Preventing adverse outcomes in individuals who have rheumatic diseases is a daily goal for rheumatologists. For example, rheumatologists prescribe medications and perform screening to prevent erosions in rheumatoid arthritis (RA), renal failure in systemic lupus erythematosus and flares across all diseases. Many of these actions are classified as secondary or tertiary prevention, because individuals have…
Calciphylaxis is a poorly understood and life-threatening ischemic vasculopathy characterized by calcification of the small- and medium-size arteries in the skin, subcutaneous tissue and internal organs, which leads to thrombosis, tissue necrosis and painful skin ulcerations that won’t heal. The disease has a 50–80% mortality rate. Although affected patients typically have end-stage renal disease (ESRD)…
NEW YORK (Reuters Health)—In Lyme-endemic areas, synovial fluid white blood cell (WBC) count isn’t very helpful in distinguishing septic from Lyme arthritis of the hip, a new study suggests. Use of newer-generation Lyme disease diagnostics are necessary to avoid the “under- and overdiagnosis of Lyme arthritis at the time that initial management decisions must be…
You see a patient for the first time to establish care for Sjögren’s disease. She complains of dry eyes, dry mouth and diffuse arthralgias. You do not appreciate any synovitis on physical exam. Of note, you are the fourth rheumatologist she has seen during the past year. Toward the end of the clinic visit, she…
History A 39-year-old woman returns for follow-up for her rheumatoid arthritis. She has positive rheumatoid factor, but no organ or systemic involvement. She has joint swelling and pain in her left hand, right elbow and right knee. Her pain is at an 8 on a 10-point scale. She states the pain is worse in the…
Note: Updated May 2, 2018, to correct a link in the reference section. The error was introduced in editing. A 44-year-old Caucasian woman presented to the outpatient rheumatology clinic that had followed her for several years for rheumatoid arthritis. She was compliant with her regimen of hydroxychloroquine, etanercept and salsalate. Her chief complaint was worsening…
Various drugs are known to cause musculoskeletal symptoms, such as arthralgias, myalgias, drug-induced lupus and serum sickness.1 In the rheumatology world, the most commonly recognized drugs that can cause musculoskeletal symptoms are hydralazine, minocycline, fluoroquinolones and, recently, the dipeptidyl peptidase 4 (DPP-4) inhibitor class of medications. Although beta blockers also have a noted side effect…
The demonstrated connection between persistent effusion-synovitis and cartilage damage in certain osteoarthritis (OA) patients has implications for targeted treatment that updates previous OA treatment parameters…
SAN DIEGO—In a roundup of current research in rheumatoid arthritis (RA) presented at the 2017 ACR/ARHP Annual Meeting Nov. 3–8, Mark C. Genovese, MD, professor of medicine in the Division of Immunology and Rheumatology at Stanford University, Palo Alto, Calif., urged his audience to reflect on the impact therapy advances have made on RA. “In…
SAN DIEGO—Proposed classification criteria for systemic lupus erythematosus (SLE), which are supported but not yet approved by the ACR and EULAR, debuted on Nov. 7 at the 2017 ACR/ARHP Annual Meeting. An international steering committee developed and validated the criteria, with patient input and the consensus of more than 150 global SLE experts. Researchers referred…