Blogs

life,stage,age,lifespan

Still's disease: paediatrics to adults, a continuum or not?

Dr. Ilenia Di Cola and Dr. Piero Ruscitti
Jul 25, 2022
Still’s disease is a rare inflammatory disorder, affecting less than 1 person per 2000 people. This disease may occur in both children and adults, namely as systemic juvenile idiopathic arthritis (sJIA) and adult-onset Still’s disease (AOSD). The paediatric form was described by George Still in 1896, whereas the adult variant later by Eric Bywaters in 1971. However only the adult disease is identified by the name of Still.
Hands caring bond

The Sacred Bond

Kathryn H. Dao, M.D.
Jul 21, 2022
Patients and their family for years have been inviting me to their dinners, picnics, baptisms, anniversaries, and funerals. I always felt somewhat awkward when asked to participate in a patient’s life outside of my office or the hospital setting and usually will decline politely. I tell myself I should not blur the lines between patient care and friendship. I broke this rule recently.
Stills,continuum

The Still’s Continua

Petros Efthimiou, MD, FACR
Jul 20, 2022

The concept of a “Still’s disease continuum” that encompasses both sJIA and AOSD is based on the many common clinical, genetic and laboratory features shared by both sJIA and AOSD.

thermometer fever adult

AOSD: complicated disease or a disease with complications?

Bella Mehta, MBBS, MS
Jul 18, 2022
Many clinicians may not have seen a case of AOSD during training, which overall leads to several delays in referrals and appropriate diagnosis for AOSD patients. AOSD is an autoinflammatory disease where innate immunity plays a primary role and is characterized by seemingly unprovoked inflammation, but without the high-titer autoantibodies or antigen specific T cells seen in autoimmune diseases.
Myth vs reality

Myths & Misconceptions with Febrile Disorders

Rachel Tate, DO
Jul 12, 2022
Still’s disease and autoinflammatory disorders are rare conditions unified by recurrent fevers and inflammation of skin, joints, and other organs. While labs often support the diagnosis, these conditions are best diagnosed by genetic testing, or by specific criteria (in the absence of a genetic test). The following is a table that lists common misconceptions (myths) and their clarifying explanations.
reflections,ripple

2021 GRAPPA Recommendations - Looking Back, Looking Forward

Artie Kavanaugh, MD
Jul 11, 2022
With the recent publication of the third iteration of the GRAPPA Psoriatic Arthritis (PsA) treatment recommendations, it seems to be an auspicious time to reflect on some key considerations that arose during the development of the recommendations, as well as to look towards what the future may hold.
group,office,people,glue,work

ICYMI: Who is Your Glue?

Jack Cush, MD
Jul 07, 2022
I’ve often talked about the nurses in my clinic as being the glue, the clinic glue, my personal glue. Without them, the day and task would never go as well and just might crash and burn, if not for their steadying influence.
Thermometer

Five Mistakes When Diagnosing Still’s Disease

Jack Cush, MD
Jul 06, 2022

Adult-onset Still's presents an interesting and diagnostic challenge when encountered. Here are 5 tips to improve your diagnostic acumen for this febrile disorder.

heel enthesitis spur calcaneal

A Domain-Based Approach to the GRAPPA Psoriatic Arthritis Treatment Recommendations

Laura Coates
Jul 05, 2022

With their publication in June 2022 (1), the 3rd iteration of the Group for Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) Treatment recommendations for Psoriatic Arthritis (PsA) may have set a record or sorts.

overcome,challenge

I Need a Nemesis

Jack Cush, MD
Jun 09, 2022
A nemesis is so much more than the "enemy". Your nemesis defines what matters most to you and how you will overcome. Seth Godin once said, “Pick your enemies, pick your future”.
abdominal-pain-2821941_640.jpg

The Contribution of the Gut Microbiome and Diet to Joint Inflammation in PsA

Christopher Ritchlin, MD, MPH
Apr 29, 2022
Interactions of the gut microbiota in humans promote the release of a variety of metabolites with profound effects on human health and immune regulation.
Coin toss

Toss of a Coin - How do You Choose PsA Medication?

M. Elaine Husni, MD, MPH
Apr 27, 2022
When balancing all these disease domains, individual phenotypes, and comorbidities, sometimes treatment decisions can feel like tossing a coin. Fortunately, numerous guidelines have been published to help us do better than tossing a coin…or do they? 

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