CHICAGO—Can non-drug interventions improve the lives of patients with scleroderma? Janet L. Poole, PhD, OTR/L, professor and director of the Occupational Therapy Graduate Program of the School of Medicine, University of New Mexico, Albuquerque, addressed this question when she presented the ARHP Distinguished Lecture at the 2018 ACR/ARHP Annual Meeting. She discussed the challenges faced…
CHICAGO—Held during the 2018 ACR/ARHP Annual Meeting, the ACR Review Course covered a wide range of topics for rheumatologists—from advances in pain and rheumatic disease management to the intersection of rheumatology and neurology. Session speakers shared insights, as well as state-of-the-art approaches to diagnosis, management and treatment. Inflammatory Myopathies Julie J. Paik, MD, MHS, assistant…
CHICAGO—Medications have frequently been implicated as a cause of musculoskeletal complaints, including persistent arthralgias, arthritis and myalgias.1 The list of offending agents is diverse, and the degree of symptoms is variable. In the world of transplant recipients, this list is exhaustive and includes immunosuppressive agents (cyclosporine, tacrolimus); myeloid growth factors, such as G-CSF; antibiotics (quinolones);…
CHICAGO—In the Thieves Market session at the 2018 ACR/ARHP Annual Meeting, rheumatologists from around the country presented a slate of challenging cases that emphasized the importance of clinical persistence and attention to detail, and the need to consider diagnoses that might not be common or obvious. Three of them are summarized below. (Look for more…
Patients who develop neuropsychiatric symptoms of SLE have a small nucleotide polymorphism (SNP) in an intron in a Ca++ ion channel gene that influences some, but not all, events regulated by Ca++. The SNP appears to influence activation induced apoptosis rates and cytokine production, specifically IL-4, in a disease- and genotype-specific manner…
Polymyalgia rheumatica (PMR) is an inflammatory rheumatic condition characterized by pain and morning stiffness at the neck, shoulders and hip girdle. It can be associated with giant cell arteritis (GCA); in fact, the two disorders may represent a continuum of the same disease process. This case describes a patient who initially refused treatment for PMR…
(Reuters Health)—Vitamin D supplementation may not improve bone density or prevent fractures and falls in adults, a large new analysis suggests. After combining data from 81 randomized controlled trials, researchers found no bone benefits from supplementing the vitamin, according to the report in The Lancet Diabetes & Endocrinology, online October 4. “Our results show that…
NEW YORK (Reuters Health)—In what is believed to be the largest study investigating genetic and clinical determinants of osteoporotic fracture risk, only a genetic predisposition to low bone mineral density (BMD) had a potential causal role to play. “Notably, genetic predisposition to lower levels of vitamin D and estimated calcium intake from dairy sources were…
BALTIMORE—Rheumatologists may not think about osteoporosis on a daily basis, but they should, said Dr. Karl Insogna, the Ensign Professor of Medicine at Yale University School of Medicine and director of the Yale Bone Center in New Haven, Conn., in his recent lecture at the Maryland Society for the Rheumatic Diseases. With approximately 75 million…
Rheumatoid arthritis (RA) is characterized by polyarthritis, especially involving hands and wrists. Without treatment, RA usually evolves to articular deformities. Unfortunately, although rheumatoid deformities are characteristic, they are not pathognomonic, and we should be aware of possible mimics.1 Neuropathic arthropathy (NA), similar to other diseases, such as hemochromatosis, psoriatic arthritis, calcium pyrophosphate deposition disease, Jaccoud…