There are many clues that can be gleaned from the medication lists that patients bring with them to clinic. "Hate, Hate steroids" read a note one of my patients had written for me at the bottom of her list. Of all the double-edged swords we wield in clinic, glucocorticosteroids (prednisone and others) engender the strongest feelings and the... »

INDIANAPOLIS – In case you haven’t heard, the greatest show on earth is coming to Indianapolis. The drum roll leading up to the Super Bowl has been getting louder and louder over the last year. A local grocery store has run an ad in the newspaper every day counting down the number of days until the great event. The city is suffused with a carnival... »

Perhaps my technical breakthrough will seem like a small matter to you, but between patient appointments I couldn’t restrain myself from bragging to the nurse that I had managed a paperless document transfer from the hospital electronic medical record to the office EMR.

This geeky accomplishment had eluded me for months. When our office converted to an... »

Rheumatologists are full of pranks. First, we take a medical history and ask people where they are hurting. And then we always end up pushing or probing or testing those tender areas. After patient yelp in pain, we look at them with great sincerity and ask, "did that hurt?"

While examining the hands of an elderly lady, I asked the stupid... »

Falling is a frightening but all too common experience for elderly patients. The unpredictable nature of falling makes it a difficult problem clinically. Falling even has its own ICD-9 code (E888.9). Hip and wrist fractures are common resulting injuries, as are black eyes, broken glasses, broken noses, and injured pride. Even if patients are lucky enough to... »

Once in a while you can make an immediate diagnosis of a patient’s condition as soon as you open the exam room door. This was one of those times. I opened the door and there was a young man with the most flagrant Gottron’s patches that I had seen in a while. Resisting the temptation to blurt out, “You have dermatomyositis!” before even introducing myself, I... »

Taking a good social history from patients involves asking about alcohol consumption. Drinking has many wide-ranging health implications. But as a rheumatologist, my concerns regarding my patient’s drinking habits are fairly narrow. Alcohol consumption plays havoc with a gouty patient’s hyperuricemia. Alcohol also doesn’t mix well with many rheumatoid... »