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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Rheumatology Case Report: Deep Vein Thrombosis Detected by Point-of-Care Ultrasound
Case A 46-year-old Caucasian female presented to the outpatient rheumatology clinic where she had been followed for several years. Her chief complaint was pain in her right knee, posterior right thigh and right hip that had begun gradually over the previous three weeks. Her past medical history was significant for rheumatoid arthritis (RA), obesity and…
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…
New NICE Guidance for Low Back Pain
If left untreated, low back pain can cause long-term disability. To aid its diagnosis and management, the National Institute for Health and Care Excellence has released revised guidance. Recommendations include the use of risk stratification tools for diagnosis, as well as physical activity or a comprehensive program that addresses biomechanical, aerobic and/or psychological needs…
Volatility of the Gut Microbiome Tied to IBD
NEW YORK (Reuters Health)—Fluctuations in the gut microbiome over time could underlie inflammatory bowel disease (IBD), including Crohn’s and ulcerative colitis, researchers suggest. “Both the state and the dynamics of the human gut microbiome in healthy individuals are highly personalized. Although cross-sectional studies have revealed dysbiosis of the gut microbiome in IBD, little is known…
The ACR’s Gout Guideline Co-Author Shares Insight on Treating Pain, Ongoing Patient Care
WASHINGTON, D.C.—Despite the value of guidelines, they often “are not read,” said N. Lawrence Edwards, MD, professor of medicine specializing in rheumatology at the University of Florida, at the 2016 ACR/ARHP Annual Meeting talk titled, New & Emerging Therapies for Gout, as part of the ACR Review Course. Or if they are read, they aren’t…
ACR Recommends You Treat the Symptoms for Gout Patients
In 1982, my wife (also a rheumatologist) and I attended our first American Rheumatism Association (now the ACR) national meeting. After the meeting we stayed with a friend in a suburb of Boston, where we also had the opportunity to meet our hostess’ in-laws, a retired general practitioner and his wife. When her father-in-law shook…
Gout Treatments Effective If Patients Maintain Lifelong Adherence to Therapies
Although gout is one of the most effectively treated of all rheumatic diseases, it is among the worst-managed diseases long term, as shown by many studies. “Treatments are excellent, yet are dramatically under-utilized,” says Theodore Fields, MD, FACP, rheumatologist, Hospital for Special Surgery (HSS), New York. “This is because some gout patients feel better between…
Lesinurad with Allopurinol When Allopurinol Alone Is Insufficient
Current guidelines for the long-term management of gout recommend a combination of lifestyle management and/or pharmacotherapy to lower serum UA levels to <6.0 mg/dL in most patients or <5.0 mg/dL in patients with more severe disease. Allopurinol is the most widely used xanthine oxidase inhibitor and is recommended in treatment guidelines as a first-line urate-lowering…
New Test Yields Rapid Infliximab Drug Concentrations
NEW YORK (Reuters Health)—A new test provides rapid infliximab drug concentrations that enable immediate dosing adjustments, researchers from Belgium report. “With this rapid test, our biggest wish is to persuade physicians to now perform and use infliximab measurements also in their own daily clinical practice, as many practical and organizational issues that went along with…
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