A recent study reinforces the growing understanding that the fatigue many SLE patients experience should be considered a lupus symptom. Researchers found that using patient-reported outcomes to identify type 2 symptoms of SLE may improve patient communication, understanding and overall care…
ATLANTA—Two ways to investigate injuries to the upper extremities are by in-depth physical examinations and ultrasound. In a Clinical Practice session at the 2019 ACR/ARP Annual Meeting, Anatomy: Correlating Physical Exam and Ultrasound in Common Sports Injuries of the Upper Extremity, Carlin Senter, MD, FACP, associate professor of primary care sports medicine at the University…
NEW YORK (Reuters Health)—Ultrasound guidance does not improve the effectiveness of treat-to-target therapy in rheumatoid arthritis (RA), new findings confirm. “Incorporating ultrasound information in treatment decisions did not lead to reduced MRI inflammation or less structural damage compared with a conventional treatment strategy,” Dr. Ulf Sundin of Diakonhjemmet Hospital, Oslo, and colleagues write in Rheumatology….
ATLANTA—The authors of the new draft ACR treatment guideline for the management of gout presented the draft guideline on Nov. 13 at the 2019 ACR/ARP Annual Meeting. Based on evidence from more than 130 published studies, there are 42 recommendations, of which 16 were strong, including 27 for urate-lowering therapy (ULT) management, 13 of which…
A 56-year-old automobile mechanic was referred to our rheumatology service by his orthopedist to evaluate left posterior knee pain and swelling that had been present for three months. The patient had undergone bilateral total knee arthroplasties (TKAs) for sports-related osteoarthritis three years before. In addition to the knee pain, the patient described several years of…
Immune checkpoint inhibitors (ICIs) targeting the cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) or programmed cell death protein 1 (PD-1) axes have revolutionized therapy and improved survival in advanced cancers. However, these immune system modulators also lead to immune-related adverse events (IRAEs).1,2 In clinical trials, IRAEs mainly involved the gastrointestinal tract, skin, endocrine glands, liver and lung,…
The new EULAR/ACR classification criteria for SLE offer improved sensitivity and specificity, as well as more accurately reflect the current tests used to clinically diagnose SLE. A positive ANA test is obligatory…
A 43-year-old woman is establishing care in your new urban clinic after her previous rheumatologist stopped accepting her Medicaid insurance more than a year ago. Since that time, she has been trying to find a new rheumatologist who will accept Medicaid. She lives 90 miles away in a small town without a rheumatologist. Seven years…
Rheumatoid arthritis (RA) is a chronic systemic autoimmune inflammatory disease. Although RA develops its central pathology within the synovium of diarthrodial joints, many non-articular organs can be involved, particularly in patients with severe joint disease.1 Although most patients are asymptomatic, cardiac involvement is relatively common and includes rheumatic heart nodules, pericarditis (30–50%), pericardial effusion and…
Accurately classifying patients with psoriatic arthritis (PsA) can be difficult, especially patients with monoarticular/oligoarticular and polyarticular forms of PsA. A session at the 2019 European Congress of Rheumatology provided insight into the assessment and treatment of PsA subtypes…