Joint Bone Spine最新文献

Objective: Dactylitis has been identified as an important feature of psoriatic arthritis (PsA) with poorer prognosis. Moreover, ultrasound can reveal subclinical dactylitis, however its significance is unclear. Therefore, in this study we aimed to determine the impact of subclinical dactylitis on PsA severity.

Methods: The study was performed based on the PKUPsA cohort. Patients with complete ultrasound assessment on synovitis, tenosynovitis, and soft tissue of both hands and feet were recruited. They were further classified into subgroups based on the presence of clinical or ultrasound evidence of dactylitis. Their clinical characteristics were compared.

Results: Among the 223 PsA patients enrolled, there were 90 (40.4%) patients with clinical manifestations of dactylitis (clinical dactylitis group), 26 (11.7%) with evidence of dactylitis on ultrasound however not on physical examination (subclinical dactylitis group), and 107 (47.9%) patients with neither clinical nor ultrasound evidence of dactylitis (no-dactylitis group). Compared with no-dactylitis group, patients in clinical dactylitis group had more swollen joint count (4 vs 2, P<0.01), tender joint count (4 vs 3, P<0.05), and greater median disease activity index in PsA (DAPSA) (25.0 vs 18.3, P<0.05). Moreover, 116 PsA patients in clinical dactylitis or subclinical dactylitis groups also had more tender joint count (4 vs 2, P<0.01), swollen joint count (4 vs 3, p<0.001), median C reactive protein levels (18.1 vs 11.8, P<0.05) and median DAPSA scores (25.5 vs 16.1, P<0.01). Even excluding the digits with dactylitis from counting, the swollen joint count of 116 patients with dactylitis remained significantly greater than that of no-dactylitis group (3 vs 2, P<0.01). 26 patients in subclinical dactylitis group also showed significantly higher DAPSA scores (27.2 vs 16.1, P<0.05), more swollen joint count (4.5 vs 2, P<0.01) and tender joint count (5 vs 3, P<0.05) than no-dactylitis group.

Conclusion: Subclinical dactylitis also represents a more active phenotype of PsA, which calls for more attention and probably more aggressive therapy.

Objectives: This systematic review aims to (1) summarize the clinical, laboratory, and imaging characteristics of Palmar Fasciitis and Polyarthritis Syndrome (PFPAS) patients and (2) evaluate the effectiveness of different treatments.

Methods: We conducted a systematic search of three electronic databases (Scopus, Embase, and PubMed) from inception to December 31, 2023. We presented demographic and clinical features, along with laboratory factors and imaging examinations of PFPAS patients. Additionally, we outline main treatments and evaluate therapeutic effectiveness.

Results: A total of 121 patients were included in the analysis, with a mean onset age of 61.4 years. Swelling or thickening (49.6%, n=60/121) and pain (41.3%, n=50/121) were characteristic musculoskeletal symptoms of the hands. The median time between onset of PFPAS symptoms and detection of malignancy was 4 months, with a median survival of 13.0 months (range = 2 to 69). The abnormal rate of ultrasound, magnetic resonance imaging, and bone scan of the musculoskeletal system was more than 80%. Effective therapeutic responses were observed in 66.0% (n=33/50) of cases treated with chemotherapies and 79.2% (n=19/24) with operations. Two patients who received biologics achieved partial remission.

Conclusion: PFPAS is a rare paraneoplastic condition, and early recognition of its distinctive symptoms may lead to the detection of underlying malignancy and timely treatments, potentially saving lives.

Objectives: To investigate dietary practices and beliefs of patients with rheumatic and musculoskeletal diseases (RMDs) and associated factors.

Methods: In 2019-2020, a cross-sectional multicentre study enrolled patients with inflammatory arthritis (IA) (rheumatoid arthritis [RA], axial spondyloarthritis [axSpA]) or hand osteoarthritis (HOA) from secondary- and tertiary-care centres. A self-administered questionnaire explored dietary practices and patients' perceived effects of diet, foods and beverages on symptoms. Univariable and multivariable analyses investigated factors associated with diets and patients' views.

Results: Of 448 included patients, data for 392 were analysed (123 with RA, 161 with axSpA, 108 with HOA), 26% were on or had been on at least one exclusion diet (mostly cow's milk- and gluten-free diets in IA, mostly cow's milk-free diet and detox/fasting in HOA). Only 5% of patients followed the Mediterranean diet. Among patients who had tried a diet, 51% reported a decrease in pain. Overall, 42% of patients identified at least one food or beverage that increased or decreased pain. On multivariable analyses, dieting or the perceived effect of food on pain was associated with health beliefs (positive or negative), the use of complementary and alternative medicines, and lack of support or information from healthcare professionals. Patients had received little dietary information from their physicians.

Conclusions: This study provides insights into patients' dietary practices and factors associated with these practices, including patients' health beliefs and insufficient support by health professionals, in RMDs.