Evaluating patients with arthritis of recent onset - Studies in pathogenesis and prognosis

被引:18
作者
El-Gabalawy, HS [1 ]
Duray, P [1 ]
Goldbach-Mansky, R [1 ]
机构
[1] NIH, Bethesda, MD 20892 USA
来源
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION | 2000年 / 284卷 / 18期
关键词
D O I
10.1001/jama.284.18.2368
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Inflammatory synovitis of recent onset poses a diagnostic and prognostic challenge to primary care physicians and rheumatologists, A lack of understanding of the underlying etiologic and pathogenic processes limits the ability to distinguish forms of arthritis that follow a benign, self-limiting course from forms that proceed to an aggressive, erosive disease requiring intensive immunosuppressive therapy. It is estimated that between 30% and 40% of patients presenting with early synovitis have disease that remains unclassified. Using data from a cohort of patients with early synovitis and reviewing current literature, we discuss investigational approaches toward a new classification of patients with early synovitis. Although a lack of understanding of this heterogeneous clinical syndrome has led clinicians to take a largely empirical approach to treatment thus far, the evolving awareness of disease predisposition at a genetic level and the expanding ability to specifically manipulate biological pathways may ultimately change the approach to this clinical problem.
引用
收藏
页码:2368 / 2373
页数:6
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