Top 5 and Bottom 5 Joints (Best of 2015)

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Who knows or ponders the articulations (joints) more so than the rheumatologist or orthopedist? We know their anatomy, their contours, tender sites and how to examine them. Adults have over 200 bones and up to 360 joints. Imagine if you had to do a DAS360?

The Differential Diagnosis of Heel Pain (Best of 2015)

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A slim, yoga bending, middle aged school teacher seeks a rheumatology consultation to determine the cause and cure for her left lateral heel pain for the past 6 months. No trauma, no crazy footwear and no systemic symptoms, uveitis, or peripheral/axial arthritis.

The Nine Lives of Hydroxychloroquine (Best of 2015)

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Hydroxychloroquine is one of many medications frequently used in rheumatology practice.

Rheumatologists Should be on Twitter (Best of 2015)

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Twitter? Really?

Famous Rheumatologist Quotes – Part I (Best of 2015: #8)

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A famous quote from Verna Wright, MD,states, “Clinicians may all too easily spend years writing“doing well” in the notes of a patient who has become progressively crippled before their eyes".

Building a Better Rheumatologist (Best of 2015)

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There’s a certain comfort to work that is rote, mechanistic and almost automatic.

Alcohol and Methotrexate - What Do You Advise? (Best of 2015: #9)

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What are your rules on methotrexate and alcohol use? How about casual, social or occasional alcohol use? If one alcoholic beverage is ok, what about 2, 3 or six while taking MTX?

Preventing Hepatitis B Reactivation Due to Immunosuppressive Drug Treatments (Best of 2015)

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Reactivation of hepatitis B virus infection can have devastating consequences, especially amongst those patients receiving immunosuppressive therapy.

Chikungunya Spread Continues (Best of 2015)

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The spread of the viral infection Chikungunya continues with the CDC issuing a travel advisory for those traveling to Mexico, where over 7000 cases of the viral infection have been reported.

DAS28-CRP or DAS28-ESR: Are they Biosimilar? (Best of 2015)

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The disease activity score (DAS28) has been developed as a dynamic assessment tool and a therapeutic response measure for use in clinical trials and practice.

Should Lupus Patients Receive Influenza and Pneumococcal Vaccines? (Best of 2015)

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Barry Waters, MD*: I have a 21 yr old lupus nephritis patient on mycophenolate, hydroxychloroquine and prednisone 40 mg per day.

When to Taper Patients Off Opioids

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I am often asked the question: When is the right time to taper a patient off opioids?

My view is that a patient should be tapered any time the risks exceed the benefits, or when treatment goals are not being met.

Will the Balance of JAK inhibition Yield Better Outcomes? Results of New JAK inhibitor - Peficitinib

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Researchers from Keio University have published their results using novel JAK inhibitor peficitinib (ASP015K) as a monotherapy in moderate to severe RA patients. 

In Academic Leadership, Women Outnumbered by Men With Moustaches

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A study published in the BMJ Christmas issue shows only 13% of academic positions at US medical schools are held by women. Sadly, and strangely, even the uncommon subset, men with moustaches, outnumbered (20%) the women in academic leadership spots. 

Predicting and Preventing Rheumatoid Arthritis

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Rheumatologists and physicians are commonly asked, "what can I do to avoid rheumatoid arthritis?"  This is usually a concern for family members of those affected by RA.

Bariatric Surgery Improves Rheumatoid Arthritis Outcomes

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Obesity is a modest risk factor for rheumatoid arthritis (RA) onset. More importantly, obese patients have significanty lower treatment responses to DMARDs and biologics, making them harder to treat than your average RA patient.

Herpes Zoster Increases the Risk of Stroke and MI

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At the 2015 ACR annual meeting in San Francisco, Len Calabrese, DO, of the Cleveland Clinic, gave a plenary session talk linking "shingles" infection to an increased risk of CVA (

Can Gout and Rheumatoid Arthritis Coexist?

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German investigators studied 100 RA patients with a uric acid > 6 mg/dl and assessed them for MSU crystal deposit with dual energy computed tomography (DECT) of both feet and hands.

Plasmacytoid Dendritic Cells Influences Early, But Not Established Lupus

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The Journal of Immunology has published the findings of Virginia Tech researchers who have studied plasmacytoid dendritic cells and their ability to induce type I alpha interferon (IFN-α) in lupus. (Citation source: http://buff.ly/1MceeCl)