Rheumatology
- Finger nodules: Tip of the gouty iceberg
Recurrent, dramatic flares are the cardinal symptom of gouty disease, but some patients exhibit tophi on physical examination or imaging—without flares or pain.
- Reincarnating autoimmunity: Immune-related adverse events as new diseases
The range of adverse events is broad. Any organ can be affected, and any naturally occurring autoimmune process can be mimicked by the massive inflammation generated by checkpoint inhibition.
- Chronic centralized pain syndromes: A rheumatologist’s perspective
Centralized pain syndromes are vexing for patients and clinicians. In this issue, Volcheck and colleagues present a framework for understanding chronic centralized pain and for developing an actionable treatment plan for patients.
- Brodie abscess in an 87-year-old man
Though Brodie abscess is rare in older adults, timely diagnosis and treatment can prevent exacerbation of the abscess and avoid the need for additional surgical treatment, shortening the duration of hospitalization and preventing long-term complications.
- Central sensitization, chronic pain, and other symptoms: Better understanding, better management
Clinicians have a pivotal role by providing patient education, which can affect perception, management, functional status, and quality of life.
- To repeat or not to repeat? Measuring bone mineral density during anti-resorptive therapy or a drug holiday
The authors present evidence for and against monitoring bone mineral density in these patients, arguing against a one-size-fits-all approach.
- The constellation of vitamin D, the acute-phase response, and inflammation
An astronomic increase in vitamin D testing and supplementation is happening in the absence of an evidence-based rationale.
- Vitamin D: A metabolic bone disease perspective
When checking levels, clinicians should keep in mind that vitamin D levels fluctuate by season and time of day, and that different laboratories may use different assays that yield different results.
- Bone turnover markers to monitor oral bisphosphonate therapy
Rapid changes in levels of bone turnover markers can be useful in monitoring the effectiveness of therapy and improving adherence to therapy.
- Making best use of bone turnover markers to monitor oral bisphosphonate therapy
Clinical applications of bone turnover markers can include determining when to start or end a bisphosphonate “holiday” and measuring treatment response.