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Eosinophilia: A Diagnostic Evaluation Guide for Rheumatologists

Praveen Akuthota, MD, Aryeh Fischer, MD, & Michael E. Wechsler, MD  |  

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…

Rheumatology Coding Corner Question: Trigger-Point Injections for Fibromyalgia

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A 65-year-old established female patient returns to the office for a follow-up visit for her diagnosis of fibromyalgia. She complains of pain, stiffness and swelling in her left hand, elbow and neck that is persistent since her last visit. The pain is considerably worse in the morning. She denies any fevers, cough or dyspnea. The…

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…

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…