Abscesses are typically caused by infections, but some are, instead, sterile. Aseptic abscesses (AAs) are characterized by the same neutrophil-rich histopathology as infectious abscesses; however, they don’t improve with antibiotics. Rather, AAs require treatment with anti-inflammatory medications. Although relatively rare, this phenomenon is important for rheumatologists to recognize given its frequent association with underlying systemic…
Rheumatologists who are outstanding clinicians, providing consistently exceptional care to patients and serving as role models for colleagues and trainees, are highlighted in our Lessons from a Master Clinician series. Here, we offer insights from clinicians who have achieved a level of distinction in the field of rheumatology. Jonathan Kay, MD, is professor of medicine,…
During the peak of the coronavirus pandemic in Washington, D.C., we were asked to evaluate a 14-year-old boy admitted to the pediatric hospitalist service. He had been healthy until two weeks before, when he noted a sore throat, and soon after he developed fevers and rashes without congestion, shortness of breath, conjunctivitis or swollen lymph…
Lipoma arborescens is a rare, benign intra-articular lesion characterized by diffuse replacement of synovial tissue by mature adipocytes, causing a villous lipomatous proliferation of the synovial membrane.1 Typically, this is a monoarticular condition, with the knee being the most commonly affected although it has been rarely reported to occur in an oligo-/polyarticular fashion and in…
NEW YORK (Reuters Health)—A single injection into the hip of steroid and local anesthetic improved pain and function in patients with hip osteoarthritis in a randomized controlled trial, with most of the benefit seen early after treatment. Researchers at two community-based clinics in England assigned 199 volunteers to receive either an ultrasound guided intra-articular hip…
The axial phenotype of psoriatic arthritis (axPsA) is an excellent example of a major controversy in rheumatology that has become the focus of attention because of the emergence of new therapies with different mechanisms of action for alleviating joint inflammation. It was first described in 1961 but, until recently, it has largely remained under the…
The etiology of psoriatic arthritis (PsA) is poorly understood but current evidence supports an interaction between genetic and environmental factors that coalesce to promote local tissue inflammation.1-3 The pivotal cytokines that underlie the local inflammatory response in a wide range of tissues are interleukin (IL) 23, IL-17 and tumor necrosis factor (TNF).4 The central contribution…
As the cloud moved away from the tent, Miriam’s skin suddenly became diseased, as white as snow. When Aaron turned toward her, he saw that she was diseased. —Numbers 12:10 For 29 years he [Fray Pedro de Urraca] was afflicted by … pain, suffering it at once in all the joints of his body, with…
Two new ACR Clinical Practice Guidelines provide recommendations on the pharmacologic management of JIA, focusing on treatment of oligoarthritis, temporomandibular arthritis & systemic JIA, as well as nonpharmacologic therapies, medication monitoring, immunizations & imaging.
A 44-year-old woman presented to the emergency department with bifrontal headaches that had started approximately one month earlier. She was diagnosed with migraines and discharged home. Three days later, the patient returned to the emergency department upon recurrence of her headaches, and this time she also reported abnormal leg movements. A computerized tomography (CT) scan…