Scenario: A patient with rheumatoid arthritis (RA) presents for a follow-up visit. After addressing her inflammatory arthritis symptoms, medications and laboratory results, she is asked if she has any other questions, and she begins describing her chronic low back pain, which has become worse despite physical therapy (PT). She requests stronger medications because her RA…
Rheumatologists who are outstanding clinicians, providing consistently exceptional care to patients and serving as role models for colleagues and trainees, are highlighted in our Lessons from a Master Clinician series. Here, we offer insights from clinicians who have achieved a level of distinction in the field of rheumatology. Jonathan Kay, MD, is professor of medicine,…
The growing rheumatologist workforce shortage has loomed over the profession, threatening to undercut the delivery of care to the increasing number of patients with rheumatic conditions. “The workforce shortage is an existential threat to the field of rheumatology and to the care we deliver to our patients,” says ACR President Kenneth Saag, MD, who lauded…
A clinical conundrum that rheumatologists often face is making a diagnostic or therapeutic decision in the absence of evidence-based data to guide clinical decision making. MedNet is a digital community of physicians created to improve knowledge sharing among physicians and help ensure patients get the highest quality care. The goal of the platform, according to…
Lupus & Perinatal Outcomes Adverse perinatal outcomes before & after diagnosis with systemic lupus erythematosus among African American Women By Meghan Angley, PhD, & S. Sam Lim, MD Why was this study done? Previous studies have suggested that women with systemic lupus erythematosus (SLE) may experience adverse perinatal outcomes, including preterm and small-for-gestational-age birth, in…
Erosive Polyarticular Chronic Tophaceous Gout in a Young Man A 27-year-old man was referred to us for joint pain and nodular swelling over multiple joints. His symptoms started when he was 13 years old, but he was sub-optimally treated. On examination, we found marked digital deformity, with multiple large tophi over the small joints of…
The COVID-19 pandemic has filled hospitals with patients with rapidly progressive respiratory failure and diffuse bilateral opacities on chest X-ray.1 Additionally, many patients with severe COVID-19 develop acute kidney injury and require dialysis.2 Pulmonary-renal syndromes are also important to consider in this setting. Although alveolar hemorrhage is a cardinal feature of this syndrome, many patients…
On Dec. 27, 2017, RaDonda Vaught killed Charlene Murphey, allegedly. Ms. Murphey was a lifelong resident of Gallatin, a suburb of Nashville, Tenn. She was well known from having worked at the local Walmart for 24 years, before she retired in 2012, when she was 65 years old.1 On Dec. 24, 2017, she was helping…
During the peak of the coronavirus pandemic in Washington, D.C., we were asked to evaluate a 14-year-old boy admitted to the pediatric hospitalist service. He had been healthy until two weeks before, when he noted a sore throat, and soon after he developed fevers and rashes without congestion, shortness of breath, conjunctivitis or swollen lymph…
Lipoma arborescens is a rare, benign intra-articular lesion characterized by diffuse replacement of synovial tissue by mature adipocytes, causing a villous lipomatous proliferation of the synovial membrane.1 Typically, this is a monoarticular condition, with the knee being the most commonly affected although it has been rarely reported to occur in an oligo-/polyarticular fashion and in…