A recent study found that mycophenolate mofetil is an effective alternative for the treatment of systemic scleroderma with interstitial lung disease, resulting in possible long-term improvement. According to Aryeh Fischer, MD, this new research points to the future expansion of treatment options…
The human intestinal microbiota is home to more than 1,000 bacterial species, containing approximately 3 million genes, many of which code for functions that have the potential to affect human physiology.1 Smaller numbers of organisms are also present in the skin, upper gastrointestinal tract, female reproductive tract and the oro- and nasopharynx. As tools have…
Editor’s note: In this recurring feature, we first present a series of images (this page) for your review, and then a brief discussion of the findings and diagnosis. Before you turn to the discussion, examine these images carefully and draw your own conclusions. History A 49-year-old woman presents with one year of chronic left ankle…
Discussing aching joints, sore muscles and tender limbs is all in our day’s work. We are rheumatologists; we deal in misery. But trying to parse the true meaning of these terms is among the most vexing of clinical challenges.
Settling into room 501 at Maine Medical Center, Mrs. N was on her way to the bathroom when she felt it coming on. One moment she was okay; the next, her chest felt damp and cold, even as her face flushed and her temperature spiked. Her forehead glistened beads of warm sweat. She felt the…
SAN FRANCISCO—The Kveim-Siltzbach skin test for a diagnosis of sarcoidosis was developed in 1941, then popularized in 1961. Since then, the knowledge base about the disease has not expanded much, said Kristin Highland, MD, who has dual appointments at Cleveland Clinic’s Respiratory Institute and Orthopedics and Rheumatology Institute. “We don’t know a whole lot more…
Value is the ratio of quality to cost. The delivery and measurement of healthcare quality, however, is complex. “We first need to understand and define the health outcomes that are important to patients. Then we need to put into place care pathways that will lead to those outcomes, and finally we need mechanisms to measure…
One of your first clinical assignments as a medical student was likely to have been the lung exam. Its key descriptors may still resonate in your mind: inspection, palpation, percussion and ausculÂtation. Proudly parading down the hospital corridors, your newly purchased stethoscope snugly tucked inside your lab coat pocket, you carefully place its cold metal…
The Case A 41-year-old woman was referred to the dermatology clinic for a three-month history of tender lesions on her elbows and around the joints of her hands. Her medical history was notable for seropositive, non-erosive rheumatoid arthritis (RA), which was being treated with 5 mg predÂnisone daily, 10 mg methotrexate weekly by mouth, 200…
SAN FRANCISCO—The risk of stroke after herpes zoster (HZ) infection is elevated in the period immediately after infection in patients with autoimmune diseases, according to a study presented at the 2015 ACR/ARHP Annual Meeting.1 The findings were presented in a scientific session, called Discover 2015, that highlighted new research. In another study from the session,…