Rheumatology Feature News

Examining the Role of Diet in Rheumatoid Arthritis

Examining the Role of Diet in Rheumatoid Arthritis

Many components of diet have been implicated as possible risk factors for RA, with varying degrees of evidence.

Inflammatory Arthritis and the Gut Microbiome: Do Microbes Hold the Key to New Treatments?

Inflammatory Arthritis and the Gut Microbiome: Do Microbes Hold the Key to New Treatments?

Recent research points to an association between the gut microbiome composition and various types of immune-mediated inflammatory arthritides.

Expanding Healthcare Access With Nurse-Led Care in Rheumatoid Arthritis

Expanding Healthcare Access With Nurse-Led Care in Rheumatoid Arthritis

A recent systematic review found that nurse-led care is effective, acceptable, and safe in patients with rheumatoid arthritis.

Stat Consult: Chronic Low Back Pain

Stat Consult: Chronic Low Back Pain

Chronic low back pain (LBP) defined as persistent or fluctuating musculoskeletal pain of lower back and lumbar spine lasting >3 months.

Case Study: Cardiac conditions of rheumatoid arthritis

Case Study: Cardiac conditions of rheumatoid arthritis

A 69-year-old man with no prior medical history presents over the course of several months with new-onset nonspecific joint pain and swelling without evidence of erosions.

Photosensitivity diseases: a review of sun-exposed skin rashes

Photosensitivity diseases: a review of sun-exposed skin rashes

An overview of porphyrias, lupus erythematosus, rosacea, drug-induced photosensitivity, polymorphous light eruption, and solar urticaria.

Rheumatoid arthritis: risk factors, clinical signs, and treatment

Rheumatoid arthritis: risk factors, clinical signs, and treatment

Early diagnosis and aggressive treatment are essential to mitigate the cascading events that lead to irreversible joint erosion in rheumatoid arthritis.

Raynaud phenomenon: a cold-weather condition

Raynaud phenomenon: a cold-weather condition

A thorough work-up can differentiate between primary and secondary forms, mitigating progression of a more severe underlying disease.

Gold may possess anti-inflammatory agents

Gold may possess anti-inflammatory agents

The use of gold therapy as an anticancer agent appears promising, as does its more common use as a DMARD.

Osteoarthritis: conservative treatment options

Osteoarthritis: conservative treatment options

Osteoarthritis is one of the most common problems encountered in primary care, and conservative treatment can improve patients' quality of life.

Current and emerging medications for psoriasis

Current and emerging medications for psoriasis

A number of therapeutic options exist for patients with psoriasis, including phototherapy and systemic and biologic agents.

A multidisciplinary approach to treating enteropathic spondyloarthritis

A multidisciplinary approach to treating enteropathic spondyloarthritis

A multidisciplinary approach to diagnosing and treating enteropathic spondyloarthritis (ESpA) is the best way to ensure a patient gets comprehensive care.

DMARDs remain first choice of therapy for rheumatoid arthritis

DMARDs remain first choice of therapy for rheumatoid arthritis

Updated American College of Rheumatology recommendations suggest using first-line DMARDs in combination with biologic agents and nonbiologic DMARDs to achieve therapeutic efficacy in rheumatoid arthritis treatment.

Intra-articular injections
 for severe osteoarthritis

Intra-articular injections
 for severe osteoarthritis


For patients with severe osteoarthritis, dangling their legs can help with intra-articular injections.

Understanding Dupuytren disease

Understanding Dupuytren disease

Needle aponeurotomy and collagenase Clostridium histolyticum are both viable options for treating patients with Dupuytren disease.

Methylsulfonylmethane may alleviate osteoarthritis burden

Methylsulfonylmethane may alleviate osteoarthritis burden

Methylsulfonylmethane may help treat osteoarthritis and may eventually create a way to detect melanoma.

Rapidly worsening eye pain and ankylosing spondylitis

Rapidly worsening eye pain and ankylosing spondylitis

A women presenting with eye pain and photo sensitivity was diagnosed with ankylosing spondylitis.

Bee-venom therapy too risky for treating osteoarthritis, RA inflammation

Bee-venom therapy too risky for treating osteoarthritis, RA inflammation

The risks of bee-venom therapy outweigh the potential benefits, and clinicians should discourage patients from this therapeutic method.

Weighing the pros, cons of craniosacral therapy

Weighing the pros, cons of craniosacral therapy

The benefits of CranioSacral Therapy may not outweigh the intensive training and medical costs associated with the treatment.

Craniosacral therapy may be helpful, but not curative

Craniosacral therapy may be helpful, but not curative

Due to the limited amount of high-quality human studies, craniosacral therapy should not be suggested as a first-line treatment.

Unusual use of radiation therapy for pelvic pain

Unusual use of radiation therapy for pelvic pain

A woman suffers cyclic pain after multiple abdominal and pelvic surgeries.

Solving the mystery 
of rheumatic disease

Solving the mystery 
of rheumatic disease

Selecting appropriate lab tests when evaluating persons with symptoms suggesting a rheumatic condition often requires a bit of detective work.

Gout management 
in patients with CKD

Gout management 
in patients with CKD

The most recent guidelines from the American College of Rheumatology
include pharmacologic and nonpharmacologic therapy for hyperuricemia.

Underlying problems of scoliosis

Underlying problems of scoliosis

A girl with scoliosis returns to the clinic complaining of ankle pain.

Osteoarthritis and 
Rheumatoid ­Arthritis 2012: Pathophysiology, Diagnosis, 
and Treatment

Osteoarthritis and 
Rheumatoid ­Arthritis 2012: Pathophysiology, Diagnosis, 
and Treatment

This article highlights the differences in the pathophysiology and diagnostic criteria for OA and RA, and also describes current and potentially new treatment options for these conditions.

Osteoporosis in a patient taking anti-seizure medication

Osteoporosis in a patient taking anti-seizure medication


Are dual-energy x ray absorptiometry scans safe for patients taking anti-seizure medication?

Stinging nettle: Alternative treatment for BPH, osteoarthritis, other pro-inflammatory ailments

Stinging nettle: Alternative treatment for BPH, osteoarthritis, other pro-inflammatory ailments

Stinging nettle has been used to treat arthritis and other inflammatory conditions since the 10th century.

Vitamin D deficiency: Beyond bone health

Vitamin D deficiency: Beyond bone health

Vitamin D promotes absorption of calcium in the intestine and maintains adequate serum phosphate and calcium concentrations.

When is surgical intervention advisable for Parkinson disease?

When is surgical intervention advisable for Parkinson disease?

Is there a window of opportunity when surgical intervention is most successful for patient's with Parkinson disease?

Acupuncture best for chronic low back pain and osteoarthritis management

Acupuncture best for chronic low back pain and osteoarthritis management

The National Institutes of Health noted that there is enough scientific evidence of acupuncture's efficacy to warrant its use in certain clinical situations.

Tart cherry: A superfruit with antiinflammatory and cardiac benefits

Tart cherry: A superfruit with antiinflammatory and cardiac benefits

A growing body of evidence has linked the tart cherry to substantial anti-inflammatory benefits, including reduced arthritic and gout pain, and several cardiac benefits.

Secondary malignancy following breast and uterine cancer

Could a patient's anterior thigh pain signify osteosarcoma?

A new understanding of 
osteoarthritis

A new understanding of 
osteoarthritis

Ongoing research and new developments hold promise for altering 
osteoarthritis and go beyond simply treating the symptoms.

The role of vitamin D in post-fracture symptoms

Can vitamin D deficiency play a role in post-fracture pain?

Check for flat feet in young patients with shin splints

Ruling out pes planus can help avoid unnecessary prescriptions and referrals.

Do PPIs affect calcium absorption?

Are there any studies that confirm effective calcium absorption when the patient is taking long-term proton pump inhibitors (PPIs) along with oral calcium?

Lupus and the autoimmune process in 2012

Lupus and the autoimmune process in 2012

Thanks to new prevention strategies and safer treatments, patients are surviving almost as long as their counterparts without lupus.

A simple case of cellulitis on the third finger is a lot more

A simple case of cellulitis on the third finger is a lot more

A patient presents to the emergency department complaining of pain that originated over the distal tip of the digit.

Choosing the best inflammation marker

Which serologic measure of inflammation is the most cost-effective and reliable when monitoring inflammatory disease?

Rose hips prized for high vitamin C content, antiinflammatory properties

Rose hips prized for high vitamin C content, antiinflammatory properties

Rose hips are a mild, pleasant supplement that are safe for routine use. Providers may recommend this product as adjunctive therapy for a wide range of conditions or as a routine preventive regimen.

When a patient falls, the pain 
indicates dislocation

When a patient falls, the pain 
indicates dislocation

Tenderness over the hypothenar eminence, swelling and limited flexion also suggest fracture.

Easing children's anxiety over cast removal

Cast saws can be terrifying for children. An orthopedic physician assistant shares a tip to help ease pediatric patient's fear.

A running accident leads to the discovery of a humeral lesion

A running accident leads to the discovery of a humeral lesion

A woman fractured her upper arm in a fall while exercising. A large osteolytic growth was discovered on x-ray.

Discoid lupus erythematosus laboratory follow-up

How often should blood tests be repeated to rule out systemic lupus erythematosus (SLE) in a patient positive for discoid lupus erythematosus (DLE)?

Remember to HALT SLIPS in older patients

A clinician offers a useful mnemonic device to help prevent falls in older patients.

Nutrition's effect on rheumatologic conditions

Are there any common nutritional deficiencies associated with osteoarthritis (OA), rheumatoid arthritis (RA), and gout?

Willow bark relieves pain and inflammation

Willow bark relieves pain and inflammation

Willow bark contains the chemical salicin, which is the precursor to aspirin.The active salicin in white willow bark acts primarily as both an analgesic and an antipyretic. The actual mechanism of action of salicin is very similar to that of modern prescription medications in the cyclo-oxygenase-1 and 2 (COX-1, COX-2) pathways.

Licorice

Licorice

Medically, licorice traditionally has been used as a general anti-inflammatory, antitussive, GI soothant, and for respiratory support. The potential for antiviral activity and hepatocellular protection in cases of hepatitis C has also been discussed.

Gouty arthritis: How to make the diagnosis

Gouty arthritis: How to make the diagnosis

This painful disease greatly impacts the daily lives of those who suffer from it. Diagnosis, treatment, and lifestyle modification can ease long-term effects

Blisters on the hands and fingers of a woman with discolored urine

Blisters on the hands and fingers of a woman with discolored urine

Mild hypertrichosis and hyperpigmentation of the face were also noted, and plasma porphyrins were grossly elevated.

Use fracture risk to predict osteoporosis

Use fracture risk to predict osteoporosis

Be sure to consult guidelines from the National Osteoporosis Foundation for advice on optimizing calcium and vitamin D intake and reducing fall risk.

GI side effects of pain medication

What are the side effects of fentanyl?

Osteoporosis conundrum

What is the mechanism of action of teriparatide, the new parathyroid hormone (PTH) analog being used for the treatment of osteoporosis?

Painless bump on the leg for two years' duration

Painless bump on the leg for two years' duration

The boy had no history of pain, rapid growth, or trauma-associated local or systemic abnormalities.

Risks and benefits of bisphosphonate therapy

At what T-score and patient age does the benefit of bisphosphonate therapy outweigh the risk?

Treating giant cell arteritis to avoid complications

Treating giant cell arteritis to avoid complications

Seen primarily in individuals older than age 50 years, this inflammatory disorder is characterized by headache, jaw pain, and vision difficulties.

Falls in older adults: averting a disaster

Falls in older adults: averting a disaster

Falls can lead to hip fracture and head injury and can raise the risk of early death. Fortunately, this public-health problem is largely preventable.

Chronic inflammatory conditions and CRP levels

What is the relevance of a cardiac C-reactive protein level in a patient with an underlying inflammatory condition, such as rheumatoid arthritis?

Unexplained low-back pain in an adolescent with scoliosis

Unexplained low-back pain in an adolescent with scoliosis

Nothing offered more than temporary relief for the aching, constant pain, which was unaccompanied by other symptoms.

More tips on gout prevention

Treat the acute pain of gout aggressively and early on in the flare.

Cancer missed because patient lacked health insurance

Nurse commits to dedicating more time to free clinics.

Selenium

Selenium

Selenium is a stable trace-metal element that is found in such cruciferous foods as broccoli, garlic, and onions, as well as in meats, seafood, and nuts. In the human body, selenium is essential for protein synthesis and multiple enzymatic functions.

Pain-clinic referral

When is it appropriate to refer patients to a pain clinic?

Sniffing out phony back pain

What is the best way to differentiate between a patient who has legitimate back pain and someone who is looking for a drug prescription or workers' compensation?

Slip and fall ends in more than a simple muscle strain

Slip and fall ends in more than a simple muscle strain

Four weeks after the accident, the patient was still in severe pain and reported urinary frequency.

Can glucosamine and chondroitin affect lipid levels?

What role does glucosamine and chondroitin play in elevating LDL?

Does fibromyalgia require sleep testing?

Should all patients with fibromyalgia undergo sleep studies?

Blue fingers linked with breathlessness

A physically fit young woman seeks medical care when she develops increasing dyspnea and signs of a circulatory disorder.

Low back pain: Steps you may be overlooking

Your main challenge is to pinpoint the true cause and limit invasive interventions. A leading rheumatologist tells how to achieve these goals.

Facial plaques in aging men

Two aging men develop similar-appearing asymptomatic facial plaques.

Gout

Gout

The various clinical presentations of this painful form of arthritis result from tissue deposition of monosodium urate crystals.

Assessing knee pain in the primary-care clinic

Assessing knee pain in the primary-care clinic

Not all knee complaints require orthopedic referral. This review of basic testing and exam techniques will help you arrive at an accurate diagnosis.

New-onset neck and shoulder pain in an arthritis patient

New-onset neck and shoulder pain in an arthritis patient

A UTI triggers complications in a patient with two forms of arthritis.

Painful pedal erythema

Two elderly men present with painful red rashes on their feet and lower leg. One patient had a history of gout, the other essential thrombocytosis.

The links between oral and systemic health

The links between oral and systemic health

While research into specific cause-and-effect relationships continues, there are still plenty of reasons to encourage patients to take care of their mouth.

Arthroscopic surgery may not be beneficial for moderate-to-severe knee osteoarthritis

Arthroscopic surgery may not be beneficial for moderate-to-severe knee osteoarthritis

For moderate-to-severe secondary or idiopathic knee osteoarthritis, the addition of arthroscopic surgery appears no more effective than optimized physical and medical therapy alone.

New pain drug approved

Hyperuricemia and gout are on the rise

Hyperuricemia and gout are on the rise

This common, painful form of arthritis is caused by a buildup of excess uric acid in the blood. Our expert takes you from diagnosis to treatment.

Keep low back pain patients out of surgery

Education, self-management, and pharmacologic as well as nonpharmacologic therapies take center stage in this latest, jointly issued guideline.

Self-care can relieve back pain

Clinicians may be able to help patients with chronic back pain overcome discomfort by employing a self-care program known as the Alexander technique...

Stop Crohn's and arthritis meds for knee surgery?

We are treating a patient who is currently on infliximab (Remicade) and methotrexate for severe Crohn's disease and rheumatoid arthritis. Because of severe joint pain, she would like to have her...

Alternative treatment for gout offered

A short course of a corticosteroid could supplant nonsteroidal anti-inflammatory drugs (NSAIDs) as the medication of choice for...

Combination therapy boosts RA remission

Adding etanercept (Enbrel) to methotrexate therapy for early rheumatoid arthritis (RA) resulted in...

Help For Polyarthritis With Gastritis

What is the most effective treatment for polyarthritis in a patient with...

Is it time to stop indomethacin for gout?

Is it time to stop indomethacin for gout?

Indomethacin is harder on the stomach than most other nonsteroidal anti-inflammatory drugs.

Was Mrs. W's back pain preventable?

Her discomfort could have been from inevitable arthritis, but there were signs of a different diagnosis.

Tripod sign for back pain

A useful clinical pearl to help spot the drug-seeking patient with low back pain.

Back and leg pain aggravated by hiking

The patient began to lose hope after a canyon hike re-aggravated her low back pan and leg numbness.

Lidocaine patches for back pain?

Current studies have focused on these patches as adjunctive therapy to more traditional modes of treatment.

Choosing right the therapy for herniated disks

Choosing right the therapy for herniated disks

Studies have determined which patients would benefit from spine surgery and which ones would not.

Can a heating pad cause cancer?

The patient is concerned about skin and other cancers due to excessive exposure to the warmth.

Best therapy for gout

Which is safest—indomethacin or colchicine?

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