The ability to intervene at the earliest phases in the pathogenesis of a chronic rheumatic disease caused by auto-inflammatory, autoimmune, or tissue injury mechanisms has th epotential to prevent disease manifestations and consequences, limited loss of quality of life, comorbidity, and costs to society. This issue is dedicated to exploring the stages of rheumatic disease, biologic mechanisms contributing to the pathogenesis along with possible ways to study and screen for persons at risk with the ultimate goal of finding ways to prevent these devastating diseases.

There are numerous monographs devoted to rheumatoid arthritis. What sets this issue apart is that it keeps an eye to the future. Topics explored include measurement of RA disease activity today and in the future; epidemiology of RA – implications for prevention and risk assessment; genes that predispose to RA – relevance to current and future therapeutic strategies; multiple kinases – assessment of the best targets in treating RA; assessment, prevention and treatment of cardiovascular morbidity in RA; mechanistic insights and approaches to prevention of bone damage in RA; cell-cell interactions in RA synovium as potential new targets for treatment; alternative strategies for modulating the function of B lymphocytes in RA; innate immunity in RA; ascertainment and management of preclinical RA.

In only the last four years, there have been dramatic changes in the understanding of the immunology, genetic/epigenetic associations, and identification of new targets for therapy in Systemic Lupus Erythematosus. The editors have enlisted a superb group of authors to present articles detailing cutting-edge advances in these areas.

In this first-of-its-kind issue of Rheumatic Disease Clinics, guest editor Dr. Bryant R. England brings his considerable expertise to the topic of Environmental Triggers for Rheumatic Diseases. In practical, state-of-the-art articles, top experts examine the connection between some of the most commonly seen rheumatic disease and environmental triggers for the disease. - Contains 13 practice-oriented topics including inhalant and mucosal-related environmental risks for rheumatoid arthritis; lifestyle, hormonal, and microbial-related environmental risks for rheumatoid arthritis; environmental risks for systemic lupus erythematosus; environmental risks for osteoarthritis; targeting environmental risks to prevent rheumatic diseases; and more. - Provides in-depth clinical reviews on environmental triggers for rheumatic diseases, offering actionable insights for clinical practice. - Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.

To ensure the best possible clinical outcomes for arthritis patients, it is essential that they be seen early and treated appropriately at the earliest opportunity. Early therapy has proven much more effective than that given late. This issue of Rheumatic Disease Clinics of North America brings the rheumatologist up to date on the latest treatments and interventions in evolving arthritis and established early arthritis. Topics covered include early rheumatoid arthritis, psoriatic arthritis, undifferentiated arthritis, oligoarthritis, osteoarthritis, and others. Imaging modalities are addressed as well as various contemporary treatments including biologics.

The lungs are involved so frequently with rheumatologic problems. This issue will cover Radiology of lung disease in the rheumatic diseases, Histopathology of lung disease in the rheumatic diseases, Determining respiratory impairment, Lung disease in RA, Lung disease in scleroderma, and many more!

Gout is now the most common form of inflammatory arthritis in the United States, with a recent resurgence of research interest in its cause and management. Calcium crystal-related arthritis has also attracted renewed attention, with new nomenclature having been recently elaborated, aiding contemporary research efforts. This topic has never been covered in Rheumatic Disease Clinics and it represents a large content hole. The articles will cover diagnosis, management, emerging therapies and imaging.