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For 2 months, a 29-year-old man had pain and circular, soft swelling (7 x 7 cm in diameter) over the anterior left knee, superficial to the patellar ligament. Pain was minimal and associated with extension and flexion).

With the advent of expensive laboratory tests and sophisticated imaging, the diagnosis of rheumatoid arthritis (RA) remains clinical. Because early detection is important for preventing clinical and radiographic progression, revision of the diagnostic criteria was needed and has been implemented.

Gout is a chronic, progressive disease that is managed most effectively when the patient's serum urate level is reduced to lower than 6 mg/dL by early therapeutic intervention.

A 31-year-old Asian man presented for evaluation of left foot pain that began on the day before his clinic visit while he was practicing parkour (the physical discipline of training to overcome obstacles within one’s path by using only the human body and objects in the environment). He had no significant medical history. The patient recalled leaping from a platform toward a horizontal bar attached to a wall a few feet away. During the lift-off phase of the jump, he experienced a snapping sensation in his left foot, with subsequent pain in the arch and heel. Immediately after this event, he was unable to ambulate.

Idiopathic inflammatory myopathy is a term applied to a group of relatively rare diseases that present with the gradual onset of weakness of shoulder and pelvic girdle muscles. These diseases include polymyositis and dermatomyositis, as well as myositis associated with neoplastic disease, myositis associated with underlying collagen-vascular disease, and inclusion body myositis.

DISH, a radiographic finding characterized by abnormal calcification and ossification in the axial skeleton and in ligaments and entheses,1 most often affects the thoracic spine. Of note, the findings almost always are more prominent on the right side (the left side may be spared because of aortic pulsations). The enthesopathy, also called“whiskering,” can affect the pelvic brim, ischial tuberosities, greater trochanters, and other features that have ligamentous attachments.2 Diagnosis often is made after an incidental finding in an asymptomatic patient.

A 50 year-old physician experienced the abrupt onset of tenderness and swelling in the distal interphalangeal (DIP) joint of his right index finger. His only significant past medical history was Wolf-Parkinson-White syndrome, which was managed successfully with ablation. The same symptoms subsequently occurred in the DIP joints of his left index finger and fifth digits of both hands. No other digits were affected. The symptoms made it difficult for him to type on the computer. He denied trauma to the affected fingers, although he is an athlete and had had a left middle finger avulsion fracture, right middle finger dislocation, and left radial frac-ture. He had no systemic or other joint involvement.

Rheumatology Myths Busted

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The American College of Rheumatology has put together a list of 13 myths about rheumatoid arthritis.

A new study suggests joint complaints attributed to the popular breast cancer drugs are not associated with inflammatory arthritis or autoimmune disease.

Physicians treating patients with fibromyalgia syndrome should rule out coexisting disorders and establish possible inducing factors.

The numerous symptom domains of fibromyalgia syndrome (FMS) include pain, fatigue, sleep disturbance, mood disturbance, and cognitive dysfunction, as well as close association with other “central sensory augmentation” conditions, such as irritable bowel syndrome and various forms of headache.

Varying practitioner beliefs about what makes patients who have fibromyalgia syndrome (FMS) “behave” differently from the general population are complicated by a paucity of studies, heterogeneity of the patient population, and other factors.

Gout is the most common inflammatory arthritis. Arthrocentesis and identification of negatively birefringent monosodium urate crystals from aspirate is the gold standard for diagnosis.

With the rising incidence of obesity and an increasing older population, the burden of osteoarthritis (OA) is expected to grow. Understanding of the disease is limited, and there are indications that many patients are receiving suboptimal care.