aid in its deployment in clinical practice.</p>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":" ","pages":"102055"},"PeriodicalIF":4.5,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630982","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":"Role of rheumatoid arthritis registries worldwide: What have they taught us?","authors":"Paul Studenic ,&nbsp;Yvette Meissner ,&nbsp;Lianne Kearsley-Fleet ,&nbsp;Diederik De Cock","doi":"10.1016/j.berh.2024.102017","DOIUrl":"10.1016/j.berh.2024.102017","url":null,"abstract":"<div><div>Rheumatoid arthritis (RA) is one of the most common rheumatic conditions, impacting quality of life on several domains. Major breakthroughs have been achieved over the past three decades in the management benefitting the patients’ lives. With increasing as well as novel treatment options, clinical registries have been established and continuously evolve to portray patient characteristics, monitor disease activity of RA, effectiveness and safety of the novel compounds. The greatest insights derived from registries is our current knowledge on the risks for malignancies and infections but also extending our knowledge collected in clinical trials on comparative effectiveness, long-term drug utilisation and under-represented populations. Moreover, the possible evolution of registries involving Big Data and AI, and the increased focus on patient centredness is discussed.</div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"39 1","pages":"Article 102017"},"PeriodicalIF":4.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480082","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}

{"title":"Joint replacement for rheumatoid arthritis: When, why, and how! Insights from an orthopedic surgeon","authors":"Hu Li ,&nbsp;Hao Liu ,&nbsp;Boyang Wang ,&nbsp;Ninggang Liang ,&nbsp;Moxuan Wu ,&nbsp;Xuan Qi ,&nbsp;Houshan Lu","doi":"10.1016/j.berh.2025.102034","DOIUrl":"10.1016/j.berh.2025.102034","url":null,"abstract":"&lt;div&gt;&lt;div&gt;The past several decades have seen significant advancements in joint replacement surgery for rheumatoid arthritis (RA). Joint replacement procedures have become vital options for patients with severe joint damage and functional impairment. There has been an increased emphasis on personalized surgical strategies that tailor joint replacement decisions based on a patient's unique clinical characteristics and the extent of joint damage. Achieving personalized outcomes requires clearly understanding the patient's baseline joint function and comparative data on different prosthetic designs and techniques. Comprehensive preoperative preparation is fundamental to ensuring surgical success. This includes thoroughly evaluating the patient's medication history, the extent of joint damage, and overall systemic health. Despite careful surgical planning, trade-offs between different replacement options often remain. In this paper, we review the perioperative preparation and surgical techniques in joint replacement surgery for RA. Additionally, we discuss the challenges in optimizing postoperative rehabilitation and preventing complications, which remains a key factor in achieving full recovery and maximizing the benefits of joint replacement surgery for RA patients.&lt;/div&gt;&lt;div&gt;The pathological basis of RA is an acute or chronic inflammation of the synovial membrane. As a result, synovial joints throughout the body can be affected, including joints in the upper limbs (shoulders, elbows, wrists, metacarpophalangeal joints, and interphalangeal joints) as well as in the lower limbs (hips, knees, and ankles). If drug treatments fail to control inflammation adequately, recurrent synovitis in the affected joints can lead to swelling, effusion, cartilage erosion, and eventual cartilage loss. Due to decreased weight-bearing, along with the use of various medications—particularly glucocorticoids—widespread subchondral bone osteoporosis, bone marrow edema, and bone destruction may occur, leading to cystic degeneration and even extensive bone defects.&lt;/div&gt;&lt;div&gt;In the advanced stages of RA, deformities can develop, such as “boutonniere” and “swan-neck” deformities in the fingers, ulnar deviation of the wrist, “otto pelvic” due to central acetabular erosion and dislocation of the hip, varus or valgus deformities of the knee, flexion contractures, and destruction or fusion of the ankle joint. The foot can also present deformities, such as hallux valgus and overlapping toes.&lt;/div&gt;&lt;div&gt;Total joint replacement surgery has become the most effective surgical treatment for severe joint destruction and deformities in late-stage RA. Among all joints, the hip and knee are the most frequently replaced, as their dysfunction severely impacts the patient's ability to walk, leading to disability and loss of mobility. In this review, we provided a comprehensive discussion on the perioperative management of patients with RA, focusing on preoperative preparation, intraoperative pl","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"39 1","pages":"Article 102034"},"PeriodicalIF":4.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015748","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":"Theory & practice of Treat-to-Target (T2T) in rheumatoid arthritis","authors":"Jing He,&nbsp;Yifan Wang,&nbsp;Qinghong Liu,&nbsp;Ru Li","doi":"10.1016/j.berh.2024.102018","DOIUrl":"10.1016/j.berh.2024.102018","url":null,"abstract":"<div><div>The Treat-to-Target (T2T) approach in rheumatoid arthritis (RA) emphasizes the systematic and regular adjustment of therapy based on predefined targets, typically remission or low disease activity. This review explores the evidence supporting the Treat-to-Target (T2T) strategy, its practical implementation, and its impact on comorbidities in rheumatoid arthritis (RA). Special attention is given to the role of biologics in managing RA, examining whether they effectively treat or reduce associated comorbidities. The review synthesizes findings from randomized controlled trials, meta-analyses, and real-world data to provide a comprehensive overview of T2T's theoretical framework and clinical practice.</div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"39 1","pages":"Article 102018"},"PeriodicalIF":4.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631996","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}