A 68-year-old female patient returns to the office for a second round of Inflectra (infliximab-dyyb) infusion for her rheumatoid arthritis with rheumatoid factor of multiple joints without organ or systems involvement. She reports pain, stiffness and swelling in her left and right knees and right elbow and rates the pain at a 9 on a…
The Diagnostic View: Our Findings
Click here for the case. Discussion Image 1 demonstrates two nodules in the right lung, one over the lateral costophrenic sulcus (2.4 x1.7 cm, not shown); and another in the middle lobe (3.1 x 2.6 cm), with lobulated and spiculated margins (red arrow). There was no lymphadenopathy or pleural effusion. Of note, a normal chest…
The Diagnostic View: Assess Your Rheumatology Knowledge
Editor’s note: In this occasional feature, we first present a series of images (this page) for your review, and then a brief discussion of the findings and diagnosis. Before you read the discussion, examine these images carefully and draw your own conclusions. History A 39-year-old white woman with a three-year history of seropositive rheumatoid arthritis…
ACR Praises Congress for Bill with Part B Fix, Therapy Caps Repeal
The ACR praises Congressional leaders for passing the sweeping spending agreement, which includes a technical provision reversing a Centers for Medicare & Medicaid Services (CMS) policy that would have linked physicians’ quality payment adjustments to Medicare Part B drug costs starting in 2019. The ACR also applauds the inclusion of provisions that permanently repeal Medicare…
Funding Available for Community Practitioners from the Rheumatology Research Foundation
Few opportunities exist for rheumatologists in community-based practice who, in addition to taking care of patients, want to test their own observations through research. Limited funding, time constraints and competition from larger academic medical centers are some of the barriers hindering clinical research in this setting. The Rheumatology Research Foundation is addressing this issue with…
6 Things Endocrinologists Want Rheumatologists to Know
In your daily contact with rheumatology patients, you likely come across several who have type 1 or 2 diabetes. Are you doing all you can to maximize their treatment? Most physicians know about the damaging health effects of uncontrolled diabetes. From vision loss to kidney failure to nerve damage, those with diabetes require regular vigilance…
Rheumatologists Discuss Opportunities, Benefits Found in Retirement
Retirement is not always the closing chapter of a long career. For some rheumatologists, it’s the start of new, fulfilling storylines. “I never thought I wouldn’t practice medicine until I was physically unable to do it anymore,” says Harry Gewanter, MD, who retired from his Richmond, Va., pediatric rheumatology practice two years ago. Dr. Gewanter…
Exciting Advances in Giant Cell Arteritis Diagnosis & Treatment
Baltimore—Rheumatologists and meteorologists share more in common than you might suspect, said Dr. Rebecca Manno, assistant professor of medicine for the Division of Rheumatology at Johns Hopkins University, Baltimore, and assistant director of the Johns Hopkins Vasculitis Center. At a March 8 meeting of the Maryland Society for the Rheumatic Diseases, Dr. Manno used the…
Case Review: MRI Leads to Non-Rheumatic Diagnosis Surprise
Rheumatologists often rely on magnetic resonance imaging (MRI) in the evaluation of suspected muscular diseases. Here, we describe a case in which unexpected findings on MRI pointed to a diagnosis rarely considered as a mimicker of rheumatologic disease. The Case A 19-year-old man of Middle Eastern descent was admitted to our hospital for evaluation of…
Case Report: Refractory Calciphylaxis in Lupus
Calciphylaxis is a poorly understood and life-threatening ischemic vasculopathy characterized by calcification of the small- and medium-size arteries in the skin, subcutaneous tissue and internal organs, which leads to thrombosis, tissue necrosis and painful skin ulcerations that won’t heal. The disease has a 50–80% mortality rate. Although affected patients typically have end-stage renal disease (ESRD)…
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