Patients with chronic kidney disease (CKD) often experience joint pain due to various etiologies, including crystalline arthropathies, renal osteodystrophy, amyloid arthropathy, erosive osteoarthritis, avascular necrosis and even erosive spondylarthrosis.1 Below, we present a case of crystalline arthropathy in a patient with chronic kidney disease, mistaken for gout. The Case A 29-year-old man was admitted to…
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The Tortured Path to the Cortisone Discovery
CHICAGO—The path to the discovery of cortisone—a top-selling, important drug, with dozens of indications—was complicated by failure, false moves, desperation and obsession. The tale, recounted in the Philip Hench, MD, Memorial Lecture: Crossroads of History & Hope: Discovery & First Use of Cortisone for RA at the 2018 ACR/ARHP Annual Meeting in October, is an…
Case Report: Acne Drug Leads Patient to Retinoid Hyperostosis
Presentation A 26-year-old man with a history of acne vulgaris and hidradenitis suppurativa presented to our rheumatology clinic with persistent back pain and stiffness of three years’ duration. He described bilateral low back pain that was worse when he arose in the morning and at night when he was trying to sleep. In a similar…
Case Report: Ehlers-Danlos Syndrome Mimicking Vasculitis
A 43-year-old man with a past medical history of type 2 diabetes mellitus, bilateral inguinal hernia repair as a child and prior cholecystectomy woke from sleep with sudden-onset periumbilical abdominal pain. He was admitted to another hospital, but required transfer to our surgical intensive care unit after a recurrent episode of severe abdominal pain, during…
Prescribing Hope: The Placebo Effect Endures
“Wait. I can explain.” One could imagine this phrase coming up under many conditions in daily life. When I first became a physician, however, I would never have expected to use this phrase in my clinic. In medical school, I was taught the importance of dialogue in establishing a relationship with a patient. Statistics indicate…
Many in U.S. Take More Calcium Supplements than Necessary
(Reuters Health)—Some adults in the U.S. who use supplements to get their daily requirement of calcium are taking higher doses than necessary, a recent study suggests. Researchers examined nationally representative survey data on dietary habits and vitamin and supplement use collected between 1999 and 2014 from 42,038 adults. About one in 20 adults got a…
Potential Therapeutic Target for SpA
Innate lymphoid cells (ILCs) in the joints of patients may drive the pathology of spondyloarthritis through the production of granulocyte colony-stimulating factor (GM-CSF). A recent study found that both GM-CSF-producing CD4 T cells and the GM-CSF+ Th17 cells expressed high levels of GPR65—indicating that both GM-CSF and GPR65 may be therapeutic targets for spondyloarthritis…
Eat to Fight Inflammation & Promote Weight Loss
Managing weight loss through diet may help patients with rheumatic disease reduce inflammation. Here are some strategies on weight loss and eating for rheumatologists and patients…
When Is a Doctor Too Old to Practice?
Steady hands, nerves of steel: The endoscopic transphenoidal hypophysectomy is a delicate neurosurgical procedure. Using a three-dimensional microscope and a powerful magnetic resonance imaging machine to guide them, the surgeon must meticulously dissect the throat tissues, navigate through the palate and the sinuses to reach the base of the skull where the pea-sized master gland,…
TNF Stabilizes Inflammatory RNA in Synoviocytes
A recent study has helped researchers gain insight into the genome-wide regulation of mRNA stability in RA fibroblast-like synoviocytes (FLS). Chronic exposure of FLS to tumor necrosis factor appears to increase mRNA stability, enhancing the expression of inflammatory genes and the perpetuation of synovitis…
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