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Articles tagged with "Diagnosis"

Diagnostic Imaging in Patient with Left Hip Pain: Findings

Jennifer L. Demertzis, MD  |  August 18, 2015

View the question. Findings/Diagnosis The AP radiograph of the left hip (see Figure 1) shows periarticular, well-defined erosions of the left hip (white arrow) without joint space narrowing or osteophytes. There is no fracture. There are surgical clips and a calcified mass in the right hemipelvis (black ellipsis), representing a failed renal transplant. The coronal STIR…

EULAR 2015: RA Research Shows Imperfect Guidelines, Suggests Strategies with Biologics

Thomas R. Collins  |  August 17, 2015

ROME, Italy—Even with classification criteria that have been updated and refined over time, rheumatoid arthritis is still a diagnosis that ultimately has to be made with clinical judgment, said Ronald van Vollenhoven, MD, PhD, professor of medicine and chief of clinical therapy research in inflammatory diseases at the Karolinska University in Sweden. His remarks came…

Catastrophic Antiphospholipid Syndrome with Pulmonary Hemorrhage: A Case Report

Joy-Ann Tabanor, MD, Hyun Bae, MD, Girish Sonpal, MD, & Karlene Williams, MD  |  August 17, 2015

Antiphospholipid syndrome (APS) is an autoimmune condition characterized by hypercoagulability often manifested as recurrent thrombosis or pregnancy complications, with persistently circulating antiphospholipid (aPL) antibodies or lupus anticoagulant. Catastrophic APS (CAPS), also known as Asherson syndrome, occurs in less than 1% of cases of APS and involves occlusive microangiopathy in at least three organ systems.1 Case…

How to Deliver Difficult News about Patients' Diagnoses

How to Deliver Difficult News about Patients’ Diagnoses

Karen Appold  |  July 14, 2015

Telling a patient that he or she has been diagnosed with rheumatoid arthritis (RA), ankylosing spondylitis, fibromyalgia or another debilitating, painful and/or chronic condition can be upsetting for a patient to hear and difficult for a rheumatologist to convey. Given this, it’s important to prepare for the appointment. “Take a few minutes beforehand to contemplate…

Polymyalgia Rheumatica Misdiagnosis Results in Positive Outcome

Hiroshi Watanabe, MD, PhD  |  July 14, 2015

In late February 2011, a 68-year-old woman visited the rheumatology outpatient clinic. She had been congenitally healthy and had been a field athlete in her early days. Beginning in early January 2011, she became aware of pain in her neck and both shoulders, with pain spreading to her lower back and thighs. She also became…

The ACR’s State-of-the-Art Clinical Symposium: Rheumatic, Malignant Disease Mimics Call for Diligence from Rheumatologists

Thomas R. Collins  |  July 14, 2015

CHICAGO—David Daikh, MD, PhD, professor of medicine at the University of California San Francisco and chief of the Rheumatology Division at the San Francisco VA Medical Center, said the overlap between malignant disease and rheumatic disease means rheumatologists should stay aware that more may be going on than just a rheumatic disorder. He made his…

Diagnostic Imaging in Patient with Atraumatic Left Shoulder Pain: History

Jennifer L. Demertzis, MD  |  July 14, 2015

Editor’s note: In this recurring feature, we first present a series of images (this page) for your review, and then a brief discussion of the findings and diagnosis. Before you turn to the discussion, examine these images carefully and draw your own conclusions. History A 56-year-old man with end-stage renal disease on peritoneal dialysis presents…

Diagnostic Imaging in Patient with Atraumatic Left Shoulder Pain: Findings

Jennifer L. Demertzis, MD  |  July 14, 2015

View the question. Findings/Diagnosis The AP radiograph of the left shoulder (see Figure 1) shows erosions of the proximal humeral and glenoid articular surfaces (black arrows) without joint-space narrowing. There is a well-defined marginal erosion with overhanging edge at the junction of the proximal humeral articular surface and rotator cuff insertion on the greater tuberosity (ellipse)….

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Eosinophilia: A Diagnostic Evaluation Guide for Rheumatologists

Praveen Akuthota, MD, Aryeh Fischer, MD, & Michael E. Wechsler, MD  |  June 15, 2015

Clinical Vignette A 45-year-old woman with long-standing asthma and chronic sinusitis has new-onset peripheral neuropathy, arthralgias, fatigue, progressive dyspnea and a nonproductive cough. She has never smoked and has no environmental exposures. Her medications include an albuterol metered-dose inhaler (which she uses daily); an inhaled corticosteroid, montelukast; and ibuprofen (which she takes occasionally). She is…

Rheumatologist Recalls Personal Experience with RA

Monica Piecyk, MD  |  May 15, 2015

In late March 2012, I awoke with pain in my left hand. I had difficulty moving my metacarpophalangeal (MCP) joints. They did not move smoothly, but clunked. As I repeatedly attempted to open and close my hand, I realized that I had morning stiffness. As the pain and stiffness gradually improved over the next hour,…

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