Subjectivity and the differences in how patients with autoimmune and other diseases perceive pain make the study and treatment of pain difficult. But Yvonne Lee, MD, says future advances in neuroimaging may aid in the objective study of pain and innovative treatments…
The boy who could not walk: S.L. is a previously healthy 10-year-old boy who has not walked for three months. Physical examination reveals swollen wrists, knees, ankles and several toes. There is reduced hip range of motion and flexion contractures of both knees. He can stand with assistance, but is unable to take a single…
Settling into room 501 at Maine Medical Center, Mrs. N was on her way to the bathroom when she felt it coming on. One moment she was okay; the next, her chest felt damp and cold, even as her face flushed and her temperature spiked. Her forehead glistened beads of warm sweat. She felt the…
Ophthalmologists may be more likely to initially diagnose and treat scleritis, an inflammation of the scleral tissues of the eye. However, rheumatologists need to remain aware of the condition as well: It’s commonly associated with rheumatic disorders, such as rheumatoid arthritis (RA). Scleritis can present in the eye anteriorly or posteriorly. “Anterior scleritis can be…
SAN FRANCISCO—The organisms in the gut are remarkably malleable with diet, dangling the possibility that diseases could potentially be affected by the food that people eat, according to an expert here at the 2015 ACR/ARHP Annual Meeting. Diet Starting with studies of animal feces from zoos and from the wild, in which researchers found that…
SAN FRANCISCO—A 40-year-old woman shows up in the clinic with scarring alopecia, with an area of hyperpigmentation on the rim of her scalp, extending from just behind the temple to behind her ears. An examination with a dermatoscope shows hyperkeratotic follicular plugging. The case—in this example, the discoid form of cutaneous lupus erythematosus (DLE)—is one…
SAN FRANCISCO—Inflammation can be either acute or chronic, and it’s the inflammatory responses that don’t shut down normally, or resolve, that cause tissue damage in rheumatic disease. “Resolution bridges the gap between acute inflammation and adaptive immunity,” said Derek W. Gilroy, PhD, head of the Centre for Clinical Pharmacology and Professor of Immunology at University…
The approach of under-treating rheumatic disease in pregnant patients is changing, according to Bonnie Lee Bermas, MD. Dr. Bermas discusses with The Rheumatologist the need for more research on how drugs affect this patient group, and how timing of conception and disease stability play important roles in the safe outcomes of mother and infant…
One of your first clinical assignments as a medical student was likely to have been the lung exam. Its key descriptors may still resonate in your mind: inspection, palpation, percussion and auscultation. Proudly parading down the hospital corridors, your newly purchased stethoscope snugly tucked inside your lab coat pocket, you carefully place its cold metal…
It is valuable to understand the semantics of consultant comments. A journal article I once read indicated that when a consultant reports having seen a series of individuals with a given problem, it means they have seen two cases. When they report they have experience with a problem, they mean they have seen a (one)…