Garuda - Garba Rujukan Digital

Indonesian Rheumatology Association (IRA) Recommendations for Diagnosis and Management of Osteoarthritis (Knee, Hand, Hip) Rakhma Yanti Helmi; Najirman; Ida Ayu Ratih Wulansari Manuaba; Andri Reza Rahmadi; Pande Ketut Kurniari; Malikul Chair; Ika Vemilia Warlisti; Eka Kurniawan; Harry Isbagio; Handono Kalim; Rudy Hidayat; Laniyati Hamijoyo; Cesarius Singgih Wahono; Sumariyono
Indonesian Journal of Rheumatology Vol. 15 No. 1 (2023): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v15i1.225

Background: Osteoarthritis (OA) is the most common form arthritis in the world, and its prevalence is predicted to rise higher in the future due to increasing life expectancy and growing number of elderly population. With the emergence of new treatment options in the last several years, a better understanding of OA diagnosis and management is required by every physician in Indonesia. Methods: A panel of eight selected rheumatologists from the Indonesian Rheumatologist Association (IRA) developed recommendations based on key questions formulated by a steering committee from IRA. These recommendation materials were taken from several online databases such as PubMed, Science Direct, and Google Scholar. Level of evidence and grades of recommendation were then assigned, and each member of the panelist team will assign a score to express their level of agreement. Results: A total of 25 recommendations discussing the diagnosis, pharmacological and non-pharmacological therapies, as well as monitoring for OA were formulated. Conclusion: These recommendations can be used to help clinicians in accurately diagnosing OA and choosing the most suitable therapy for their patients. All recommendation statements were tailored to the clinical setting, facility, and drug availability in Indonesia.

Pathophysiology and Management of Primary Osteoporosis: A Narrative Literature Review Dendi Andrean; Najirman; Eka Kurniawan
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 7 No. 8 (2023): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v7i8.856

The pathophysiology of primary osteoporosis primarily involves changes at the cellular and bone tissue levels. This process involves an imbalance between the activity of bone-destroying cells (osteoclasts) and bone-constructing cells (osteoblasts). Osteoclasts are responsible for the resorption of old and damaged bone tissue, while osteoblasts build new bone. In osteoporosis, osteoclast activity increases and osteoblasts decrease, resulting in loss of bone mass. Treatment of primary osteoporosis involves a holistic approach that includes lifestyle changes, use of medications, and fracture prevention. The main goal of management is to slow down the decline in bone density, prevent bone fractures, and improve the quality of life of sufferers. Increasing your intake of calcium and vitamin D, as well as regular physical exercise, can help maintain bone mass. Meanwhile, drugs such as bisphosphonates and teriparatide can be used to inhibit bone breakdown or stimulate new bone formation.

Acute Gouty Arthritis with Knee Effusion in a Patient with Chronic Lymphocytic Leukemia: Diagnostic Confirmation and Pre-Chemotherapy Hyperuricemia Management Panji Hadi Permana; Eka Kurniawan; Raveinal; Deka Viotra; Fadrian Fadrian
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 6 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i6.1614

Background: Gout and chronic lymphocytic leukemia (CLL) represent distinct hematologic and rheumatologic pathologies; however, their concurrent presentation presents significant diagnostic and therapeutic challenges. Tumor lysis syndrome and chemotherapy-induced hyperuricemia are recognized complications of hematologic malignancies, yet the manifestation of acute gouty arthritis with crystallographic confirmation in CLL patients remains an underreported clinical scenario requiring careful diagnostic stratification. Case presentation: We present a 69-year-old male farmer with newly diagnosed CLL (stage C, Binet classification) admitted for acute left knee arthritis with effusion, left ankle arthritis, and concurrent community-acquired pneumonia (CAP). Clinical examination revealed articular inflammation characterized by pain, swelling, erythema, warmth, and significant joint effusion with documented flexion limitation and positive bulging sign. Musculoskeletal ultrasound demonstrated double contour sign, synovial hypertrophy, and effusion measuring 5.8 cm in the suprapatellar recess with monosodium urate (MSU) crystal deposition confirmed by polarized light microscopy of synovial fluid (5,350 cells/mm³, 40% polymorphonuclear neutrophils, 60% mononuclear cells, positive MSU crystals). Serum uric acid was elevated at 10.6 mg/dL. The patient was successfully managed with colchicine, methylprednisolone, arthrocentesis, and supportive care while maintaining CLL treatment preparedness. Conclusion: This case illustrates the importance of confirmatory synovial fluid analysis and ultrasound imaging in the diagnosis of acute gout in the context of hematologic malignancy. Optimal management requires careful coordination between rheumatology and hematology-oncology services to prevent therapeutic complications and ensure safe chemotherapy initiation in CLL patients with concurrent acute gouty arthritis and hyperuricemia.

Correlation between serum bone remodeling biomarkers and CTX-1 levels among patients with rheumatoid arthritis: A cross-sectional study at a provincial referral hospital in Indonesia Najirman Najirman; Eka Kurniawan; Herdian Herdian
Narra J Vol. 6 No. 2 (2026): August 2026
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v6i2.2831

Rheumatoid arthritis (RA) is associated with accelerated bone loss, partly mediated by dysregulation of the receptor activator of nuclear factor-κB (RANK)/RANK ligand (RANKL)/osteoprotegerin (OPG) pathway, which regulates osteoclast activity. Carboxy-terminal cross-linked telopeptide of type I collagen (CTX-1) is a biochemical marker of bone resorption and may reflect increased skeletal turnover in RA. Although previous studies have evaluated RANKL, OPG, and the RANKL/OPG ratio in relation to bone mineral density, osteoporosis, and fracture risk, the correlations of circulating RANK, RANKL, and OPG with CTX-1 remain insufficiently characterized in patients with RA. The aim of this study was to evaluate the correlations of serum RANK, RANKL, and OPG levels with serum CTX-1 levels in patients with RA. An analytical cross-sectional study was conducted at a provincial referral hospital in Padang, Indonesia, from July to December 2024, during which patients with RA were recruited through consecutive sampling. Serum RANK, RANKL, OPG, and CTX-1 concentrations were measured using enzyme-linked immunosorbent assays. Correlations were assessed using Pearson’s correlation analysis. The mean age of the patients was 40.30±5.08 years. The mean serum concentrations of RANK, RANKL, OPG, and CTX-1 were 5.20±2.83, 6.55±3.14, 0.17±0.09, and 2.10±1.10 ng/mL, respectively. Serum RANK and RANKL levels showed very strong positive correlations with CTX-1 levels (r=0.928 and r=0.929, respectively; both p<0.001). Serum OPG levels also showed a strong positive correlation with CTX-1 levels (r=0.786; p<0.001). These findings suggest that circulating components of the RANK/RANKL/OPG pathway are associated with biochemical bone resorption in patients with RA. However, a larger longitudinal study incorporating disease activity, treatment exposure and bone mineral density is required to determine their clinical relevance.

Acute Gouty Arthritis with Knee Effusion in a Patient with Chronic Lymphocytic Leukemia: Diagnostic Confirmation and Pre-Chemotherapy Hyperuricemia Management Panji Hadi Permana; Eka Kurniawan; Raveinal; Deka Viotra; Fadrian Fadrian
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 6 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i6.1614

Background: Gout and chronic lymphocytic leukemia (CLL) represent distinct hematologic and rheumatologic pathologies; however, their concurrent presentation presents significant diagnostic and therapeutic challenges. Tumor lysis syndrome and chemotherapy-induced hyperuricemia are recognized complications of hematologic malignancies, yet the manifestation of acute gouty arthritis with crystallographic confirmation in CLL patients remains an underreported clinical scenario requiring careful diagnostic stratification. Case presentation: We present a 69-year-old male farmer with newly diagnosed CLL (stage C, Binet classification) admitted for acute left knee arthritis with effusion, left ankle arthritis, and concurrent community-acquired pneumonia (CAP). Clinical examination revealed articular inflammation characterized by pain, swelling, erythema, warmth, and significant joint effusion with documented flexion limitation and positive bulging sign. Musculoskeletal ultrasound demonstrated double contour sign, synovial hypertrophy, and effusion measuring 5.8 cm in the suprapatellar recess with monosodium urate (MSU) crystal deposition confirmed by polarized light microscopy of synovial fluid (5,350 cells/mm³, 40% polymorphonuclear neutrophils, 60% mononuclear cells, positive MSU crystals). Serum uric acid was elevated at 10.6 mg/dL. The patient was successfully managed with colchicine, methylprednisolone, arthrocentesis, and supportive care while maintaining CLL treatment preparedness. Conclusion: This case illustrates the importance of confirmatory synovial fluid analysis and ultrasound imaging in the diagnosis of acute gout in the context of hematologic malignancy. Optimal management requires careful coordination between rheumatology and hematology-oncology services to prevent therapeutic complications and ensure safe chemotherapy initiation in CLL patients with concurrent acute gouty arthritis and hyperuricemia.

Management of Arthritis Associated with Inflammatory Bowel Disease (IBD): A Systematic Review of Conventional and Targeted Therapies Iqbal Habibie; Najirman; Eka Kurniawan
International Journal of Health and Pharmaceutical (IJHP) Vol. 6 No. 3 (2026): August 2026
Publisher : CV. Inara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51601/ijhp.v6i3.681

Inflammatory bowel disease (IBD), encompassing Crohn's disease and ulcerative colitis, is a chronic inflammatory disorder of the gastrointestinal tract associated with significant extraintestinal manifestations. Arthritis is the most frequent extraintestinal manifestation, with an overall prevalence of 17–39%, and is classified as a subtype of spondyloarthritis involving axial and/or peripheral joints. Peripheral arthritis is generally non-erosive, with the oligoarticular variant correlating with intestinal disease activity, whereas axial arthritis—including sacroiliitis and ankylosing spondylitis—tends to progress independently of bowel disease activity. This narrative review aims to provide a comprehensive overview of IBD-associated arthritis, covering its definition, epidemiology, pathogenesis, clinical manifestations, diagnosis, and management. Pathogenesis involves three interconnected mechanisms: extension of intestinal immune responses, gut microbiota dysregulation through Th17 pathway activation, and genetic predisposition mediated by HLA-B27 and NOD2/CARD15. Diagnosis relies on ASAS clinical criteria, with MRI as the preferred modality for early detection of axial involvement. Management requires an integrated approach; TNF-α inhibitors serve as first-line therapy in active disease, while JAK inhibitors, ustekinumab, and vedolizumab represent promising novel therapeutic options. Multidisciplinary collaboration between gastroenterologists and rheumatologists is essential to optimize long-term clinical outcomes.

HUBUNGAN AKTIVITAS PENYAKIT DENGAN KUALITAS HIDUP PADA PASIEN ARTRITIS REUMATOID Bagas Pandega Wirayuda; Eka Kurniawan; Nuzulia Irawati; Najirman Najirman; Rini Gusya Liza; Dina Arfiani Rusjdi
EMPIRIS : Jurnal Sains, Teknologi dan Kesehatan Vol. 3 No. 3 (2026): EMPIRIS : Jurnal Sains, Teknologi dan Kesehatan, September 2026
Publisher : Lembaga Pendidikan dan Penelitian Manggala Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.62335/empiris.v3i3.2949

Rheumatoid arthritis is a chronic autoimmune inflammatory disease that is progressive in nature and may lead to joint dysfunction as well as decreased quality of life. Disease activity is one of the important factors influencing the quality of life of patients with rheumatoid arthritis. This study aimed to determine the relationship between disease activity and quality of life among patients with rheumatoid arthritis at Dr. M. Djamil General Hospital, Padang. This study used an analytical cross-sectional design. Data were collected from November 2024 to January 2025 involving thirty-nine patients with rheumatoid arthritis who met the ACR/EULAR 2010 criteria. Disease activity was measured using the Disease Activity Score-28 based on erythrocyte sedimentation rate, while quality of life was assessed using the Short Form-36 questionnaire. Data analysis was performed using Pearson correlation test. The results showed a mean disease activity score of 3.08 ± 1.26 and a mean quality of life score of 72.01 ± 17.22. Statistical analysis demonstrated a weak negative correlation between disease activity and quality of life (r = −0.093; p > 0.05). These findings indicate that an increase in disease activity tends to be followed by a decrease in the quality of life of patients with rheumatoid arthritis.

Title

Found 7 Documents
Search

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Title Search

Found 7 Documents Search

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Title

Found 7 Documents
Search