Shrinking lung syndrome (SLS) is a rare cause of dyspnea that has been most commonly described in patients with systemic lupus erythematosus (SLE), but is also found in systemic sclerosis, Sjögren’s disease and rheumatoid arthritis. Shrinking lung syndrome is characterized by a restrictive pattern on lung spirometry, despite normal lung parenchyma, and an elevated diaphragm.1…
The Case A 47-year-old woman presented with a one-year history of bilateral submandibular gland swelling, mild symptoms of xerostomia and xerophthalmia and arthralgias in her fingers. A review of systems was otherwise unremarkable. On physical examination, her submandibular glands on both sides were enlarged and had a firm texture. Her parotid glands were normal, as…
In medicine, as in advertising, pictures can be worth a thousand words. From arthritis to vasculitis, imaging studies have been variably employed to aid in the diagnosis, treatment, risk stratification and prognostication of patients with rheumatic and musculoskeletal disorders. The same holds true with the idiopathic inflammatory myopathies (IIM), in which the clinical utility is…
The Case A 56-year-old white woman was evaluated for a one-year history of painless bumps on the dorsal aspect of the proximal interphalangeal (PIP) joints of both hands and suspected flexor tenosynovitis in her palms. On examination, small cystic nodules without erythema or tenderness were present on the dorsal aspect of several PIP joints (see…
This EULAR 2022 session discussed the increasing role of imaging in the diagnosis of gout.
A 17-year-old woman presents with chronic finger pain experienced over six months that is worse in the mornings. On physical exam, the patient has no joint swelling, pain on range of motion or limitation of range of motion in any of her finger joints. She has a tender, subcutaneous, firm, flesh-colored nodule on the lateral…
At the 17th Annual Advances in the Diagnosis & Treatment of the Rheumatic Diseases meeting, Dana DiRenzo, MD, MHS, RhMSUS, discussed the use of ultrasound imaging in patients with inflammatory arthritis.
A 51-year-old man with a history of limited systemic sclerosis with Raynaud’s phenomenon and pulmonary hypertension being treated with tadalafil and macitentan presented to a clinic with ulceration of his right pinkie. The patient had injured the finger two months earlier. He reported poor healing and the presence of a persistent ulcer since the injury….
Ultrasound may provide unique insights into the effects of immune checkpoint inhibitors on the human body beyond the immune system. Research suggests synovitis and inflammatory tendon involvement are commonly seen in patients with immune checkpoint inhibitor-induced inflammatory arthritis.
A 27-year-old, left-handed man was referred to our ultrasound clinic for left elbow pain. History The patient had been a pitcher on a Minor League Baseball team. Two years before, he developed sudden, severe medial elbow pain while pitching in a game. The pain was associated with some tingling down the left medial forearm. The…