Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases最新文献

{"title":"Don't Miss Vasculitic Myopathy Without Elevated Creatine Phosphokinase.","authors":"Hirotaka Yamamoto, Yoshihiro Iwamoto","doi":"10.1097/RHU.0000000000002384","DOIUrl":"10.1097/RHU.0000000000002384","url":null,"abstract":"","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":"e224"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148261237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Convergent Mixed-methods Study of the User Perspectives for an Individualized, Computerized, Collaboratively Produced, Evidence-based Patient Self-administered Systemic Lupus Erythematosus Decision Aid.","authors":"Jasvinder A Singh, Haiyan Qu","doi":"10.1097/RHU.0000000000002382","DOIUrl":"10.1097/RHU.0000000000002382","url":null,"abstract":"<p><strong>Objectives: </strong>Elicit patient feedback on a computerized systemic lupus erythematosus (SLE) patient decision aid (PtDA).</p><p><strong>Methods: </strong>We embedded a mixed-methods study in a multicenter SLE PtDA implementation project at 15 US rheumatology clinics during 2019-2023. A patient self-administered survey included questions on the acceptability of information quality (6-item), the amount of information, the inclusion of enough information for decision-making, the usefulness of the SLE PtDA in decision-making, and whether it was balanced (1-item each). Qualitative assessment was with 2 open-ended questions: (1) What did you like about the decision aid? (2) What suggestions do you have to improve the decision aid?</p><p><strong>Results: </strong>A high proportion of 1895 SLE patients, 78% to 92%, rated the acceptability of the information quality of SLE PtDA as good to excellent. Of participants, 82% rated the amount of information as just right; 79% reported inclusion of enough information; 90% found it useful for making SLE therapy decisions; and the presentation of the data in the SLE PtDA was balanced for 82%. The top 3 responses about what participants liked were: (1) SLE PtDA content (39.2%), (2) positive experience (36.6%), and (3) its format and design (9.0%). The top 3 suggestions about improving the SLE PtDA were: (1) provide information about treatment options and medication (14.7%), (2) improve the design (13.6%), and (3) provide more information (5.7%).</p><p><strong>Conclusions: </strong>The SLE PtDA met patients' expectations for information amount and quality in a mixed-methods study. SLE PtDA was modified based on target population feedback.</p>","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":"e206-e212"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148650479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Social Media and Artificial Intelligence on Illness Perception and Treatment Adherence in Patients With Rheumatic Diseases.","authors":"Egla Samantha Sanchez-Peralta, Sharon Hervert-Bulbarella, Margarita Isabel Alarcon-Jarquin, Ana Cecilia Bardan-Inchaustegui, Angel Kevin Garza-Elizondo, Pablo Gamez-Siller, Jesus Alberto Cardenas-de la Garza, Dionicio Angel Galarza-Delgado, Diana Elsa Flores-Alvarado","doi":"10.1097/RHU.0000000000002389","DOIUrl":"10.1097/RHU.0000000000002389","url":null,"abstract":"<p><strong>Background/objective: </strong>In the wake of the COVID-19 \"infodemic,\" patients increasingly turn to social media (SM) and artificial intelligence (AI) for health information. In regions with unique sociocultural challenges and varying education levels, understanding electronic health literacy (HL) is vital. This study evaluated engagement with and attitudes toward SM/AI among patients with rheumatology conditions to inform patient-centered care.</p><p><strong>Methods: </strong>We conducted an observational, cross-sectional study at a tertiary outpatient clinic in Monterrey, Mexico, from August 2024 to November 2024. Ninety-five adult patients (median age: 50; 92.6% females) completed a structured questionnaire comprising the eHealth Literacy Scale (eHEALS), the SM Engagement Questionnaire (SMEQ), and the AI Attitude Scale (AIAS-4). Comparisons between age groups (≤45 vs. >45 y) were performed using the χ 2 test and the Mann-Whitney U test ( p < 0.05).</p><p><strong>Results: </strong>Daily SM use was almost universal (94.7%), and 30.5% had used AI for disease-related questions. Patients aged 45 or younger showed significantly higher electronic HL ( p = 0.010) and engagement with SM ( p < 0.001). Importantly, younger patients were less likely to change their treatment based on SM content compared with older patients ( p = 0.043). Although attitudes toward AI did not vary by age, 84.2% of patients believed their doctors were open to discussing digital information, and 91.6% would use SM if recommended by their physicians.</p><p><strong>Conclusions: </strong>Digital health literacy significantly influences how patients process online information and manage treatment adherence.</p>","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":"188-191"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148564455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paraneoplastic Immunoglobulin A Vasculitis With Rapidly Progressive Glomerulonephritis in a Patient With Metastatic Meningioma: Case Report and Literature Review.","authors":"Aryan Jain, Mayur Pabba, Aditya Jain, Aman Pal, Kelly Beers, Lee Shapiro, Swati Mehta","doi":"10.1097/RHU.0000000000002364","DOIUrl":"10.1097/RHU.0000000000002364","url":null,"abstract":"<p><p>Immunoglobulin A vasculitis with renal involvement (IgAVN) is an immune complex-mediated glomerulonephritis characterized by mesangial deposition of IgA1-containing immune complexes. Although malignancy-associated vasculitis is recognized, paraneoplastic IgAVN remains rare, and its clinical patterns and optimal management strategies are not well defined. We present an illustrative case of relapsing crescentic IgAVN temporally associated with metastatic meningioma and contextualize this presentation through a focused review of published cases from 2000 to 2025. A total of 21 adult cases of IgA vasculitis with renal involvement have been reported, predominantly affecting men. The reported malignancies included hematologic, gastrointestinal, pulmonary, renal, and genitourinary cancers. In most cases, vasculitis and malignancy were diagnosed concurrently or within a short temporal window, supporting a potential paraneoplastic relationship. Renal manifestations ranged from hematuria and proteinuria to rapidly progressive glomerulonephritis. The outcomes and prognosis varied for these patients: complete remission occurred in 43% of cases, partial remission in 24%, and progression in 24%. Our review suggests that combined malignancy-directed therapy and corticosteroids may be associated with more favorable renal outcomes compared with immunosuppression alone. Proposed mechanisms include tumor antigen-driven immune complex formation, dysregulated glycosylation of IgA1, and complement activation. However, mechanistic data remain limited. Recognition of this association is clinically important, as adult-onset, relapsing, or unusually aggressive IgAVN should prompt evaluation for underlying malignancy or cancer progression. Further study is needed to clarify pathophysiologic pathways and to guide evidence-based management in this rare but clinically significant entity.</p>","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":"e213-e221"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148020518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pneumatic Compression-assisted Arthrocentesis in the Noneffusive Knee.","authors":"Rosemina A Patel, Matthew K McElwee, Chantalle D Geller, Luke J Haseler, Philip A Band, Wilmer L Sibbitt","doi":"10.1097/RHU.0000000000002383","DOIUrl":"https://doi.org/10.1097/RHU.0000000000002383","url":null,"abstract":"","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":"32 6","pages":"e225"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral Femoral Head Avascular Necrosis With Crescent Sign.","authors":"Andwele Walrond, Cindy Flower","doi":"10.1097/RHU.0000000000002373","DOIUrl":"10.1097/RHU.0000000000002373","url":null,"abstract":"","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":"e223"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148230510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cryoglobulinemic Vasculitis Revealing Primary Sjögren Syndrome.","authors":"Yi-Fan Mai, Wen-Ting Yu","doi":"10.1097/RHU.0000000000002350","DOIUrl":"10.1097/RHU.0000000000002350","url":null,"abstract":"","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":"e222"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147826142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Impact of Familial Mediterranean Fever on Physical Activity in Children Using the Physical Activity Questionnaire for Children (PAQ-C): A Comparative Study With Healthy Controls.","authors":"Zelal Aydin, Eda Nur Dizman, Hatice Kubra Dursun, Merve Ozen Balci, Feray Kaya, Elif Kucuk, Lutfiye Koru, Ufuk Furkan Ozdemir, Serpil Meric Toprak, Ferit Durankus, Kubra Ozturk, Fatih Haslak","doi":"10.1097/RHU.0000000000002359","DOIUrl":"10.1097/RHU.0000000000002359","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate physical activity levels of children with Familial Mediterranean fever (FMF), and to compare these levels with age-matched and sex-matched healthy peers. A secondary aim was to investigate associations between physical activity, acute phase reactants (APRs), and disease activity scores.</p><p><strong>Methods: </strong>This cross-sectional study enrolled FMF patients aged 9 to 14 years and matched healthy controls. Disease activity was assessed using Pras scores, Auto-Inflammatory Diseases Activity Index (AIDAI), and International Severity Scoring System for FMF (ISSF). Physical activity was evaluated weekly using the Physical Activity Questionnaire for Children (PAQ-C) over 3 months. Correlations of PAQ-C scores with APRs and disease activity parameters were analyzed at multiple time points, and repeated-measures analyses were performed.</p><p><strong>Results: </strong>Overall, 140 participants were included (70 in the control group and 70 in the patient group). The study group had significantly lower PAQ-C scores than controls (2.75±0.71 vs. 3.37±0.54; p <0.001). Patients with exercise-related leg pain had significantly lower PAQ-C scores than those without pain (2.54±0.60 vs. 2.99±0.76; p =0.007). A significant negative correlation was found between age and PAQ-C scores in the study group ( r =-0.377, p =0.001). PAQ-C scores were negatively correlated with ISSF scores (r =-0.278, p =0.020 and r =-0.288, p =0.016) and the AIDAI scores ( r =-0.305, p =0.010 and r =-0.396, p <0.001) at first and the third months.</p><p><strong>Conclusions: </strong>This study demonstrates that children with FMF have reduced physical activity, particularly those with exercise-induced leg pain. The decline with age may reflect increased disease awareness, emphasizing the need for monitoring and promoting safe physical engagement in disease management.</p>","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":"e200-e205"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of the EOS 2D/3D Imaging System for the Evaluation of Calcinosis in Juvenile Dermatomyositis: A Retrospective Case Series.","authors":"Ciara A Maguire, Carli N Lawrence, Shailee V Lala, Lynne P Pinkney, Jessica Perfetto, Vikash S Oza, Philip J Kahn","doi":"10.1097/RHU.0000000000002342","DOIUrl":"10.1097/RHU.0000000000002342","url":null,"abstract":"<p><strong>Background/objective: </strong>Juvenile dermatomyositis (JDM) is a systemic autoimmune vasculopathy, which may be complicated by calcinosis of the skin and subcutaneous tissues. Calcinosis is often associated with pain, ulceration, infection, impaired mobility, and reduced quality of life, yet no gold standard exists for its detection and longitudinal monitoring. Current evaluation relies on clinical examination (history plus physical examination) with or without targeted conventional radiography, which may underestimate disease burden and expose children to cumulative doses of ionizing radiation. The EOS 2D/3D imaging system provides rapid, whole-body imaging with substantially reduced radiation exposure. Thus, we sought to explore its utility in assessing calcinosis in JDM.</p><p><strong>Methods: </strong>In this retrospective case series, we investigated NYU pediatric patients with JDM who underwent EOS imaging for evaluation of calcinosis. EOS images and conventional radiographs were independently reviewed by 2 radiologists blinded to clinical data, with a focus on the anatomic distribution of calcinosis.</p><p><strong>Results: </strong>Seven patients (5 female, 2 male, ages 10 to 17 years) met the inclusion criteria, of whom 6 underwent both EOS and x-ray imaging. EOS imaging accurately identified calcinosis of the trunk and lower extremities in all cases and detected calcinosis not previously appreciated on clinical examination or dedicated radiographs in every patient. In 2 patients, EOS imaging failed to detect all upper-extremity calcinosis, likely due to the use of standard orthopedic positioning.</p><p><strong>Conclusions: </strong>EOS imaging appears to be a valid alternative to conventional radiography for evaluating calcinosis of the trunk and lower extremities in JDM, while offering the advantages of lower radiation exposure, rapid acquisition, and broader anatomic coverage. Development of JDM-specific positioning protocols may improve the detection of upper-extremity disease.</p>","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":"197-200"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Baseline Bone Mineral Density Predicts Treatment Switch in Pediatric Chronic Nonbacterial Osteomyelitis: A Real-World Cohort Study.","authors":"Muserref K Cuceoglu, Merve Canturk, Ezgi D Batu, Adalet E Yildiz, Halide O Basaran, Yelda Bilginer, Ustun Aydingoz, Alev Ozon, Seza Ozen","doi":"10.1097/RHU.0000000000002326","DOIUrl":"10.1097/RHU.0000000000002326","url":null,"abstract":"<p><strong>Objectives: </strong>To assess whether baseline bone mineral density (BMD) influences treatment response and predicts the need for treatment switching in patients with chronic nonbacterial osteomyelitis (CNO).</p><p><strong>Methods: </strong>Demographics and clinical characteristics of patients, 25-OH vitamin D levels, radiologic findings (dual-energy X-ray absorptiometry, magnetic resonance imaging), and treatment switching were evaluated. First, patients were divided into 2 groups based on their treatment options: group 1 (NSAIDs/cDMARDs) and group 2 (TNFi/bisphosphonates). In addition, predictive factors for treatment switching were identified through binary logistic regression analysis in patients evaluated by DEXA.</p><p><strong>Results: </strong>Ninety-one patients (females, 54.9%) with CNO were included. BMD was analyzed in 48 (52.7%) patients and was normal in 20 (41.6%), osteoporotic in 19 (39.6%), and osteopenic in 9 (18.8%). Overall, 42 (68.9%) patients had vitamin D insufficiency/deficiency. In group 1 (n=10), none of the patients had osteoporosis, 3 (30%) had osteopenia, and 7 (70%) had normal BMD results, whereas in group 2 (n=38), 19 (50%) had osteoporosis and 6 (15.7%) had osteopenia ( p =0.016). Multivariate logistic regression analysis revealed that osteoporosis (OR=7.685, 95% CI: 1.679-26.562, p =0.009) and axial involvement (OR=2.625, 95% CI: 1.751-13.069, p =0.034) were the predictive factors for the treatment switching.</p><p><strong>Conclusion: </strong>Patients with normal BMD were more likely to respond well to first-line treatment. Osteoporosis and axial involvement are predictive factors for therapy switching in refractory disease. Although vitamin D deficiency is common in our cohort, its effect on relapse was not found. Monitoring of osteoporosis may be critical in the selection of second-line treatment.</p>","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":"e192-e199"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147278133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}