Joint Bone Spine最新文献

{"title":"The role of the gut and intestinal dysbiosis in the pathogenesis of Spondyloarthritis.","authors":"Daniele Mauro, Benjamin Cai, Antonio Ciancio, Giulio Forte, Saviana Gandolfo, Ranjeny Thomas, Anne-Sophie Bergot, Francesco Ciccia","doi":"10.1016/j.jbspin.2025.105923","DOIUrl":"https://doi.org/10.1016/j.jbspin.2025.105923","url":null,"abstract":"<p><p>Spondyloarthritis (SpA) encompasses chronic inflammatory diseases affecting both axial and peripheral joints. Emerging evidence highlights a pivotal role for the gut-joint axis in SpA pathogenesis, where intestinal dysbiosis and barrier dysfunction facilitate microbial translocation and trigger systemic immune activation. Clinical observations of subclinical gut inflammation, alongside findings from HLA-B27 transgenic rats and SKG mice, underscore the gut's role in initiating joint pathology. Genetic predispositions, particularly HLA-B27, further exacerbate these processes through mechanisms such as endoplasmic reticulum stress and IL-23-mediated T-cell activation. This review integrates epidemiological, mechanistic, and experimental insights to elucidate the complex interplay between the gut microbiota and immune responses in SpA, outlining potential avenues for targeted intervention.</p>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":" ","pages":"105923"},"PeriodicalIF":3.8,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic accuracy and trajectories of referrals for gout to rheumatology","authors":"Timothy S.H. Kwok ,&nbsp;Sangeeta Bajaj ,&nbsp;Tripti Papneja ,&nbsp;Vandana Ahluwalia ,&nbsp;Gregory Choy ,&nbsp;Raman Joshi","doi":"10.1016/j.jbspin.2025.105919","DOIUrl":"10.1016/j.jbspin.2025.105919","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate diagnostic accuracy and trajectories of gout referrals to rheumatology including factors associated with an accurate diagnosis.</div></div><div><h3>Methods</h3><div>We performed a retrospective cohort study of referrals at 4 rheumatology clinics in Brampton, Canada from December 2019 to January 2023. We assessed gout diagnostic accuracy referenced to the rheumatologist's “gold standard” diagnosis, describing alternative final diagnoses. Using multivariable logistic regression, we identified factors associated with an accurate gout diagnosis.</div></div><div><h3>Results</h3><div>Among 4315 patients, 216 were diagnosed with gout. Of 191 gout referrals (mean (SD) age 58.4 (15.4) years; 77.0% male), the diagnosis was unchanged in 159 (83.2%) patients with alternative diagnoses comprising osteoarthritis, autoimmune inflammatory arthritis and calcium pyrophosphate deposition disease. Referring physicians had moderate-to-high sensitivity (73.6%, 95% CI: 67.2–79.4), specificity (99.2%, 95% CI: 98.9–99.5), positive predictive value (83.2%, 95% CI: 77.2–88.2), negative predictive value (98.6%, 95% CI: 98.2–99.0) and inter-rater reliability (Cohen's kappa: 0.77, 95% CI: 0.72–0.82). Accuracy was highest amongst internists and emergency room physicians. Male sex (OR 14.32, 95% CI: 4.44–46.17), serum urate ≥<!--> <!-->500<!--> <!-->μmol/L (OR 9.10, 95% CI: 2.19–7.78), lower extremity monoarthritis (OR 5.08, 95% CI: 1.59–16.27) and symptom duration ≤<!--> <!-->2<!--> <!-->weeks (OR 3.87, 95% CI 1.23–12.21) were predictive of a final gout diagnosis.</div></div><div><h3>Conclusions</h3><div>Referring providers had reasonably high accuracy in diagnosing gout. Traditional risk factors were associated with concordance with the consultant rheumatologist. Suboptimal gout care likely does not stem at point-of-diagnosis and quality improvement efforts should be focused on mitigating treatment-associated care gaps.</div></div>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"92 6","pages":"Article 105919"},"PeriodicalIF":3.8,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation by modern imaging of anterior chest wall involvement in axial spondyloarthritis with or without chest complaint","authors":"Pauline Brevet ,&nbsp;Camille Mercier ,&nbsp;Baptiste Gérard ,&nbsp;Marie Kozyreff-Meurice ,&nbsp;Gilles Avenel ,&nbsp;Thierry Lequerré ,&nbsp;Paul Michelin ,&nbsp;Olivier Vittecoq","doi":"10.1016/j.jbspin.2025.105918","DOIUrl":"10.1016/j.jbspin.2025.105918","url":null,"abstract":"","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"92 5","pages":"Article 105918"},"PeriodicalIF":3.8,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound in rheumatic and musculoskeletal diseases: From musculoskeletal to organ involvement","authors":"Lyubomyra Kun ,&nbsp;Irina Gessl ,&nbsp;Georgios Filippou ,&nbsp;Matteo Ferrito ,&nbsp;Roberto Giacomelli ,&nbsp;Peter Mandl","doi":"10.1016/j.jbspin.2025.105920","DOIUrl":"10.1016/j.jbspin.2025.105920","url":null,"abstract":"<div><div>In last two decades, the use of ultrasound has assumed an increasingly important role in the assessment of almost all rheumatic and musculoskeletal diseases. Over the years, much advancement has been made in the sonographic evaluation of articular and periarticular structures, validating definitions of normal sonographic appearance of various types of tissues and structures as well as elementary sonographic lesions and scoring systems to apply in the detection and monitoring of inflammatory and structural lesions. Since extra-articular involvement is very common in rheumatic and musculoskeletal diseases, there is growing interest and evidence on how ultrasound can be applied to the examination of different tissues and organs beyond synovial joints. In this narrative review, we will provide an overview of the available data on the use of ultrasound in the musculoskeletal system (joint, tendon, enthesis, muscle) and extra-articular organs (cardiovascular system, salivary and lacrimal gland, lung, skin and nails), including elementary lesions, scoring systems and their relevance to diagnosis, monitoring, prediction and assessing treatment efficacy in rheumatic and musculoskeletal diseases.</div></div>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"92 6","pages":"Article 105920"},"PeriodicalIF":3.8,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hospital and patient factors predict length of stay in patients with osteoarthritis undergoing total primary hip replacement","authors":"Kranti C. Rumalla ,&nbsp;Sumanth R. Chandrupatla ,&nbsp;Jasvinder A. Singh","doi":"10.1016/j.jbspin.2025.105913","DOIUrl":"10.1016/j.jbspin.2025.105913","url":null,"abstract":"<div><h3>Objectives</h3><div>Over 450,000 primary total hip arthroplasties (THA) are performed each year in the US, with osteoarthritis (OA) as the major indication for primary THA. We examined the association of patient, payer, hospital, and geographic factors with extended lengths of stay (eLOS) and increased hospital costs in primary THA.</div></div><div><h3>Methods</h3><div>We utilized the National Inpatient Sample (NIS) to identify patients with OA who underwent primary THA in 2019. Diagnoses and procedures were identified using the <em>International Classification of Disease</em> (ICD-10) codes. We stratified healthcare/resource utilization by the occurrence of an extended length of hospital stay (eLOS) at 90th percentile or higher, i.e.,<!--> <!-->&gt;<!--> <!-->3<!--> <!-->days. We used univariate and multivariable-adjusted logistic regression analyses to assess whether patient, payer, hospital, and geographic factors associated with an eLOS. Predictive probabilities from multivariable analyses were used in area under the curve (AUC) analysis.</div></div><div><h3>Results</h3><div>There were 1,525,730 primary THAs performed for patients with OA during 2016–2019. Patient race and ethnicity, Medicaid or Medicare payer status, income, age/sex and nearly all regional, and hospital, characteristics were independently associated with eLOS (&gt;<!--> <!-->3<!--> <!-->days; ROC C-statistic<!--> <!-->=<!--> <!-->0.78).</div></div><div><h3>Conclusion</h3><div>Patient race and ethnicity and insurance payer status are important patient-level determinants of longer LOS for primary THA hospitalizations in the US. Well-known geographical and hospital-level factors are negatively associated with the hospitalization stay duration outcomes of primary THA in patients with OA. Policy and other interventions targeting these factors may help reduce inpatient healthcare utilization for primary THA.</div></div>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"92 5","pages":"Article 105913"},"PeriodicalIF":3.8,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between familial Mediterranean fever and incident cirrhosis: A population-based matched cohort study","authors":"Michal Carmiel-Haggai ,&nbsp;Rula Daood ,&nbsp;Fadi Fassan ,&nbsp;Helana Jeries ,&nbsp;Dikla Dror-Zur ,&nbsp;Mahmud Omar ,&nbsp;Abdulla Watad ,&nbsp;Tal Patalon ,&nbsp;Mohammad E. Naffaa","doi":"10.1016/j.jbspin.2025.105917","DOIUrl":"10.1016/j.jbspin.2025.105917","url":null,"abstract":"<div><h3>Objective</h3><div>The association between FMF and incident liver cirrhosis is not widely studied. In this study, we aimed to examine the association between FMF and incident liver cirrhosis in a population-based cohort.</div></div><div><h3>Methods</h3><div>Patients with FMF aged<!--> <!-->≥<!--> <!-->18 in the Maccabi Healthcare Services (MHS) database were identified according to ICD-9 code 277.31 between January 1st, 2000 and December 31st, 2022. A control group was 1:1 age and gender-matched. Patients with chronic liver disease or cirrhosis were excluded, as well as patients who were treated with methotrexate, amiodarone or tamoxifen and patients with less than 12 months of follow-up. Incident cirrhosis was defined as a new diagnosis of cirrhosis according to ICD-9 code (571.5), newly diagnosed major cirrhotic complications or liver transplantation. The Cox proportional hazards models were used to examine the association between FMF and incident cirrhosis and the Kaplan-Meier curves to study the event-free survival.</div></div><div><h3>Results</h3><div>Incident cirrhosis was detected among 2.1% and 0.4% in the study and control groups, respectively, <em>P</em> <!-->&lt;<!--> <!-->0.01. Being in the FMF group was associated with a significantly increased risk of incident cirrhosis (HR<!--> <!-->=<!--> <!-->2.60, 95% CI: 1.54–4.38, <em>P</em> <!-->&lt;<!--> <!-->0.01). At 7 years, the cirrhosis-free survival rate was 98.2% in the study group and 99.6% in the control group (<em>P</em> <!-->&lt;<!--> <!-->0.01).</div></div><div><h3>Conclusion</h3><div>FMF was associated with incident cirrhosis, irrespective of the traditional risk factors for metabolic syndrome, suggesting the contribution of the inflammatory state to the development of cirrhosis.</div></div>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"92 6","pages":"Article 105917"},"PeriodicalIF":3.8,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Active hand inflammation. Differing clinical and ultrasound patterns in patients with rheumatoid arthritis and psoriatic arthritis - A Cross-Sectional, Multicenter Study.","authors":"Julio Ramírez, Vicenç Torrente-Segarra, Andrea Cuervo, Mireia Moreno, Ana Belén Azuaga, Lourdes Mateo, Beatriz Frade, Andrea Zacarías, Noemí Busquets-Pérez, Susana Holgado, Paula Estrada, Oscar Camacho, Juan José De Agustín, Carme Moragues, María Bonet, Sandra Farietta, Patricia Corzo, Andrés Ponce, Virginia Ruiz-Esquide, Lucía Alascio, Juan D Cañete","doi":"10.1016/j.jbspin.2025.105916","DOIUrl":"https://doi.org/10.1016/j.jbspin.2025.105916","url":null,"abstract":"<p><strong>Objectives: </strong>To define ultrasound (US) characteristics in patients with Rheumatoid Arthritis (RA) and Psoriatic Arthritis (PsA) exhibiting active hand inflammation.</p><p><strong>Methods: </strong>This cross-sectional, multicenter study collected epidemiological and clinical data from RA and PsA patients with active hand inflammation. US examinations of wrists and metacarpophalangeal joints were performed, focusing on extensor and flexor tendons.</p><p><strong>Results: </strong>A total of 292 patients were included: 192 (61.7%) were women, with a mean age of 56.1 years and mean disease duration of 105.4 months. Ninety-one patients (31.1%) had seropositive RA, 79 (27%) had seronegative RA, and 122 (41.7%) had PsA. Overall, 125 patients (42.8%) exhibited erosive disease, with 103 (35.2%) receiving targeted therapies. All patients had active disease (mean SDAI: 29.5; mean DAPSA: 22.3). Among the cohort, 144 patients (49.3%) showed synovial hypertrophy (SH) > 2 + Power Doppler (PD). This was more common in seropositive (72.5%) than in seronegative RA (43%) or PsA (36%) (p<0.001). Erosive disease [OR 8.4 (3.9-18), p<0.001] and US global score [OR 1.1 (1-1.1), p<0.001] were associated with SH>2+PD. Extensor paratenonitis was more frequent in PsA (27%) compared to seropositive (9.8%) and seronegative RA (18.9%) (p<0.01). The number of swollen joints [OR 1.1 (1-1.2), p<0.001] and joint ankylosis [OR 4.3 (1.1-16.9), p<0.05] were positively associated with paratenonitis.</p><p><strong>Conclusions: </strong>Synovial pannus was characteristic of RA, while paratenonitis was more common in PsA. SH>2+PD correlated with erosive disease, highlighting the need for prospective studies to validate US as a decision-making tool in arthritis.</p>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":" ","pages":"105916"},"PeriodicalIF":3.8,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The use of bisphosphonates in osteoid osteoma and osteoblastoma of difficult location: A useful and safe medical alternative","authors":"François Robin ,&nbsp;Raphael Guillin ,&nbsp;Romain Lecigne ,&nbsp;Philippe Violas ,&nbsp;Florence Burtin ,&nbsp;Julien Maximen ,&nbsp;Mickael Ropars ,&nbsp;Valérie Bousson ,&nbsp;Pascal Guggenbuhl","doi":"10.1016/j.jbspin.2025.105911","DOIUrl":"10.1016/j.jbspin.2025.105911","url":null,"abstract":"","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"92 5","pages":"Article 105911"},"PeriodicalIF":3.8,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Weighing in on Obesity and Psoriatic Arthritis - Time to move beyond association to robust randomised trials.","authors":"Stefan Siebert, Naveed Sattar, Lyn D Ferguson","doi":"10.1016/j.jbspin.2025.105915","DOIUrl":"https://doi.org/10.1016/j.jbspin.2025.105915","url":null,"abstract":"<p><p>Almost one in two individuals with psoriatic arthritis (PsA) are now living with obesity. Obesity increases the risk of developing PsA, worsens disease activity, pain and fatigue, impairs treatment response, and amplifies the risk of many cardiometabolic comorbidities already more prevalent in PsA. Despite the increasing evidence for the pathogenic role of obesity in PsA, current treatment focuses on immune mediated therapies, with limited attention to tackling excess adiposity. Residual pain and disease activity in PsA can in turn adversely impact physical activity, leading to a cycle of further weight gain and worse disease activity. Preliminary evidence from dietary interventions in patients with PsA and obesity suggests weight loss of ≥5% body weight can improve disease activity, holding promise for potentially even better improvements with newer pharmacological anti-obesity therapies, such as incretin-based weight loss medicines, which result in average weight losses of 15-20%. In this narrative review, we provide an overview of the adverse impacts of obesity in PsA and discuss weight loss therapies now available to help address this. We highlight the urgent need for robust randomised controlled trials of weight loss therapies in patients with PsA and obesity to determine their clinical and cost effectiveness in PsA management and to inform where these are best implemented in the disease course and treatment pathway.</p>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":" ","pages":"105915"},"PeriodicalIF":3.8,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interplay between osteoporosis and dementia.","authors":"Véronique Breuil, Marie Charlotte Trojani","doi":"10.1016/j.jbspin.2025.105912","DOIUrl":"10.1016/j.jbspin.2025.105912","url":null,"abstract":"","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}