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An official publication of the ACR and the ARP serving rheumatologists and rheumatology professionals

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The Future of Pediatric Rheumatology Grounded in Evolution of Childhood Arthritis and Rheumatology Research Alliance

Yukiko Kimura, MD, & Laura E. Schanberg, MD  |  

Pediatric rheumatology was formally recognized as a specialty in 1991 by the American Board of Pediatrics. Prior to this time, children with rheumatic diseases were treated by a hodgepodge of providers. In addition to providers who had training as pediatric rheumatologists, general pediatricians, adult rheumatologists, allergist-immunologists, orthopedists, pediatric infectious disease specialists and others treated children…

Rheumatology Case Report: Systemic Capillary Leak Syndrome and Rheumatoid Arthritis

Alexis Smith, MD, & Angus Worthing, MD, FACP, FACR  |  

Systemic capillary leak syndrome (SCLS) is a very rare disorder, characterized by recurrent episodes of severe hypotension, hypoalbuminemia and hemoconcentration.1 Attacks of SCLS occur in three phases: 1) prodrome; 2) hypovolemia with weight gain; and 3) hypervolemia with fluid overload and polyuria often complicated by pulmonary edema. Often, compartment syndrome can lead to rhabdomyolysis as…

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Assessing Autoimmune Disease Symptoms in Silicone Breast Implant Recipients

Charles Radis, DO  |  

My nurse, Joanne, took me aside before I began my next consult. “Room No. 5, breast implant patient. Her lawyer organized the records.” She handed me a hefty three-ring notebook organized by color-coded tabs. “Her attorney called just now,” Joanne raised an eyebrow, “and told me to tell you that, to save time, he highlighted…

Infection Greater Worry Than Flare: Collaborative Guideline Offers Guidance to Prevent Joint Replacement Complications & Failure

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WASHINGTON, D.C.—Total joint arthroplasty is one of the most common surgical procedures performed on adults with end-stage arthritis. One recent estimate showed that 2.5 million individuals in the U.S. are living with a total hip replacement and 4.7 million are living with knee replacements. For their patients with inflammatory arthritis, rheumatologists and orthopedic surgeons must…

MACRA: More Points, Smarter Future

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As the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is implemented in January with new models for quality-based reimbursement payments, rheumatologists must seize control of how they will be paid now—and in the future. This message was stressed by speakers during Holy MACRA! How to Survive and Thrive in the Era of MACRA,…

Advocating Where It Counts: A Conversation with Incoming Government Affairs Committee Chair Angus Worthing, MD, FACR, FACP

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As he prepares to take on his newest volunteer role with the ACR, leading the Government Affairs Committee (GAC), Angus Worthing, MD, FACR, FACP, is looking forward to making the most of the opportunities that a unified government can offer the ACR in advocating for rheumatology care. “Advocacy is an investment in our profession—regardless of…

Rheumatology Drug Updates: Celecoxib and Cardiovascular Safety Trial Results Reviewed

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Nonsteroidal anti-inflammatory drugs (NSAIDs) have been used therapeutically since the 1960s.1 Evidence of adverse cardiovascular outcomes led to the withdrawal of the selective COX-2 inhibitor rofecoxib in September 2004, when the question of cardiovascular safety of NSAIDs first came into the limelight.2 Valdecoxib (Bextra) was subsequently withdrawn from the market in April 2005 due to…

Self-Driven Care Can be Difficult for Adolescents Transitioning from Pediatric to Adult Rheumatology Provider

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When treating adolescent patients who are making the important, sometimes bumpy crossing from a pediatric to an adult rheumatology practice, there’s no one-size-fits-all approach. “We have to be flexible on the receiving end when talking with these patients, and flexible with their families, too,” says Peter A. Nigrovic, MD, director of the Center for Adults…