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Case Report: Ultrasound Reveals Cause of Post-Arthroplasty Knee Pain
A 65-year-old woman was referred by an orthopedist to a rheumatologist for left knee pain. Previously, in 2014, she underwent left total knee arthroplasty (TKA) for severe osteoarthritis in a different institution. Following the procedure, she experienced severe chronic anterolateral knee pain at rest, exacerbated by walking. Because she was rendered wheelchair bound and required…
Ultrasound Aids Diagnosis of Man with Knee Pain & Swelling
A 56-year-old automobile mechanic was referred to our rheumatology service by his orthopedist to evaluate left posterior knee pain and swelling that had been present for three months. The patient had undergone bilateral total knee arthroplasties (TKAs) for sports-related osteoarthritis three years before. In addition to the knee pain, the patient described several years of…
Collaborative Guideline Addresses the Perioperative Use of Antirheumatic Drug Therapy
A new guideline developed by the ACR and the American Association of Hip and Knee Surgeons addresses the perioperative use of antirheumatic drug therapy. Specifically, it provides recommendations on the use of traditional disease-modifying antirheumatic drugs, biologic agents, tofacitinib and glucocorticoids in adults with RA; SpA, including ankylosing spondylitis and psoriatic arthritis; JIA; or SLE undergoing elective THA or TKA. The guideline provides recommendations regarding when to continue, when to withhold and when to restart these medications, and the optimal perioperative dosing of glucocorticoids…
Pain Management Research Sheds Light on Postsurgical Pain Sensitization, Opioid Risks, Nondrug Interventions
WASHINGTON, D.C.—Successful management of pain remains a challenge for rheumatologists. Five research abstracts presented at the 2016 ACR/ARHP Annual Meeting in a session titled Pain—Basic and Clinical Aspects offered new insights on pain sensitization, and the risks and effects of various pain therapies. Knee Pain After Surgery Can we predict which patients will have longer-term…