COVID-19 causes myriad cardiac dysfunctions, ranging from mild to fulminant disease, including myocarditis, acute congestive heart failure, cardiogenic shock and sudden cardiac death.1,2 COVID-19 myocarditis can mimic cardiac sarcoidosis clinically and on cardiac imaging, which can lead to diagnostic challenges and treatment delays. We present a case of cardiac sarcoidosis with interval development of metabolic…
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How a Trip to the Vet Made Me a Better Doc
A plain X-ray film appeared on the computer screen—a humerus, a radius and an ulna were all visible. My pupils zoomed around the screen, and on initial inspection, everything looked fine. However, this X-ray was unlike any film I had ever reviewed. You see, it was for my then 4-year-old puppy, Lexi. My sweet little…
Rheumatology & the Shifting Patient Landscape
Rheumatologists are often called upon to see patients with unexplained symptoms and mysterious illnesses and to manage disease, sometimes with a dearth of evidence. Patients in rheumatology practices also tend to explore treatment modalities outside of the established medical model, sometimes referred to as fringe medicine. Complementary and alternative medicine practices that comprise fringe medicine…
The ACR Takes a Stand: How Position Statements Are Created
Through the development of position statements that lay out the ACR’s official stance on issues related to the management of rheumatic and musculoskeletal conditions, the Committee on Rheumatologic Care helps outline policies that affect the practice of rheumatology and the wellbeing and care of patients.
ACR Releases New Vaccination Guideline
The ACR recently released its first guideline focused on vaccination in adult and pediatric patients with rheumatic and musculoskeletal diseases.1 The guideline recommends modifications to certain vaccine and medication schedules to increase immunogenicity and ensure patient safety, while encouraging providers not to miss vaccination opportunities. The Need Patients with rheumatic conditions who are on immunosuppressive…
The ACR Selects Tien-I Karleen Su, MD, FACR, as Community Practice Council Chair
Tien-I Karleen Su, MD, FACR, who co-founded a practice in California, has been named the first chair of the CPC. Her first task will be to help fill out the council with rheumatology professionals from small or independent practices.
Supplemental Vitamin D May Not Protect Against Fractures in Healthy Adults
Supplemental vitamin D may not significantly lower the risk of fractures in generally healthy adults compared with placebo, according to a large study by LeBoff et al.
Point-of-Care Uric Acid Testing
In June 2022, I listened to several presentations on gout at EULAR’s European Congress of Rheumatology. Most began with data confirming a sad truth that we, as rheumatology providers, are all aware of: too many patients are taking subtherapeutic doses of urate-lowering therapy (ULT).1,2 Recommendations from the American College of Physicians in 2017 advocated for…
2022 ACR Guideline for Vaccinations in Patients with RMDs
This guideline provides evidence-based recommendations on the use of vaccinations in children and adults with rheumatic and musculoskeletal diseases. It includes expanded indications for some vaccines, as well as guidance on whether to hold immunosuppressive medications or delay vaccination to maximize vaccine immunogenicity and efficacy.
Glucocorticoids May Decrease White Matter Integrity & Change Gray Matter Volume
Van der Meulen et al. found the use of both systemic and inhaled glucocorticoids is associated with changes in several brain imaging parameters, including decreased white matter integrity and gray matter volume. Study patients also reported more depressive symptoms and tiredness than controls.
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