The Intersection of Immunology & Rheumatology

Insights case studies presented in this year’s Thieves Market

CHICAGO—Each year, ACR Convergence showcases fascinating and complex clinical cases presented by rheumatology fellows in training from around the world. Two sessions are presented, one highlighting pediatric cases and one highlighting adult cases. For this year’s adult session of the Thieves Market, a committee led by Angelo Gaffo, MD, University of Birmingham, Ala., Curry Koening, MD, University of Texas (UT) Health Austin’s Rheumatology Clinic and UT Health Austin’s Musculoskeletal Institute, and Naomi Schlesinger, University of Utah, selected four case studies from over 200 entries. 

In the session on Oct. 27, each presenter discussed the different diagnostic and management approaches used, provided information on how to recognize unusual presentations of common rheumatic diseases and discussed how to identify and recognize essential mimics of rheumatic diseases. Prior to revealing the final diagnosis of each case, session participants had the opportunity to compare how they would diagnose and manage the problem presented to the other session participants and the presenters. At the end of the session, participants also vote for their favorite case study. This year’s case studies were:

• Kidney You Not (case 1) presented by Michelle Benjamin, MD, from Stanford University Health Care, Stanford, Calif.;
• The Mystery of the Petite, Pigmented, Polyarthritic Lady (case 2) presented by Simren Singh, DO, from Advocate Christ Medical Center, Oak Lawn, Ill.;
• A Tale of the Silent Guard & Ceramic Core (case 3) presented by Azmad Kareem Bin Anwardeen, MBBS, MRCP, from the Rheumatology Unit, Hospital Putrajaya, Putrajaya, Malaysia; and
• When the Disease Doesn’t Fit: A Tale of Weakness, Contractures, and Clues (case 4) presented by Jennifer Abdalla, MD, MS, from LSU Health Sciences Center, New Orleans.

This year’s winner was A Tale of the Silent Guard & Ceramic Core (case 3), which won 75% of the total audience vote. The case was presented by Dr Anwardeen, and as an award, he received a complimentary registration to ACR Convergence 2026 and will be featured in a brief report publication.

Dr. Gaffo

“The session was all around an educational, fascinating and fun session,” Dr. Gaffo said. “It demonstrated the quality of our rheumatology trainees.”

A Tale of the Silent Guard & Ceramic Core

The case study featured a 25-year-old man who initially presented with seronegative inflammatory arthritis. Dr. Anwardeen said that, at first, it seemed like a straightforward rheumatic case. However, the presentation gradually revealed the need for a deeper study of a hidden immune dysfunction due to recurrent infections over time and imaging showing a porcelain aorta.