In early June, the ACR released an updated guideline on the management of rheumatoid arthritis, which includes new recommendations for specific high-risk groups.1 The guideline includes 44 recommendations—seven of which are strong and 37 conditional. It underscores the role of methotrexate as a cornerstone therapy and emphasizes minimizing glucocorticoids, when possible. Guideline Development Process At…
Calciphylaxis, or calcific uremic arteriolopathy, is a rare disease characterized by calcification of the arterioles and capillaries in the dermis and subcutaneous tissue, resulting in thrombus formation and subsequent skin ischemia and necrosis.1 This serious condition most commonly occurs in patients with end-stage renal disease (ESRD) requiring dialysis or in kidney transplant recipients. In rare…
Clinically amyopathic dermatomyositis (CADM), a rare subset of dermatomyositis (DM), is an autoimmune disease characterized by cutaneous findings of typical DM without evidence of myositis. Childhood presentation of CADM is rare, and not many studies describe the epidemiology of juvenile CADM.1,2 Although lung disease is rare among patients with juvenile DM, a few reports have…
ACR CONVERGENCE 2020—Research has shown time and again the benefits and low risk of physical activity for people with rheumatic diseases, but only a third or less of patients meet guidelines for this activity, Patricia Katz, PhD, professor of medicine and health policy at the University of California, San Francisco, said in the ARP Distinguished…
Research from Ellingwood et al. examines how often patients diagnosed with early RA experience episodic joint inflammation and describes characteristics that may result in RA development.
In a controlled, large-cohort, longitudinal study from Canada, Atiquazzaman et al. found that use of non-steroidal anti-inflammatory drugs (NSAIDs) substantially contributes to increased cardiovascular disease risk among people with osteoarthritis (OA).1 This is the first study to evaluate the mediating role that NSAIDs play in the association between OA and cardiovascular disease (CVD), and the…
A team of healthcare practitioners and researchers, spearheaded by the Infectious Diseases Society of America (IDSA), the American Academy of Neurology (AAN) and the ACR, has developed updated evidence-based clinical practice guidelines for the prevention, diagnosis and treatment of Lyme disease. The 2020 guidelines cover a wide variety of Lyme disease manifestations, including Lyme arthritis. Linda…
Our patient was a 33-year-old, 5’2″ Asian woman with a past medical history of systemic lupus erythematosus (SLE). The diagnosis was based on serologies positive for anti-nuclear antibodies (ANAs), as well as antibodies to Sm, RNP and SSA. Her illness included neuropsychiatric and cutaneous involvement. She also had a diagnosis of Hashimoto’s thyroiditis. She presented…
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…