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How should rheumatologists respond to demands for medical marijuana, either from legislatures or directly from patients? Here from a knowledgeable source are 8 reasons (and more) why the medical and scientific evidence weighs heavily against it, especially in rheumatology.

myelodysplastic syndrome

For more than half of patients with myelodysplastic syndrome, swollen and tender joints preceded diagnosis by nearly a year, according to a new study. Also last week in the nonspecialty journals: A shark genome shows early steps in immune system evolution.

There's limited study of whether disease-modifying drugs for rheumatoid arthritis, with the exception of methotrexate and anakinra, present a risk to a fetus. However, curiously, adverse pregnancy outcomes may increase a healthy mother's risk for developing RA.

Tocilizumab (Actemra) appears to dampen inflammation, increase hemoglobin, and improve inflammatory anemia in rheumatoid arthritis (RA), judging from post hoc analysis of a randomized late-stage clinical trial.

Last year's approval of belimumab (Benlysta) revolutionized lupus treatment. How safe and effective is it, actually? Do similar inhibitors of the B-cell activating factor BAFF, now in testing, appear even more promising? Here are the basics from an expert on the subject.

A study from the Netherlands has found a range of minimum serum levels of adalimumab that are associated with a good clinical response in rheumatoid arthritis. As in other studies, adding methotrexate helps.

New in the non-rheumatology journals: Among osteoarthritis patients in the UK, 10-year survival rates were doubled after metal-on-metal (MoM) hip resurfacing, compared with other types of hip replacement.

Why are gout patients seeking treatment from their healthcare providers at three times the rate they were in the later 20th century? Researchers suggest that better disease awareness and an aging population may hold the answers.

ACR2013: Joints erode in systemic lupus erythematosus and primary Sjӧgren’s Syndrome. But French researchers say their MRI studies don't justify classing them as erosive disorders like rheumatoid arthritis.

ACR2013: As well as neonatal lupus and heart block, new research suggests that children born to women with lupus may face higher risks for autism and attention deficit hyperactivity disorder.

This 6-year-old boy presents to the ER with a 2-day history of increasing pain and swelling in his right ankle. On the day of his arrival, he also developed the rash pictured here. The patient denies any other symptoms aside from his ankle and knee pain. His chest X-ray, vital signs, complete blood count (CBC), and basic chemistry panel were normal, though urinalysis showed a trace of blood.

ACR 2013: Debates about drug costs in rheumatoid arthritis dominated discussions at ACR this year, and one session was formally billed a debate. Will less-costly triple therapy someday be mandated for early RA?

Reports in a pediatric ophthalmology journal reveal risk factors and best treatments for refractory/recurrent uveitis in JIA.

ACR2013: Apremilast, a new kind of anti-inflammatory, proved significantly better than placebo against psoriatic arthritis after 52 weeks. Adverse effects were short-lived. Results for ustekinumab also held up after a year.