Scleromyxedema is a primary cutaneous mucinosis characterized by a diffuse and generalized papular skin eruption of mucinous deposits throughout the upper dermis. In addition to dermatologic manifestations, scleromyxedema may involve the cardiopulmonary, gastrointestinal, renal and nervous systems. Dermato-neuro syndrome (DNS) is a rare, severe neurologic complication of scleromyxedema.1,2 The pathogenesis of DNS is unknown, but…
Background & Objectives Worldwide, osteoarthritis (OA) is a highly prevalent, chronic joint disease that causes pain, disability and loss of function. Global trends demonstrated an increase of more than 100% in years lived with disability due to OA from 1990 to 2019. However, no nonsurgical intervention exists to prevent, halt or even delay OA progression….
Renal biopsy is a valuable tool for the accurate diagnosis and management of patients with kidney involvement due to rheumatic disease. Agnes B. Fogo, MD, shared her expertise on renal pathology and insights into what rheumatologists should know, during a session at the 2022 ACR Education Exchange.
Hip and knee replacements—despite advancement in treatments for rheumatic diseases, some patients will still need to undergo these surgeries. Here are insights into the considerations, costs and complications of total joint arthroplasty.
Although the diagnosis and treatment of gout are sometimes straightforward, pracÂtitioners encounter challenges in patients with atypical presentations, as well as those with medically complex situations or refractory disease. Here, gout experts share insights into some of these scenarios. Flare in Hospitalized Patients When not contraindicated, the 2020 ACR Guideline for the Management of Gout…
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…
Because rheumatologists and mental health experts both treat patients with depression, anxiety, pain, disability and sleep disorders, provider cross-training may benefit patients and providers themselves. “When a patient has active psychosocial distress, this has a negative effect on their physical function. Similarly, if a patient has active physical symptoms, like a rheumatoid arthritis flare, this…
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…
Rheumatologists who are outstanding clinicians, providing consistently exceptional care to patients and serving as role models for colleagues and trainees, are highlighted 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. Jonathan Kay, MD, is professor of medicine,…
Erosive Polyarticular Chronic Tophaceous Gout in a Young Man A 27-year-old man was referred to us for joint pain and nodular swelling over multiple joints. His symptoms started when he was 13 years old, but he was sub-optimally treated. On examination, we found marked digital deformity, with multiple large tophi over the small joints of…