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Articles tagged with "Clinical"

APS: What Rheumatologists Should Know about Hughes Syndrome

Graham R.V. Hughes, MD, FRCP  |  February 17, 2016

The problem that dogs the work of all of those treating patients with antiphospholipid syndrome (APS) is the apparent lack of knowledge of the syndrome, both by the general public, as well as by swaths of the medical fraternity. Perhaps it was ever thus—a syndrome less than 40 years old could be described as new,…

Case Study in Dermatology: Tender Papules on Elbows, Hands in RA

Drew Kurtzman, MD, & Timothy McCalmont, MD, with Ruth Ann Vleugels, MD, MPH, & Joseph F. Merola, MD, MMSc  |  February 17, 2016

The Case A 41-year-old woman was referred to the dermatology clinic for a three-month history of tender lesions on her elbows and around the joints of her hands. Her medical history was notable for seropositive, non-erosive rheumatoid arthritis (RA), which was being treated with 5 mg pred­nisone daily, 10 mg methotrexate weekly by mouth, 200…

Rheumatology Case Report: Chondromyxoid Fibroma of the Sternum

Rajaie Namas, MD, Reshma Khan, MD, & Bernard Rubin, DO  |  February 16, 2016

A 47-year-old Caucasian woman presented to the rheumatology clinic with a one-year history of pain and swelling involving the wrists, hands, ankles and feet that progressively worsened. Her symptoms included generalized fatigue, morning stiffness in the hands and lower back lasting more than an hour, Raynaud’s phenomena (triphasic), photosensitivity, tightening of the skin of the…

Case Report: Sternoclavicular Erosions in a Patient with Uncontrolled RA

Diana M. Girnita, MD, PhD, Avis Ware, MD, Sangita Kapur, MD, & Christine Chhakchhuak, MD  |  December 17, 2015

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…

Clues to Diagnosing, Managing Vanishing Aneurysms

Taral Parikh, MD, G.C. Yathish, MD, Parikshit Sagdeo, MD, Balakrishnan Canchi, MD, & Gurmeet Mangat, MD  |  December 16, 2015

Case report: A 27-year-old male was referred to the rheumatology outpatient department in February 2015 from the urology department after complaining of recent-onset uncontrolled hypertension (220/160 mmHg), headache and vomiting. In 2010, he was admitted to the urologist for sudden-onset left lumbar region pain and recent-onset hypertension. Clinical examination and the blood tests were normal….

Rheumatology Fellow Questions Diagnostic Utility of Patient Physical Exam

Bharat Kumar, MD, MME, FACP, FAAAAI, RhMSUS  |  November 17, 2015

“Do you seriously want me to stand on my tiptoes?” my gruff 68-year-old patient at the VA Rheumatology Clinic asked, incredulous. “I came with a walker. I think you very well know, doc, that if I get on my tippy-toes, then I’m going to fall flat on my face.” He had a point, one that…

Sjögrens Syndrome: The Need to Bridge Patient Symptoms & Objective Findings

Sjögrens Syndrome: The Need to Bridge Patient Symptoms & Objective Findings

Robert I. Fox, MD, PhD, & Carla M. Fox, RN  |  November 17, 2015

Despite a generation of advances in molecular biology, a huge gap exists between the Sjögren’s syndrome (SS) patient’s description of their symptoms and the objective findings. Current issues include: Many SS patients are misclassified as either rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE), even within rheumatology clinics. Frequently, the sickest SS patients with extraglandular…

Fellows’ Forum Case Report: Palmar Fasciitis & Polyarthritis Syndrome

Naveen Raj, DO, MPH, Marc Kesselman, DO, & Barry Waters, MD  |  November 16, 2015

Case report: A 78-year-old Caucasian female presented to our outpatient rheumatology clinic with pain in her bilateral shoulders, hands and knees that began suddenly one month earlier. She admitted to stiffness in her hands lasting several hours, and expressed an inability to extend her fingers. She denied fever, rashes, jaw claudication, headache or visual changes….

Musculoskeletal Ultrasound: A Valuable Tool for Diagnosing Rheumatic Illnesses

Musculoskeletal Ultrasound: A Valuable Tool for Diagnosing Rheumatic Illnesses

Khushboo Sheth, MBBS, & Christopher Scola, MD  |  October 15, 2015

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…

Rheumatologist Nathan Wei, MD, Focuses on Alternatives to Surgery for Athletes

Eric Butterman  |  October 14, 2015

Nathan Wei, MD, FACP, FACR, admits that he didn’t exactly agree with the amount certain things were encouraged in his family. “Aspects such as academics and music were focused on so much,” he says. “I wanted to break out from that upbringing. I wanted to add in more of what I wanted to do.” And…

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