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Javascript is not enabled in your browser. Enabling JavaScript in your browser will allow you to experience all the features of our site. Learn how to enable JavaScript on your browser. Important strides have been made in understanding the pathophysiologic basis of many inflammatory conditions in recent years, but rheumatology remains a discipline in which diagnosis is rooted in the medical history skillfully extracted from the patient, the careful physical examination, and the discriminating use of laboratory tests and imaging. Moreover, selection of the most appropriate therapy for patients with rheumatic diseases also remains heavily reliant upon clinical experience.

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This book will pool together the clinical wisdom of seasoned, expert rheumatologists who participate in the care of patients with autoimmune diseases, systemic inflammatory disorders, and all other rheumatic conditions. Data from one study, presented only in abstract form, show that intravenous cyclophosphamide treatment once every 2 weeks is as effective as oral daily cyclophosphamide but safer.

A Clinician's Pearls & Myths in Rheumatology

However, daily oral treatment is currently the preferred approach for induction of remission. Some studies suggest oral therapy improves the chance of sustained remission. Oral cyclophosphamide can be titrated based on white cell count, another safety feature. Patients who fail to respond to conventional daily cyclophosphamide should be considered to have an infection.

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Systemic vasculitis is almost always reliably controlled with conventional therapy, thus it is important to consider aspergillosis and other agents in refractory cases. Induction of neutropenia is not essential for achieving remission. Episcleritis often is an overlooked clue that a patient's vasculitis has flared.

Courtesy Dr. A frequent signal of disease flare in patients with systemic vasculitis is episcleritis, Dr. Stone said.

A Clinician's Pearls and Myths in Rheumatology

The Wegener's granulomatosis patient who was misdiagnosed with RA presented with this ocular condition—the most common ocular manifestation of systemic vasculitis—signaling renewed disease activity. The patient was having a flare but didn't realize it. John H. None yet. Combine Editions. Stone Average rating: 4.

A Clinician's Pearls & Myths in Rheumatology by John H Stone

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Klippel ,. Stone Editor.

Leslie J. Crofford Editor. Manuel Ramos-Casals Editor ,. Haralampos M.