The past 25 years in paediatric rheumatology: insights from monogenic diseases.

The past 25 years have seen major novel developments in the field of paediatric rheumatology. The concept of autoinflammation was introduced to this field, and medicine more broadly, with studies of familial Mediterranean fever, the most common autoinflammatory disease globally. New data on the positive evolutionary selection of familial Mediterranean fever-associated genetic variants might be pertinent to mild gain-of-function variants reported in other disease-associated genes. Genetic studies have unveiled the complexity of human heritability to inflammation and flourishing data from rare monogenic disorders have contributed to a better understanding of general disease mechanisms in paediatric rheumatic conditions. Beyond genomics, the application of other 'omics' technologies, including transcriptomics, proteomics and metabolomics, has generated an enormous dataset that can be applied to the development of new therapies and in the practice of precision medicine. Novel biomarkers for monitoring disease activity and progression have also emerged. A surge in the development of targeted biologic therapies has led to durable remission and improved prognosis for many diseases that in the past caused major complications. Last but not least, the COVID-19 pandemic has affected paediatric rheumatology practice and has sparked new investigations into the link between viral infections and unregulated inflammatory responses in children.

History Page: Leaders in MSK Radiology: Stanislas de Sèze, 1903-2000.

This history page is dedicated to the memory and achievements of the French rheumatologist Stanislas de Sèze whose name is connected to the so-called de Sèze view, used to evaluate the sacroiliac joints, the lumbar and lower thoracic spine, pelvis, and hip joints on a single anteroposterior radiograph.

Eric Bywaters and Barbara Ansell: Founders of Modern Pediatric Rheumatology.

Eric Bywaters and Barbara Ansell were, without doubt, two of the giants in the field of Rheumatology. With their keen clinical observations and their visionary development of a dedicated multidisciplinary program focusing on diagnosis, treatment, and research, they are remembered as the founders of the modern specialty of Pediatric Rheumatology.

Jacques Forestier: Forgotten Contributions of a Rheumatologist to Spine Surgery.

Jacques Forestier (1890-1978) was a well-known rheumatologist and radiologist whose innovations have revolutionized spinal neurosurgery and rheumatology. He was well known as "Doctor Lipiodol" for his accidental discovery of spinal myelography, which he later extrapolated for use in many body cavities and their pathologies. He was the first to describe "senile ankylosing hyperostosis of the spine," which was later renamed "diffuse idiopathic skeletal hyperostosis." Furthermore, he is credited with the first use of gold salts as a disease-modifying therapy for rheumatoid arthritis. We have presented a historical vignette to chronicle the life of Jacques Forestier and his contributions to the field of spinal neurosurgery.

[Bertolt Brecht. Did he really have rheumatic fever?] / Bertolt Brecht. Hatte er wirklich ein rheumatisches Fieber?

The writer Bertolt Brecht (1898-1956) is known for his poems, dramas and the "epic or dialectical theater" he founded. He was retrospectively postulated to have had rheumatic fever because of heart problems and neuromuscular symptoms in his youth. Based on current rheumatological knowledge, it cannot be deduced with certainty from the available documents that Brecht had rheumatic fever. At most, a very unusual manifestation of rheumatic fever can be suspected with atypical rheumatic chorea and a very atypical course of rheumatic carditis. Several deviations from the classical clinical picture-the absence of fever and arthritis, no typical symptoms of Sydenham's chorea, the lack of a diagnosis of heart valve defects in adolescence-lead to extensive differential diagnostic considerations. A possible psychosomatic origin through functional heart complaints must even be postulated if a temporary previous organic cause cannot be excluded. Only the use of the advanced diagnostics available today with Doppler sonography of the heart, cardiac magnetic resonance imaging (MRI), throat swabs for Streptococci and streptococcal serology would have made it possible to diagnose Brecht's cardiac symptoms in his adolescence without a doubt and to differentiate them from functional heart complaints. His death is verified by medical documents clearly documenting bacterial endocarditis with evidence of coli bacteria caused by urological interventions with subsequent febrile episodes and pyelonephritis.

Not only laboratory to clinic: the translational work of William S. C. Copeman in rheumatology.

Since the arrival of Translational Medicine (TM), as both a term and movement in the late 1990s, it has been associated almost exclusively with attempts to accelerate the "translation" of research-laboratory findings to improve efficacy and outcomes in clinical practice (Krueger et al. in Hist Philos Life Sci 41:57, 2019). This framing privileges one source of change in medicine, that from bench-to-bedside. In this article we dig into the history of translation research to identify and discuss three other types of translational work in medicine that can also reshape ideas, practices, institutions, behaviours, or all of these, to produce transformations in clinical effectiveness. These are: (1) making accessible state-of-the-art knowledge and best practice across the medical profession; (2) remodelling and creating institutions to better develop and make available specialist knowledge and practice; and (3) improving public and patient understandings of disease prevention, symptoms and treatments. We do so by examining the work of William S. C. Copeman, a dominant figure in British rheumatology from the 1930 through the late 1960s. Throughout his long career, Copeman blended approaches to "translation" in order to produce transformative change in clinical medicine, making his work an exemplar of our expanded notion of TM.