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The Rheumatologist: November 2021

Standing on a Hidden Burden: The Oft-Overlooked Problem of Foot and Ankle Osteoarthritis

Standing on a Hidden Burden: The Oft-Overlooked Problem of Foot and Ankle Osteoarthritis

Kade L. Paterson, PhD, BPod, BAppSci(Hons), Marian T. Hannan, DSc, MPH, Lara Chapman, MSc, BPod, Edward Roddy, DM, FRCP, Hylton B. Menz, PhD, BPod, & Catherine Bowen, PhD, BPod  |  November 14, 2021

The high prevalence and significant burden of osteoarthritis (OA) are well known. But it’s becoming apparent that OA research efforts don’t necessarily match disease prevalence or disability. The International Foot and Ankle Osteoarthritis Consortium (IFOAC) is an international organization of volunteers that seeks to highlight a major and often overlooked problem in OA research—foot and…

Understanding Risk in the COVID-19 Era

Ethan Craig, MD, MHS  |  November 14, 2021

On Sept. 9, my 5-year-old son boarded a bus for his first day of kindergarten. In some senses, this was no different from any other year. We spent weeks trying to get him excited for school (he is not a fan of changes). We went to kindergarten orientation, toured his classroom and sat on his…

Asymmetrical Laughter by a Provider Erodes Trust

M. Cameron Hay, PhD, & Kerby Hyland  |  November 14, 2021

It was Christmas Eve, 1996. The pain had become excruciating—it had to be for Kerby to opt to go to the hos­pital on Christmas Eve because Kerby’s pain tolerance was high. At that point, he had been living with what had ultimately been diagnosed as psoriatic arthritis for about 30 years. That Christmas Eve, the…

Atypical Giant Cell Arteritis Case Illustrates Diagnosis, Management Challenges

Atypical Giant Cell Arteritis Case Illustrates Diagnosis, Management Challenges

Ashraf Raslan, MD, Dorian Infantino, MD, Roman Zuckerman, DO, & Daniel Berlin, MD  |  November 14, 2021

Giant cell arteritis (GCA) is a granulomatous vasculitis of large- and medium-sized arteries, usually affecting the cranial branches of the aortic arch. It is the most common vasculitis, with the highest risk factor being age. Accurate diagnosis and prompt initiation of therapy are of great importance to prevent serious complications, with the most feared being…

RheumPAC Hosts Rep. Mariannette Miller-Meeks, MD, in a Conversation on Healthcare Legislation

From the College  |  October 25, 2021

Earlier this month, RheumPAC donors joined the Iowa representative, an ophthalmologist, for a virtual discussion about healthcare legislation and how it can help specialty providers and their patients.

Vasculitis Guidelines in Focus, Part 3: EGPA

Michael Putman, MD  |  September 14, 2021

In this third article in the series, we talk with Philip Seo, MD, MHS, about eosinophilic granulomatosis with polyangiitis (EGPA).

Case Report: Rheumatoid Arthritis Complicated by Large Granular Lymphocytic Leukemia

Nam D. Nguyen, DO (Maj., USAF, MC), Erica Hill, DO (Lt. Col., USAF, MC), & Jay Higgs, MD (Col. [ret], USAF, MC)  |  November 14, 2021

Large granular lymphocytic (LGL) leukemia is a rare, chronic, lymphoproliferative disorder of cytotoxic T cell or natural killer cell lineage with an annual incidence of 0.72 cases per 1 million people in the U.S.1 The most common sub­type of LGL leukemia, T-LGL leukemia, follows an indolent disease course and accounts for approximately 85% of cases….

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A Rheumatologist & Pulmonologist Discuss RA-ILD

Joshua Solomon, MD, & Paul F. Dellaripa, MD  |  November 14, 2021

Introduction The understanding and treatment of rheuma­toid arthritis (RA) has evolved dramatically in the past 20 years. As gains have been made in treating joint disease in RA, our understanding of the impact of extra-articular manifestations of RA, such as cardiac and lung disease—specifically interstitial lung disease (ILD)—has gradually increased. While rheumatologists increasingly appreciate the…

How to Find Space for Scholarship in Private Practice

Jason Liebowitz, MD, FACR  |  November 14, 2021

A key question many graduating rheumatology fellows face each year is: Are you interested in pursuing a career in academic medicine or in private practice? Although the two tracks are not mutually exclusive, it is true that juggling the demands of scholarly work, medical education and a busy clinical workload is by no means easy….

How Do Reduced-Dose Glucocorticoids Plus Rituximab Affect ANCA-Associated Vasculitis?

Lara C. Pullen, PhD  |  October 13, 2021

Furuta et al. evaluated the benefits of reducing glucocorticoid doses during remission induction for patients with ANCA-associated vasculitis. The researchers found a reduced-dose-glucocorticoid-plus-rituximab regimen was noninferior to a regimen of high-dose glucocorticoids plus rituximab in these patients.

COVID-19 Vaccination Induces T Cell Response in Patients Treated with Rituximab

Lara C. Pullen, PhD  |  September 14, 2021

Research indicates mRNA vaccination for SARS‐CoV‐2 infection may induce a T cell response in vulnerable, immunocompromised patient populations being treated with rituximab.

Case Report: A Rare Mimic of Giant Cell Arteritis

Iryna Nemesh, MD, Saleema Kherani, MD MPH, Shikha Singla, MD, & William Wirostko, MD  |  November 14, 2021

Syphilis is a chronic sexually transmitted disease (STD) caused by the spirochete Treponema pallidum. The clinical manifestations of syphilis are divided into four stages: 1) the primary stage, characterized by painless mucosal or cutaneous chancre at the site of infection that resolves spontaneously; 2) the secondary stage in which a generalized maculopapular rash and condyloma…

2 ARP Volunteers Share Their Enriching Experiences

Elizabeth Hofheinz, MPH, MEd  |  November 14, 2021

It may not take a village, but when it comes to providing stellar care to rheumatology and musculoskeletal patients, it definitely takes a team. To ensure all rheumatology professionals are thoroughly prepared to serve their patients’ needs in a personalized manner, there is the ARP—the Association of Rheumatology Professionals. The ARP, the interprofessional division of…

New Video Shows How to Perform a Lip Biopsy to Diagnose Sjögren’s Syndrome

Susan Bernstein  |  November 14, 2021

Labial salivary gland biopsy (i.e., lip biopsy) is a useful tool to help diagnose Sjögren’s syndrome in suspected patients, but most rheumatologists are not trained to perform the minimally invasive procedure. A new, 40-minute training video and slide presentation with step-by-step instructions may help them fill that critical skill gap. Two rheumatologists collaborated to create…

Experts Share Insights & Advice on Reproductive Health for Patients with Rheumatic Disease

Kelly Tyrrell  |  September 24, 2021

Contraception, disease control, family planning and managing life with an infant—five experts addressed these concerns and more for patients with rheumatic disease during a special online webinar.

Passive Exposure to Smoking May Increase Rheumatoid Arthritis Risk

Katie Robinson  |  November 14, 2021

EULAR—Passive exposure to smoking during childhood or adulthood increases the risk of developing rheumatoid arthritis (RA), according to a large prospective cohort study of healthy French women presented during EULAR’s 2021 virtual European Congress of Rheumatology. Moreover, the association was mainly observed among women who had themselves never smoked.1 “In this study, we found an…

The 2021 ARP President’s Awards & Merit Awards

Patrice Fusillo  |  November 14, 2021

During ACR Convergence 2021 in early November, the ACR and the ARP honored a group of distinguished individuals who have made significant contributions to rheumatology research, education and patient care. This month, The Rheumatologist profiles the winners of the ARP President’s and Merit Awards. ARP PRESIDENT’S AWARDS The ARP president can choose to honor ACR/ARP…

The 2021 ACR Masters

Patrice Fusillo  |  November 14, 2021

Recognition as an ACR Master is one of the highest honors the College bestows. The designation of Master is conferred on ACR members, age 65 or older by Oct. 1 of the year in which they are nominated, who have made outstanding contributions to the ACR and the field of rheumatology through scholarly achievement and/or…

TNF Inhibitors & Pregnancy: How Well Does the Treatment Guidance Work?

Michele B. Kaufman, PharmD, BCGP  |  October 21, 2021

Ghalandari et al. sought to validate the guidance outlined by EULAR for the use of anti-rheumatic drugs during pregnancy, finding that following its guidance for tumor necrosis factor inhibitors led to no or low concentrations of these agents in cord blood.

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