Case Presentation The patient was a 42-year-old African American female diagnosed with systemic lupus erythematosus (SLE) based on the findings of polyarthritis, malar and discoid rash, fatigue, positive double-stranded DNA (dsDNA) ribonucleoprotein and Smith antibodies, and low serum complement levels. Her SLE had been well controlled on hydroxychloroquine 400 mg daily, oral methotrexate 25 mg…
“I have pain all over my body” is a challenging response after you’ve asked a new patient what brings them in for their visit. You immediately suspect that this patient has fibromyalgia. The prevalence of fibromyalgia in the U.S. is 5 million people, and it is among the most common conditions in many rheumatology practices….
At the Hospital for Special Surgery (HSS), New York, rheumatologists and social workers have found that an interdisciplinary approach to care for systemic lupus erythematosus (SLE) patients improves the overall patient experience. “Our goal is to help patients navigate the complex healthcare system,” says Jillian Rose, LCSW, MPH, assistant director, Community Engagement, Diversity & Research….
A 56-year-old African American man presents to the emergency department with polyarthralgias and a fever of 103ºF. One month prior to admission, he presented with right knee pain and swelling. Blood cultures grew S. epidermidis. He was treated for presumed septic arthritis complicated by MSSE bacteremia. He was treated with meropenem and a prolonged course…
Case A 46-year-old Caucasian female presented to the outpatient rheumatology clinic where she had been followed for several years. Her chief complaint was pain in her right knee, posterior right thigh and right hip that had begun gradually over the previous three weeks. Her past medical history was significant for rheumatoid arthritis (RA), obesity and…
(Reuters Health)—The risk that surgery patients will become chronic opioid users may be similar after minor procedures or major operations, a U.S. study suggests. Three to six months after surgery, new chronic opioid use was about 5.9% with minor operations and 6.5% with major surgery, the study found. The rate was just 0.4% in people…
As clinicians, we are familiar with pain, stiffness and soreness—subjective nouns that define our métier. These helpful words serve as signposts that direct us along the path to the proper diagnosis. Consider the young man with a stiff, sore back (a case of ankylosing spondylitis?) or the postpartum woman experiencing newly painful, stiff and sore…
Celiac is an autoimmune disease with both gastrointestinal and neurological implications. A recent review examined the immunological research on celiac disease to date, detailing the role of T cells and the protein TG2 in disease pathology…
The side effects of rheumatic conditions and their treatments can cause symptoms some may find awkward or embarrassing to discuss with their physicians. But Ara Dikranian, MD, says rheumatologists must address intimacy issues, both physical and emotional, with all patients…
NEW YORK (Reuters Health)—In patients taking methotrexate for rheumatoid arthritis (RA), moderate alcohol consumption – that is, no higher than existing U.K. guidelines for the general population – was not associated with an increased risk of transaminitis, researchers say. The study is both the largest to examine alcohol and methotrexate (MTX) and the first to…