Joint Bone Spine最新文献

{"title":"An inflammatory mass of periodontoid space resulting from calcium crystal deposition","authors":"Sophie Pouplin, Mathilde Baril, Benjamin Hebant","doi":"10.1016/j.jbspin.2025.105987","DOIUrl":"10.1016/j.jbspin.2025.105987","url":null,"abstract":"","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"93 1","pages":"Article 105987"},"PeriodicalIF":4.3,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253812","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":"Epidemiology, outcomes, and expenditures of hospitalized patients with systemic sclerosis: Insights from the U.S. National Inpatient Sample","authors":"Patompong Ungprasert ,&nbsp;Paul T. Kroner","doi":"10.1016/j.jbspin.2025.105985","DOIUrl":"10.1016/j.jbspin.2025.105985","url":null,"abstract":"<div><h3>Objectives</h3><div>The inpatient epidemiology, morbidity, mortality, and healthcare expenditures associated with systemic sclerosis (SSc) remain poorly characterized. This study utilizes a national inpatient database to provide a comprehensive assessment of these parameters.</div></div><div><h3>Methods</h3><div>We identified adult patients with SSc from the 2021 National Inpatient Sample (NIS) using ICD-10-CM codes. The NIS, the largest publicly available all-payer inpatient healthcare database in the U.S., represents data from over 4000 non-federal acute care hospitals. A matched comparator group without SSc was created to serve as comparators. Extracted data included demographics, primary admission diagnoses, length of stay (LOS), in-hospital mortality and morbidity, comorbidities, and healthcare expenditures. Multivariable analyses were adjusted for age, sex, race/ethnicity, Charlson Comorbidity Index, payer type, median income, and hospital characteristics.</div></div><div><h3>Results</h3><div>The inpatient prevalence of SSc was 86.7 per 100,000 admissions. The most common primary diagnoses among SSc hospitalizations were sepsis (22.7%), heart failure with hypertension (14.4%), and COVID-19 (11.5%). The cohort was predominantly female (84.2%) with a mean age of 63.5 years. Compared to non-SSc admissions, SSc hospitalizations were associated with significantly longer LOS (mean difference 0.7 days; 95% CI: 0.5–0.9) and greater healthcare costs, including an adjusted mean increase of $3277 in hospital costs (95% CI: $2051–$4504) and $11,801 in total charges (95% CI: $6485–$17,116). SSc was also associated with increased odds of in-hospital mortality (adjusted OR 1.42; 95% CI: 1.26–1.61), shock (aOR 1.30; 95% CI: 1.17–1.44), systemic inflammatory response syndrome (aOR 1.32; 95% CI: 1.01–1.74), and acute respiratory distress syndrome (aOR 1.45; 95% CI: 1.12–1.87). Multivariate analysis also revealed that patients with SSc had significantly higher odds of several comorbid conditions, including pulmonary hypertension, interstitial lung disease, osteoporosis, Sjögren's syndrome, and hypertension.</div></div><div><h3>Conclusions</h3><div>The inpatient prevalence of SSc exceeds its general population prevalence, indicating a high need for hospital-level care. Hospitalizations among patients with SSc are associated with worse clinical outcomes and significantly greater healthcare expenditures.</div></div>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"93 2","pages":"Article 105985"},"PeriodicalIF":4.3,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214554","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":"Teleconsultation for rheumatoid arthritis: A selective therapeutic tool in routine care","authors":"Jérôme Avouac,&nbsp;Olivier Fogel,&nbsp;Anna Molto,&nbsp;Yannick Allanore","doi":"10.1016/j.jbspin.2025.105983","DOIUrl":"10.1016/j.jbspin.2025.105983","url":null,"abstract":"","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"93 2","pages":"Article 105983"},"PeriodicalIF":4.3,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214560","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":"Social and occupational factors are associated with musculoskeletal pain prevalence in the general population: A population-based cohort study","authors":"Florian Bailly ,&nbsp;Benjamin Granger ,&nbsp;Violaine Foltz ,&nbsp;Sofiane Kab ,&nbsp;Audrey Petit ,&nbsp;Florence Tubach ,&nbsp;Bruno Fautrel","doi":"10.1016/j.jbspin.2025.105984","DOIUrl":"10.1016/j.jbspin.2025.105984","url":null,"abstract":"<div><h3>Objective</h3><div>Musculoskeletal pain (MP) is a leading cause of disability worldwide, affecting individual well-being and public health. However, in the literature, the prevalence of MP varies considerably because of methodological inconsistencies, selection biases, and differences in case definitions. This study aimed to estimate the population-based prevalence of MP in France and identify key demographic, socioeconomic, and occupational factors associated with MP.</div></div><div><h3>Methods</h3><div>This cross-sectional study used baseline data for the CONSTANCES cohort study, a large, population-based epidemiological study with participants representative of the French adult population (18–69<!--> <!-->years old). Inverse probability weighting was used to correct for selection bias and to improve the generalizability of prevalence estimates. MP was assessed with the Nordic Musculoskeletal Questionnaire, with significant pain defined as lasting<!--> <!-->&gt;<!--> <!-->30<!--> <!-->days in the past 12<!--> <!-->months. Multivariate logistic regression models were used to identify factors associated with low back pain, estimating odds ratios (ORs) and 95% confidence intervals (CIs).</div></div><div><h3>Results</h3><div>Among 193,436 participants, 46.2% reported pain in at least one anatomical site. The most affected areas were the low back (26.6% adjusted prevalence), shoulder (21.4%), neck (19.0%), and knee (19.1%). Odds of low back pain was associated with female sex (OR: 1.39 [95% CI: 1.32–1.47]), older age, obesity, depression (1.71 [1.62–1.80]), and comorbidity burden (1.20 [1.15–1.25]). Odds of low back pain was associated with moderate or high occupational physical activity (OR: 1.33 [1.20–1.50] and 1.69 [1.48–1.93]) but was inversely associated with very active leisure-time physical activity (0.82 [0.70–0.96]). Education level but not household income was a significant socioeconomic factor associated with MP.</div></div><div><h3>Conclusion</h3><div>MP imposes a substantial burden on the French population, particularly among individuals with physically demanding jobs and low education levels. These findings highlight the paradox of physical activity associated with MP.</div></div>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"93 2","pages":"Article 105984"},"PeriodicalIF":4.3,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208181","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":"Novel CNNM2 variant causing hypomagnesemia and early-onset calcium pyrophosphate deposition disease: A case report","authors":"Caroline Robert ,&nbsp;Léa Perrot ,&nbsp;Alexia Zelus ,&nbsp;Emmanuel Letavernier ,&nbsp;Guillaume Courbon ,&nbsp;Pierre Lafforgue ,&nbsp;Thomas Robert ,&nbsp;Nathalie Balandraud","doi":"10.1016/j.jbspin.2025.105982","DOIUrl":"10.1016/j.jbspin.2025.105982","url":null,"abstract":"<div><div>Calcium pyrophosphate deposition (CPPD) disease is a common crystal arthropathy in the elderly, but its early-onset forms are rare. While secondary hypomagnesemia is a recognized contributor to CCPD, inherited renal magnesium-wasting syndromes remain underdiagnosed. Here we performed a whole exome sequencing (ES) in order to detect pathogenic variants in a 58-year-old male patient with early and severe, refractory CPPD disease. We conducted a comprehensive clinical, biochemical, radiological, and genetic evaluation of the patient. ES was performed and filtered for rare, likely pathogenic variants following ACMG/AMP criteria. Cascade genetic testing was performed in family members. Hypomagnesemia with inappropriate renal magnesium loss was found. Radiographs revealed diffuse chondrocalcinosis ES identified a novel heterozygous Cyclin and CBS Domain Divalent Metal Cation Transport Mediator (CNNM2) missense variant (c.319G&gt;C; p.Gly107Arg), absent from population databases and predicted deleterious (REVEL 0.82). This variant affects a highly conserved residue in the extracellular β-barrel domain. Family screening revealed two additional carriers with isolated hypomagnesemia, consistent with autosomal dominant inheritance. CNNM2 encodes a basolateral magnesium transporter in the tubule. This is the first reported case of CPPD linked to a CNNM2 variant through persistent hypomagnesemia. Its variants have been linked to renal hypomagnesemia, neurological comorbidities, but no link to CPPD has been described. This expands the phenotypic spectrum of CNNM2-related disorders and highlights the relevance of genetic testing in CPPD cases with unexplained hypomagnesemia. Building on published functional studies and domain-level protein modeling, we propose a simplified three-tier classification scheme that organizes CNNM2 variants into clinically meaningful categories.</div></div>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"93 1","pages":"Article 105982"},"PeriodicalIF":4.3,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193892","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":"Current understanding of the challenges in the diagnosis and management of spondyloarthritis in older adults","authors":"Jacob Corum Williams ,&nbsp;Helena Marzo-Ortega","doi":"10.1016/j.jbspin.2025.105981","DOIUrl":"10.1016/j.jbspin.2025.105981","url":null,"abstract":"<div><div>Spondyloarthritis (SpA) encompasses a group of immune-mediated, inflammatory diseases, most notably axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA). As the global population ages, so does the population living with these conditions. Age-related immune changes — including chronic low-grade inflammation and the accumulation of senescent T cells — are increasingly recognised as contributors to disease pathophysiology in these individuals. People over the age of 50 often present with a distinct clinical phenotype, including more peripheral arthritis, dactylitis, and psoriasis. A subset may also present with pitting oedema and polymyalgic symptoms, sometimes associated with underlying malignancy. Imaging in older adults can be challenging, as structural and inflammatory changes such as bone marrow oedema and erosions may be seen in asymptomatic individuals without SpA, increasing the risk of misdiagnosis. Age-related comorbidities — including frailty, sarcopenia, falls, fractures, and dementia — occur more frequently in older individuals with SpA, further complicating diagnosis and treatment. Despite this, therapeutic responses appear similar to those in younger populations, particularly with tumour necrosis factor inhibitors (TNFi). Nonetheless, clinicians must be cautious of increased risks of serious infection and heart failure in this age group. Important questions remain about the long-term safety of disease-modifying antirheumatic drugs (DMARDs) in older patients and the efficacy and tolerability of newer biologic or synthetic agents targeting interleukin-17 (IL-17), IL-12/23 and Janus Kinases (JAK) pathways. A better understanding of SpA in older age is critical to delivering effective, individualised care to this growing population.</div></div>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"93 1","pages":"Article 105981"},"PeriodicalIF":4.3,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193933","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":"Vaccinating patients with autoimmune diseases","authors":"Ai Li Yeo ,&nbsp;Kevin L. Winthrop","doi":"10.1016/j.jbspin.2025.105978","DOIUrl":"10.1016/j.jbspin.2025.105978","url":null,"abstract":"<div><h3>Purpose</h3><div>Vaccine preventable diseases, especially respiratory infections, occur at higher frequency in patients with rheumatic diseases who are immunosuppressed. The focus of this review is to highlight vaccinations that patients with rheumatic diseases should optimally receive, with a focus on efficacy and safety of vaccines.</div></div><div><h3>Main findings</h3><div>In general, vaccines are effective in reducing the burden of infection. However, due to underlying immunosuppression, their efficacy is most likely reduced compared to the general population. This is even true of the novel vaccines, mRNA and subunit vaccines. Emerging evidence, particularly for withholding methotrexate for 1–2 weeks post vaccination can improve immunogenicity without significantly increasing the risk of disease flare. Administration of live vaccines continue to provide clinicians a challenge especially in the setting of recent measles outbreaks. Assessing underlying degree of immunosuppression and following national guidelines can help clinicians vaccinate these patients safely. If this is not possible, then measles immunoglobulin can be administered.</div></div><div><h3>Principle conclusions</h3><div>Vaccination is an important part of infection reduction strategies for the rheumatologist to consider during a consultation as the number of vaccines available for infective conditions increases. High dose prednisolone, B cell depleting therapies, and methotrexate have the most evidence for reduced vaccine responses and where feasible, attempts should be made to vaccinate when immunosuppression is thought to be lower.</div></div>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"93 2","pages":"Article 105978"},"PeriodicalIF":4.3,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187424","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":"A new biochemical score from synovial fluid for diagnosing septic arthritis","authors":"Isabelle Sacco ,&nbsp;Chayma Saadan ,&nbsp;Laura Pina Vegas ,&nbsp;Xavier Chevalier ,&nbsp;Bérénice Souhail ,&nbsp;Raphael Lepeule ,&nbsp;Nadia Oubaya ,&nbsp;Jean-Philippe Bastard ,&nbsp;Soraya Fellahi ,&nbsp;Florent Eymard","doi":"10.1016/j.jbspin.2025.105980","DOIUrl":"10.1016/j.jbspin.2025.105980","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the diagnostic performance of synovial fluid (SF) biochemical markers and assess the value of combining their measurements into a composite score for identifying septic arthritis (SA).</div></div><div><h3>Methods</h3><div>Patients who underwent arthrocentesis with SF biochemical analysis (proteins, glucose, lactate dehydrogenase (LDH), lactate) were included in the initial cohort (IC) (May 2018-May 2021) or the validation cohort (June 2021–March 2023). Using IC data, we compared marker levels in SA vs. non-SA and vs. crystal-related arthritis (C-rA) subgroup. Based on receiver operating characteristic (ROC) curves, we identified two thresholds (one optimizing sensitivity, the other specificity) to assign a score of 0–2 for each biomarker. We developed a composite score by combining the individual scores for discriminative biomarkers and assessed its diagnostic performance.</div></div><div><h3>Results</h3><div>We included 190 SF (170 patients) in the IC; 36 SF (18.9%) were septic. Glucose level was lower in SA than non-SA and C-rA, but lactate and LDH levels were higher (<em>P</em> <!-->&lt;<!--> <!-->0.001). The composite score was developed with a 0–6 scale, with the following thresholds: glucose (≤<!--> <!-->7 and ≤<!--> <!-->1.5<!--> <!-->mmol/L), lactate (≥<!--> <!-->4.5 and ≥<!--> <!-->7.5<!--> <!-->mmol/L), and LDH (≥<!--> <!-->600 and ≥<!--> <!-->1200 UI/L). A composite score ≥<!--> <!-->3 had 100% sensitivity and 73.9% specificity for SA diagnosis in the IC cohort, and a score≥<!--> <!-->5 had 55.5% sensitivity and 97.8% specificity. These findings were consistent in the validation cohort.</div></div><div><h3>Conclusion</h3><div>A combined score based on SF markers including glucose, LDH, and lactate may be an effective method for rapidly ruling out SA. A multicentric study is warranted to confirm these results.</div></div>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"93 2","pages":"Article 105980"},"PeriodicalIF":4.3,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187497","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":"Axial spondyloarthritis and polymyalgia rheumatica: When differential diagnosis is not that obvious","authors":"Margarida Lucas Rocha ,&nbsp;Sofia Ramiro ,&nbsp;Alexandre Sepriano","doi":"10.1016/j.jbspin.2025.105977","DOIUrl":"10.1016/j.jbspin.2025.105977","url":null,"abstract":"","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"93 2","pages":"Article 105977"},"PeriodicalIF":4.3,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187443","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":"Pyomyositis of the obturator internus muscle","authors":"Théo Renaud ,&nbsp;Adrien Le Pluart ,&nbsp;Paul Arnolfo ,&nbsp;Christelle Darrieutort-Laffite","doi":"10.1016/j.jbspin.2025.105979","DOIUrl":"10.1016/j.jbspin.2025.105979","url":null,"abstract":"","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"92 6","pages":"Article 105979"},"PeriodicalIF":4.3,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187449","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}