The COVID-19 pandemic has filled hospitals with patients with rapidly progressive respiratory failure and diffuse bilateral opacities on chest X-ray.1 Additionally, many patients with severe COVID-19 develop acute kidney injury and require dialysis.2 Pulmonary-renal syndromes are also important to consider in this setting. Although alveolar hemorrhage is a cardinal feature of this syndrome, many patients…
Diagnostic Challenges of MIS-C
During the peak of the coronavirus pandemic in Washington, D.C., we were asked to evaluate a 14-year-old boy admitted to the pediatric hospitalist service. He had been healthy until two weeks before, when he noted a sore throat, and soon after he developed fevers and rashes without congestion, shortness of breath, conjunctivitis or swollen lymph…
Case Report: Lipoma Arborescens of the Knee
Lipoma arborescens is a rare, benign intra-articular lesion characterized by diffuse replacement of synovial tissue by mature adipocytes, causing a villous lipomatous proliferation of the synovial membrane.1 Typically, this is a monoarticular condition, with the knee being the most commonly affected although it has been rarely reported to occur in an oligo-/polyarticular fashion and in…
Case Report: Blunt Smoker Denies Tobacco Use, Delaying Diagnosis
Cannabis arteritis mirrors thromboangiitis obliterans in its clinical and arteriographic presentation, but its relevant exposure is cannabis rather than tobacco.1 Whether cannabis arteritis is a subset of thromboangiitis obliterans or a unique pathologic entity is debatable. Delta-9-tetrahydrocannabinol, the primary psychoactive component of cannabis, is a peripheral vasoconstrictor.2 This offers mechanistic insight into how cannabis may…
Case Report: An Uncommon Incidental Finding
In certain ethnic populations and geographic locations, being a genetic carrier of sickle cell trait is common. Despite its prevalence, a recent report studied 100 mothers who were informed their newborn child had tested positive for sickle cell trait, and of these mothers less than half were aware of their carrier status prior to conception.1…
Medication Preferences & Current Practices for PsA
With many new agents designed to treat PsA, rheumatologists and patients have options. Schwartzman et al. examined the real-world use of different treatments and ranked patient medication preferences.
Intra-Articular Steroid/Lidocaine Injection Improves Hip Arthritis Pain, Function
NEW YORK (Reuters Health)—A single injection into the hip of steroid and local anesthetic improved pain and function in patients with hip osteoarthritis in a randomized controlled trial, with most of the benefit seen early after treatment. Researchers at two community-based clinics in England assigned 199 volunteers to receive either an ultrasound guided intra-articular hip…
Denosumab vs. Zoledronate: An Analysis of Treatments for Low Bone Mineral Density in Patients with HIV
In a small study of men with low bone mineral density (BDM) living with HIV and taking anti-retroviral therapy, both zoledronate or denosumab were well tolerated and effective for bone mineral density of the lumbar spine and femoral neck.
Imaging of Axial Psoriatic Arthritis
The axial phenotype of psoriatic arthritis (axPsA) is an excellent example of a major controversy in rheumatology that has become the focus of attention because of the emergence of new therapies with different mechanisms of action for alleviating joint inflammation. It was first described in 1961 but, until recently, it has largely remained under the…
Axial Disease in Psoriatic Arthritis
When Moll and Wright first described the spondyloarthritides in the early 1970s, the archetype of the group was ankylosing spondylitis (AS).1 The shared clinical features of the spondyloarthritides were sacroiliitis; asymmetric large joint peripheral arthritis; psoriasis or psoriaform skin lesions, including keratoderma blennorrhagica; uveitis; and bowel inflammation. Moll and Wright described five clinical subgroups of…
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