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…
Immune checkpoint inhibitors (ICIs) targeting the cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) or programmed cell death protein 1 (PD-1) axes have revolutionized therapy and improved survival in advanced cancers. However, these immune system modulators also lead to immune-related adverse events (IRAEs).1,2 In clinical trials, IRAEs mainly involved the gastrointestinal tract, skin, endocrine glands, liver and lung,…
People with or at risk for symptomatic knee osteoarthritis (OA) may be assigned to four depression subtypes with distinct clusters of depressive symptoms that may affect pain and disability over time, according to a new study in Arthritis Care & Research.1 Four depression subtypes were identified in the study using the Center for Epidemiologic Studies…
Autoinflammatory diseases are genetically diverse, but clinically similar, conditions distinct from autoimmune illnesses, such as systemic lupus erythematosus or rheumatoid arthritis. Clinically, they are defined by recurrent episodes of inflammation that follow a characteristic pattern each time they occur. Some have a set length of time during which fever, peritonitis or arthritis manifest. Others are…
A 52-year-old man living in greater Boston with a history of hypertension presented at our rheumatology clinic with bilateral knee pain and swelling. He had been in his usual state of health until four months earlier when he developed right knee pain and swelling without an incipient trauma, which did not improve with non-steroidal anti-inflammatory…