AimTo determine whether early clinical, laboratory and musculoskeletal ultrasound (MSUS) characteristics can be used as early detectors of juvenile idiopathic arthritis.Patients and methodsForty (40) patients with juvenile idiopathic arthritis (JIA) diagnosed according to the ILAR criteria [1] and 20 healthy control children. All patients were subjected to the following assessment at base line and at follow up after 6 months: Clinical evaluation, MSUS examination and laboratory evaluation.ResultsOf the 40 patients, 6 patients (15%) had systemic onset subtype, 8 (20%) oligoarticular extended, 9 (22.5%) oligoarticular persistent, 5 (12.5%) polyarticular rheumatoid factor (RF) +ve, 6 (15%) polyarticular RF −ve, 5 (12.5%) enthesitis related subtype and only one patient (2.5%) had psoriatic JIA. MSUS detected more synovitis than clinical examination (subclinical synovitis) both at base line and at follow up. MSUS is highly sensitive for early detection of joint involvement in JIA when compared to physical examination. Significant decrease in the mean cartilage thickness of the patients measured at follow up as compared to measures at base line.ConclusionMSUS is highly sensitive for early detection of joint involvement in JIA when compared to physical examination

The results indicated that treatment with PEG-IFN alfa-2a plus ribavirin can achieve a complete clinical response in patients with HCV-related MC. Complete clinical response correlates with the eradication of HCV.

Background: Early identification and disease monitoring of secondary osteoporosis(OP) in rheumatoid arthritis (RA) are challenges for rheumatologists, identification of biomarkers predictive to bone mineral density (BMD) change is crucial in management. Serum 14-3-3η protein is validated as a diagnostic and prognostic biomarker in RA. Meanwhile the exact mechanism by which 14-3-3η intervenes osteoporosis is still unclear and few studies have been focused on it. Our aim was to evaluate the association among 14-3-3η protein, inflammation, bone remodeling, osteoporosis risk and disease activity in RA patients. Methods: Bone mineral density was measured using dual energy X-ray absorptiometry, serum samples were collected for all participants. Quantitative enzyme-linked immunosorbent assay (ELISA) was used to determine 14-3-3η, TNF-α and IL-6 levels. Meanwhile, B-CTX and PINP were measured using electrochemical luminescence immune-analyzer. The diagnostic value of each marker was determined via receiver operating characteristic (ROC) curve, and the association between 14-3-3η and osteoporosis was assessed using multiple logistic regression which identified 14-3-3η as an independent risk factor for RA-related osteoporosis. Results: Seventy-two RA patients and twenty five controls. Patients were divided into three subgroups, normal BMD, osteopenia, and osteoporotic. Serum 14-3-3 η, TNF-α, B-CTX and IL-6 level were the highest and PINP is the lowest in osteoporosis group, There were significant differences among the subgroups (p<0.05). Also, there were significant positive correlation between 14-3-3 η and TNF-α,B-CTX ,IL-6 (p<0.05) while it had significant negative correlation with both BMD, PINP (p<0.05). Conclusion Serum 14-3-3η is independent risk factor for RA-related osteoporosis. Serum 14-3-3η detection by itself or combined with other indices was helpful in predicting osteoporosis. Its effect on osteoporosis may be due to its role in adjusting inflammation and bone remodeling.