Mysterious Ways The juxtaposition of the old and the new was readily evident that busy Wednesday morning. My first patient, a 94-year-old gentleman, Hal, arrived with a precise request. His rheumatologist for the past 40 years had just retired, and he was searching for a doctor with expertise in the use of gold sodium aurothioglucose,…
SAN DIEGO—The proposed classification criteria for systemic lupus erythematosus (SLE), supported but not yet approved by the ACR and EULAR, were 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. Rheumatology researchers…
In a Year in Review session at the 2017 ACR/ARHP Annual Meeting, Daniel Solomon, MD, MPH, highlighted the latest and most intriguing aspects of clinical research on rheumatic diseases from 2017. His discussion touched on medical therapy, genetics, the effects of bariatric surgery and diet, cancer risk and more…
A 57-year-old Ghanaian woman was referred to our rheumatology practice with acute, left elbow swelling and pain. The referring oncologist suspected gout, because the patient had hyperuricemia. Six months before, the patient was diagnosed with stage IV human T-lymphotropic virus type 1 (HTLV-1)-associated adult T cell lymphoma (ATLL). Her initial oncologic manifestations included multiple thoracic,…
A 51-year-old Caucasian female was referred by a local rheumatologist to the Center of Autoinflammatory Diseases at Stony Brook University, N.Y., for an unusual disease presentation. The patient had had recurrent polyarthritis, fever and rash for the previous three years. She described having a migratory polyarthritis affecting the shoulders, knees, ankles and bilateral forefoot, with…
MADRID—Researchers say that whole-body MRI could yield an earlier diagnosis of spondyloarthropathy (SpA) in patients with early inflammatory joint symptoms, according to findings presented in a poster session at the Annual European Congress of Rheumatology (EULAR). The approach could lead to earlier treatment and better outcomes, they say. Investigators at the University of Leeds recruited…
A 22-year-old Indian male presented to the emergency department with hemoptysis. A month prior, he had presented to an urgent care center complaining of cough with occasional episodes of blood-tinged sputum in the morning. He was diagnosed with community-acquired pneumonia based on a chest X-ray without laboratory testing and was prescribed levofloxacin. A few days…
A two-year study among patients with knee osteoarthritis (OA) showed that steroid injections for knee pain were no more effective than saline injections and actually reduced cartilage volume more than placebo. The study, conducted at Tufts Medical Center in Boston, looked at progression of cartilage loss and change in knee pain after treatment with placebo…
A recent study has helped researchers gain insight into the genome-wide regulation of mRNA stability in RA fibroblast-like synoviocytes (FLS). Chronic exposure of FLS to tumor necrosis factor appears to increase mRNA stability, enhancing the expression of inflammatory genes and the perpetuation of synovitis…
The Osteoarthritis Research Society International (OARSI) held the 2017 OARSI World Congress in Las Vegas, April 27–30. Below, we report on two of the sessions held. Retinoic Acid & Hand Osteoarthritis Retinoic acid is a vitamin A derivative and hormonal signaling molecule with a role in cartilage and skeletal development. Retinoic acid has complex function,…