Objective: To determine whether musculoskeletal ultrasound (MSUS) abnormalities were associated with thyroid dysfunction. Methods: This study included 109 patients with thyroid diseases, including thyroid dysfunction or autoimmune thyroid disease. Patients were categorized as euthyroid, hypothyroid, or hyperthyroid based on their recent thyroid function tests. To evaluate MSUS, an experienced rheumatologist examined the presence of synovial fluid, synovial hypertrophy, and grade of inflammation in both gray-scale and power Doppler scans of the knee joint. Associations between MSUS abnormalities, thyroid status, visual analog scale (VAS) score for knee pain, and presence of thyroid autoantibodies were investigated. Results: MSUS abnormalities were more frequently associated with hyperthyroid or hypothyroid states than with a euthyroid state. High knee VAS score was significantly associated with overall MSUS severity score regardless of knee osteoarthritis. However, there was no difference in MSUS abnormalities based on the presence of thyroid autoantibodies. Conclusions: Both hypothyroid and hyperthyroid states were associated with MSUS abnormalities and knee arthralgia. MSUS examination may be helpful in uncontrolled thyroid dysfunction and knee arthralgia.

Kim BY, et al. Ann Surg Treat Res. 2023 Oct;105(4):188-197. https://doi.org/10.4174/astr.2023.105.4.188

Background: To compare the frequency of high-risk osteoporotic fracture in patients with knee OA (OA) using the fracture risk assessment tool (FRAX) and the bone mineral density (BMD). Methods: We retrospectively assessed 282 Korean patients with knee OA who visited five medical centers and 1165 healthy controls (HCs) aged ≥50 years without knee OA. After matching for age, sex, and body mass index, 478 subjects (239 patients with knee OA and 239 HCs) were included. Results: Based on the BMD, the frequency of osteoporosis was 40.2% in patients with knee OA and 36.4% in HCs. The predicted mean FRAX major osteoporotic fracture probabilities calculated with or without femur neck BMD differed significantly between the knee OA and HCs (6.9 ± 3.8% versus 6.1 ± 2.8%, p = 0.000 and 8 ± 3.6% versus 6.8 ± 2.3%, p < 0.001, respectively). The mean FRAX hip fracture probabilities calculated with or without femur neck BMD differed significantly in the knee OA and HCs (2.1 ± 2.4% versus 1.7 ± 1.8%, p = 0.006 and 3 ± 2.3% versus 2.4 ± 1.6%, p < 0.001, respectively). Conclusion: Our study suggests that FRAX may have a clinical impact on treatment decisions to reduce osteoporotic facture in patients with knee OA.

Objective: Rheumatoid arthritis (RA) increases the risk of cardiovascular disease. This study aimed to investigate the short-and long-term prognosis of patients with and without RA who underwent percutaneous coronary intervention (PCI). Methods: The Korean National Health Insurance Service claims database was used to extract data on 236,134 patients (34,493 with RA and 201,641 without RA) who underwent PCI between 2008 and 2019. The primary outcome was major adverse cardiovascular events (MACE), including all-cause mortality, myocardial infarction, stroke, transient ischemic attack, or coronary revascularization with short-term (30-day) and long-term outcomes. The secondary outcomes were the individual components of MACE. Results: During a 10-year follow-up, patients with RA showed a shorter median survival time from MACE than their counterparts (with RA: 4.29 years vs. without RA: 6.10 years). RA was significantly associated with an increased risk of MACEs in long-term outcomes (hazard ratio (HR) 1.07, 95% confidence intervals (CI) 1.06–1.09, p<0.001), but not with short-term outcomes (HR 1.02, 95% CI 0.99–1.06, p = 0.222). RA was an independent predictor of an increased risk of all the MACE components. Conclusion: In patients who underwent PCI, RA did not increase the risk of short-term cardiovascular outcomes but increased the risk of long-term adverse outcomes.

Objectives: This study aims to assess the efficacy and safety of mycophenolate mofetil (MMF) on lung function and skin thickness in Korean patients with systemic sclerosis-interstitial lung disease (SSc-ILD) in a real-world setting. Patients and methods: This retrospective, medical chart-based study was performed at four centers in South Korea and included 34 patients (2 males, 32 females; median age 50.5 years; range, 25 to 72 years) with SSc-ILD. We investigated changes in forced vital capacity (FVC), diffusion capacity of the lung for carbon monoxide (DLCO), and modified Rodnan skin score (mRSS) according to MMF treatment for 24 months. Results: The mean dose and treatment duration of MMF were 1,338.2±439.0 mg/day and 13.1±9.3 months, respectively. Although FVC decreased significantly at 15 months, FVC and DLCO did not change significantly during treatment with MMF. Median mRSS decreased significantly from 17.5 (2-40) to 10.5 (2-40) units (p

Background/Objectives: Rheumatoid arthritis-associated interstitial lung disease (RA-ILD) significantly affects disease prognosis and patient survival. The impact of conventional synthetic DMARDs (csDMARDs) and biologic/targeted synthetic DMARDs (b/tsDMARDs) on RA-ILD prognoses remains unclear. This study aimed to investigate the effects of csDMARDs and b/tsDMARDs on RA-ILD progression and prognosis based on pulmonary function tests (PFTs), high-resolution computed tomography (HRCT), and symptom changes. Methods: This multicenter, retrospective, observational study included patients with RA-ILD at 13 referral hospitals in South Korea. The participants were categorized into csDMARD-only and b/tsDMARD-exposed groups. RA-ILD prognosis was assessed over a 24-month follow-up period using serial PFTs (the forced vital capacity [FVC] and diffusing capacity of the lungs for carbon monoxide [DLCO]), HRCT findings, and clinical symptom changes. Kaplan–Meier survival analyses and Cox proportional hazards models were used to compare disease progression risk while adjusting for baseline lung function, RA disease activity, and glucocorticoid use. Results: Among 127 eligible patients, 22 (17.3%) were exposed to b/tsDMARDs, predominantly abatacept and tocilizumab. During a mean follow-up of 2.8 years, 65 (51.2%) patients experienced RA-ILD progression. A higher baseline Disease Activity Score-28 with erythrocyte sedimentation rate (DAS28-ESR) (adjusted hazard ratio [aHR]: 1.344, 95% confidence interval [CI]: 1.136–1.590, p = 0.001) and initially prescribed prednisone dose (aHR: 1.078, 95% CI: 1.011–1.151, p = 0.023) were significant prognostic factors for ILD progression. No statistically significant difference in progression risk was observed between the csDMARD-only and b/tsDMARD-exposed groups (aHR: 0.937, p = 0.851). Conclusions: The RA-ILD prognosis was more strongly influenced by disease activity, rather than the type of DMARD used. These findings emphasize the importance of maintaining low RA disease activity to improve RA-ILD prognosis.