Journal of Rheumatology

With improved disease control, an increasing number of women with rheumatic diseases (RDs) are considering pregnancies. Though there are many international guidelines available for managing pregnancies in RD, the execution of a plan for such care is generally limited by several factors, leaving gaps between evidence and practice.1-4 .

We read with great interest the recent article by Ramdani and colleagues in The Journal of Rheumatology on a nationwide multicenter, retrospective study conducted in France describing the status of the occurrence of IgA vasculitis (IgAV) after coronavirus disease 2019 (COVID-19) vaccination.1 We support and appreciate the authors' work and agree with their conclusions that IgA vasculitis following COVID-19 vaccination is usually benign and that a fortuitous link cannot be ruled out and now requires a worldwide pharmacovigilance study, but there are some concerns about some of the details in the article...

Gold is highly prized for its luster, is malleable, and may have been among the first metals used for medical purposes by humans. The first documentation of the use of gold metal as a medical device is in 4500-year-old Egyptian mummies.

OBJECTIVE: To examine the effect of biologic sex on wait-times to first rheumatology appointment in a central triage system before and during the COVID-19 pandemic. METHODS: De-identified data of all referred patients between November 2019 and June 2022 were extracted from the electronic medical record. Variables including time from referral to first appointment, biologic sex, referral period, urgency status, age, and geographic location were collected and analyzed...

Granulomatosis with polyangiitis (GPA) is an antineutrophil cytoplasmic antibody-associated vasculitis that affects mainly small-sized vessels and is characterized by upper and lower respiratory tract, kidney, eye, skin, and neurologic involvement.

Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAVs) are multiorgan autoimmune disorders resulting in irreversible organ damage. Left untreated, AAVs are fatal, and aggressive immunosuppressive treatment has transformed them into chronic relapsing conditions.

OBJECTIVE: To assess trends in incidence of heart failure (HF) in patients with incident rheumatoid arthritis (RA) in 1980-2009 and to compare different HF definitions in RA. METHODS: The study population comprised Olmsted County, Minnesota residents with incident RA (age ≥ 18 years, 1987 ACR criteria met in 1980-2009). All subjects were followed until death, migration, or 04/30/2019. Incident HF events were defined as: 1) Framingham criteria for HF; 2) Diagnosis of HF (outpatient or inpatient) by a physician; 3) ICD-9/10 codes for HF...

We greatly appreciated the manuscript by Björn Buehring et al1 about the high prevalence of foot insufficiency fractures (IFs) in patients with inflammatory rheumatic and musculoskeletal diseases (RMDs) who were referred for magnetic resonance imaging (MRI) because of foot pain, for several reasons. First, in using MRI, IFs were frequently diagnosed (7.5%) in referred patients with RMDs who had foot pain, and even more frequently in patients with inflammatory RMDs than in patients with noninflammatory RMDs (9...

First, we would like to thank Wang and colleagues for their careful reading and relevant comments.1 Concerning the first remark, it is indeed an error on the pre-proof manuscript, which has been corrected in the final version.

OBJECTIVE: To evaluate levels of burnout and correlates of burnout among U.S. rheumatology fellows. METHODS: U.S. rheumatology fellows were invited to complete an electronic survey in 2019. Burnout was assessed utilizing Maslach Burnout Inventory (MBI). Measures of depression, fatigue, quality of life, and training year were also collected. Open-ended questions about perceived factors to promote resiliency and factors leading to increased burnout were included. Bivariate and multivariate regression analyses were used to examine correlates of burnout...

Calcinosis cutis is the deposition of insoluble calcium in the skin and subcutaneous tissues, frequently associated with autoimmune connective tissue diseases, including systemic sclerosis (SSc).1 Calcinosis in SSc presents as subcutaneous nodules of variable size and shape, most frequently on the fingers, but can also affect other locations.2 .

Disseminated nontuberculous mycobacterium (NTM) infection is rare in the differential diagnosis of rheumatoid nodules. The infection is seen primarily in immunosuppressed patients and has been reported in patients with rheumatoid arthritis.

OBJECTIVE: To evaluate tocilizumab (TCZ) efficacy in refractory Behcet's Disease (BD) patients. METHODS: Multicenter study of 30 patients fulfilling the International Criteria for BD and treated with TCZ at different European referral centres. The clinical response was evaluated at 6 months (M6) from TCZ initiation. RESULTS: Ninety percent of BD patients were refractory or intolerant to anti-TNF-α agents. Overall, TCZ was effective in 25 (83%) BD patients of whom 18 (60%) and 7 (23%) were complete and partial responders, respectively...

OBJECTIVE: Psoriatic arthritis (PsA) prevalence estimates vary across studies; studies based on national data are few. We aimed to estimate the prevalence of clinically diagnosed PsA in Sweden in 2017, overall and stratified by sex/age/education/geography, and to quantify disease-modifying anti-rheumatic drug (DMARD) use among those in contact with specialized rheumatology care 2015-2017. METHODS: Individuals, 18-79 years (y), alive, residing in Sweden on December 31, 2017, with a prior PsA diagnosis were identified from the National Patient Register (NPR) and/or the Swedish Rheumatology Quality Register (SRQ)...

During my first 2 years of medical school, I noticed how many syndromes and symptoms are named after animals. These visual metaphors are especially memorable because they evoke clear and vivid images and shapes.

Erosive gout is a hallmark of severe disease and an indication to begin urate-lowering therapy, which can be started concurrently during a gout flare, to prevent further articular damage and flare recurrence.1 A 56-year-old male refugee presented to clinic with several days of left knee pain and swelling.

Described in 2011 as a magnetic resonance imaging (MRI) finding of bone marrow edema situated around a physis at the time of fusion, focal periphyseal edema (FOPE) has been described only in the knees1 and hips2 of adolescents between 12 and 16 years of age. Symptoms range from 2 days to 1 year and resolve without any treatment. Some adolescents may be asymptomatic.3 .

Mental health, which encompasses psychological and emotional well-being, is increasingly being recognized as an important aspect of overall health in youth with chronic disease. Particularly in this time of the mental health crisis in children due in large part to the coronavirus disease 2019 (COVID-19) pandemic,1 with evidence of adverse effects on managing rheumatologic disease,2 addressing mental health issues has become critical.

OBJECTIVE: Medial opening wedge high tibial osteotomy (HTO) aims to improve symptoms for patients with knee osteoarthritis (OA) and varus alignment, yet the likelihood of achieving a minimum clinical threshold of response and the factors predictive of response are unclear. We evaluated the proportion of patients meeting responder criteria based on the Outcome Measures in Rheumatology-Osteoarthritis Research Society International consensus 2 years after medial opening wedge HTO and investigated predictors of response...

Treatment options for rheumatoid arthritis (RA), spondyloarthritis (SpA) and psoriatic arthritis (PsA) have improved with the introduction of biologic and targeted synthetic disease-modifying antirheumatic drugs. Although a good clinical response and even remission can be achieved in most cases, a low quality of life (QOL), depression, and chronic pain often persist and lead to an increased disease burden.