I am a few weeks post-retirement. Having written thank you notes and completed urgent home projects, I swing in a hammock at our currently fire-threatened cabin north of Winthrop, Wash., and reflect. I feel like a young boy while freely flipping pages of a hand-scribed picture book, The Principles of Uncertainty, by Maira Kalman. She…
Search results for: musculoskeletal ultrasound
Case Report: Interstitial Lung Disease with Positive ANCA Test
“Worst of all is the pain in my calves,” she said. “It feels like burning deep inside.” So began my first encounter with a 69-year-old woman who was referred to rheumatology clinic for evaluation of two months of constitutional symptoms and a positive ANCA test, which had been ordered by her primary care doctor. Her…
Diagnostic Imaging in Patient with Left Hip Pain: Findings
View the question. Findings/Diagnosis The AP radiograph of the left hip (see Figure 1) shows periarticular, well-defined erosions of the left hip (white arrow) without joint space narrowing or osteophytes. There is no fracture. There are surgical clips and a calcified mass in the right hemipelvis (black ellipsis), representing a failed renal transplant. The coronal STIR…
The ACR’s State-of-the-Art Clinical Symposium: Rheumatologists Weigh in on Tough-to-Treat Cases, Paget’s Disease, Imaging
CHICAGO—A 49-year-old woman has had RA for eight years. She has a rheumatoid factor reading of 35, an aCCP reading of 160, erythrocyte sedimentation rate of 42, plus erosions. She has been on methotrexate. She tried etanercept for six months, but then it stopped working. She was on 40 mg of adalimumab weekly, but it…
Diagnostic Imaging in Patient with Atraumatic Left Shoulder Pain: Findings
View the question. Findings/Diagnosis The AP radiograph of the left shoulder (see Figure 1) shows erosions of the proximal humeral and glenoid articular surfaces (black arrows) without joint-space narrowing. There is a well-defined marginal erosion with overhanging edge at the junction of the proximal humeral articular surface and rotator cuff insertion on the greater tuberosity (ellipse)….
Diagnostic Imaging in Patient with Elbow Pain: Findings
View the question. Transverse (see Figure 1) and longitudinal (see Figure 2) ultrasound images show an anechoic collection (asterisks), which surrounds the distal biceps tendon (b). The collection is compressible (not shown here). The biceps tendon is heterogeneous in echo texture, with fiber dropouts and an irregular border (in the transverse view). The elbow joint…
When Rheumatology and Cancer Collide
Chronic inflammation, cancer and autoimmunity are inextricably linked
Clinical Applications of Dual-Energy Computed Tomography for Rheumatology
Advanced imaging technique allows physicians to detect deposition of monosodium urate crystals not apparent in physical exams and better diagnose gout
What Role Does Fascia Play in Rheumatic Diseases?
Recent research explores possible connections between abnormalities in fasciae and painful musculoskeletal conditions such as chronic back pain, osteoarthritis, and rheumatoid arthritis, as well as scleroderma
Coding Corner Question: August
Test your coding knowledge for a separate identifiable service billed for a patient with rheumatoid arthritis