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A pleomorphic hyalinizing angiectatic tumor (PHAT) is a rare soft tissue lesion that mainly affects superficial soft tissue in the lower extremities. PHAT is classified as a borderline/intermediate-grade soft tissue tumor because of the substantial risk of local recurrence.

The severity scores of dyspepsia symptoms and dyspepsia-related quality of life disturbance are higher in patients with fibromyalgia syndrome (FMS) than in patients with rheumatoid arthritis (RA) and in healthy persons.

Sustained disease-modifying antirheumatic drug (DMARD)-free remission occurs in about 10% of patients with rheumatoid arthritis (RA). It can be predicted by several clinical variables that are assessed routinely in outpatient clinics.

Knee pain in an 81-year-old man

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An 81-year-old man with had a one-year history of right knee pain that had worsened in recent weeks despite no trauma or injury. What does the X-ray show?

An 84-year-old woman presented with pain and swelling in her knees and hands. She had a history of severe psoriasis and osteoarthritis. How can you make a differential diagnosis when OA may coexist with rheumatoid arthritis, psoriatic arthritis, OA, and crystal arthritis? Read on to find out.

The precautionary recommendations for the H1N1 (swine) flu in persons with lupus currently are not different from those for the general public, according to the Lupus Foundation of America (LFA). However, because persons with lupus often are at increased risk for infections, especially if they are taking immunosuppressive agents, they should be particularly vigilant about taking the generally recommended precautions.

Although many medications are used for the management of systemic lupus erythematosus (SLE) and its complications, only aspirin, corticosteroids, and the antimalarial drug hydroxychloroquine (HCQ) are specifically approved by the FDA.1 Most other medications used for SLE treatment are commercially available off label (Table 1), usually borrowed from cancer or transplant regimens. In some cases, medications have been approved for a specific clinical manifestation seen in both idiopathic disease and SLE, such as bosentan for pulmonary hypertension.

The impact of biomechanical factors on rheumatoid arthritis (RA) has gained increased attention from researchers, as evidenced by studies reported in Clinical Biomechanics. For example, reevaluating knee kinematics over time is important in patients with RA who wear a mobile-bearing total knee prosthesis, according to investigators at the Biomechanics and Imaging Group, Department of Orthopaedics, Leiden University Medical Center, Leiden, the Netherlands.

ABSTRACT: Pay for performance (P4P) is causing physicians to examine how they provide care individually and collectively within local health systems. It is the most recent attempt by Medicare and commercial payers to reduce the cost and improve the outcomes of health care. Understanding P4P and deciding how to manage the multiple programs being implemented by payers will challenge physicians' ethics and practice resources. Improving health care for musculoskeletal diseases will require cooperation among the specialties that share responsibility for this care and improved methods for coordinating and documenting it. (J Musculoskel Med. 2009;26:207-212)

A new clinical practice guideline for low back pain (LBP) favors the use of noninvasive treatments over interventional procedures and suggests shared decision making between physicians and patients for better outcomes. Issued by the American Pain Society (APS), the guideline provides clinicians with several recommendations to help determine the best approaches to treating patients with LBP.

As a consequence of playing the role of the weekend warrior, recreational athletes often present with knee or leg pain. Generally, these patients can be categorized in 1 of 3 age-related groups (although, paradoxically, the injuries are not necessarily age-dependent):

Clinicians caring for patients with musculoskeletal disorders may see patients who have underlying conditions that typically are evaluated and managed by allergy and immunology specialists. Although diagnosis of these conditions may be challenging, new insights into their pathogenesis have led to advances in diagnosis and therapy.

Researchers and clinicians often point to biomechanical elements, particularly aberrant biomechanical forces and pathological responses to them, as key factors in osteoarthritis (OA) disease progression.

PHR Pitfalls

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Personal health records, designed to help patients keep all of their medical records in one place and make it easier for doctors to access patient files, may actually lead to inaccurate information and, as a result, improper treatment, some doctors fear.

Heel pain (calcaneodynia) is most commonly due to plantar fasciitis, but has many other causes including nerve entrapment, stress fracture, and sciatica. This review describes an overall approach to diagnosis, discusses conservative treatments and highlights the most prevalent surgical procedures.

The features of systemic lupus erythematosus (SLE) are common in the lifetime course of rheumatoid arthritis (RA) and are significantly associated with an increased mortality risk, even after adjusting for well-described RA-specific predictors of mortality. For some SLE features, the increased risk may be as high as 6-fold.

The main predictor of adherence to a multimodal treatment program for patients with fibromyalgia syndrome (FMS) is barriers, such as lack of time, too much effort, stressful events, and fatigue. Because barriers are important for adherence and adherence is related to outcomes, using a questionnaire about barriers is recommended as a basis for discussing them with patients.

ABSTRACT: High ankle sprains are not as common as low anklesprains, but they are a significant injury, and the diagnosis may bechallenging. The primary role of the syndesmosis is to maintain therelationship of the talus to the tibia under physiological loads.Toaccomplish this, the distal tibiofibular joint must maintain its stability.The syndesmosis is injured most often with external rotation at theankle joint while the foot is dorsiflexed and pronated. On physicalexamination, tenderness is located in the area of the anterior syndesmosis.There are several special tests for syndesmosis injuries.Radiographic assessment is helpful. The usefulness of classificationsystems is not well defined. The optimal rehabilitation programis unknown. Rehabilitation generally is divided into phases.(J Musculoskel Med. 2008;25:564-569)