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Vertebral fragility fractures – How to treat them?
Publication date: Available online 16 May 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Manuela L. Ferreira, Lyn MarchAbstractApproximately 20% of men and women aged 50 years or older will present with a vertebral fragility fracture - a prevalence that steadily increases with age. The condition may be associated with severe pain and disability, significant reductions in overall quality of life, mobility, social participation, sleep quality and increased fear for the future. There is, however, no current consensus on what constitutes the best management of symptomatic vertebral fractures. Moreover, ev...
Source: Best Practice and Research Clinical Rheumatology - May 16, 2019 Category: Rheumatology Source Type: research

Principles and current concepts in the surgical treatment of fragility fractures in the elderly
Publication date: Available online 14 May 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Sascha Halvachizadeh, Henrik Teuber, Hans-Christoph Pape, Florin AllemannAbstractThe constant rise in fragility fractures is proportional to the constant rise in life expectancy. Treatment of fragility fractures can be challenging because of severe fractures, poor bone quality, significant co-morbidities, and reduced mobility. However, new surgical techniques and implants have been developed that address these challenges and show improvement in overall patient outcomes. This review addresses general considerations...
Source: Best Practice and Research Clinical Rheumatology - May 16, 2019 Category: Rheumatology Source Type: research

Secondary fracture prevention: Drug treatment, fall prevention and nutrition requirements
Publication date: Available online 13 May 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): P. Geusens, W.F. Lems, S. Bours, J.P. vd BerghAbstractIn view of the high imminent risk for subsequent fractures, evaluation as early as possible after the fracture will result in early decisions about drug treatment, fall prevention and nutritional supplements.Drug treatment includes anti-resorptive and bone forming agents. Anti-resorptive therapy with broad spectrum fracture prevention and early anti-fracture effects are the first choice. In patients with multiple or severe VFs, the bone forming agent teriparati...
Source: Best Practice and Research Clinical Rheumatology - May 14, 2019 Category: Rheumatology Source Type: research

New concepts of pain
Publication date: Available online 13 May 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Anne-Priscille Trouvin, Serge PerrotAbstractActive research is being conducted on musculoskeletal pain, and recent concepts will help clinicians and researchers to develop better approaches:-the new pain taxonomy recently has been modified with a third descriptor with the concept of nociplastic pain.-the latest International Classification of Diseases (ICD-11) includes an IASP task force that developed a new classification system for pain. In this new classification, one can differentiate primary musculoskeletal p...
Source: Best Practice and Research Clinical Rheumatology - May 14, 2019 Category: Rheumatology Source Type: research

Interdisciplinary care of hip fractures: Orthogeriatric models, alternative models, interdisciplinary teamwork
Publication date: Available online 30 April 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Anette Hylen Ranhoff, Ingvild Saltvedt, Frede Frihagen, Johan Raeder, Sameer Maini, Olav SletvoldAbstractHip fractures are common among older people, and the prognosis is serious in terms of mobility, independence in daily life activities, and cognition, with 42% of patients never achieving the same function as before the fracture. Norway has the highest incidence of hip fractures, and the important tasks are to improve patient care and prevent new fractures.The aim was to develop Norwegian Guidelines for Interd...
Source: Best Practice and Research Clinical Rheumatology - April 30, 2019 Category: Rheumatology Source Type: research

Opportunities and challenges in the treatment of psoriatic arthritis
Publication date: Available online 25 April 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Oliver FitzGerald, Christopher RitchlinAbstractIn this chapter, we review the opportunities and challenges posed by the treatment options currently available in the treatment of psoriatic arthritis. Both established and new or emerging treatment options are discussed using a domain-based approach. Finally, approaches to how treatment can be optimized together with some clinical pearls are presented and discussed. With the increasing treatment options available, we need a better way of deciding which treatment sh...
Source: Best Practice and Research Clinical Rheumatology - April 26, 2019 Category: Rheumatology Source Type: research

Macrophagic myofasciitis-associated dysfunctioning: An update of neuropsychological and neuroimaging features
Publication date: Available online 24 April 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Mehdi Aoun Sebaiti, Marie Abrivard, Paul Blanc-Durand, Axel Van Der Gucht, Sarah Souvannanorath, Paul Kauv, Romain K. Gherardi, Emmanuel Itti, François Jérôme AuthierAbstractMacrophagic myofasciitis (MMF) syndrome is a subtype of autoimmune/inflammatory syndrome induced by adjuvants (ASIA) or Shoenfeld's syndrome, characterized by the presence of stereotyped inflammatory lesions at muscle biopsy attesting the long-term persistence of aluminum hydroxide particles at the site of previous immunization. Most freq...
Source: Best Practice and Research Clinical Rheumatology - April 25, 2019 Category: Rheumatology Source Type: research

Preface: Pearls in autoimmunity
Publication date: Available online 22 April 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Carlo Perricone, Yehuda Shoenfeld (Source: Best Practice and Research Clinical Rheumatology)
Source: Best Practice and Research Clinical Rheumatology - April 23, 2019 Category: Rheumatology Source Type: research

Hepatitis B and C infection in patients undergoing biologic and targeted therapies for rheumatic diseases
This article summarizes the prevalence and risk factors of hepatitis B and C reactivation in patients with rheumatic diseases undergoing biologic and targeted therapies, as well as the recommendations for screening, monitoring, and treatment of these infections. (Source: Best Practice and Research Clinical Rheumatology)
Source: Best Practice and Research Clinical Rheumatology - April 20, 2019 Category: Rheumatology Source Type: research

The forefront of autoimmunity
Publication date: Available online 19 April 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Carlo Perricone, Yehuda Shoenfeld (Source: Best Practice and Research Clinical Rheumatology)
Source: Best Practice and Research Clinical Rheumatology - April 20, 2019 Category: Rheumatology Source Type: research

Physical activity, exercise and rheumatoid arthritis: Effectiveness, mechanisms and implementation
Publication date: Available online 17 April 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): George S. Metsios, George D. KitasAbstractRheumatoid arthritis (RA) is characterised by functional disability, pain, fatigue and body composition alterations that can further impact on the physical dysfunction seen in RA. RA is also associated with systemic manifestations, most notably an increased risk for cardiovascular disease. There is strong evidence to suggest that increasing physical activity and/or exercise can simultaneously improve symptoms and reduce the impact of systemic manifestations in RA. Howeve...
Source: Best Practice and Research Clinical Rheumatology - April 18, 2019 Category: Rheumatology Source Type: research

Myositis in clinical practice—relevance of new antibodies
Publication date: Available online 17 April 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Siamak Moghadam-Kia, Rohit Aggarwal, Chester V. OddisAbstractNovel classification schemes for idiopathic inflammatory myopathy are based on serologic and histopathologic features. The presence of specific myositis autoantibodies may correspond to particular clinical phenotypes. Patients with a known diagnosis of inflammatory myopathy require a prompt clinical evaluation and the assessment of myositis-associated autoantibodies. Patients possessing autoantibodies associated with ILD or those with any pulmonary sym...
Source: Best Practice and Research Clinical Rheumatology - April 18, 2019 Category: Rheumatology Source Type: research

Management of vaccination in rheumatic disease
Publication date: Available online 17 April 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Peter K.K. Wong, Patrick HanrahanAbstractAutoimmune inflammatory rheumatic diseases (AIIRD) such as rheumatoid arthritis and spondyloarthritis, including psoriatic arthritis and ankylosing spondylitis are associated with an increased risk of infection due to a combination of the immunosuppressive effect of the AIIRD, comorbidities, and use of corticosteroids and the immunosuppressive effect of conventional synthetic disease-modifying antirheumatic drugs (DMARDs), targeted synthetic (ts-) DMARDs, and biologic (b-...
Source: Best Practice and Research Clinical Rheumatology - April 18, 2019 Category: Rheumatology Source Type: research

Management of pregnancy and lactation
Publication date: Available online 15 April 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Lisa R. Sammaritano, Bonnie L. BermasAbstractManagement of pregnancy in patients with rheumatic and musculoskeletal disorders is both challenging and rewarding. Most patients with rheumatic disease can have a successful pregnancy. Pregnancy outcome is improved when maternal autoimmune disease is stable or quiescent. Prepregnancy evaluation and counseling is important to identify risk factors for adverse maternal and pregnancy outcomes and to guide therapy and monitoring. Severe disease-related damage, disease ac...
Source: Best Practice and Research Clinical Rheumatology - April 16, 2019 Category: Rheumatology Source Type: research

A comparison of a fluorescence enzyme immunoassay versus indirect immunofluorescence for initial screening of connective tissue diseases: Systematic literature review and meta-analysis of diagnostic test accuracy studies
Publication date: Available online 15 April 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Michelle Elaine Orme, Carmen Andalucia, Sigrid Sjölander, Xavier BossuytAbstractThe aim was to compare indirect immunofluorescence (IIF) and fluorescence enzyme immunoassay (FEIA) for initial screening of connective tissue diseases (CTDs) and to evaluate whether combining IIF with FEIA adds value.A comprehensive systematic literature review was conducted to identify fully paired, cross-sectional or case–control studies on ANA screening of CTD reporting results for IIF and FEIA. Study quality was assessed usin...
Source: Best Practice and Research Clinical Rheumatology - April 16, 2019 Category: Rheumatology Source Type: research