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Case Report: Diagnosing a Lupus-Flare Mimic

Nobuya Abe, MD, Yuichiro Fujieda, MD, PhD, & Tatsuya Atsumi, MD, PhD  |  August 12, 2020

The diagnosis of rheumatic diseases requires the exclusion of other systemic disorders. Infection, hematologic conditions, malignancies and some drugs may all lead to syndromes that closely mimic rheumatic diseases, which may lead to diagnostic delays. Idiopathic multicentric Castleman disease (iMCD) is a heterogeneous group of lympho­proliferative diseases (LPDs) characterized by systemic inflammatory manifestations.1,2 As with…

Case Report: What’s Causing This Severe Case of Rhabdomyolysis?

Aditya S. Pawaskar, MBBS, MD, & Weishali V. Joshi, MD  |  August 12, 2020

Rhabdomyolysis is a clinical syndrome characterized by muscle tissue necrosis and release of intramuscular components into the circulation. Typical manifestations include muscle pain and myoglobinuria, causing dark urine. Serum creatinine kinase (CK) enzyme levels are usually markedly elevated. Severity can range from muscle enzyme elevation in the serum of an otherwise asymptomatic patient to extremely…

A transverse view of the ulnar groove in full elbow extension. The red arrow indicates the advancing edge of the MHTr.

Recurrent Medial Elbow Pain Following Successful Tommy John Surgery

Mark H. Greenberg, MD, RMSK, RhMSUS, A. Lee Day, MD, RMSK, James W. Fant Jr., MD, & Christopher G. Mazoue, MD  |  August 12, 2020

A 27-year-old, left-handed man was referred to our ultrasound clinic for left elbow pain. History The patient had been a pitcher on a Minor League Baseball team. Two years before, he developed sudden, severe medial elbow pain while pitching in a game. The pain was associated with some tingling down the left medial forearm. The…

9 Steps to Transform Your Rheumatology Practice

Erin Arnold, MD; William Arnold, MD; Gary Crump, MD; David Sikes, MD; Drew Johnson, MS, MBA; & Timothy Harrington, MD  |  August 12, 2020

The ACR position statement on access to care proposes the goal that “… all patients have timely access to expert rheuma­tology care … .”1 The reality is that new and established rheumatology patient wait times are often prolonged, causing delays in necessary diagnosis and treatment. The 2005 and 2015 ACR Workforce studies document intractable and…

The Problem with Peer Review

Philip Seo, MD, MHS  |  August 12, 2020

I should have paid more attention in medical school. If I had, I might have remembered enough about basic pathophysiology to know why everyone was suddenly pulling their patients off of lisinopril. For those of you who need a quick primer: When the pressure in the renal artery drops, the kidney secretes renin. Working together,…

MIA Studio / shutterstock.com

ACR Releases COVID-19 & MIS-C Clinical Guidance for Kids with Rheumatic Disease

Gretchen Henkel  |  August 12, 2020

The ACR has released clinical guidance documents for pediatric patients with rheumatic disease in the context of the COVID-19 pandemic, including one for multi-system inflammatory syndrome in children (MIS-C). Jay Mehta, MD, MS, an attending physician in the Division of Rheumatology and director of the Pediatric Rheumatology Fellowship at the Children’s Hospital of Philadelphia (CHOP),…

Bisphosphonates Reduce Bone Toughness Over Time

Will Boggs, MD  |  August 11, 2020

NEW YORK (Reuters Health)—Using bisphosphonates for several years is associated with increasing brittleness and decreasing toughness of bone, according to a new review. “Long-term treatment with bisphosphonates can have negative side effects in some people because of their effects on bone toughness [toughness = the energy that bone tissue can absorb before cracking],” David B….

NIH Taps Lindsey Criswell, MD, MPH, DSc, as Director of NIAMS

National Institutes of Health  |  August 11, 2020

National Institutes of Health Director Francis S. Collins, MD, PhD, has selected Lindsey A. Criswell, MD, MPH, DSc, as director of NIH’s National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). A rheumatologist, Dr. Criswell is currently the vice chancellor of research at the University of California, San Francisco (UCSF). She is a professor…

Continuing Medical Education Credit, Maintenance of Certification Points Now Available Through ACR’s RISE Registry

From the College  |  August 10, 2020

Rheumatology Informatics System for Effectiveness registry users can complete an online performance improvement activity to earn up to 20 continuing medical education credits and 20 maintenance of certification points.

CMS Releases 2021 Proposed Rule for the Quality Payment Program

From the College  |  August 10, 2020

The ACR has highlighted critical changes for the 2021 performance year outlined in the proposed rule released Aug. 3 by the Centers for Medicare & Medicaid Services.

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