Osteoarticular Infections Caused by Non-Aspergillus Filamentous Fungi in Adult and Pediatric Patients: A Systematic Review.

Journal and index pages often block iframe embedding. This reader keeps the evidence details in Orthonotes and leaves the source page one click away.

Abstract

[Indexed for MEDLINE] 2. Ann Rheum Dis. 2026 Jun;85(6):1092-1109. doi: 10.1016/j.ard.2026.02.025. Epub 2026 Mar 26. Frequency and characteristics of axial involvement in psoriatic arthritis: results from the International Multicentre AXIS Study. Torgutalp M(1), Almodovar R(2), Azevedo VF(3), Baraliakos X(4), Bosch FVD(5), Braun J(6), Chandran V(7), Coates LC(8), Deodhar A(9), Diekhoff T(10), Fagni F(11), Floris A(12), Gaalen FAV(13), Garcia-Salinas R(14), Gensler LS(15), Goel N(16), Gottlieb AB(17), Heijde DV(13), Helliwell PS(18), Hermann KGA(19), Kalyoncu U(20), Kiltz U(4), Kynaston-Pearson F(21), Lambert RG(22), Laxminarayan R(23), Leung YY(24), Llop M(25), López-Medina C(26), López-Rodríguez A(27), Gentiloni MML(28), Lunteren MV(13), Magrey M(29), Maharaj AB(30), Maldonado-Ficco H(31), Maksymowych WP(32), Marzo-Ortega H(33), Massarotti M(34), Mathew AJ(35), Mease P(36), Nash P(37), Navarro-Compán V(38), Østergaard M(39), Proft F(40), Protopopov M(40), Ranza R(41), Rohekar S(42), Salvarani C(43), Schiotis RE(44), Shenker N(45), Sieper J(40), Solmaz D(46), Soriano ER(47), Shan Tam L(48), Toledo RA(49), Wei JC(50), Ziade N(51), Gladman DD(52), Poddubnyy D(53). Author information: (1)Department of Gastroenterology, Infectious Diseases and Rheumatology (including Nutrition Medicine), Charité - Universitätsmedizin Berlin, Berlin, Germany; Department of Rheumatology and Clinical Immunology, Charité - Universitätsmedizin Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology IA, Berlin, Germany. Electronic address: murat.torgutalp@charite.de. (2)Rheumatology Unit, Fundation Alcorcón University Hospital. Alcorcón, Madrid, Spain. (3)Department of Internal Medicine, Federal University of Paraná, Curitiba, Paraná, Brazil. (4)Ruhr-Universität Bochum, Rheumazentrum Ruhrgebiet, Herne, Bochum, Germany. (5)VIB-UGent Center for Inflammation Research, Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium; Department of Rheumatology, University Hospital Ghent, Ghent, Belgium. (6)Ruhr-Universität Bochum, Rheumazentrum Ruhrgebiet, Herne, Bochum, Germany; Rheumatologisches Versorgungszentrum Steglitz, Berlin, Germany. (7)Gladman Krembil Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, ON, Canada; Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, ON, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada. (8)Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK. (9)Division of Arthritis & Rheumatic Diseases (OP09), Oregon Health & Science University, Portland, OR, USA. (10)Department of Radiology, Immanuel Clinic Ruedersdorf, University Hospital of Brandenburg Medical School, Ruedersdorf bei Berlin, Brandenburg, Germany. (11)Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Bavaria, Germany. (12)Rheumatology Unit, AOU and University of Cagliari, Monserrato, Italy. (13)Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands. (14)Rheumatology Unit Hospital Italiano de La Plata- Universidad Nacional de La Plata, La Plata, Argentina. (15)Department of Medicine/Rheumatology, University of California, San Francisco, CA, USA. (16)Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, NC, USA. (17)Department of Dermatology, Icahn School of Medicine at Mt Sinai, New York, NY, USA. (18)Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK. (19)Department of Radiology, Charité - Universtitätsmedizin Berlin, Berlin, Germany. (20)Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Türkiye. (21)University Hospitals of Derby and Burton NHS Trust, Derby, UK. (22)Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, AB, Canada. (23)Department of Rheumatology, UHDB, Queen's Hospital, Burton on Trent, UK. (24)Department of Rheumatology & Immunology, Singapore General Hospital, Singapore; Duke-NUS Medical School, Singapore. (25)Department of Rheumatology, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain. (26)Department of Rheumatology, Reina Sofia University Hospital, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), University of Cordoba, Cordoba, Spain. (27)Department of Rheumatology, Hospital San Javier, Centro de Investigación en enfermedades autoinmunes (CINEA), Guadalajara, Jalisco, México. (28)Medical Clinic, Department of Clinical and Molecular Sciences, Marche Polytechnic University & Department of Internal Medicine, Azienda Ospedaliero-Universitaria delle Marche, Italy. (29)Case Western Reserve University School of Medicine, University Hospitals, Cleveland, OH, USA. (30)Department of Internal Medicine and Therapeutics, Faculty of Health Sciences, Walter Sisulu University, Mthatha, Eastern Cape, South Africa. (31)Rheumatology Section, Hospital San Antonio de Padua and Clinica Regional Del Sud, Rio Cuarto, Cordoba, Argentina. (32)Department of Medicine, University of Alberta, Edmonton, AB, Canada. (33)NIHR Leeds Biomedical Research Centre, The Leeds Teaching Hospitals NHS Trust and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK. (34)Department of Rheumatology, University Hospitals Dorset NHS Foundation Trust, Christchurch Hospital, Christchurch, UK. (35)Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, Tamil Nadu, India. (36)Department of Rheumatology Research, Providence Swedish Medical Center and University of Washington, Seattle, WA, USA. (37)School of Medicine, Griffith University, Brisbane, QLD, Australia. (38)Department of Rheumatology, University Hospital La Paz, IdiPaz, Madrid, Spain. (39)Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. (40)Department of Gastroenterology, Infectious Diseases and Rheumatology (including Nutrition Medicine), Charité - Universitätsmedizin Berlin, Berlin, Germany. (41)Rheumatology Unit, Hospital de Clinicas, Universidade Federal de Uberlandia, Uberlandia, Minas Gerais, Brazil. (42)Division of Rheumatology, Department of Medicine, Western University, London, ON, Canada. (43)Division of Rheumatology, Azienda USL-IRCCS di Reggio Emilia and Università di Modena e Reggio Emilia, Reggio Emilia, Italy. (44)Clinical Hospital of Infectious Diseases, Rheumatology Outpatient Division, Cluj-Napoca, Romania. (45)Cambridge University Hospitals NHS Trust, Cambridge, Cambridge, UK; Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge, UK. (46)Division of Rheumatology, Department of Internal Medicine, Izmir Katip Celebi University School of Medicine, Izmir, Türkiye. (47)Rheumatology Service, Internal Medicine Service, Hospital Italiano de Buenos Aires, and University Hospital Italiano de Buenos Aires, Argentina. (48)Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Hong Kong, People's Republic of China. (49)Rheumatology discipline, Medical School of São José do Rio Preto (FAMERP), São José do Rio Preto, São Paulo, Brazil. (50)Department of Allergy, Immunology & Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan; Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan. (51)Rheumatology Department, Saint Joseph University and Hotel-Dieu de France Hospital, Beirut, Lebanon. (52)Gladman Krembil Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, ON, Canada; Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada. (53)Department of Gastroenterology, Infectious Diseases and Rheumatology (including Nutrition Medicine), Charité - Universitätsmedizin Berlin, Berlin, Germany; Gladman Krembil Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, ON, Canada; Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada. OBJECTIVES: The Axial Involvement in Psoriatic Arthritis (AXIS) cohort aimed at evaluating the frequency of and clinical and imaging features of axial involvement in psoriatic arthritis (PsA). METHODS: AXIS (NCT04434885) is a prospective, multicentre, cross-sectional study conducted in 19 countries, by the Assessment of SpondyloArthritis International Society and the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis. Participants with a diagnosis of PsA meeting ClASsification criteria for Psoriatic ARthritis with musculoskeletal symptom duration ≤10 years and no prior exposure to biological or targeted synthetic disease-modifying antirheumatic drugs were consecutively included. Standardised clinical, laboratory, and imaging assessments (radiography and magnetic resonance imaging of the axial skeleton, including sacroiliac joints [SIJs] and spine), were performed. Imaging was reviewed locally and centrally to detect axial involvement. The presence of axial involvement was determined by local investigator judgement before and after central-imaging review. RESULTS: Among 409 participants, axial involvement was identified in 153 (37.4%) based on the investigator's initial assessment and was decreased to 112 (27.4%) in the final evaluation after incorporating central-imaging review. Participants with axial involvement were younger (45.2 ± 13.8 vs 47.6 ± 12.6 years), more often male (56.3% vs 51.5%), and had a higher frequency of human leukocyte antigen (HLA)-B*27 positivity (22.4% vs 10.8%), inflammatory back pain (IBP) (74.7% vs 43.4%), and elevated C-reactive protein (CRP) (52.7% vs 37.4%). Active inflammatory and structural imaging changes were highly discriminative between participants with and without axial involvement. The central review identified imaging signs of axial involvement (active inflammation or structural lesions) in 95 participants (23.2%). CONCLUSIONS: Axial involvement was identified in 27.4% of participants with PsA after final diagnostic assessment, with associated features including HLA-B*27 positivity, IBP, elevated CRP, and imaging changes in SIJ or spine. Copyright © 2026 The Author(s). Published by Elsevier B.V. All rights reserved. DOI: 10.1016/j.ard.2026.02.025