The Most Interesting Medical Cases in Rheumatology

The world of rheumatology is filled with challenge, excitement and some of the most intriguing cases out there. Figure 1 is home to many of these cases, shared by healthcare providers from across the globe. Here are five of the most interesting cases in rheumatology.

#5. Can You Spot the Abnormality?

A 72-year-old presented to a clinic with fatigue and elevated inflammatory markers. A vascular surgeon noted highly abnormal blood vessels in the femoral artery during an endarterectomy and stated a belief that the patient has vasculitis.

A rheumatologist from outside the hospital recommended temporal artery biopsies, coming back negative. The surgeon disagreed with this, requesting a second opinion. Who do you think is right?

Is the issue in the vasculitis tissue? View the case and join the conversation.

#4. A Peculiar Pattern

In this case, a 30-year-old presented with an unusual pattern appearing across the back of the neck, starting a few weeks ago. The pediatric resident who presented this case noted a history of severe chronic migraines and erythromelalgia. 

What do you think is the cause? View the case and find out.

#3. Painful Patches and Finger Deformity

This interesting rheumatology case describes a 32-year-old with hypertension, dislipidemia and diabetes mellitus who presented with scaly wide patches on the extensors of both lower and upper limbs. The family medicine resident who shared this case also noted the ring and pinky fingers of the right hand were fixed in a flexed position. 

Do you know the diagnosis? View the case and leave your comments.

#2. A Deformity Reversed

The #2 most interesting case in rheumatology takes us through the story of a 68-year-old with rheumatic foot deformities, experiencing pain and difficulty walking. The orthopedic surgeon sharing this case outlined the approach for treatment; using a plantar approach, performing a hallux arthrodesis along with the Hoffman procedure, as well as metatarsal head resections. 

Want to see the outcome of treatment? See the before and after photos.

#1. What’s the Best Treatment for this Classic Case?

Our #1 most interesting medical case in rheumatology is shared by a Figure 1 member physician assistant. This is what they had to say about the case: “71 y/o female with long-standing seropositive rheumatoid arthritis. Initially diagnosed in the late 1970s. She fondly recalls her days of treatment at a gold clinic. Currently, disease activity is kept to a minimum on current regimen of IV abatacept 1000mg Qmonthly and PO leflunomide 10mg daily.” 

While this case is a common presentation in the world of rheumatology, one commenter specializing in rheumatology even described it as “the bread and butter of our clinic every day”, it did spark a conversation around “the ‘old gold’ treatment”, as well as a variety of other treatment options going all the way to bee stings!

What are your thoughts on treatment? View the case and share your thoughts in the comments.

Published October 10, 2022

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