A 2026 practical review of morphea (localized scleroderma) across age groups — an organ-sparing autoimmune skin disease distinct from systemic sclerosis. Covers classification, the high-stakes subtypes (pansclerotic, facial linear), activity-vs-damage assessment, and management anchored on long-course methotrexate plus a steroid bridge, where depth and site dictate aggressiveness.
A 2026 practical distillation of the 2023 ACR/CHEST guidelines on SSc-ILD — the single leading cause of death in systemic sclerosis. Covers proper screening (full PFTs + non-contrast HRCT), monitoring schedules, the first-line drug evidence (mycophenolate, tocilizumab, rituximab, nintedanib), and the strong recommendation against glucocorticoids.
A 2026 pictorial review of the conditions that mimic sacroiliitis on SIJ MRI — bone marrow oedema is sensitive but the least specific sign, and overcalling it risks committing patients to lifelong biologic therapy. Erosion, lesion combinations, topographic location, semi-axial imaging and clinical context are the defences against false-positive reads.
Work through a previously healthy 7-year-old girl with six weeks of progressive bilateral leg pain and a limp — one finding at a time. Twelve multiple-choice checkpoints test how you reshape a broad differential as imaging, labs and, crucially, a dietary history land on a diagnosis that is easy to miss.
Step through a 76-year-old woman’s diagnostic journey — palpable purpura, falling kidney function, a stroke, a new murmur — one finding at a time. Fourteen multiple-choice checkpoints test how you reshape the differential as each piece of data lands.
A contemporary NEJM review of idiopathic inflammatory myopathies — the five-subtype framework (IBM, IMNM, antisynthetase syndrome, overlap, dermatomyositis), the autoantibody revolution that now anchors classification, and the shift toward subtype-specific therapy with biologics, JAK/TYK2 inhibitors, and CAR-T.
In a 28,781-patient EMR phenome-wide study, a high ANA titer (≥1:640) without autoimmune disease was strongly enriched for non-AI liver disease (NAFLD/NASH, alcohol-related) and metabolic comorbidity — broadening the differential for an unexplained high-titer ANA beyond the usual autoimmune workup.