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This image from the MRI demonstrates suprapatellar bursal fluid of mixed signal.

Case Report: Persistent Knee Warmth Mimics Juvenile Idiopathic Arthritis

Eman Bamashmous, MBBS, Buthaina Al Adba, MBBS, CABP, & Sharon Bout-Tabaku, MD, MSCE  |  March 14, 2022

Intra-articular venous malformations of the knee are an uncommon cause of knee pain in children. Presenting symptoms of this rare subtype of venous malformation often include nonspecific pain and joint swelling, which may be episodic, and accompanied by limited range of motion. The signs and symptoms can mimic juvenile idiopathic arthritis (JIA). Timely diagnosis of…

Filed under:ConditionsOther Rheumatic Conditions Tagged with:case reportjuvenile idiopathic arthritis (JIA)mimicsvenous malformation

Medium-sized blood vessels are seen in the dermis and at the dermal-subcutaneous junction. The black arrow identifies a venule, and the blue arrow points to a fibrin deposition in the vessel wall. Extravasated neutrophils and erythrocytes are seen in the interstitium.

Case Report: A Polyarteritis Nodosa Conundrum

Hannah Krebsbach, MD, Ileannette Robledo Vega, MD, Nirupa Patel, MD, & Nkechinyere Emejuaiwe, MD, MPH  |  March 14, 2022

Polyarteritis nodosa (PAN) is a systemic necrotizing vasculitis that typically affects medium-sized muscular arteries. The clinical subsets of PAN are idiopathic, generalized, secondary hepatitis B virus (HBV) associated and cutaneous PAN. These clinical subsets are important because of their therapeutic implications. Virtually any organ system can be affected in generalized PAN, but this vasculitis tends…

Filed under:ConditionsVasculitis Tagged with:case reportdyspneaFellowsFellows Forumpolyarteritis nodosashrinking lung syndrome

Stmool / shutterstock.com

How to Avoid Cognitive Errors in Rheumatology

Megan Milne, MD, & Rebecca E. Sadun, MD, PhD  |  March 14, 2022

The 1999 Institute of Medicine report To Err Is Human gave a sobering depiction of the magnitude and consequences of medical error.1 The report concluded that approximately 98,000 people die in hospitals annually due to preventable medical errors. Of all the errors detailed in this report, diagnostic errors have since been determined to be the…

Filed under:Professional Topics Tagged with:best practicesbiascognitive errorsErrorsmedical errors

Prior Authorization Is Under Review

Philip Seo, MD, MHS  |  February 10, 2022

I just couldn’t believe it. Like all of you, I receive many requests to see patients urgently. And like all of you, I can’t possibly accommodate all of those requests. So I triage: I look through the referrals and try to differentiate patients who want to be seen from those who need to be seen….

Filed under:OpinionRheuminationsSpeak Out Rheum Tagged with:prior authorization

Andrew Brookes / Image Source on Offset

Clinical Insights into Axial Spondyloarthritis: Rheumatology Drugs at a Glance, Part 5

Mary Choy, PharmD, BCGP, FASHP  |  February 10, 2022

Over the past few years, biosimilars and other new drugs have been introduced to treat rheumatic illnesses. Some of the conditions we treat have numerous drug options; others have few or only off-label options. This series, Rheumatology Drugs at a Glance, provides streamlined information on the administration of biologic, biosimilar and other medications used to…

Filed under:Axial SpondyloarthritisBiologics/DMARDsConditionsDrug Updates Tagged with:Ankylosing SpondylitisAS Resource Center

How to Manage Critical Illness in Patients with Autoimmune Disease

Lara C. Pullen, PhD  |  February 2, 2022

Patients in intensive care may experience dangerous manifestations of rheumatic disease, such as digital ischemia, multi-system organ failure and more. In a session at ACR Convergence 2021, experts addressed how to manage and treat these critically ill patients.

Filed under:ACR ConvergenceConditionsMeeting Reports Tagged with:ACR Convergence 2021digital ischemialungsmacrophage activation syndromeMASpatient carerespiratory

Tocilizumab Promising for the Treatment of Polymyalgia Rheumatica

Michele B. Kaufman, PharmD, BCGP  |  January 1, 2022

In a study, patients with new-onset polymyalgia rheumatica (PMR) who were treated with subcutaneous tocilizumab were more likely to achieve sustained, glucocorticoid-free remission than patients who received placebo.

Filed under:ACR ConvergenceDrug UpdatesMeeting Reports

A positron emission tomography (PET) scan shows a 3 cm, hypermetabolic mass adjacent to the stomach.

Case Report: Elevated Inflammatory Markers & a Hypermetabolic Mass

Lisa L. Korn, MD, PhD, Mina L. Xu, MD, & Cristina Brunet, MD  |  December 16, 2021

Consulting rheumatologists often assess patients with atypical clinical presentations for the possibility of an underlying rheumatic disease. Inflammatory syndromes that are not clearly rheumatic in nature can be particularly challenging to diagnose. Here, we share the case of a young woman with a long-standing undiagnosed illness and highly elevated inflammatory markers, and describe the evaluation…

Filed under:Conditions Tagged with:Castleman's diseasemultidisciplinary care

Vax Hesitancy? Myths & Facts for Patients

Susan Bernstein  |  December 16, 2021

Although more than 189,300,000 eligible Americans are fully vaccinated against SARS-CoV-2 as of Oct. 18, 2021, vaccine hesitancy persists.1 The U.S. Centers for Disease Control and Prevention (CDC), citing data from the U.S. Census Bureau’s Household Pulse Survey collected between May 26 and June 7, 2021, reports that in some U.S. counties—particularly in the Southeast…

Filed under:Patient Perspective Tagged with:COVID-19vaccinationvaccine hesitancy

New Booklet Offers Tips for Diagnosing Lupus, Images of Presentation on Skin of Color & More Insights

Renée Bacher  |  December 16, 2021

For decades, rheumatologist Cindy Flower, MD, accumulated images of systemic lupus erythematosus (SLE) in her patients, as well as clinical vignettes to use in teaching at Queen Elizabeth Hospital in Bridgetown, Barbados. For decades, she has wanted to do something wide-reaching with these materials, sharing information from her practice and her mentor, the late Prof….

Filed under:ConditionsSystemic Lupus Erythematosus Tagged with:general practitioners

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