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Background: Arthritis can have profound debilitating effects on the hand secondary to finger deformities and pain. Arthroplasty of the metacarpophalangeal (MCP) and proximal interphalangeal (PIP) can be performed to reduce pain while maintaining joint range of motion.

Methods: We used outpatient surgery registries from the states of California and Florida to assess the trends of arthroplasty across several recent years and to determine if the outcomes differ based on disease etiology.

Results: We found that there has been a steady decline in number of MCP arthroplasty procedures performed annually between 2005 and 2011 while PIP arthroplasty procedures peaked in 2007 and have since also declined. There was an overall complication rate of 2.4% and no difference in cardiac, respiratory, deep venous thrombosis and infection between patients with osteoarthritis and other arthritic etiologies. However, the risk of device failure in patients with rheumatoid arthritis is found to be significantly higher than for patients with osteoarthritis (p < 0.01).

Conclusions: PIP and MCP arthroplasty are safe procedures with an overall low complication rate. The increased risk of device related complications observed in patients with rheumatoid arthritis can be used to appropriately counsel this patient population regarding post-operative expectations and prognosis.

Systemic sclerosis (SSc) is a systemic connective tissue disorder characterized by progressive skin and visceral organ fibrosis, vasculopathy, and immune dysregulation. Interstitial lung disease (ILD) is a common manifestation and major contributor to morbidity and mortality. Immunosuppression is usually indicated for extensive or progressive SSc-ILD. Recently, antifibrotic and biological therapies have been shown to be efficacious in treating SSc-ILD in various studies. In this article, we will descriptively review the latest evidence on the treatment of SSc-ILD.

Pregnancy and fetal outcomes in patients suffering from systemic lupus erythematosus or antiphospholipid syndrome have been well described, as these are more common diseases and associated with frequent maternal and fetal complications. The data is scant about pregnancy-related morbidity and its outcome among less common rheumatic diseases like inflammatory myositis, systemic sclerosis (SSc), and vasculitis. Inflammatory myositis, vasculitis, and SSc are associated with higher risk of spontaneous abortions, preterm delivery, and intrauterine growth restriction (IUGR). Conception during active disease is associated with poor pregnancy outcomes, hence good control of disease is important. These diseases also increase risk of maternal complications like hypertension, preeclampsia, and antepartum hemorrhage. Due to rarity of these diseases, the individual experience of a physician is limited, thus it requires a collaborative team approach to have best outcome.

Systemic sclerosis (SSc) is a connective tissue disorder with multiple organ involvement. Interstitial lung disease (ILD) is particularly significant as it is the leading cause of death in SSc patients. The clinical course of SSc-ILD is highly variable. It can progress rapidly or remain stable without treatment. Disease progression can occur both early and late in the course of the disease. This heterogeneity exemplifies the need to identify those who are at risk of developing ILD and those who are at risk of deterioration. In this article, we will review the latest evidence on the prevalence of SSc-ILD, the predictors of SSc-ILD development, and the risk factors for its progression.