Stay current in the ever-changing discipline of rheumatology with clear, reliable guidance from Hochberg’s Rheumatology, one of the most respected and trusted sources in the field. Designed to meet the needs of the practicing clinician, this medical reference book provides extensive, authoritative coverage of rheumatic diseases from basic scientific principles to practical points of clinical management in a lucid, logical, user-friendly manner.

New to this edition

• Remain up to date on the latest information in rheumatology through 13 brand-new chapters covering biomedical and translation science, disease and outcome assessment, new imaging modalities, early emerging disease, clinical therapeutics, patient management, and rehabilitation.
• Take advantage of expanded coverage of small molecule treatment, biologics, biomarkers, epigenetics, biosimilars, and cell-based therapies.
• Focus on the core knowledge needed for successful results with each chapter co-authored by an internationally-renowned specialist in the field.
• Easily find the information you need thanks to a consistent, user-friendly format with templated content and large-scale images.
• Access the full text online at Expert Consult.

Author Info

By Marc C. Hochberg, MD, MPH, Professor of Medicine and Epidemiology and Preventative Medicine; Head, Division of Rheumatology and Clinical Immunology, University of Maryland School of Medicine, Baltimore, Maryland, USA ; Alan J. Silman, MD, ARC Professor of Rheumatic Disease Epidemiology, Director, ARC Epidemiology Research Unit, University of Manchester, UK; Josef S. Smolen, MD, Professor of Medicine, Chariman, Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna;Chariman, Second Department of Medicine, Center for Rheumatic Diseases, Hietzing Hospital, Vienna, Austria ; Michael E. Weinblatt, MD, John R. and Eileen K. Riedman Professor of Medicine, Harvard Medical School; Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Boston, Massachusetts, USA and Michael H. Weisman, MD, Chief, Division of Rheumatology, Professor of Medicine, Cedars-Sinai Medical Center, David Geffen School of Medicine and UCLA, Los Angeles, California, UA

Table of Contents

Section 1: The Scientific Basis of Rheumatic Disease

• 1. Epidemiologic concepts and the classification of rheumatic and musculoskeletal conditions
• 2. Principles of clinical outcome assessment
• 3. Principles of health economics and application to rheumatic disorders
• 4. The synovium
• 5. The articular cartilage
• 6. Bone structure and function
• 7. Tendons and ligaments
• 8. Connective tissue responses to mechanical stresses
• 9. Biomechanics of peripheral joints
• 10. Biomechanics of the spine
• 11. Principles of genetic epidemiology
• 12. Principles and techniques in molecular biology
• 13. Cytokines
• 14. Signal transduction in immune cells
• 15. The principles of adaptive immunity
• 16. Principles of innate immunity
• 17. Systems biology
• 18. Epigenetics in Rheumatology
• 19. The microbiome in rheumatic diseases
• 20. Tissue destruction and repair
• 21. Principles of tissue engineering and cell- and gene-based therapy
• 22. Osteoimmunology
• 23. Inflammation and its mediators
• 24. Scientific basis of pain
• 25. Effects of the neuroendocrine system on development and function of the immune system
• 26. Interpreting the medical literature for the rheumatologist; study design and levels of evidence
• 27. Ethics in clinical trials

Section 2: Clinical Basis of Rheumatic Disease

• 28. History and physical examination
• 29. Pattern recognition in arthritis
• 30. Role of laboratory tests in rheumatic disorders
• 31. Synovial fluid analysis
• 32. Minimally invasive procedures
• 33. Skin in rheumatic disease
• 34. The eye in rheumatic disease
• 35. The heart in rheumatic disease
• 36. The lung in rheumatic disease
• 37. Gastrointestinal tract and rheumatic disease
• 38. The kidney and rheumatic disease
• 39. The nervous system in rheumatic disease

Section 3: Evaluation: Imaging Techniques

• 40. Conventional radiography and computed tomography
• 41. Functional magnetic resonance imaging
• 42. Musculoskeletal ultrasound
• 43. Bone scintigraphy and positron emission tomography
• 44. DXA and measurement of bone
• 45. Use of imaging as an outcome measure in rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis in clinical trials

Section 4: Principles of Management

• 46. Arthritis patient education, health promotion, and team approaches to management
• 47. Principles of rehabilitation: physical and occupational therapy
• 48a. Complementary and alternative medicine
• 48b. Placebos, Caring and Healing in Rheumatology
• 49. Drug Development
• 50. Non-pharmacologic pain management
• 51. Pharmacogenomics in rheumatology
• 52. Principles of opioid treatment of chronic musculoskeletal pain
• 53. Non-steroidal anti-inflammatory drugs
• 54. Systemic glucocorticoids in rheumatology
• 55. Antimalarials, parenteral gold, sulfasalazine, and other nonimmunosuppressive DMARDS
• 56. Methotrexate
• 57. Leflunomide
• 58. Immunosuppressives: Cyclosporine, Cyclophosphamide, Azathioprine, Mycophenolate mofetil
• 59. T-cell costimulation and other directed therapies
• 60. B-Cell Therapy
• 61. Cytokine neutralizers: IL-1 inhibitors
• 62. IL-6 Inhibition
• 63. Tumor necrosis factor blocking therapies
• 64. Kinase inhibition – a new therapeutic principle in rheumatology
• 65. Emerging therapeutic targets: GM-CSF, IL-17and IL-23
• 66. Biosimilars in Rheumatology
• 67. Infections and biologic therapy in rheumatoid arthritis
• 68. Drugs and pregnancy
• 69. Aspiration and injection of joints and periarticular tissues and intralesional therapy
• 70. Perioperative care of the rheumatic disease patient

Section 5: Regional and Widespread Pain

• 71. Neck pain
• 72. Lumbar spine disorders
• 73. The shoulder
• 74. The elbow
• 75. The wrist and hand
• 76. The hip
• 77. The knee
• 78. The ankle and foot
• 79. The temporomandibular joint
• 80. Fibromyalgia and related syndrome
• 81. Entrapment neuropathies and compartment syndromes
• 82. Complex regional pain syndrome (reflex sympathetic dystrophy)

Section 6: Rheumatoid Arthritis and Other Synovial Disorders

• 83. Classification and epidemiology of rheumatoid arthritis
• 84. Preclinical features of rheumatoid arthritis
• 85. Clinical features of rheumatoid arthritis
• 86. Extra-articular features of rheumatoid arthritis and systemic involvement
• 87. Adult-onset Still's disease
• 88. Imaging of rheumatoid arthritis
• 89. The contribution of genetic factors to rheumatoid arthritis
• 90. Animal models of arthritis
• 91. Autoantibodies in rheumatoid arthritis
• 92. Cellular immunity in rheumatoid arthritis
• 93. Angiogenesis and vasculogenesis in rheumatoid arthritis
• 94. The rheumatoid joint: synovitis and tissue destruction
• 95. Evaluation and management of early inflammatory polyarthritis
• 96. Evaluation and outcomes of patients with rheumatoid arthritis
• 97. Management of rheumatoid arthritis: synovitis
• 98. Multidisciplinary approach to rheumatoid arthritis

Section 7: Pediatric Rheumatology

• 99a. Evaluation of musculoskeletal complaints in children: Clinical Evaluation
• 99b. Evaluation of musculoskeletal complaints in children: Non-inflammatory musculoskeletal disorders
• 100. Classification and epidemiology of juvenile idiopathic arthritis
• 101. Clinical Features of juvenile idiopathic arthritis
• 102. Etiology and pathogenesis of juvenile idiopathic arthritis
• 103. Management of juvenile idiopathic arthritis
• 104. The juvenile-onset spondyloarthropathies
• 105. Connective tissues diseases in children
• 106. Rehabilitation and psychosocial issues in juvenile idiopathic arthritis

Section 8: Infection-Related Rheumatic Diseases

• 107. Infectious Arthritis I: Bacterial Arthritis
• 108. Infectious Arthritis II: Mycobacterium, brucella, fungal, and parasites
• 109. Lyme disease
• 110. Rheumatologic aspects of viral infections
• 111. Acute rheumatic fever
• 112. Reactive arthritis

Section 9: Spondyloarthropathies

• 113. Classification and epidemiology of spondyloarthritis
• 114. Clinical features of axial spondylarthritis
• 115. Etiology, pathogenesis, and pathophysiology of ankylosing spondylitis
• 116. Genetics of axial spondyloarthritis
• 117. Imaging of spondyloarthritis
• 118. Management of ankylosing spondylitis/axial spondyloarthritis
• 119. Classification and epidemiology of psoriatic arthritis
• 120. Clinical features of psoriatic arthritis
• 121. Etiology and pathogenesis of psoriatic arthritis
• 122. Management of psoriatic arthritis
• 123. Enthesopathies

Section 10: Connective Tissue Disorders

• 124. Epidemiology and classification of systemic lupus erythematosus
• 125. Preclinical features of lupus
• 126. Clinical features of systemic lupus erythematosus
• 127. Genetics of lupus
• 128. Immunopathology of systemic lupus erythematosus
• 129. Animal models of lupus
• 130. Autoantibodies in systemic lupus erythematosus
• 131. Pathogenesis of lupus
• 132. Drug-induced lupus
• 133. Assessing disease activity and outcome in systemic lupus erythematosus
• 134. The management of non-renal/non-CNS lupus
• 135. Treatment of Neuropsychiatric Lupus
• 136. Systemic lupus erythematosus: treatment-renal involvement
• 137. Systemic lupus erythematosus in the pregnant patient and neonatal lupus
• 138. Sjögren syndrome
• 139. Antiphospholipid syndrome: overview of pathogensis, diagnosis, and management
• 140. Classification and epidemiology of scleroderma
• 141. Assessing disease activity and outcome in scleroderma
• 142. Clinical features of systemic sclerosis
• 143. Etiology and pathogenesis of systemic sclerosis
• 144. Management of systemic sclerosis
• 145. Pulmonary management of systemic sclerosis
• 146. Raynaud's phenomonen
• 147. Localized scleroderma and scleroderma-like syndromes
• 148. Clinical features, classification, and epidemiology of inflammatory muscle disease
• 149. Inflammatory muscle disease-etiology and pathogenesis (myositis)
• 150. Management of inflammatory muscle disease
• 151. Metabolic, drug-induced, and other non-inflammatory myopathies
• 152. Overlap syndromes

Section 11: The Vasculitides

• 153. Classification and epidemiology of vasculitis
• 154. Biology and immunopathogenesis of vasculitis
• 155. Polyarteritis nodosa and Cogan's Syndrome
• 156. Polymyalgia rheumatica and giant cell arteritis
• 157. ANCA-associated vasculitis
• 158. Takayasu's arteritis
• 159. Behçet's syndrome
• 160. Kawasaki disease
• 161. Henoch schoenlein purpura/Immunoglobulin-A vasculitis
• 162. Cutaneous vasculitis and panniculitis
• 163. Cryoglobulinemia
• 164. Primary angiitis of the central nervous system

Section 12: Other Systemic Illnesses

• 165. Monogenic Autoinflammatory Diseases
• 166. Sarcoidosis
• 167. Relapsing polychondritis
• 168. Amyloidosis
• 169. Digital clubbing and hypertrophic osteoarthropathy
• 170. Miscellaneous arthropathies

Section 13: Osteoarthritis and Related Disorders

• 171. Osteoarthritis: epidemiology and classification
• 172. Local and systemic risk factors for incidence and progression of osteoarthritis
• 173. Clinical features of osteoarthritis
• 174. Animal models of osteoarthritis
• 175. Pathogenesis and pathology of osteoarthritis
• 176. Genetics of osteoarthritis
• 177. Imaging of osteoarthritis
• 178. Assessment of the patient with osteoarthritis and measurement of outcomes
• 179. Preclinical osteoarthritis
• 180. Assessment of imaging outcomes in osteoarthritis
• 181. Management of osteoarthritis
• 182. Diffuse idiopathic skeletal hyperostosis
• 183. Neuropathic arthropathy
• 184. Osteonecrosis
• 185. Rare Osteoarthritis: Ochronosis and Kashin–Beck disease

Section 14: Crystal-Related Arthropathies

• 186. Epidemiology of Gout
• 187. Etiology and pathogenesis of gout
• 188. Clinical gout
• 189. The management of gout and hyperuricemia
• 190. Calcium pyrophosphate crystal-associated arthropathy
• 191. Basic calcium phosphate crystal deposition disease
• 192. Other crystal-related arthropathies

Section 15: Endocrine and Hemoglobin-Related Arthritis and Storage Diseases

• 193. Rheumatoid manifestations of endocrine and lipid disease
• 194. Hemophilia and von Willebrand disease
• 195. Joint and bone lesions in hemoglobinopathies
• 196. Hemochromatosis

Section 16: Metabolic Bone Disease

• 197. Epidemiology and classification of osteoporosis
• 198. Osteoporosis: clinical features of osteoporosis
• 199. Pathogenesis of osteoporosis
• 200. Biochemical markers in bone disease
• 201. Management of osteoporosis
• 202. Glucocorticoid-induced osteoporosis
• 203. Osteomalacia and rickets
• 204. Primary hyperparathyroidism: rheumatologic manifestations and bone disease
• 205. Renal osteodystrophy
• 206. Paget's disease of bone

Section 17: Heritable Disease and Tumors of Bone and Connective Tissue

• 207. Gaucher's disease
• 208. Mucopolysaccharidoses
• 209. Heritable connective tissue disorders
• 210. Hypermobility syndrome
• 211. Skeletal dysplasias
• 212. Bone tumors