The year was 1991. It was my first Tuesday as a rheumatology fellow at the University of Pittsburgh’s Presbyterian Hospital. Navigating a maze of buildings and hallways, I delivered myself to the entrance to the scleroderma clinic. Running late and not knowing whether there was a separate entrance for staff, I clicked open the door….
(Reuters Health)—A growing number of patients are seeking care from rheumatologists for chronic health problems like arthritis, back pain and osteoporosis, just as the supply of specialists is shrinking, two new studies suggest. An estimated 6,013 clinicians in the U.S. specialized in rheumatology as of 2015, the equivalent of 5,415 full-time providers, according to one…
The Case A 58-year-old patient with knee osteoarthritis has been decreasing her physical activity over the past several years due to painful joints, which has resulted in significant weight gain. At her appointment, you encourage her to engage in more physical activity and eat a well-balanced diet. A few weeks later, the patient returns to…
For Daniel Albert, MD, a rheumatologist with the Dartmouth-Hitchcock Medical Center in Lebanon, N.H., some of his most defining medical experiences haven’t taken place within his practice, but in exotic locales such as a rainforest on the island of Borneo. One of many physicians across the world who volunteer their time and expertise on medical…
SAN DIEGO—It’s no secret: Autoimmune, inflammatory rheumatic disease raises a patient’s risk of cardiovascular disease (CVD). “Inflammation may affect all aspects of the cardiac structure and function,” said Rekha Mankad, MD, FACC, director of the Women’s Heart Clinic at the Mayo Clinic in Rochester, Minn. Dr. Mankad also oversees a cardio-rheumatology clinic to assess and treat…
Although two decades have ticked by, rheumatologist Michael Lockshin, MD, MACR, still remembers the enlightening nature of many conversations he had with his curious and persistent patient Barbara Volcker, the wife of former U.S. Federal Reserve Chairman Paul Volcker. “The conversations we had at that time led to the mission of the Barbara Volcker Center,”…
The Presentation A pale, quiet woman—her mother—wheeled the girl into my clinic. It was a blistering Florida day, and the girl was shivering. She glanced up at me when I said hello and asked her name. “Hi,” she said, giving me a broad smile. Her smile was the only broad thing about her. Her elbows…
What factors drive inflammation and progressive disease in ankylosing spondylitis (AS)? The answers have long eluded rheumatologists. Although 90% of patients with AS test positive for the HLA-B27 gene, pieces remain missing in our understanding of this chronic, inflammatory disease, which often leads to pain, spinal fusion and, in about half of patients, gut involvement,…
A number of autoinflammatory syndromes that result from genetic mutations have been described recently. The vast majority occur in children. However, three periodic fever syndromes are important for rheumatologists who treat adults to know about. The goal of this review is to provide a concise description of each condition, and to help the clinician understand…
Necrotizing autoimmune myopathy (NAM) is a relatively recently discovered subgroup of inflammatory myopathies. NAM is characterized by predominant muscle fiber necrosis and regeneration with little or no inflammation.1 One subgroup of NAM is 3-hydroxy-3-methylglutaryl-CoA reductase antibody (HMGCR Ab)-related immune-mediated necrotizing myopathy (IMNM), which occurs (rarely) after statin exposure, with a rough incidence of two per…