The past five years have been busier than usual for the Churg-Strauss syndrome. It was renamed eosinophilic granulomatosis with polyangiitis (EGPA).1 Longitudinal cohorts totaling 484 patients—approximately as many as all previous series combined—were described.2,3 A proposal was advanced to remove and rename a subset in which vasculitis may not be present.4 And shortly after the…
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…
NEW YORK (Reuters Health)—Obesity in women and current smoking in men appear to be the strongest predictors of lack of remission in early rheumatoid arthritis (RA) within one year, according to new research presented June 13 at EULAR 2018, the annual meeting of the European League Against Rheumatism, in Amsterdam.1 Even though early identification and…
Over the past several decades, the medical community has been moving toward a model of shared decision making. In addition to its ethical advantages, shared decision making potentially yields such benefits as improved medical adherence and better health outcomes. With the proliferation of treatment options and changes in the larger culture, shared decision making is…
After total hip or knee arthroplasty, flares are common in patients with rheumatoid arthritis (RA), according to a recently published study.1 Higher disease activity at baseline appears to be linked to flares, but use of such medications as biologics and methotrexate did not independently predict flaring. “Contrary to the notion that patients with established RA…
Granulomatosis with polyangiitis (GPA) was first described in the British Medical Journal in 1897 by Scottish otolaryngologist Peter McBride.1 GPA is a relatively rare, systemic necrotizing vasculitis that can make diagnosis challenging. The incidence has been estimated anywhere between two and 12 cases per million.2 GPA mainly affects adults between the ages of 45 and…
Preventing adverse outcomes in individuals who have rheumatic diseases is a daily goal for rheumatologists. For example, rheumatologists prescribe medications and perform screening to prevent erosions in rheumatoid arthritis (RA), renal failure in systemic lupus erythematosus and flares across all diseases. Many of these actions are classified as secondary or tertiary prevention, because individuals have…
“Wait. I can explain.” One could imagine this phrase coming up under many conditions in daily life. When I first became a physician, however, I would never have expected to use this phrase in my clinic. In medical school, I was taught the importance of dialogue in establishing a relationship with a patient. Statistics indicate…
How do you ask a new patient about sex and gender—or know which pronoun to use? Keep the conversation straightforward and respectful to put everyone at ease, says Morgan Orndorff, a transgender man who works as an administrator at a major academic medical center. “Everyone is a little different in terms of their sensitivity level”…