Methotrexate—an affordable, established drug for rheumatoid arthritis—may also be helpful for patients suffering from osteoarthritis (OA) of the hand, a recent study reports.1 Treatment of hand OA and inflammation with 20 mg of methotrexate for six months had a moderate, but potentially clinically meaningful, effect on reducing pain and stiffness in patients with symptomatic hand…
Search results for: musculoskeletal
When Rheumatologists Have Rheumatic Diseases
“I think we learn from medicine everywhere that it is, at its heart, a human endeavor, requiring good science but also a limitless curiosity and interest in your fellow human being, and that the physician-patient relationship is key; all else follows from it.”1 These profound words from Abraham Verghese, MD, MACP, Linda R. Meier…
Advice for New Rheumatology Fellows: Construct Winner’s Triangles
June is always a bittersweet month, at least in academic medicine. We get to look forward to a new fresh set of faces coming into our training programs, but we also have to say goodbye to those once-fresh faces that have progressed through their medical education journeys. These transitions are never easy, neither for the…
Telehealth Triage Study Seeks to Close Gaps in Care
Reducing the time to diagnosis and initiation of appropriate treatment is paramount to intercept inflammatory damage in patients at the onset of rheumatic disease. But those targets can be delayed by provider shortages and other barriers to care. Since last June, Remission Medical, a virtual rheumatology clinic, has been partnering with Mayo Clinic to find…
Rheumatology’s Systems-Based Thinking Plays Well on Capitol Hill
One of the great joys of rheumatology is that it prioritizes systems-based thinking. Whether integrating data from radiographic imaging or piecing together a puzzling case of autoimmunity, rheumatologists are tasked with understanding how systems fundamentally work. In fact, this emphasis on systems-based thinking is often what draws and keeps the best and smartest physicians within…
The Physical Exam Begins with a Handshake
During the height of the pandemic four years ago, I took every precaution to avoid, or at the very least, delay contracting COVID-19. I religiously wore a mask in all public settings, I washed my hands so frequently that my skin became dry and cracked, and I studiously maintained a six-foot distance from others. But…
Case Report: Complicated Presentation Eventually Explained by Rare Syndrome
Pachydermoperiostosis (PDP), also known as Touraine-Solente-Golé syndrome or primary hypertrophic osteoarthropathy, is a rare syndrome that can be inherited as autosomal dominant, autosomal recessive, or sporadically. This progressive disease primarily affects males, who tend to have more severe features than females. PDP usually occurs during adolescence, often starting around puberty.1 The main clinical features are…
A Delicate Balance: How to Avoid Overmedicalization in Rheumatology
Rheumatologist Rachelle Buchbinder, AO, MBBS (Hons), MSc, PhD, discusses reducing overdiagnosis, overtreatment, low-value care and waste in medicine.
When to Check Drug Levels & Why
Checking blood levels of commonly used disease-modifying anti-rheumatic drugs (DMARDs) has gained widespread attention in the rheumatology community, even resulting in a recent guidance document from EULAR for biologics.1 Although a highly useful tool, drug level measurement in rheumatology is not without challenges; many of our drugs violate the basic principles of pharmacology that we…
Reflecting on B Cell-Depleting Therapies & COVID-19
In the early days of the COVID-19 pandemic, confusion and concern for immunosuppressed patients grew among rheumatologists and patients alike. Research has helped bridge the knowledge gap, and treatment options for COVID-19 have helped ease concerns.
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