UBA1 and VEXAS syndrome: From a methodological perspective, three specific constraints merit emphasis: first, the absence of UBA1 genetic sequencing prevents molecular confirmation of the suspected VEXAS syndrome pathogenesis; second, the lack of comprehensive dynamic immune monitoring throughout the clinical course restricts our understanding of the temporal relationship between immune reconstitution and disease manifestations; third, the inherent heterogeneity of obtained cartilage tissue samples introduces potential interpretation biases in histological assessments.