It has been about 20 years since the Institute of Medicine (now the National Academy of Medicine) published the report To Err Is Human: Building a Safer Health System, shining light on the impact of medical errors in healthcare.1 In response to that publication, the focus on quality improvement (QI) started in the inpatient setting,…
My fellow was laughing at me. By itself, I don’t think this was an unusual occurrence. I am quite certain that my fellows laugh at me all the time. That said, when such laughter is called for, I am accustomed to a certain protocol being observed. In general, I expect the laughter to be contained,…
These are difficult times for rheumatologists. We have seen sharp declines in face-to-face patient visits since the COVID‑19 pandemic began. Many of us have questions about the best ways to maintain employee and patient safety while keeping our practices afloat and continuing to provide optimal care. The volunteer leaders at the ACR continue to care…
ACR Convergence 2020—the ACR’s annual meeting—will be presented online. Get ready for an innovative experience.
No event in recent history has caused such far-reaching changes within the medical industry as the ongoing COVID-19 pandemic. Similar to its ability to spread indiscriminately—infecting people regardless of age, race or socioeconomic background—the virus is inducing immediate and, likely, permanent changes across the entire spectrum of healthcare. Comfortable routines of healthcare delivery have been…
Interactive rheumatology education has flourished online thanks to grassroots efforts & ACR support…
If you’re a rheumatologist, you likely remember the moment of truth on your match day—the day of revelation, when the complex computer algorithm set up by the National Resident Matching Program (NRMP) accommodates the wishes of programs and applicants and then discloses into which program an applicant has been placed. Although it has always been…
For most rheumatologists, the key elements of the physical exam—inspection, palpation, percussion and auscultation—have long been second nature, but a fifth modality has grown in importance with respect to making the correct diagnosis: ultrasound. From evaluating for Doppler signal and additional findings indicative of synovitis to identifying bony erosions, chondrocalcinosis, tophi and other articular and…
As rheumatologists, we relish the thrill of diagnostic conundrums that accompany our immune-mediated multi-system and often undifferentiated disease processes. Many rheumatologic diagnoses are essentially diagnoses of exclusion. We’re accustomed to diagnosing iatrogenesis, infection and malignancy as often as we diagnose rheumatic disease. Complex clinical problem solving and critical reasoning are our forte, and to do…
Like the medical profession itself, the education of doctors serving in rheumatology fellowships across the nation marches on despite the unexpected hurdles posed by the COVID-19 pandemic. Practice Changes “The pandemic has changed the way our fellows see patients; we are now seeing almost all patients using telemedicine,” says Bonita Libman, MD, FACR, FACP, fellowship…
At the Johns Hopkins School of Medicine Division of Rheumatology, Baltimore, registered nurses (RNs) are an integral aspect of the rheumatology fellowship program. This gives the fellows information and insight into areas of practice they might not otherwise receive. “This [practice] is a result of our very strong belief that an integrated and interdisciplinary approach,…
Rheumatologists who are outstanding clinicians, provide consistently exceptional care to patients and serve as role models for colleagues and trainees are in the spotlight in our Lessons from a Master Clinician series. Here, we offer insights from clinicians who have achieved a level of distinction in the field of rheumatology and who are respected by…
A 61-year-old Caucasian woman with a history of seropositive rheumatoid arthritis (RA) was hospitalized for a several-month history of progressively worsening left ankle pain and swelling. She had been unable to bear weight on her left leg for several days and did not notice improvement in symptoms with 20 mg of prednisone daily, which she…
A pediatric rheumatologist in the thick of treating children with COVID-19 confronts a new and evolving syndrome.
COVID-19 has generated an outpouring of fast-paced, late-breaking new developments. The majority of countries (188) around the world have reported cases of COVID-19.1 As of April 1, 2020, the Centers for Disease Control and Prevention had reported cases in every U.S. jurisdiction (50 states, District of Columbia, Puerto Rico, Guam, the Northern Mariana Islands and…
ACR BEYOND LIVE—A moonshot concept in rheumatology has long been centered on the question of whether autoimmune disease can be cured. A less frequently posed inquiry, albeit equally important, is: Can the onset of autoimmune disease be prevented in the first place? At the 2020 ACR State-of-the-Art Clinical Symposium, Kevin Deane, MD, PhD, associate professor…
ACR BEYOND LIVE—Much, if not all, of rheumatology relies on clinical interpretation of historical, laboratory and imaging information to formulate a coherent diagnosis and treatment plan—even when such information is incomplete or has multiple possible interpretations. One of the best examples of this situation pertains to nonradiographic axial spondyloarthritis (nr-axSpA), a condition that is just…
ACR BEYOND LIVE—Among patients with systemic lupus erythematosus (SLE), lupus nephritis remains one of the leading causes of mortality, and patients with both SLE and end-stage renal disease demonstrate standardized mortality ratios higher than 60 times that of patients with SLE who have normal kidney function.1 Although the ACR Guidelines for Screening, Treatment, and Management…
Prescribing stewardship is just one ethical consideration facing rheumatologists during the COVID-19 pandemic.
As a young child growing up in Oxford, Ohio, Veena Patel, MD, demonstrated a talent for arts and crafts. At age 7, she painted a portrait of her father, now a retired mechanical engineer, which he still proudly admires. Dr. Patel, an assistant rheumatology professor at Dell Medical School—the graduate medical school of the University…
The FDA has approved a 25 mg/mL dose of an oral solution of celecoxib to treat adults with acute migraine…
The FDA is reviewing supplemental Biologics License Applications for golimumab to treat polyarticular JIA and juvenile PsA…
NEW YORK (Reuters Health)—Long-term rituximab use lowers the chance of relapse of anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis (AAV), compared with standard maintenance therapy, according to a report from the MAINRITSAN3 randomized trial. “Physicians should consider AAV to be a long-lasting, chronic disease which requires maintenance therapy,” says Dr. Pierre Charles of Cochin Hospital, Paris…