Low back pain (LBP) is one of the most common reasons for physician appointments. However, treatment results remain suboptimal, resulting in high rates of chronic pain, narcotic usage, surgery, depression and disability—all at great cost to individuals and the nation. One reason for this is the current practice of grouping all low back pain patients…
Recognizing the need to provide guidance on the current disparate management of polymyalgia rheumatica (PMR), the American College of Rheumatology (ACR), in collaboration with the European League Against Rheumatism (EULAR), recently published the first international set of recommendations for the screening, treatment and management of PMR.1,2 Specifically, the recommendations offer guidance on the use of…
A recent trend to incorporate patient-reported outcomes (PROs) in clinical research, and ultimately clinical practice, is a response to the need to better measure and treat what patients truly care about, and adapt to the changing healthcare environment, which increasingly includes patient satisfaction as a key metric for overall quality of care, a metric tied…
James K. Smith, MD, believes in thinking several moves ahead. Consider your opponent. Gauge your strategy. Be aggressive when you need to be. Those are key aspects of his philosophy in rheumatology—and chess. Initiation Dr. Smith’s love of chess started after he had started his family. “I first got involved in the game through my…
Patient education has always been at the core of the nursing profession. Nurses pride themselves on being great teachers and patient advocates. When self-injectable biologics were first introduced to the market, one of the main goals was to make patients independent and put them in the driver’s seat of their own care. Yet without a…
Gout affects nearly 4% of American adults, causing joint inflammation, pain and crystal deposits that may lead to bone erosion over time. At least five different classification criteria for gout are used worldwide, creating potential discrepancies in clinical trial enrollment and eventual results. An international panel of investigators collaborated to create new, standardized gout classification…
“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…
As the Association of Rheumatology Health Professionals (ARHP) continues to celebrate its 50th anniversary, The Rheumatologist recently spent time with Charter Member and Past President Marlin N. Shields, RPT, discussing the history of the ARHP and the changes he has seen in rheumatology. One topic that was, and remains, near and dear to him is…
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…
I sometimes find myself mired in sticky clinical circumstances. I am facing a distraught patient who is seeking my opinion about a condition that, according to some, may not truly belong in the rheumatologist’s bailiwick. Case example: hearing loss. The Steroid Test Sudden sensorineural hearing loss (SSNHL) and its relative, autoimmune inner ear disease (AIED),…