Best Practice & Research in Clinical Rheumatology最新文献

{"title":"Practical utilization of sonography for the assessment of muscle diseases in rheumatology","authors":"Takeshi Yoshida,&nbsp;Jemima Albayda","doi":"10.1016/j.berh.2025.102055","DOIUrl":"10.1016/j.berh.2025.102055","url":null,"abstract":"<div><div><span><span>Muscular manifestations are common complaints encountered in daily rheumatology practice. </span>Magnetic resonance imaging<span> and electromyography<span> are employed to evaluate muscular manifestations associated with myositis<span> 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<span>. 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 </span></span></span></span></span>inflammatory cell<span><span><span> infiltrates observed in histopathological analysis. Additionally, it can evaluate non-inflammatory muscular conditions, such as muscular dystrophy, </span>sarcopenia, and certain </span>neurologic disorders<span> 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.</span></span></div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"39 3","pages":"Article 102055"},"PeriodicalIF":4.8,"publicationDate":"2025-09-01","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":"Clinical utility of ultrasound and MRI in rheumatoid arthritis: An expert review","authors":"David A. Kellner ,&nbsp;Nicolette T. Morris ,&nbsp;Stephanie M. Lee ,&nbsp;Joshua F. Baker ,&nbsp;Philip Chu ,&nbsp;Veena K. Ranganath ,&nbsp;Gurjit S. Kaeley ,&nbsp;Howard H. Yang","doi":"10.1016/j.berh.2025.102072","DOIUrl":"10.1016/j.berh.2025.102072","url":null,"abstract":"<div><div><span>Musculoskeletal ultrasound (MSUS) and magnetic resonance imaging (MRI) are advanced imaging techniques that are increasingly important in the diagnosis and management of </span>rheumatoid arthritis<span> (RA) and have significantly enhanced the rheumatologist's ability to assess RA disease activity<span> 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.</span></span></div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"39 3","pages":"Article 102072"},"PeriodicalIF":4.8,"publicationDate":"2025-09-01","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}

{"title":"Integrating handheld ultrasound in rheumatology: A review of benefits and drawbacks","authors":"Ricardo Sabido-Sauri ,&nbsp;Lihi Eder ,&nbsp;Paul Emery ,&nbsp;Sibel Zehra Aydin","doi":"10.1016/j.berh.2025.102085","DOIUrl":"10.1016/j.berh.2025.102085","url":null,"abstract":"<div><div>Musculoskeletal ultrasound is a key tool in rheumatology<span> 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.</span></div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"39 3","pages":"Article 102085"},"PeriodicalIF":4.8,"publicationDate":"2025-09-01","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}

{"title":"The role of ultrasound and magnetic resonance imaging in the assessment of musculoskeletal involvement in systemic lupus erythematosus: A review of recent advances and insights","authors":"Andrea Di Matteo ,&nbsp;Patricia Corzo ,&nbsp;Emilio Filippucci","doi":"10.1016/j.berh.2025.102042","DOIUrl":"10.1016/j.berh.2025.102042","url":null,"abstract":"<div><div><span><span>Systemic lupus erythematosus<span> (SLE) is an autoimmune disease characterized by diverse manifestations, with musculoskeletal (MSK) involvement being one of the most prevalent and debilitating. Traditional perceptions of SLE arthritis as mild and primarily non-erosive are increasingly challenged by advanced imaging techniques, such as ultrasound and magnetic resonance imaging (MRI). These modalities have revealed subclinical inflammatory changes, structural damage, and peri-articular </span></span>soft tissue involvement in both symptomatic and asymptomatic patients. Ultrasound is highly sensitive in detecting </span>synovitis<span><span>, tenosynovitis<span>, and entheseal abnormalities, also in patients without clinical arthritis, offering insights into subclinical disease activity that would otherwise remain undiagnosed. MRI, while less commonly used due to cost and accessibility, remains the gold standard for detecting </span></span>bone marrow oedema, subtle erosions, and inflammatory changes.</span></div><div><span>Recent studies demonstrate that subclinical synovitis<span> and tenosynovitis, identified through imaging, may precede clinical symptoms in some patients, emphasizing the potential prognostic value of these findings. Bone erosions, once thought rare in SLE, are now observed across various </span></span>arthropathy subtypes, challenging traditional classifications. Imaging has also revealed the presence of entheseal and muscle involvement, expanding the understanding of SLE-related MSK pathology.</div><div>This review highlights the transformative role of ultrasound and MRI in diagnosing, monitoring, and managing MSK involvement in SLE. Incorporating imaging findings into routine practice and updated classification criteria may enable early intervention and personalized treatment. While significant advancements have been made in imaging technologies for detecting musculoskeletal involvement in SLE, challenges remain in standardizing protocols and correlating findings with disease activity and outcomes. Further research is needed to address these challenges and further explore the prognostic significance of imaging findings.</div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"39 3","pages":"Article 102042"},"PeriodicalIF":4.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517411","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 for inflammatory neuropathies","authors":"Federico Zaottini ,&nbsp;Federico Pistoia ,&nbsp;Riccardo Picasso ,&nbsp;Marta Macciò ,&nbsp;Giovanni Marcenaro ,&nbsp;Marina Grandis ,&nbsp;Luana Benedetti ,&nbsp;Carlo Martinoli","doi":"10.1016/j.berh.2025.102066","DOIUrl":"10.1016/j.berh.2025.102066","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"39 3","pages":"Article 102066"},"PeriodicalIF":4.8,"publicationDate":"2025-09-01","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}

{"title":"Imaging in the diagnosis and management of peripheral psoriatic arthritis: Update and recent advances","authors":"Ashish J. Mathew ,&nbsp;Alan L. Zhou ,&nbsp;Mikkel Østergaard ,&nbsp;Sahil Koppikar","doi":"10.1016/j.berh.2025.102061","DOIUrl":"10.1016/j.berh.2025.102061","url":null,"abstract":"<div><div><span><span>Psoriatic arthritis is an immune-mediated </span>inflammatory disease characterized by inflammatory and structural changes in multiple clinical domains, including peripheral and axial arthritis, </span>enthesitis<span><span>, and dactylitis<span>. Early diagnosis and initiation of targeted therapies in patients with PsA lead to a better </span></span>quality of life<span><span>. Conventional radiography<span> 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 </span></span>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.</span></span></div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"39 3","pages":"Article 102061"},"PeriodicalIF":4.8,"publicationDate":"2025-09-01","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":"Corrigendum to “Arthritis related to parasitic infections” [Best Practice Res Clinic Rheumatol 39 (2025) 102062]","authors":"Shaheed Ahmed ,&nbsp;Jasmin Raja","doi":"10.1016/j.berh.2025.102086","DOIUrl":"10.1016/j.berh.2025.102086","url":null,"abstract":"","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"39 3","pages":"Article 102086"},"PeriodicalIF":4.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668958","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 ,&nbsp;Luca Seitz ,&nbsp;Wolfgang A. Schmidt","doi":"10.1016/j.berh.2025.102060","DOIUrl":"10.1016/j.berh.2025.102060","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"39 3","pages":"Article 102060"},"PeriodicalIF":4.8,"publicationDate":"2025-09-01","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":"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}

{"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}