Virtual Rheumatology Practicum - Adult

The ACR Committee on Training and Workforce is pleased to present the Virtual Rheumatology Practicum for Adult Rheumatology Fellows (ViP Adult). This 8-week lecture series, which launched July 6, 2020, is designed for first-year fellows in training enrolled in adult fellowship programs. View the ViP program schedule for the schedule of topics, learning objectives, and materials to read in advance.

Program Schedule, Learning Objectives, and Advance Reading Material   - Updated July 23, 2020Note: You may need to clear your browser's cache to view the updated document.

Watch ViP Adult Playlist  

This program is designed for educational purposes only. The material presented is not intended to represent the only or the best methods appropriate for the medical situations discussed, but rather is intended to present the opinions of the authors or presenters, which may be helpful to other practitioners. Attendees participating in this education activity sponsored by the ACR do so with full knowledge that they waive any claim they may have against the ACR for reliance on any information presented during this educational activity.

 

ViP - Adult Lectures


Lecture 16 Recording (August 28)  

MSK Ultrasound
Eugene Kissin, MD

In this presentation, Eugene Kissin, MD, discusses the basics of ultrasound imaging and equipment settings, scanning techniques for the shoulder and hip, and ultrasound use for diagnosis of gout and PMR.

Fibromyalgia & Chronic MSK Pain
Leslie Crofford, MD

In this presentation, Leslie Crofford, MD, discusses basic mechanisms of pain from peripheral nociceptors to pain transmission pathways and central nervous system involvement. Concepts of acute, persistent, and nociplastic pain will be introduced. The recognition and management of fibromyalgia, a prototypical nociplastic, or centralized pain syndrome, will be reviewed.


Lecture 15 Recording (August 24)  

Antiphospholipid Syndrome
Medha Barbhaiya, MD, MPH

In this presentation, Medha Barbhaiya, MD, MPH, discusses the epidemiology, etiology/pathogenesis, clinical manifestations, diagnosis, and treatment of antiphospholipid syndrome.

Management of Pregnancy in Rheumatic Diseases Patients
Bonnie L. Bermas, MD

In this presentation, Bonnie L. Bermas, MD, discusses her approach to the management of rheumatic diseases during pregnancy using SLE and RA as prototypes. Dr. Bermas emphasizes medication compatibility in pregnancy and lactation, as well as for paternal exposure.


Lecture 14 Recording (August 20)  

Innate Immunity
Michael Pillinger, MD

In this presentation, Michael Pillinger, MD, reviews the mechanisms of innate immunity, the processes through which never-before-seen foreign threats are neutralized or resisted until the adaptive immune system can become activated, how innate immunity can result in disease—typically rheumatic disease—is considered, as well as how innate immunity and inflammation are regulated.

Acquired Immunity in Rheumatic Disease
R. John Looney, MD

In this presentation, R. John Looney, MD, reviews the adaptive immune system and the key roles played by adaptive immunity in rheumatic diseases.


Lecture 13 Recording (August 17)  

Viral Arthritis
Cassandra Calabrese, DO

In this presentation, Cassandra Calabrese, DO, discusses rheumatic manifestations of key viral infections including epidemiology, pathophysiology, clinical presentation, and pertinent diagnostics and management principles.

Biologics and Targeted Small Molecules in Rheumatoid Arthritis
Eric M. Ruderman, MD

In this presentation, Eric M. Ruderman, MD, reviews the biologic and targeted small molecule therapies used in the treatment of rheumatoid arthritis, including mechanism of action, selection of agents, safety, and use in special circumstances, including pregnancy and peri-operatively.


Lecture 12 Recording (August 13)  

Osteoporosis
Marcy Bolster, MD

In this case-based presentation on osteoporosis, Marcy Bolster, MD, discusses therapeutic options for the management of osteoporosis, distinguishing optimal therapy duration. Potential risks and adverse effects of medications used in the treatment of osteoporosis are also discussed, as well as the evidence behind recommendations for duration of therapy, introduction of a drug holiday, and guidance for the resumption of therapy after a drug holiday.

Osteoarthritis
Marc Hochberg, MD

In this presentation, Marc Hochberg, MD, provides a brief overview of the conceptual definition, epidemiology, pathophysiology, clinical features, and management of patients with osteoarthritis (OA). OA is the most common form of arthritis and is a disease of the whole joint characterized by alteration in the homeostasis of chondrocyte metabolism with the degradation of articular cartilage, changes in subchondral bone and synovitis with activation of the innate immune system. Current management is focused on control of joint pain, reduction of activity limitation, and remediation of physical disability. Future management goals are the development of disease-modifying OA drugs that will alter the underlying pathophysiology and lead to improved and clinically relevant outcomes for patients.


Lecture 11 Recording (August 10)  

Conventional Synthetic DMARDs: Old Dogs and New Tricks
Amy C. Cannella, MD, MS, RhMSUS

In this presentation, Amy C. Cannella, MD, MS, RhMSUS, reviews commonly used DMARDs (MTX, LEF, SSZ, HCQ, AZA, MMF), including mechanism of action, pharmacology, dosing, toxicity, monitoring strategies and use in pregnancy and lactation.

Lyme Arthritis
Robert Kalish, MD

Lyme arthritis remains a clinical entity rheumatologists should be comfortable diagnosing and managing. In this presentation, Robert Kalish, MD, reviews the diagnosis, clinical features, and management of Lyme arthritis including post-infectious and treatment-refractory arthritis, and touches upon the entity of “chronic Lyme disease” and tick-borne co-infections.

Past ViP - Adult Recordings

Lecture 10 Recording (August 6)  

Crystalline Arthritis
Brian Mandell, MD

In this presentation, Brian Mandell, MD, will discuss an overview of the pathophysiologic basis for gout, focusing on areas that can be directly addressed by effective therapy. This provides attendees with a rational and evidence-based approach to managing patients with different stages of gout. A brief discussion of calcium pyrophosphate arthritis will be presented.

Spondyloarthritis
Lianne Gensler, MD

In this presentation, Lianne Gensler, MD, uses a case-based approach to review the clinical presentation and manifestations, including extra musculoskeletal manifestations, imaging findings, and initial approach to treatment across the spectrum of disease.


Lecture 9 Recording (August 3)  

Rheumatoid Arthritis – Clinical Presentation, Pathogenesis and Diagnosis
Uzma Jalal Haque, MD

In this presentation, Uzma Jalal Haque, MD, provides a broad overview of rheumatoid arthritis. This includes a discussion of pathogenesis, clinical manifestations, and diagnosis of rheumatoid arthritis.

Rheumatoid Arthritis - Pharmacologic and Other Therapeutics
James O'Dell, MD

In this presentation, James O'Dell, MD, will focus on initial foundational principles in treating rheumatoid arthritis, including early diagnosis, treating to a target, and the use of DMARDs, especially methotrexate.


Lecture 8 Recording (July 30)  

Vasculitis - Non-ANCA
Jason Springer, MD, MS

In this presentation, Jason Springer, MD, MS, provides an overview of forms of non-ANCA associated vasculitis, including Takayasu’s arteritis, polyarteritis nodosa, IgA vasculitis, cryoglobulinemic vasculitis, and Behçet’s disease. This includes discussions of clinical manifestations, differential diagnosis, diagnostic approaches, and therapeutic management of these forms of vasculitis.

Scleroderma
Richard Silver, MD, MACR

Systemic sclerosis has the highest case-specific mortality among the systemic autoimmune diseases. In this presentation, Richard Silver, MD, MACR, will review the clinical aspects of scleroderma, including racial and gender disparities, and will outline the three facets of scleroderma pathophysiology: autoimmunity, vasculopathy, and fibrosis.


Lecture 7 Recording (July 27)  

Vasculitis
Anisha Dua, MD, MPH; Phillip Seo, MD, MHS

In this presentation, Anisha Dua, MD, MPH, and Philip Seo, MD, MHS, provide a broad overview of the ANCA-associated vasculitides. This includes a discussion of clinical manifestations, diagnostic issues, and treatment considerations.

Myositis
Rohit Aggarwal, MD

In this presentation, Rohit Aggarwal, MD, will cover basics in myositis diagnosis, classification, clinical phenotypes, autoantibodies, as well as associated conditions like interstitial lung disease and cancer-associated myositis. Management strategies for myositis and myositis associated interstitial lung disease will be briefly discussed.


Lecture 6 Recording (July 23)  

Recognition and Treatment of Macrophage Activation Syndromes
W. Winn Chatham, MD

In this presentation, W. Winn Chatham, MD, will review clinical and laboratory features of macrophage activation syndrome (MAS). The known triggers for MAS and what is known about the underlying immunopathogenesis and genetic susceptibility will also be discussed. In this context, reported effective treatment strategies will also be reviewed.

Sjögren's Syndrome for the Clinician
Chadwick, Johr, MD

Sjögren's syndrome is one of the more common systemic autoimmune diseases. It is easily misdiagnosed and often poorly understood. In this presentation, Chadwick, Johr, MD, will focus on practical clinical aspects of the disease using a question and answer approach.


Lecture 5 Recording (July 20)  

Lupus
Rosalind Ramsey-Goldman, MD

The goal of this presentation is to provide a basis to build your clinical knowledge base about lupus while seeing patients in the outpatient or hospital setting. In this presentation, Rosalind Ramsey-Goldman, MD, will cover the epidemiology of lupus, including health disparities, making the diagnosis of lupus including interpretation of a positive anti-nuclear antibody (ANA), review the protean manifestations of lupus, and review management to minimize damage from the disease and treatment.

Lupus Nephritis
Joan Mitchell, MD

In this presentation, Joan Mitchell, MD, will review the current understanding of nephritis pathophysiology and the clinical evidence supporting current treatment options. Progress in the application of emerging knowledge about immune processes to treatment selection and dosing will be critiqued.


Lecture 4 Recording (July 16)  

Musculoskeletal Exam of the Shoulder and Knee
Michael J. Battistone, MD

In this presentation, Michael J. Battistone, MD, introduces a systematic approach to the physical examination of the shoulder and knee, and discusses how the findings can be used to help distinguish among common causes for shoulder and knee pain. Following a review of basic anatomy, videos will be shown to demonstrate the sequence of the exams, with details of maneuvers discussed afterward. The integration of exam findings into clinical decision making regarding the use of X-ray and MRI will also be discussed.

Giant Cell Arteritis
Rebecca Manno, MD, MHS

In this presentation, Rebecca Manno, MD, MHS, will review the clinical and radiographic features of giant cell arteritis, including the role of temporal artery biopsy and large vessel imaging. Treatment strategies for GCA will be discussed, including the use of biologic agents.


Lecture 3 Recording (July 13)  

Laboratory Tests in the Rheumatic Diseases
Sterling G. West, MD, MACP, MACR

This presentation, based on an actual case, will examine the use and interpretation of the most common laboratory tests that are ordered during the evaluation of a patient presenting with a possible inflammatory rheumatic disease. The laboratory tests that will be discussed include ESR, CRP, RF, anti-CCP, ANA, complement, ANCA, as well as others. See if you can diagnose the patient’s disease before the final laboratory test is ordered.

Approach to Arthrocentesis and Injections
Kenneth S. O'Rourke, MD

In this presentation, Kenneth O’Rourke, MD, provides an overview of the technical aspects of arthrocentesis and soft tissue injections. Following a review of synovial fluid analysis, a detailed description of the sequential steps of these procedures is provided. Key elements that differentiate corticosteroid preparations, skin antiseptic options, local anesthetics, and the selection of needles and other hardware are reviewed.


Lecture 2 Recording (July 9)  

Enhancing Patient Care and Teaching During Inpatient Consultation
Eli Miloslavsky, MD

Subspecialty consultation is an increasingly utilized hospital resource and is a critical component of patient care, resident and student education, as well as a recruitment tool for subspecialties. In this session, we will review best practices for being a consultant in the inpatient setting with a particular focus on teaching during consultation.

Primer on Plain Radiography for Rheumatology Fellows
Beth Jonas, MD, FACR

In this presentation, we will outline the plain radiographic features of arthritis, with a focus primarily on the hands. We will discuss findings in the soft tissues, boney alignment, bone mineral density, evaluation of the joint spaces, and the appearance of erosions in the common forms of arthritis. We will review the common patterns of joint involvement in arthritis.


Lecture 1 Recording (July 6)

Approach to the Patient with Arthritis
Jason Kolfenbach, MD, University of Colorado

In this presentation, Jason Kolfenbach, MD, provides an overview to the evaluation of patients presenting with arthritic complaints, with a focus on developing a systematic approach to the differential diagnosis of inflammatory arthritis. Key elements from the history and physical exam that drive the subsequent selection of laboratory and imaging studies will be reviewed.

Rheumatology Emergencies
Lisa Criscione-Schreiber, MD, MEd, Duke University

This presentation covers general principles for approaching urgent situations that a rheumatologist may encounter in clinical practice. Through a review of four representative cases, attendees will learn about the appropriate history, physical examination and laboratory evaluation in patients with acute rheumatic presentations. Additionally, differential diagnoses and the initial treatment of these conditions are reviewed.

 

Questions

If you have questions about ViP Adult, contact Connie Herndon, Director of Research, Training, and Workforce.

 

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