Avoiding real and apparent conflicts of interest is a fundamental principle of guideline development, but what should we do when every thought leader is conflicted? An example of this conundrum in rheumatology has been the ACR’s ongoing effort to establish guidelines for the management of lupus nephritis, which has been stymied by the fact that…
Periungual Erythema & Its Translation on Nailfold Videocapillaroscopy in a Patient with Very Early Systemic Sclerosis A 66-year-old woman presented with Raynaud’s phenomenon and periungual erythema. HEp-2 immunofluorescence assay was positive for antinuclear antibodies, showing a centromere pattern. The presence of anti-centromere antibodies was confirmed by chemiluminescent immunoassay. The patient was diagnosed with very early…
Women are substantially under-represented among the recipients of major awards in rheumatology, according to a 2022 study by Halling et al., which looked at the gender award gap in North America and Europe over the past two decades.1 This trend is also seen in other fields, with only one woman winning the Fields Medal in…
COVID-19 causes myriad cardiac dysfunctions, ranging from mild to fulminant disease, including myocarditis, acute congestive heart failure, cardiogenic shock and sudden cardiac death.1,2 COVID-19 myocarditis can mimic cardiac sarcoidosis clinically and on cardiac imaging, which can lead to diagnostic challenges and treatment delays. We present a case of cardiac sarcoidosis with interval development of metabolic…
I have been reading Yuval Harari’s thought-provoking and engaging book, Sapiens: A Brief History of Humankind, about our species’ struggles and the path that led to our emergence as the predominant species. I was captivated by the drawing of the hand of one of our ancestors and mused about what that forebear was thinking as…
A plain X-ray film appeared on the computer screen—a humerus, a radius and an ulna were all visible. My pupils zoomed around the screen, and on initial inspection, everything looked fine. However, this X-ray was unlike any film I had ever reviewed. You see, it was for my then 4-year-old puppy, Lexi. My sweet little…
Rheumatologists are often called upon to see patients with unexplained symptoms and mysterious illnesses and to manage disease, sometimes with a dearth of evidence. Patients in rheumatology practices also tend to explore treatment modalities outside of the established medical model, sometimes referred to as fringe medicine. Complementary and alternative medicine practices that comprise fringe medicine…
Adami et al. examined the fracture risk associated with glucocorticoid treatment in women with inflammatory rheumatic musculoskeletal diseases, finding that low-dose glucocorticoid use may result in significant bone mineral density loss in patients who are not on anti-osteoporotic drugs.
Through the development of position statements that lay out the ACR’s official stance on issues related to the management of rheumatic and musculoskeletal conditions, the Committee on Rheumatologic Care helps outline policies that affect the practice of rheumatology and the wellbeing and care of patients.
The ACR recently released its first guideline focused on vaccination in adult and pediatric patients with rheumatic and musculoskeletal diseases.1 The guideline recommends modifications to certain vaccine and medication schedules to increase immunogenicity and ensure patient safety, while encouraging providers not to miss vaccination opportunities. The Need Patients with rheumatic conditions who are on immunosuppressive…