In July 2017, Todd A. Graham, MD, a practicing orthopedic surgeon in South Bend, Ind., was fatally shot after getting into a heated dispute with a patient and her husband over a requested opioid prescription.1 The murder of Dr. Graham is a tragic example of the potential dangers of physician-patient disagreements. Rheumatology patients often endure…
In your daily contact with rheumatology patients, you likely come across several who have type 1 or 2 diabetes. Are you doing all you can to maximize their treatment? Most physicians know about the damaging health effects of uncontrolled diabetes. From vision loss to kidney failure to nerve damage, those with diabetes require regular vigilance…
Rheumatologists often rely on magnetic resonance imaging (MRI) in the evaluation of suspected muscular diseases. Here, we describe a case in which unexpected findings on MRI pointed to a diagnosis rarely considered as a mimicker of rheumatologic disease. The Case A 19-year-old man of Middle Eastern descent was admitted to our hospital for evaluation of…
Calciphylaxis is a poorly understood and life-threatening ischemic vasculopathy characterized by calcification of the small- and medium-size arteries in the skin, subcutaneous tissue and internal organs, which leads to thrombosis, tissue necrosis and painful skin ulcerations that won’t heal. The disease has a 50–80% mortality rate. Although affected patients typically have end-stage renal disease (ESRD)…
A yearlong pilot study that evaluated the safety and efficacy of belimumab in a small group of patients with early diffuse systemic sclerosis found no significant difference in the number of adverse events between those treated with the drug and those who received a placebo. Currently, no drugs are approved specifically for the treatment of…
Eosinophilia is usually defined as an eosinophil count of more than 500/microL in peripheral blood.1 An eosinophil count of more than 1,500 is referred to as hypereosinophilia (HE); hypereosinophilic syndrome (HES) is defined as HE associated with organ dysfunction attributable to eosinophilia.2 Eosinophilia can occur due to infectious, malignancy, autoimmune or allergic etiologies. However, a…
Many trainees tell me they’re attracted to rheumatology because it demands becoming a complete physician. We need knowledge of the brain, eye, lung, kidney, liver, skin, bones and vascular system to be effective rheumatologists. And because our diseases are frequently multisystem diseases, rheumatologists must be the quintessential collaborators. For more than 30 years, I’ve directed…
Immunoglobin G4-related disease (IgG4-RD) is a rare fibro-inflammatory disease of unknown etiology that has been recently recognized. It can cause fibro-inflammatory masses in almost every organ of the body and is associated with dense lymphoplasmacytic infiltration of IgG4-postitive plasma cells, storiform fibrosis and elevated levels of serum IgG4.1 IgG4-RD is a systemic disease that may…
On July 28, 2018, the USP will publish preliminary updates to existing drug compounding standards that could affect whether rheumatologists maintain the ability to mix, combine or otherwise customize medications in office for individual patient use. The ACR, in concert with the American Medical Association (AMA) and others, is working to help ensure rheumatologists can…
(Reuters Health)—Patients with rheumatoid arthritis (RA) may be more likely to become disabled if they’re obese, a U.S. study suggests. Researchers examined data on more than 25,000 patients with RA. Most were overweight or obese when they joined the study. Those who were severely obese were more likely to report some disability at baseline. Over…