Proving that a picture can be worth at least a thousand words, this slide show with links to case studies offers a chance to review the basics of diagnosis and treatment.
In this first case, the patient was suffering his third episode of gout. The first metatarsophalangeal joint of his left foot was erythematous, hot, and tender, and the intense pain was resistant to treatment with colchicine.
The top men's health concerns include heart disease, cancer, accidents, and chronic lower respiratory diseases. This compact slide show provides visual presentations of other clinical problems that pose a threat to men and that might be seen in primary care practice. More »
They may be supported by guidelines and commonly used in practice, but joint injections with glucocorticoids for acute gout are not backed by any randomized controlled clinical trials, according to a new Cochrane report. However, the report backs away from saying they should not be used. More »
A series of studies using functional MRI have identified brain-signal patterns specific for pain that are attenuated by opioids: Also last week: top rheumatology findings of 2012, more on TNF inhibitors and cancer, and concerns about vitamin D. More »
Here: how omega-3 fatty acids may help reduce the risk of atrial fibrillation (AF) in postcardiac surgery patients; how incident HF can help predict adverse outcomes in patients with AF; and why an old gout drug may help reduce the risk of AF in patients with heart failure. More »
See clinical features of rheumatologic diseases including rheumatoid arthritis, systemic lupus erythematosus, dermatomyositis, psoriatic arthritis, scleroderma More »
The RADAI joint index designed for rheumatoid arthritis patients provides equally powerful information about disease status in osteoarthritis and psoriatic arthritis, according to a new comparative study. As a guide to severity, it is much quicker than waiting for lab results to come in. More »
Despite hopes that rilonacept might provide a better alternative to NSAIDs or colchicines for gout pain, it does not provide significant relief either on its own or as an add-on therapy to indomethacin. More »
Does this evidence from recent research overturn some generally accepted principles about gout, rheumatoid arthritis, reactive arthritis, and osteoarthritis? Most of these studies were undertaken in order to test ideas that were described as common wisdom in rheumatology. More »
Dual-energy CT scans of ligaments and bones in patients with tophaceous gout showed patterns of monosodium urate crystal deposition suggestive of a role for biomechanical strain. The Achilles tendon was the most commonly involved site. More »
All About Gout and Pseudogout: Meeting A Growing Challenge
Most patients with hyperuricemia do not go on to have gout, and it may be seen with any other cause of acute monoarthritis. On the other hand, serum uric acid levels may drop to normal values during an acute gout attack, due to an increase in renal excretion, so a normal value does not exclude this diagnosis. . ..
Joint Aspiration and Injection: A Look at the Basics
Cellulitis overlying a swollen joint is not a contraindication if it is the only portal for intra-articular access. The risk of introducing infection by aspirating through cellulitic skin is far less than the risk of unmanaged septic arthritis. . ..
Limited Joint Mobility in Diabetes Mellitus: The Clinical Implications
Take care not to be overenthusiastic about the prayer-sign test for limited joint mobility, for instance in patients with diabetes. One study found that 26% of healthy controls were not able to make complete contact of the palmar surfaces. . ..
Viral causes are implicated in potentially deadly A-DRESS SYNDROME (dermatitis, hepatitis, interstitial nephritis, and eosinophilia) among allopurinol users. Skin biopsy and a wide panel of viral titers are well advised. . ..
Latent Tuberculosis Infection in RA: The Disease and the Diagnosis
Although tuberculosis is common in RA even in the absence of treatment, false-negative tuberculin skin test results are frequent because of either immunosuppressive treatment or a natural waning of immunity. . ..
The quads and hamstrings of OA patients who later have knee replacement seem to be firing continuously, according to new biomechanics research. Training with the Alexander technique may offer relief. . ..
Recognizing and Managing Posterior Cruciate Ligament Injuries
Gradually increasing mild pain in the back of the knee, stiffness, and pain with squatting or kneeling may be the only signs of PCL injury, arising long past the acute period after a seemingly trivial inciting event. . ..
Recognizing Rheumatologic Aspects of Cocaine Abuse
Cocaine and its contaminants, primarily levamisole, can cause lesions of the earlobes and cheeks, midline granulomatous lesions, and a mimic of vasculitis. . ..
Is There Truly A Therapeutic "Window of Opportunity" in RA?
Combined studies of more than 6,000 patients agree: To lessen joint damage and achieve remission, treat rheumatoid arthritis at least during the first 12 weeks after diagnosis.. . .
Raynaud's phenomenon is usually absent from eosinophilic fasciitis, which may be difficult to differentiate from scleroderma. Nearly all scleroderma patients have Raynaud's, usually early on. . .
Key Differences between FQHCs and RHCs Chastity Werner, RHIT, June 13, 2013 FQHCs and RHCs take up a unique niche among physician practices. And that affects compensation and billing.
Improving Care Coordination in Your Practice Susanne Madden, June 12, 2013 Practices are feverishly working to control the rising costs of healthcare - effective care coordination can help.
Refunding Overpayments: Two Options for Medical Practices Ericka L. Adler, June 12, 2013 Medicare and Medicaid providers must return overpayments once identified. Here are two different refund approaches for practices to consider when necessary.
iPad Alternatives for Mobile Physicians Marisa Torrieri, June 11, 2013 As more physicians are seeing the merits of media tablets, the market is expanding, too.
Proving that a picture can be worth at least a thousand words, this slide show with links to case studies offers a chance to review the basics of diagnosis and treatment.
