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Soft tissue masses are very common and may appear in the context of rheumatic diseases. They usually occur alone but may occasionally be part of the syndromes and can sometimes involve periarticular tissues. Soft tissue masses can be divided into several categories. In this article, we have categorized them into 3 different groups: (1) pseudotumors, (2) benign tumors, and (3) malignant tumors. Parotid enlargement will also be discussed in this study. The majority of Soft tissue masses are pseudotumors or benign tumors, which can be easily characterized with ultrasound, therefore, considered the first screening tool in the study of this type of lesion. If the tumor is deep or poorly accessible, or present with suspected signs of malignancy, the sonographer may suggest expanding the study with magnetic resonance imaging and/or an ultrasound-guided biopsy of the lesion. Ultrasound is also a good technique for the parotid and submandibular glands and is very useful for evaluating and monitoring Sjogren's syndrome. [ABSTRACT FROM AUTHOR]

Background: Giant cell arteritis (GCA) is a heterogeneous disease with diverse clinical presentations and varying degrees of severity. This study aimed to assess the incidence of 3 clinical subsets in GCA and analyze associated severe complications and survival rates. By identifying distinct clinical patterns, the goal is to customize treatment approaches and minimize severe complications during follow-up. Methods: This retrospective study classified clinical manifestations of GCA into 3 major phenotypes based on the reason for consultation: i) cranial, ii) extracranial, and iii) occult GCA. These groups were analyzed and compared for acute complications, including severe ischemic complications, "true" occlusive disease, and late complications such as aortic aneurysm. Survival data were also collected during follow-up. Results: Visual disturbances were more common in the cranial GCA group compared to other subsets (P < .001). Blindness and stroke showed a clinically relevant trend, although statistical differences were not significant between the cranial GCA groups. Limb claudication was significantly more prevalent in the extracranial subset compared to the cranial or occult GCA subsets (12% vs. 2.6% vs. 0% respectively). Severe ischemic complications and true occlusive disease were more frequent in the cranial GCA groups (60%, P = .005 and 40%, P = 1.64 respectively). Regarding mortality, there were no statistically significant differences in survival among the different clinical subsets. However, the occult GCA subset showed a trend towards a higher prevalence of deaths, both overall and specifically due to GCA. Conclusion: Clinical subsets in GCA present distinct complications and survival outcomes, with the cranial subset showing a higher incidence of severe ischemic events and the occult subset associated with delayed diagnosis and increased mortality. Recognizing these subsets is crucial for tailored treatment approaches and improving patient prognosis. Further prospective studies are needed to refine diagnostic and therapeutic strategies. [ABSTRACT FROM AUTHOR]

In rheumatoid arthritis (RA) synovium, ATP, and ADP are released, sparking inflammation. Ectoenzymes CD39 and CD73 metabolize these purine nucleotides, generating anti-inflammatory adenosine. Therefore, dysregulated CD39 and CD73 expression may impact RA development. We assessed CD39 and CD73 expression in peripheral blood from 15 healthy controls (Cs) and 35 RA patients at baseline and after 3 and 6 months of tocilizumab treatment using flow cytometry. Additionally, ectoenzyme expression was examined on cultured T cells to understand activation and IL-6 effects. At baseline, RA patients exhibited a lower CD8+CD39−CD73+ cell percentage, which inversely correlated with DAS28. Additionally, they had lower percentages of Treg CD39+CD73+ and CD39−CD73− cells. Good responders tended to have lower B CD39+CD73+ cell percentages at baseline and 3 months. Additionally, Treg, CD8+ T and B cells inversely correlated with DAS28. T-cell activation increased CD39 and decreased CD73 expression, regardless of IL-6. IL-6 reduced IFNγ-secreting CD4+ T-cell percentage in Cs, but increased the percentage of IFNγ-secreting CD4+ and CD8+ T cells in RA patients. These findings indicate differing CD39 and CD73 expression in RA and Cs, influenced by T-cell activation and IL-6. Correlations between these molecules and RA activity suggest their role in dysregulated inflammation in RA. [ABSTRACT FROM AUTHOR]

In rheumatoid arthritis (RA) synovium, ATP, and ADP are released, sparking inflammation. Ectoenzymes CD39 and CD73 metabolize these purine nucleotides, generating anti-inflammatory adenosine. Therefore, dysregulated CD39 and CD73 expression may impact RA development. We assessed CD39 and CD73 expression in peripheral blood from 15 healthy controls (Cs) and 35 RA patients at baseline and after 3 and 6 months of tocilizumab treatment using flow cytometry. Additionally, ectoenzyme expression was examined on cultured T cells to understand activation and IL-6 effects. At baseline, RA patients exhibited a lower CD8 + CD39 - CD73 + cell percentage, which inversely correlated with DAS28. Additionally, they had lower percentages of Treg CD39 + CD73 + and CD39 - CD73 - cells. Good responders tended to have lower B CD39 + CD73 + cell percentages at baseline and 3 months. Additionally, Treg, CD8 + T and B cells inversely correlated with DAS28. T-cell activation increased CD39 and decreased CD73 expression, regardless of IL-6. IL-6 reduced IFNγ-secreting CD4 + T-cell percentage in Cs, but increased the percentage of IFNγ-secreting CD4 + and CD8 + T cells in RA patients. These findings indicate differing CD39 and CD73 expression in RA and Cs, influenced by T-cell activation and IL-6. Correlations between these molecules and RA activity suggest their role in dysregulated inflammation in RA.

Objectives: Dactylitis is an important clinical domain of psoriatic arthritis (PsA) associated with significant burden of disease and impaired function. Post-hoc analysis of the FUTURE 5 study was performed to evaluate the efficacy of secukinumab in patients with dactylitis at baseline over 2 years., Methods: Randomised patients received secukinumab 300mg with loading dose (LD)/150mg LD/150mg without loading dose/placebo. Assessment of dactylitis was based on Leeds Dactylitis Index. Exploratory analyses included resolution of dactylitis based on severity, time to first resolution of dactylitis (Kaplan-Meier estimate) and resolution of dactylitis (heatmap analysis). Clinical efficacy outcomes, composite domains of disease activity, health-related quality of life (HRQoL) and radiographic progression using van der Heijde-modified total Sharp score were assessed in patients with/without dactylitis at baseline., Results: Overall, 389/996 (39%) patients presented with dactylitis at baseline, had more active clinical disease and greater disease activity than those without dactylitis at baseline. Resolution of dactylitis was observed across all treatment groups at Week 104. Improvement in joints, enthesitis, skin psoriasis, nail outcomes, physical function and HRQoL were sustained over 2 years in patients with dactylitis at baseline. With secukinumab treatment, >80% of patients did not show structural radiographic progression. The proportion of non-structural radiographic progressors were comparable across patients with/without dactylitis at baseline with secukinumab treatment over 2 years., Conclusions: Patients with dactylitis at baseline were associated with higher burden of disease. Secukinumab provided sustained improvements across all clinical outcomes, QoL and inhibition of radiographic progression in PsA patients with dactylitis at baseline over 2 years.

Objectives: The aims of this study are to evaluate the level of fear of post-injection pain prior to the administration, the difficulty in handling the device, and the level of satisfaction of patients using a pre-filled syringe versus an etanercept pen, as well as to evaluate the usefulness of the training given by nursing staff prior to starting with the pen, and the preferences of patients after using both devices., Method: A prospective study was designed to follow-up a cohort of patients during a 6 months period. The data was collected using questionnaires and analyzed with SPSS 18.00. Rank and McNemar tests were performed. Statistical significance was pre-set at an α level of 0.05., Results: A total of 29 patients were included, of whom 69% female, and with a mean age 52.5±10.9 years. Of these, 48% had rheumatoid arthritis, 28% psoriatic arthritis, 21% ankylosing spondylitis, and 3% undifferentiated spondyloarthropathy. There were no statistically significant differences either with the fear or pain or handling of the device between the syringe and the pen (P=.469; P=.812; P=.169 respectively). At 6 months, 59% of patients referred to being satisfied or very satisfied with the pen. Almost all (93%) found useful or very useful the training given by nursing staff prior to using the pen, and 55% preferred the pen over the pre-filled syringe., Conclusions: The etanercept pen is another subcutaneous device option for patients with chronic arthritis. According to the present study, nursing educational workshops before starting this therapy are recommended., (Copyright © 2012 Elsevier España, S.L. All rights reserved.)