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…
Case A 46-year-old Caucasian female presented to the outpatient rheumatology clinic where she had been followed for several years. Her chief complaint was pain in her right knee, posterior right thigh and right hip that had begun gradually over the previous three weeks. Her past medical history was significant for rheumatoid arthritis (RA), obesity and…
The clinical practice guidelines for managing Sjögren’s syndrome, developed by the Sjögren’s Syndrome Foundation with the ACR, were designed to improve quality and consistency of care. In total, 19 recommendations were agreed on, which include managing the rheumatic and systemic aspects of the disease. Recommendations include a decision tree for the use of DMARDs for inflammatory musculoskeletal pain, use of self-care measures and exercise to reduce fatigue, and the use of rituximab in selected clinical settings for oral and ocular dryness…
A 13-year-old black male, described by his mother as a very active and energetic child, is referred to a pediatric rheumatologist. His chief complaint is muscle pain in both legs, which he has experienced for the past three weeks. His mother is a patient of an adult rheumatologist at this clinic and is quite concerned….
Antisynthetase syndrome (AS) is strongly associated with the presence of antibodies to aminoacyl-transfer RNA (tRNA) synthetases (ARSs) that are implicated in the pathogenesis of myositis and interstitial lung disease (ILD). Antibodies against eight antisynthetases have been identified and are detected in 16–26% of patients with idiopathic inflammatory myopathies (IIM).1 Serum assays for five of these…
WASHINGTON, D.C.—Often, no clear explanation exists in neutrophilic dermatosis cases that links a patient’s skin disorder with an internal condition, expert Joseph Jorizzo, MD, professor, founder and former chair of the Dermatology Department at Wake Forest University in Winston-Salem, N.C., and professor of clinical dermatology at Wevascularill Cornell Medical College in New York, told attendees…
WASHINGTON, D.C.—“Rheumatic manifestations are [often] the initial presentation of a systemic disease, but they can [also] occur during the course of the disorder,” said Joseph Markenson, MD, speaking in the ACR/ARHP Annual Meeting talk, Rheumatic Manifestations of Endocrine Disease, during the ACR Review Course. Dr. Markenson is professor of clinical medicine and a rheumatologist at Weill…
When treating adolescent patients who are making the important, sometimes bumpy crossing from a pediatric to an adult rheumatology practice, there’s no one-size-fits-all approach. “We have to be flexible on the receiving end when talking with these patients, and flexible with their families, too,” says Peter A. Nigrovic, MD, director of the Center for Adults…
Established wisdom holds that patients with rheumatoid arthritis (RA) will fare better if their disease is diagnosed as early as possible, and treatments with disease-modifying drugs are started before inflammation can do more damage to joints and tissue. Usually, early diagnosis means spotting the clinical signs of disease, but new research tells us more about…