Current Rheumatology Reviews - Volume 1, Issue 2, 2005

Bone scanning is one of the most common procedures performed in the majority of nuclear medicine departments. Radionuclides on 99m-Tc phosphonates initiated the widespread use of bone scintigraphy over 40 years ago. These diagnostic methods exhibit excellent sensitivity in the detection of local abnormalities of bone metabolism, but specificity is lacking. Interpretation using conventional radiological diagnostic Read More

Mounting evidence points to the importance of the role played by inflammatory mediators, such as cytokines or prostanoids, in the degradation of cartilage, not only in inflammatory arthritis, but also in degenerative joint diseases. In addition to well-known mediators such as interleukin-1, recent investigations have revealed the distinctive roles of a variety of other mediators in the regulation of cartilage matrix turnover. Th Read More

There is a lot of evidence that osteoclasts have a pivotal role in the subchondral, periarticular and general bone loss in rheumatoid arthritis. Bisphosphonates have a high affinity for bone where they are strong inhibitors of osteoclast mediated bone resorption. There is no doubt that bisphosphonates are useful in patients with postmenopausal or glucocorticoid induced osteoporosis certainly if these patients also suffer Read More

Programmed cell death (i.e. apoptosis) plays a critical role in the pathogenesis and progression of several arthritic conditions and autoimmune disorders. Apoptosis induction is dependent on the extent to which the initiating apoptotic signal occurs via a receptor-mediated event (i.e. extrinsic pathway) or by changes in mitochondrial membrane permeability (i.e. intrinsic pathway). In this regard, differential activation of downstr Read More

Rheumatoid arthritis (RA) is a chronic, multisystem autoimmune disease characterized by persistent accumulation of leukocytes in the synovial compartment. The influx of the leukocytes is important as a critical step in the pathogenesis of RA. Chemotactic cytokines (chemokines) play a critical role in the pathogenesis of RA not only by inducing the migration of inflammatory cells but also by enhancing the production of in Read More

Over the past decades, a number of studies have evaluated the long-term outcome of juvenile idiopathic arthritis (JIA) and some of them have also attempted to identify early prognostic factors. The available data indicate that JIA is not a benign disease because a substantial number of patients still enter adulthood with persistently active disease and may develop severe physical disability. Although a great deal of data are accum Read More

Tumor necrosis factor (TNF) and TNF receptors are members of a family of molecules with important regulatory functions that include cellular activation and apoptosis. Neutralization of TNFa has proven to be effective in a variety of inflammatory disorders and autoimmune diseases such as rheumatoid arthritis and Crohn's disease. Treatment of inflammatory myopathies remains a challenge, especially in the case of refracto Read More

Despite the various classical works, the mechanism of chronic low back pain has not been fully understood. Recent improvement of neuroanatomical techniques has enabled discrimination of fine neural elements as well as exact tracing of the neural projection. Use of these techniques to elucidate the fine innervation of the vertebral column has provided numerous original findings. The present article reviews Read More

The presence of antiphospholipid antibodies (aPL) combined with venous or arterial thrombosis, and/or obstetric complications defines the antiphospholipid syndrome (APS). Lupus anticoagulants (LA) and anticardiolipin antibodies (aCL) were the first described aPL. It has been shown that aPL, despite their name, are not directed against anionic phospholipids, as had previously thought, but are a part of a large family o Read More

For over 20 years cyclophosphamide, either intravenous or oral, has been widely used in the treatment of patients with lupus nephritis, cerebritis and vasculitis. Although clearly beneficial for many patients, its propensity to cause haematological complications and reduced fertility has made it unpopular with both patients and physicians. The introduction of mycophenalate mofetil, and the exciting potential for other forms of th Read More

Hyperuricemia is strongly associated with several known risk factors for cardiac disease including hypertension, diabetes mellitus, hypercholesterolemia and obesity. Despite this association between hyperuricemia and these coronary artery disease risk indicators, most studies have failed to demonstrate a direct causal relationship between hyperuricemia itself and cardiovascular disease. It has been suggested Read More

The history of syphilis is one of irresponsibility, mythology and more recently, scientific insight. Pseudo-Descartian (defined as 'I think, therefore I publish') mythology has until now precluded any cogent discussion of where the disease originated and who was responsible for its spread. Evidence-based research now allows clear separation of syphilis from others in its class of treponematosis. Examination of skeletons fro Read More