Syphilis, an ancient disease caused by the spirochete Treponema pallidum, has been historically referred to as the great mimicker given its heterogenous presentation. Both systemic lupus erythematosus (SLE) and syphilis can have multi-systemic involvement. Both parvovirus B19 and syphilis have been reported to cause histologic features similar to those seen in lupus nephritis. We present…
Despite an expanding armamentarium of disease-modifying treatments for rheumatoid arthritis (RA), some patients with RA remain symptomatic.1 Current treatment guidelines from both the ACR and the European Alliance of Associations for Rheumatology (EULAR) recommend treat-to-target strategies to achieve remission or low disease activity, and patients want to feel better.2,3 So how can we best help…
Rheumatologists who are outstanding clinicians, provide consistently exceptional care to patients and serve as role models for colleagues and trainees are in the spotlight in our Lessons from a Master Clinician series. Here, we offer insights from clinicians who have achieved a level of distinction in the field of rheumatology. Eric L. Matteson, MD, MPH,…
In medicine, as in advertising, pictures can be worth a thousand words. From arthritis to vasculitis, imaging studies have been variably employed to aid in the diagnosis, treatment, risk stratification and prognostication of patients with rheumatic and musculoskeletal disorders. The same holds true with the idiopathic inflammatory myopathies (IIM), in which the clinical utility is…
On a highway traversed by cement trucks and Beetle-Bug auto-rickshaws we travel north from Bangalore, India, for a house call. It is 2007, and the city leaves us grudgingly. Between fields of loose chocolate soil and sprigs of beans poking skyward, the skeletons of homes and businesses rise; armies of workers lay brick from wooden…
“Fifty percent of kids with rheumatic disease are taken care of by adult providers,” says Jay J. Mehta, MD, MS, attending physician and fellowship program director, Department of Rheumatology, Children’s Hospital of Philadelphia, and a co-author of the ACR’s recent pediatric workforce shortage study.1,2 “But adult rheumatologists may not have specific training in the rheumatic…
MoCA as a Screening Test in SLE Assessing the utility of the Montreal Cognitive Assessment (MoCA) By Oshrat E. Tayer-Shifman, MD, Kimberley Yuen, BSc, MD, & Zahi Touma, MD, PhD, FACP, FACR Why was this study done? Cognitive impairment is a common manifestation of systemic lupus erythematosus (SLE), with a prevalence of 40% based on…
On Nov. 1, the CMS finalized the Medicare Physician Fee Schedule for 2023. The rule finalizes many policies, significantly: a 4.5% decrease in the conversion factor, a delay in split/shared implementation, continued refinement of evaluation and management coding and documentation, and telehealth flexibilities that will remain in place through 2023. Thanks to ACR advocacy, the CMS reinstated five-minute pre- and post-service times for musculoskeletal ultrasound codes.
The study of rheumatology (and medicine) in art, history, literature and music is engaging and informative.1-12 In this article, we present some instances when rheumatic and autoimmune diseases in certain individuals may have affected the course of history in Western civilization. Physicians are usually concerned, appropriately, with the effects of illness on the lives of…
Research from Gloersen et al. suggests the systemic effects of obesity, as measured by leptin, may play a role in the severity of pain experienced by patients with hand osteoarthritis.