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Official Journal of the American College of Rheumatology

EDITORIALS

Malignant Lymphoma Presenting as Tietze's Syndrome

A. Fioravanti, C. Tofi, L. Volterrani, and R. Marcolongo 229

Focusing Interventions for Disability Among Patients With Rheumatoid Arthritis

Edward H. Yelin and Patricia P. Katz 231

ORIGINAL ARTICLES

Ankylosing Spondylitis

Medication Toxicity Among Patients With Ankylosing Spondylitis

Michael M. Ward and Susana Kuzis 234

Use of a Numerical Rating Scale as an Answer Modality in Ankylosing Spondylitis-Specific Questionnaires

Astrid van Tubergen, Iris Debats, Liliane Ryser, John Londono, Ruben Burgos-Vargas, Mario H. Cardiel, Robert Landewe, Gerold Stucki, and Desiree van der Heijde 242

One-Year Open-Label Trial of Thalidomide in Ankylosing Spondylitis

Feng Huang, Jieruo Gu, Wei Zhao, Jian Zhu, Jianglin Zhang, and David Tak Yan Yu 249

Clinical Analysis

Statistical Presentation and Analysis of Ordered Categorical Outcome Data in Rheumatology Journals

Michael P. LaValley and David T. Felson 255

Fibromyalgia

Does the Label "Fibromyalgia" Alter Health Status, Function, and Health Service Utilization? A Prospective, Within-Group Comparison in a Community Cohort of Adults With Chronic Widespread Pain

Kevin P. White, Warren R. Nielson, Manfred Harth, Truls Ostbye, and Mark Speechley 260

Factors of Importance for Work Disability in Women With Fibromyalgia: An Interview Study

Gunilla M. Liedberg and Chris M. Henriksson 266

Genetic Studies

The Genetic Contribution to Carpal Tunnel Syndrome in Women: A Twin Study

Alan J. Hakim, Lynn Cherkas, Sameh El Zayat, Alexander J. MacGregor, and Tim D. Spector 275

Osteoarthritis

A Randomized, Controlled Trial to Evaluate the Slow-Acting Symptom-Modifying Effects of Colchicine in Osteoarthritis of the Knee: A Preliminary Report

Siddharth K. Das, S. Ramakrishnan, Kavita Mishra, Ragini Srivastava, G. G. Agarwal, Ragini Singh, and A. R. Sircar 280

Rheumatoid Arthritis

Physician Treatment Preferences in Rheumatoid Arthritis of Differing Disease Severity and Activity: The Impact of Cost on First-Line Therapy

Doruk Erkan, Yusuf Yazici, Melanie J. Harrison, and Stephen A. Paget 285

Psychological Interventions for Rheumatoid Arthritis: A Meta-Analysis of Randomized Controlled Trials

John A. Astin, William Beckner, Karen Soeken, Marc C. Hochberg, and Brian Berman 291

Association of Interleukin-4 and Interleukin-1B Gene Variants With Larsen Score Progression in Rheumatoid Arthritis

Stephane Genevay, Francesco S. di Giovine, Thomas V. Perneger, Tania Silvestri, Sibylle Stingelin, Gordon Duff, and Pierre-Andre Guerne 303

Systemic Lupus Erythematosus

Systemic Lupus Erythematosus in Three Ethnic Groups. X. Measuring Cognitive Impairment With the Cognitive Symptoms Inventory

Graciela S. Alarcon, Leanne Cianfrini, Laurence A. Bradley, Martha L. Sanchez, Kemi Brooks, Alan W. Friedman, Bruce A. Baethge, Barri J. Fessler, Holly M. Bastian, Jeffrey M. Roseman, Gerald McGwin, Jr., and John D. Reveille, for the LUMINA Study Group 310

Vasculitis

Effect of Wegener's Granulomatosis on Work Disability, Need for Medical Care, and Quality of Life in Patients Younger Than 40 Years at Diagnosis

Eva Reinhold-Keller, Karen Herlyn, Rosemarie Wagner-Bastmeyer, Joachim Gutfleisch, Hartmut H. Peter, Heiner H. Raspe, and Wolfgang L. Gross 320

High Rate of Renal Relapse in 71 Patients With Wegener's Granulomatosis Under Maintenance of Remission With Low-Dose Methotrexate

Eva Reinhold-Keller, Claudia O. E. Fink, Karen Herlyn, Wolfgang L. Gross, and Kirsten de Groot 326

SPECIAL ARTICLE

The Disablement Process in Rheumatoid Arthritis

Agustin Escalante and Inmaculada del Rincon 333

UPDATE

Pathogenesis of Lupus

Kurt Oelke and Bruce Richardson 343

LETTERS

Increased Frequency of Malignancy Found in Patients Presenting With New-Onset Polymyalgic Symptoms Suggested to Have Polymyalgia Rheumatica

Glenn Haugeberg, H. Dovland, and V. Johnsen 346

Nonmedication Approaches In Hand Osteoarthritis

George E. Ehrlich 347

Comment on Prescribing Tumor Necrosis Factor Inhibitors

Lonnie B. Hanauer 347

ANNOUNCEMENTS 23A

Cover image: These are award-winning images from the 2001 American College of Rheumatology slide contest. The photograph of the hands is typical of severe Sweet's syndrome (neutrophilic dermatosis). This 63-year-old man presented to his primary care physician with a 2-week complaint of sores on his hands and arms. His examination revealed ulcerated lesions in various stages of healing on his hands, wrists, and arms, and a few lesions on his tongue and buccal mucosa. He denied any fever, rash, or other systemic symptoms. He was referred to Rheumatology, where his physical examination was as above. The differential included vasculitis, calciphylaxis, and dermatitis herpetiformis. His laboratory values showed a mild leukocytosis and elevated erythrocyte sedimentation rate. Other laboratory values (immunoglobulin levels, complement levels, antinuclear antibody titers, and hepatitis serologies) were normal. A biopsy of one of the hand lesions (low-power view, left, and high-power view, right) showed an intense inflammatory cell infiltrate of the skin that was predominantly neutrophils. Special stains for bacteria and fungi were negative. There were no histologic signs of vasculitis. The diagnosis of Sweet's syndrome was made. The patient was treated with prednisone, nonsteroidal antiinflammatory drugs, and local skin care with excellent results.

Submitted by Alvin F. Wells, MD, PhD
Duke University Medical Center, Durham, North Carolina
(Currently, Associate Medical Director for Immunology,
Abbott Laboratories, Chicago, Illinois).