A 65-year-old woman was referred by an orthopedist to a rheumatologist for left knee pain. Previously, in 2014, she underwent left total knee arthroplasty (TKA) for severe osteoarthritis in a different institution. Following the procedure, she experienced severe chronic anterolateral knee pain at rest, exacerbated by walking. Because she was rendered wheelchair bound and required…
In March 2020, an elderly married couple living on Long Island, N.Y., presented to our emergency department with symptoms suspicious for COVID-19 infection. The wife, a-76-year-old woman, presented with complaints of subjective fevers, minimal dry cough and headaches of one-week duration. She denied having any chills, rhinorrhea, diarrhea, abdominal pain or shortness of breath. Two…
A timely and personal appeal to all those who can to become or remain civically active in this critical time.
ATLANTA—Macrophage activation syndrome (MAS), a subset of hemophagocytic lymphohistiocytosis (HLH) disease, can be a fatal result of rheumatic disease. But there’s good news: New therapeutic options for refractory MAS targeting individual cytokines are emerging. At the 2019 ACR/ARP Annual Meeting, possible therapeutic options were presented during a pediatric-focused clinical and translational research track, Therapeutic Approaches…
ATLANTA—Managing pediatric patients with rheumatic disease involves special considerations, such as developmental concerns and physiological traits that may affect dosing of medications, according to two experts. During a session at the 2019 ACR/ARP Annual Meeting, Courtney Kremer, ARNP, a pediatric nurse practitioner at the University of Iowa Stead Family Children’s Hospital, Iowa City, and Jessica…
In Canada, five provinces will now reimburse patients with plaque psoriasis who use risankizumab. Also, Canada Health has approved apremilast for treating adults with plaque psoriasis and psoriatic arthritis…
GCA, GPA, myositis, new research—rheumatology care keeps clinicians on their toes & requires them to stay up to date…
How does a patient transition from health to active SLE? This question is the crux of the research conducted by Judith A. James, MD, PhD, and colleagues…
Scenario 1: Direct Billing A 70-year-old female patient with rheumatoid arthritis in multiple joints and positive rheumatoid factor returns to the practice for her fourth infusion of infliximab with the nurse practitioner (NP). She reports no fevers, cough, dyspnea or concurrent illness. She rates the severity of her joint pain at 6 on a 10-point…
The Johns Hopkins Lupus Center, Baltimore, has described its experience using hydroxychloroquine (HCQ) levels.1 Forty-four percent of its patients had levels below 500 ng/mL (partial nonadherence); 13% were severely nonadherent (<200 ng/mL). They were shown their results and educated on HCQ adherence. Adherence then improved to 80%; those with lower HCQ levels had higher disease…