Among the clinical manifestations of systemic lupus erythematosus (SLE) is an arthropathy, which is usually nonerosive. In many cases the joint involvement is mild. A subset of patients have deforming, nonerosive Jaccoud's arthropathy, and a minority have an arthropathy with clinical findings similar to rheumatoid arthritis (RA) that has been called "rhupus." We report our series of eight patients (seven female, one male) with rhupus arthropathy. Patients were between the ages of 17 and 38 years (average: 30.3 years) at disease onset. All had deforming or Jaccoud's arthropathy, and three had erosive disease. The arthritis was typically the first disease manifestation. Other symptoms of lupus including vasculitis and glomerulonephritis appeared after an average of 2.8 years. All had positive antinuclear antibody and rheumatoid factor. Rhupus arthritis is not a combination of RA and SLE, but should be regarded as a variant of the arthropathy of lupus.

Systemic lupus erythematosus is an autoimmune and inflammatory disease with multiple clinical manifestations, including arthropathy. The clinical presentation of articular involvement is variable, ranging from arthralgia without erosions or deformity to an erosive arthropathy and severe functional disability. A subset of patients with this articular involvement have Jaccoud's arthropathy, and others have an arthropathy with clinical findings similar to rheumatoid arthritis that has been called "rhupus." In this paper we review the historical evolution of concepts of lupus arthropathy, from deforming arthritis to rhupus, and conclude that rhupus is not a combination of rheumatoid arthritis and lupus. Instead, rhupus arthropathy should be regarded as a variant of the arthropathy of systemic lupus erythematosus.

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There is compelling evidence that arguing with peers in educational contexts fosters students’ content knowledge and argumentation skills. Indeed, curricula have already been developed that, through tailored support for peer argumentation, promote both content knowledge and argumentation skills simultaneously. However, we do not yet know how to optimize the occurrence of peer argumentation, although there are suggestions in the literature that computers may have a role to play. Likewise, there are uncertainties about the mechanisms through which the benefits of peer argumentation are achieved, especially whether (and how) there is interdependence across the two types of benefit. In this paper, we report a quasi-experimental study randomized at class level, which addresses these two issues. A total of 502 fourth-grade students and 20 classes and teachers covered a module in science under three conditions: (1) using a curriculum that was already known to promote peer argumentation and content knowledge (standard support), (2) using the same curriculum but with additional computer-based support (computer-enhanced support), and (3) a routinely taught control group. Students’ argumentation skills and content knowledge were assessed. Content knowledge was assessed prior to and after the intervention, with immediate and delayed posttests. Multiple regression analyses showed that peer argumentation was indeed most frequent in the computer-enhanced condition. Moreover, on the basis of a multilevel path analysis, we found that individual contributions to peer argumentation had a direct effect on posttest argumentation skills and an indirect effect on posttest content knowledge, both immediate and delayed. The indirect effect of argumentation on delayed posttest content knowledge was mediated by immediate posttest knowledge and posttest argumentation skills.