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Updates to Axial Spondyloarthritis Guideline

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A 2019 update of the ACR’s previous clinical practice guideline on axial spondyloarthritis is now available online. Lead investigator Michael Ward, MD, shares advice for implementing the guideline updates, including those related to sequencing and tapering biologics, and knowing when to obtain images.

Case Report: Not All Crystals Are Gout

Katherine Yates, MD, Erin H. Penn, MD, & Minna J. Kohler, MD   |  

Patients with chronic kidney disease (CKD) often experience joint pain due to various etiologies, including crystalline arthropathies, renal osteodystrophy, amyloid arthropathy, erosive osteoarthritis, avascular necrosis and even erosive spondylarthrosis.1 Below, we present a case of crystalline arthropathy in a patient with chronic kidney disease, mistaken for gout. The Case A 29-year-old man was admitted to…

Case Report: RA Patient Suffers Methotrexate-Induced Cutaneous Lesions

Nitasha Kumar, MD  |  

Methotrexate (MTX) remains the predominant medication used by rheumatologists to treat rheumatoid arthritis (RA). Doses of 7.5–25 mg per week with daily folic acid are generally prescribed. Despite its common use, MTX must be prescribed cautiously given the potential adverse effects when taken incorrectly or without folic acid supplementation. Cases of MTX-induced cutaneous ulceration have…

Study Probes New Gene Therapy for Severe, Localized Scleroderma (Morphea)

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In September 2018, the U.S. Food & Drug Administration (FDA) granted fast-track status to FCX‑013, a gene therapy product developed to treat moderate to severe localized scleroderma (morphea). Previously, the treatment received an orphan drug designation for localized scleroderma, as well as a rare pediatric disease designation. Phase 1 and 2 studies will assess safety…

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Case Report: A Patient Helps Diagnose Familial Mediterranean Fever

Taylor Faulk, MD, & Matthew B. Carroll, MD  |  

Autoinflammatory diseases are genetically diverse, but clinically similar, conditions distinct from autoimmune illnesses, such as systemic lupus erythematosus or rheumatoid arthritis. Clinically, they are defined by recurrent episodes of inflammation that follow a characteristic pattern each time they occur. Some have a set length of time during which fever, peritonitis or arthritis manifest. Others are…

This chest CT shows new left upper lobe groundglass opacity.

Case Report: Could Myocarditis + Shortness of Breath = EGPA?

Ambreesh Chawla, MD, Ashwini Komarla, MD, & Sujatha Vuyyuru, MD  |  

Eosinophilic granulomatosis with polyangiitis (EGPA), also known as Churg-Strauss syndrome or allergic granulomatosis and angiitis, is a rare small- and medium-vessel vasculitis. This disease was first described by American pathologists Jacob Churg and Lotte Strauss in 1951.1 Although the vasculitis is often not apparent in the initial phases of the disease, EGPA can affect any…

Rheumatology Drugs at a Glance, Part 3: Rheumatoid Arthritis

Mary Choy, PharmD, BCGP, FASHP  |  

Over the past few years, bio­similars and other new drugs have been introduced to treat rheumatic illnesses. Some of the conditions we treat have numerous drug options, others have few or only off-label options. This series, “Rheumatology Drugs at a Glance,” provides streamlined information on the administration of biologic, biosimilar and small molecule inhibitor drugs…

What’s a Rheumatologist? Rheumatic Disease Awareness Month spurs support for rheumatology patients & professionals

Paula Marchetta, MD, MBA  |  

It happens all the time. We can see it coming—that quizzical look or the hesitant nod after someone asks what we do for a living. We are so accustomed to the next question that we often provide the answer before someone even has a chance to ask it: “What’s a rheumatologist?” The ACR has long…