HLA-B27 may be a phenotypic expression of axial spondyloarthritis (SpA), according to a large international study. The study found patients with axial SpA who were positive for HLA-B27 had more severe radiographic damage than those who were negative for HLA-B27, and three quarters of study patients with ankylosis spondyloarthritis were HLA-B27 positive.
The axial phenotype of psoriatic arthritis (axPsA) is an excellent example of a major controversy in rheumatology that has become the focus of attention because of the emergence of new therapies with different mechanisms of action for alleviating joint inflammation. It was first described in 1961 but, until recently, it has largely remained under the…
Recent research indicates tumor necrosis factor inhibitors may slow disease progression in the spine of patients with axial spondyloarthritis.
New diagnostic approaches combined with new evidence about pathogenesis are providing opportunities to help rheumatologists manage calcium pyrophosphate deposition disease.
CHICAGO—Is erosive, inflammatory osteoarthritis (EOA) a separate condition from osteoarthritis (OA)? Roberta Ramonda, MD, PhD, a rheumatologist at the University of Padova, Italy, spoke at the 2018 ACR/ARHP Annual Meeting on the clinical presentation of EOA and how it differs from OA. EOA is characterized by a frequent aggressive clinical course and occurs most often…
CHICAGO—When it comes to correctly diagnosing joint pain in children, “things take time,” said Michael L. Miller, MD, quoting Danish physicist and poet Piet Hein. Children with pain but normal physical examinations may need to return to the clinic for repeat evaluation over several months. “I often tell parents that laboratory tests may help in…
The evaluation of a child with arthralgia who has a normal physical examination provides a challenge to rheumatologists. Here are some insights into assessing and treating children with musculoskeletal pain syndromes…
A 36-year-old woman presented at the Johns Hopkins Arthritis Center for a second opinion regarding a diagnosis of psoriatic arthritis (PsA). One year prior to our evaluation, she had developed pain and stiffness in her hands, feet, knees, ankles, elbows and shoulders. She had mild plaque psoriasis of the scalp and base of the neck,…
Gut microbiota may provide insight into important environmental triggers for autoimmune diseases. New research in mice indicates that intestinal dysbiosis triggers a mucosal immune response that stimulates T and B cells, which are critical to the development of inflammatory arthritis…
SAN DIEGO—Since the identification of the autoinflammatory disease, familial Mediterranean fever (FMF), researchers have identified an alphabet soup of other autoinflammatory diseases with genetic underpinnings, from PAPA (pyogenic arthritis with pyoderma gangrenosum and acne) to NIAID (NLRP1-associated autoinflammation with arthritis and dyskeratosis) to TRAPS (TNF receptor-associated periodic syndrome). The torrent of discoveries, brought about largely…