In late February 2011, a 68-year-old woman visited the rheumatology outpatient clinic. She had been congenitally healthy and had been a field athlete in her early days. Beginning in early January 2011, she became aware of pain in her neck and both shoulders, with pain spreading to her lower back and thighs. She also became…
Diagnostic Imaging in Patient with Atraumatic Left Shoulder Pain: History
Editor’s note: In this recurring feature, we first present a series of images (this page) for your review, and then a brief discussion of the findings and diagnosis. Before you turn to the discussion, examine these images carefully and draw your own conclusions. History A 56-year-old man with end-stage renal disease on peritoneal dialysis presents…
Diagnostic Imaging in Patient with Atraumatic Left Shoulder Pain: Findings
View the question. Findings/Diagnosis The AP radiograph of the left shoulder (see Figure 1) shows erosions of the proximal humeral and glenoid articular surfaces (black arrows) without joint-space narrowing. There is a well-defined marginal erosion with overhanging edge at the junction of the proximal humeral articular surface and rotator cuff insertion on the greater tuberosity (ellipse)….
Knee Surgery for Pain May Not Be Worthwhile
(Reuters Health)—Middle-aged and older adults with torn cartilage or painful arthritis in their knee are not likely to benefit from arthroscopic surgery, and could be harmed by it, a review of past studies hints. Researchers reviewed nine previous studies with a combined 1,270 patients and found the surgery no better than other options like exercise…
Knee Osteoarthritis Pain Worse with Insomnia
(Reuters Health)—People suffering from osteoarthritis, the most common type of joint inflammation, are more likely to have knee pain when they also have difficulty getting enough sleep, a study suggests. Researchers found that people with knee osteoarthritis and insomnia were also more likely to suffer from a nervous system disorder called “central sensitization” that makes…
Pain Perception May Depend on Multiple Immediate-Environment Stimuli
Can merely crossing your fingers change the way your brain perceives pain when you touch different stimuli with three fingers? Perhaps so, according to a new study by UK-based researchers, when taken into context with the immediate environment. Changes in posture could potentially provide a way to influence chronic pain if basic science results lead…
Isometric Exercise May Immediately Reduce Pain of Patellar Tendinopathy
NEW YORK (Reuters Health)—Volleyball players with patellar tendinopathy reported an immediate easing of their pain after isometric exercise, and the effect persisted for 45 minutes after the intervention, a new study has found. In contrast, isotonic exercise appeared to diminish the athletes’ pain to a lesser degree, and the effect did not last at the…
Melioidosis: What Rheumatologists Need to Know
Burkholderia pseudomallei, the causative agent of melioidosis, is endemic in Southeast Asia and northern Australia.1 In recent years, the incidence of melioidosis has increased worldwide. Septic arthritis is a rare, but well-recognized, manifestation of melioidosis. Case Report A 49-year-old woman with known diabetes was admitted elsewhere with uncontrolled diabetes and fever. She was found to…
The Diagnostic View: Assess Your Rheumatology Knowledge
Radiograph, MR images of a 55-year-old man with chronic back pain
The Diagnostic View: Our Findings
Radiograph, MR images reveal symmetric erosive sacroiliitis in a patient who was diagnosed with ankylosing spondylitis
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