Antiphospholipid syndrome (APS) is an autoimmune clotting disorder that may present catastrophically with multiple thromboses over a short period of time. In this article, we examine the case of a woman with undiagnosed APS whose first symptoms presented during a long-haul flight. A review of the literature on thrombosis at high altitudes and during long…
New research shows tanezumab may be safe and effective for patients with osteoarthritis pain…
As Lyme disease and Lyme arthritis spread to new regions in North America, physicians may ned to become aware of their signs and symptoms. Allen C. Steere, MD, says “Lyme arthritis is more complicated to treat than other manifestations of the disease.” Here are some best practices for treating Lyme arthritis…
In several U.S. states, Blue Cross/Blue Shield and other insurers have dropped or are considering dropping coverage of hyaluronic acid injection—or viscosupplementation—for patients with knee osteoarthritis. The decision appears to be based on guidelines published by the American Academy of Orthopaedic Surgeons in 2013, which at that time specified that research had not found hyaluronic…
CHICAGO—The placebo effect in treating pain in osteoarthritis (OA) should not be discounted, an expert said at the ACR State-of-the-Art Clinical Symposium in April. It’s especially important to accept the effect as real considering that trials of pain therapies in OA generate such high placebo effects (typically at least 40%) and that OA treatment options,…
Videos designed to help patients understand and manage chronic rheumatologic diseases can lead to gains in clarity about the disease duration, symptoms, medications, and the importance of regular visits with a physician. A study published in a recent issue of Arthritis Care & Research looks at the development and impact of three educational videos for…
Through much of the 20th century, dedicated rheumatic disease units were found in hospitals across the U.S. and countries around the world. In the latter part of the century, this began to change, with hospitals moving toward the consult model of care for rheumatic patients. This change reflects larger shifts in the medical world toward…
Rheumatoid arthritis (RA) is characterized by polyarthritis, especially involving hands and wrists. Without treatment, RA usually evolves to articular deformities. Unfortunately, although rheumatoid deformities are characteristic, they are not pathognomonic, and we should be aware of possible mimics.1 Neuropathic arthropathy (NA), similar to other diseases, such as hemochromatosis, psoriatic arthritis, calcium pyrophosphate deposition disease, Jaccoud…
Non-steroidal anti-inflammatory drugs (NSAIDs) are the most used drugs for acute and chronic pain. More than 30 billion doses of NSAIDs are consumed annually from more than 70 million prescriptions.1 Despite their common use, NSAIDs are not free of serious toxicities. In the pre-Vioxx (rofecoxib) era, gastrointestinal toxicity was the primary concern for many NSAIDs….
A recent position statement by the Society of Behavioral Medicine (SBM) concludes that patients with persistent pain need better access to psychosocial care in all healthcare settings.1 The SBM offers 10 health policy recommendations for improving such access, including removing system-related barriers, providing referral tools, reimbursing for evidence-based psychosocial approaches, prioritizing generalist-level and specialist pain…