I have worked as an advanced practice provider (APP) in pediatric rheumatology for nearly 16 years. My collaborating physicians have allowed me to function to the full extent of my scope of practice while allowing me to develop professionally within the subspecialty. My latest endeavor has been learning how to perform musculoskeletal ultrasound (MSUS) and…
If approved by the U.S. Food and Drug Administration (FDA), difficult-to-treat patients with axial spondyloarthritis who fail or are intolerant to standard treatment with tumor necrosis factor inhibitors (TNFi) may have a new treatment option. That new option is a high-affinity monoclonal antibody, called ixekizumab, which selectively targets an area linked to the immunopathology of…
SAN FRANCISCO—The challenges of trying to solve the puzzle of lupus, in light of its broad heterogeneity of symptoms, manifestations in clinical involvement and treatment response, and the sheer complexities of the immune system, are driving researchers into ever more elaborate investigations of how the immune system functions in lupus patients. Genetic, transcriptomic and epigenetic…
SAN FRANCISCO—The 13th International Congress on Systemic Lupus Erythematosus (SLE), held April 5–8, highlighted continuing advances in the fight against lupus, a chronic, inflammatory, autoimmune disease affecting multiple organ systems. The rheumatologist’s ability to control this incurable and life-threatening condition is limited both by its heterogeneous presentation and by the lack of successful treatment options,…
A recent analysis of retrospective clinical data on patients with systemic lupus erythematosus (SLE) at 14 Canadian centers found that a surprisingly high proportion—at least one-third—had active disease at any point over five years of data collection.1 It has been a longstanding belief among clinicians that SLE becomes less active over time, although its accumulation…
Kim Steinbarger, PT, MHS, knows how physical and occupational therapy can make a difference for patients with rheumatic diseases. Ms. Steinbarger was just two years into her career as a physical therapist (PT) when she was diagnosed with rheumatoid arthritis (RA) in 1991. “I’ve seen how regular exercise serves as an important tool in managing…
Eosinophilic gastroenteritis (EGE) is a rare condition caused by eosinophilic infiltration of the gastrointestinal (GI) tract. The condition is subdivided into the GI layers it affects: mucosal, muscular and subserosal.1 EGE usually presents with non-specific GI symptoms, such as impaired motility, intestinal obstruction and, rarely, ascites.2 Below, we report a rare case of EGE leading…
Monosodium urate (MSU) crystal deposition commonly occurs within the distal appendicular skeleton. The peripheral nature of gout is a hallmark feature described in the ACR and the European League Against Rheumatism (EULAR) clinical practice guidelines.1 In this article, we report a rare presentation of a common disease: a case of axial gouty arthropathy masquerading as…
We have often heard it said that opportunity arises from challenges. Challenge, of course, is really just a polite way of saying problem—and for our patients, problems abound when it comes to obtaining timely and affordable access to the rheumatologic care they need. Access in this context has many meanings: There is access to life-changing…
I would like to tell you a story. Two, actually. I am just returning from the 19th International Vasculitis and ANCA Workshop, which is always a fascinating meeting. In its inception, it was a workshop, in the true sense of the word. Now, we discuss anti-neutrophil cytoplasmic antibody (ANCA) testing as casually as we discuss…