Elliot Rosenstein, MD, spends most weekend mornings and late afternoons a bit differently than other rheumatologists. He feeds and waters chickens, rabbits, llamas, horses, goats and guinea fowl, as well as an orphaned peacock. Dr. Rosenstein is one of two medical directors at the Institute of Rheumatic & Autoimmune Disease (IRAD) at Overlook Medical Center,…
Teaching junior learners, such as medical students and residents, is increasingly important in rheumatology. Given the anticipated shortage of rheumatologists, attracting more trainees to our field and enhancing knowledge of the rheumatic diseases among physicians in other fields are critical to meeting the needs of our patients.1,2 In addition, clinical reasoning is a vital skill…
The prescription is a powerful tool for a physician. As rheumatologists, we prescribe many things—drugs, physical therapy, durable medical equipment—but what about stress reduction? We are very specific about times of day to take medications and in what manner. Patients ask: With or without food? With other medications? Before or after other prescribed medications? If…
Acute febrile neutrophilic dermatosis, or Sweet syndrome, is an inflammatory disease that classically presents with fever, leukocytosis and tender, erythematous plaques characterized by neutrophilic infiltrates on biopsy. Sweet syndrome has been reported in association with several autoimmune diseases, including inflammatory bowel disease, systemic lupus erythematous, rheumatoid arthritis and sarcoidosis.1 Here, we discuss a case of…
In light of new challenges to individuals’ reproductive rights and the known challenges of clinical management of rheumatic disease patients during pregnancy, we review the current state of reproductive rheumatology and the management of patients with rheumatic disease during pregnancy.
Hip and knee replacements—despite advancement in treatments for rheumatic diseases, some patients will still need to undergo these surgeries. Here are insights into the considerations, costs and complications of total joint arthroplasty.
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…
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…
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…
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…