WASHINGTON, D.C.—The vast majority of the attention given to vasculitis at the ACR/ARHP Annual Meeting, year after year, focuses on ANCA-associated vasculitis and large-vessel vasculitis, said Philip Seo, MD, MHS, director of the Johns Hopkins Vasculitis Center and moderator of the 2016 ACR Review Course titled, Neglected Vasculitis. That leaves out a lot. “These are…
When Symptoms of Rheumatic Disorder Point to Endocrine Disease
WASHINGTON, D.C.—“Rheumatic manifestations are [often] the initial presentation of a systemic disease, but they can [also] occur during the course of the disorder,” said Joseph Markenson, MD, speaking in the ACR/ARHP Annual Meeting talk, Rheumatic Manifestations of Endocrine Disease, during the ACR Review Course. Dr. Markenson is professor of clinical medicine and a rheumatologist at Weill…
ACR Recommends You Treat the Symptoms for Gout Patients
In 1982, my wife (also a rheumatologist) and I attended our first American Rheumatism Association (now the ACR) national meeting. After the meeting we stayed with a friend in a suburb of Boston, where we also had the opportunity to meet our hostess’ in-laws, a retired general practitioner and his wife. When her father-in-law shook…
Assessing Autoimmune Disease Symptoms in Silicone Breast Implant Recipients
My nurse, Joanne, took me aside before I began my next consult. “Room No. 5, breast implant patient. Her lawyer organized the records.” She handed me a hefty three-ring notebook organized by color-coded tabs. “Her attorney called just now,” Joanne raised an eyebrow, “and told me to tell you that, to save time, he highlighted…
6 Ways to Identify, Deal with Burnout in Rheumatology Fellowship
“Burnout? In rheumatology fellowship? You’re kidding me, right?” That was the response of one of my very good friends from residency who is now a cardiology fellow, when I told him that I was concerned that one of my co-fellows, at another institution, was on the verge of burning out. Stepping back, I could understand…
Fellow’s Forum Case Report: Waldenström Macroglobulinemia
A 73-year-old white male presented with a one-day history of a cold, painful, right foot. The foot had a blue discoloration to it, particularly the toes. The emergency physician suspected an atheroembolic cause, given this patient’s age and history of coronary artery disease. However, the patient also reported a one-year history of painful pallor in…
Scleritis Often Diagnosed by Ophthalmologists, But Rheumatologists Help Determine Systemic Causes
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…
APS: What Rheumatologists Should Know about Hughes Syndrome
The problem that dogs the work of all of those treating patients with antiphospholipid syndrome (APS) is the apparent lack of knowledge of the syndrome, both by the general public, as well as by swaths of the medical fraternity. Perhaps it was ever thus—a syndrome less than 40 years old could be described as new,…
Rheumatic Disease Manifestations in the Central Nervous System
SAN FRANCISCO—Let’s say your radiologist comes to you and says that an angiogram gives a diagnosis of CNS vasculitis on four patients, all with acute onset of headache and stroke: One is a 25-year-old woman who is three months pregnant. Another is a 50-year-old man using excessive doses of nasal decongestants. Another is a 40-year-old…
Diagnostic Clues, Tips Useful for Differentiating RA and Lyme Disease
RA vs. Lyme I am writing to comment on your interesting and useful article that appeared on the front page of the August issue of The Rheumatologist, “RA vs. Lyme,” by Charles Radis, DO. Arriving at a definite diagnosis of active RA early on is often not an easy task. The author of this article…