A 56-year-old African American man presents to the emergency department with polyarthralgias and a fever of 103ºF. One month prior to admission, he presented with right knee pain and swelling. Blood cultures grew S. epidermidis. He was treated for presumed septic arthritis complicated by MSSE bacteremia. He was treated with meropenem and a prolonged course…
Case A 46-year-old Caucasian female presented to the outpatient rheumatology clinic where she had been followed for several years. Her chief complaint was pain in her right knee, posterior right thigh and right hip that had begun gradually over the previous three weeks. Her past medical history was significant for rheumatoid arthritis (RA), obesity and…
(Reuters Health)—The risk that surgery patients will become chronic opioid users may be similar after minor procedures or major operations, a U.S. study suggests. Three to six months after surgery, new chronic opioid use was about 5.9% with minor operations and 6.5% with major surgery, the study found. The rate was just 0.4% in people…
As clinicians, we are familiar with pain, stiffness and soreness—subjective nouns that define our métier. These helpful words serve as signposts that direct us along the path to the proper diagnosis. Consider the young man with a stiff, sore back (a case of ankylosing spondylitis?) or the postpartum woman experiencing newly painful, stiff and sore…
Celiac is an autoimmune disease with both gastrointestinal and neurological implications. A recent review examined the immunological research on celiac disease to date, detailing the role of T cells and the protein TG2 in disease pathology…
The side effects of rheumatic conditions and their treatments can cause symptoms some may find awkward or embarrassing to discuss with their physicians. But Ara Dikranian, MD, says rheumatologists must address intimacy issues, both physical and emotional, with all patients…
NEW YORK (Reuters Health)—In patients taking methotrexate for rheumatoid arthritis (RA), moderate alcohol consumption – that is, no higher than existing U.K. guidelines for the general population – was not associated with an increased risk of transaminitis, researchers say. The study is both the largest to examine alcohol and methotrexate (MTX) and the first to…
NEW YORK (Reuters Health)—Obesity and higher fat mass are associated with increased levels of inflammatory markers in women with rheumatoid arthritis (RA), researchers report. “Physicians should recognize that C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) are affected by obesity in patients with and without rheumatoid arthritis, especially in women,” Dr. Michael D. George from the University of…
(Reuters Health)—Spinal manipulation may work as well for easing lower back pain as anti-inflammatory medications, a research review concludes. Based on data from 15 previously conducted trials involving a total of 1,711 adults, the study team found that spinal manipulation achieved meaningful reductions in pain and improvements in function after six weeks of treatment. The…
NEW YORK (Reuters Health)—There are insufficient data to make evidence-based decisions regarding the benefits and harms of osteoporosis medications in patients with chronic kidney disease (CKD), according to a systematic review and meta-analysis. “We found low to moderate evidence for the effects of some but not all of the medications, and the evidence was limited…