Ankylosing spondylitis primarily affects the joints and ligaments of the spine, but may also have an impact on other joints. Patients experience pain and stiffness that limit mobility in the back and other affected joints. Symptoms can come and go, last for long periods of time and be severe. Anti-tumor necrosis factor (anti-TNF) drugs are…
FDA Issues Safety Alerts for Bisphosphonates & SGLT2 Inhibitors
Safety The Food and Drug Administration (FDA) has updated the Warnings and Precautions sections of prescribing information for the bisphosphonate agents, including risedronate sodium tablets and combinations with calcium (Actonel/Atelvia), alendronate and combinations with vitamin D (Binosto/Fosamax), ibandronate (Boniva), etidronate (Didronel) and the RANK-ligand inhibitor denosumab (Prolia/Xgeva).1 This information relates to an increased risk for…
Physical Therapy, Exercise Advances for Knee Osteoarthritis
Millions of adults suffer from painful knee osteoarthritis (OA). Although physical activity can help improve pain and reduce functional limitations, many people with OA are physically inactive. For people living with knee OA, it can be difficult to get started with or continue on a physical activity program, because pain and other symptoms can make…
Pediatric to Adult Care Transition Challenging for Patients with JIA
Dr. Sheffield is an adult rheumatologist who received the following referral request from a family doctor: “Please see this 22-year-old male with a history of juvenile arthritis for ongoing care. I have only seen him once, and have no previous medical records.” Dr. Sheffield meets with Paul, who reports that he has had arthritis since…
Rheumatologist Recalls Personal Experience with RA
In late March 2012, I awoke with pain in my left hand. I had difficulty moving my metacarpophalangeal (MCP) joints. They did not move smoothly, but clunked. As I repeatedly attempted to open and close my hand, I realized that I had morning stiffness. As the pain and stiffness gradually improved over the next hour,…
Melioidosis: What Rheumatologists Need to Know
Burkholderia pseudomallei, the causative agent of melioidosis, is endemic in Southeast Asia and northern Australia.1 In recent years, the incidence of melioidosis has increased worldwide. Septic arthritis is a rare, but well-recognized, manifestation of melioidosis. Case Report A 49-year-old woman with known diabetes was admitted elsewhere with uncontrolled diabetes and fever. She was found to…
Progress Made in Search for a Fibromyalgia Biomarker
Fibromyalgia syndrome (FMS), rheumatoid arthritis (RA) and spondyloarthritis (SpA) all exhibit multifaceted manifestations, and many patients exhibit overlapping comorbidities. However, patients with FMS are distinct from others in that they experience widespread pain, fatigue and mood changes, including anxiety and depression. Although its hallmark symptom of pain causes rheumatologists to consider FMS a pain disorder,…
Dermatology Symptoms Point to Connective Tissue Disorder
The Case A 68-year-old woman with a past medical history of Charcot-Marie-Tooth presents with thickening of the skin on her trunk and extremities, which she has had for the past seven months (see Figures 1 and 2). Her symptoms first began with swelling of her bilateral upper and lower extremities. She is now having difficulty…
Letters: Biomarkers for Rheumatoid Arthritis
Biomarkers for RA I read the article, “Finding Biomarkers in RA Remains Elusive Goal” (February 2015 The Rheumatologist), with great interest. The author correctly identifies the multi-biomarker disease activity assay (MBDA; Vectra DA) as a potential biomarker that identifies RA patients at risk for radiographic progression. The author names a study presented at the 2014…
Letters: Standardize Squeeze Test for Inflammatory Arthritis?
Squeeze Test in Inflammatory Arthritis, Need for Standardization? The first use of the squeeze test as a clinical maneuver to detect inflammatory arthritis in patients with hand problems was described by Recth in 1988, and Morton described its use for patients with foot problems.1,2 In 1991, Eberhardt and Rigby proposed the clinical maneuver be used…
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