A 12-year-old male established patient with inflammatory bowel disease with associated juvenile spondyloarthropathy returns to the office for a follow-up visit for his infliximab infusion. The patient reports moderate pain in his right hip after walking for extended periods of time or after sports activities. He denies any other joint pain and denies any joint…
Exercise Therapy Recommended to Manage Knee Osteoarthritis
The benefits of exercise therapy for individuals with knee osteoarthritis (OA) are well known. The ACR strongly recommends both aquatic exercise and land-based aerobic and resistance exercise for managing knee OA.1 A recent Cochrane systematic review and meta-analysis concluded that high-quality evidence supports the use of exercise to reduce pain and improve physical function and…
Rheumatology Drug Updates: Labeling for Fluoroquinolones; FDA to Review Benzhydrocodone/Acetaminophen Combination
FDA Restricts Fluoroquinolone Use The U.S. Food and Drug Administration (FDA) has twice previously communicated safety information about systemic fluoroquinolones—in August 2013 and July 2008. The safety issues of this medication class described in its latest Drug Safety Communication were also discussed at a November 2015 FDA Advisory Committee meeting.1 The FDA is now advising…
Rheumatologists on the Move, July 2016
HSS Holds First Rheumatology Gala The Hospital for Special Surgery (HSS) in New York City hosted a Rheumatology Gala in May. The event, held at The Park Avenue Armory in Manhattan, was held to increase awareness of HSS’s leading research and treatment of rheumatic diseases—particularly with “high-net worth people,” according to former ACR President Mary…
Practicing Telemedicine Raises Legal Considerations for Rheumatologists
With the evolution and advancement of technology, it was only a matter of time before such changes affected the medical industry. Although the concept of telemedicine dates back more than 50 years, emphasis on cost-effective quality healthcare coupled with technological advancements has caused a resurgence of telemedicine in recent years. What constitutes telemedicine largely depends…
3D Printing in Rheumatology Holds Promise for External Devices, Joints
When Abby Paterson, PhD, started her doctoral work in product design and technology at Loughborough University in the United Kingdom in 2009, she says 3D printing was little known by clinicians or the general public. Now, the technology is seemingly everywhere. For Dr. Paterson, the advancing science has led to a promising project focused on…
Rheumatology Case Report: Concomitant Lupus with Features of Scleroderma, Castleman Disease
We report a case of a 27-year-old woman who was initially diagnosed with systemic lupus erythematosus (SLE), had features of scleroderma and was subsequently found to have lymph node biopsy consistent with multicentric Castleman disease (MCD). She also had serologic evidence of acute Epstein-Barr virus (EBV) infection (vs. reactivation of EBV). The occurrence of MCD…
Conformational Flexibility in HLA-B27 Provides Clues to Development of Ankylosing Spondylitis
Understanding how human leukocyte antigen (HLA) class I molecule B27 promotes spondyloarthritis has intrigued researchers for four decades. Although the association between the single gene variant HLA-B27—specifically some of its subtypes—with ankylosing spondylitis (AS) is particularly strong, how HLA-B27 directly influences disease development has not yet been clearly explained, although hypotheses continue to be generated….
Rheumatology Fellow Faces Dilemma over Choice to Specialize or Generalize
Half a century ago, Konrad Lorenz, the pioneering animal behavior expert, wrote that “Philosophers are people who know less and less about more and more, until they know nothing about everything. Scientists are people who know more and more about less and less, until they know everything about nothing.” As I start the last year…
Rheumatoid Arthritis & Autoimmune Glomerulonephritis
Rheumatoid arthritis (RA) is rarely associated with renal manifestations, but secondary amyloidosis due to chronic inflammation is reported to be the etiology of renal dysfunction in many cases of RA.1,2 The discovery of biologic therapy, with TNF-alpha inhibitors in particular, made a huge difference in the disease course and prognosis of RA patients. However, TNF-alpha…
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