ATLANTA—At the ACR/ARP 2019 Annual Meeting, several widely renowned experts across an array of specialty subjects provided a comprehensive and compelling review of advances in the understanding, diagnosis and treatment of a number of rheumatologic conditions. Sjögren’s Syndrome Frederick Vivino, MD, FACR, chief of rheumatology at Penn Presbyterian Medical Center and professor of clinical medicine…
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Case Report: A Patient’s Clubbing & Arthralgias Resist Diagnosis
A 59-year-old woman presented to our rheumatology clinic with a six-month history of a symmetric polyarthritis. She initially experienced pain in both knees. As time progressed, she began to notice pain in her ankles, hips, shoulders, hands and feet. She experienced joint stiffness lasting for more than 30 minutes every morning. She also described worsening…
2 Patients on Different DMARDs Experience Different COVID-19 Disease Courses
In March 2020, an elderly married couple living on Long Island, N.Y., presented to our emergency department with symptoms suspicious for COVID-19 infection. The wife, a-76-year-old woman, presented with complaints of subjective fevers, minimal dry cough and headaches of one-week duration. She denied having any chills, rhinorrhea, diarrhea, abdominal pain or shortness of breath. Two…
How to Leverage Patient-Reported Outcomes to Improve Care for SLE Patients
A recent study reinforces the growing understanding that the fatigue many SLE patients experience should be considered a lupus symptom. Researchers found that using patient-reported outcomes to identify type 2 symptoms of SLE may improve patient communication, understanding and overall care…
How to Diagnose Upper Extremity Injuries
ATLANTA—Two ways to investigate injuries to the upper extremities are by in-depth physical examinations and ultrasound. In a Clinical Practice session at the 2019 ACR/ARP Annual Meeting, Anatomy: Correlating Physical Exam and Ultrasound in Common Sports Injuries of the Upper Extremity, Carlin Senter, MD, FACP, associate professor of primary care sports medicine at the University…
According to MRI, Ultrasound Guidance Does Not Improve Treat-to-Target in RA
NEW YORK (Reuters Health)—Ultrasound guidance does not improve the effectiveness of treat-to-target therapy in rheumatoid arthritis (RA), new findings confirm. “Incorporating ultrasound information in treatment decisions did not lead to reduced MRI inflammation or less structural damage compared with a conventional treatment strategy,” Dr. Ulf Sundin of Diakonhjemmet Hospital, Oslo, and colleagues write in Rheumatology….
New Draft Gout Guideline Released
ATLANTA—The authors of the new draft ACR treatment guideline for the management of gout presented the draft guideline on Nov. 13 at the 2019 ACR/ARP Annual Meeting. Based on evidence from more than 130 published studies, there are 42 recommendations, of which 16 were strong, including 27 for urate-lowering therapy (ULT) management, 13 of which…
Ultrasound Aids Diagnosis of Man with Knee Pain & Swelling
A 56-year-old automobile mechanic was referred to our rheumatology service by his orthopedist to evaluate left posterior knee pain and swelling that had been present for three months. The patient had undergone bilateral total knee arthroplasties (TKAs) for sports-related osteoarthritis three years before. In addition to the knee pain, the patient described several years of…
Case Report: Tumor Treatment Unleashes Autoimmunity
Immune checkpoint inhibitors (ICIs) targeting the cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) or programmed cell death protein 1 (PD-1) axes have revolutionized therapy and improved survival in advanced cancers. However, these immune system modulators also lead to immune-related adverse events (IRAEs).1,2 In clinical trials, IRAEs mainly involved the gastrointestinal tract, skin, endocrine glands, liver and lung,…
2019 EULAR/ACR SLE Classification Criteria Offer Improved Sensitivity & Specificity
The new EULAR/ACR classification criteria for SLE offer improved sensitivity and specificity, as well as more accurately reflect the current tests used to clinically diagnose SLE. A positive ANA test is obligatory…
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