CHICAGO—To drive home the importance of how social determinants can make or break a person’s health, Jillian Rose, LCSW, MPH, the director of community, engagement, diversity and research at the Hospital for Special Surgery in New York City, told a story about a gardener planting flowers at the 2018 ACR/ARHP Annual Meeting. In the story,…
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Rheumatoid Arthritis Prevention, Remission & Treatment De-Escalation
CHICAGO—With an ever-strengthening foundation beneath the pathophysiology and prediction of rheumatoid arthritis (RA), the field may soon focus more intently on prevention, an expert said at the 2018 ACR/ARHP Annual Meeting. The session also covered the latest in remission targets and therapy de-escalation. RA Prevention Kevin Deane, MD, PhD, associate professor of medicine and principal…
How to Proceed When Kids Present with Joint Pain but Normal Exams
CHICAGO—When it comes to correctly diagnosing joint pain in children, “things take time,” said Michael L. Miller, MD, quoting Danish physicist and poet Piet Hein. Children with pain but normal physical examinations may need to return to the clinic for repeat evaluation over several months. “I often tell parents that laboratory tests may help in…
Rheumatology Clinics Add Pharmacists to Care Teams, See Benefits
CHICAGO—Could the addition of a pharmacist to rheumatology care teams improve patient satisfaction, decrease staff burnout or reduce medication-related problems? Three panelists in Integrating Pharmacists into the Workforce, a session at the 2018 ACR/ARHP Annual Meeting, shared positive experiences with this interdisciplinary care model. Less Burnout, More Satisfaction Ten years ago, the Arthritis Treatment Center…
The ACR Has Introduced a New Reproductive Health Guideline Draft
CHICAGO—Reproductive health can be a concern for patients with rheumatic diseases, and practitioners in both disciplines often work closely together. The Reproductive Health in Rheumatic and Musculoskeletal Diseases Guideline, a draft of new clinical recommendations developed by an ACR-convened group for pregnant women, post-menopausal women, lactating women, and women and men trying to conceive or…
Get to Know the ARP’s Power Couple
Bob and Jan Richardson’s separate paths to physical therapy and rheumatology involve wrestling and horses—although not at the same time. Their intertwining stories also involve a fair amount of serendipity. Mr. Bob Richardson For Bob Richardson, PT, MEd, the path started in the late 1950s, when he was wrapping up a fulfilling college wrestling career…
Case Report: Coccidioides Immitis Infects a Patient’s Vascular Graft
A 76-year-old Caucasian male with a history of abdominal aortic aneurysm repair five years earlier presented with three months duration of worsening periumbilical abdominal pain associated with nausea, non-bloody emesis, decreased appetite, fatigue and a 40 lb. weight loss. He denied having fever, chills, night sweats, temporal headaches, vision loss, chest pain, shortness of breath and…
Predicting the Unpredictable – Taming the Impulse to Treat
One of my fellows could take better care of his patients if it weren’t for the attendings getting in his way. Or so he tells me. I can hear the howls of protest already. This statement isn’t fair—it is too broad, it doesn’t fairly depict the nuances of the situation or his point of view. First,…
Case Report: Lymphocytic Vasculitis of the Central Nervous System
Vasculitis is a group of chronic inflammatory diseases in which the blood vessel is the target of an immune reaction. They can be secondary to connective tissue disease, idiopathic or due to infection, neoplasm or drugs.1 Primary angiitis of the central nervous system (PACNS) is a rare syndrome characterized by inflammatory cell infiltration and necrosis…
Medicare Changes Could Have Some Patients Paying More for Drugs
(Reuters Health)—A proposed shift in Medicare coverage for medicines administered by doctors may help reduce total drug spending, but a new study suggests it may also lead to higher out-of-pocket costs for some patients. Right now, drugs given by infusion or injection in outpatient settings are covered by Medicare Part B, which is part of…
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