Volume 8 Issue 1, January 2012

New data—this time from genetic association studies—again implicate the Wnt signaling pathway in the etiology of Dupruyten Disease. Nevertheless, functional studies, and cohorts of different ethnic backgrounds, are needed to distinguish cause and effect in this enigmatic fibrosing disorder.

Measuring bone structure could improve prediction of bone strength, but the clinical feasibility of available imaging technologies is limited. The trabecular bone score—a dual-energy X-ray absorptiometry texture algorithm—has shown promise in fracture prediction in a large cohort study, and might provide a practical means of assessing bone quality.

Biomarkers and surrogate outcome measures can be used to monitor disease development, but what can biomarkers tell us about disease processes in axial spondyloarthritis? New research suggests that some biomarkers might be useful in monitoring patients with ankylosing spondylitis, but greater understanding of the pathological mechanisms is needed.

Lessons from the study of other rheumatic diseases are improving our understanding of diffuse idiopathic skeletal hyperostosis (DISH). New data implicate Dickkopf-1 in the evolution of the most severe manifestations of the condition. Nevertheless, real insights into the pathogenesis—and treatments that might result from them—are still lacking.

Comorbid cardiovascular disease is a substantial problem in rheumatoid arthritis (RA). Disease-related factors such as inflammation combine with traditional risk factors to produce an interrelated excess of risk that can be pharmacologically modified. Here, the authors summarize the evidence—and knowledge gaps—regarding the influence of biologic therapies on cardiovascular risk parameters in patients with RA.

Hand osteoarthritis (OA) is a prevalent, heterogeneous disorder that was, until recently, often overlooked in clinical research. In this Review, the authors provide an overview of hand OA, describing the diagnosis, clinical burden, disease course and associated risk factors, with particular attention to the key features of the hand OA subsets thumb base OA and erosive OA.

The perioperative management of patients with rheumatic diseases who are due to undergo surgical procedures presents unique challenges, such as the increased cardiovascular risk associated with these diseases, the effect on infection risk associated with drugs used for their treatment, and the altered coagulation state associated with antiphospholipid antibodies. In this Review, the authors present a decision-support system intended to aid the rheumatologist faced with this clinical scenario.

Fibrosis of the skin and other organs is a key feature of systemic sclerosis (SSc). Studies performed during the past decade have provided a more detailed insight to the cellular and immune mechanisms underlying the fibrotic process in SSc. In this Review, the authors describe these important recent findings, and how our improved understanding of SSc fibrosis has facilitated the development of potential targeted therapies.

Reactive arthritis is a form of inflammatory arthritis associated with bacterial infection. In this article, the authors describe the current state of our knowledge regardingChlamydia-induced reactive arthritis, including chlamydial persistence in joints, susceptibility factors and host and pathogen biology, and discuss future research priorities in this disease.