New research in mice has found that treatment with a vitamin C derivative can effectively suppress the generation of mitochondrial superoxide, which plays a role in cartilage degeneration and the progression of osteoarthritis…
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RA Diagnosis Uses Lab Tests, Clinical Insight to Rule Out Lyme
What struck me first as I walked by the exam room where Lynn P. sat was the swelling in her fingers and wrists. The bloated hands rested unnaturally on her thighs, palms up, fingers slightly flexed. Her strawberry-blond curls were offset by a high-neck, loose-fitting, burgundy sweater. Her pale skin matched her trim slacks. She had…
Rheumatologist Blends Mixology Hobby with Medical Career
It takes adjustment and patience. That sounds like rheumatology. But for Fred Murphy, DO, FACP, FACR, it also defines his other career—drink inventor. From a drink for the whole family to another he claims helps hangovers, creating beverages is a challenge he relishes. “It’s fun to see what I can come up with next,” he…
Rheumatology Coding Corner Question: Office Visit for Chronic Idiopathic Gout
Follow-up Visit with Time A 62-year-old male patient returns to the office for a follow-up visit for chronic idiopathic gout without tophi. The patient’s present uric acid level is 4.0, and he is now taking allopurinol 450 mg per day. Previously, he was taken off indapamide due to an increase in his uric acid. He…
The ACR’s State-of-the-Art Clinical Symposium: Rheumatologists Weigh in on Tough-to-Treat Cases, Paget’s Disease, Imaging
CHICAGO—A 49-year-old woman has had RA for eight years. She has a rheumatoid factor reading of 35, an aCCP reading of 160, erythrocyte sedimentation rate of 42, plus erosions. She has been on methotrexate. She tried etanercept for six months, but then it stopped working. She was on 40 mg of adalimumab weekly, but it…
Knee Osteoarthritis Pain Worse with Insomnia
(Reuters Health)—People suffering from osteoarthritis, the most common type of joint inflammation, are more likely to have knee pain when they also have difficulty getting enough sleep, a study suggests. Researchers found that people with knee osteoarthritis and insomnia were also more likely to suffer from a nervous system disorder called “central sensitization” that makes…
Eosinophilia: A Diagnostic Evaluation Guide for Rheumatologists
Clinical Vignette A 45-year-old woman with long-standing asthma and chronic sinusitis has new-onset peripheral neuropathy, arthralgias, fatigue, progressive dyspnea and a nonproductive cough. She has never smoked and has no environmental exposures. Her medications include an albuterol metered-dose inhaler (which she uses daily); an inhaled corticosteroid, montelukast; and ibuprofen (which she takes occasionally). She is…
Tips for Treating Insomnia in Rheumatology Patients
Chronic insomnia is a common complaint for patients with rheumatic diseases and conditions. In fact, sleep disturbances are among the most common symptoms of both fibromyalgia and rheumatoid arthritis (RA), with more than 50% of chronic pain patients reporting sleep disturbances. Pain combined with insomnia can lead to a vicious cycle, says Ruth Gentry, PhD,…
Disease Management Programs Help Patients Cope with Chronic Diseases
For patients living with a chronic disease, such as rheumatoid arthritis or osteoarthritis, learning to manage and cope with the myriad adverse symptoms that accompany these diseases is key to improving quality of life and helping reduce the cost burden of these illnesses on the healthcare system. One important way rheumatologists can help is by…
Rheumatology Fellowship Programs Could Benefit from Leadership Training
The beep of the cellphone text got me off the armchair. I had been feeling cozy and comfortable. Outside the window, it was a blissful winter wonderland—the one, I believe, Nat King Cole intended when recording “The Christmas Song.” But at the same time, I was anxious to hear whether my clinic would be canceled…
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