Lipoma arborescens is a rare, benign intra-articular lesion characterized by diffuse replacement of synovial tissue by mature adipocytes, causing a villous lipomatous proliferation of the synovial membrane.1 Typically, this is a monoarticular condition, with the knee being the most commonly affected although it has been rarely reported to occur in an oligo-/polyarticular fashion and in…
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Case Report: Blunt Smoker Denies Tobacco Use, Delaying Diagnosis
Cannabis arteritis mirrors thromboangiitis obliterans in its clinical and arteriographic presentation, but its relevant exposure is cannabis rather than tobacco.1 Whether cannabis arteritis is a subset of thromboangiitis obliterans or a unique pathologic entity is debatable. Delta-9-tetrahydrocannabinol, the primary psychoactive component of cannabis, is a peripheral vasoconstrictor.2 This offers mechanistic insight into how cannabis may…
Case Report: Pulmonary Sarcoid-Like Reaction in Patient Treated with Etanercept
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…
Case Report: Intermittent Fevers in a Patient with pJIA
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…
Case Report: Perplexing Pulmonary Nodules
Pulmonary nodules are common; most are benign, but the differential diagnosis is broad and includes life-threatening possibilities.1 Our patient is a former smoker who has a history of a complex autoimmune disease and multiple pulmonary nodules. This case was challenging, but clinical, radiographic and histologic clues helped lead to the correct diagnosis. Case Presentation The…
Case Report: A Polyarteritis Nodosa Conundrum
Polyarteritis nodosa (PAN) is a systemic necrotizing vasculitis that typically affects medium-sized muscular arteries. The clinical subsets of PAN are idiopathic, generalized, secondary hepatitis B virus (HBV) associated and cutaneous PAN. These clinical subsets are important because of their therapeutic implications. Virtually any organ system can be affected in generalized PAN, but this vasculitis tends…
Tocilizumab Promising for the Treatment of Polymyalgia Rheumatica
In a study, patients with new-onset polymyalgia rheumatica (PMR) who were treated with subcutaneous tocilizumab were more likely to achieve sustained, glucocorticoid-free remission than patients who received placebo.
Telehealth Exercise & Diet Programs Curb Pain & Boost Function in Knee OA
NEW YORK (Reuters Health)—In patients with knee osteoarthritis (OA), telehealth-delivered exercise and diet programs are superior to electronic health information for reducing pain and improving function, although the contribution of diet is modest, a randomized trial shows.1 “This research provides evidence from a large clinical trial to help tease out how much benefit dietary weight…
From Strength to Strength: Idiopathic Inflammatory Myopathy Diagnosis & Management
During the ACR Convergence 2021 Review Course, Rohit Aggarwal, MD, MS, provided an update on idiopathic inflammatory myopathy.
Top 12: Research in Systemic Lupus Erythematosus at a Glance
Dr. Pisetsky’s picks for the top research in lupus presented at ACR Convergence 2021.
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