We routinely treat disorders such as rheumatoid arthritis, lupus, scleroderma, and ankylosing spondylitis with immuno- suppressive drugs. Yet if infection were known to be the root cause, this course of action would seem counterintuitive, if not potentially dangerous in the short or long run.
This provocative essay by Stephen Paget MD of the Hospital for Special Surgery raises a provocative question or two.
Who do you think is on the wrong track: Paget, or rheumatology? Weigh in with your opinion at the end of the article.
From the top nonspecialty journals: Treatment decisions in rheumatoid arthritis, a drug option for psoriatic arthritis, and reason to think inflammation may trigger major mood disorders. More »
EULAR 2013: A study analyzing levels of physical activity in rheumatoid arthritis patients finds that being sedentary does not generally correlate with common signs of physical disability. More »
EULAR 2013: The latest revelation from efforts to test the OMERACT-MRI scoring system shows that MRI can work as well as CT in assessing joint space narrowing in RA of the hand. More »
A review of five clinical trials shows that a new subcutaneous formulation of abatacept (Orencia) is as safe and effective short-term in rheumatoid arthritis (RA) as intravenous abatacept, maintaining improvements in clinical and functional efficacy over time. More »
The past decade has seen remarkable advances in our understanding of rheumatoid arthritis. However, challenges remain. Resolving them offers hope for even greater success in the future. More »
Quest Diagnostics says the biomarker 14-3-3eta in its new test greatly improves sensitivity in detecting early rheumatoid arthritis. But the data is not yet published. 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. . .
Search for studies:. Study Record Detail. Study Evaluating Etanercept in Patients With RheumatoidArthritis( RA), Juvenile Idiopathic Arthritis ( JIA), or Psoriatic Arthritis ( PsA) in Spain.
Search for studies:. Study Record Detail. Analysis of Birth Outcomes of Swedish and Danish Women Exposed to Remicade With Inflammatory Bowel Disease, RheumatoidArthritis, Psoriatic Arthritis, Ankylosing Spondylitis, and Psoriasis.
Relaxation Response Training for the Treatment of RheumatoidArthritis. This study has been completed. ... Study NCT00056667 Information provided by National Institute of Arthritis and Musculoskeletal and Skin Diseases ( NIAMS).
The armamentarium of treatment modalities available to physicians seeing patients with rheumatoid arthritis (RA) and other forms of inflammatory arthritis has increased dramatically in recent years. In particular, the introduction of the biologic disease-modifying antirheumatic drugs (DMARDs), most notably the tumor necrosis factor a (TNF-a) inhibitors, has afforded clinicians new opportunities to mitigate disease progression.
Rheumatoid arthritis (RA) often presents late, when irreversible damage has occurred. More than half of primary care consultations are for joint pain, but the average time from initial presentation with symptoms to confirmation of diagnosis of RA is 18 weeks.
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.
