Abscesses are typically caused by infections, but some are, instead, sterile. Aseptic abscesses (AAs) are characterized by the same neutrophil-rich histoÂpathology as infectious abscesses; however, they don’t improve with antibiotics. Rather, AAs require treatment with anti-inflammatory medications. Although relatively rare, this phenomenon is important for rheumatologists to recognize given its frequent association with underÂlying systemic…
Scenario: A patient with rheumatoid arthritis (RA) presents for a follow-up visit. After addressing her inflammatory arthritis symptoms, medications and laboratory results, she is asked if she has any other questions, and she begins describing her chronic low back pain, which has become worse despite physical therapy (PT). She requests stronger medications because her RA…
The axial phenotype of psoriatic arthritis (axPsA) is an excellent example of a major controversy in rheumatology that has become the focus of attention because of the emergence of new therapies with different mechanisms of action for alleviating joint inflammation. It was first described in 1961 but, until recently, it has largely remained under the…
When Moll and Wright first described the spondyloarthritides in the early 1970s, the archetype of the group was ankylosing spondylitis (AS).1 The shared clinical features of the spondyloarthritides were sacroiliitis; asymmetric large joint peripheral arthritis; psoriasis or psoriaform skin lesions, including keratoderma blennorrhagica; uveitis; and bowel inflammation. Moll and Wright described five clinical subgroups of…
At the 17th Annual Advances in the Diagnosis and Treatment of the Rheumatic Diseases meeting at Johns Hopkins School of Medicine, Baltimore, Atul Deodhar, MD, discussed ankylosing spondylitis and non-radiographic axial spondyloarthritis & clarified common misconceptions about these conditions.
The 1999 Institute of Medicine report To Err Is Human gave a sobering depiction of the magnitude and consequences of medical error.1 The report concluded that approximately 98,000 people die in hospitals annually due to preventable medical errors. Of all the errors detailed in this report, diagnostic errors have since been determined to be the…
Spondyloarthropathy (SpA) can be difficult to diagnose, with rheumatologists sometimes relying on classification criteria designed for clinical trials. Research examines how the use of MRIs affects the finding of bone marrow edema and the diagnosis of axial SpA.
Spondyloarthropathy is an ancient form of arthritis shared by multiple orders and classes of the animal kingdom. Camarasaurus, a genus of quadrupedal, herbivorous dinosaur, holds the record for the earliest known case of spondyloarthropathy—147 million years ago.
Over the past few years, biosimilars and other new drugs have been introduced to treat rheumatic illnesses. Some of the conditions we treat have numerous drug options; others have few or only off-label options. This series, Rheumatology Drugs at a Glance, provides streamlined information on the administration of biologic, biosimilar and other medications used to…
Consulting rheumatologists often assess patients with atypical clinical presentations for the possibility of an underlying rheumatic disease. Inflammatory syndromes that are not clearly rheumatic in nature can be particularly challenging to diagnose. Here, we share the case of a young woman with a long-standing undiagnosed illness and highly elevated inflammatory markers, and describe the evaluation…