Search results for "Rheumatology"
Fibromyalgia characterized by controversy
There is very clear, objective evidence that fibromyalgia is a real problem. But there remains considerable dissent among the medical community about the condition's cause.
https://immattersacp.org/archives/2016/09/fibromyalgia.htm
1 Sep 2016
MKSAP Quiz: 4-week history of joint pain, rash
A 33-year-old woman is evaluated for a 4-week history of recurrent worsening joint pain and a new rash on the chest and upper back. She reports sun exposure from spending time at the beach. Following a physical exam, what is the most likely diagnosis for the rash?
https://immattersacp.org/archives/2021/05/mksap-quiz-4-week-history-of-joint-pain-rash.htm
1 May 2021
Guideline released on rheumatoid arthritis treatment
Among other recommendations, the guideline panel recommended a treat-to-target approach rather than a nontargeted approach in patients with early symptomatic RA and those with established RA, regardless of disease activity.
https://immattersacp.org/weekly/archives/2015/11/24/4.htm
24 Nov 2015
MKSAP Quiz: 8-year history of joint pain
A 50-year-old man is evaluated for an 8-year history of joint pain, particularly in the hands, and progressively worsening fatigue. Medical history is otherwise unremarkable. He takes ibuprofen as needed. There are swelling and tenderness of the second and third metacarpophalangeal (MCP) joints bilaterally, and tenderness but no swelling of the fourth and fifth MCP joints bilaterally. There is bony hypertrophy of the first MCP joints and knees bilaterally. The proximal interphalangeal joints and wrists are normal. Following a physical exam, lab studies, and a radiograph, what is the most appropriate diagnostic test to perform next?
https://immattersacp.org/archives/2017/05/mksap.htm
1 May 2017
Noninvasive treatment almost always best for knee pain
Knee symptoms are the most common musculoskeletal reason why patients visit their doctors, and in most cases, except when breaks or infection is suspected, physicians should recommend the use of nonsurgical treatments first.
https://immattersacp.org/archives/2016/04/knees.htm
1 Apr 2016
MKSAP Quiz: follow-up visit for gout
A 55-year-old man is evaluated during a follow-up visit for gout. Two years ago, he had been treated with allopurinol and developed a hypersensitivity reaction. Over the past several months, he has had recurrent attacks of acute, episodic swelling of the first metatarsophalangeal joints with increasing involvement of other joints, including the ankles and knees. Laboratory studies showed significant hyperuricemia. History is also significant for Crohn disease, hypertension, chronic kidney disease (estimated glomerular filtration rate of 55 mL/min/1.73 m2), and nonalcoholic fatty liver disease. Current medications are diltiazem and azathioprine, which he has been taking for the past 9 months. Which of these is a contraindication to the use of febuxostat in this patient?
https://immattersacp.org/weekly/archives/2017/01/24/3.htm
24 Jan 2017
Free educational tools available for diagnosis, treatment of lupus
Free educational resources are available through the American College of Rheumatology's Lupus Initiative to reduce health disparities for patients disproportionately affected by lupus based on race, ethnicity and gender.
https://immattersacp.org/weekly/archives/2012/09/18/9.htm
18 Sep 2012
MKSAP Quiz: evaluation for progressive left knee pain
A 34-year-old man is evaluated for progressive left knee pain. The pain causes difficulty with his work as a mail carrier, particularly when walking. His occupation does not require repetitive bending. He played football in college and experienced left knee trauma during sports participation; he underwent left meniscectomy and stopped playing sports. His mother has osteoarthritis of the hands that developed at age 65 years. Following a physical exam and radiographs, what is the most likely cause of this patient's left knee osteoarthritis?
https://immattersacp.org/weekly/archives/2016/10/04/3.htm
4 Oct 2016
4 steps to managing osteoarthritis pain in the elderly
Weight loss and nutritional counseling should be the first step, while opioids are always and only a last resort.
https://immattersacp.org/archives/2016/07/osteoarthritis.htm
1 Jul 2016
Lupus presentation may be an ‘imitator’
Lupus can involve multiple organ systems and shares the same, sometimes nonspecific presentation as other conditions. But a diligent internist##mdash;an “excellent generalist” in the words of one expert##mdash;can pick up on the correct diagnosis.
https://immattersacp.org/archives/2014/11/lupus.htm
1 Nov 2014