A 50-year-old male patient returns to the office for a follow-up visit for a diagnosis of generalized primary osteoarthritis of multiple sites. The patient tells the medical assistant that he is experiencing sharp throbbing pain in his left hip and right and left knees. He states the pain level is 6 out of 10 and…
Medical Paradoxes in Clinic, Lab Should Encourage Physicians to Reappraise Ideas about Health and Disease
Wash your hands. This most basic tenet of proper hygiene has been drummed into our heads for years. It’s an obvious infection prevention activity, yet for years, compliance among physicians and other caregivers has been lackluster. To rectify this matter, regulatory agencies began auditing hospital staff adherence to this axiom of infection prevention. Not only…
Ethics Forum: Ethical Challenges Arise for Rheumatologists Pressed to See Patients of High Social, Professional Standing Before Others
The Case You’re working in a busy rheumatology practice with wait times of two to three months for new outpatient consultations. A hospital administrator requests that his daughter see you right away. All but one of your urgent appointment slots for the week is already filled, and there are several patients on a waitlist; these…
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…
Rheumatology Drug Updates: Giant Cell Arteritis Relapse Possible if Tocilizumab Discontinued; Plus Updates on Rituximab, Etanercept
GCA Relapse Possible When Discontinuing Tocilizumab In a Phase 2 randomized, controlled trial, tocilizumab, an anti-IL-6 biologic agent, was shown to induce and maintain remission for up to 52 weeks in patients with giant cell arteritis (GCA).1 During this trial, patients with GCA were randomized in a 2:1 ratio to receive 8 mg/kg bodyweight tocilizumab…
Biomedical Research Key to Advancing Clinical Care for Rheumatic Diseases
WASHINGTON, D.C.—The importance of biomedical research to advancing clinical care with the ultimate goal of improving patients’ lives was on display during an ACR Discovery 2016 plenary session at the 2016 ACR/ARHP Annual Meeting. The session offered new ways to think about and treat select rheumatologic diseases, including research showing for the first time the…
How to Manage Patients with Giant Cell Arteritis and Polymyalgia Rheumatica
WASHINGTON, D.C.—From diagnosis questions to infection risk to treatment decisions, handling giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) comes with a range of challenges for clinicians. Speaking in the ACR Review Course at the 2016 ACR/ARHP Annual Meeting, an expert—Rebecca Manno, MD, MHS, assistant professor of medicine in rheumatology at Johns Hopkins, as well…
How to Diagnose Shoulder Pain
WASHINGTON, D.C.—A 70-year-old woman had been diagnosed with rotator cuff disease three years earlier and received an array of treatments. What she hadn’t received was an X-ray. She’d had an MRI, and her doctor—not an orthopedist or a rheumatologist, but a primary care physician—had zeroed in on degenerative changes in her rotator cuff. The problem,…
Digital Healthcare Devices, Sensors Gaining Ground as Portable Personal Coaches
WASHINGTON, D.C.—A friendly, but stern, voice talks to Joseph Kvedar, MD, vice president of Connected Health at Partners HealthCare, from his smartphone. Dr. Kvedar has just woken up. “Good morning, Joe! Here’s the tale of the tape. Your blood pressure and cholesterol are fine. Your sleep deficit is now up to three hours for the week….
Electronic Medical Records Have Mixed Impact on Quality, Quantity of Healthcare
The widespread implementation of electronic medical records (EMRs) and electronic health records (EHRs) has significantly changed the quality and quantity of healthcare for both the better and the worse. The digitalization of medical records provides comprehensive documentation of all events and actions associated with an individual’s medical care. Likewise, legibility, accountability and credibility are greatly…
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