Patients with chronic kidney disease (CKD) often experience joint pain due to various etiologies, including crystalline arthropathies, renal osteodystrophy, amyloid arthropathy, erosive osteoarthritis, avascular necrosis and even erosive spondylarthrosis.1 Below, we present a case of crystalline arthropathy in a patient with chronic kidney disease, mistaken for gout. The Case A 29-year-old man was admitted to…
Methotrexate (MTX) remains the predominant medication used by rheumatologists to treat rheumatoid arthritis (RA). Doses of 7.5–25 mg per week with daily folic acid are generally prescribed. Despite its common use, MTX must be prescribed cautiously given the potential adverse effects when taken incorrectly or without folic acid supplementation. Cases of MTX-induced cutaneous ulceration have…
Many, if not all, rheumatologists seek to grow as clinicians so they can provide consistently exceptional care to patients and serve as role models for colleagues and trainees. In this series, Lessons from a Master Clinician, we compile insights from clinicians who have achieved a level of distinction in the field of rheumatology. Gail Kerr,…
Eosinophilic granulomatosis with polyangiitis (EGPA), also known as Churg-Strauss syndrome or allergic granulomatosis and angiitis, is a rare small- and medium-vessel vasculitis. This disease was first described by American pathologists Jacob Churg and Lotte Strauss in 1951.1 Although the vasculitis is often not apparent in the initial phases of the disease, EGPA can affect any…
Rheumatology is a field rife with uncertainty. With regard to both diagnosis and treatment, we live in a world of rare diseases that are difficult to study. As a result, we are often left without an answer to our diagnostic dilemmas and without clarity when deciding the best treatment options for our patients. For rheumatologists…
Congratulations! You’ve decided to become a rheumatologist and, in so doing, join the ranks of some of the most intelligent, empathic and dynamic physicians out there. But between your decision today and where you see yourself in three, five or 10 years, many more decisions must be made. Arguably, the most important is the decision…
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 small molecule inhibitor drugs…
“And of course, I am not telling you to do it. That would be illegal.” As a general rule, I try not to instruct my patients to break the law. My business model depends on repeat customers, so placing a patient at risk of getting arrested—even if that risk is remote—doesn’t seem like a good…
We just learned that Dr. Brown passed away at his home Sunday night, Dec. 1. We are reposting this recent story in his honor. He will be missed.
Increased reimbursement would reflect value of cognitive care and other time-intensive services provided by rheumatologists.