In the middle of a busy clinic I go to see my next patient, a 16-year-old girl with a swollen knee. I had seen her the week before and, after discussing the options regarding treatment of her arthritis, had organized a joint injection for today. As I walk in the door she emphatically informs me,…
The idiopathic inflammatory myopathies (IIM) encompass eight categories: 1) dermatomyositis (DM) in adults, 2) juvenile dermatomyositis, 3) amyopathic DM, 4) cancer-associated DM, 5) polymyositis, 6) immune-mediated necrotizing myopathy, 7) inclusion body myositis, and 8) overlap myositis.1 These categories help classify the myopathies based on clinical and histologic features. The incidence of IIM is estimated at…
Questions What type of drug is interchangeable with an FDA-approved biologic? What drug is used in conjunction with infliximab, unless the patient cannot tolerate it? What can be used as a key element in an evaluation and management (E/M) service, along with the history, exam and medical decision making? What drives the level of an…
Using virtual reality in rehabilitation can have benefits—as long as it is properly understood. In fact, some evidence suggests benefits from the judicious use of immersive virtual reality with patients with rheumatic diagnoses. People tend to have a lower perception of effort compared with actual exertion and lower reports of pain with longer time to exhaustion.
ATLANTA—Encouraging data on interleukin (IL) 23/IL-17 pathway drugs in psoriatic arthritis (PsA), JAK inhibitors in rheumatoid arthritis (RA) treatment and new evidence on physical activity and bone health in women were among the highlights of the 2019 ACR/ARP Annual Meeting’s Clinical Year in Review. Susan Manzi, MD, MPH, director of the Lupus Center for Excellence…
Case Presentation A 45-year-old man with crystal-proven gout, poorly controlled diabetes and chronic kidney disease was lost to follow-up for six years and presented back to the VA clinic in the midst of a gout flare. He stated he had continued taking 100 mg of allopurinol daily, but his serum urate level was 13.8 mg/dL….
ATLANTA—At the 2019 ACR/ARP Annual Meeting in November, the ACR and the 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 about their individual contributions to advancing rheumatology. You’ll also find a…
A 55-year-old male patient diagnosed with generalized osteoarthritis and diagnosed with end stage renal failure (ESRD) 20 months previously presents to the office to see the rheumatologist. The patient has a commercial insurance plan and Medicare. Which carrier is primary for this visit? Commercial insurance carrier Medicare You do not know because it is not…
A patient with rheumatoid arthritis (RA) asks if diet can help ease their symptoms. Or maybe a patient with severe knee osteoarthritis (OA) seeks diet advice because they want to lose weight and relieve pressure on their joints. Although there’s no specific nutrition plan for patients with rheumatic diseases, research has shown many dietary factors…
The recently updated Osteoarthritis Research Society International (OARSI) guideline offers comprehensive and patient-centered treatment approaches for individuals with knee, hip and polyarticular OA…