A 32-year-old male patient with rheumatoid arthritis affecting multiple joints without rheumatoid factor returns to the office for a follow-up visit with the nurse practitioner (NP). The patient states his overall pain has improved since his previous visit, although he rates the severity of his right shoulder and right wrist pain at a 5 on…
Search results for: synovitis
Case Report: A Patient Helps Diagnose Familial Mediterranean Fever
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…
What Attracts Us to Rheumatology? A Veteran Rheumatologist Reflects
What attracts physicians to a career in rheumatology? Traditionally, the foundation of clinical training at both the medical student and house staff level is based on inpatient services. There are many reasons for this, predominantly revolving around access to patients available for teaching. The result: Trainees are predominantly exposed to a group of conditions that…
Case Report: An Adult-Onset Still’s Disease Mimic
A 53-year-old man was hospitalized for pericarditis, abdominal lymphadenopathy of unknown origin and non-bloody diarrhea. He was admitted for four days, and then he was discharged home without incident. Two months after his initial presentation, he was readmitted for the evaluation of several new issues, including symmetric arthralgias, hypovolemia with associated electrolyte abnormalities and concurrent…
Lyme Arthritis: Presentation, Diagnosis & Treatment
A 52-year-old man living in greater Boston with a history of hyperÂtension presented at our rheumatology clinic with bilateral knee pain and swelling. He had been in his usual state of health until four months earlier when he developed right knee pain and swelling without an incipient trauma, which did not improve with non-steroidal anti-inflammatory…
In Memoriam: Harold Edward Paulus, MD
Harold Edward Paulus, MD, professor of medicine (emeritus) at University of California, Los Angeles (UCLA), died April 5, 2019. During his nearly 90 years of life, he contributed hugely to clinical science and patient care in rheumatology. Hal was crazy smart. And if he had an idea, that idea had to be nurtured and expanded….
A Case of Eosinophilic Fasciitis Presenting with Pansclerotic Morphea
Eosinophilic fasciitis generally presents with the acute onset of edema followed by progressive skin induration in the setting of hypergammaglobulinemia, an elevated erythrocyte sedimentation rate (ESR) and peripheral eosinophilia in 63–93% of patients.1,2 Skin involvement is typically limited to 20.1% of total body surface area and most commonly involves the extremities symmetrically.1,3 The condition was…
New Tools for Myositis Diagnosis, Classification & Management
CHICAGO—At Hot Topics in Myositis, a session at the 2018 ACR/ARHP Annual Meeting, three experts discussed new classification criteria for idiopathic inflammatory myopathies (IIM) and offered practical primers on overlap myositis conditions and inclusion body myositis (IBM). New Myositis Classification Criteria After a 10-year development process, the new EULAR/ACR Classification Criteria for Adult and Juvenile…
MRI-Guided Therapy Offers No Improvement Over Conventional Treat to Target for RA
New research does not support the use of a magnetic resonance imaging (MRI)-guided strategy for treating RA patients. The study found that among RA patients in remission, an MRI-guided treat-to-target strategy compared with a conventional treat-to-target strategy did not result in improved disease activity remission rates or reduced radiographic progression…
State-of-the-Art Approaches to Rheumatic Disease Diagnosis, Management & Treatment
CHICAGO—Held during the 2018 ACR/ARHP Annual Meeting, the ACR Review Course covered a wide range of topics for rheumatologists—from advances in pain and rheumatic disease management to the intersection of rheumatology and neurology. Session speakers shared insights, as well as state-of-the-art approaches to diagnosis, management and treatment. Inflammatory Myopathies Julie J. Paik, MD, MHS, assistant…
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