As a manifestation of hyperuricemia, inflammatory bullous lesions have rarely been described in the past century. A more classic presentation of hyperuricemia is acute inflammatory gouty arthritis, characterized by the deposition of monosodium urate crystals. Other complications of chronic untreated hyperuricemia may include polyarticular arthritis, tophus formation and possible chronic destructive lesions of the bone,…
A 66-year-old woman returns to the office for a follow-up visit. She is seen by the physician assistant (PA) for her rheumatoid arthritis. She is experiencing burning pain in her right knee, and she reports that after going for her morning walk, she rates the pain at a 6 on a scale of 10. She…
A 66-year-old female patient returns to the office complaining of swelling and a burning pain in her right first toe. She rates the pain level at a 9 out of 10. She currently takes an over-the-counter non-steroidal anti-inflammatory drug (NSAID), but it has done little to alleviate the pain. This is her second episode this…
CHICAGO—A clustering of cases in Lyme, Conn., in 1975 led to the discovery of Lyme disease. Allen C. Steere, MD, professor of medicine at Harvard Medical School in Boston, investigated that outbreak, and he shared his knowledge of Lyme disease with rheumatologists gathered at the ACR’s State-of-the-Art Clinical Symposium in April. He explained that Lyme arthritis…
Highlights from the 2017 EULAR Congress 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…
The first clinical practice guidelines for Sjögren’s syndrome have been released, the culmination of an initiative by the Sjögren’s Syndrome Foundation.1 These standard-of-care recommendations are intended to provide consistency in practice patterns, inform coverage and reimbursement policies, lead to the design and implementation of educational programs, highlight the needs for future research and fill a…
Rheumatologists treating HIV patients in 2017 must think through many important factors as this population ages. As we continue to learn, rheumatologists must consider important drug–drug interactions, relatively uncommon rheumatological presentations of HIV, as well as specific diagnostic challenges. Working closely with infectious disease specialists is the best way to achieve optimum care for this…
In a recent study, researchers examined the osteoclastogenic role of the histamine 4 receptor (H4R), measuring the peripheral blood and synovial fluid monocytes in patients with RA. Results showed that multiple cytokines stimulated H4R expression, suggesting the blockage of H4R may be a useful drug target to decrease the joint damage associated with RA…
A 53-year-old female presented to the clinic for severe polyarticular joint pain and was found to have a seronegative inflammatory arthritis. Six months before, she had completed 10 months of treatment for stage IV metastatic melanoma with the immune checkpoint inhibitors, nivolumab and ipilimumab, achieving complete remission of her cancer. She said that throughout her…
A 56-year-old African American man presents to the emergency department with polyarthralgias and a fever of 103ºF. One month prior to admission, he presented with right knee pain and swelling. Blood cultures grew S. epidermidis. He was treated for presumed septic arthritis complicated by MSSE bacteremia. He was treated with meropenem and a prolonged course…