In this case report, we describe a severe acrosyndrome occurring in a young girl, leading to major functional impairment and significant cosmetic sequelae. We report the case of an 18 year old young woman whose quality of life has been severely impaired since 2023. Her initial symptoms consisted of a burning sensation and heat in the distal parts of the lower limbs, occurring in the absence of any trauma. Soon after immersing her feet in ice water, she developed rapid onset erythema and edema. Despite multiple topical treatments, her condition progressed, and she underwent a skin graft, which failed to achieve satisfactory healing. Angiotomoscintigraphy revealed an active bilateral osteoblastic pattern with significant bone and soft tissue involvement, as well as joint space alterations compatible with complex regional pain syndrome (algodystrophy). Conversely, lymphoscintigraphy showed moderate lymphatic insufficiency. In the absence of effective corrective management, her clinical condition continued to worsen, raising significant diagnostic and therapeutic challenges. Two years later, the presentation was suggestive of a critical, permanent idiopathic erythromelalgia, associated with perilesional dyspigmentation following grafting, leading to severe cosmetic disfigurement, discontinuation of physical activity, and a profound psychological impact. This severe and progressive acrosyndrome required extensive etiological investigation and posed a major diagnostic and therapeutic challenge. Early recognition is essential in order to limit trophic complications and improve functional and cosmetic outcomes.
Aim: The aim of this study was to investigate the clinical, functional, and radiological characteristics of hand osteoarthritis (HOA) and to assess their interrelationships. Methods: Between July 2024 and September 2024, a total of 44 women (22 with symptomatic HOA, mean age: 61.55 ± 9.66 years; 22 control participants without symptomatic HOA, mean age: 60.59 ± 8.42 years) were enrolled in the current study. Demographic characteristics were recorded. Grip and pinch strength were measured using a dynamometer and pinch meter. Pain intensity over the previous week was assessed using the visual analog scale (VAS). Functional disability was evaluated using the Duruöz Hand Index (DHI) and the Australian/Canadian Osteoarthritis Hand Index (AUSCAN). The Kellgren–Lawrence (KL) OA scoring system was used for radiological staging evaluation. Results: Sociodemographic characteristics were similar between groups (P > .05), except for longer morning stiffness duration in the HOA group (P=.009). Compared with controls, the HOA group had higher pain and disability scores and lower grip and pinch strength (all P < .05). In BH–FDR-adjusted analyses within the HOA group, DHI correlated negatively with bilateral grip strength and positively with AUSCAN pain, physical function, and total scores, while KL-total score correlated negatively with right-hand grip strength. In controls, no DHI correlations remained significant after BH–FDR correction, and KL-total score correlated only with left-hand grip strength. Conclusion: In this cohort, patient-reported functional measures, particularly the DHI, appeared to reflect functional burden more closely than radiographic grading alone in symptomatic HOA.
Objection: Data on the clinical course of COVID-19 and subsequent humoral immune responses in patients with rheumatic diseases remain limited. This study aimed to compare SARS-CoV-2 antibody responses between patients with rheumatic diseases and healthy controls and to identify clinical and treatment-related factors associated with antibody levels. Methods: This prospectively designed, single-center cross-sectional study included unvaccinated adults with rheumatoid arthritis, systemic lupus erythematosus, or ankylosing spondylitis who had a previous COVID-19 infection, along with age- and sex-matched healthy controls. COVID-19 was identified by PCR confirmation or compatible thoracic CT findings, and anti-spike and anti-nucleocapsid SARS-CoV-2 antibodies were assessed 1-6 months after infection using Elecsys immunoassays. Results: PCR-confirmed infection (P< .001) and several COVID-19-related symptoms, including headache, dyspnea, nausea/vomiting, fatigue, sore throat, and arthralgia, were significantly more frequent in the patient group (all P < .05). However, hospitalization and pulmonary involvement were each significantly more common in the control group (both P< .001). Intensive care admission was similarly low in both groups. Anti-S seropositivity was significantly higher in patients than in controls (P < .001), while anti-N seropositivity and anti-N/anti-S antibody titers were comparable between groups. Antibody levels did not differ significantly among rheumatic disease subgroups. However, both anti-N and anti-S titers were significantly higher in patients not receiving biologic therapy (both P < .001). Conclusion: Humoral immune responses following COVID-19 appeared to be largely preserved in patients with rheumatic diseases. Although anti-S seropositivity was higher in the patient group, antibody titers were lower among those receiving biologic therapy, suggesting a potential treatment-related effect on humoral immunity. Larger studies are warranted to confirm these findings.
Foot and lower limb deformities are common manifestations of several rheumatic and musculoskeletal diseases (RMDs) and are frequently associated with impaired gait performance and functional limitations and pain. The aim of this Narrative Review was to provide a biomechanical and clinical overview of the impact of structural deformities of lower limb on kinematics in patients with RMDs. The Review focuses on conditions with significant musculoskeletal involvement, including rheumatoid arthritis, axial spondyloarthritis, psoriatic arthritis, osteoarthritis, and systemic sclerosis, and examines how these deformities influence joint kinematic and spatiotemporal parameters during gait. Understanding the relationship between gait kinematics and structural deformities of foot and lower limb in RMDs, may support more targeted clinical assessment and help inform rehabilitation strategies aimed at improving functional mobility, independence, and overall quality of life.
Objective: Joint pain is a frequent complaint in clinical practice, often affecting patients’ quality of life. Differentiating between inflammatory rheumatological diseases and non-inflammatory causes, such as osteoarthritis or fibromyalgia, is essential for proper management. This study aimed to evaluate the prevalence of inflammatory rheumatological diagnoses in patients presenting with joint pain and to assess their demographic characteristics. Methods: A retrospective observational study was conducted on 2732 patients who visited the rheumatology outpatient clinic between October 20, 2023, and August 20, 2025, and whose primary ICD-10 diagnosis was joint pain (M25.5). Only first-time visits were included. Secondary diagnoses were used to classify patients into 2 groups: inflammatory rheumatological and non-inflammatory rheumatological. Data were analyzed using Excel and IBM SPSS v25. The Mann–Whitney U-test and chi-square test were used for age and gender comparisons, respectively. Results: Of the patients, 29.4% (n=803) were diagnosed with inflammatory rheumatological diseases, while 70.6% (n=1.929) had non-inflammatory conditions. The mean age was 52.6 ± 13.3 years in the inflammatory group and 54.8 ± 12.9 years in the non-rheumatological group (P < .001). Female patients comprised 78% of the total population, with a significant gender difference between the 2 groups (P < .001). Conclusion: Nearly one-third of patients with joint pain referred to rheumatology received an inflammatory rheumatological diagnosis. These findings may inform clinical triage, improve early diagnosis, and contribute to more efficient healthcare utilization.
The differential diagnosis of large vessel vasculitis (LVV) in patients with cancer is often challenging. We describe a 56-year-old woman with a long-standing history of recurrent breast carcinoma who developed LVV detected on [18F] FDG-PET/CT. Over 18 years, she underwent multiple treatments for cancer, including initial surgery with adjuvant oral cyclophosphamide and UFT for 3 years, surgery for liver metastasis followed by palbociclib, and surgery for bilateral ovarian metastases without subsequent chemotherapy, followed by monthly intramuscular fulvestrant. Notably, she had never received granulocyte colony-stimulating factor (G-CSF). Based on clinical and imaging findings, the LVV was diagnosed as Takayasu arteritis (TAK). Treatment with weekly or biweekly subcutaneous tocilizumab (TCZ) combined with low-dose prednisolone was initiated, during which peripheral eosinophilia developed. This case underscores the diagnostic complexity of LVV in patients with cancer and highlights a potential association between TCZ therapy and eosinophilia.
Objectives: Psoriatic arthritis (PsA) affects approximately one-fifth of psoriasis patients. Given that cutaneous symptoms typically precede joint involvement, dermatologists hold a critical position for early recognition of PsA. Methods: A 30-item structured survey, developed by study authors, was distributed to members of the Turkish Society of Dermatology. This study aims to investigate the current clinical practices, barriers to early recognition, and the factors influencing referral patterns for PsA among dermatologists. Results: Eighty dermatologists participated in the survey. While most respondents inquired about PsA-related symptoms (85%), the utilization of validated screening tools was remarkably low (8.7%). A positive correlation was found between the dermatologists’ self- reported competency in assessing PsA-related symptoms and performance of physical examinations (r = 0.667, P = .001). Significant barriers to the early recognition of PsA included a lack of sufficient time in outpatient visits (61.3%) and patient under-reporting (60.0%). Most dermatologists (93.8%) preferred dual-efficacy treatments for their patients with a suspicion of PsA. Initiation of systemic treatment by dermatologists prior to rheumatology consultation was significantly associated with longer waiting times in the rheumatology referral pathway (P = .008). Conclusion: This study demonstrates that standardized screening tools for the early diagnosis of PsA are not routinely integrated into dermatology practice of our study participants, while inquiries about joint and back pain are common. A trend was observed where prolonged waiting periods for rheumatological evaluations coincided with dermatologists initiating systemic treatment independently. Improving screening strategies, musculoskeletal assessment skills of dermatologists, patient awareness, and access to rheumatology care are essential for optimizing clinical practice.
Granulomatous mastitis (GM) is an inflammatory breast disease that may rarely be accompanied by systemic manifestations such as erythema nodosum (EN) and arthritis. In recent years, the association of GM with EN, with or without arthritis, has been recognized as GMENA syndrome. This report presents a case of GMENA syndrome and reviews the published literature. A 26-year-old woman presented with swelling, erythema, pain, and discharge in the left breast. Initial evaluation suggested infectious mastitis, but prolonged antibiotic therapy was ineffective. During follow-up, bilateral ankle arthritis and pretibial EN developed. Laboratory tests showed marked systemic inflammation. Core needle biopsy demonstrated chronic granulomatous inflammation, and microbiological studies were negative. The GMENA syndrome was diagnosed after exclusion of alternative causes. Methylprednisolone led to rapid improvement in both breast and systemic manifestations. A review of published cases showed a similar pattern of unilateral breast involvement, EN, and frequent peripheral arthritis or arthralgia, with generally favorable responses to corticosteroid therapy. Granulomatous mastitis should be considered in patients with treatment-resistant inflammatory breast lesions accompanied by systemic findings such as EN and arthritis. Recognition of this clinical pattern may help avoid unnecessary antibiotic use and allow timely initiation of appropriate immunosuppressive treatment.
VEXAS syndrome is a recently identified adult-onset autoinflammatory disorder resulting from somatic mutations in the ubiquitin-like modifier activating enzyme 1 (UBA1) gene, characterized by concurrent systemic inflammation and hematologic abnormalities. Since its initial description in 2020, VEXAS syndrome has become recognized as a prototype hemato-inflammatory condition at the intersection of rheumatology and hematology. The clinical presentation is diverse, including refractory inflammation, neutrophilic dermatoses, chondritis, vasculitis, pulmonary involvement, and progressive cytopenias, frequently mimicking established rheumatologic and hematologic diseases. Diagnosis requires a high degree of clinical suspicion and confirmation of somatic UBA1 mutations through appropriate molecular techniques. Management remains challenging; glucocorticoids provide temporary symptom control, while targeted therapies, hypomethylating agents, and hematopoietic stem cell transplantation are emerging as disease-modifying options for selected patients. This narrative review summarizes an overview of current understanding regarding the pathogenesis, clinical features, diagnostic strategies, and management strategies for VEXAS syndrome, aiming to improve awareness and facilitate timely diagnosis and optimal patient care.
Objective: Several factors such as effectiveness, safety, and compliance affect the drug survival in chronic disorders. Physicians consider long-term retention rates and reasons for discontinuation when selecting therapies. Identification of predictors of clinical response to certolizumab pegol (CZP) may aid the decision-making process for treating patients with psoriatic arthritis (PsA). The purpose of this study is to assess the drug survival of CZP in patients with PsA and to identify the predictors and reasons for discontinuation. Methods: Data on patient characteristics, demographics, diagnosis, disease duration, treatment, and outcomes have been collected since 2011 in Turkish Biologic (TURKBIO) Registry. By the end of December 2020, 68 PsA patients received CZP and were included. Kaplan–Meier analysis was used for drug survival analysis. Cox regression analysis was performed to evaluate the predictors associated with drug survival. Results: During a median follow-up of 47 months, 17 patients discontinued CZP treatment. At 36 months, the retention rate was 61.6%. Patients who discontinued CZP were older and had longer disease duration (P=.012 and P=.002, respectively). HLA-B27 positivity was associated with lower drug survival (P=.035). Biologic-naive patients demonstrated higher drug survival in Kaplan–Meier analysis (log-rank P=.02), although baseline comparison did not reach statistical significance (P = .062). In Cox regression analysis, age was identified as an independent predictor of treatment discontinuation (hazard ratio: 1.063, 95% CI: 1.019-1.109, P=.004). Conclusion: In this real-world analysis from the TURKBIO registry, CZP demonstrated moderate long-term drug retention in patients with PsA. Older age was independently associated with reduced treatment persistence, while longer disease duration was also associated with lower retention. Biologic-naive status was linked to improved drug survival. HLA-B27 positivity was also associated with lower drug survival; however, this finding should be interpreted with caution due to limited data availability. These results support the potential benefit of earlier initiation of CZP, particularly in biologic-naive patients, while highlighting the need for further studies to clarify the role of genetic factors in treatment persistence.
Leishmaniasis—particularly visceral leishmaniasis (VL)—is marked by profound immune dysregulation, including polyclonal hypergammaglobulinemia, cytopenias, and broad autoantibody positivity, often mimicking autoimmune diseases (AID) such as systemic lupus erythematosus (SLE) and autoimmune hepatitis (AIH). In addition, immunosuppressive and biologic therapies used in AID may increase susceptibility to opportunistic leishmaniasis. This narrative review synthesizes primary studies and relevant literature to examine (i) autoimmune-like clinical and serological features of VL and other forms of leishmaniasis; (ii) occurrence in patients with AID receiving immunosuppressive therapy; (iii) underlying immunological mechanisms; and (iv) clinical implications for diagnosis and management. Evidence consistently shows frequent autoantibody positivity in VL, including antinuclear antibodies, anti-extractable nuclear antigen antibodies, rheumatoid factor, and direct Coombs positivity, often reversible after antiparasitic treatment. Clinical presentations resembling SLE or AIH are well documented. Increased cases are reported in patients receiving anti–tumor necrosis factor therapy, particularly in endemic areas. These findings highlight diagnostic overlap and reinforce the need to consider VL in autoimmune-like syndromes. Visceral leishmaniasis may induce “reactive autoimmunity” and simulate AID; thus, screening, exclusion of active infection, and post-treatment reassessment are essential to prevent misdiagnosis and inappropriate immunosuppression.
Objective: This study aimed to evaluate the reliability and readability of publicly available online information on lymphedema across different website typologies. A Google search was performed using the keyword “lymphedema,” and the first 200 results were screened. Eligible websites providing patient-oriented information were assessed for typology, reliability, readability, and content coverage. Reliability was evaluated using the Journal of the American Medical Association (JAMA) benchmark criteria, and readability was assessed using established readability formulas. Content analysis examined the presence of essential clinical information, including etiology, symptoms, diagnosis, and treatment options such as medication, exercise, rehabilitation, surgery, and prevention. Non-text pages, duplicates, advertisements, and inaccessible websites were excluded. Methods: A total of 143 websites were analyzed, of which 45 (31.5%) demonstrated high reliability (JAMA ≥3). Readability scores showed no meaningful differences across website typologies, although government and professional websites tended to have slightly easier reading levels. High-reliability websites exhibited marginally lower readability ease; however, these differences were not statistically significant. Content analysis revealed significant variation among website categories in the reporting of surgery (P=.02) and prevention (P=.01). No significant differences were identified between the top 10 search results and the remaining websites regarding reliability or readability. Health portal websites provided the most comprehensive clinical information, whereas other website types showed incomplete coverage in at least one informational domain. Results: Overall, variability in readability among website categories was limited, and no specific typology consistently offered superior accessibility. Compared with previous research that evaluated narrower website samples, this cross-sectional analysis provides a comprehensive assessment of reliability, readability, and informational completeness. Conclusion: These findings indicate that a substantial proportion of online lymphedema information remains suboptimal in reliability and clarity. Improving digital patient education requires coordinated efforts from healthcare professionals, academic institutions, and professional organizations to ensure that online resources are accurate, understandable, and accessible.
Objective: The pathogenesis of ankylosing spondylitis (AS) involves both genetic and environmental factors. This study aimed to investigate whether shared living spaces increase the risk of AS development in the spouses of patients with AS. Methods: The study included consecutive AS patients from the Hacettepe University Rheumatology Clinic (November 2021-June 2022) diagnosed using the Assessment of SpondyloArthritis international Society (ASAS) criteria. This research was conducted using a cross-sectional design. Spouses with reported AS were evaluated to confirm diagnoses. Confirmed AS cases were included, while undiagnosed inflammatory low back pain cases were excluded. Two rheumatologists independently assessed the spouses using pelvic radiography and sacroiliac magnetic resonance imaging, if needed. Standardized incidence ratios (SIRs) were calculated by dividing the observed number of cases by the expected number of cases, derived from age- and sex-specific incidence rates applied to the person-years at risk. Results: Among the 680 patients, 582 (85.6%) had AS, 72 (10.6%) had non-radiographic axial spondyloarthritis, and 26 (3.8%) had peripheral spondyloarthritis. The mean follow-up was 10.6 (±7.9) years. Spouses of 7 patients (1.2%, 95% CI: 0.5-2.5) met the ASAS criteria for AS. Excluding 2 patients diagnosed before marriage, the prevalence of AS among spouses was 5/580 (0.86%, 95% CI: 0.3-2). Over 12 635 person-years of marriage, 5 new AS cases were observed vs. 0.82 expected (SIR: 6.1, 95% CI: 2.0-14.2). Among unrelated spouses, 3 post-marriage AS cases were observed over 12 613 person-years, yielding an SIR of 3.65 (95% CI: 0.75-10.68). Conclusion: Among spouses living in the same environment, the diagnosis of AS increased by approximately sixfold. Even after excluding consanguineous couples, the incidence of AS remained higher than expected among unrelated spouses, although the statistical significance was limited by the small number of observed cases. This observation may suggest a role for shared environmental factors in the development of AS.
Aim:This study aimed to compare demographic, biochemical, and electrophysiological parameters between patients with carpal tunnel syndrome (CTS) and healthy individuals, and to evaluate the potential roles of these parameters in the disease’s pathophysiology. Material and Methods:The study included 62 healthy controls and 408 patients with CTS (128 unilateral and 280 bilateral). Demographic characteristics, biochemical parameters (including vitamin D, hemoglobin, ferritin, and other routine biochemical tests), and electromyography (EMG) findings were assessed. Comparisons between groups were performed using appropriate non-parametric tests, with a p-value of <0.05 considered statistically significant. Results:Levels of vitamin D, hemoglobin, and ferritin were significantly reduced in patients with CTS, compared with healthy controls (all p<0.01). No significant differences were detected in the remaining biochemical parameters. Electrophysiological evaluation demonstrated that disease severity was more pronounced in bilateral CTS cases than in unilateral cases. Conclusion:It has been demonstrated that not only anatomical and mechanical factors but also metabolic and hematological parameters may play a role in the development of CTS. In particular, incorporating the assessment of vitamin D, hemoglobin, and ferritin levels into routine evaluations may contribute to the early diagnosis and management of CTS.
Deep vein thrombosis (DVT) is a potentially serious vascular condition with multiple well-established risk factors, including immobility, surgery, trauma, malignancy, and inherited or acquired thrombophilias. Infectious causes of DVT are rare but have been increasingly recognized, with brucellosis being one such unusual infectious etiology. Brucellosis is a zoonotic infection caused by Brucella species, endemic in many regions, including the Middle East, Mediterranean countries, and parts of Latin America. While musculoskeletal manifestations such as arthritis, spondylitis, and sacroiliitis are commonly reported, vascular complications like DVT are seldom described. Highlighting these rare presentations is important for early recognition and appropriate management. We report the case of a 22-year-old woman with no prior chronic illnesses who presented with a 10-day history of bilateral leg pain, swelling, and redness. She was initially referred to the rheumatology clinic with a provisional diagnosis of arthritis. On physical examination, both ankles were erythematous, warm, and edematous; Homan’s sign was positive in the left leg. Doppler ultrasonography confirmed DVT in the affected limbs. Laboratory tests revealed elevated acute-phase reactants, including erythrocyte sedimentation rate and C-reactive protein. Blood cultures grew Gram-negative coccobacilli, and serological tests, including rose bengal and serum tube agglutination, were positive for Brucella. Following infectious diseases consultation, a diagnosis of acute brucellosis was made, and combination therapy with rifampicin and doxycycline was initiated. Concurrently, anticoagulation therapy with warfarin was initiated under the guidance of the cardiovascular surgery team. The patient’s clinical symptoms gradually improved with combined antimicrobial and anticoagulant therapy. Brucellosis, though rare, should be considered in the differential diagnosis of DVT, especially in endemic regions. Early recognition allows timely antimicrobial and anticoagulant therapy. Clinicians should suspect infectious causes of DVT in patients with limb swelling, pain, or systemic symptoms, even without classical risk factors.
Sjögren’s syndrome (SjS) is a chronic autoimmune disorder characterized by lymphocytic infiltration of the exocrine glands, which can also affect the gastrointestinal (GI) tract, hepatobiliary system, and pancreatic exocrine tissues. Approximately one-third of patients experience GI-related symptoms, with xerostomia, dysphagia, dyspepsia, and atrophic gastritis being the most commonly reported manifestations. SjS is also associated with autoimmune liver diseases, including autoimmune hepatitis and primary biliary cholangitis. Pancreatic involvement is less frequent, but may present as autoimmune pancreatitis or exocrine pancreatic insufficiency. The complexity of SjS and the variety of its manifestations underscore the importance of a multidisciplinary management approach, where collaboration among healthcare professionals is crucial for optimising patient outcomes.
Aim: It is not easy to differentiate Brucella sacroiliitis from axial spondyloarthritis (axSpA)-related sacroiliitis using conventional magnetic resonance imaging (MRI). Histogram analysis, a new technique, is considered useful for differential diagnosis. This study aimed to investigate the role of MRI histogram analysis in the differential diagnosis of Brucella sacroiliitis and axSpA-related sacroiliitis. Material and Methods: This study included 25 patients with axSpA-related sacroiliitis and 25 patients with sacroiliitis secondary to brucellosis. Histogram analysis of the sacroiliac MRI images of the patients was performed on inflammatory areas detected on the T2 fat-suppressed sequence. Ten percent, 90 percent, entropy, kurtosis, maximum, mean, median, minimum, skewness uniformity, and variance values were measured. The values obtained were compared between the groups. Results: There was a statistically significant difference between the 10 percent, median, and minimum values (p=0.018, p=0.029, p=0.002, respectively) and no difference between the other values (p>0.05 for all). Conclusion: MRI histogram analysis appears promising as a potential complementary tool for differentiating Brucella sacroiliitis from sacroiliitis associated with axSpA; however, these findings are preliminary and require confirmation in larger studies.
The aim of this case report was to evaluate the potential efficacy of adjunctive ozone therapy combined with tocilizumab in treating refractory lower extremity ulcers in patients with diffuse systemic sclerosis (SSc). We report two female patients with diffuse SSc who developed refractory ulcers despite prior therapies, including azathioprine, mycophenolate mofetil, cyclophosphamide, and vasodilators. Both patients were receiving weekly subcutaneous tocilizumab (162 mg) when ozone therapy was introduced. The protocol consisted of major autohemotherapy with ozone (initial dose 15 µg/mL; maintenance dose 65 µg/mL), combined with ozone bagging. Treatment included 25 daily sessions, 25 twice-weekly sessions, and subsequent weekly maintenance sessions. Both patients exhibited significant ulcer healing, pain reduction, and improved mobility, suggesting synergistic effects beyond those of tocilizumab monotherapy. Refractory SSc-associated ulcers remain a therapeutic challenge. The combination of tocilizumab and ozone therapy may provide additional benefits through anti-inflammatory and microcirculatory mechanisms. Controlled trials are warranted.
Aim: Psoriatic arthritis (PsA) is expected to cause an increased risk of scoliosis because it affects the axial skeleton asymmetrically. In this study, we compared the frequency of scoliosis in PsA patients with that in healthy controls (HC) and axial spondyloarthritis (axSpA) patients. Thus, we aimed to explore whether scoliosis might be a clinical feature of PsA and to assess its potential role in differentiating PsA from axSpA. Material and Methods: The study included 60 PsA patients, 60 axSpA patients and 40 HC. All individuals in the study were assessed for the presence of scoliosis by physical examination. Scoliosis radiography was performed in those with a positive scoliosis test on physical examination. The Cobb angle was measured using the appropriate method. A two-tailed significance level of 0.05 was considered in all analyses. Results: Within this research, the frequency of scoliosis in PsA patients was compared with the axSpA and HC groups. The Cobb angle value was notably higher in the PsA group compared to axSpA and HC (p=0.006 and p=0.007, respectively). On physical examination, scoliosis findings and coronal spinal curvature, were observed at elevated rates in the PsA group relative to the other two groups (p>0.05 for all, indicating no statistical significance). Scoliosis was more frequent in the PsA group than in the axSpA group (p=0.046). All scoliosis cases in PsA were in mild or moderate severity. Conclusion: Both the frequency of scoliosis and Cobb angle values were greater in PsA than those in axSpA. This outcome may be associated with the asymmetric involvement of lateral spinal structures typical of PsA. Overall, these results indicate that scoliosis could serve as a supportive marker for PsA and may aid in differentiating PsA from axSpA.
Aim: Pulmonary involvement is a major contributor to both morbidity and mortality in systemic sclerosis (SSc). While specific autoantibodies, such as anti-Scl-70 and anti-centromere, have been linked to distinct disease subtypes and organ complications, the role of anti-Ro antibodies in SSc—particularly in relation to pulmonary manifestations—has not been fully elucidated. Understanding this relationship may provide insights into disease stratification and risk assessment for lung involvement in SSc patients. This study aimed to determine the prevalence of anti-Ro antibodies in patients with SSc and to investigate their potential association with pulmonary complications, including interstitial lung disease and pulmonary arterial hypertension. Material and Methods: We retrospectively reviewed 73 patients with SSc who underwent anti-Ro antibody testing, chest X-rays, and high-resolution computed tomography (HRCT). Serum levels of anti-Scl-70, anti-centromere, anti-Ro, and anti-La antibodies were measured using enzyme-linked immunosorbent assay, with a positivity threshold of ≥21 IU/mL, while antinuclear antibodies (ANA) were assessed via indirect immunofluorescence. Pulmonary changes were evaluated by imaging, with particular attention to reticular patterns, ground-glass opacities, and honeycombing. Results: ANA positivity was observed in 94.5% of patients. Anti-Scl-70 and anti-centromere antibodies were detected in 52.8% and 18.8% of patients, respectively. Anti-Ro antibodies were positive in six patients (8.2% of the cohort); all were also ANA-positive. Two patients (2.7% of the cohort) were positive for anti-Scl-70, while none exhibited anti-centromere antibodies. Pulmonary abnormalities were more frequently observed in anti-Ro-positive patients on both chest radiographs and HRCT, although these differences did not reach statistical significance. Conclusion: Anti-Ro antibodies were uncommon in SSc, but were associated with a non-significant trend toward increased pulmonary involvement. Larger prospective studies, especially evaluating anti-Ro52, are needed to clarify their clinical relevance.
