Because rheumatologists and mental health experts both treat patients with depression, anxiety, pain, disability and sleep disorders, provider cross-training may benefit patients and providers themselves. “When a patient has active psychosocial distress, this has a negative effect on their physical function. Similarly, if a patient has active physical symptoms, like a rheumatoid arthritis flare, this…
I wouldn’t normally look to professional basketball as a model for healthcare, but sometimes answers come from unexpected places. The observation that elite athletes are not like you and me—medically speaking—is not new. In the second century AD, the pontifex maximus in Pergamum recognized this fact and appointed Claudius Galen physician to the gladiators, making…
Eosinophilic granulomatosis with polyangiitis (EGPA) is an anti-neutrophil cytoplasmic antibody-associated vasculitis typically characterized by asthma, peripheral eosinophilia and medium- to small-vessel necrotizing vasculitis. Cutaneous manifestations in EGPA are diverse. Palpable purpura is the most common presentation, but urticaria, erythematous macules and papules, livedo reticularis, digital necrosis and cutaneous nodules have also been described.1 Non-hemorrhagic bullae…
Abscesses are typically caused by infections, but some are, instead, sterile. Aseptic abscesses (AAs) are characterized by the same neutrophil-rich histopathology as infectious abscesses; however, they don’t improve with antibiotics. Rather, AAs require treatment with anti-inflammatory medications. Although relatively rare, this phenomenon is important for rheumatologists to recognize given its frequent association with underlying systemic…
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…
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…
A 25-year-old Mexican American woman with a five-year history of systemic lupus erythematosus (SLE) presents with refractory, acute cutaneous lupus erythematosus (ACLE) and subacute cutaneous lupus erythematosus (SCLE) affecting the scalp, face and hands. Her serologic phenotype is characterized by elevated anti-nuclear, anti-double-stranded deoxyribonucleic acid (dsDNA), anti-ribonucleoprotein (RNP), anti-Smith and anti-SS-A (Ro) antibodies and chronically…
When my daughter was a second-year internal medicine resident at Massachusetts General Hospital, Boston, she called me excitedly one evening. “Dad,” she reported, “I think I saw the optic nerve for the first time today with an ophthalmoscope.” I suppose I should have shared her exuberance, except that when I went to medical school, a…
McMahan et al. examined how abnormal gastrointestinal (GI) transit may contribute to GI severity and symptoms in patients with systemic sclerosis (SSc). About 90% of people with SSc have GI tract involvement, and understanding the connection between GI symptoms, their severity and abnormal GI transit may permit targeted therapeutic approaches for these patients.
Findings support the continued use of TNF inhibitor monotherapy in individuals with immune-mediated inflammatory diseases. In the study, these patients had a lower risk of hospitalization or death caused by COVID-19 than patients on other commonly prescribed treatment regimens
The Washington Rheumatology Alliance is focused on creative ways to increase the rheumatology workforce to meet the demand for care, such as instituting clinical rotations in rheumatology for nurse practitioner programs and advocating for pediatric rheumatologist loan forgiveness.
Information overload generated by the media, family, friends and colleagues is apparent today. Personal beliefs play an important role in how we filter and process the abundant information available and subsequently identify its utility in daily life. Regardless of professional specialty, individual beliefs underpin personal approaches to clinical care, research development and engagement with patients…
Lichenoid Cutaneous Lupus Erythematosus Mimicking Acanthosis Nigricans The photos depict a 45-year-old woman who presented to the Lupus Clinic of the University of São Paulo, Brazil, with lesions closely resembling acanthosis nigricans on her neck (A and B). The lesions had been present for four months. The patient had lived with systemic lupus erythematosus (SLE)…
In response to ACR and provider concerns about administrative burden, CVS Caremark has issued a streamlined version of its prior authorization forms for many biologic drugs.
Effective for dates of service on or after April 1, the Healthcare Common Procedure Coding System (HCPCS) code J0491 is valid for billing 1 mg anifrolumab-fnia.
Although the diagnosis and treatment of gout are sometimes straightforward, practitioners encounter challenges in patients with atypical presentations, as well as those with medically complex situations or refractory disease. Here, gout experts share insights into some of these scenarios. Flare in Hospitalized Patients When not contraindicated, the 2020 ACR Guideline for the Management of Gout…
Medal for Excellence Awarded to Graciela Alarcón, MD Graciela (Chela) S. Alarcón, MD, MPH, is the emeritus Jane Knight Lowe Chair of Medicine in Rheumatology at the University of Alabama at Birmingham (UAB), and a professor of medicine (emeritus) at Universidad Peruana Cayetano Heredia (UPCH), Lima, Perú, her alma mater. Last fall, she received the…
Jennifer May, MD, a rheumatologist with Rapid City Medical Center, South Dakota, completed her undergraduate degree at Augustana University, Sioux Falls, S.D., and earned her medical degree at the University of South Dakota School of Medicine, Vermillion. She was in the fourth grade when she first began playing the viola. Although she came to love…
ACR CONVERGENCE 2021—Using pooled data from the TULIP-1 and TULIP-2 clinical trials, researchers set out to identify whether more patients with systemic lupus erythematosus (SLE) being treated with anifrolumab achieved a low disease activity state than patients with SLE who received placebo.1-3 An analysis of the data was presented at ACR Convergence 2021 by Eric…