Low back pain is a common complaint encountered in the general practitioner’s office. In fact, about two-thirds of adults suffer from low back pain at some point in their life, and it is second to only upper respiratory problems as a reason for visits to a physician. Axial spondyloarthritis is an autoimmune disease that results in inflammation in the spine. A number of therapies exist for this condition and early therapy may prevent progressive spinal fusion. Given the sheer prevalence of low back pain, identifying patients with axial spondyloarthritis can be challenging.
Giant cell arteritis (GCA) is the most common vasculitis in adults above 50 years of age. GCA is a rheumatological emergency. Rapid diagnosis and treatment are required to reduce the risk of complications.
Giant cell arteritis (GCA) is the most common vasculitis in adults above 50 years of age. GCA is a rheumatological emergency. Rapid diagnosis and treatment are required to reduce the risk of complications.
Despite being one of the most common forms of arthritis afflicting adults, optimal care of patients with gout including treatment of acute attacks as well as long-term management is not always achieved.
Gout is one of the most common forms of arthritis, affecting 1.4% of the population. Primary care physicians diagnose and manage most patients with gout. While the gold standard for diagnosing gout is visualization of monosodium urate crystals (MSU) in joint fluid under polarization microscopy, this is not always the case.
The Canadian Rheumatology Association (CRA), American College of Rheumatology (ACR), and European League against Rheumatism (EULAR)7 have put forward revised guidelines in the recent years in their treatment approaches for rheumatoid arthritis. More than ever there is an emphasis on early diagnosis and appropriate treatment with disease-modifying anti-rheumatic drugs (DMARDs).
Rheumatoid arthritis has been described to be associated with an increased risk of cardiovascular disease. This risk appears to be multifactorial in nature. However, there is emerging evidence that glucocorticoids play a role.
Spironolactone or eplerenone should be added to BB and ACEi/ARB in NYHA class II HF patients with EF < 30-35% in the absence of significant renal impairment or hyperkalemia.
Ultrasound can be a powerful tool in distinguishing thyroid nodules with malignant potential from benign ones. Thyroid nodules found on physical examination are common. Fewer than 5% of these nodules are malignant.
In April 2012, NEJM published The EINSTEIN-PE study, which looked at the use of oral Rivaroxaban for the treatment of symptomatic pulmonary embolism in 4833 patients.
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