Scenario 1 History: A 45-year-old male patient with sero-negative rheumatoid arthritis affecting multiple sites, but with no organ or systems involvement, comes for a follow-up visit. The patient reports swelling of the left knee with throbbing left knee pain. He rates the severity of his pain at an 8 on a 10-point scale. The pain…
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Dr. Christine Thorburn: From Olympic Cyclist to Rheumatologist
Growing up in Iowa, Christine Thorburn, MD, loved to run track and cross-country and dreamed of one day being an Olympic runner. Little did the future rheumatologist know that a knee injury would cause her to change course and become a professional road cyclist who would represent the U.S. in two Olympic Games. Dr. Thorburn…
Bone Marrow Edema Studied for Spondyloarthritis Diagnostic Insights
Researchers in Demark studied joints of young adult athletes to better understand the difference in bone marrow edema common in healthy people vs. what is experienced by patients with spondyloarthritis, a serious inflammatory condition of the spine and sacroiliac joints. Early recognition of spondylo-arthritis can be tricky because it can be confused with symptoms and…
5 Ways to Improve Your Collaboration with Orthopedic Surgeons
Rheumatologists and orthopedic surgeons must frequently collaborate to provide optimal patient care. Sometimes, they may even work at the same practice and form a care team for easy collaboration. Still, patient management from both specialties can be challenging, and specialists from both sides can learn from each other. How Crossover Starts Rheumatologists and orthopedic surgeons…
How Does Down Syndrome Affect Musculoskeletal Health?
Down syndrome (trisomy 21) is one of the most common chromosomal abnormalities. According to the Genomic Resource Centre of the World Health Organization, each year 3,000–5,000 children are born with this chromosome disorder, and about 250,000 families have at least one member with Down syndrome in the U.S. Down syndrome is caused by numerical aneuploidy,…
Study Finds Tocilizumab Could Be Treatment Option for Takayasu Arteritis
For patients with refractory Takayasu arteritis (TAK), glucocorticoids (GCs) are often provided as the initial therapy for treatment. However, GCs are often associated with adverse effects for long-term use; relapse also occurs frequently during GC tapering.1 TAK involves interleukin (IL) 6. Tocilizumab—a recombinant, humanized, anti-IL-6 receptor (IL-6R) monoclonal antibody—was first reported by Nishimoto et al….
The Classification & Diagnosis of Granulomatosis with Polyangiitis
Based on the classification system developed by the Chapel Hill Consensus Conference, anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis is defined as a necrotizing vasculitis involving small vessels that is associated with myeloperoxidase (MPO) ANCA or proteinase 3 (PR3) ANCA and displays minimal immune deposits. The mechanism behind the pathogenesis of ANCA-associated vasculitis is not fully…
Does the Metal-Fatigue Principle Apply to Elderly Bones?
Can principles from engineering provide a broader understanding of how the human skeleton works and be used to help prevent a common and often consequential event for people as they age—bone fractures? Research from a team of investigators that includes orthopedic surgeons and mechanical engineers suggests that, yes, looking at how engineered materials, such as…
Antiphospholipid Syndrome: The Risk of Travel at High Altitudes
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…
Lyme Arthritis Treatment Protocols Critical as Lyme Disease Spreads
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…
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