News

Examining the right foot of a 54-year-old male reveals a red, swollen, warm, and exquisitely tender right first toe joint. What is the differential diagnosis?

The FDA has approved ustekinumab (Stelara) alone or as an adjunct to methotrexate for adults with psoriatic arthritis.

The patient presented with fever, dyspnea, and productive cough. He also had worsening lower-extremity arthralgia. Can you guess the diagnosis?

In a 30-year-old woman with decreased range of motion in several joints, radiographs show bony fusion, profound osteopenia, erosions and advanced arthrosis.

A tocilizumab-methotrexate combo appears to inhibit circulating biomarkers of joint tissue remodeling at sites of inflammation in rheumatoid arthritis.

For the first time, the European Medicines Agency's biosimilars program has recommended approval of a monoclonal antibody. It has given thumbs-up to an alternative formulation of infliximab to treat inflammatory conditions including RA, ankylosing spondylitis, and psoriatic arthritis.

With the FDA poised to issue guidance for mobile health app designers, this review includes several well-regarded apps for rheumatoid arthritis and mentions a few newcomers.

Rheumatoid arthritis patients taking a combination of etanercept (Enbrel) and methotrexate do better, but only slightly, than those on monotherapy with the tumor necrosis factor-α inhibitor, according to a Canadian multicenter clinical trial.

Michael R. Clark, MD, MPH, MBA, outlines the vulnerabilities that put patients with acute pain at risk of transitioning into new chronic pain.

Final results from the international AMPLE Trial show nearly identical benefits for abatacept (Orencia) and adalimumab (Humira) plus methotrexate for early rheumatoid arthritis.

Last week the major British journal published an exhaustive series of reviews on autoimmune rheumatic disease, summarized briefly here. Also new in the nonspecialty journals: Macitentan for pulmonary hypertension, small fiber neuropathy in Sjögren syndrome, and risk factors for infection with glucocorticoids.

Using nutritional supplement mixtures consisting of arginine, glutamine, and beta-hydroxy-beta-methylbutyrate (HMB) may speed up wound healing in diabetic foot ulcers.

This young woman presented with severe leg pain, night sweats, and fever of unknown origin. The diagnosis of polyarteritis nodosa had several unusual features.

For early undifferentiated arthritis, give methotrexate or combinations of DMARDs and corticosteroids sooner rather than later to suppress disease activity and radiographic progression, says a literature review.

She presented with such severe calf pain she could no longer walk unassisted, with a months-long history of fever of unknown origin. What does the MRI show?

Most fibromyalgia patients randomized to continuing milnacipran (Savella) at the end of a clinical trial never noticed an increase in pain. Patients in the placebo group had quite a different experience.

A biomarker of tissue destruction called C1M can show disease activity among rheumatoid arthritis patients to monitor drug therapy, and can detect joint damage progression.

Contrary to American College of Rheumatology recommendations, analysis of data from a clinical trial reveals methotrexate monotherapy as the best initial treatment for early rheumatoid arthritis that has a poor outlook.

Fibromyalgia patients who don't respond to Lyrica (pregabalin) may see their pain scores significantly improve after adding Savella (milnacipran) to their treatment regimens.

One reason no good solution yet exists for osteoarthritis may be that rheumatology has been viewing many disease processes as a single entity. In an editorial, four rheumatologists offer a new disease model that they hope will rationalize future clinical research.

This case and a bonus set of images from another woman with the same diagnosis reveal some of the many manifestations of her condition. Can you guess her diagnosis?

The elderly man with hypertension and polyarticular tophaceous gout experiences intermittent dizziness, neck pain, and arm weakness. Which condition is responsible?

An 82-year-old man with hypertension and gout developed periods of dizziness, neck pain, and arm weakness. Could the gout be responsible?

An international panel of rheumatologists issues new recommendations for the diagnosis and management of gout -- hoping to improve often uneven and suboptimal patient care that exists despite numerous care guidelines and new therapies.

Evidence from animal and human studies supports efforts to use the natural lubricant proteoglycan 4 (lubricin) to protect joints threatened by injury or disease, primarily osteoarthritis. The only thing wanted now is clinical proof of the concept. Gregory Jay MD PhD reviews the history and the potential of this new strategy.

Though recent reviews were unable to provide evidence of efficacy for several complementary treatments for rheumatoid arthritis (RA), a group of researchers decided to clinically evaluate the effectiveness of static electric field therapy by high voltage alternating current (EF-HVAC) in the chronic inflammatory autoimmune disorder.

Progressive multifocal leukoencephalopathy (PML) is a rare but potentially fatal adverse effect of biologic therapy for rheumatologic disorders. Here, a specialist on the topic from Cleveland Clinic offers a brief review of the risks and realities.

Images taken 7 months apart show subtle densities of the left knee that has been causing pain. The woman also has subluxation of the fingers, without erosion.

New this week in the nonspecialty journals: Tattoos and sarcoidosis, oral ulcers and autoimmunity, gout and heart disease, and a review about a gene that affects autoimmune inflammation.

Patients with knee or shoulder pain often take it for granted that their damaged joint needs fixing, says this author. Preventing unnecessary surgery may begin with doctors who recognize and correct this misconception.