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Search results for: synovitis

Enthesitis: New Insights into the Pathogenesis, Diagnostic Modalities & Treatment

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Enthesitis is a central feature of spondyloarthritis (SpA). This review article summarizes the substantial progress that has been made in addressing the pathophysiology, molecular mechanisms, genetic associations, clinical features, diagnostic modalities and treatment of enthesitis. Further examination into the role of the inflammatory mediators, including IL-17, IL-22, and IL-23 as well as potentially others, in driving enthesitis and bone formation will be important to direct our attention toward future therapeutic targeted pathways in patients with SpA…

More Evidence Biomarkers Predict RA Relapse with DMARD Taper

Megan Brooks  |  

NEW YORK (Reuters Health)—For rheumatoid arthritis (RA) patients in stable remission, a panel of inflammatory markers in blood can help predict the odds of relapse when disease-modifying anti-rheumatic drug (DMARD) therapy is tapered, say researchers from Germany. The multibiomarker disease activity (MBDA) score, when combined with anticitrullinated protein antibody (ACPA) testing, can predict relapse in…

Case Report: Sternoclavicular Erosions in a Patient with Uncontrolled RA

Diana M. Girnita, MD, PhD, Avis Ware, MD, Sangita Kapur, MD, & Christine Chhakchhuak, MD  |  

Sternoclavicular joint involvement has rarely been reported in the context of active rheumatoid arthritis (RA).1 Traditionally, rheumatologists use serial radiographs of hands and feet to diagnose, monitor for progression or evaluate the response to treatment. The sternoclavicular (SC) joint is not a typical joint assessed for RA. However, the fact that it is a diarthrodial…

Rheumatologist Steven S. Overman Reflects on His Last Day of Practice, Future of Specialty

Steven S. Overman, MD, MPH • illustrations by Alice C. Gray  |  

I am a few weeks post-retirement. Having written thank you notes and completed urgent home projects, I swing in a hammock at our currently fire-threatened cabin north of Winthrop, Wash., and reflect. I feel like a young boy while freely flipping pages of a hand-scribed picture book, The Principles of Uncertainty, by Maira Kalman. She…

Musculoskeletal Ultrasound: A Valuable Tool for Diagnosing Rheumatic Illnesses

Musculoskeletal Ultrasound: A Valuable Tool for Diagnosing Rheumatic Illnesses

Khushboo Sheth, MBBS, & Christopher Scola, MD  |  

Musculoskeletal (MSK) ultrasound is a valuable imaging modality for the practicing rheumatologist and provides an efficient tool with high diagnostic value in the evaluation of patients with musculoskeletal complaints. The use of MSK ultrasound has evolved in the U.S. due to the emergence of less-expensive, portable ultrasound units, which provide high-quality gray-scale and power Doppler…

Case Report: Interstitial Lung Disease with Positive ANCA Test

Sara Tedeschi, MD  |  

“Worst of all is the pain in my calves,” she said. “It feels like burning deep inside.” So began my first encounter with a 69-year-old woman who was referred to rheumatology clinic for evaluation of two months of constitutional symptoms and a positive ANCA test, which had been ordered by her primary care doctor. Her…

Figure 1: Hematoxylin & Eosin Staining

Systemic Lupus Erythematosus Without Kidney Involvement: A Case Report

Paul Hoover, MD, PhD, & Lindsey MacFarlane, MD  |  

A 35-year-old female with a history of systemic lupus erythematosus (SLE) without kidney involvement was admitted to our hospital with low-grade fevers, headache, increasing lower extremity edema and elevated blood pressure. History She was first diagnosed with SLE as a teenager when she developed oral ulcers and pleuritic chest pain and tested positive for anti-Smith…

Fellow’s Forum Case Report: Limited Cutaneous Systemic Sclerosis

Eunjung Kim, MD, Hyun Bae, MD, Ritu Kathuria, MD, Alexandra Gottdiener, MD, & Girish Sonpal, MD, FACR  |  

Systemic sclerosis (SSc) is an acquired, sporadic, autoimmune, connective tissue disease with two subsets: limited cutaneous scleroderma (lcSSc) and diffuse cutaneous scleroderma (dcSSc). In the U.S., the annual incidence is about 20 cases per 1 million adults, with a prevalence of about 240 cases per 1 million adults.1 As with other connective tissue disorders, SSc…

EULAR 2015: Role of ACPA Positivity in Osteoarthritis

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ROME, Italy—The role of ACPA positivity in osteoarthritis is coming more into focus, with results from recent studies by researchers in Germany showing that ACPA positivity apparently works in concert with rheumatoid factor positivity to enhance bone erosion and that ACPA-positive patients show signs of bone erosion before they have clinical signs of arthritis. The…