I have been tongue-tied, of late. When I was a medical student, I was told not to turn the physical examination into an aerobic workout. This sage piece of advice was imparted by my physical examination preceptor, who had watched me perform a complete examination on a hapless volunteer. At the time, I thought of…
Convex-walking shoes, dietary supplements, advancements in nerve growth factor inhibitors and more—Xavier Chevalier gave an overview and new insights into treatments for osteoarthritis.
Tumor necrosis factor-α inhibitors (TNFi’s) have emerged as an integral part of therapeutic strategies for several rheumatic diseases. TNF-α is a pro-inflammatory cytokine implicated in the pathogenesis of rheumatoid arthritis (RA), seronegative spondyloarthropathies and inflammatory bowel disease (IBD). It also plays a central role in the immune response to mycobacterial infection. Many biologic agents, particularly…
Humans are not perfectly symmetrical. Almost everyone has one ear that’s higher or one foot that’s larger than the other. Similarly, leg lengths are often not quite the same. There is disagreement as to what constitutes a clinically significant difference, but some studies suggest that leg length discrepancy (LLD) can lead to osteoarthritis (OA) of…
Reactive arthritis is classically associated with an infectious etiology, such as Salmonella, Yersinia, Campylobacter, Chlamydia or gonorrhea. Clostridium difficile is a rare, and recently recognized, causative agent for this condition.1 Case Presentation The patient is a 21-year-old man with a past medical history significant for hereditary spherocytosis and Crohn’s disease, complicated by an anorectal fistula,…
Through the development of a multidisciplinary musculoskeletal institute, we have created a model that facilitates coordination of care of complex patients between medical and surgical subspecialists, physical therapists, dieticians and social workers. A case is presented to demonstrate the improved care experience for both patients and providers and to share our learnings more broadly. The…
During ACR Convergence 2020 in early November, the ACR and ARP honored a group of distinguished individuals who have made significant contributions to rheumatology research, education and patient care. This month, The Rheumatologist speaks with the winners of the ARP Merit Awards and the ACR’s Distinguished Fellows. In addition, we bring you the first ever…
Case Presentation History of present illness A 66-year-old white woman presented with unexplained, recurrent episodes of high fever, abdominal pain, rash and arthralgias occurring over the previous three years. During typical episodes, the patient experienced flu-like symptoms, followed by fever, abdominal pain and non-bloody diarrhea without tenesmus. Her temperatures were 101–103ºF, with chills lasting up…
Some have opined, cynically, that transformative changes will not come to medical education and training, and to healthcare, until pigs fly. Well, in 2009–10, “swine flu,” and now we are in the midst of an unprecedented and disruptive pandemic, affecting virtually all aspects of our lives, including fellowships.1 As someone who started a rheumatology fellowship…
Patients with meniscal tear experience similar levels of reduced pain and improved physical function when treated with either arthroscopic partial meniscectomy or physical therapy, according to a recent study. The study also found these improvements were long term—lasting through the five-year follow up…