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Despite the increasingly recognized impact of hand osteoarthritis, clinical trials of therapeutics for this disease are lacking. In this context, the authors of this Viewpoint article highlight the limitations of current outcome measures for hand osteoarthritis, and argue that improvements to these measures are needed, as well as the development of new tools.
Congenital heart block is a serious cardiac manifestation of neonatal lupus erythematosus that is associated with exposure to maternal autoantibodies against components of the SSA/Ro–SSB/La ribonucleoprotein complex. This Review outlines our current hypothesis regarding the pathogenesis of this disease and discusses how basic research can be applied to ensure appropriate prevention and management strategies are followed.
In this Review, Dr Erkan and Prof Lockshin discuss the current management strategies for patients who are persistently positive for antiphospholipid antibodies, and also introduce some of the new and experimental 'immunomodulatory' approaches that are being investigated for managing antiphospholipid syndrome.
Traditionally, diagnosis of osteoarthritis has relied upon conventional radiography, but there are discrepancies between clinical symptoms and radiographic findings. Novel imaging modalities, especially MRI, are providing new insights into the osteoarthritis phenotype and the potential tissue origins of pain in joint disease.
The authors present the case of a 49-year-old man diagnosed with chronic unilateral sacroiliitis who did not respond to conventional therapy with corticosteroids and NSAIDs. A single intra-articular injection of the tumor necrosis factor inhibitor infliximab resulted in gradual and steady improvements in pain, stiffness and inflammation.