Non-hip/non-vertebral fractures – How to treat best?
Publication date: Available online 16 May 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Pierre Hoffmeyer, Hermes Miozzari, Nicolas HolzerAbstractFractures of the extremities in the elderly constitute more than two-thirds of all fragility fractures befalling frail, osteoporotic and sarcopenic patients. Although treatment controversies abound, consensus exists. Upper extremity fractures hinder activities of daily living and are debilitating. Open fractures or displaced fractures will need surgical intervention. Wrist fractures treated operatively allow early use of the hand. Most pelvic fractures a...
Source: Best Practice and Research Clinical Rheumatology - May 17, 2019 Category: Rheumatology Source Type: research

Fracture liaison programs
Publication date: Available online 16 May 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Piet Geusens, Sandrine P.G. Bours, Caroline E. Wyers, Joop P. van den BerghAbstractIn view of the high imminent risk of having subsequent fractures after a fracture, early evaluation and treatment decisions to prevent subsequent fractures are advocated. After a hip fracture, the fracture liaison service (FLS) and orthogeriatric care are considered the most appropriate organisational approaches for secondary fracture prevention following a recent fracture.Their introduction and implementation have been shown to...
Source: Best Practice and Research Clinical Rheumatology - May 17, 2019 Category: Rheumatology Source Type: research

Vertebral fragility fractures – How to treat them?
Publication date: Available online 16 May 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Manuela L. Ferreira, Lyn MarchAbstractApproximately 20% of men and women aged 50 years or older will present with a vertebral fragility fracture - a prevalence that steadily increases with age. The condition may be associated with severe pain and disability, significant reductions in overall quality of life, mobility, social participation, sleep quality and increased fear for the future. There is, however, no current consensus on what constitutes the best management of symptomatic vertebral fractures. Moreover...
Source: Best Practice and Research Clinical Rheumatology - May 16, 2019 Category: Rheumatology Source Type: research

Principles and current concepts in the surgical treatment of fragility fractures in the elderly
Publication date: Available online 14 May 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Sascha Halvachizadeh, Henrik Teuber, Hans-Christoph Pape, Florin AllemannAbstractThe constant rise in fragility fractures is proportional to the constant rise in life expectancy. Treatment of fragility fractures can be challenging because of severe fractures, poor bone quality, significant co-morbidities, and reduced mobility. However, new surgical techniques and implants have been developed that address these challenges and show improvement in overall patient outcomes. This review addresses general considerat...
Source: Best Practice and Research Clinical Rheumatology - May 16, 2019 Category: Rheumatology Source Type: research

Secondary fracture prevention: Drug treatment, fall prevention and nutrition requirements
Publication date: Available online 13 May 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): P. Geusens, W.F. Lems, S. Bours, J.P. vd BerghAbstractIn view of the high imminent risk for subsequent fractures, evaluation as early as possible after the fracture will result in early decisions about drug treatment, fall prevention and nutritional supplements.Drug treatment includes anti-resorptive and bone forming agents. Anti-resorptive therapy with broad spectrum fracture prevention and early anti-fracture effects are the first choice. In patients with multiple or severe VFs, the bone forming agent teripa...
Source: Best Practice and Research Clinical Rheumatology - May 14, 2019 Category: Rheumatology Source Type: research

New concepts of pain
Publication date: Available online 13 May 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Anne-Priscille Trouvin, Serge PerrotAbstractActive research is being conducted on musculoskeletal pain, and recent concepts will help clinicians and researchers to develop better approaches:-the new pain taxonomy recently has been modified with a third descriptor with the concept of nociplastic pain.-the latest International Classification of Diseases (ICD-11) includes an IASP task force that developed a new classification system for pain. In this new classification, one can differentiate primary musculoskelet...
Source: Best Practice and Research Clinical Rheumatology - May 14, 2019 Category: Rheumatology Source Type: research

Interdisciplinary care of hip fractures: Orthogeriatric models, alternative models, interdisciplinary teamwork
Publication date: Available online 30 April 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Anette Hylen Ranhoff, Ingvild Saltvedt, Frede Frihagen, Johan Raeder, Sameer Maini, Olav SletvoldAbstractHip fractures are common among older people, and the prognosis is serious in terms of mobility, independence in daily life activities, and cognition, with 42% of patients never achieving the same function as before the fracture. Norway has the highest incidence of hip fractures, and the important tasks are to improve patient care and prevent new fractures.The aim was to develop Norwegian Guidelines for In...
Source: Best Practice and Research Clinical Rheumatology - April 30, 2019 Category: Rheumatology Source Type: research

Opportunities and challenges in the treatment of psoriatic arthritis
Publication date: Available online 25 April 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Oliver FitzGerald, Christopher RitchlinAbstractIn this chapter, we review the opportunities and challenges posed by the treatment options currently available in the treatment of psoriatic arthritis. Both established and new or emerging treatment options are discussed using a domain-based approach. Finally, approaches to how treatment can be optimized together with some clinical pearls are presented and discussed. With the increasing treatment options available, we need a better way of deciding which treatmen...
Source: Best Practice and Research Clinical Rheumatology - April 26, 2019 Category: Rheumatology Source Type: research

Macrophagic myofasciitis-associated dysfunctioning: An update of neuropsychological and neuroimaging features
Publication date: Available online 24 April 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Mehdi Aoun Sebaiti, Marie Abrivard, Paul Blanc-Durand, Axel Van Der Gucht, Sarah Souvannanorath, Paul Kauv, Romain K. Gherardi, Emmanuel Itti, François Jérôme AuthierAbstractMacrophagic myofasciitis (MMF) syndrome is a subtype of autoimmune/inflammatory syndrome induced by adjuvants (ASIA) or Shoenfeld's syndrome, characterized by the presence of stereotyped inflammatory lesions at muscle biopsy attesting the long-term persistence of aluminum hydroxide particles at the site of previous im...
Source: Best Practice and Research Clinical Rheumatology - April 25, 2019 Category: Rheumatology Source Type: research

Preface: Pearls in autoimmunity
Publication date: Available online 22 April 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Carlo Perricone, Yehuda Shoenfeld (Source: Best Practice and Research Clinical Rheumatology)
Source: Best Practice and Research Clinical Rheumatology - April 23, 2019 Category: Rheumatology Source Type: research

Hepatitis B and C infection in patients undergoing biologic and targeted therapies for rheumatic diseases
This article summarizes the prevalence and risk factors of hepatitis B and C reactivation in patients with rheumatic diseases undergoing biologic and targeted therapies, as well as the recommendations for screening, monitoring, and treatment of these infections. (Source: Best Practice and Research Clinical Rheumatology)
Source: Best Practice and Research Clinical Rheumatology - April 20, 2019 Category: Rheumatology Source Type: research

The forefront of autoimmunity
Publication date: Available online 19 April 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Carlo Perricone, Yehuda Shoenfeld (Source: Best Practice and Research Clinical Rheumatology)
Source: Best Practice and Research Clinical Rheumatology - April 20, 2019 Category: Rheumatology Source Type: research

Physical activity, exercise and rheumatoid arthritis: Effectiveness, mechanisms and implementation
Publication date: Available online 17 April 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): George S. Metsios, George D. KitasAbstractRheumatoid arthritis (RA) is characterised by functional disability, pain, fatigue and body composition alterations that can further impact on the physical dysfunction seen in RA. RA is also associated with systemic manifestations, most notably an increased risk for cardiovascular disease. There is strong evidence to suggest that increasing physical activity and/or exercise can simultaneously improve symptoms and reduce the impact of systemic manifestations in RA. Ho...
Source: Best Practice and Research Clinical Rheumatology - April 19, 2019 Category: Rheumatology Source Type: research

Myositis in clinical practice—relevance of new antibodies
Publication date: Available online 17 April 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Siamak Moghadam-Kia, Rohit Aggarwal, Chester V. OddisAbstractNovel classification schemes for idiopathic inflammatory myopathy are based on serologic and histopathologic features. The presence of specific myositis autoantibodies may correspond to particular clinical phenotypes. Patients with a known diagnosis of inflammatory myopathy require a prompt clinical evaluation and the assessment of myositis-associated autoantibodies. Patients possessing autoantibodies associated with ILD or those with any pulmonary...
Source: Best Practice and Research Clinical Rheumatology - April 19, 2019 Category: Rheumatology Source Type: research

Management of vaccination in rheumatic disease
Publication date: Available online 17 April 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Peter K.K. Wong, Patrick HanrahanAbstractAutoimmune inflammatory rheumatic diseases (AIIRD) such as rheumatoid arthritis and spondyloarthritis, including psoriatic arthritis and ankylosing spondylitis are associated with an increased risk of infection due to a combination of the immunosuppressive effect of the AIIRD, comorbidities, and use of corticosteroids and the immunosuppressive effect of conventional synthetic disease-modifying antirheumatic drugs (DMARDs), targeted synthetic (ts-) DMARDs, and biologic...
Source: Best Practice and Research Clinical Rheumatology - April 19, 2019 Category: Rheumatology Source Type: research

Management of pregnancy and lactation
Publication date: Available online 15 April 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Lisa R. Sammaritano, Bonnie L. BermasAbstractManagement of pregnancy in patients with rheumatic and musculoskeletal disorders is both challenging and rewarding. Most patients with rheumatic disease can have a successful pregnancy. Pregnancy outcome is improved when maternal autoimmune disease is stable or quiescent. Prepregnancy evaluation and counseling is important to identify risk factors for adverse maternal and pregnancy outcomes and to guide therapy and monitoring. Severe disease-related damage, diseas...
Source: Best Practice and Research Clinical Rheumatology - April 16, 2019 Category: Rheumatology Source Type: research

A comparison of a fluorescence enzyme immunoassay versus indirect immunofluorescence for initial screening of connective tissue diseases: Systematic literature review and meta-analysis of diagnostic test accuracy studies
Publication date: Available online 15 April 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Michelle Elaine Orme, Carmen Andalucia, Sigrid Sjölander, Xavier BossuytAbstractThe aim was to compare indirect immunofluorescence (IIF) and fluorescence enzyme immunoassay (FEIA) for initial screening of connective tissue diseases (CTDs) and to evaluate whether combining IIF with FEIA adds value.A comprehensive systematic literature review was conducted to identify fully paired, cross-sectional or case–control studies on ANA screening of CTD reporting results for IIF and FEIA. Study quality was a...
Source: Best Practice and Research Clinical Rheumatology - April 16, 2019 Category: Rheumatology Source Type: research

Checkpoint inhibitor-associated autoimmunity
Publication date: Available online 15 April 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Karim Ladak, Anne R. BassAbstractCheckpoint inhibitors (CI) have revolutionized the management of many cancers but can result in immune-related adverse events (IRAE). In this chapter, we review the clinical manifestations and management of the most common IRAE, plus less common IRAE, such as inflammatory arthritis, of particular interest to rheumatologists. We review the mechanism of action of CI, predictors of IRAE, and the impact of IRAE on cancer outcomes. The study of IRAE is in its infancy; there are ve...
Source: Best Practice and Research Clinical Rheumatology - April 16, 2019 Category: Rheumatology Source Type: research

Malignancy and rheumatoid arthritis: Epidemiology, risk factors and management
Publication date: Available online 15 April 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Diederik De Cock, Kimme HyrichAbstractRheumatoid arthritis (RA) is a chronic inflammatory condition that can result in pain and functional disability. It is also associated with an increased occurrence of comorbidities, including an increased risk of certain cancers such as lung cancer and lymphoma. The aetiopathogenesis of this increased cancer risk is likely multifactorial and includes shared risk factors as well as chronic inflammation. There is also a concern that the treatment for RA itself may increase...
Source: Best Practice and Research Clinical Rheumatology - April 16, 2019 Category: Rheumatology Source Type: research

Management of complex gout in clinical practice: Update on therapeutic approaches
Publication date: Available online 12 April 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Ravi K. Narang, Nicola DalbethAbstractIncreasing therapeutic options are available for gout management. Anti-inflammatory agents are used in the acute management of gout flares, and interleukin-1 inhibitors are effective for those unable to take conventional anti-inflammatory treatments. Lowering of serum urate remains the cornerstone of effective long-term management. Allopurinol is the first-line urate-lowering therapy, and a gradual dose-escalation strategy to serum urate target is recommended. Febuxostat...
Source: Best Practice and Research Clinical Rheumatology - April 14, 2019 Category: Rheumatology Source Type: research

Recent advances in spondyloarthritis
Publication date: Available online 13 April 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Denis Poddubnyy, Nigil Haroon (Source: Best Practice and Research Clinical Rheumatology)
Source: Best Practice and Research Clinical Rheumatology - April 14, 2019 Category: Rheumatology Source Type: research

An overview of biologic disease-modifying antirheumatic drugs in axial spondyloarthritis and psoriatic arthritis
Publication date: Available online 21 March 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Anthony So, Robert Davies InmanAbstractBiologic disease-modifying antirheumatic drugs (bDMARDs) are engineered proteins with high affinity for various proinflammatory immune mediators to reduce inflammation and its sequelae in various rheumatic diseases. These medications, introduced at the advent of the 21st century, have revolutionized the treatment of axial spondyloarthritis (including ankylosing spondylitis) and psoriatic arthritis. Currently approved bDMARDs for axial spondyloarthritis are etanercept, i...
Source: Best Practice and Research Clinical Rheumatology - March 21, 2019 Category: Rheumatology Source Type: research

A pragmatic approach to prevent post-traumatic osteoarthritis after sport or exercise-related joint injury
Publication date: Available online 14 March 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Jackie L. Whittaker, Ewa M. RoosAbstractLower extremity musculoskeletal injuries are common in sport and exercise, and associated with increased risk of obesity and post-traumatic osteoarthritis (PTOA). Unlike other forms of osteoarthritis, PTOA is common at a younger age and associated with more rapid progression, which may impact career choices, long-term general health and reduce quality of life. Individuals who suffer an activity-related joint injury and present with abnormal joint morphology, elevated a...
Source: Best Practice and Research Clinical Rheumatology - March 15, 2019 Category: Rheumatology Source Type: research

Current trends in tendinopathy management
Publication date: Available online 8 March 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Tanusha B. Cardoso, Tania Pizzari, Rita Kinsella, Danielle Hope, Jill L. CookAbstractTendinopathy (pain and dysfunction in a tendon) is a prevalent clinical musculoskeletal presentation across the age spectrum, mostly in active and sporting people. Excess load above the tendon's usual capacity is the primary cause of clinical presentation. The propensity towards chronicity and the extended times for recovery and optimal function and the challenge of managing tendinopathy in a sporting competition season make ...
Source: Best Practice and Research Clinical Rheumatology - March 9, 2019 Category: Rheumatology Source Type: research

Epilepsy is not statistically associated with systemic sclerosis but significantly impacts on mortality: A real-world epidemiological survey-based study
Publication date: Available online 7 March 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Abdulla Watad, Nicola Luigi Bragazzi, Francesco Brigo, Mohammad Adawi, Naim Mahroum, Doron Comaneshter, Daniela Amital, Arnon D. Cohen, Howard AmitalAbstractLittle is known about the relationship between epilepsy and SSc. Our study included 2431 SSc patients and 12,710 age- and sex-matched controls. In 209 controls (1.6%) and 66 SSc patients (2.7%), epilepsy diagnosis was made (not significant). In the multivariate logistic regression analysis, higher age (OR 1.01 [95% CI 1.00–1.02], p = 0.020...
Source: Best Practice and Research Clinical Rheumatology - March 8, 2019 Category: Rheumatology Source Type: research

Cardiovascular morbidity and mortality in ankylosing spondylitis and psoriatic arthritis
Publication date: Available online 6 March 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Jean W. Liew, Sofia Ramiro, Lianne S. GenslerAbstractThe cardiovascular burden in inflammatory rheumatic diseases is well recognized. Recently, this burden has been highlighted in ankylosing spondylitis (also known as radiographic axial spondyloarthritis) and psoriatic arthritis. We review the cardiovascular morbidity and mortality in these diseases, as well as the prevalence and incidence of traditional cardiovascular risk factors. We examine the contribution of anti-inflammatory therapy with nonsteroidal an...
Source: Best Practice and Research Clinical Rheumatology - March 7, 2019 Category: Rheumatology Source Type: research

Current trends in sport and exercise hip conditions: Intra-articular and extra-articular hip pain, with detailed focus on femoroacetabular impingement (FAI) syndrome
Publication date: Available online 4 March 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Joanne Kemp, Alison Grimaldi, Joshua Heerey, Denise Jones, Mark Scholes, Peter Lawrenson, Sally Coburn, Matthew KingAbstractMusculoskeletal conditions, such as hip pain are leading causes of pain and disability. Hip pain is the second most common cause of lower limb musculoskeletal pain, and is commonly seen in active individuals. Hip and groin pain may have intra-articular and extra-articular causes. Femoroacetabular impingement (FAI) syndrome and the associated pathologies are common intra-articular causes ...
Source: Best Practice and Research Clinical Rheumatology - March 6, 2019 Category: Rheumatology Source Type: research

Time to diagnosis of fibromyalgia and factors associated with delayed diagnosis in primary care
Publication date: Available online 4 March 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Omer Gendelman, Howard Amital, Yael Bar-On, Dana Ben-Ami Shor, Daniela Amital, Shmuel Tiosano, Varda Shalev, Gabriel Chodick, Dahlia WeitzmanAbstractFibromyalgia is a complex disorder, and its diagnosis often comprises a challenge for physicians.We aimed to assess the time from the appearance of early symptoms to the definite diagnosis of fibromyalgia and to delineate patient and physician factors associated with this delay.The database of a large healthcare services provider was searched for all fibromyalgia...
Source: Best Practice and Research Clinical Rheumatology - March 6, 2019 Category: Rheumatology Source Type: research

Peripheral spondyloarthritis: Concept, diagnosis and treatment
Publication date: Available online 2 March 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Anna Molto, Joachim SieperAbstractPeripheral spondyloarthritis refers to spondyloarthritis with predominant peripheral (arthritis, enthesitis or dactylitis) involvement. Diagnosis can be challenging, particularly in the absence of SpA extra-articular manifestations such as uveitis, psoriasis or inflammatory bowel disease. Evaluation of disease activity should always include assessment of objective signs of inflammation, particularly in the presence of enthesitis as the sole peripheral manifestation, mainly du...
Source: Best Practice and Research Clinical Rheumatology - March 4, 2019 Category: Rheumatology Source Type: research

Disease modification in axial spondyloarthritis
Publication date: Available online 2 March 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Ismail Sari, Nigil HaroonAbstractThe concept of “disease modification” refers to an intervention that modifies the natural clinical course of the disease along with improvement of symptoms. With regard to this, providing treatment that improves clinical signs and symptoms of axial spondyloarthritis (axSpA) and that impacts disease pathogenesis by slowing/halting bone formation is the main goal of this concept. It has been proven that currently available treatments including biologics and nonsteroi...
Source: Best Practice and Research Clinical Rheumatology - March 4, 2019 Category: Rheumatology Source Type: research

Autoinflammatory/autoimmunity syndrome induced by adjuvants (Shoenfeld's syndrome) in patients after a polypropylene mesh implantation
In conclusion, 40 patients developed symptoms of a systemic illness after a mesh operation. All patients fulfilled the diagnostic criteria for ASIA. One quarter of the patients had an immunodeficiency, whereas in approximately half of the patients, an autoimmune disease developed. We postulate that PP mesh implants may increase the risk of developing (auto)immune diseases by acting as an adjuvant. (Source: Best Practice and Research Clinical Rheumatology)
Source: Best Practice and Research Clinical Rheumatology - March 1, 2019 Category: Rheumatology Source Type: research

Central nervous system involvement in rheumatoid arthritis patients and the potential implications of using biological agents
Publication date: Available online 27 February 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Fabiola Atzeni, Rossella Talotta, Ignazio Francesco Masala, Maria Chiara Gerardi, Roberto Casale, Piercarlo Sarzi-PuttiniAbstractCentral nervous system (CNS) involvement is quite unusual in patients with rheumatoid arthritis (RA), although cerebral vasculitis, rheumatoid nodules and meningitis have all been reported, and patients with RA may also have CNS comorbidities such as stroke and neuro-degenerative and demyelinating syndromes. It has been found that biological drugs, especially anti-tumour necrosi...
Source: Best Practice and Research Clinical Rheumatology - March 1, 2019 Category: Rheumatology Source Type: research

Implementation science to reduce the prevalence and burden of MSK disorders following sport and exercise-related injury
Publication date: Available online 28 February 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Evert Verhagen, Femke van NassauAbstractAlthough safety in sports and physical activity is an important prerequisite for continuing participation and maintenance of a healthy, physically active lifestyle, to date little effort has been placed upon moving evidence into preventive practice. Amongst researchers it is still often assumed that a program will disseminate itself after proven to be effective. Recently, however, there has been an increased recognition of the importance of theory-driven approaches ...
Source: Best Practice and Research Clinical Rheumatology - March 1, 2019 Category: Rheumatology Source Type: research

Efficacy and survival of golimumab with and without methotrexate in patients with psoriatic arthritis: A retrospective study from daily clinical practice
Publication date: Available online 27 February 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Kassem Sharif, Omer Gendelman, Pnina Langevitz, Tatiana Reitblat, Abdulla Watad, Yehuda Shoenfeld, Josef Azuri, Howard Amital, Nicola Luigi Bragazzi, Ora ShovmanAbstractGolimumab is a recombinant human monoclonal antibody targeted against tumour necrosis factor-alpha (TNF-α). Golimumab is effective in the management of patients with active psoriatic arthritis (PsA).The aim of this study is to evaluate the clinical efficacy and survival of golimumab monotherapy versus co-administration with methotrex...
Source: Best Practice and Research Clinical Rheumatology - February 27, 2019 Category: Rheumatology Source Type: research

Rheumatoid arthritis and thyroid dysfunction: A cross-sectional study and a review of the literature
Publication date: Available online 26 February 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Hussein Mahagna, Alyssa Caplan, Abdulla Watad, Nicola Luigi Bragazzi, Kassem Sharif, Shmuel Tiosano, Naim Mahroum, Hen Hendel, Yehuda Shoenfeld, Doron Comaneshter, Arnon D. Cohen, Howard AmitalAbstractThyroid dysfunction appears to show increased prevalence in many autoimmune diseases; however, this comorbidity has not been properly investigated in patients with RA. This issue was addressed in this cross-sectional study.Using the database of the Clalit Health Services (CHS) in Israel, RA patients were pai...
Source: Best Practice and Research Clinical Rheumatology - February 26, 2019 Category: Rheumatology Source Type: research

Mutants of β2-glycoprotein I: Their features and potent applications
Publication date: Available online 26 February 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Lianhua Shen, Nuriza Ulul Azmi, Xian Wen Tan, Shinsuke Yasuda, Arum Tri Wahyuningsih, Junko Inagaki, Kazuko Kobayashi, Eiji Ando, Takanori Sasaki, Eiji MatsuuraAbstractβ2-Glycoprotein I (β2GPI) is a highly-glycosylated plasma protein composed of five homologous domains which regulates coagulation, fibrinolysis, and/or angiogenesis by interacting to negatively charged hydrophobic molecules and/or with plasminogen and its metabolites. The present study focused on structural and functional cha...
Source: Best Practice and Research Clinical Rheumatology - February 26, 2019 Category: Rheumatology Source Type: research

Mortality of patients with systemic lupus erythematosus admitted to the intensive care unit – A retrospective single-center study
Publication date: Available online 23 February 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Guy Zamir, Yael Haviv-Yadid, Kassem Sharif, Nicola Luigi Bragazzi, Abdulla Watad, Amir Dagan, Howard Amital, Yehuda Shoenfeld, Ora ShovmanAbstractSystemic lupus erythematosus (SLE) is a heterogeneous autoimmune disease that results in increased morbidity and mortality. Under certain conditions, patients with SLE may be admitted to the intensive care unit (ICU) secondary to infectious disease flare-ups or other non-SLE disease conditions that are aggravated by SLE. The aim of our study was to investigate t...
Source: Best Practice and Research Clinical Rheumatology - February 25, 2019 Category: Rheumatology Source Type: research

Managing low back pain in active adolescents
Publication date: Available online 23 February 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Kieran O'Sullivan, Mary O'Keeffe, Bruce B. Forster, Sadia Raheez Qamar, Andrew van der Westhuizen, Peter B. O'SullivanAbstractAdolescent low back pain has received limited research attention despite its potentially considerable impact on quality of life. The role of diagnostic triage to identify serious or specific pathology and/or order relevant investigations is considered. An overview of contemporary pain mechanisms is provided, with specific reference to the wide range of risk factors for persist...
Source: Best Practice and Research Clinical Rheumatology - February 25, 2019 Category: Rheumatology Source Type: research

Rethinking patellofemoral pain: Prevention, management and long-term consequences
Publication date: Available online 22 February 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Kay M. Crossley, Marienke van Middelkoop, Christian J. Barton, Adam G. CulvenorAbstractPatellofemoral pain is one of the most common knee complaints, particularly among physically active young individuals. Although once thought to be self-limiting, prospective studies have demonstrated the propensity towards the chronicity of patellofemoral pain (PFP). The pathogenesis of PFP is complex, with multiple interactive pathways suggested to contribute to its onset and persistence. Quadriceps weakness is one of ...
Source: Best Practice and Research Clinical Rheumatology - February 23, 2019 Category: Rheumatology Source Type: research

Mimickers of neuropsychiatric manifestations in systemic lupus erythematosus
Publication date: Available online 22 February 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Jaqueline Cristina de Amorim, Aline Kuhl Torricelli, Renan Bazuco Frittoli, Aline Tamires Lapa, Sergio San Juan Dertkigil, Fabiano Reis, Lilian TL. Costallat, Marcondes Cavalcante França Junior, Simone AppenzellerAbstractSystemic lupus erythematosus (SLE), presenting with new onset or worsening neuropsychiatric (NP) symptoms, is a challenge in clinical practice. Mimickers such as infections, drug-induced side effects, metabolic abnormalities, malignancies, and alcohol-related disorders have to be e...
Source: Best Practice and Research Clinical Rheumatology - February 23, 2019 Category: Rheumatology Source Type: research

Current trends in sport injury prevention
Publication date: Available online 23 February 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Carolyn A. Emery, Kati PasanenAbstractParticipation in sport and recreation has important positive implications for public health across the lifespan; however, the burden of sport-related musculoskeletal injury is significant, with the greatest risk being in youth and young adults. Moving upstream to primary prevention of injury is a public health priority that will have significant implications for reducing the long-term consequences of musculoskeletal injury including early post-traumatic osteoarthritis...
Source: Best Practice and Research Clinical Rheumatology - February 23, 2019 Category: Rheumatology Source Type: research

Rituximab induction without maintenance for granulomatosis with polyangiitis and dialysis – Case report and literature review
We describe a case of a 32-year-old woman admitted for pulmonary infiltrates and acute renal failure. Autoimmune workup revealed an elevated titer of proteinase 3-antineutrophil cytoplasmic antibody (PR3-ANCA). The diagnosis of granulomatosis with polyangiitis (GPA) was confirmed by renal biopsy. The patient received induction therapy with IV rituximab (375 mg/m2 per week for 4 weeks) along with systemic high-dose IV corticosteroids and one pulse of IV cyclophosphamide (1000 mg). Rapid deterioration of her kidney function led to pulmonary edema requiring intensive care (ICU) hospitalization. Dialysis and plasmaph...
Source: Best Practice and Research Clinical Rheumatology - February 22, 2019 Category: Rheumatology Source Type: research

Youth sport: Friend or Foe?
Publication date: Available online 21 February 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Carly D. McKay, Sean P. Cumming, Tracy BlakeAbstractParticipation in youth sport has been promoted as part of a healthy lifestyle, with benefits for physical fitness, social development, and mental wellbeing. Yet, sport carries an inherent risk of injury, which for young athletes may have both immediate and long-term consequences. Amidst significant public debate about the pros and cons of youth sport, this review considers the physiological, psychological, and social factors that inform decisions around ...
Source: Best Practice and Research Clinical Rheumatology - February 22, 2019 Category: Rheumatology Source Type: research

Do the benefits of participation in sport and exercise outweigh the negatives? An academic review
Publication date: Available online 21 February 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Kathryn Mills, Dean Dudley, Natalie J. CollinsAbstractPublic health campaigns promote regular exercise and physical activity. These campaigns are founded on global recommendations that a combination of aerobic and resistance exercise is required, on a weekly basis, to maximise physical and mental health. However, participation in all forms of sports and physical activity has inherent risks that need to be considered by both health practitioners making activity recommendations and the people participating....
Source: Best Practice and Research Clinical Rheumatology - February 22, 2019 Category: Rheumatology Source Type: research

The diagnostic value of 14-3-3η protein levels in patients with rheumatoid arthritis
Publication date: Available online 21 February 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): O. Shovman, B. Gilburd, A. Watad, H. Amital, P. Langevitz, N.L. Bragazzi, M. Adawi, D. Perez, G. Bornstein, C. Grossman, M. Lidar, M. Blank, J. Azuri, N.K. Biln, A. Marotta, Y. ShoenfeldAbstract14-3-3η may represent a useful diagnostic biomarker for rheumatoid arthritis (RA). We assessed the prevalence and serum levels of 14-3-3η in patients with RA and in patients with other rheumatic diseases.Serum levels of 14-3-3η were measured in 96 patients with RA, in 101 patients with other rheumatic d...
Source: Best Practice and Research Clinical Rheumatology - February 22, 2019 Category: Rheumatology Source Type: research

Outcomes of patients with systemic sclerosis treated with tocilizumab: Case series and review of the literature
Publication date: Available online 21 February 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Galia Zacay, Yair LevyAbstractThe treatment of systemic sclerosis (SSc) presents a clinical challenge because of the progressive nature of the disease, relatively poor prognosis, and lack of a proven treatment. In the last 10 years, several studies demonstrated the importance of interleukin 6 (IL6) as a pivotal cytokine in the development of fibrosis and angiopathy, especially in SSc. Tocilizumab, an IL6 receptor antibody, has shown promising results for patients with SSc.A total of 16 patients with SSc w...
Source: Best Practice and Research Clinical Rheumatology - February 22, 2019 Category: Rheumatology Source Type: research

The sacroiliac joint – Victim or culprit
Publication date: Available online 21 February 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): James Booth, Samuel MorrisAbstractIt is estimated that 10–30% of all low back pain is attributed to the sacroiliac joints. There are many challenges to diagnosing and treating the sacroiliac joints. Central to this challenge is determining whether the sacroiliac joint is the primary source of pain or dysfunction. This paper considers the complexities of diagnosis and management of sacroiliac joint dysfunction by providing a best evidence informed overview of the mechanics of the sacroiliac joint, th...
Source: Best Practice and Research Clinical Rheumatology - February 22, 2019 Category: Rheumatology Source Type: research

Evidence-based recommendations for the management of anterior cruciate ligament (ACL) rupture
The objectives of management are to restore knee function, address psychological barriers to activity participation, prevent further injury and osteoarthritis, and optimize long-term quality of life. The three main treatment options for ACL rupture are (1) rehabilitation as first-line treatment (followed by ACL reconstruction (ACLR) in patients, who develop functional instability), (2) ACLR and post-operative rehabilitation as the first-line treatment, and (3) pre-operative rehabilitation followed by ACLR and post-operative rehabilitation. We provide practical recommendations for informing and discussing management options...
Source: Best Practice and Research Clinical Rheumatology - February 22, 2019 Category: Rheumatology Source Type: research

Emerging treatment options for spondyloarthritis
Publication date: Available online 21 February 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Murat Torgutalp, Denis PoddubnyyAbstractThe management of spondyloarthritis (SpA) has substantially changed as a consequence of the introduction of biologic disease-modifying antirheumatic drugs (bDMARDs). However, the treatment options in patients with axial SpA (axSpA) not responding to nonsteroidal anti-inflammatory drugs (NSAIDs) had been restricted to tumor necrosis factor alpha (TNFα) inhibitors for almost 15 years. With the approval of secukinumab, an interleukin (IL)-17A inhibitor, there is ...
Source: Best Practice and Research Clinical Rheumatology - February 22, 2019 Category: Rheumatology Source Type: research

Choosing Wisely after a sport and exercise-related injury
Publication date: Available online 22 February 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Joshua R. Zadro, Ian A. Harris, Christina Abdelshaheed, Carolyn Broderick, Christian J. Barton, James Linklater, Christopher G. MaherAbstractLow-value care is receiving substantial attention in many fields of medicine but little-to-none in sports medicine. Common interventions for sport and exercise-related injuries include medical imaging, medication, surgery and rehabilitation, but there is emerging evidence of the inappropriate use of these interventions.This chapter aims to increase awareness of low-v...
Source: Best Practice and Research Clinical Rheumatology - February 22, 2019 Category: Rheumatology Source Type: research