ROME, Italy—The medical environment is increasingly adapting to the possibilities of optimizing care by individualizing medical treatment and tailoring treatment to disease phenotypes. Data suggest that individualizing exercise therapy, an important treatment modality for rheumatic and musculoskeletal diseases, can help control disease, maximize function, minimize functional barriers and decrease the risk of co-morbidity.1,2,3 Personalizing exercise…
One parent wishes that she could have consulted a crystal ball at the beginning of her daughter’s illness to have “some kind of idea of what we were in for. There are so many stages of letting go of the idea of what your little kid is in for in life, what they are going…
Ankle arthritis is a debilitating condition that leaves many patients in severe pain and greatly limits their activities. Until recently, the standard treatment for bone-on-bone ankle pain has been ankle fusion, or arthrodesis, in which surgeons literally fuse the bones of the ankle joint together. However, in the past few years, total ankle replacement surgery,…
What struck me first as I walked by the exam room where Lynn P. sat was the swelling in her fingers and wrists. The bloated hands rested unnaturally on her thighs, palms up, fingers slightly flexed. Her strawberry-blond curls were offset by a high-neck, loose-fitting, burgundy sweater. Her pale skin matched her trim slacks. She had…
NEW YORK (Reuters Health)—Some placebos are more effective than others, and these differences can influence the apparent outcomes of clinical trials, according to a systematic review and meta-analysis of osteoarthritis trials. “More surprising than the fact that all placebos are not equal is the magnitude of that difference,” Dr. Raveendhara R. Bannuru, from Tufts Medical…
CHICAGO—With the approval of the Jak inhibitors (i.e., jakinibs) tofacitinib and ruxolitinib—and others being investigated—rheumatologists need to arm themselves with an understanding of these drugs so they can think critically when evaluating them and deciding how to use them, said John O’Shea, MD, chief of the Molecular Immunology and Inflammation Branch of and scientific director…
Safety The Food and Drug Administration (FDA) has updated the Warnings and Precautions sections of prescribing information for the bisphosphonate agents, including risedronate sodium tablets and combinations with calcium (Actonel/Atelvia), alendronate and combinations with vitamin D (Binosto/Fosamax), ibandronate (Boniva), etidronate (Didronel) and the RANK-ligand inhibitor denosumab (Prolia/Xgeva).1 This information relates to an increased risk for…
In late March 2012, I awoke with pain in my left hand. I had difficulty moving my metacarpophalangeal (MCP) joints. They did not move smoothly, but clunked. As I repeatedly attempted to open and close my hand, I realized that I had morning stiffness. As the pain and stiffness gradually improved over the next hour,…
Burkholderia pseudomallei, the causative agent of melioidosis, is endemic in Southeast Asia and northern Australia.1 In recent years, the incidence of melioidosis has increased worldwide. Septic arthritis is a rare, but well-recognized, manifestation of melioidosis. Case Report A 49-year-old woman with known diabetes was admitted elsewhere with uncontrolled diabetes and fever. She was found to…
The Case A 68-year-old woman with a past medical history of Charcot-Marie-Tooth presents with thickening of the skin on her trunk and extremities, which she has had for the past seven months (see Figures 1 and 2). Her symptoms first began with swelling of her bilateral upper and lower extremities. She is now having difficulty…