A 76-year-old Caucasian male with a history of abdominal aortic aneurysm repair five years earlier presented with three months duration of worsening periumbilical abdominal pain associated with nausea, non-bloody emesis, decreased appetite, fatigue and a 40 lb. weight loss. He denied having fever, chills, night sweats, temporal headaches, vision loss, chest pain, shortness of breath and…
When a patient has both primary immune deficiency and autoimmune disease, the combination can lead to life-threatening complications. Here are some insights into the challenges of diagnosing and treating this rare subset of patients…
The evaluation of a child with arthralgia who has a normal physical examination provides a challenge to rheumatologists. Here are some insights into assessing and treating children with musculoskeletal pain syndromes…
As of Jan. 1, 2019, the Centers for Medicare & Medicaid Services (CMS) will implement several coding and documentation policies to provide immediate burden reduction to providers. The 2019 Medicare Physician Fee Schedule Final Rule (MPFS) released Nov. 1, 2018, by the CMS contained significant changes to the Medicare Part B coding and documentation policies…
By the time Kelly Conway was diagnosed with rheumatoid arthritis (RA) in 2007, she had already been living with symptoms of the disease for 23 years. Her first symptom appeared when she was 14—knee pain that was incorrectly diagnosed as tendonitis. Over the years, she has experienced fevers and sore joints. She was diagnosed with…
A study published in the May issue of Arthritis Care & Research may be the first to examine the long-term outcomes of childhood-onset lupus, otherwise known as pediatric systemic lupus erythematosus (SLE), a chronic, multisystem autoimmune disease with a highly variable clinical course. Previous studies examined cross-sectional views of damage accrued. According to the Childhood…
Polymyalgia rheumatica (PMR) is an inflammatory rheumatic condition characterized by pain and morning stiffness at the neck, shoulders and hip girdle. It can be associated with giant cell arteritis (GCA); in fact, the two disorders may represent a continuum of the same disease process. This case describes a patient who initially refused treatment for PMR…
ZURICH (Reuters)—The U.S. Food and Drug Administration (FDA) has rejected Novartis’s bid to repurpose a drug now approved for rare inflammatory diseases to be used in a group of heart attack survivors, according to the Swiss drugmaker. The company received an FDA letter turning down its bid to make canakinumab a targeted therapy for those…
Patients with polymyalgia rheumatica (PMR) or peripheral arthritis may require extra vigilance during treatment because of a suspected link to giant cell arteritis (GCA) and, potentially, permanent vision loss. “Development of giant cell arteritis after treating polymyalgia or peripheral arthritis: a retrospective case-control study,” a March 2018 study published in The Journal of Rheumatology, suggests…
Synovitis, acne, pustulosis, hyperostosis and osteitis (SAPHO) syndrome is a heterogeneous, inflammatory, musculoskeletal disease. The disease is an insidious, sterile osteitis with associated skin and synovial inflammation.1 Diagnosis can prove challenging, but a thorough clinical history, high clinical suspicion and imaging techniques can help clinch it. The below case reveals a rare, fulminant presentation of…