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Diagnostics
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Advances and Challenges in the Diagnosis and Treatment of Rheumatic...
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Advances and Challenges in the Diagnosis and Treatment of Rheumatic Diseases

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Clinical Diagnosis and Prognosis".

Deadline for manuscript submissions: closed (28 February 2026) | Viewed by 3902

Editors

Prof. Dr. Anastas Batalov

E-Mail Website
Guest Editor
1. Medical Faculty, Medical University, 4000 Plovdiv, Bulgaria
2. Rheumatology Clinic, University Hospital ‘Kaspela’, 4000 Plovdiv, Bulgaria
Interests: rheumatology
Dr. Mariela Geneva-Popova

E-Mail Website
Guest Editor Assistant
1. Medical Faculty, Medical University, 4000 Plovdiv, Bulgaria
2. Rheumatology Clinic, University Hospital ‘Kaspela’, 4000 Plovdiv, Bulgaria
Interests: internal diseases; rheumatology
Dr. Zgurov Batalov

E-Mail Website
Guest Editor Assistant
1. Medical Faculty, Medical University, 4000 Plovdiv, Bulgaria
2. Rheumatology Clinic, University Hospital ‘Kaspela’, 4000 Plovdiv, Bulgaria
Interests: rheumatology

Special Issue Information

Dear Colleagues,

This Special Issue is aimed at providing a comprehensive overview of the latest developments and persistent hurdles in rheumatologic care. It explores innovative diagnostic tools, such as advanced imaging techniques including musculoskeletal ultrasound, and biomarker discovery, alongside evolving treatment strategies, including biologics, targeted therapies, and personalized medicine. The research also addresses challenges like early disease detection, treatment resistance, and comorbidities in conditions such as rheumatoid arthritis, lupus, and osteoarthritis. Aimed at clinicians and researchers, this Issue bridges translational research and clinical practice, offering insights to optimize patient outcomes in rheumatology through the integration of emerging technologies like ultrasound in diagnostic and therapeutic approaches.

Prof. Dr. Anastas Batalov
Guest Editor

Dr. Mariela Geneva-Popova
Dr. Zgurov Batalov
Guest Editor Assistants

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • rheumatology 
  • rheumatic diseases 
  • musculoskeletal ultrasound 
  • clinical diagnostics 
  • biomarkers 
  • precision medicine

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Published Papers (3 papers)

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Research

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15 pages, 1278 KB  
Article
Potential Utility of Combined Salivary Calprotectin and Anti-Cyclic Citrullinated Peptide in Rheumatoid Arthritis Assessment
by Misong Kim, Young Il Kim, Yeon-Ah Lee and Seung-Jae Hong
Diagnostics 2026, 16(1), 23; https://doi.org/10.3390/diagnostics16010023 - 21 Dec 2025
Cited by 1 | Viewed by 929
Abstract
Background/Objectives: Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by persistent synovial inflammation and progressive joint damage. Although serum biomarkers such as rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) are widely used, blood-based testing is invasive. Saliva has emerged as [...] Read more.
Background/Objectives: Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by persistent synovial inflammation and progressive joint damage. Although serum biomarkers such as rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) are widely used, blood-based testing is invasive. Saliva has emerged as a noninvasive diagnostic medium with clinical potential. This study aimed to evaluate the potential utility of salivary calprotectin and anti-CCP antibodies for discriminating patients with RA from healthy controls. Methods: Saliva samples were collected from 58 RA patients and 50 healthy controls. Salivary calprotectin and anti-CCP antibody levels were quantified using enzyme-linked immunosorbent assay. The diagnostic performance was evaluated using receiver operating characteristic curve analysis and logistic regression models that incorporated both biomarkers and clinical variables. Results: Patients with RA exhibited significantly higher salivary calprotectin and anti-CCP levels than controls (both p < 0.001). Calprotectin showed high sensitivity (79.31%), whereas anti-CCP displayed high specificity (84.00%). Salivary calprotectin was associated with disease duration and joint damage, while anti-CCP correlated with the erythrocyte sedimentation rate, RF, and serum anti-CCP. A multivariate model combining salivary biomarkers with clinical factors indicated an excellent diagnostic discrimination. Conclusions: Salivary calprotectin and anti-CCP antibodies show potential as complementary noninvasive biomarkers for distinguishing patients with established RA from healthy controls. However, as saliva samples were not collected at the time of initial diagnosis, these findings primarily support disease discrimination rather than early detection. Further prospective studies involving newly diagnosed and at-risk populations are required to clarify their role in early diagnosis, monitoring, and clinical implementation. Full article
(This article belongs to the Special Issue Advances and Challenges in the Diagnosis and Treatment of Rheumatic Diseases)
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12 pages, 1668 KB  
Article
Hand Osteoarthritis in the Elderly: The Prevalence of Articular Cartilage Defects in Radiographically Normal and Affected Joints
by Reiji Nishimura, Tohru Hashimoto, Takeshi Fukuda, Tohru Yano, Kazuhiro Maeda, Masataka Okabe and Takeshi Miyawaki
Diagnostics 2025, 15(21), 2669; https://doi.org/10.3390/diagnostics15212669 - 22 Oct 2025
Viewed by 1140
Abstract
Background: Hand osteoarthritis (OA) is a highly prevalent disease that significantly impairs quality of life among many patients. The direct evaluation of cartilage defects associated with OA in vivo is challenging, and indirect assessments using X-ray images are commonly employed. The aim [...] Read more.
Background: Hand osteoarthritis (OA) is a highly prevalent disease that significantly impairs quality of life among many patients. The direct evaluation of cartilage defects associated with OA in vivo is challenging, and indirect assessments using X-ray images are commonly employed. The aim of this study was to evaluate the relationship between X-ray images of finger joints and cartilage defects. Methods: This study included 42 hands from cadavers that were fixed with alcohol and formalin. After X-ray posteroanterior images of all the finger joints were taken, the extent of the cartilage defects was observed macroscopically. On X-ray images, OA was defined as a modified Kellgren–Lawrence scale score of 2 or higher. Histological examinations were performed on several joints with cartilage defects to confirm whether the macroscopic cartilage defects corresponded to the histological cartilage defects. Results: A total of 588 joints were evaluated. On X-ray images, OA was observed in 20.2% of the joints, and cartilage defects were present in 45.1%. Among joints with cartilage defects, the prevalence of joints without radiographic OA was 55.1%. On the other hand, 31.1% of joints without radiographic OA had cartilage defects. Cartilage defects were identified in all joints with radiographic OA. Conclusions: The use of X-ray images to evaluate OA is beneficial; however, when interpreting radiographic OA, it is important to note that early or partial OA may not be detectable. Additionally, when OA findings are present on X-ray images, cartilage defects are always present. Full article
(This article belongs to the Special Issue Advances and Challenges in the Diagnosis and Treatment of Rheumatic Diseases)
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Review

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28 pages, 733 KB  
Review
Cardiovascular Involvement in Systemic Lupus Erythematosus: Focus on Arrhythmias
by Monica Claudia Dobos, Veronica Ungurean, Diana Elena Costan, Mara Russu, Anca Ouatu, Paula Cristina Morariu, Alexandru Florinel Oancea, Maria Mihaela Godun, Diana-Elena Floria, Dragos Traian Marcu, Genoveva Livia Baroi, Silviu Marcel Stanciu, Anton Knieling, Daniela Maria Tanase, Codrina Ancuta and Mariana Floria
Diagnostics 2026, 16(3), 372; https://doi.org/10.3390/diagnostics16030372 - 23 Jan 2026
Cited by 1 | Viewed by 1506
Abstract
Background: Cardiovascular implications in systemic lupus erythematosus (SLE) are common and varied, including impacts on the pericardium, myocardium, valves, coronary arteries, and conduction system; all of these could be potential substrates or triggers of cardiac arrhythmias by interfering with disease severity and specific [...] Read more.
Background: Cardiovascular implications in systemic lupus erythematosus (SLE) are common and varied, including impacts on the pericardium, myocardium, valves, coronary arteries, and conduction system; all of these could be potential substrates or triggers of cardiac arrhythmias by interfering with disease severity and specific medication. Therefore, this narrative review aimed to assess the cardiac involvement in SLE underlying, mainly, cardiac arrhythmias. Methods: We analyzed studies, published between 2015 and 2025 on PubMed, which explore cardiovascular involvement with a focus on arrhythmias in SLE from the perspectives of epidemiology, underlying mechanisms, diagnostic techniques, and the impact of standard and biologic therapies. Results: The cardiac manifestation of LES (lupus pericarditis, lupus myocarditis, Libman–Sacks endocarditis, coronary artery disease, coronary vasculitis or myocardial fibrosis) represents a substrate for arrhythmia risk. These substrates, in association with other arrhythmias mechanisms considered as triggers or conduction abnormalities, determined arrhythmogenic conditions in these patients. In addition to structural heart disease, arrhythmias in SLE are caused by ongoing inflammation, immune system irregularities, microvascular problems, autonomic imbalance, oxidative stress, and side effects from treatments. Despite this complex background, arrhythmias are often overlooked and not routinely investigated in SLE care. Data that show how disease-modifying drugs may affect arrhythmias are limited and inconsistent, highlighting significant gaps in knowledge. Cardiac arrhythmias are a significant but, as yet, insufficiently underrecognized aspect of SLE, with serious implications for prognosis. Conclusions: Systemic lupus erythematosus causes cardiovascular involvement that is associated with arrhythmias through various and complexes mechanisms, mainly related to direct cardiovascular structural damage, systemic inflammation or specific therapies. Data on arrhythmias secondary to cardiovascular damage in patients with SLE in the literature are limited. Therefore, early detection of electrical issues, regular cardiovascular evaluation in high-risk patients, and careful management of treatment effects are vital. A coordinated, multidisciplinary cardio-rheumatology approach is essential to improving arrhythmia detection, tailoring treatments, and ultimately decreasing cardiovascular complications and deaths in SLE patients. Full article
(This article belongs to the Special Issue Advances and Challenges in the Diagnosis and Treatment of Rheumatic Diseases)
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