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…
Rheumatoid arthritis (RA) is a systemic autoimmune disease that affects approximately 1% of the adult population, and involvement of extra-articular tissue occurs in approximately 40% of patients over their lifetimes.1 RA-associated pericardial disease is an uncommon complication, and surgery is the only definitive therapy—according to current literature. In this report, we present the case of…
Immune checkpoint inhibitors (ICIs) targeting the cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) or programmed cell death protein 1 (PD-1) axes have revolutionized therapy and improved survival in advanced cancers. However, these immune system modulators also lead to immune-related adverse events (IRAEs).1,2 In clinical trials, IRAEs mainly involved the gastrointestinal tract, skin, endocrine glands, liver and lung,…
Case Presentation A 45-year-old man with crystal-proven gout, poorly controlled diabetes and chronic kidney disease was lost to follow-up for six years and presented back to the VA clinic in the midst of a gout flare. He stated he had continued taking 100 mg of allopurinol daily, but his serum urate level was 13.8 mg/dL….
A recent study advances the understanding of factors associated with a target serum urate level of 6 mg/dL or less. Researchers found such factors as having a rheumatologist as the main provider of gout care contributed to achieving and maintaining this outcome. However, the presence of co-morbidities lowered a patient’s chances for achieving the target serum urate level, even with allopurinol use…
The new EULAR/ACR classification criteria for SLE offer improved sensitivity and specificity, as well as more accurately reflect the current tests used to clinically diagnose SLE. A positive ANA test is obligatory…
New research seeking to describe the characteristics of undefined, systemic autoinflammatory diseases may have identified distinct subgroups, including pericarditis and intellectual impairment…
A recent study has taken a more detailed look at the relationship between physical activity and the risk of developing rheumatoid arthritis (RA). Researchers found the more patients exercised weekly the lower their overall risk, specifically brisk and very brisk walking paces, along with longer cumulative average walking hours weekly were associated with a reduced risk for RA…
Patients with axial spondyloarthritis have a chronic, immune-mediated inflammatory disease that tends to localize to the sacroiliac joints and spine. Ankylosing spondylitis is, perhaps, the most representative of this group of diseases. Rheumatologists treat patients with axial spondyloarthritis with biologics, such as tumor necrosis factor inhibitors (TNFi’s), which can improve quality of life, activity and…
Historically, ankylosing spondylitis was considered mainly a male disease. But it has become evident this predominance is not as great as previously believed. Here we discuss recent developments in the area, including potential differences between the sexes in symptom and disease burden, immunological and genetic background, diagnostic delay, treatment response and ongoing research questions. Medical…