Discussing aching joints, sore muscles and tender limbs is all in our day’s work. We are rheumatologists; we deal in misery. But trying to parse the true meaning of these terms is among the most vexing of clinical challenges.
Diagnosis Can Be Elusive for Fever of Unknown Origin
Settling into room 501 at Maine Medical Center, Mrs. N was on her way to the bathroom when she felt it coming on. One moment she was okay; the next, her chest felt damp and cold, even as her face flushed and her temperature spiked. Her forehead glistened beads of warm sweat. She felt the…
Scleritis Often Diagnosed by Ophthalmologists, But Rheumatologists Help Determine Systemic Causes
Ophthalmologists may be more likely to initially diagnose and treat scleritis, an inflammation of the scleral tissues of the eye. However, rheumatologists need to remain aware of the condition as well: It’s commonly associated with rheumatic disorders, such as rheumatoid arthritis (RA). Scleritis can present in the eye anteriorly or posteriorly. “Anterior scleritis can be…
2015 ACR/ARHP Annual Meeting: How to Identify, Manage Metabolic Myopathies & Their Mimics
SAN FRANCISCO—An athletic 19-year-old male has an episode of rhabdomyolysis, a breakdown of muscle tissue that leads to contents of muscle fiber in the blood, after weight-lifting and basketball drills. But his labs come back normal. He cuts down on his exercise, but has a second episode four months later, then finally sees a rheumatologist…
How Rural Rheumatologists Are Coping with Passage of Affordable Care Act, Changes in Reimbursement, Payment Systems
Four years ago, a series of articles in The Rheumatologist talked about the practice of rheumatology in rural settings. Since then, changes have occurred, with the passage of the Affordable Care Act (ACA), differences in reimbursement and the trek toward value-based payment systems. One major concern expressed in the original article was the fact that…
Hospital for Special Surgery Focuses on Measuring, Adding Value
Value is the ratio of quality to cost. The delivery and measurement of healthcare quality, however, is complex. “We first need to understand and define the health outcomes that are important to patients. Then we need to put into place care pathways that will lead to those outcomes, and finally we need mechanisms to measure…
Opinion: Role of Rheumatology Nurse Should Be Expanded
The care of patients with rheumatic diseases has undergone a great transition, with high expectations for both patients and healthcare professionals to achieve quality outcomes for the many different disorders. Integral to this goal is the development of new care models, with evolving roles for the various care providers on the multidisciplinary team.1-3 A new…
Opinion: Rheumatologists Cautioned Against Wasteful Testing to Find Rare Diseases
What rheumatologist doesn’t love the good old zebra hunt? You know—the pursuit of diagnosing the extraordinarily rare disease purely through pluck and wits. The zebra hunt is almost a tradition, a perennial topic of polite, but subtly boastful, conversation among peers and the subject of numerous career-building case reports. The hunt also happens to be…
From the Expert: New Insights into Treating Pregnant Patients with Rheumatic Disease
The approach of under-treating rheumatic disease in pregnant patients is changing, according to Bonnie Lee Bermas, MD. Dr. Bermas discusses with The Rheumatologist the need for more research on how drugs affect this patient group, and how timing of conception and disease stability play important roles in the safe outcomes of mother and infant…
Patients Get Mixed Reactions from Docs over Mail-Ordered Genetic Tests
(Reuters Health)—Patients who order direct-to-consumer genetic tests report mixed experiences when they take the results to their doctors, a new study found. About a quarter of people who ordered direct-to-consumer genetic testing from such companies as 23andMe reported discussing the results with their primary care doctors. But nearly one in five were not at all…
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