News

Images taken 7 months apart show subtle densities of the left knee that has been causing pain. The woman also has subluxation of the fingers, without erosion.

New this week in the nonspecialty journals: Tattoos and sarcoidosis, oral ulcers and autoimmunity, gout and heart disease, and a review about a gene that affects autoimmune inflammation.

Patients with knee or shoulder pain often take it for granted that their damaged joint needs fixing, says this author. Preventing unnecessary surgery may begin with doctors who recognize and correct this misconception.

A 45-year-old woman presented with longstanding left knee pain. Both knee and hand radiographs showed abnormalities. Bony infarcts had become complicated by an infection/septic joint and had progressed to frank bony destruction.

Returning from the Phillipines, the patient came to the clinic with atraumatic right knee swelling and loss of range of motion. He arrived in a wheelchair. He had osteoarthritis, but denied any constitutional symptoms. Joint aspiration produced grossly milky white pus. What's going on?

EULAR 2013: Data to support effectiveness of a new biomarker test for rheumatoid arthritis that is already on the market have now been reported in a public presentation.

A third of their multiple sclerosis patients without rheumatic conditions tested positive for autoantibodies. These neurologists say their routine use in MS diagnosis is unwarranted.

Psoriasis is the most common autoimmune disease, and an important manifestation of psoriatic arthritis in patients with joint pain. Try out this compact slide show to hone your skills at differential diagnosis.

EULAR 2013: Two-year data from a head-to-head comparison of abatacept and adalimumab show them comparably effective for rheumatoid arthritis. But the former is less costly with fewer noteworthy adverse effects.

The manifestations of granulomatosis with polyangiitis varies widely. This case study describes a 49-year-old man who presented with cough, chills, and chest pain who had a mediastinal mass and ocular involvement.

EULAR 2013: Your assignment for patients who have ankylosing spondylitis and psoriatic arthritis: Partner with them as they strive for a normal life, says an expert task force.

EULAR 2013: A study analyzing levels of physical activity in rheumatoid arthritis patients finds that being sedentary does not generally correlate with common signs of physical disability.

EULAR 2013: More fuel for the debate about hyaluronic acid injections for knee osteoarthritis. A small randomized trial finds that supplementing them with a jab of botulinum toxin (Botox) may significantly increase their effectiveness.

Data from a national registry of ankylosing spondylitis reveal that patients not finding relief from one THF inhibitor usually benefit from trying a different one.

In a new revision of its 2009 guidelines on knee osteoarthritis, the American Academy of Orthopaedic Surgeons reverses a formerly noncommital stance on intra-articular hyaluronic acid injections, now deeming the weight of evidence insufficient to support their efficacy.

Dr. Lim discusses the challenges of diagnosing and treating lupus, the tools and resources offered by the Lupus Initiative, and the impact of unconscious bias on care.

Merck & Co. has ceased development of its experimental therapy for Parkinson's disease after the drug failed to show superiority to placebo in initial data from a series of phase III clinical trials.

Does the lupus patient have comorbid age-related osteoarthritis? Is it iliopsoas bursitis or trochanteric pain syndrome? Eight images with reflections on differential diagnosis of hip pain.

A phase I pharmacokinetic clinical trial shows that escalating doses of oral treprostinil diethanolamine temporarily improve cutaneous perfusion and temperature in scleroderma patients with peripheral vascular disease and digital ulcers.

Like so many inflammatory conditions, complex regional pain syndrome (yes, there's growing evidence it's inflammatory) demands early treatment. Yet it is devilishly difficult to recognize its initial stages. Here are the signs, and an algorithm for management.

New in the nonspecialty journals: A new option for patients with autoimmune disease and HCV infection. The value of combined therapy for osteoporosis. Prognosis predictors for chronic pain, a new opioid adverse effect, and more ...

Is it a form of lupus, myositis, or a drug reaction? Check your knowledge of skin eruptions and the associated rheumatologic conditions in this brief photo essay.

A small, randomized clinical trial from Germany suggests that two weeks of high-dose oral prednisone produces a clinically relevant response in patients with active ankylyosing spondylitis (AS) refractory to NSAIDs.

New in the non-rheumatology journals, much about pain: A review based on 2012 fibromyalgia guidelines from Canada, a viewpoint on safe use of opioids, the evidence to back spinal pain interventions. Also: fast-track arthroplasty, and more newfound genes.

Quest Diagnostics says the biomarker 14-3-3eta in its new test greatly improves sensitivity in detecting early rheumatoid arthritis. But the data is not yet published.

New research has examined 3D motion and muscle activity in knee osteoarthritis, and correlated gait with pain. Result: a better description of knees destined for replacement.

A 39-year-old woman, in her eighth week of pregnancy, experienced aching pain that worsened with activity. Weakness and fatigue set in three days later in her thigh and proximal arm muscle. Then a mildly pruritic rash developed across the forehead, nose, and forearms.

Synovitis is present in 90% of painful knees, and emerging data is showing that this inflammation is "not just a bystander" in osteoarthritis-induced damage. Research is revealing the roles of macrophages and T-cells, and signposts toward new drug targets.

At the OARSI annual meeting in Philadelphia, two osteoarthritis experts tacklde the issue of whether to focus first on structural abnormalities or pain, and merged toward a consensus.

OARSI 2013: More support for the supplement chondroitin sulfate (CS) in osteoarthritis: In a large observational study from Spain, six months' use of CS significantly reduced the likelihood of having total knee replacement. Observers noted the well-known issues in applying this knowledge in the US.