The ACR position statement on access to care proposes the goal that “… all patients have timely access to expert rheumatology care … .”1 The reality is that new and established rheumatology patient wait times are often prolonged, causing delays in necessary diagnosis and treatment. The 2005 and 2015 ACR Workforce studies document intractable and…
A 61-year-old Caucasian woman with a history of seropositive rheumatoid arthritis (RA) was hospitalized for a several-month history of progressively worsening left ankle pain and swelling. She had been unable to bear weight on her left leg for several days and did not notice improvement in symptoms with 20 mg of prednisone daily, which she…
Rheumatologists who are outstanding clinicians, provide consistently exceptional care to patients and serve as role models for colleagues and trainees are in the spotlight in our Lessons from a Master Clinician series. Here, we offer insights from clinicians who have achieved a level of distinction in the field of rheumatology and who are respected by…
For most rheumatologists, the key elements of the physical exam—inspection, palpation, percussion and auscultation—have long been second nature, but a fifth modality has grown in importance with respect to making the correct diagnosis: ultrasound. From evaluating for Doppler signal and additional findings indicative of synovitis to identifying bony erosions, chondrocalcinosis, tophi and other articular and…
My fellow was laughing at me. By itself, I don’t think this was an unusual occurrence. I am quite certain that my fellows laugh at me all the time. That said, when such laughter is called for, I am accustomed to a certain protocol being observed. In general, I expect the laughter to be contained,…
ACR & EULAR recommendations for the treatment of patients with rheumatic illness during the COVID-19 pandemic are explored…
ACR BEYOND LIVE—Among patients with systemic lupus erythematosus (SLE), lupus nephritis remains one of the leading causes of mortality, and patients with both SLE and end-stage renal disease demonstrate standardized mortality ratios higher than 60 times that of patients with SLE who have normal kidney function.1 Although the ACR Guidelines for Screening, Treatment, and Management…
ACR BEYOND LIVE—Much, if not all, of rheumatology relies on clinical interpretation of historical, laboratory and imaging information to formulate a coherent diagnosis and treatment plan—even when such information is incomplete or has multiple possible interpretations. One of the best examples of this situation pertains to nonradiographic axial spondyloarthritis (nr-axSpA), a condition that is just…
Keith Sullivan, MD, Receives Lifetime Achievement Award Mentorship, collaboration and a quest for cure shine through as major themes in the distinguished career of Keith M. Sullivan, MD, the James B. Wyngaarden Professor of Medicine, Duke University Medical Center, Durham, N.C. On Friday, Feb. 21, those themes dominated his acceptance speech when he received a…
Primary hemophagocytic lymphohistiocytosis (HLH) is caused by genetic mutations and inherited syndromes; it therefore occurs in the pediatric age group. Secondary HLH, however, is more common in adults and is often triggered by other disease states, such as malignancies, chronic immunosuppression, infections and autoimmune disease.1,2 Macrophage activation syndrome (MAS) is a subset of secondary HLH…