The traditional management of psoriatic arthritis (PsA) includes NSAIDs, corticosteroids and DMARDs. Advancement in the knowledge of the immunopathogenesis of PsA has been associated with the development of biologic agents which have revolutionized the management of the disease. Among biologics drugs, there are the 4 currently available anti-TNFα blocking agents (etanercept, infliximab, adalimu...

Tuberculosis (TB) of the musculoskeletal system is a rare clinical condition. Multifocal bone involvement is extremely rare and difficult to recognize. Thus, due to the diverse and atypical clinical manifestations of multifocal skeletal TB, the disease is easy to misdiagnose. In the present study, a rare case of atypical disseminated multifocal skeletal TB was reported, which exhibited uncommon...

Systemic sclerosis (scleroderma, SSc) and mixed connective tissue disease (MCTD) are chronic autoimmune diseases characterised by a broad spectrum of clinical manifestations including different forms of musculoskeletal involvement, skin and vascular changes, as well as internal organ complications. Clinical course and outcomes might vary from mild forms with good clinical prognosis to severe ra...

The cytokines interleukin (IL)-12 and interleukin (IL)-23 have been implicated variously in the pathogenesis of psoriasis and psoriatic arthritis (PsA). By corollary, the IL-12/23 inhibitor, Ustekinumab has been developed as an approved therapeutic for the skin and musculoskeletal syndrome of psoriasis / PsA. This review describes briefly the role of IL-12 and IL-23 in the pathophysiology of ps...

This chapter serves as a primer on the pathophysiology of both diabetes mellitus and Charcot arthropathy for the orthopedic surgeon. In regards to diabetes we will focus on the pathophysiology as it pertains to musculoskeletal manifestations of the disease process. The pathophysiology that underlies the development of diabetes is beyond the scope of this chapter. We will discuss both the histor...

Psoriatic arthritis is a multisystem disorder which, from a measurement standpoint, demands consideration of its cutaneous manifestations and both axial and peripheral musculoskeletal involvement. Measurements of various aspects of impairment, ability/disability, and participation/handicap are feasible using existing measurement techniques, which are for the most part valid, reliable, and respo...

According to the World Health Organization in developed countries pathology of musculoskeletal system ranks No. 2 among reasons of disablement for a period of less than two weeks, trailing only to respiratory diseases, but it takes the first place for periods of time above two weeks. In general manifestations of arthrosis of various localizations are diagnosed in 9.6% of men and 18% of women ab...

Endothelial cells form a multifunctional cell lining that covers all of the inner surface of blood vessels and regulates several important physiological and pathological reactions. These include inflammation/immune reaction, blood vessel tonus, hemostasis/thrombosis, angiogenesis and so on. Behçet’s Disease (BD) is a chronic, relapsing, multisystemic disorder characterized by urogenital ulcers ...

M icroscopic polyangiitis is a necrotising vasculitis primarily affecting small vessels, with few or no immune deposits. Patients are characterised by positive antineutrophil cytoplasmic antibodies (ANCA), mainly perinuclear pattern. The spectrum of clinical manifestations is broad, including the kidney, musculoskeletal system, lung, gastrointestinal tract, skin, ear, nose, and throat, and neur...

The acronym of SAPHO syndrome (synovitis, acne, pustulosis, hyperostosis and osteitis) combines a cluster of cutaneous and musculoskeletal manifestations, such as hyperostosis of bones of the anterior chest wall associated with acne fulminans and hidradenitis suppurativa. There are no validated diagnostic criteria in children. Nonsteroidal anti-inflammatory drugs are not always sufficient, and ...