Key Takeaways from ACR Review Course Save

The ACR Review Course was superb once again from top to bottom, from Blue Fingers to Practical Treatment of RA. Every year I wonder if I should skip it and attend something else or try something novel such as spending an extra day at home, but each year I go. And I have never regretted it. Oh yes there have been clunker lectures, but the sum of the product has always been excellent and I have never failed to come away with a few “pearls”, but also a regained security in how I have been doing things. I always find myself reviewing my notes or the slides over the next six months or so as I encounter the next perplexing patient.  And if it’s not in my notes I can call the lecturer and discuss my patient with him/her. I have always found the speakers to be most willing to help. The syllabus provides a great source of the most up to date clinician/researcher list on a variety of topics.

Here are my take-home messages and “pearls” from the ACR Review Course: 

• If the thumb is involved in Raynaud's look for secondary causes. In secondary Raynaud's with structural disease look at large as well as small vessels. Pain = continued ischemia and future risk of tissue loss. In scleroderma related hand ischemia always do an Allen’s test as the Ulnar artery is as likely to be involved as is the Radial artery. Raynaud’s will return after a micro sympathectomy. (Fred Wigley)
• See an Ophthamologist if there is eye pain, the vision is affected, there is sensitivity to light and the eye is red. Limited GPA and RA are the leading Rheumatic causes of Scleritis. (James Rosenbaum) 
• Up to 18% of endocarditis and 40% of TB may be ANCA positive. (Sharon Chung) 
• In the evaluation of axial spondyloarthropathies MRI without Gad and CRP over ESR are preferred. (LianneGensler) 
• It is better to have Pulmonary Fibrosis with a CTD than to be Idiopathic Fibrosis. (Paul Noble)
• The Antiphospholipid Syndrome is a complimentopathy.(Michelle Petri) 
• It’s never to early or to Late to treat RA. (Arthur Kavanaugh)

Finally the breaks and lunch during the review provide a wonderful opportunity to catch up with old friends and meet some of the next generation of Thought Leaders.  You can get a pulse on “what’s Hot” at the meeting and plan your next few days.  If you have not attended the Review in a few years come back and if you have never attended give it a try. It is an amazing day of knowledge, reconnection, and seeing what’s important. Hope to see you next year.