History A 39-year-old woman returns for follow-up for her rheumatoid arthritis. She has positive rheumatoid factor, but no organ or systemic involvement. She has joint swelling and pain in her left hand, right elbow and right knee. Her pain is at an 8 on a 10-point scale. She states the pain is worse in the…
Physicians have three contractual options when it comes to the Medicare program: participating, non-participating and opting out. Providers should keep the old saying “look before you leap” at the forefront when considering opting in or out of the Medicare program. Since 2001, physician costs have been on the rise, with only minimal increases in reimbursements,…
The Rheumatology Research Foundation has been actively involved with the NIH’s Accelerating Medicines Partnership for Rheumatoid Arthritis and Systemic Lupus Erythematosus (AMP RA/SLE) program, launched in 2014 as a public–private partnership to spur development of new therapeutic options for RA and lupus. Recently, the NIH released new datasets that will help clinical investigators accelerate therapies…
In the complex web of interactions between systemic inflammatory response, rheumatic disease and disease-modifying anti-rheumatic drugs (DMARDs), what is the potential for using rheumatologic therapies to treat other medical conditions linked to inflammation? Some medical researchers have looked at cardiac conditions, and others have examined the overlap with Alzheimer’s disease and other dementias. Positive effects…
For people with rheumatoid arthritis (RA), fatigue can be a debilitating symptom that interferes with daily life and significantly reduces quality of life. Managing fatigue can be difficult; it is linked to disease activity and a host of other conditions that commonly accompany RA, such as depression, sleep problems and obesity. A new study, however,…
When Harry Spiera, MD, stepped out of the New York University School of Medicine in 1958, rheumatology was in its infancy. Obviously, much has changed for both the physician and the specialty over the 58 years between then and his recent retirement. “Early on, rheumatology was the most clinical of the specialties, because the science…
Note: Updated May 2, 2018, to correct a link in the reference section. The error was introduced in editing. A 44-year-old Caucasian woman presented to the outpatient rheumatology clinic that had followed her for several years for rheumatoid arthritis. She was compliant with her regimen of hydroxychloroquine, etanercept and salsalate. Her chief complaint was worsening…
The year was 1978. I was a newly married, 25-year-old registered nurse working on a medical unit at Mercy Medical Center in Oshkosh, Wis. I began to notice morning stiffness, increasing fatigue, and bilateral heel and ankle pain. Every step hurt as I walked down the halls to care for my patients. My diagnosis was…
A 58-year-old African American woman with a past medical history of hypertension (HTN), hyperlipidemia, severe gastroesophageal reflux disease (GERD) and limited cutaneous systemic sclerosis (lcSSc) presented to the emergency department with shortness of breath (SOB) and progressive bilateral lower extremity swelling for three weeks. She denied any chest pain, but endorsed generalized fatigue and dyspnea…
Canakinumab may be a useful first-line treatment for renal transplant recipients with familial Mediterranean fever (FMF), according to recent research. Immunosuppressive drugs can interact with colchicine, the standard first-line treatment for FMF, and increase the incidence of side effects, such as diarrhea and myopathy…