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Search results for: chronic pain

Lyme Disease Not Predictor of Long-Term Physical, Mental Health Issues

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Lyme disease is often considered a cause of chronic fatigue, pain and other incapacitating symptoms. This assumption stems from analyses of patients who seek retreatment for Lyme disease. However, a new study suggests that Lyme disease is not life altering in the long term for most patients. Specifically, patients with culture-confirmed Lyme disease have similar…

Pediatric to Adult Care Transition Challenging for Patients with JIA

Pediatric to Adult Care Transition Challenging for Patients with JIA

Lynn R. Spiegel, MD, FRCPC  |  

Dr. Sheffield is an adult rheumatologist who received the following referral request from a family doctor: “Please see this 22-year-old male with a history of juvenile arthritis for ongoing care. I have only seen him once, and have no previous medical records.” Dr. Sheffield meets with Paul, who reports that he has had arthritis since…

Rheumatologist Recalls Personal Experience with RA

Monica Piecyk, MD  |  

In late March 2012, I awoke with pain in my left hand. I had difficulty moving my metacarpophalangeal (MCP) joints. They did not move smoothly, but clunked. As I repeatedly attempted to open and close my hand, I realized that I had morning stiffness. As the pain and stiffness gradually improved over the next hour,…

Melioidosis: What Rheumatologists Need to Know

G.C. Yathish, MD, Taral Parikh, MD, Parikshit Sagdeo, MD, Balakrishnan Canchi, MD, and Gurmeet Mangat, MD  |  

Burkholderia pseudomallei, the causative agent of melioidosis, is endemic in Southeast Asia and northern Australia.1 In recent years, the incidence of melioidosis has increased worldwide. Septic arthritis is a rare, but well-recognized, manifestation of melioidosis. Case Report A 49-year-old woman with known diabetes was admitted elsewhere with uncontrolled diabetes and fever. She was found to…

Psoriatic Arthritis: Recognize, Manage Comorbidities

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As the literature on comorbidities linked to psoriatic arthritis (PsA) expands, it’s becoming more difficult for clinicians to keep up with what comorbidities should be assessed and how these comorbidities affect treatment selection. Given this, rheumatologists at the Perelman School of Medicine at University of Pennsylvania, Cleveland Clinic and Hospital for Special Surgery in New…

Figures 1 & 2: On exam, the patient had thickening of the skin on her extremities.

Dermatology Symptoms Point to Connective Tissue Disorder

Natalie A. Wright, MD, and Joseph F. Merola, MD, MMSc, FAAD, FACR  |  

The Case A 68-year-old woman with a past medical history of Charcot-Marie-Tooth presents with thickening of the skin on her trunk and extremities, which she has had for the past seven months (see Figures 1 and 2). Her symptoms first began with swelling of her bilateral upper and lower extremities. She is now having difficulty…

Rehabilitation, Therapy Goals for Scleroderma, Acroosteolysis

Lauren Tarsi and Marie B. Corkery, PT, DPT, MHS, FAAOMPT  |  

Scleroderma is a rare rheumatologic auto­immune disease that affects the skin and can also affect other organs. Due to excess formation of scar tissue, blood flow to the extremities is decreased, primarily to the hands, and tissues often become hypoxic, resulting in sclerodactyly and proximal skin involvement.2 The incidence of scleroderma in the U.S. is…

Plaquenil: From Malaria Treatment to Managing Lupus, RA

Charles Radis, DO  |  

In 1984, I wrote my first prescription for the antimalarial drug, hydroxychloroquine (Plaquenil), for a 28-year-old woman with SLE. She was considerably overweight, with inflammatory arthritis and a photosensitive rash, and I worried that oral corticosteroids would tip her over into diabetes. I presented the case to my attending, Steven Malawista, MD, at the Yale…