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The Rheumatologist: April 2022

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Private Practice, Research, Academia? Career Tips for Rheumatology Fellows

Herbert S.B. Baraf, MD, FACP, MACR  |  April 15, 2022

As rheumatology fellows approach the end of what for many is 25th grade, it’s time to focus on what you want to do for the rest of your life. For most rheumatology fellows it will be some form of clinical practice, although enormous opportunities exist throughout the medical field for you to apply your talents….

Stronger Together: The Future of Physician Unions

Philip Seo, MD, MHS  |  April 15, 2022

If you ever want to be depressed, turn to the internet. This might strike some of you as a truism. Certainly, between the pandemic and the war in Ukraine, it is difficult to open your browser without being smacked in the face by a dismally depressing piece of news. In this par­ticular case, however, I’m…

In Memoriam: James F. Fries, MD

Halsted R. Holman, MD  |  April 15, 2022

James Franklin Fries was born on Aug. 25, 1938, in Normal, Ill. His mother taught middle school English and his father was a college business professor. Jim graduated from Stanford University in 1960 with a major in philosophy, and received his MD at Johns Hopkins Uni­versity, Baltimore, in 1964. He pursued internal medicine and rheumatology…

In Memoriam: Samuel Strober, MD

Theodore Pincus, MD  |  April 15, 2022

Samuel Strober was born on May 8, 1940, in Brooklyn, N.Y., the oldest son of Lee and Julius Strober. Sam attended Public School 92 in Brooklyn and Stuyvesant High School in Manhattan, and graduated from Columbia College, New York, in 1961, and Harvard Medical School, Boston, in 1966. While in high school, Sam won a…

The ACR Image Competition 2021 Results, Part 2: People’s Choice

Kunal Chandwar, MD, MBBS; IMAGE FROM SOUTH ASIA  |  April 15, 2022

People’s Choice: Keratoderma Blennorrhagica Submitted by Kunal Chandwar, MD, MBBS, King George’s Medical University, Lucknow, India, the photo depicts extensive keratoderma blennorrhagica in a patient with reactive arthritis. Spondyloarthropathies An 18-year-old man presented with psoriasiform plaque-like lesions that began on the limbs and progressed to involve his entire body (including his face) over a month….

Trends in State White Bagging Legislation

Joseph Cantrell, JD  |  March 22, 2022

The ACR is working with partners in several states to legislate against policies that require physicians to acquire provider-administered drugs through a preferred specialty pharmacy designated by a payer or pharmacy benefit manager.

The Role Ultrasound Imaging Plays in Diagnosing Hemangiomas

Clara Lin, MD, RhMSUS  |  April 15, 2022

A 17-year-old woman presents with chronic finger pain experienced over six months that is worse in the mornings. On physical exam, the patient has no joint swelling, pain on range of motion or limitation of range of motion in any of her finger joints. She has a tender, subcutaneous, firm, flesh-colored nodule on the lateral…

Case Report: An Unusual Presentation of Neuro-Behçet’s Disease

Zeba Faroqui, MD  |  April 15, 2022

A 44-year-old woman presented to the emergency department with bifrontal headaches that had started approximately one month earlier. She was diagnosed with migraines and discharged home. Three days later, the patient returned to the emergency department upon recurrence of her headaches, and this time she also reported abnormal leg movements. A computerized tomography (CT) scan…

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How Our Thinking Impacts Our Judgment

Joel M. Kremer, MD, MACR  |  April 15, 2022

Let’s start with a couple of short riddles: What question can you never answer “yes” to? Which word does not belong in the following list: stop cop mop chop prop or crop? [The answers appear at the end of this article.] Riddles are designed to make us think beyond the obvious answer. There is usually…

Lessons from Caring for the Underinsured & Uninsured

Samantha C. Shapiro, MD  |  February 17, 2022

As the first rheumatologist at a federally qualified health center in Austin, Texas, Samantha Shapiro, MD, learned several practical tips for the care of uninsured and underinsured patients with rheumatic diseases.

Case Report: Intermittent Fevers in a Patient with pJIA

Osman Bhatty, MD, Dale Kobrin, MD, Lauren Mathos, DO, Nazia Khatoon, MD, Yazan Samhouri, MD, Naga Sai Krishna Patibandla, MD, & Mary Chester Wasko, MD, MSc  |  April 15, 2022

A 26-year-old woman presented to our emergency department (ED) with intermittent fevers, nausea and vomiting. She had a past medical history of well-controlled, anti-nuclear antibody positive and rheumatoid factor negative polyarticular juvenile idiopathic arthritis (pJIA) and Crohn’s disease. Her maintenance treatment consisted of monthly intravenous infliximab, 10 mg of oral methotrexate weekly and 20 mg…

What I Learned from My Year on the ACR’s Government Affairs Committee

Kaitlyn Brittan, MD  |  March 7, 2022

As a fellow-in-training member of the ACR’s Government Affairs Committee, Kaitlyn Brittan, MD, found a sense of personal satisfaction and empowerment by having a voice through advocacy.

Case Report: Pulmonary Sarcoid-Like Reaction in Patient Treated with Etanercept

Luis Lora Garcia, MD, Sneha Centala, MD, MS, Gitanjali Lobo, MD, Shahla Mallick, MD, & Diana Girnita, MD, PhD  |  April 15, 2022

Sarcoidosis is a multisystem disease characterized by noncaseating granulomas in affected tissues, mostly involving the lungs and lymph nodes.1,2 The etiology of sarcoidosis remains unknown but is thought to be due to an inflammatory response to an antigen exposure in genetically predisposed individuals.1 Tumor necrosis factor-α (TNF‑α), a pro-inflammatory cytokine, plays an essential role in…

ACR Wins Top Honors for Public Education Campaign

Carina Stanton  |  February 10, 2022

Every year, the Ragan PR Daily Awards recognize the most outstanding public relations campaigns and initiatives. Due to the ACR’s work to elevate the voices of patients living with rheumatic diseases, its 2020 Rheumatic Diseases Awareness Month campaign has received three of these major awards.

ARP Launches Boot Camp for Advanced Practice Providers New to Rheumatology

Kurt Ullman  |  April 5, 2022

The 2015 American College of Rheumatology (ACR) Workforce Study projected that by 2030 the number of adult rheumatologists will decline by 25%.1 The result: Demand for rheumatologists is projected to be more than twice the available supply of providers by 2030. Advanced practice rheumatology professionals can help practices overcome the barrier this mismatch will create…

Study: COVID-19 Vaccinations Are Safe for Patients with Lupus

Thomas R. Collins  |  April 15, 2022

COVID-19 vaccinations are safe for patients with systemic lupus erythematosus (SLE), with manageable side effects and a low incidence of flare, according to a recently published study in The Lancet.1 The use of mRNA vaccines, such as those from Pfizer-BioNTech and Moderna, which have been viewed as riskier than traditional vaccines because of a concern…

Common Misconceptions Clarified: Ankylosing Spondylitis & Non-Radiographic Axial Spondyloarthritis

Jason Liebowitz, MD, FACR  |  March 23, 2022

At the 17th Annual Advances in the Diagnosis and Treatment of the Rheumatic Diseases meeting at Johns Hopkins School of Medicine, Baltimore, Atul Deodhar, MD, discussed ankylosing spondylitis and non-radiographic axial spondyloarthritis & clarified common misconceptions about these conditions.

Tissue Evaluation: Understanding Rheumatoid Arthritis Inside & Out

Jason Liebowitz, MD, FACR  |  March 23, 2022

At the 17th Annual Advances in the Diagnosis and Treatment of the Rheumatic Diseases meeting, Clifton Bingham, MD, delves into research into rheumatoid arthritis at the cellular level.

The Power of Power Doppler: Ultrasound Imaging in RA

Jason Liebowitz, MD, FACR  |  March 23, 2022

At the 17th Annual Advances in the Diagnosis & Treatment of the Rheumatic Diseases meeting, Dana DiRenzo, MD, MHS, RhMSUS, discussed the use of ultrasound imaging in patients with inflammatory arthritis.

New No-Surprises Rules May Affect Rheumatology Services at Hospitals

Emily A. Johnson, JD  |  April 15, 2022

This month, we offer an overview of the federal No Surprises Act, which stipulates that healthcare insurers may not surprise patients with out-of-network care bills, instead requiring healthcare providers and insurers to broker price compromises between themselves. The No Surprises Act, enacted on a bipartisan basis in December 2020, protects patients from surprise billing from…

Rheum After 5: Dr. David Pisetsky, Storyteller

Carol Patton  |  April 15, 2022

David S. Pisetsky, MD, PhD, often tells people that science involves reading and writing as much as conducting experiments. No matter what discoveries are made in the lab, if they can’t be communicated well or put into context, he asks, how can they be used to advance the field and benefit patients? The recipient of…

FDA Approves Secukinumab for Children with Enthesitis-Related Arthritis & PsA

Michele B. Kaufman, PharmD, BCGP  |  February 2, 2022

The FDA has approved the use of secukinumab for pediatric patients with enthesitis-related arthritis and psoriatic arthritis, after research showed a longer time to disease flare than placebo.

Improving Bone Mineral Density: Risedronate vs. Denosumab

Michele B. Kaufman, PharmD, BCGP  |  March 2, 2022

Treatment with denosumab for patients with RA and glucocorticoid-induced osteoporosis led to greater increases in bone mineral density of the lumbar spine and hips of patients than treatment with risedronate.

Broadcasting Rheumatology Information to Wider Audiences

Kelly Tyrrell  |  February 3, 2022

Since starting the ACR on Air podcast in 2019, Mohammad Ursani, MD, FACP, RhMSUS, has become chair of the Committee on Communications and Marketing. Here, he shares some plans for the ACR website, podcast and more.

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