In your daily contact with rheumatology patients, you likely come across several who have type 1 or 2 diabetes. Are you doing all you can to maximize their treatment? Most physicians know about the damaging health effects of uncontrolled diabetes. From vision loss to kidney failure to nerve damage, those with diabetes require regular vigilance…
Retirement is not always the closing chapter of a long career. For some rheumatologists, it’s the start of new, fulfilling storylines. “I never thought I wouldn’t practice medicine until I was physically unable to do it anymore,” says Harry Gewanter, MD, who retired from his Richmond, Va., pediatric rheumatology practice two years ago. Dr. Gewanter…
For patients with hip osteoarthritis (OA), pain management and maintaining function are primary therapy goals. Current guidelines offer recommendations on nonpharmacologic and pharmacologic approaches to addressing these issues in hip OA. For patients in whom pharmacologic management is considered, the use of intra-articular steroid injections is one option. In its 2012 guidelines (the most current…
For many uninsured and underinsured patients in Yuba City, Calif., seeing a rheumatologist used to mean taking a day off from work and driving 108 miles, roundtrip, to the University of California Davis Medical Center. That changed this year when patients were offered the option of having a telemedicine consultation with a rheumatologist as part…
A proposed model to predict the risk of giant cell arteritis (GCA) prior to a temporal artery biopsy could help triage patients and guide decision making about the need for biopsy or monitoring (see Figure 1). There’s no specific biomarker for GCA, and GCA can be a “diagnostic conundrum, especially when it presents in an…
Note: Updated May 2, 2018, to correct a link in the reference section. The error was introduced in editing. A 44-year-old Caucasian woman presented to the outpatient rheumatology clinic that had followed her for several years for rheumatoid arthritis. She was compliant with her regimen of hydroxychloroquine, etanercept and salsalate. Her chief complaint was worsening…
In this review, the authors address the key pathophysiologic mechanisms that drive acute and chronic chikungunya arthritis, arguably the most incapacitating sequela among long-lasting chikungunya virus disease manifestations, based on recent animal experimental disease models and epidemiologic studies. They explore the latest findings in therapeutic development aimed at limiting viral spread and at immune and…
Despite our best efforts and modern interventions, we still have patients in the intensive care unit with organ failure. Although renal failure can be mitigated by dialysis, patients with cardiac or respiratory failure secondary to active autoimmune disease raise difficult clinical and ethical issues. Two recent cases, both with organ failure, led us to examine…
SAN DIEGO—Recent research tells us more about giant cell arteritis (GCA) to help rheumatologists more accurately diagnose and effectively treat patients with this type of vasculitis. On Nov. 6 at the ACR/ARHP Annual Meeting, three experts explored the latest findings on GCA pathogenesis, diagnostic approaches, imaging modalities and growing treatment options. GCA: What’s Really Happening?…
SAN DIEGO—What are the predisposing genes that suggest who will develop active systemic lupus erythematosus and who will stay healthy? Decades of research data help rheumatologists clarify this picture, says Argyrios N. Theofilopoulos, MD, professor of immunology and microbiology at Scripps Research Institute in La Jolla, Calif. At his Nov. 5 lecture at the 2017…