Nature Reviews Rheumatology 5, 593 (2009). doi:10.1038/nrrheum.2009.215

Authors: Patricia J. Hunter & Lucy R. Wedderburn

Transcriptomics and proteomics are transforming our understanding of juvenile idiopathic arthritis by revealing molecular signatures associated with the various clinical classifications. The challenge now is to find biomarkers that will predict disease course and response to medication in order to improve outcomes for children with arthritis.

Nature Reviews Rheumatology 5, 594 (2009). doi:10.1038/nrrheum.2009.213

Author: Thomas Bardin

Insight into the immunopathogenesis of crystal-induced inflammation has opened the door to a new approach to therapy. Could interleukin-1 antagonists be the answer to managing acute gout?

Nature Reviews Rheumatology 5, 596 (2009). doi:10.1038/nrrheum.2009.212

Author: Chris Deighton

Golimumab effectively reduces the signs and symptoms of active rheumatoid arthritis in patients who have previously failed treatment with at least one tumor necrosis factor inhibitor. Is it now time to develop strategies for sequential drug administration?

Nature Reviews Rheumatology 5, 597 (2009). doi:10.1038/nrrheum.2009.214

Author: Maxime Dougados

Randomized controlled trials investigating non-pharmacological therapies for hand osteoarthritis are rare. One such study now suggests that neoprene splints could be effective for the treatment of base-of-thumb osteoarthritis—but some questions remain unanswered.

Nature Reviews Rheumatology 5, 599 (2009). doi:10.1038/nrrheum.2009.204

Authors: Robert J. Daher, Nadeen O. Chahine, Andrew S. Greenberg, Nicholas A. Sgaglione & Daniel A. Grande

Lesions in articular cartilage can result in significant musculoskeletal morbidity and display unique biomechanical characteristics that make repair difficult, at best. Several surgical procedures have been devised in an attempt to relieve pain, restore function, and delay or stop the progression of cartilaginous lesions. Advanced

Nature Reviews Rheumatology 5, 608 (2009). doi:10.1038/nrrheum.2009.207

Authors: Astrid M. van Tubergen & Robert B. M. Landewé

Spondyloarthritis (SpA) usually follows a chronic disease course that requires regular medical care and monitoring to control for increased disease activity and to maintain physical function. This Review describes the instruments and imaging techniques available for monitoring SpA in clinical practice. Specifically, questionnaires, physical examination

Nature Reviews Rheumatology 5, 616 (2009). doi:10.1038/nrrheum.2009.209

Authors: Claudia Macaubas, Khoa Nguyen, Diana Milojevic, Jane L. Park & Elizabeth D. Mellins

Juvenile idiopathic arthritis (JIA) refers to a group of chronic childhood arthropathies of unknown etiology, currently classified into subtypes primarily on the basis of clinical features. Research has focused on the hypothesis that these subtypes arise through distinct etiologic pathways. In this Review, we discuss

Nature Reviews Rheumatology 5, 627 (2009). doi:10.1038/nrrheum.2009.203

Authors: Dirkjan van Schaardenburg & Ben A. C. Dijkmans

Several advances have been made in the understanding of the pathogenesis, as well as in the clinical evaluation and treatment, of early inflammatory arthritis. The presence of anti-citrullinated protein antibodies (ACPAs) has emerged as a major new biomarker for use in clinical practice. The presence

Nature Reviews Rheumatology 5, 634 (2009). doi:10.1038/nrrheum.2009.210

Authors: Allen P. Anandarajah & Christopher T. Ritchlin

Psoriatic arthritis (PsA) is a chronic inflammatory musculoskeletal disorder associated with a heterogeneous disease presentation, varied disease expression and an unpredictable but often chronically destructive clinical course. Joint damage can occur early in the disease; indeed, several imaging modalities have demonstrated subclinical joint involvement in

Nature Reviews Rheumatology 5, 643 (2009). doi:10.1038/nrrheum.2009.208

Authors: Heikki Valleala, Tamara Tuuminen, Heikki Repo, Kari K. Eklund & Marjatta Leirisalo-Repo

Background. A 55-year-old, HLA-B27-positive Finnish woman presented with migratory, sterile polyarthritis.Investigations. Physical examination, chest radiography, serologic testing, microscopy, M. tuberculosis-specific interferon γ enzyme-linked immunospot (ELISPOT) assay, smear and culture of synovial fluid for acid-fast bacilli, and PCR.Diagnosis. The patient's

Nature Reviews Rheumatology 5, 648 (2009). doi:10.1038/nrrheum.2009.196

Authors: Nancy Agmon-Levin, Ziv Paz, Eitan Israeli & Yehuda Shoenfeld

Vaccines have been used for over 200 years and are the most effective way of preventing the morbidity and mortality associated with infections. Like other drugs, vaccines can cause adverse events, but unlike conventional medicines, which are prescribed to people who are ill, vaccines are