Millions of adults suffer from painful knee osteoarthritis (OA). Although physical activity can help improve pain and reduce functional limitations, many people with OA are physically inactive. For people living with knee OA, it can be difficult to get started with or continue on a physical activity program, because pain and other symptoms can make…
Dr. Sheffield is an adult rheumatologist who received the following referral request from a family doctor: “Please see this 22-year-old male with a history of juvenile arthritis for ongoing care. I have only seen him once, and have no previous medical records.” Dr. Sheffield meets with Paul, who reports that he has had arthritis since…
In late March 2012, I awoke with pain in my left hand. I had difficulty moving my metacarpophalangeal (MCP) joints. They did not move smoothly, but clunked. As I repeatedly attempted to open and close my hand, I realized that I had morning stiffness. As the pain and stiffness gradually improved over the next hour,…
Burkholderia pseudomallei, the causative agent of melioidosis, is endemic in Southeast Asia and northern Australia.1 In recent years, the incidence of melioidosis has increased worldwide. Septic arthritis is a rare, but well-recognized, manifestation of melioidosis. Case Report A 49-year-old woman with known diabetes was admitted elsewhere with uncontrolled diabetes and fever. She was found to…
Fibromyalgia syndrome (FMS), rheumatoid arthritis (RA) and spondyloarthritis (SpA) all exhibit multifaceted manifestations, and many patients exhibit overlapping comorbidities. However, patients with FMS are distinct from others in that they experience widespread pain, fatigue and mood changes, including anxiety and depression. Although its hallmark symptom of pain causes rheumatologists to consider FMS a pain disorder,…
The Case A 68-year-old woman with a past medical history of Charcot-Marie-Tooth presents with thickening of the skin on her trunk and extremities, which she has had for the past seven months (see Figures 1 and 2). Her symptoms first began with swelling of her bilateral upper and lower extremities. She is now having difficulty…
Biomarkers for RA I read the article, “Finding Biomarkers in RA Remains Elusive Goal” (February 2015 The Rheumatologist), with great interest. The author correctly identifies the multi-biomarker disease activity assay (MBDA; Vectra DA) as a potential biomarker that identifies RA patients at risk for radiographic progression. The author names a study presented at the 2014…
Squeeze Test in Inflammatory Arthritis, Need for Standardization? The first use of the squeeze test as a clinical maneuver to detect inflammatory arthritis in patients with hand problems was described by Recth in 1988, and Morton described its use for patients with foot problems.1,2 In 1991, Eberhardt and Rigby proposed the clinical maneuver be used…
As the literature on comorbidities linked to psoriatic arthritis (PsA) expands, it’s becoming more difficult for clinicians to keep up with what comorbidities should be assessed and how these comorbidities affect treatment selection. Given this, rheumatologists at the Perelman School of Medicine at University of Pennsylvania, Cleveland Clinic and Hospital for Special Surgery in New…
Scleroderma is a rare rheumatologic autoimmune disease that affects the skin and can also affect other organs. Due to excess formation of scar tissue, blood flow to the extremities is decreased, primarily to the hands, and tissues often become hypoxic, resulting in sclerodactyly and proximal skin involvement.2 The incidence of scleroderma in the U.S. is…