As rheumatologists, we relish the thrill of diagnostic conundrums that accompany our immune-mediated multi-system and often undifferentiated disease processes. Many rheumatologic diagnoses are essentially diagnoses of exclusion. We’re accustomed to diagnosing iatrogenesis, infection and malignancy as often as we diagnose rheumatic disease. Complex clinical problem solving and critical reasoning are our forte, and to do…
For most rheumatologists, the key elements of the physical exam—inspection, palpation, percussion and auscultation—have long been second nature, but a fifth modality has grown in importance with respect to making the correct diagnosis: ultrasound. From evaluating for Doppler signal and additional findings indicative of synovitis to identifying bony erosions, chondrocalcinosis, tophi and other articular and…
If you’re a rheumatologist, you likely remember the moment of truth on your match day—the day of revelation, when the complex computer algorithm set up by the National Resident Matching Program (NRMP) accommodates the wishes of programs and applicants and then discloses into which program an applicant has been placed. Although it has always been…
No event in recent history has caused such far-reaching changes within the medical industry as the ongoing COVID-19 pandemic. Similar to its ability to spread indiscriminately—infecting people regardless of age, race or socioeconomic background—the virus is inducing immediate and, likely, permanent changes across the entire spectrum of healthcare. Comfortable routines of healthcare delivery have been…
These are difficult times for rheumatologists. We have seen sharp declines in face-to-face patient visits since the COVID‑19 pandemic began. Many of us have questions about the best ways to maintain employee and patient safety while keeping our practices afloat and continuing to provide optimal care. The volunteer leaders at the ACR continue to care…
My fellow was laughing at me. By itself, I don’t think this was an unusual occurrence. I am quite certain that my fellows laugh at me all the time. That said, when such laughter is called for, I am accustomed to a certain protocol being observed. In general, I expect the laughter to be contained,…
It has been about 20 years since the Institute of Medicine (now the National Academy of Medicine) published the report To Err Is Human: Building a Safer Health System, shining light on the impact of medical errors in healthcare.1 In response to that publication, the focus on quality improvement (QI) started in the inpatient setting,…
HORSHAM, PA—The Janssen Pharmaceutical Companies of Johnson & Johnson announced that the U.S. Food and Drug Administration (FDA) has approved Tremfya (guselkumab) for adult patients with active psoriatic arthritis (PsA), a chronic progressive disease characterized by painful joints and skin inflammation.1,2 Tremfya is the first treatment approved for active PsA that selectively inhibits interleukin (IL)…
Research has shown ixekizumab improves pain and the sexual health of patients with genital psoriasis…
Patient with autoimmune disease may experience medical emergencies. Here is an overview of recognition and management of three emergent situations for patients with scleroderma: critical digital ischemia, scleroderma renal crisis and intestinal pseudo-obstruction…