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Mean time from vaccine administration to clinical manifestations onset was 9 days (range 1-28); most patients 16 (53.3%) received the BNT162b2 vaccine. Interestingly, amongst systemic AEs, arthralgia is one of the most common [[2]] and only isolated cases [[6]-[9]] of inflammatory rheumatic diseases developed after COVID-19 vaccine administration have been described to date. [Extracted from the article]

Background: Frailty is a construct recently introduced in the context of inflammatory joint diseases. To date, it is not clear if frailty can act as a negative factor in the achievement of comprehensive disease control (CDC) in patients suffering from rheumatoid arthritis (RA). Aim: To verify whether frailty is a factor hindering the achievement of CDC in patients with RA starting a biologic drug. Methods: RA patients requiring a treatment with a biologic drug were included. Patients were classified as achieving or not achieving CDC after 12 months of treatment. Patients were classified as non-frail, mildly frail, moderately frail and severely frail according to the Comprehensive Rheumatologic Assessment of Frailty (CRAF). Frailty was tested using the Mann–Whitney or Kruskal-Wallis test for continuous variables and chi-square test or Fisher's exact test for comparison with categorical variables. A multivariable logistic regression was performed to identify factors associated with prediction of CDC achievers. Results: A total of 214 RA patients were followed for 12 months, 14.5% achieved CDC. Eighty-four (39.3%) patients were non-frail, 57 (26.6%) were mildly frail, 14 (6.5%) were moderately frail and 59 (27.6%) were severely frail. The multivariable logistic regression analysis identified the CRAF score at baseline as an independent variable for CDC achievement at 12 months (p = 0.0040). Discussion: Frailty is a frequent condition in RA patients and reduces the chances of achieving CDC. Conclusions: Frailty, measured by CRAF, reduced the likelihood of CDC achievement in RA patients treated with a biologic agent. Key Points • Frailty is an under-researched condition in rheumatoid arthritis affecting more than 60% of patients. • Frailty is a condition that hinders the achievement of comprehensive disease control after 1 year of treatment with biological drugs in patients with rheumatoid arthritis. [ABSTRACT FROM AUTHOR]

Purpose of Review: To highlight the potential uses and applications of imaging in the assessment of the most common and relevant musculoskeletal (MSK) manifestations in systemic lupus erythematosus (SLE). Recent Findings: Ultrasound (US) and magnetic resonance imaging (MRI) are accurate and sensitive in the assessment of inflammation and structural damage at the joint and soft tissue structures in patients with SLE. The US is particularly helpful for the detection of joint and/or tendon inflammation in patients with arthralgia but without clinical synovitis, and for the early identification of bone erosions. MRI plays a key role in the early diagnosis of osteonecrosis and in the assessment of muscle involvement (i.e., myositis and myopathy). Conventional radiography (CR) remains the traditional gold standard for the evaluation of structural damage in patients with joint involvement, and for the study of bone pathology. The diagnostic value of CR is affected by the poor sensitivity in demonstrating early structural changes at joint and soft tissue level. Computed tomography allows a detailed evaluation of bone damage. However, the inability to distinguish different soft tissues and the need for ionizing radiation limit its use to selected clinical circumstances. Nuclear imaging techniques are valuable resources in patients with suspected bone infection (i.e., osteomyelitis), especially when MRI is contraindicated. Finally, dual energy X-ray absorptiometry represents the imaging mainstay for the assessment and monitoring of bone status in patients with or at-risk of osteoporosis. Summary: Imaging provides relevant and valuable information in the assessment of MSK involvement in SLE. [ABSTRACT FROM AUTHOR]

Ultrasound is a rapidly evolving technique that is gaining an increasing success in the assessment of psoriatic arthritis. Most of the studies have been aimed at investigating its ability in the assessment of joints, tendons, and entheses in psoriatic arthritis patients. Less attention has been paid to demonstrate the potential of ultrasound in the evaluation of skin and nail. The aim of this pictorial essay was to show the main high-frequency grayscale and power Doppler ultrasound findings in patients with psoriatic arthritis at joint, tendon, enthesis, skin, and nail level. [ABSTRACT FROM AUTHOR]

The aim of this study was to ascertain which clinical and immunological factors are associated with Raynaud’s phenomenon (RP) in patients with undifferentiated connective tissue disease (UCTD) and to investigate microvascular involvement. A total of 78 patients were evaluated. They all showed symptoms suggestive of a connective tissue disorder (CTD), but did not fulfil the criteria for any of the defined CTDs. They all had a disease duration of at least 1 year. Nailfold capillaroscopy (NC) was performed using a computerised videomicroscope. We diagnosed RP in 52.5% of our patients. Patients with RP showed a higher occurrence of oesophageal dysmotility (p=0.001) and anti-ribonucleoprotein (RNP) antibodies (p=0.004) than those without RP. The distinguishing capillaroscopic characteristics of UCTD patients with RP were widened and irregularly enlarged loops (75 and 55%, respectively), giant capillaries (35%), and less than two haemorrhages per finger (40%). The combination of features indicative of a ‘slow’ scleroderma pattern was present in 18 of 40 patients with UCTD and RP (p=0.0003). Only 3 of the original 78 patients (3.8%) developed a definite CTD. In none of our patients did we observe avascular areas or changes from the original capillaroscopic pattern during follow-up examination. Our study indicates that patients with UCTD would seem to have a benign form of RP, since they show the absence of cutaneous complications, the existence of a mild microvascular damage and a stable nailfold capillary pattern. Further examinations of these patients will be required in order to confirm our findings. [ABSTRACT FROM AUTHOR]

Objectives: To establish the prevalence of the associated secondary diseases in patients with Raynaud’s phenomenon (RP) attending a rheumatology specialty centre and to determine the frequency with which a secondary illness develops in those having RP, in absence of a well-defined secondary cause. Methods: 118 consecutive patients were evaluated. Medical history, physical and laboratory investigations entered into a database. Patients with primary RP and patients with RP who did not fulfil any diagnostic criteria for inclusion in a secondary form were followed up over a three-year period. Results: 63 RP patients were found with related conditions. 35 patients met criteria for inclusion in a primary RP group, 20 patients had ‘unclassifiable’ RP, of which two (10%) developed a well-defined disease. None of the primary RP patients developed a secondary disease. Conclusions: This study shows that less than 50% of patients with RP attending a rheumatology specialty centre have a connective tissue disease. Patients with isolated RP appear to have a benign disease, since primary RP remains as such, and only a small percentage of patients with ‘unclassifiable’ RP evolve into a well-defined CTD. [ABSTRACT FROM AUTHOR]