Rheumatoid arthritis (RA) is a chronic systemic autoimmune inflammatory disease. Although RA develops its central pathology within the synovium of diarthrodial joints, many non-articular organs can be involved, particularly in patients with severe joint disease.1 Although most patients are asymptomatic, cardiac involvement is relatively common and includes rheumatic heart nodules, pericarditis (30–50%), pericardial effusion and…
At the close of my first year in fellowship, a co-fellow opened a packed cabinet behind her desk, and untold volumes of methodically annotated medical articles burst forth. Impressed not only by her diligence but also by the sheer volume of paper, I made a mental note to read more and to read more efficiently….
We spend a good portion of our day in front of screens—televisions, computers, tablets, phones and more. Social media (#SoMe) use has been on the rise, and its marriage to medicine seems inevitable. Merriam-Webster, aka America’s most trusted online dictionary, defines social media as forms of electronic communication through which users create online communities to…
As the shortage of rheumatologists is expected to worsen, practices and fellowship programs are asking how to attract top talent. Here are tips for how individuals can raise rheumatology’s profile and reach out to med students and new rheumatologists…
If you read The Rheumatologist regularly, you may remember a column I wrote a few months ago about giving and receiving feedback (July 2017). I wrote it when I was finishing fellowship and looking back at six years of my graduate medical education. Now, as an attending physician who spends a considerable amount of time…
The Presentation A pale, quiet woman—her mother—wheeled the girl into my clinic. It was a blistering Florida day, and the girl was shivering. She glanced up at me when I said hello and asked her name. “Hi,” she said, giving me a broad smile. Her smile was the only broad thing about her. Her elbows…
Necrotizing autoimmune myopathy (NAM) is a relatively recently discovered subgroup of inflammatory myopathies. NAM is characterized by predominant muscle fiber necrosis and regeneration with little or no inflammation.1 One subgroup of NAM is 3-hydroxy-3-methylglutaryl-CoA reductase antibody (HMGCR Ab)-related immune-mediated necrotizing myopathy (IMNM), which occurs (rarely) after statin exposure, with a rough incidence of two per…
During the two or three short years of a rheumatology fellowship, there is so much to learn: the subtle art of the musculoskeletal examination, the intricacies of the immune system and the indications for a dizzyingly increasing array of new medications, to name just a few topics. One topic that you rarely hear about, but…
A 51-year-old Caucasian female was referred by a local rheumatologist to the Center of Autoinflammatory Diseases at Stony Brook University, N.Y., for an unusual disease presentation. The patient had had recurrent polyarthritis, fever and rash for the previous three years. She described having a migratory polyarthritis affecting the shoulders, knees, ankles and bilateral forefoot, with…
The ACR Rheumatology Research Workshop (RRW) is a two-day meeting designed to promote interactions between early and established investigators to foster collaboration and facilitate career mentoring. The RRW is targeted to rheumatology fellows, junior faculty, medical/graduate students, and residents interested in learning more about how to succeed in a research career for rheumatology. RRW is…