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

{"title":"Multilevel Axial Gout: Dramatic Response to IL-1 Inhibition.","authors":"Fizza Zulfiqar, Elie Gertner","doi":"10.1097/RHU.0000000000002370","DOIUrl":"10.1097/RHU.0000000000002370","url":null,"abstract":"","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":"e187-e188"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148230477","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":"Postmenopausal Osteoporosis, Endothelial Dysfunction, and Cardiovascular Risk.","authors":"Marie-Eva Pickering, Christian Heiss, Véronique Morel, Gisèle Pickering, Marion Couderc, Sylvain Mathieu, Sandrine Malochet-Guinamand, Julie Durif, Vincent Sapin, Bruno Pereira, Anne Tournadre, Roland Chapurlat","doi":"10.1097/RHU.0000000000002352","DOIUrl":"10.1097/RHU.0000000000002352","url":null,"abstract":"<p><strong>Background/objectives: </strong>Bone and cardiovascular health are interconnected, yet their relationship with endothelial function in postmenopausal osteoporosis remains insufficiently understood. This study aimed to investigate, in women with osteoporosis, the associations between endothelial function, assessed by flow-mediated dilation (FMD), bone turnover, and cardiovascular disease risk.</p><p><strong>Methods: </strong>This cohort study included consecutive postmenopausal osteoporosis outpatients from the Rheumatology Department of Clermont-Ferrand University Hospital, France. FMD was measured at the brachial artery and values contextualized with age-matched healthy women's data reported in the literature. Associations between FMD and bone-related parameters (bone mineral density, bone markers, fracture history, and treatments), and Systematic Coronary Risk Evaluation (SCORE2/2-OP) were analyzed.</p><p><strong>Results: </strong>A total of 111 postmenopausal women with osteoporosis (mean age 69.4 ± 7.9 y; mean FMD=3.14 ± 2.28%) were included. No significant associations were found between FMD and bone-related parameters. FMD was positively associated with prior bisphosphonate use ( r =0.270, p =0.007) and inversely associated with SCORE2/2-OP ( r =-0.212, p =0.035), particularly among younger participants. Overall, 49.5% of patients had high/very high SCORE2/2-OP, and 55% of those classified as low/intermediate SCORE2/2-OP exhibited low FMD values.</p><p><strong>Conclusions: </strong>Measurement of the endothelial function in postmenopausal osteoporosis brings additional information to cardiovascular risk calculation, suggesting that factors beyond traditional cardiovascular risk determinants contribute to vascular impairment. In clinical practice, our findings support cautious cardiovascular follow-up even in osteoporotic patients with low cardiovascular risk and underline possible positive effects of bisphosphonates on endothelial function.</p>","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":"e159-e165"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148202077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to the Letter to the Editor Regarding the Article \"Delays in the Diagnosis and Treatment of Lupus in the Southern Cone,\" Published in a Special Supplement of Journal of Clinical Rheumatology (January 2026).","authors":"Rosana Quintana","doi":"10.1097/RHU.0000000000002361","DOIUrl":"10.1097/RHU.0000000000002361","url":null,"abstract":"","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":"e190-e191"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849245","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":"Association of Diet, Supplements, and Physical Activity With Risk of Incident Spondyloarthritis.","authors":"Griffin J Reed, Cynthia S Crowson, Ryan J Lennon, John M Davis, Vanessa L Kronzer","doi":"10.1097/RHU.0000000000002332","DOIUrl":"10.1097/RHU.0000000000002332","url":null,"abstract":"<p><strong>Background/objective: </strong>Dietary, supplement, and activity exposures have only been studied in spondyloarthritis (SpA) with retrospective studies. We aimed to determine the association of diet, supplements, and physical activity with incident SpA.</p><p><strong>Patients and methods: </strong>We performed a case-control study in the Mayo Clinic Biobank from 2009 through 2015, matching criteria-confirmed incident SpA cases to controls 1:5 on age, sex, recruitment year, and location. Questionnaires assessed 16 dietary, 29 supplement, and leisure-time/work activity exposures. Logistic regression models calculated adjusted odds ratios (aOR) with 95% CIs of SpA for each exposure, adjusting for covariates. Sensitivity analyses were conducted within HLA-B27-positive patients, and those with baseline questionnaires completed 5+ years before index.</p><p><strong>Results: </strong>We identified 73 cases of incident SpA matched with 365 controls (mean age: 60, 70% females). No dietary or activity exposures were associated with SpA overall. However, among HLA-B27-positive individuals, non-diet soft drink consumption was associated with increased risk of SpA (aOR: 4.82, 95% CI: 1.29-18.1), whereas caffeinated coffee was associated with decreased risk (aOR: 0.20, 95% CI: 0.04-0.89). Zinc was associated with increased risk of SpA (aOR: 4.16, 95% CI: 1.19-14.6), as were B vitamins in the HLA-B27-positive subgroup (aOR: 4.21, 95% CI: 1.04-17.1). In the 5-year sensitivity analysis, low leisure-time physical activity plus high work physical activity was associated with increased risk of SpA (relative excess risk due to interaction: 0.50, 95% CI: 0.03-0.98).</p><p><strong>Conclusions: </strong>Due to small sample size and multiple comparisons, the risk factors we identified (non-diet soft drinks, B vitamins, and zinc) should be considered hypothesis-generating and warrant further investigation.</p>","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":"e143-e149"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147597508","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":"Diffuse Idiopathic Skeletal Hyperostosis Masking Cervical Ossification of the Posterior Longitudinal Ligament.","authors":"Yi-Fan Mai","doi":"10.1097/RHU.0000000000002355","DOIUrl":"10.1097/RHU.0000000000002355","url":null,"abstract":"","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":"e185-e186"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849265","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":"Clinical and Autoantibody Profile of Inflammatory Myopathies in a Mexican Cohort: A Descriptive Study.","authors":"Grisel G Sanchez-Medieta, Selene M Delgado-Ayala, Ana Cecilia Arana-Guajardo, Miguel A Villareal-Alarcon, Dionicio A Galarza-Delgado, Lourdes Gil-Flores, David Vega-Morales","doi":"10.1097/RHU.0000000000002343","DOIUrl":"10.1097/RHU.0000000000002343","url":null,"abstract":"<p><strong>Background: </strong>Inflammatory myopathies (IIMs) are a group of autoimmune diseases characterized by muscle inflammation and systemic features. Although autoantibody profiling has improved disease classification, regional data from Latin America remain limited.</p><p><strong>Objective: </strong>To describe the clinical and serological characteristics of a Mexican cohort.</p><p><strong>Methods: </strong>We conducted a cross-sectional study of adult patients who met the 2017 EULAR/ACR criteria for IIMs at a tertiary rheumatology clinic in Monterrey, Mexico, from 2015 to 2019. We interviewed patients, reviewed medical records, and performed a myositis autoantibody immunoblot panel and summarized clinical features by autoantibody positivity.</p><p><strong>Results: </strong>Seventy patients were included (74.3% female, mean age 44 y). Dermatomyositis was the most frequent clinical subtype (68.6%). The most common clinical features included proximal muscle weakness, Gottron's papules, and articular involvement. The most prevalent autoantibodies were anti-Ro52 (34.3%), anti-Mi2a (24.3%), and anti-PL7 (14.3%). Less common antibodies included anti-MDA5, anti-SRP, anti-TIF1γ, anti-NXP2, anti-Ku, and others, with frequencies ranging from 1.4% to 12.9%.</p><p><strong>Conclusions: </strong>This study provides a detailed clinical-serological characterization of IIMs in a Mexican cohort. Our findings reinforce recognized clinico-serological phenotypes and suggest regional patterns, including the high prevalence of anti-Ro52. These results underscore the need for broader autoantibody testing and contribute to the understanding of IIM heterogeneity in underrepresented populations.</p>","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":"152-156"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147535136","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":"Cognitive Intrusion of Pain, Autobiographical Memory Characteristics, and Aggression Across Rheumatic Diseases: A Cross-sectional Comparative Study.","authors":"I Merve Uçar Baytaroğlu, Kübra Çelik, Meryem Ümit Kurban, Gizem Özan Cerrahoğlu, Tuğba Erbey, Faika Sanal Karahan, Gülay Alp","doi":"10.1097/RHU.0000000000002393","DOIUrl":"https://doi.org/10.1097/RHU.0000000000002393","url":null,"abstract":"<p><strong>Objective: </strong>Cognitive intrusion of pain, autobiographical memory, and aggression have not been simultaneously compared in rheumatic diseases. We compared these constructs across rheumatoid arthritis (RA), psoriatic arthritis (PsA), osteoarthritis (OA), and fibromyalgia (FM) and identified disease-specific predictors.</p><p><strong>Methods: </strong>Two hundred twenty-five patients (62 RA, 52 PsA, 56 OA, 55 FM) were assessed (May to October 2025) with the Experience of Cognitive Intrusion of Pain Scale (ECIPS), Autobiographical Memory Questionnaire (AMQ), Buss-Perry Aggression Scale (BPAS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Visual Analog Scale (VAS). Disease burden was measured with the Disease Activity Score 28-C-reactive protein (DAS28-CRP), Disease Activity Index for Psoriatic Arthritis (DAPSA), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Fibromyalgia Impact Questionnaire (FIQ). Analysis of variance and covariance (ANOVA, ANCOVA; age, sex, depression, anxiety) and multiple regression were applied with Benjamini-Hochberg false discovery rate (FDR) correction.</p><p><strong>Results: </strong>After adjustment, ECIPS did not differ across groups (F3,217=0.63, p=0.595, partial η²=0.009). Hostility differences attenuated after mood adjustment (p=0.784). Scene imagery differed among groups (p=0.023). Physical aggression (β=0.270, p=0.005) and memory rehearsal (β=0.653, p<0.001) were associated with cognitive intrusion. DAS28-CRP predicted ECIPS in RA (β=0.357, p=0.006) and FIQ in FM (β=0.401, p=0.003). No medication subgroup differences emerged.</p><p><strong>Conclusions: </strong>Cognitive pain intrusion did not differ across rheumatic diseases after mood adjustment (partial η²=0.009). Because the ECIPS lacks rheumatology validation, this may reflect limited measurement sensitivity, residual confounding, or insufficient power rather than true equivalence. Disease activity was independently associated with cognitive intrusion in RA and FM. Rheumatology-specific psychometric validation is warranted.</p>","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148650426","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":"Recommendations of the Argentine Society of Rheumatology for the Treatment of Patients With Rheumatoid Arthritis: 2025 Update Part I.","authors":"Emilce E Schneeberger, Gustavo Citera, Natalia V Zamora, Enrique R Soriano Guppy, María V Martire, Eduardo F Mysler, Silvia B Papasidero, Rodrigo N García Salinas, Guillermo A Berbotto, Gustavo C Casado, Carla A Gobbi, Hernán Maldonado Ficco, Rodolfo S Pérez Alamino, Bernardo Pons-Estel, Javier E Rosa, Darío Scublinsky, Anastasia Secco, José L Velasco Zamora, María A Correa, Alejandra M Babini, Edson J Velozo, Cecilia A Asnal, Tomás Cazenave, Alejandro Martínez Muñóz, María C de la Vega","doi":"10.1097/RHU.0000000000002391","DOIUrl":"https://doi.org/10.1097/RHU.0000000000002391","url":null,"abstract":"<p><strong>Background: </strong>Rheumatoid arthritis (RA) is a severe, systemic chronic rheumatic disease, and it is important for each country and/or region to develop management recommendations adapted to its needs and resources.</p><p><strong>Objectives: </strong>To update the Argentine treatment recommendations for the management of patients with RA.</p><p><strong>Methods: </strong>The working group comprised a principal investigator, 8 methodologists and 23 expert rheumatologists. Seventy-one PICO questions were developed. A systematic literature review (SLR) was conducted using the Medline (PubMed), LILACS, and Cochrane Library databases. Grey literature was also searched. The evidence was appraised using the GRADE methodology. Voting was anonymous and conducted virtually, and recommendations required at least 70% agreement to achieve consensus.</p><p><strong>Results: </strong>A total of 21 recommendations were developed, addressing Mediterranean diet, subcutaneous versus oral methotrexate, and therapeutic strategies across different clinical scenarios, including: csDMARD naive, inadequate response (IR) to csDMARD, IR to b/tsDMARD (cycling versus swapping), monotherapy, tapering in patients with sustained remission, and management of patients with concomitant interstitial lung disease or rheumatoid vasculitis. In most cases, the levels of evidence and degrees of agreement were moderate.</p><p><strong>Conclusions: </strong>These recommendations are intended to be a practical tool to assist rheumatologists in making the most appropriate treatment decisions for their patients.</p>","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148611999","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":"Neutrophil/Lymphocyte Ratio as a Diagnostic Tool to Distinguish Infection From Disease Reactivation in Systemic Lupus Erythematosus: An Analytical Observational Study.","authors":"Freddy Liñán-Ponce, Juan Leiva-Goicochea","doi":"10.1097/RHU.0000000000002376","DOIUrl":"https://doi.org/10.1097/RHU.0000000000002376","url":null,"abstract":"<p><strong>Introduction: </strong>Differentiating between infection and flare in patients with systemic lupus erythematosus (SLE) presents a clinical challenge due to the overlap of clinical manifestations and laboratory findings. The neutrophil-to-lymphocyte ratio (NLR) has been proposed as an accessible marker of systemic inflammation. The aim was to evaluate the association and diagnostic performance of NLR in identifying infection and differentiating it from a flare in patients with SLE.</p><p><strong>Methods: </strong>A longitudinal analytical observational study was conducted at the Víctor Lazarte Echegaray Hospital (Peru) between January 2019 and June 2025. 213 patients with SLE were included, of whom 136 presented with flares and 77 with infection. The NLR was calculated from the complete blood count at the time of clinical evaluation. Its association with infection was assessed using logistic regression, and its diagnostic performance was evaluated using receiver operating characteristic ROC curves, comparing it with C-reactive protein (CRP).</p><p><strong>Results: </strong>The NLR was significantly higher in patients with infection. In logistic regression analysis, elevated NLR values were associated with infection (OR: 1.25; 95% CI: 1.15-1.36; p<0.001), remaining significant after adjustment (adjusted OR: 1.18; 95% CI: 1.08-1.30; p<0.001). The NLR showed excellent discriminative ability (AUC: 0.97), with a cutoff point of 6.8, sensitivity of 90%, and specificity of 92%. C-reactive protein (CRP) showed similar performance (AUC: 0.97). The combined model increased sensitivity to 97% and reduced the negative likelihood ratio to 0.03.</p><p><strong>Conclusions: </strong>NLR is a simple, accessible, and low-cost marker that allows differentiation between infection and flare in patients with SLE, with diagnostic performance comparable to that of CRP. Its combined use can improve clinical decision-making in hospital settings.</p>","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148582114","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":"Impending Abdominal Aortic Aneurysm Rupture Associated With IgG4-RD.","authors":"Guan-Quan Liao, Hsien-Tzung Liao","doi":"10.1097/RHU.0000000000002390","DOIUrl":"https://doi.org/10.1097/RHU.0000000000002390","url":null,"abstract":"","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148440745","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}