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An official publication of the ACR and the ARP serving rheumatologists and rheumatology professionals

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Conditions

Subcategories:Axial SpondyloarthritisGout and Crystalline ArthritisGuidelinesMyositisOsteoarthritis and Bone DisordersOther Rheumatic ConditionsPain SyndromesPediatric ConditionsPsoriatic ArthritisRheumatoid ArthritisSjögren’s DiseaseSoft Tissue PainSystemic Lupus ErythematosusSystemic SclerosisVasculitis

Management of Meniscal Tears: Surgery May Not Be Necessary

Lara C. Pullen, PhD  |  November 18, 2019

Patients with meniscal tear experience similar levels of reduced pain and improved physical function when treated with either arthroscopic partial meniscectomy or physical therapy, according to a recent study. The study also found these improvements were long term—lasting through the five-year follow up…

Figures 1 & 2: Transverse and longitudinal ultrasound views, respectively, of the left posterior knee, revealing a cystic mass with heterogeneous internal echotexture and no stalk.

Ultrasound Aids Diagnosis of Man with Knee Pain & Swelling

Mark H. Greenberg, MD, RMSK, RhMSUS, Prem Patel, Elijah Mitcham, MD, James W. Fant Jr., MD, & Frank R. Voss, MD  |  November 17, 2019

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…

Case Report: Rheumatoid Arthritis-Associated Restrictive Pericarditis

Scott Rodriguez, MD, Kenton Powell, MD, & Daniel Albert, MD  |  November 17, 2019

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…

Case Report: Tumor Treatment Unleashes Autoimmunity

Shuwei Wang, MD, Gulam A. Manji, MD, PhD, & Anca D. Askanase, MD  |  November 17, 2019

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,…

A CT of the abdomen demonstrated numerous hypodense lesions present in both lobes of the liver, with the largest lesion measuring 2.0 x 3.1 cm.

Case Report: A Patient with Gout Develops Granulomatous Hepatitis

Raj Vachhani, MD, & Angelo L. Gaffo, MD, MSPH  |  November 16, 2019

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….

Insight into Achieving & Maintaining Target Serum Urate Levels in Gout Patients

Lara C. Pullen, PhD  |  November 11, 2019

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…

2019 EULAR/ACR SLE Classification Criteria Offer Improved Sensitivity & Specificity

Susan Bernstein  |  November 6, 2019

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…

Insight into the Characteristics of Orphan Autoinflammatory Disorders

Carina Stanton  |  November 4, 2019

New research seeking to describe the characteristics of undefined, systemic autoinflammatory diseases may have identified distinct subgroups, including pericarditis and intellectual impairment…

Physical Activity Reduces Risk of Rheumatoid Arthritis

Lara C. Pullen, PhD  |  October 31, 2019

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…

Do Patients with Ankylosing Spondylitis in Remission Still Need TNF Inhibitors?

Lara C. Pullen, PhD  |  October 24, 2019

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…

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