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…
As rheumatologists, we relish the thrill of diagnostic conundrums that accompany our immune-mediated multi-system and often undifferentiated disease processes. Many rheumatologic diagnoses are essentially diagnoses of exclusion. We’re accustomed to diagnosing iatrogenesis, infection and malignancy as often as we diagnose rheumatic disease. Complex clinical problem solving and critical reasoning are our forte, and to do…
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,…
HORSHAM, PA—The Janssen Pharmaceutical Companies of Johnson & Johnson announced that the U.S. Food and Drug Administration (FDA) has approved Tremfya (guselkumab) for adult patients with active psoriatic arthritis (PsA), a chronic progressive disease characterized by painful joints and skin inflammation.1,2 Tremfya is the first treatment approved for active PsA that selectively inhibits interleukin (IL)…
Patient with autoimmune disease may experience medical emergencies. Here is an overview of recognition and management of three emergent situations for patients with scleroderma: critical digital ischemia, scleroderma renal crisis and intestinal pseudo-obstruction…
NEW YORK (Reuters Health)—Patients with some inflammatory rheumatic conditions are at higher risk for hospital-diagnosed COVID-19 infection compared with the general population, but it depends on the condition and therapy used to treat it, according to a study from Spain. It’s now clear that older patients and those with some common diseases are at increased…
What do rheumatology and wizardry have in common? More than you may think. Like basilisks, rheumatic diseases are often elusive and changing in presentation…
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…