Editor’s note: In this recurring feature, we first present a series of ultrasound images for your review, and then a brief discussion of the findings and diagnosis. Before you scroll to the discussion, examine these images carefully and draw your own conclusions. History A 2-year-old boy with a history of multiple strokes and vertebral artery…
A new case series outlines the treatment and duration of symptoms of 10 patients experiencing the musculoskeletal manifestations of immune-related adverse events. Researchers found these symptoms may last for more than a year, but can generally be treated with low to moderate doses of corticosteroids…
CHICAGO—In the Thieves Market session at the 2018 ACR/ARHP Annual Meeting, rheumatologists from around the country presented a slate of challenging cases that emphasized the importance of clinical persistence and attention to detail, and the need to consider diagnoses that might not be common or obvious. Three of them are summarized below. (Look for more…
CHICAGO—Is erosive, inflammatory osteoarthritis (EOA) a separate condition from osteoarthritis (OA)? Roberta Ramonda, MD, PhD, a rheumatologist at the University of Padova, Italy, spoke at the 2018 ACR/ARHP Annual Meeting on the clinical presentation of EOA and how it differs from OA. EOA is characterized by a frequent aggressive clinical course and occurs most often…
New evidence from a clinical trial of rituximab has identified the pathogenetic role of B cells in the earliest, pre-arthritis stage of autoantibody-positive RA…
CHICAGO—When it comes to correctly diagnosing joint pain in children, “things take time,” said Michael L. Miller, MD, quoting Danish physicist and poet Piet Hein. Children with pain but normal physical examinations may need to return to the clinic for repeat evaluation over several months. “I often tell parents that laboratory tests may help in…
An analysis of treat-to-target therapy assessing two ultrasound definitions of remission for patients with early rheumatoid arthritis (RA) has concluded that using ultrasound remission as a target was not associated with better long-term outcomes for RA patients.1 Compared with MRI, ultrasound costs less, is more accessible and offers the ability to scan more joints in…
Primary Sjögren’s syndrome is a systemic autoimmune condition noted for findings of xerostomia, keratoconjunctivitis sicca and focal lymphocyte infiltrate in salivary glands.1 In the initial publications regarding keratoconjunctivitis sicca, Henrik Sjögren, a Swedish ophthalmologist, described a group of 19 women with dry eyes, some of whom had other organ dryness and inflammatory infiltrates.2,3 The syndrome…
A typical patient with a rheumatic disease needs a multifaceted treatment approach to address comorbidities, minimize disability, promote quality of life and improve survival. To achieve these outcomes, rheumatology research has evolved from examining a single treatment to studying the best treatment approaches. Examples of these strategy trials include how to best combine pharmaceutical therapies,…
The evaluation of a child with arthralgia who has a normal physical examination provides a challenge to rheumatologists. Here are some insights into assessing and treating children with musculoskeletal pain syndromes…