Erosive Polyarticular Chronic Tophaceous Gout in a Young Man A 27-year-old man was referred to us for joint pain and nodular swelling over multiple joints. His symptoms started when he was 13 years old, but he was sub-optimally treated. On examination, we found marked digital deformity, with multiple large tophi over the small joints of…
How Our Thinking Impacts Our Judgment
Let’s start with a couple of short riddles: What question can you never answer “yes” to? Which word does not belong in the following list: stop cop mop chop prop or crop? [The answers appear at the end of this article.] Riddles are designed to make us think beyond the obvious answer. There is usually…
The ACR Image Competition 2021 Results, Part 2: People’s Choice
People’s Choice: Keratoderma Blennorrhagica Submitted by Kunal Chandwar, MD, MBBS, King George’s Medical University, Lucknow, India, the photo depicts extensive keratoderma blennorrhagica in a patient with reactive arthritis. Spondyloarthropathies An 18-year-old man presented with psoriasiform plaque-like lesions that began on the limbs and progressed to involve his entire body (including his face) over a month….
The ACR Image Competition 2021 Results: Best Overall
Best Overall: Cutaneous Manifestations of Dermatomyositis These images, submitted by Santhanam Lakshminarayanan, MD, associate professor of medicine in the Division of Rheumatology the University of Connecticut School of Medicine, Farmington, show a 32-year-old Black woman with classic cutaneous manifestations of dermatomyositis: heliotrope rash; periorbital edema with complete closure of the eyes; erythema nodosum on the…
How to Avoid Cognitive Errors in Rheumatology
The 1999 Institute of Medicine report To Err Is Human gave a sobering depiction of the magnitude and consequences of medical error.1 The report concluded that approximately 98,000 people die in hospitals annually due to preventable medical errors. Of all the errors detailed in this report, diagnostic errors have since been determined to be the…
COVID-19 Disproportionately Stymies Women Researchers
The COVID-19 pandemic changed pretty much every facet of human activity, from home life to social interactions to the workplace. Medicine and research kept up a dizzying pace throughout the pandemic, with physicians and researchers working clinic hours even if they were able to use telemedicine to do some of their work from home. For…
Addressing Racism & Discrimination in Academic Rheumatology Settings
Implicit bias negatively affects patients and clinicians alike in a variety of healthcare settings. Unconscious feelings and attitudes about others can damage professional and personal relationships. Demystifying Bias At the virtual ACR Division & Program Directors Conference in March, three physician leaders presented a panel called, Demystifying Bias: Empowering You to Have Courageous Conversations, and…
Diversity: From Concepts to Outcomes
ACR CONVERGENCE 2020—In 2020, terms like unconscious bias, diversity and inclusivity are buzzwords in rheumatology, as well as throughout American society. The COVID-19 pandemic revealed stark disparities in healthcare outcomes for rheumatic disease patients of racial and ethnic minorities, including new research that shows Black and Latinx patients have a higher risk of hospitalization and…
Conquering Systemic Racism in Medicine
2020 has not only borne witness to a global pandemic, but also to increasing fervor in the fight for racial equity. In a wave of opposition to the systemic racism in the U.S., people have been in the streets demonstrating and protesting against social injustice and have taken to social media to promote political action….
Gender Disparity in Invited Commentary Authorship
A case-control study found only 23% of invited commentaries for peer-reviewed medical journals had women as their corresponding authors. The study also revealed women are 21% less likely to write such commentaries as men with similar expertise and author seniority…