Case Presentation The patient was a 42-year-old African American female diagnosed with systemic lupus erythematosus (SLE) based on the findings of polyarthritis, malar and discoid rash, fatigue, positive double-stranded DNA (dsDNA) ribonucleoprotein and Smith antibodies, and low serum complement levels. Her SLE had been well controlled on hydroxychloroquine 400 mg daily, oral methotrexate 25 mg…
Straightforward Approach Can Help Rheumatology Health Professionals Engage with Fibromyalgia Patients
“I have pain all over my body” is a challenging response after you’ve asked a new patient what brings them in for their visit. You immediately suspect that this patient has fibromyalgia. The prevalence of fibromyalgia in the U.S. is 5 million people, and it is among the most common conditions in many rheumatology practices….
Rheumatologists, Social Workers Collaborate to Help Patients with Lupus
At the Hospital for Special Surgery (HSS), New York, rheumatologists and social workers have found that an interdisciplinary approach to care for systemic lupus erythematosus (SLE) patients improves the overall patient experience. “Our goal is to help patients navigate the complex healthcare system,” says Jillian Rose, LCSW, MPH, assistant director, Community Engagement, Diversity & Research….
Rheumatologists Weigh Pros, Cons of Working in Academia
Some rheumatologists find that an option other than working in a private practice makes the most sense for them. The reasons rheumatologists choose hospital or academic employment vary. Individual Choice When Lisa Criscione-Schreiber, MD, MEd, associate professor of medicine and rheumatology training program director, Duke University, Durham, N.C., was finishing her fellowship in 2003, she…
Volunteers Wanted to Join the ACR’s Committees, Board of Directors, Research Foundation
In 1974, President Nixon established a week in April to recognize the importance of volunteering. National Volunteer Week is scheduled for April 23–29 this year. At the College, we like to acknowledge and thank our volunteers year round. The mission of the College cannot be achieved without the time, effort, talent and dedication of our…
Diagnosis of Acute Gouty Arthritis Obscured by Anchoring Bias
A 56-year-old African American man presents to the emergency department with polyarthralgias and a fever of 103ºF. One month prior to admission, he presented with right knee pain and swelling. Blood cultures grew S. epidermidis. He was treated for presumed septic arthritis complicated by MSSE bacteremia. He was treated with meropenem and a prolonged course…
How to Bill Medicare Patients for Non-Covered Services
What do you do when you are presented with a patient who needs treatment but the patient’s insurance company will not pay for the services? Can you provide the services anyway? Who will pay for them? How do you collect payment for such services? If the patient consents to receive the services in spite of…
Ethics Forum: Teach Rheumatology Fellows to Use Good Judgment in Pharmaceutical Company Interactions
We teach medical students, residents and fellows evidence-based medicine to lay the groundwork for rational prescribing and good clinical judgment. But should we stop our rheumatology fellows from interacting with pharmaceutical companies as part of this foundation? It is not surprising that pharmaceutical companies can influence physician prescribing through gifts. At least, it should not…
Salsa Dancing Gives Medical Instructor Confidence Boost
Alyssa B. Dufour, PhD, is a salsa dancing junkie. Besides taking weekly dance lessons, she salsa dances three times a week at local clubs or studios and practices routines around the house—while cooking dinner, getting dressed or watching TV. She can’t seem to get enough of the social dance that has boosted her confidence in…
Rheumatology Case Report: Deep Vein Thrombosis Detected by Point-of-Care Ultrasound
Case A 46-year-old Caucasian female presented to the outpatient rheumatology clinic where she had been followed for several years. Her chief complaint was pain in her right knee, posterior right thigh and right hip that had begun gradually over the previous three weeks. Her past medical history was significant for rheumatoid arthritis (RA), obesity and…
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