Articles By Patricia Harkins, MD
Why should rheumatologists care about aging?
The global population is aging and none of our rheumatic diseases are immune to the impact of the complexities and so-called “geriatric syndromes”, including sarcopenia, frailty, falls and cognitive impairment, associated with the aging process. Whilst we are increasingly aware of these syndromes, it is sometimes overwhelming to consider just how we may incorporate the unique needs of our older patients into our already busy clinical practice – or perhaps until now we were unsure of their significance and relevance. Why should we care about aging?
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Say Goodbye to Methotrexate in PMR?
For decades, glucocorticoids (GCs) have formed the backbone of polymyalgia rheumatica (PMR) management.
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Fast track clinics -the future of PMR care?
Over the past year we have implemented a fast track clinic for PMR at our institution in Dublin. Patients are referred predominantly from primary care, and we aim to see patients within a one to two week window. Without a doubt, patient outcomes are far superior with the instigation of the fast track clinic as part of our service.
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Pain in Psoriatic Arthritis
The prioritisation of pain, and its evaluation, is important in those with psoriatic arthritis, when the already incredibly heterogenous nature of the condition can complicate assessment. Whilst we lean towards all pain in PsA being nociceptive in nature, evidence suggests that a significant proportion of patients with PsA also have nociplastic pain, characterised by fibromyalgia.
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Imaging in PMR
Despite the fact that polymyalgia rheumatica is the most prevalent inflammatory rheumatic disease in those over 65 years of age, progress in its diagnosis, monitoring and management have failed to garner momentum in decades past. However, ACR22 has fostered significant promise for its future.
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“Hey PRESTO!” – Early identification of psoriatic arthritis
Despite a wealth of treatment options, a number of notable unmet needs remain in PsA, most notably the significant diagnostic delay that many patients endure. We are all aware that those with psoriatic skin disease are the most at risk cohort for PsA. Identifying patients with psoriasis who have, or are at increased risk of PsA, appears to be the low hanging fruit that we just can’t fully seem to grasp.
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