A 56-year-old African American man presents to the emergency department with polyarthralgias and a fever of 103ºF. One month prior to admission, he presented with right knee pain and swelling. Blood cultures grew S. epidermidis. He was treated for presumed septic arthritis complicated by MSSE bacteremia. He was treated with meropenem and a prolonged course…
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Weakness, Fatigue Can Signal Underlying Rheumatologic Disease
As clinicians, we are familiar with pain, stiffness and soreness—subjective nouns that define our métier. These helpful words serve as signposts that direct us along the path to the proper diagnosis. Consider the young man with a stiff, sore back (a case of ankylosing spondylitis?) or the postpartum woman experiencing newly painful, stiff and sore…
Intimacy & Rheumatic Conditions
The side effects of rheumatic conditions and their treatments can cause symptoms some may find awkward or embarrassing to discuss with their physicians. But Ara Dikranian, MD, says rheumatologists must address intimacy issues, both physical and emotional, with all patients…
Moderate Alcohol Use Could Be Safe with Methotrexate for RA
NEW YORK (Reuters Health)—In patients taking methotrexate for rheumatoid arthritis (RA), moderate alcohol consumption – that is, no higher than existing U.K. guidelines for the general population – was not associated with an increased risk of transaminitis, researchers say. The study is both the largest to examine alcohol and methotrexate (MTX) and the first to…
How to Leverage Physical Therapy & Technology to Help Patients Stay Fit & Decrease Pain
For patients living with rheumatic diseases, the benefits of physical therapy and exercise cannot be overstated. “Working with a physical therapist provides a chance for careful evaluation of how the patient is moving and experiencing pain,” says Maura Iversen, BSc, PT, DPT, SD, MPH…
Rheumatology March Coding Corner Question: Pediatric Rheumatology Consult
A 13-year-old black male, described by his mother as a very active and energetic child, is referred to a pediatric rheumatologist. His chief complaint is muscle pain in both legs, which he has experienced for the past three weeks. His mother is a patient of an adult rheumatologist at this clinic and is quite concerned….
New Findings on Rheumatic Drug Therapies among Patients with Ankylosing Spondylitis, Gout, SLE
WASHINGTON, D.C.—Taking high-dose non-steroidal anti-inflammatory drugs (NSAIDs) with a TNF inhibitor as an ankylosing spondylitis (AS) patient is linked with a 61% decrease in the chances your disease will progress, suggesting there may be a synergy when the drugs are used together, according to a longitudinal observational study from researchers at the University of California,…
Funding Sources for Scientific Discovery, Medical Research
The Phone Call A phone call in the middle of the night can rattle one’s nerves. The rush of adrenaline sets the heart pounding as our ears brace for what we are about to hear next. A distress call from an elderly parent or a child away at college? Is everyone safe? Or may this…
Environmental Factors in Pediatric Systemic Autoimmune Diseases
Systemic autoimmune diseases are thought to result from immune dysregulation in genetically susceptible individuals who were exposed to environmental risk factors. Many studies have identified genetic risk factors for these diseases, but concordance rates among monozygotic twins are 25–40%, suggesting that nonheritable environmental factors play a more prominent role.1,2 Through carefully conducted epidemiologic and other…
Spinal Underwear May Relieve Lower Back Pain
A recent study in nurses and healthcare professionals examined the efficacy of a novel ergonomic aid for managing low back pain. After a three-month trial, researchers found that the aid, Spinal Underwear, reduced low back pain, suggesting that musculoskeletal symptoms may be influenced by posture and somatization…
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