Pub Date : 2025-12-11DOI: 10.1016/j.semarthrit.2025.152894
S.E. (Sabine) Kloprogge, J.J. (Jacoline) van den Driest, L. (Laura) Struik, S.M.A. (Sita) Bierma-Zeinstra, M. (Marienke) van Middelkoop
Objective
Osteoarthritis (OA) of the first metatarsophalangeal (MTP) joint is accompanied by pain and stiffness and associated with reduced health-related quality of life. Although prevalence of radiographic 1st MTP joint OA is high, the incidence of clinical 1st MTP joint OA is unknown. Therefore, we aimed to determine the incidence and management of general practice (GP) consultations for symptomatic 1st MTP joint OA.
Methods
A retrospective cohort study was conducted using electronic health records of GPs. An algorithm was defined to identify 1st MTP joint OA patients based on free text and codified data between 2013 and 2022. First MTP joint OA incidence rate, comorbidities and management strategies were assessed.
Results
The overall 1st MTP joint OA incidence was 0.74/1000 person-years in patients ≥35 years. The most initiated management by GPs was explanation/reassurance (360/672 (53.6 %)), followed by referral to podiatry (171/672 (25.4 %)) and orthopedic surgeon consultation (162/672 (24.1 %)). Of the 823 patients consulting their GP with foot/toe problems in the year before diagnosis, 491 (47.1 %) were referred to radiology, and 271 (26 %) for orthopedic surgeon consultation.
Conclusion
The incidence of 1st MTP joint OA has been estimated for the first time in general practice. Most patients are diagnosed after referral to radiology or orthopedic surgeon consultation. From diagnosis, half of 1st MTP joint OA patients are referred, mostly for orthopedic surgeon consultation and podiatry. As evidence for these diagnostic and management strategies is lacking, research into their effectiveness for 1st MTP joint OA in general practice is needed.
{"title":"Incidence and management of first metatarsophalangeal joint osteoarthritis in Dutch general practice estimates from the Rijnmond Primary Care Database","authors":"S.E. (Sabine) Kloprogge, J.J. (Jacoline) van den Driest, L. (Laura) Struik, S.M.A. (Sita) Bierma-Zeinstra, M. (Marienke) van Middelkoop","doi":"10.1016/j.semarthrit.2025.152894","DOIUrl":"10.1016/j.semarthrit.2025.152894","url":null,"abstract":"<div><h3>Objective</h3><div>Osteoarthritis (OA) of the first metatarsophalangeal (MTP) joint is accompanied by pain and stiffness and associated with reduced health-related quality of life. Although prevalence of radiographic 1st MTP joint OA is high, the incidence of clinical 1st MTP joint OA is unknown. Therefore, we aimed to determine the incidence and management of general practice (GP) consultations for symptomatic 1st MTP joint OA.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted using electronic health records of GPs. An algorithm was defined to identify 1st MTP joint OA patients based on free text and codified data between 2013 and 2022. First MTP joint OA incidence rate, comorbidities and management strategies were assessed.</div></div><div><h3>Results</h3><div>The overall 1st MTP joint OA incidence was 0.74/1000 person-years in patients ≥35 years. The most initiated management by GPs was explanation/reassurance (360/672 (53.6 %)), followed by referral to podiatry (171/672 (25.4 %)) and orthopedic surgeon consultation (162/672 (24.1 %)). Of the 823 patients consulting their GP with foot/toe problems in the year before diagnosis, 491 (47.1 %) were referred to radiology, and 271 (26 %) for orthopedic surgeon consultation.</div></div><div><h3>Conclusion</h3><div>The incidence of 1st MTP joint OA has been estimated for the first time in general practice. Most patients are diagnosed after referral to radiology or orthopedic surgeon consultation. From diagnosis, half of 1st MTP joint OA patients are referred, mostly for orthopedic surgeon consultation and podiatry. As evidence for these diagnostic and management strategies is lacking, research into their effectiveness for 1st MTP joint OA in general practice is needed.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"76 ","pages":"Article 152894"},"PeriodicalIF":4.4,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145782587","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}
Pub Date : 2025-12-11DOI: 10.1016/j.semarthrit.2025.152889
Kevin Chevalier , Brigitte Bader-Meunier , Isabelle Kone-Paut , Benjamin Thoreau , Marc Michel , Bertrand Godeau , Christian Agard , Thomas Papo , Karim Sacre , Raphaèle Seror , Xavier Mariette , Patrice Cacoub , Ygal Benhamou , Mathilde Leclercq , Cécile Goujard , Olivier Lambotte , Bernard Bonnotte , Maxime Samson , Félix Ackermann , Jean Schmidt , Benjamin Chaigne
Objectives
Juvenile-onset mixed connective tissue disease (jMCTD) accounts for 7–23 % of MCTD cases but remains poorly described. We aimed to characterize clinical features, treatments, and outcomes of patients with jMCTD, and compare them to adult-onset MCTD (aMCTD) patients.
Methods
We conducted a multicenter, retrospective, case-control study within the French MCTD cohort. Each jMCTD patient was compared to 3 matched aMCTD patients.
Results
Forty-seven jMCTD patients (93.6 % girls; median age at onset 14 [11–16] years) were included. Forty-four (93.6 %) jMCTD patients fulfilled either Sharp or Kasukawa diagnostic criteria. None of them met other diagnostic criteria without fulfilling Sharp or Kasukawa criteria. At diagnosis, jMCTD patients’ main manifestations were Raynaud’s phenomenon, arthralgia, and myalgia. jMCTD patients had less frequently puffy fingers than aMCTD (p < 0.0001). Cumulatively, jMCTD patients mainly received glucocorticoids (80.9 %), hydroxychloroquine (95.7 %) and immunosuppressants (93.6 %). They received a higher initial dose of glucocorticoids (30 [20–60] mg/day vs. 15 [10–35] mg/day, p = 0.02), and significantly more frequently methotrexate (Methotrexate) and rituximab (p = 0.01) over time compared to aMCTD. After a median follow-up of 9.8 [6.6–16.2] years, 29 (61.7 %) jMCTD patients were in remission (vs. 62 (44.0 %) aMCTD; p < 0.05), 36 % had progressed to another CTD (vs. 30.5 % aMCTD; p = 0.5), mainly systemic lupus erythematosus, 11 (23.4 %) had developed interstitial lung disease, 2 (4.3 %) pulmonary arterial hypertension, and 1 (2.1 %) died.
Conclusions
jMCTD share the same clinical characteristics as aMCTD patients, but less frequently have puffy fingers. Outcomes appear more favorable in jMCTD than aMCTD, with higher remission rates, albeit at the cost of more intensive treatment.
{"title":"Juvenile-onset mixed connective tissue disease: A multicenter retrospective cohort study","authors":"Kevin Chevalier , Brigitte Bader-Meunier , Isabelle Kone-Paut , Benjamin Thoreau , Marc Michel , Bertrand Godeau , Christian Agard , Thomas Papo , Karim Sacre , Raphaèle Seror , Xavier Mariette , Patrice Cacoub , Ygal Benhamou , Mathilde Leclercq , Cécile Goujard , Olivier Lambotte , Bernard Bonnotte , Maxime Samson , Félix Ackermann , Jean Schmidt , Benjamin Chaigne","doi":"10.1016/j.semarthrit.2025.152889","DOIUrl":"10.1016/j.semarthrit.2025.152889","url":null,"abstract":"<div><h3>Objectives</h3><div>Juvenile-onset mixed connective tissue disease (jMCTD) accounts for 7–23 % of MCTD cases but remains poorly described. We aimed to characterize clinical features, treatments, and outcomes of patients with jMCTD, and compare them to adult-onset MCTD (aMCTD) patients.</div></div><div><h3>Methods</h3><div>We conducted a multicenter, retrospective, case-control study within the French MCTD cohort. Each jMCTD patient was compared to 3 matched aMCTD patients.</div></div><div><h3>Results</h3><div>Forty-seven jMCTD patients (93.6 % girls; median age at onset 14 [11–16] years) were included. Forty-four (93.6 %) jMCTD patients fulfilled either Sharp or Kasukawa diagnostic criteria. None of them met other diagnostic criteria without fulfilling Sharp or Kasukawa criteria. At diagnosis, jMCTD patients’ main manifestations were Raynaud’s phenomenon, arthralgia, and myalgia. jMCTD patients had less frequently puffy fingers than aMCTD (<em>p</em> < 0.0001). Cumulatively, jMCTD patients mainly received glucocorticoids (80.9 %), hydroxychloroquine (95.7 %) and immunosuppressants (93.6 %). They received a higher initial dose of glucocorticoids (30 [20–60] mg/day <em>vs.</em> 15 [10–35] mg/day, <em>p</em> = 0.02), and significantly more frequently methotrexate (Methotrexate) and rituximab (<em>p</em> = 0.01) over time compared to aMCTD. After a median follow-up of 9.8 [6.6–16.2] years, 29 (61.7 %) jMCTD patients were in remission (<em>vs.</em> 62 (44.0 %) aMCTD; <em>p</em> < 0.05), 36 % had progressed to another CTD (<em>vs</em>. 30.5 % aMCTD; <em>p</em> = 0.5), mainly systemic lupus erythematosus, 11 (23.4 %) had developed interstitial lung disease, 2 (4.3 %) pulmonary arterial hypertension, and 1 (2.1 %) died.</div></div><div><h3>Conclusions</h3><div>jMCTD share the same clinical characteristics as aMCTD patients, but less frequently have puffy fingers. Outcomes appear more favorable in jMCTD than aMCTD, with higher remission rates, albeit at the cost of more intensive treatment.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"76 ","pages":"Article 152889"},"PeriodicalIF":4.4,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145782627","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}
Pub Date : 2025-12-11DOI: 10.1016/j.semarthrit.2025.152895
Katja Thiele , Katinka Albrecht , Carlo Veltri , Kirsten Karberg , Benjamin Köhler , Johanna Callhoff , Jutta G. Richter
Objective
To explore the development of fatigue over the past 17 years and its relationship to physician- and patient-reported outcomes and social factors in inflammatory rheumatic diseases.
Methodology
Data from ≈9300 patients per year from the German National Database (2007–2023) were included, considering arthritides, spondyloarthritides, connective tissue diseases and vasculitides. Fatigue was assessed on a numeric rating scale (0–10) with >2 defined as present and >6 as severe. Presence and severity were compared by diagnosis, gender and year. Fatigue clusters were identified based on trajectory patterns over three consecutive visits.
Results
Fatigue affected 55 % (adult onset Still disease) to 67 % (systemic sclerosis) of patients, with severe fatigue in up to 26 % (systemic sclerosis). Substantial proportions of women (47–61 %) and men (35–52 %) experienced moderate-to-severe fatigue. Despite marked improvements in inflammation-responsive outcomes (CRP -40 %, tender joints -50 %, physician disease activity -42 %) and employment (52 %→70 %), mean fatigue remained stable. Trajectory analysis identified 35 % with persistent low, 23 % persistent high, 24 % worsening, and 19 % improving fatigue. Tender joints and morning stiffness effectively discriminated between persistent high versus low fatigue clusters. Emotional well-being, physical functioning, coping, and sleep quality showed stronger associations with fatigue trajectories than inflammatory markers. Differences across fatigue clusters substantially exceeded those between diagnostic groups.
Conclusion
Fatigue affected a large proportion of both women and men across diagnoses. Fatigue trajectories reflect complex interplay of clinical and psychosocial factors. Management should incorporate multidimensional interventions addressing emotional well-being, physical function and social support beyond traditional inflammatory control.
{"title":"Trends in fatigue in inflammatory rheumatic diseases: Annual data and trajectory analysis of the German National Database 2007-2023","authors":"Katja Thiele , Katinka Albrecht , Carlo Veltri , Kirsten Karberg , Benjamin Köhler , Johanna Callhoff , Jutta G. Richter","doi":"10.1016/j.semarthrit.2025.152895","DOIUrl":"10.1016/j.semarthrit.2025.152895","url":null,"abstract":"<div><h3>Objective</h3><div>To explore the development of fatigue over the past 17 years and its relationship to physician- and patient-reported outcomes and social factors in inflammatory rheumatic diseases.</div></div><div><h3>Methodology</h3><div>Data from ≈9300 patients per year from the German National Database (2007–2023) were included, considering arthritides, spondyloarthritides, connective tissue diseases and vasculitides. Fatigue was assessed on a numeric rating scale (0–10) with >2 defined as present and >6 as severe. Presence and severity were compared by diagnosis, gender and year. Fatigue clusters were identified based on trajectory patterns over three consecutive visits.</div></div><div><h3>Results</h3><div>Fatigue affected 55 % (adult onset Still disease) to 67 % (systemic sclerosis) of patients, with severe fatigue in up to 26 % (systemic sclerosis). Substantial proportions of women (47–61 %) and men (35–52 %) experienced moderate-to-severe fatigue. Despite marked improvements in inflammation-responsive outcomes (CRP -40 %, tender joints -50 %, physician disease activity -42 %) and employment (52 %→70 %), mean fatigue remained stable. Trajectory analysis identified 35 % with persistent low, 23 % persistent high, 24 % worsening, and 19 % improving fatigue. Tender joints and morning stiffness effectively discriminated between persistent high versus low fatigue clusters. Emotional well-being, physical functioning, coping, and sleep quality showed stronger associations with fatigue trajectories than inflammatory markers. Differences across fatigue clusters substantially exceeded those between diagnostic groups.</div></div><div><h3>Conclusion</h3><div>Fatigue affected a large proportion of both women and men across diagnoses. Fatigue trajectories reflect complex interplay of clinical and psychosocial factors. Management should incorporate multidimensional interventions addressing emotional well-being, physical function and social support beyond traditional inflammatory control.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"76 ","pages":"Article 152895"},"PeriodicalIF":4.4,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145782662","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}
Pub Date : 2025-12-11DOI: 10.1016/j.semarthrit.2025.152897
Naomi J. Patel , Jiaqi Wang , Bohang Jiang , Isha Jha , Grace A. McMahon , Aubree E. McMahon , Tania Chiha , Hyon K. Choi , John H. Stone
Background/Objective
Real-world experience with standardized assessments of longitudinally-followed patients on glucocorticoids (GCs) is limited. We aimed to assess the impact of GC use on GC-related toxicity and quality-of-life in a prospective cohort.
Methods
We established a prospective cohort of adults with rheumatic diseases receiving GCs. Change in GC toxicity is measured by the Glucocorticoid Toxicity Index (GTI) following an assessment of GC toxicity at entry into the cohort using the GT-SNAPSHOT (range: 0–1592). Quality-of-life is assessed longitudinally using the Short Form-36 and EQ-5D We report the baseline characteristics of first 90 individuals, stratified by those who had ≤ 6 months vs >6 months of prior GC exposure.
Results
Of the initial 90 enrolled in LONG-TOX (mean age 59.2 years, 62 % female, most common rheumatic disease PMR and/or GCA [41 %]), the median (IQR) prior cumulative GC use duration was 71 days (23, 605). The overall median (IQR) baseline GT-SNAPSHOT score was 165 (122, 251). Those with >6 months of prior GC exposure had numerically higher median GT-SNAPSHOT scores (205 vs. 160, p = 0.08) and significantly lower SF-36 Energy/Fatigue (35 vs. 50, p = 0.01) and General Health (30 vs. 60, p < 0.001) scores than those with ≤ 6 months of exposure.
Conclusions
In this prospective cohort of individuals with autoimmune diseases, those with >6 months of GC exposure had higher baseline GC-related toxicity and lower quality-of-life than those with ≤ 6 months of exposure. This novel cohort captures important patient- and clinician-reported outcomes that will lead to a better understanding of the impact of GCs and their toxicities.
{"title":"A novel cohort to assess longitudinal glucocorticoid toxicity in individuals with rheumatic diseases: objectives, design, and initial baseline characteristics of the LONG-TOX cohort","authors":"Naomi J. Patel , Jiaqi Wang , Bohang Jiang , Isha Jha , Grace A. McMahon , Aubree E. McMahon , Tania Chiha , Hyon K. Choi , John H. Stone","doi":"10.1016/j.semarthrit.2025.152897","DOIUrl":"10.1016/j.semarthrit.2025.152897","url":null,"abstract":"<div><h3>Background/Objective</h3><div>Real-world experience with standardized assessments of longitudinally-followed patients on glucocorticoids (GCs) is limited. We aimed to assess the impact of GC use on GC-related toxicity and quality-of-life in a prospective cohort.</div></div><div><h3>Methods</h3><div>We established a prospective cohort of adults with rheumatic diseases receiving GCs. Change in GC toxicity is measured by the Glucocorticoid Toxicity Index (GTI) following an assessment of GC toxicity at entry into the cohort using the GT-SNAPSHOT (range: 0–1592). Quality-of-life is assessed longitudinally using the Short Form-36 and EQ-5D We report the baseline characteristics of first 90 individuals, stratified by those who had ≤ 6 months vs >6 months of prior GC exposure.</div></div><div><h3>Results</h3><div>Of the initial 90 enrolled in LONG-TOX (mean age 59.2 years, 62 % female, most common rheumatic disease PMR and/or GCA [41 %]), the median (IQR) prior cumulative GC use duration was 71 days (23, 605). The overall median (IQR) baseline GT-SNAPSHOT score was 165 (122, 251). Those with >6 months of prior GC exposure had numerically higher median GT-SNAPSHOT scores (205 vs. 160, <em>p</em> = 0.08) and significantly lower SF-36 Energy/Fatigue (35 vs. 50, <em>p</em> = 0.01) and General Health (30 vs. 60, <em>p</em> < 0.001) scores than those with ≤ 6 months of exposure.</div></div><div><h3>Conclusions</h3><div>In this prospective cohort of individuals with autoimmune diseases, those with >6 months of GC exposure had higher baseline GC-related toxicity and lower quality-of-life than those with ≤ 6 months of exposure. This novel cohort captures important patient- and clinician-reported outcomes that will lead to a better understanding of the impact of GCs and their toxicities.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"76 ","pages":"Article 152897"},"PeriodicalIF":4.4,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145805455","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}
Pub Date : 2025-12-11DOI: 10.1016/j.semarthrit.2025.152892
Shahriar Kolahi , Madjid Shakiba , Shahryar Rahmani , Sina Nosrat Sheybani , Dina Seyedi , Hamza Abdelmalik , Sara Parviz , Mahrouz Malek , Jonneke S. Kuperus , Mohammadreza Tahamtan
Objectives
Diffuse idiopathic skeletal hyperostosis (DISH) is a systemic condition characterized by ligamentous ossification along the spine. While its prevalence has been well described in the general population, data on its occurrence in oncology patients remain limited. This study aimed to assess the prevalence and distribution of DISH and early-phase DISH in newly diagnosed cancer patients undergoing initial staging with Computed Tomography (CT).
Materials and methods
In this retrospective cross-sectional study, 1053 adult oncology patients who underwent thoraco-abdominopelvic CT for initial staging were evaluated. DISH and early-phase DISH were diagnosed using established radiologic criteria. Vertebral body densities were measured, and associated extraspinal enthesopathies and ligamentous ossifications were documented.
Results
DISH was present in 30.3 % of patients, including 13.8 % with established DISH and 16.5 % with early-phase DISH. Prevalence was higher in older patients and males (p < 0.01). Notably, renal (43.2 %), gastric (37.5 %), and colorectal (33.7 %) cancers demonstrated significantly higher DISH rates, whereas esophageal cancer showed a lower prevalence (13.4 %). DISH was associated with decreased vertebral bone density and frequent extraspinal enthesopathies. No significant correlations were found with BMI, diabetes, or hypertension.
Conclusion
DISH is common among oncology patients and often coexists with extraspinal enthesopathies and reduced bone density. These findings suggest possible shared pathogenic mechanisms and underscore the importance of further studies exploring the relationship between DISH and malignancy.
{"title":"Diffuse idiopathic skeletal hyperostosis in the oncologic population: a cross-sectional analysis of 1053 patients","authors":"Shahriar Kolahi , Madjid Shakiba , Shahryar Rahmani , Sina Nosrat Sheybani , Dina Seyedi , Hamza Abdelmalik , Sara Parviz , Mahrouz Malek , Jonneke S. Kuperus , Mohammadreza Tahamtan","doi":"10.1016/j.semarthrit.2025.152892","DOIUrl":"10.1016/j.semarthrit.2025.152892","url":null,"abstract":"<div><h3>Objectives</h3><div>Diffuse idiopathic skeletal hyperostosis (DISH) is a systemic condition characterized by ligamentous ossification along the spine. While its prevalence has been well described in the general population, data on its occurrence in oncology patients remain limited. This study aimed to assess the prevalence and distribution of DISH and early-phase DISH in newly diagnosed cancer patients undergoing initial staging with Computed Tomography (CT).</div></div><div><h3>Materials and methods</h3><div>In this retrospective cross-sectional study, 1053 adult oncology patients who underwent thoraco-abdominopelvic CT for initial staging were evaluated. DISH and early-phase DISH were diagnosed using established radiologic criteria. Vertebral body densities were measured, and associated extraspinal enthesopathies and ligamentous ossifications were documented.</div></div><div><h3>Results</h3><div>DISH was present in 30.3 % of patients, including 13.8 % with established DISH and 16.5 % with early-phase DISH. Prevalence was higher in older patients and males <strong>(<em>p</em> < 0.01).</strong> Notably, renal (43.2 %), gastric (37.5 %), and colorectal (33.7 %) cancers demonstrated significantly higher DISH rates, whereas esophageal cancer showed a lower prevalence (13.4 %). DISH was associated with decreased vertebral bone density and frequent extraspinal enthesopathies. No significant correlations were found with BMI, diabetes, or hypertension.</div></div><div><h3>Conclusion</h3><div>DISH is common among oncology patients and often coexists with extraspinal enthesopathies and reduced bone density. These findings suggest possible shared pathogenic mechanisms and underscore the importance of further studies exploring the relationship between DISH and malignancy.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"76 ","pages":"Article 152892"},"PeriodicalIF":4.4,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145795046","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}
Pub Date : 2025-12-01DOI: 10.1016/j.semarthrit.2025.152865
Jessica A. Day , Daniel Brito de Araújo , Mickael Essouma , Edoardo Conticini , Lisa G. Rider , Daren Gibson , Adriana Maluf Elias , Claudia Saad Magalhães , Simone Appenzeller , Adam Schiffenbauer , Anneke J van der Koi , Siamak Moghadam-Kia , Vitor Tavares Paula , Julio Brandão Guimarães , Edoardo Marrani , Andrea Schwarz Doria , Samuel Katsuyuki Shinjo , IMACS WBMRI in Myopathies Working Group
Magnetic resonance imaging (MRI) has emerged as a key non-invasive tool for the evaluation of idiopathic inflammatory myopathies (IIM); however, heterogeneity in techniques, protocols, and grading systemics impedes standardization. This scoping review systematically examined the MRI techniques, protocols, and grading systems reported in the adult IIM literature. A systematic search of PubMed, EMBASE, and Cochrane databases was conducted from 2000 to 2024 using keywords related to IIM and MRI. Studies involving adults with IIM who underwent MRI were screened and reviewed for inclusion. Forty-nine studies were included in the analysis, 13 of which evaluated whole-body MRI and 36 evaluated dedicated body-part MRI, collectively reporting data from 2810 IIM patients. A wide range of imaging protocols was observed with variations in scanner type, field strength, sequence combinations, and anatomical coverage. Semi-quantitative visual grading was the most commonly used assessment method (31/49, 63.2 %), with binary scoring in 23/31 and software-assisted or automated techniques in 8/31. Six studies used descriptive analysis alone. Inter-rater agreement was reported in 15 studies, with variable reliability observed for both muscle edema (intraclass correlation coefficient [ICC] range: 0.78–1.00; kappa range: 0.30–1.00) and replacement of skeletal muscle by fat (ICC range: 0.77–0.97; kappa range: 0.54–0.93). Several studies have reported that WB-MRI patterns correlate with clinical measures of disease activity and can discriminate between myopathic diseases and IIM subtypes. In summary, despite the clinical utility of MRI for IIM, significant methodological variability remains. Future research should focus on standardizing protocols and grading systems to enhance the consistency and reliability of MRI assessments for IIM.
{"title":"Magnetic resonance imaging for adult idiopathic inflammatory myopathies: A scoping review of protocols, grading systems and applications","authors":"Jessica A. Day , Daniel Brito de Araújo , Mickael Essouma , Edoardo Conticini , Lisa G. Rider , Daren Gibson , Adriana Maluf Elias , Claudia Saad Magalhães , Simone Appenzeller , Adam Schiffenbauer , Anneke J van der Koi , Siamak Moghadam-Kia , Vitor Tavares Paula , Julio Brandão Guimarães , Edoardo Marrani , Andrea Schwarz Doria , Samuel Katsuyuki Shinjo , IMACS WBMRI in Myopathies Working Group","doi":"10.1016/j.semarthrit.2025.152865","DOIUrl":"10.1016/j.semarthrit.2025.152865","url":null,"abstract":"<div><div>Magnetic resonance imaging (MRI) has emerged as a key non-invasive tool for the evaluation of idiopathic inflammatory myopathies (IIM); however, heterogeneity in techniques, protocols, and grading systemics impedes standardization. This scoping review systematically examined the MRI techniques, protocols, and grading systems reported in the adult IIM literature. A systematic search of PubMed, EMBASE, and Cochrane databases was conducted from 2000 to 2024 using keywords related to IIM and MRI. Studies involving adults with IIM who underwent MRI were screened and reviewed for inclusion. Forty-nine studies were included in the analysis, 13 of which evaluated whole-body MRI and 36 evaluated dedicated body-part MRI, collectively reporting data from 2810 IIM patients. A wide range of imaging protocols was observed with variations in scanner type, field strength, sequence combinations, and anatomical coverage. Semi-quantitative visual grading was the most commonly used assessment method (31/49, 63.2 %), with binary scoring in 23/31 and software-assisted or automated techniques in 8/31. Six studies used descriptive analysis alone. Inter-rater agreement was reported in 15 studies, with variable reliability observed for both muscle edema (intraclass correlation coefficient [ICC] range: 0.78–1.00; kappa range: 0.30–1.00) and replacement of skeletal muscle by fat (ICC range: 0.77–0.97; kappa range: 0.54–0.93). Several studies have reported that WB-MRI patterns correlate with clinical measures of disease activity and can discriminate between myopathic diseases and IIM subtypes. In summary, despite the clinical utility of MRI for IIM, significant methodological variability remains. Future research should focus on standardizing protocols and grading systems to enhance the consistency and reliability of MRI assessments for IIM.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"75 ","pages":"Article 152865"},"PeriodicalIF":4.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145662081","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}
Pub Date : 2025-12-01DOI: 10.1016/j.semarthrit.2025.152881
Rodrigo Garcia-Salinas , Nataly MeJia-Maggi , Felicia Almada , Gisel Reyes-Jara , Alvaro Ruta , Juan Arguello , Sebastian Magri , Daniel Aletaha
Background
Seropositive arthralgia (SA), defined as joint pain without clinical synovitis in individuals positive for rheumatoid factor (RF) and/or anti-citrullinated protein antibodies (ACPA), is considered a preclinical stage of rheumatoid arthritis (RA). Early identification of individuals at risk is key for timely intervention. Objectives: To estimate the prevalence of SA in a large early arthritis cohort, compare its baseline features with RA, and identify predictors of progression to RA at one year.
Methods
This prospective study was conducted within Reuma-Check, a structured diagnostic program for early rheumatologic assessment in Argentina. Patients with SA and RA were identified based on standardized clinical, serological, and imaging assessments. SA patients were followed for 12 months. Logistic regression was used to identify independent predictors of RA development.
Results
Among 1730 patients, 208 (12%) were classified as SA and 225 (13%) as RA. Compared to RA, SA patients had fewer tender and swollen joints, lower inflammatory markers, and less Power Doppler positivity on ultrasound. At one year, 21% of SA patients progressed to RA, 14% developed other immune-mediated conditions, and 65% remained stable. In multivariate analysis, ACPA positivity was the only independent predictor of RA progression (OR: 7.7, 95% CI: 1.2–60).
Conclusions
In the Reuma-Check cohort, among individuals with seropositive arthralgia, ACPA positivity is the most robust predictor of progression to rheumatoid arthritis at 1 year.
{"title":"Progression from seropositive arthralgia to rheumatoid arthritis: One-year predictors from a large cohort in the Reuma-Check program","authors":"Rodrigo Garcia-Salinas , Nataly MeJia-Maggi , Felicia Almada , Gisel Reyes-Jara , Alvaro Ruta , Juan Arguello , Sebastian Magri , Daniel Aletaha","doi":"10.1016/j.semarthrit.2025.152881","DOIUrl":"10.1016/j.semarthrit.2025.152881","url":null,"abstract":"<div><h3>Background</h3><div>Seropositive arthralgia (SA), defined as joint pain without clinical synovitis in individuals positive for rheumatoid factor (RF) and/or anti-citrullinated protein antibodies (ACPA), is considered a preclinical stage of rheumatoid arthritis (RA). Early identification of individuals at risk is key for timely intervention. Objectives: To estimate the prevalence of SA in a large early arthritis cohort, compare its baseline features with RA, and identify predictors of progression to RA at one year.</div></div><div><h3>Methods</h3><div>This prospective study was conducted within Reuma-Check, a structured diagnostic program for early rheumatologic assessment in Argentina. Patients with SA and RA were identified based on standardized clinical, serological, and imaging assessments. SA patients were followed for 12 months. Logistic regression was used to identify independent predictors of RA development.</div></div><div><h3>Results</h3><div>Among 1730 patients, 208 (12%) were classified as SA and 225 (13%) as RA. Compared to RA, SA patients had fewer tender and swollen joints, lower inflammatory markers, and less Power Doppler positivity on ultrasound. At one year, 21% of SA patients progressed to RA, 14% developed other immune-mediated conditions, and 65% remained stable. In multivariate analysis, ACPA positivity was the only independent predictor of RA progression (OR: 7.7, 95% CI: 1.2–60).</div></div><div><h3>Conclusions</h3><div>In the Reuma-Check cohort, among individuals with seropositive arthralgia, ACPA positivity is the most robust predictor of progression to rheumatoid arthritis at 1 year.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"75 ","pages":"Article 152881"},"PeriodicalIF":4.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145588943","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}
Pub Date : 2025-12-01DOI: 10.1016/j.semarthrit.2025.152880
Takuma Ohnishi , Megan Zhao , Min Shi , Rita Volochayev , Sharon H Jackson , Anna Jansen , Nastaran Bayat , Payam Noroozi Farhadi , Kakali Sarkar , Willy A Flegel , Christine G Parks , Clarice R Weinberg , Frederick W Miller , Adam Schiffenbauer , Lisa G Rider
Objective
Systemic autoimmune rheumatic diseases (SARDs) are influenced by genetic and environmental factors. We examined pregnancy complications, early life events (birth season, birth order, feeding), and exposures to tobacco smoking in relation to SARD diagnosis.
Methods
In a case-control study, probands with SARDs were compared to same-sex close-in-age unaffected siblings (US), and demographically-matched unrelated controls (UC); 329 children (probands=124, US=115, UC=90) and 184 adults (probands=76, US=63, UC=45) were included. Conditional and unconditional logistic regression were used to examine proband–US and proband-UC comparisons. We examined associations between SARDs and exposures to smoking while adjusting for HLA-DRB1*03:01 in White probands and UC.
Results
No specific pregnancy complication was associated with SARDs; however, the total number of pregnancy complications was greater in juvenile probands. A higher proportion of juvenile-onset probands than UC were exposed to tobacco smoking, both in utero and after birth (prenatal, 20 % vs 4 %, OR=4.04, 95 %CI=1.20–17.7; household smoking before age 3, 14 % vs 3 %, OR=4.83, 95 %CI=1.31–26.1). Among adult-onset probands and US, household smoking exposure before age 10 was associated with SARDs (60 % vs 42 %, OR=10.06, 95 %CI=1.23–82.0). Among White subjects, HLA-DRB1*03:01 was associated with SARDs (juvenile-onset OR=2.03, 95 %CI=1.04–4.10; adult-onset OR=7.67, 95 %CI=2.72–26.4). After adjusting for HLA-DRB1*03:01, household smoking exposure was associated with juvenile- and adult-onset SARDs (OR=5.49, 95 %CI=1.22–39.7, and OR=4.01, 95 %CI=1.11–17.2).
Conclusion
Early life exposure to tobacco smoking is associated with SARDs; the effect remained after adjusting for the genetic risk of HLA. These findings support a role for early environmental exposures in autoimmune diseases.
{"title":"In utero and early life exposures to smoking are associated with systemic autoimmune rheumatic diseases","authors":"Takuma Ohnishi , Megan Zhao , Min Shi , Rita Volochayev , Sharon H Jackson , Anna Jansen , Nastaran Bayat , Payam Noroozi Farhadi , Kakali Sarkar , Willy A Flegel , Christine G Parks , Clarice R Weinberg , Frederick W Miller , Adam Schiffenbauer , Lisa G Rider","doi":"10.1016/j.semarthrit.2025.152880","DOIUrl":"10.1016/j.semarthrit.2025.152880","url":null,"abstract":"<div><h3>Objective</h3><div>Systemic autoimmune rheumatic diseases (SARDs) are influenced by genetic and environmental factors. We examined pregnancy complications, early life events (birth season, birth order, feeding), and exposures to tobacco smoking in relation to SARD diagnosis.</div></div><div><h3>Methods</h3><div>In a case-control study, probands with SARDs were compared to same-sex close-in-age unaffected siblings (US), and demographically-matched unrelated controls (UC); 329 children (probands=124, US=115, UC=90) and 184 adults (probands=76, US=63, UC=45) were included. Conditional and unconditional logistic regression were used to examine proband–US and proband-UC comparisons. We examined associations between SARDs and exposures to smoking while adjusting for <em>HLA-DRB1*03:01</em> in White probands and UC.</div></div><div><h3>Results</h3><div>No specific pregnancy complication was associated with SARDs; however, the total number of pregnancy complications was greater in juvenile probands. A higher proportion of juvenile-onset probands than UC were exposed to tobacco smoking, both in utero and after birth (prenatal, 20 % vs 4 %, OR=4.04, 95 %CI=1.20–17.7; household smoking before age 3, 14 % vs 3 %, OR=4.83, 95 %CI=1.31–26.1). Among adult-onset probands and US, household smoking exposure before age 10 was associated with SARDs (60 % vs 42 %, OR=10.06, 95 %CI=1.23–82.0). Among White subjects, <em>HLA-DRB1*03:01</em> was associated with SARDs (juvenile-onset OR=2.03, 95 %CI=1.04–4.10; adult-onset OR=7.67, 95 %CI=2.72–26.4). After adjusting for <em>HLA-DRB1*03:01</em>, household smoking exposure was associated with juvenile- and adult-onset SARDs (OR=5.49, 95 %CI=1.22–39.7, and OR=4.01, 95 %CI=1.11–17.2).</div></div><div><h3>Conclusion</h3><div>Early life exposure to tobacco smoking is associated with SARDs; the effect remained after adjusting for the genetic risk of HLA. These findings support a role for early environmental exposures in autoimmune diseases.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"75 ","pages":"Article 152880"},"PeriodicalIF":4.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145605602","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}
Pub Date : 2025-12-01DOI: 10.1016/j.semarthrit.2025.152887
Jeffrey B. Driban , Julieann C. Patarini , Shao-Hsien Liu , Timothy E. McAlindon , Kate L. Lapane , Stephenie C. Lemon , Adrian H. Zai , Michael C. Nevitt , Marc C. Hochberg , Jane A. Cauley , Charles B. Eaton , Susan Rubin , Erika Schneider , Grace H. Lo
{"title":"The state of the Osteoarthritis Initiative (OAI): Entering a new era","authors":"Jeffrey B. Driban , Julieann C. Patarini , Shao-Hsien Liu , Timothy E. McAlindon , Kate L. Lapane , Stephenie C. Lemon , Adrian H. Zai , Michael C. Nevitt , Marc C. Hochberg , Jane A. Cauley , Charles B. Eaton , Susan Rubin , Erika Schneider , Grace H. Lo","doi":"10.1016/j.semarthrit.2025.152887","DOIUrl":"10.1016/j.semarthrit.2025.152887","url":null,"abstract":"","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"75 ","pages":"Article 152887"},"PeriodicalIF":4.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145620339","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":"Critical commentary: Factors associated with thrombosis in Behçet syndrome: A systematic review and meta-analysis","authors":"Saketh Sainag Mandiga , Venkata Dileep Kumar Veldi , Digvijay Singh Rajawat","doi":"10.1016/j.semarthrit.2025.152875","DOIUrl":"10.1016/j.semarthrit.2025.152875","url":null,"abstract":"","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"75 ","pages":"Article 152875"},"PeriodicalIF":4.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145588910","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}