For most rheumatologists, the key elements of the physical exam—inspection, palpation, percussion and auscultation—have long been second nature, but a fifth modality has grown in importance with respect to making the correct diagnosis: ultrasound. From evaluating for Doppler signal and additional findings indicative of synovitis to identifying bony erosions, chondrocalcinosis, tophi and other articular and…
The COVID-19 pandemic is reshaping clinical rheumatology and the fellowship experience. Rheumatology education should include how to triage patients for remote visits, says second-year fellow Kanika Monga, MD…
ACR BEYOND LIVE—A moonshot concept in rheumatology has long been centered on the question of whether autoimmune disease can be cured. A less frequently posed inquiry, albeit equally important, is: Can the onset of autoimmune disease be prevented in the first place? At the 2020 ACR State-of-the-Art Clinical Symposium, Kevin Deane, MD, PhD, associate professor…
My first-ever medical mission trip, after 37 years of medical practice, was to Teleman, Alta Verapaz, Guatemala. Prior to the trip, my excitement as an adult-trained rheumatologist was balanced against my apprehension about witnessing new diseases, caring for children and practicing in an austere environment with limited medical resources. As directed by the travel clinic,…
SNOWMASS VILLAGE, COLO.—The science underlying the neurobiology of chronic pain isn’t something rheumatologists often think about. However, pain is an important reason why patients see a rheumatologist. At the 2020 ACR Winter Symposium in January, Leslie Crofford, MD, gave two presentations addressing pain experienced by rheumatology patients, including a session on the fundamental mechanisms of…
Jane’s* hands and wrists had been swollen and painful for about eight weeks. Lab findings in the ambulatory consult that came to our office revealed a cyclic citrullinated peptide antibody count >250 u/mL. We all know where this story goes, including how important the early treatment window is. Our clinic reviews all consults and tries…
A study found resident memory T cells may mediate inflammatory arthritis and trigger flares in specific joints, suggesting local depletion of these cells could be a therapeutic strategy…
ATLANTA—At the ACR/ARP 2019 Annual Meeting, several widely renowned experts across an array of specialty subjects provided a comprehensive and compelling review of advances in the understanding, diagnosis and treatment of a number of rheumatologic conditions. Sjögren’s Syndrome Frederick Vivino, MD, FACR, chief of rheumatology at Penn Presbyterian Medical Center and professor of clinical medicine…
A 59-year-old woman presented to our rheumatology clinic with a six-month history of a symmetric polyarthritis. She initially experienced pain in both knees. As time progressed, she began to notice pain in her ankles, hips, shoulders, hands and feet. She experienced joint stiffness lasting for more than 30 minutes every morning. She also described worsening…
In March 2020, an elderly married couple living on Long Island, N.Y., presented to our emergency department with symptoms suspicious for COVID-19 infection. The wife, a-76-year-old woman, presented with complaints of subjective fevers, minimal dry cough and headaches of one-week duration. She denied having any chills, rhinorrhea, diarrhea, abdominal pain or shortness of breath. Two…