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.
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 »
The FDA has approved the tumor necrosis factor (TNF) blocker golimumab (Simponi) for treatment of moderate to severe ulcerative colitis in adults. This is the first non-arthritis indication for the biologic, which is already approved for rheumatoid arthritis, psoriatic arthritis, and ankylosing... More »
In a comprehensive review of clinical trials, combination therapies with biologics offered better chances of long-term remission than monotherapy with a DMARD. 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 »
Two major examples of "crowdsourcing" genetic explanations for rheumatic diseases: a competition to explain the genetics of anti-TNF response in rheumatoid arthritis, and 14 newfound genes for juvenile idiopathic arthritis. More »
Pain, function and quality of life scores from 11% of patients with early rheumatoid arthritis rate the condition as “worse than death,” according to French researchers, with extreme pain and discomfort being a key determinant. More »
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. . .
Obese Woman With Fibromyalgia and Increasing Back Pain
Clues to spinal epidural abscess as a cause of back pain (a potentially disabling condition and thus a diagnostic "great save"):
1. Usually insidious onset 2. Usually thoracic (most back pain is cervical or lumbar) 3. Major red flag: fever (though often absent, especially early in the course). . .
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.
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