Celiac disease and gluten sensitivity are difficult to diagnose, but they affect multiple systems and are associated with other autoimmune diseases. Lan Chen, MD, PhD, believes better testing and clearer education will be a gamechanger for celiac patients…
Sir William Osler, the father of modern medicine, said “the desire to take medicine is perhaps the greatest feature that separates man from animal.” Determination of the benefit of a medication can be challenging and includes a number of factors, such as pharmacologic activities on the disease pathophysiology, pharmacokinetic properties and patient characteristics.1,2 An additional,…
A 36-year-old woman presented at the Johns Hopkins Arthritis Center for a second opinion regarding a diagnosis of psoriatic arthritis (PsA). One year prior to our evaluation, she had developed pain and stiffness in her hands, feet, knees, ankles, elbows and shoulders. She had mild plaque psoriasis of the scalp and base of the neck,…
GLENDALE, ARIZ.—Arizona is a microcosm of America’s challenges in reconciling the rheumatology workforce to growing patient demand, as quantified in the ACR’s Workforce Study of 2015.1 So it was timely this year for the Phoenix Rheumatology Association to sponsor its 1st Annual Strategic Training for Rheumatology Advanced Practice Clinicians Symposium. (Note: Advanced practice clinicians [APCs]…
With their ability to provide treatment and manage chronic illnesses, nurse practitioners can aid rheumatologists in the care of their patients…
A 67-year-old man with a recent onset of diffuse muscular pain and stiffness and an erythrocyte sedimentation rate of 55 is referred to you by his family practitioner. He has a history of non-insulin-dependent diabetes mellitus, but no history of headaches or swollen joints. He has chronic back pain, has had two surgeries and was…
NEW YORK (Reuters Health)—Solid evidence suggests that anticonvulsants provide no benefit for low back or lumbar radicular pain and a high risk of harm, researchers say. “We started the study because these drugs were increasingly being used for low back pain and radiating leg pain, without the support of strong evidence of effectiveness,” principal investigator…
A 54-year-old woman is establishing care in your clinic after retirement of her previous rheumatologist. Your review of her records suggests that she was diagnosed with systemic lupus erythematosus seven years ago on the basis of symptoms of body pain and fatigue, and serologic evidence of positive ANA 1:40 (speckled) and borderline anti-SSB antibody. She…
In your daily contact with rheumatology patients, you likely come across several who have type 1 or 2 diabetes. Are you doing all you can to maximize their treatment? Most physicians know about the damaging health effects of uncontrolled diabetes. From vision loss to kidney failure to nerve damage, those with diabetes require regular vigilance…
For many uninsured and underinsured patients in Yuba City, Calif., seeing a rheumatologist used to mean taking a day off from work and driving 108 miles, roundtrip, to the University of California Davis Medical Center. That changed this year when patients were offered the option of having a telemedicine consultation with a rheumatologist as part…