Background: Transportation is a social determinant of health that can be a barrier to care and exacerbate disparities. During the COVID pandemic, access to transport was further diminished.Monoclonal antibodies (Mab) are associated decreased hospitalization in high-risk COVID patients. Until 9/2022, the $2000 cost per dose of Mabs was paid by the federal government. However transportation [...]

Background: Individuals with autoantibodies against melanoma differentiation-associated protein 5 (MDA-5) are reported to have a significant risk of developing rapidly progressive and fatal interstitial lung disease (ILD) in clinically amyopathic dermatomyositis patients (CADM). Previous cohort studies of dermatomyositis patients who have been systematically evaluated for the presence of anti-MDA5 antibodies and associated clinical features and [...]

Background: The Antinuclear Antibody test (ANA) is a test often positive in patients with autoimmune rheumatologic disorders. However, ANA testing can also be positive in non-rheumatic conditions and in healthy individuals1. Prior studies have focused on the clinical utility of positive ANA testing in the outpatient setting by non-rheumatologists, but less is known about its [...]

Case Presentation: A previously healthy 13-year-old male presented with a chief complaint of lower back pain and rash for the past 3 weeks. Associated symptoms included profuse sweating and 10/10 lower back pain radiating to his legs that had progressed in severity with inability to ambulate. On additional questioning, other symptoms included nausea, vomiting, diffuse [...]

Case Presentation: A generally healthy 36 year old female began experiencing stiffness in her lower back with persistent aching pain. The discomfort progressively worsened over several weeks prompting multiple emergency room visits. She began to complain of severe leg spasm at the time of her admission to the hospital. Her CPK level was markedly elevated [...]

Case Presentation: A 68-year-old man with hypertension and osteoarthritis presented with fever, cough, dyspnea, and weight loss for 2 months. Prior to admission, he had received antibiotics for community-acquired pneumonia without improvement. Physical exam showed multiple ulcers at the base and sides of tongue, bilateral palmar erythematous papules with ulceration and scaling, bilateral erythematous plaques [...]

Case Presentation: The patient is a 27-year-old male with lupus anticoagulant with hypoprothrombinemia syndrome (LAHPS)/triple positive antiphospholipid syndrome (APLS) in the setting of systemic lupus erythematous (SLE) and immune thrombocytopenia (ITP) on hydroxychloroquine, mycophenolate mofetil (MMF), and prednisone for immunosuppression, who presented to the ER with worsening right upper quadrant and epigastric pain. RUQ US [...]

Case Presentation: A 79-year-old woman with hypertension and hyperlipidemia arrived to the ER after a syncopal episode. She was found in intermittent polymorphic ventricular tachycardia (VT). She was treated medically, briefly regaining sinus rhythm with possible ischemic changes (Figure 1). She was transferred to a cardiac catheterization capable facility. The study showed proximal left anterior [...]

Case Presentation: The patient is a 70 y.o. female with a history of hypertension, bilateral lower extremity deep vein thrombosis (DVT), and peripheral neuropathy, who was brought to the emergency room (ER) by EMS due to the recent onset of altered mental status. Starting a few days ago, her son noted that she was not [...]

Case Presentation: A 37 year old male with a history of asthma presented with a three day history of acute onset left upper quadrant (LUQ) abdominal pain, worse after meals and associated with nausea. He had no history of cholelithiasis, alcohol abuse or trauma. Vital signs on admission were in normal range. Exam revealed LUQ [...]