This article presents five clinical scenarios in which the initial manifestations of pediatric rheumatic diseases constitute life-threatening medical emergencies. It is intended as a problem-oriented guide for pediatricians to assist in the recognition of rheumatologic differentials in children presenting with critical illness and provides an approach to their initial investigation and management.
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http://dx.doi.org/10.1016/j.pcl.2012.03.001 | DOI Listing |
Lancet Rheumatol
January 2025
College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.
New pathogenesis-based therapeutics and evidence-based consensus treatment recommendations, often with predefined treatment goals, have remarkably improved outcomes across many chronic diseases. However, a clinically significant subgroup of patients responds poorly to interventions and show a progressive decline in the disease trajectory, which poses an increasing health-care challenge. Difficult-to-treat approaches exist in several areas of medicine and the need for similar definitions has recently also emerged in rheumatology.
View Article and Find Full Text PDFAdv Skin Wound Care
January 2025
In the Department of Dermatology, Employees' State Insurance Corporation-Post Graduate Institute of Medical Sciences and Research, in Basaidarapur, New Delhi, India. Priyanka Hemrajani, MD, is Assistant Professor; Mona Sharma, MD, and Piyush Gupta, MD, are Senior Residents; Tapan Kumar Dhali, MD, is Professor; and Paschal D'souza, MD, is Professor and Head of Department. The authors have disclosed no financial relationships related to this article. Submitted April 8, 2023; accepted in revised form April 2, 2024.
The global pandemic caused by COVID-19 led to numerous novel cases of autoimmune and rheumatologic disorders that developed postinfection. Along these lines, these authors report an unusual case of scleredema following SARS-CoV-2 infection in an individual who lacked any known risk factors. Given the emergence of newer mutant strains of COVID-19 and steadily rising numbers of people receiving COVID-19 vaccinations, physicians should remain alert for as yet unrecognized manifestations of the disease.
View Article and Find Full Text PDFJ Emerg Med
October 2024
Department of Emergency Medicine, Cleveland Clinic Akron General, Akron, Ohio; Northeast Ohio Medical University, Rootstown, Ohio. Electronic address:
Background: Behcet disease (BD) is a rare small vessel vasculitis that commonly manifests as recurrent painful oral or genital ulcerations, uveitis, and skin lesions. Some patients with BD develop neurological symptoms termed neuro-Behcet's disease. In the emergency department setting, these symptoms can be mistaken for other common acute issues including stroke, infection, epilepsy, multiple sclerosis, toxin ingestion, or psychiatric conditions.
View Article and Find Full Text PDFAJR Am J Roentgenol
January 2025
Department of Diagnostic and Interventional Radiology, The Hospital for Sick Children, Department of Medical Imaging, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
The use of whole-body MRI (WBMRI) in children, from infancy to adolescence, has expanded rapidly over the past decade, with increasing uptake and a broadening range of clinical indications. Current indications include screening for presymptomatic lesions in cancer predisposition syndromes; tumor staging in known malignancies; investigating fevers of unknown origin; as well as diagnosing and monitoring rheumatologic diseases, vascular anomalies and neuromuscular disorders. This AJR Expert Panel Narrative Review aims to offer a comprehensive discussion of WBMRI in pediatric patients, exploring protocols and other technical considerations, clinical indications, implementation challenges and troubleshooting, as well as controversies in widespread adoption, while considering emerging trends and directions.
View Article and Find Full Text PDFJ Clin Med
December 2024
Department of Orthopedics and Geriatric Sciences, Catholic University of the Sacred Heart, 00136 Rome, Italy.
: Foot and ankle injuries are one of the leading orthopedic causes of emergency department (ED) admissions. The purpose of this study was to analyze, through 5 years of data collection, differences in number and type of admissions, as well as the severity of foot and ankle trauma to the ED in the pre-pandemic period, during the COVID-19 emergency, and in the post-pandemic period. This study aims to assess epidemiological and clinical data.
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