Since the beginning of the pandemic, the ACR’s Committee on Training and Workforce (COTW) has been interested in better understanding how fellowship recruitment is affected by virtual recruitment from the perspectives of both program directors and trainees. This past year, the COTW conducted a survey study to gain the perspective of program directors.1 The Rheumatology…
Scleromyxedema is a primary cutaneous mucinosis characterized by a diffuse and generalized papular skin eruption of mucinous deposits throughout the upper dermis. In addition to dermatologic manifestations, scleromyxedema may involve the cardiopulmonary, gastrointestinal, renal and nervous systems. Dermato-neuro syndrome (DNS) is a rare, severe neurologic complication of scleromyxedema.1,2 The pathogenesis of DNS is unknown, but…
Acute febrile neutrophilic dermatosis, or Sweet syndrome, is an inflammatory disease that classically presents with fever, leukocytosis and tender, erythematous plaques characterized by neutrophilic infiltrates on biopsy. Sweet syndrome has been reported in association with several autoimmune diseases, including inflammatory bowel disease, systemic lupus erythematous, rheumatoid arthritis and sarcoidosis.1 Here, we discuss a case of…
Constructing a safe space for reporting errors is important & enables medical trainees to grow, making them better learners and scholars, and faculty members and patients to express their concerns. During a session at the 2022 ACR Education Exchange, Karina Torralba, MD, MACM, RhMSUS, provided insights into how to manage the barriers to fostering such a workplace culture.
The growing rheumatologist workforce shortage has loomed over the profession, threatening to undercut the delivery of care to the increasing number of patients with rheumatic conditions. “The workforce shortage is an existential threat to the field of rheumatology and to the care we deliver to our patients,” says ACR President Kenneth Saag, MD, who lauded…
The COVID-19 pandemic has filled hospitals with patients with rapidly progressive respiratory failure and diffuse bilateral opacities on chest X-ray.1 Additionally, many patients with severe COVID-19 develop acute kidney injury and require dialysis.2 Pulmonary-renal syndromes are also important to consider in this setting. Although alveolar hemorrhage is a cardinal feature of this syndrome, many patients…
Sarcoidosis is a multisystem disease characterized by noncaseating granulomas in affected tissues, mostly involving the lungs and lymph nodes.1,2 The etiology of sarcoidosis remains unknown but is thought to be due to an inflammatory response to an antigen exposure in genetically predisposed individuals.1 Tumor necrosis factor-α (TNF‑α), a pro-inflammatory cytokine, plays an essential role in…
A 26-year-old woman presented to our emergency department (ED) with intermittent fevers, nausea and vomiting. She had a past medical history of well-controlled, anti-nuclear antibody positive and rheumatoid factor negative polyarticular juvenile idiopathic arthritis (pJIA) and Crohn’s disease. Her maintenance treatment consisted of monthly intravenous infliximab, 10 mg of oral methotrexate weekly and 20 mg…
As rheumatology fellows approach the end of what for many is 25th grade, it’s time to focus on what you want to do for the rest of your life. For most rheumatology fellows it will be some form of clinical practice, although enormous opportunities exist throughout the medical field for you to apply your talents….
Polyarteritis nodosa (PAN) is a systemic necrotizing vasculitis that typically affects medium-sized muscular arteries. The clinical subsets of PAN are idiopathic, generalized, secondary hepatitis B virus (HBV) associated and cutaneous PAN. These clinical subsets are important because of their therapeutic implications. Virtually any organ system can be affected in generalized PAN, but this vasculitis tends…