Best Practice & Research in Clinical Rheumatology最新文献_第9页

Enthesopathies – Mechanical, inflammatory or both? 内脏病变--机械性、炎症性还是两者兼有？

IF 4.5 2区医学

Best Practice & Research in Clinical Rheumatology Pub Date : 2024-03-01 DOI: 10.1016/j.berh.2024.101966

Ricardo Sabido-Sauri , Xenofon Baraliakos , Sibel Zehra Aydin

{"title":"Enthesopathies – Mechanical, inflammatory or both?","authors":"Ricardo Sabido-Sauri , Xenofon Baraliakos , Sibel Zehra Aydin","doi":"10.1016/j.berh.2024.101966","DOIUrl":"10.1016/j.berh.2024.101966","url":null,"abstract":"<div><p><span><span>Entheses have the challenging task of transferring biomechanical forces between tendon and bone, two tissues that differ greatly in composition and mechanical properties. Consequently, entheses are adapted to withstand these forces through continuous repair mechanisms. Locally specialized cells (mechanosensitive tenocytes) are crucial in the repair, physiologically triggering </span>biochemical processes to maintain </span>hemostasis.</p><p><span>When repetitive forces cause \"material fatigue,\" or trauma exceeds the entheses' repair capacity, structural changes occur, and patients become symptomatic. Clinical assessment of </span>enthesopathies<span> mainly depends on subjective reports by the patient and lacks specificity, especially in patients with central sensitization syndromes. Ultrasonography<span> has been increasingly used to improve the diagnosis of enthesopathies. In this article, the literature on how biomechanical forces lead to entheseal inflammation, including factors contributing to differentiation into a \"clinical enthesitis\" state and the value of ultrasound to diagnose enthesopathies will be reviewed, as well as providing clues to overcome the pitfalls of imaging.</span></span></p></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"38 1","pages":"Article 101966"},"PeriodicalIF":4.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141635596","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

Myofascial pain – A major player in musculoskeletal pain 肌筋膜疼痛 - 肌肉骨骼疼痛的主要因素。

IF 4.5 2区医学

Best Practice & Research in Clinical Rheumatology Pub Date : 2024-03-01 DOI: 10.1016/j.berh.2024.101944

引用次数: 0

Cervicogenic headache – How to recognize and treat 颈源性头痛--如何识别和治疗。

IF 4.5 2区医学

Best Practice & Research in Clinical Rheumatology Pub Date : 2024-03-01 DOI: 10.1016/j.berh.2024.101931

{"title":"Cervicogenic headache – How to recognize and treat","authors":"","doi":"10.1016/j.berh.2024.101931","DOIUrl":"10.1016/j.berh.2024.101931","url":null,"abstract":"<div><p><span>Cervicogenic headache<span><span><span><span>, described almost 100 years ago, only had its clinical awakening at the end of the century with the work of Professor Sjaastad. Its classic definition is the induction of trigeminal symptoms from cervical disorders, thanks to trigeminocervical convergence mechanisms. For this reason, it can manifest several features typical of migraine, leading to diagnostic errors. Classically, subjects complain of fixed unilateral </span>headaches, with cervical onset and trigeminal irradiation, associated with reduced neck mobility and flexion strength. The headache is mild to moderate, described as pulsatile or compressive, accompanied by nausea, vomiting, </span>photophobia, </span>phonophobia<span>, and may present autonomic symptoms and dizziness. The pain duration varies from one day to weeks, and its frequency is unpredictable. A history of </span></span></span>whiplash injury<span> is common. The differential diagnosis<span> encompasses migraine and tension-type headache. Management includes physiotherapy rehabilitation, anesthetic blocks, and selectively surgical procedures. In this article, all these aspects were extensively covered.</span></span></p></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"38 1","pages":"Article 101931"},"PeriodicalIF":4.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139934063","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

Pain mechanisms for the practicing rheumatologist 风湿病执业医师的疼痛机制。

IF 4.5 2区医学

Best Practice & Research in Clinical Rheumatology Pub Date : 2024-03-01 DOI: 10.1016/j.berh.2024.101942

引用次数: 0

Pain syndromes 疼痛综合征。

IF 4.5 2区医学

Best Practice & Research in Clinical Rheumatology Pub Date : 2024-03-01 DOI: 10.1016/j.berh.2024.101985

Eduardo S. Paiva, Deeba Minhas

引用次数: 0

“Fibromyalgia – are there any new approaches?” "纤维肌痛--有什么新方法吗？

IF 4.5 2区医学

Best Practice & Research in Clinical Rheumatology Pub Date : 2024-03-01 DOI: 10.1016/j.berh.2024.101933

{"title":"“Fibromyalgia – are there any new approaches?”","authors":"","doi":"10.1016/j.berh.2024.101933","DOIUrl":"10.1016/j.berh.2024.101933","url":null,"abstract":"<div><h3>Introduction</h3><p>Approaching patients with fibromyalgia (FM) is challenging due to the limited availability of scientifically proven effective therapies.</p></div><div><h3>Objective</h3><p><span><span><span><span><span>Review the treatments in use for FM and present new knowledge that could benefit these patients. Non-pharmacological interventions are recommended as the first line of treatment: aerobic exercise, cognitive behavioral therapy and patient education, all aimed at improving pain and other symptoms. Additional approaches have been studied, such as, </span>digital health<span><span> interventions, combined treatments, noninvasive neuromodulation<span>, and others. Concerning pharmacological therapy, the mechanism of action of the medications currently used is to promote </span></span>pain modulation. Medications approved by Food and Drug Administration are </span></span>duloxetine, </span>milnacipran and </span>pregabalin<span><span>. Amitriptyline, </span>cyclobenzaprine<span><span>, gabapentin and </span>naltrexone<span> are considered for off-label use. Cannabinoids, </span></span></span></span>vitamin D supplementation are still controversial and further research is needed.</p></div><div><h3>Conclusion</h3><p>The combination of therapies, whether old, recent or reformulated, are the most effective strategy for managing symptoms in patients with fibromyalgia. Key Words: fibromyalgia, treatment, nonpharmacological interventions, pharmacological treatment.</p></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"38 1","pages":"Article 101933"},"PeriodicalIF":4.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139736634","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

“Inflammatory or non-inflammatory pain in inflammatory arthritis – How to differentiate it?” "炎症性关节炎中的炎症性或非炎症性疼痛--如何区分？

IF 4.5 2区医学

Best Practice & Research in Clinical Rheumatology Pub Date : 2024-03-01 DOI: 10.1016/j.berh.2024.101970

Piercarlo Sarzi-Puttini , Greta Pellegrino , Valeria Giorgi , Sara Francesca Bongiovanni , Giustino Varrassi , Simona Di Lascio , Diego Fornasari , Silvia Sirotti , Marco Di Carlo , Fausto Salaffi

{"title":"“Inflammatory or non-inflammatory pain in inflammatory arthritis – How to differentiate it?”","authors":"Piercarlo Sarzi-Puttini , Greta Pellegrino , Valeria Giorgi , Sara Francesca Bongiovanni , Giustino Varrassi , Simona Di Lascio , Diego Fornasari , Silvia Sirotti , Marco Di Carlo , Fausto Salaffi","doi":"10.1016/j.berh.2024.101970","DOIUrl":"10.1016/j.berh.2024.101970","url":null,"abstract":"<div><p>Pain is a significant issue in rheumatoid arthritis (RA) and psoriatic arthritis (PSA) and can have a negative impact on patients' quality of life. Despite optimal control of inflammatory disease, residual chronic pain remains a major unmet medical need in RA. Pain in RA can be secondary to inflammation but can also generate neuroendocrine responses that initiate neurogenic inflammation and enhance cytokine release, leading to persistent hyperalgesia. In addition to well-known cytokines such as TNFα and IL-6, other cytokines and the JAK-STAT pathway play a role in pain modulation and inflammation. The development of chronic pain in RA involves processes beyond inflammation or structural damage. Residual pain is often observed in patients even after achieving remission or low disease activity, suggesting the involvement of non-inflammatory and central sensitization mechanisms. Moreover, fibromyalgia syndrome (FMS) is prevalent in RA patients and may contribute to persistent pain. Factors such as depression, sleep disturbance, and pro-inflammatory cytokines may contribute to the development of fibromyalgia in RA. It is essential to identify and diagnose concomitant FMS in RA patients to better manage their symptoms. Further research is needed to unravel the complexities of pain in RA. Finally, recent studies have shown that JAK inhibitors effectively reduce residual pain in RA patients, suggesting pain-reducing effects independent of their anti-inflammatory properties.</p></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"38 1","pages":"Article 101970"},"PeriodicalIF":4.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S152169422400041X/pdfft?md5=6a420cba0f4bd0a7f9ebb5c29db38309&pid=1-s2.0-S152169422400041X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617524","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: 0

Painful Raynaud's mimics 疼痛的雷诺氏症模拟人。

IF 4.5 2区医学

Best Practice & Research in Clinical Rheumatology Pub Date : 2024-03-01 DOI: 10.1016/j.berh.2024.101948

引用次数: 0

Femoroacetabular impingement – What the rheumatologist needs to know 股骨髋臼撞击症--风湿免疫科医生须知。

IF 4.5 2区医学

Best Practice & Research in Clinical Rheumatology Pub Date : 2024-03-01 DOI: 10.1016/j.berh.2024.101932

{"title":"Femoroacetabular impingement – What the rheumatologist needs to know","authors":"","doi":"10.1016/j.berh.2024.101932","DOIUrl":"10.1016/j.berh.2024.101932","url":null,"abstract":"<div><p>Femoroacetabular impingement (FAI) syndrome is a common cause of hip and groin pain in young individuals. FAI syndrome is a triad of signs, symptoms, and imaging findings. Necessary but not sufficient for the diagnosis of FAI syndrome is the presence of cam and/or pincer morphology of the hip. However, pathological thresholds for cam and pincer morphologies are not well-established. Management of FAI syndrome is typically through either physiotherapist-led therapy or surgical intervention. Physiotherapist-led management involves exercises aimed to optimise movement patterns of the hip and pelvis to prevent impingement from occurring, activity modification and analgesia, whereas surgical management involves arthroscopic resection of the cam/pincer morphology and treatment of concomitant soft tissue pathologies such as labral tears, cartilage lesions or ligamentum teres tears. Careful consideration of intervention is required given that FAI syndrome may predispose those affected to developing future osteoarthritis of the hip. In most clinical trials, hip arthroscopy has been found to provide greater improvement in patient-reported outcomes in the short-term compared to physiotherapy, however it is unknown whether this is sustained in the long-term or affects the future development of hip osteoarthritis.</p></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"38 1","pages":"Article 101932"},"PeriodicalIF":4.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1521694224000032/pdfft?md5=cb977bb2314ed6cc7e944b3c78d6e352&pid=1-s2.0-S1521694224000032-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139713293","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: 0

Practical approaches for clinicians in chronic pain management: Strategies and solutions 为临床医生提供慢性疼痛管理的实用方法：策略与解决方案。

IF 4.5 2区医学

Best Practice & Research in Clinical Rheumatology Pub Date : 2024-03-01 DOI: 10.1016/j.berh.2024.101934

引用次数: 0