Volume 10 Issue 10, October 2014

Young adults with an acute rupture of the anterior cruciate ligament of the knee are faced with the decision of whether or not to undergo early reconstructive surgery. However, a lack of high-quality evidence means questions remain about whether this surgical strategy protects against the development of osteoarthritis in the future.

Although methotrexate is the main therapy for rheumatoid arthritis, surprisingly little is known about the optimal route of administration; bioavailability of methotrexate has been shown to vary accordingly. In terms of delaying a switch to biologic therapy, is the subcutaneous route superior to oral methotrexate therapy?

The pain associated with rheumatoid arthritis (RA) is complex, both in its manifestations and its underlying mechanisms. In this Review, the authors summarize what is known about the qualities of RA pain, the contributions of inflammation, peripheral and central pain processing and other factors, and discuss the range of therapeutic options available for the treatment of to this important symptom.

In addition to their cytotoxic, inflammatory and immunoregulatory functions, neutrophils are implicated in the pathogenesis of several autoimmune diseases, including rheumatoid arthritis. This article highlights the contributions of neutrophils to the pathophysiology of rheumatoid arthritis, focusing on the generation of autoantigens resulting from the release of neutrophil extracellular traps.

SNPs ofPTPN22, a 'shared autoimmunity gene', are important risk factors for rheumatoid arthritis, juvenile idiopathic arthritis and other autoimmune diseases. In this article, Stanford and Bottini review the function of mouse and human PTPN22 in Toll-like receptor and lymphocyte antigen-receptor signalling pathways, and suggest functional models for the involvement of PTPN22 variants in the pathogenesis of autoimmune diseases.

Despite being associated with a high rate of adverse events, biologic agents are now commonly used to treat patients with rheumatic diseases. In this comprehensive Review, the authors describe these adverse events and how rheumatologists should manage patients to treat and avoid such complications.

Diagnostic imaging in rheumatology has become an important feature of the management of a variety of rheumatic diseases. This Timeline Perspectives charts the progress in the field of imaging in rheumatology over the past few decades, with particular emphasis on developments in radiography, MRI and ultrasonography.