Current Rheumatology Reviews - Volume 6, Issue 1, 2010

Welcome to a new year and new volume of the CRR! As in past years, we promise to provide high quality, thought provoking articles of current interest to the general rheumatologist in the forthcoming issues. The purpose of this journal is to provide a forum for thought leaders to disseminate useful insights to general rheumatologists, and to publish worthy reviews from expert phsyicians. In pursuing this goal, we a Read More

The antiphospholipid syndrome (APS) is defined by the occurrence of venous and arterial thromboses, often multiple, and pregnancy morbidity (abortions, fetal deaths, premature births), in the presence of antiphospholipid antibodies, namely lupus anticoagulant, anticardiolipin antibodies, or anti-β2 glycoprotein-I antibodies [1]. The APS can be found in patients having neither clinical nor laboratory evidence of another definabl Read More

Antiphospholipid syndrome is an autoimmune disorder characterized by the presence of antiphospholipid antibodies, hypercoagulability leading to vascular thrombosis, and recurrent fetal loss. Since its recognition, a great number of cardiac manifestations have been reported in association with these antibodies: valvular disease, coronary artery disease, cardiomyopathy and intracardiac thrombosis. Pulmonary manifestation Read More

Neurologic disorders are among the most comum and important clinical manifestations associated with the antiphospholipid syndrome (APS), mainly those that affects the central nervous system (CNS). These include sroke, transient ischemic attack, Sneddon's syndrome, convulsions/epilepsy, dementia, cognitive deficits, headaches/migraine, chorea, multiple sclerosis-like, transverse myelitis, ocular sympt Read More

Antiphospholipid syndrome (APS) in pregnancy is characterized by the presence of autoantibodies in association with recurrent early miscarriages, fetal losses or severe obstetric complications such as prematurity, intrauterine growth restriction and uteroplacental insufficiency. Several mechanisms are hypothesized to explain the pathogenesis of pregnancy failures including decidual thrombosis or placental vasculopath Read More

Osteonecrosis (ON) or avascular necrosis of bone is a well recognised complication in patients with systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS). The pathogenesis of ON is probably multifactorial, of which abnormal hemostatic state such as the presence of antiphospholipid antibodies (aPL) may play an important role. In patients with aPL, bilateral involvement of femoral head is often found, Read More

The eye involvement in the antiphospholipid syndrome (APS) is particularly frequent and includes a number of annexes and anterior and/or posterior segment lesions. There is a high prevalence of transient visual mono- or binocular disturbances related to autoimmune-mediated inflammatory responses and ischemia. The posterior ocular pole is usually the most affected and the one with more severe functional d Read More

Skin manifestations are very frequent in the antiphospholipid syndrome (APS) and may be the presenting symptom of the disease. Taking into account the impact of early diagnosis on APS outcome, recognition and interpretation of these skin manifestations is paramount. Most skin lesions are the result of blood-flow impairment in the skin microvascular system. Livedo reticularis, livedo racemosa, retiform purpura and lived Read More

Endocrine manifestations of the antiphospholipid syndrome (APS) are very rare. Adrenal insufficiency, surprisingly usually due to venous infarction, is the most common. It can even be the presenting manifestation of APS, occur in patients with transient antiphospholipid antibodies or even in a neonate through transplacental transfer of maternal antiphospholipid antibodies. The presentation, differential diagnosis, and treatment Read More

The antiphospholipid syndrome is characterized by arterial/venous thrombosis and recurrent pregnancy loss in the presence of antiphospholipid antibodies in laboratory tests. There are well-documented additional associations between antiphospholipid antibodies and several abnormalities of specific cellular components of the blood, such as thrombocytopenia, hemolytic anemia, and, less frequently, leukopenia. The main hem Read More

Psoriatic arthritis (PsA) is a chronic systemic disease with inflammatory arthritis which occurs in patients who are currently or have been affected by psoriasis. PsA may result in significant functional impairment and reduced quality of life. Evidence now exists documenting the central role of TNF-α in both PsA and psoriasis. Genetic, environmental, and immunologic factors play an interrelated role which provides us with a bett Read More

Articular cartilage defects have poor healing capacity and can lead to osteoarthritis. Treatment strategies for isolated cartilage lesions of the knee are discussed with a special focus on natural history and evidence of the effectiveness of procedures. Many approaches have been undertaken during the last two decades to find treatments for biological repair of the cartilage surface. Surgical techniques include debridement, sti Read More

Rheumatoid arthritis is a common and disabling condition which can be effectively managed through a multidisciplinary approach. A review of the etiology, pathophysiology, clinical presentation, diagnosis and treatment is presented, followed by a discussion focused on the disease presentation and management in the foot and ankle. Conservative care options, perioperative considerations and surgical treatment options for rheu Read More