Test yourself against the knowledge of expert Nancy Lane MD in this 7-question quiz about aspects of osteoporosis detection and management. Dr. Lane is Director of the Musculoskeletal Diseases of Aging Research Group and the Academic Geriatric Resource Program at the UC Davis Health System in Sacramento.
Wholesale vitamin D supplementation may not prevent osteoporosis, judges a review of clinical trials. Other news: A novel drug that directly targets IL-6 up for regulatory scrutiny, newfound mutations in Sjögren's syndrome, and why eczema itches. More »
Results from the Framingham Ostoporosis Study show that change in bone mineral density over baseline offers little predictive value. Also last week: More support for diet and exercise to reduce the pain of knee OA. More »
New in the general journals: A chart review suggests rethinking recommendations about monitoring osteoporosis treatments. Also: Stroke as a presenting symptom for fungus-infected spinal injections, and more ... More »
New in the nonspecialty journals: A new option for patients with autoimmune disease and HCV infection. The value of combined therapy for osteoporosis. Prognosis predictors for chronic pain, a new opioid adverse effect, and more ... More »
Despite limitations, this study lends some reassurance that risk of osteoporosis is not likely to overshadow the benefit of proton pump inhibitors in preventing recurrent peptic ulcer, esophageal reflux symptoms, and esophageal cancer risk. More »
PML and Rituximab: What Rheumatologists Should Know
The risk for progressive multifocal leukoencephalopathy among RA patients on rituximab is extremely low, about 5/100,000. For MS patients on long-term (>24 months) natalizumab and infected with relevant pathogen, the JC virus, it is cited as 1/100. . ..
Pharmacogenetics in Rheumatology: Disappointment, Success, and a Few Challenges
The enzyme that prevents toxic reactions to the lupus drug azathioprene has little or no activity in 0.3% of individuals and only intermediate activity in 10%. The test for this, advised on the label, is a rare example of effective pharmacogenetics in rheumatology. . ..
EMG is a very helpful to differentiate myositis from disorders of the brain, nerves, or spinal cord, but among children MRI is often used to avoid the morbidity associated with muscle biopsy and EMG. Absent skin manifestations, muscle biopsy is the gold standard. . ..
Systemic Lupus Erythematosus With Features of Castleman Disease
Lymphadenopathy, fever, anemia, elevated ESR, and hypergammaglobulinemia occur often in the plasma cell type of Castleman Disease. Unlike another cause in the differential, malignancy, these are completely reversible in Castleman Disease. . ..
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. . ..
How Physicians Can Manage Unexpected Free Time Jennifer Frank, MD, October 22, 2013 Whether you have an unexpected patient no-show, or two hours before bed, figuring out how to spend spurts of free time can be a work-life balance stressor.