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Current classification criteria for rheumatoid arthritis allow its classification on the basis of the presence of erosions, in the absence of other indicators. Nevertheless, definition or quantitation of erosions was lacking. A European task force has now addressed this issue by analysing radiographic erosions in two cohorts of patients with early disease.
The American College of Rheumatology recently published a list of five strategies (comprising four diagnostic procedures and one therapeutic approach) that they consider to be often unnecessary and thus potentially wasteful. By itself this list is useful, but finding a way to reduce wasteful strategies will be a challenge.
Rapid progress is being made in the field of rheumatology. Nevertheless, disappointingly, the limited resources of the paediatric rheumatology community are being expended on the publication of consensus guidelines that represent fossilization of old ideas rather than real innovation that leads to the improved care of children.
Wnt signalling has important roles in bone development, growth and homeostasis. Herein, the authors review our current understanding of Wnt signalling in rheumatoid arthritis, osteoarthritis and spondyloarthritis, and discuss the potential therapeutic targeting of the Wnt cascades in these diseases.
In this Review, the phenotypic and genetic markers for common musculoskeletal pain conditions are discussed. Furthermore, the authors propose a heuristic approach to evaluation of the different kinds of markers associated with these conditions, which could enable greater understanding of the underlying pathophysiological processes.
Total hip and total knee replacements are common treatments for end-stage arthritis with the rates of these procedures projected to increase further over the coming decades. Currently, no evidence-based criteria exists to guide physicians in which patients to refer for these treatments meaning that there is a potential for bias in this decision-making process. Here, Lisa Mandl reviews common misperceptions among physicians regarding these procedures, and discusses data that should be considered by physicians during the referral process.
Arachnodactyly–spidery fingers–is typical of patients with one of the heritable diseases of connective tissue. This Review highlights the differences and similarities amongst these diseases and serves as a diagnostic guide to these heritable diseases including Marfan syndrome, joint hypermobility syndrome, and Ehlers–Danlos syndrome.
Cancer treatments can have severe adverse effects on bone health, and can thus increase the risk of fragility fractures both during therapy and in later life. This Review focuses on bone loss caused by breast cancer and prostate cancer treatments, and discusses lifestyle and pharmacological management strategies for reducing fracture risk in these patients.
The proinflammatory cytokine IL-17 is known to be an important factor in the pathogenesis of autoimmune joint diseases such as rheumatoid arthritis and spondyloarthritis, and therapies targeting this cytokine have shown promise. Although type 17 T helper cells are generally considered to be the main source of IL-17 in these diseases, the range of cell types that secrete this cytokine continues to expand; in particular, mast cells are receiving increased attention. Herein, the authors discuss the potential contribution of IL-17-secreting mast cells to inflammatory joint disease.
