Objective: We conducted a retrospective case–control study to investigate the risk factors for osteonecrosis of the femoral head (ONFH) in rheumatoid arthritis (RA) patients.Methods: The clinical data of patients diagnosed with RA at Fujian Provincial Hospital from January 2013 to December 2020 were retrospectively collected and evaluated. Twenty‐two patients with ONFH were identified. Eighty‐eight age‐, sex‐, and disease duration‐matched RA patients without symptomatic ONFH were randomly selected as controls in a ratio of 1:4. Logistic regression analysis was used to analyze the risk factors.Results: The anticardiolipin (ACL)‐immunoglobulin G (IgG) concentration, clinical disease activity index, simplified disease activity index, incidence of hyperlipidemia in the case group were higher than those in the control group. Multivariate logistic regression analysis did not find the independent risk factor in ONFH patients with RA.Conclusion: The pathogenesis of ONFH in RA is related to many factors such as ACL IgG, disease activity index, and hyperlipidemia. While, we went to great lengths to explore the relationship between antiphospholipid antibodies and ONFH, but it plays a very small role.

Background: Rheumatoid arthritis (RA) is a growing public health concern with rising incidence worldwide. The C‐reactive protein–triglyceride–glucose index (CTI), a composite marker of inflammation and insulin resistance, has been linked to various metabolic disorders, but its role in RA remains unclear. This study aimed to examine the association between CTI and RA risk and assess whether body mass index (BMI) mediates this relationship. Methods: We analyzed data from 4292 participants using the 2005–2010 National Health and Nutrition Examination Survey (NHANES). CTI was computed and stratified into quartiles. Multivariable logistic regression models assessed the association between CTI and RA after adjusting for demographic, socioeconomic, lifestyle, and clinical confounders. Restricted cubic spline (RCS) functions were employed to test for nonlinear patterns. Additionally, subgroup analyses examined effect modification, and mediation analysis quantified the indirect effect through BMI. Results: Elevated CTI values were independently linked to higher odds of RA. After full adjustment, each one‐unit rise in CTI corresponded to a 45% increase in RA odds (OR = 1.45, 95% CI: 1.22–1.73, p < 0.001). The RCS analysis demonstrated a significant nonlinear association (p for nonlinearity = 0.048). Stratified analyses indicated consistent patterns across sex, ethnicity, and other variables, with a more pronounced effect among individuals without diabetes (p for interaction = 0.036). Mediation findings showed that BMI accounted for 32.31% of the total CTI–RA effect ( p < 0.001). Conclusions: CTI is nonlinearly and independently associated with RA risk, partly through BMI, highlighting its potential as a biomarker linking metabolic and inflammatory pathways.

Rationale: The clinical manifestations of Fabry disease affect the nerves, kidneys, heart, skin, gastrointestinal tract and eyes. Our aim is to familiarize people with the FD diagnostic process by reporting this case. Patient concerns: A 79-year-old-male patient presented with muscle pain and weakness in the extremities, also with an increasing erythrocyte sedimentation rate and C-reactive protein. Further examinations revealed that multiple organ involvement, such as rash, myocardial hypertrophy, peripheral neuropathy. Diagnoses: Cardiac MR demonstrated hypertrophic cardiomyopathy, myocardial fibrosis and low myocardial T1 value. The patient was eventually diagnosed with Fabry disease through proteomics and genetic testing. Interventions: The treatment is enzyme replacement therapy (ERT). But this patient could not afford ERT and was given only general symptomatic treatment, pregabalin, and a gradual reduction in glucocorticoid. Outcomes: The patient’s symptoms of joint pain and muscle weakness reduced significantly, and ESR and CRP had decreased to normal. Lessons: FD is a rare disease and difficult to diagnose, but rare does not mean invisible. FD may present with signs and symptoms of rheumatic diseases. Rheumatologists should be aware and concerned about this disease.