Volume 9 Issue 4, April 2013

Neridronate, an aminobisphosphonate, has shown promise in reducing the often extreme and intransigent pain of complex regional pain syndrome. Welcomed clinically, what can this finding tell us about the enigmatic mechanisms of bisphosphonates and of complex regional pain syndrome alike?

Pharmacogenomic advances have increased understanding of allopurinol-associated severe cutaneous adverse reactions (SCARs), demonstrating that HLAB^*5801 is a strong risk factor for their development. In some populations, all patients with allopurinol-induced SCARs carry this allele. New treatment recommendations outline how this discovery should influence gout therapy, particularly the use of allopurinol.

It is never too early to tackle arthritis. Currently, classification of rheumatoid arthritis is based on the clinical assessment of synovitis. The question is: should we consider 'clinical synovitis' the gold standard for clinical decision making, or should we try something more?

Anaemia as a result of chronic inflammation is common in patients with rheumatic disease. In this Review, Weiss and Schett provide a broad overview of the topic, covering the pathogenesis, diagnosis, treatment and management of anaemia in inflammatory rheumatic disease, offering practical guidance for clinicians.

Spinal osteoarthritis primarily manifests as disease of the facet joints of the posterior spine. This Review presents the latest information about the prevalence, presentation, and nature of facet joint osteoarthritis, an important cause of spinal pain that should be viewed as failure of the whole joint rather than a disease of articular cartilage loss and bony hypertrophy.

Complex interactions between obesity, which can predispose to the development of osteoarthritis (OA), and OA, which can curtail weight-management efforts, challenge the managing physician. Nevertheless, weight loss is possible—and advisable—at all stages of the disease. Anita Wluka and colleagues unpick the interconnections between obesity and OA, review strategies for weight loss, and call for a societal approach to the management of these comorbid conditions.

Semiquantitative MRI-based scoring of joint pathology is a powerful tool in osteoarthritis (OA) research, which provides valuable information on the natural history of the disease and can be used in outcome measures. Herein, the authors discuss approaches to semiquantitative MRI-based scoring of OA features and review the scoring systems currently available for whole-joint and feature-specific assessment of knee, hand, hip, spine and shoulder OA.

The IL-12 family cytokines contribute to immune-mediated inflammation and have an important role in determining T-cell fate. Evidence from preclinical and clinical studies suggests a role of these cytokines in the pathogenesis of rheumatoid arthritis (RA). The authors discuss these data and their potential clinical implications for patients with RA.