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…
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…
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…
Scleroderma is a rare rheumatologic autoimmune disease that affects the skin and can also affect other organs. Due to excess formation of scar tissue, blood flow to the extremities is decreased, primarily to the hands, and tissues often become hypoxic, resulting in sclerodactyly and proximal skin involvement.2 The incidence of scleroderma in the U.S. is…
In 1984, I wrote my first prescription for the antimalarial drug, hydroxychloroquine (Plaquenil), for a 28-year-old woman with SLE. She was considerably overweight, with inflammatory arthritis and a photosensitive rash, and I worried that oral corticosteroids would tip her over into diabetes. I presented the case to my attending, Steven Malawista, MD, at the Yale…
Editor’s note: In this recurring feature, we first present a series of images (this page) for your review, and then a brief discussion of the findings and diagnosis. Before you turn to the discussion, examine these images carefully and draw your own conclusions. History These images were taken of an 85-year-old female with a one-year…
View the question. Transverse (see Figure 1) and longitudinal (see Figure 2) ultrasound images show an anechoic collection (asterisks), which surrounds the distal biceps tendon (b). The collection is compressible (not shown here). The biceps tendon is heterogeneous in echo texture, with fiber dropouts and an irregular border (in the transverse view). The elbow joint…
MRI inflammation, fat and new bone formation in the sacroiliac joints, spine in patients with AS
The pathogenesis of and new classification criteria for MAS
Recognizing, reducing risk of bone fractures in pediatric patients with rheumatic disease, taking glucocorticoid therapy