Endocrinology and Rheumatology: The Most Practical and Useful Topics from Two Specialties

Day 1

Clinical Approach to the Patient with Rheumatic Diseases.

Upon completion of this session, the participant should be able to: ^{GL, COMP}

1. Construct a systematic approach to the evaluation of the patient with rheumatic disease including:
   1. Appraise the central role of the history and physical examination.
   2. Differentiate several patterns, including the ASAS criteria for spondyloarthropathies, that allow clinical diagnosis of rheumatic diseases.

 Laboratory and Radiological Tests in Rheumatology.

Upon completion of this session, the participant should be able to: ^{GL, COMP}

1. Interpret the various classes of synovial fluid analysis.
2. Determine the use and limitations of laboratory testing with emphasis upon the American College of Rheumatology Choosing Wisely recommendations.
3. Discuss key x-ray findings in patients with rheumatic diseases

Systemic Lupus Erythematosus.

Upon completion of this session, the participant should be able to: ^{GL, EBM, COMP}

1. Describe the varied clinical presentations and manifestations in the course of systemic lupus erythematosus.
2. Order and interpret laboratory testing used in the diagnosis of systemic lupus erythematosus in accordance with ACR Guidelines.
3. Monitor and employ treatment options for patients with systemic lupus erythematosus according to EULAR recommendations and evidence-based results from clinical studies.

Scleroderma and Raynaud’s Disease.

Upon completion of this session, the participant should be able to: ^{GL, COMP}

1. Specify the clinical manifestations of scleroderma.
2. Apply the ACR/EULAR classification criteria for systemic sclerosis.
3. Utilize treatment available for symptomatic manifestations as per the current EULAR recommendations.
4. Apply the diagnostic work-up and treatment of Raynaud’s Phenomenon.

Day 2

Adrenal Insufficiency- Primary and Secondary.

Upon completion of this session, the participant should be able to: ^COMP

1. Apply principles learned to evaluate the diagnostic tests used to confirm the diagnosis or primary or secondary adrenal insufficiency.
2. Employ therapeutic options for patients with primary or secondary adrenal insufficiency.

Cushing’s Syndrome and other Functional Disorders of the Adrenal.

Upon completion of this session, the participant should be able to: ^COMP

1. Outline the etiology of Cushing’s syndrome.
2. Evaluate a patient with an adrenal tumor.
3. Evaluate a patient for suspected hyperaldosteronism.

Rheumatoid Arthritis: Clinical Manifestations and Treatment.

Upon completion of this session, the participant should be able to: ^{GL, COMP}

1. Specify the clinical features of rheumatoid arthritis.
2. Illustrate the systemic nature of the disease.
3. Summarize the use and toxicity of disease modifying agents as recommended by the American College of Rheumatology guidelines.

Analgesic Conundrums: Pain Treatment in Rheumatic Diseases

Upon completion of this session, the participant should be able to: ^{GL, COMP}

1. Recognize the various non-pharmacologic techniques to relieve pain.
2. Identify the relative benefits and risks of non-opioid analgesics for Rheumatic conditions as noted by the American College of Rheumatology Recommendations.

Describe the relative benefits and risks of opioid analgesics for Rheumatic conditions.

Day 3

Osteoporosis: Evaluation and Treatment.

Upon completion of this session, the participant should be able to: ^{GL, EBM, COMP}

1. Identify patients who are at risk for osteoporosis and should be evaluated with bone density testing as recommended by the International Society of Clinical Densitometry and National Osteoporosis Foundation guidelines.
2. Recommend the various nonpharmacologic and pharmacologic treatments for osteoporosis as recommended by the National Osteoporosis Foundation guidelines.

Crystal Arthropathies.

Upon completion of this session, the participant should be able to: ^{GL, EBM, COMP}

1. Apply principles from the American College of Rheumatology guidelines in the diagnosis and treatment of crystal arthropathies including gout and pseudogout.

Thyroid Case Studies.

Upon completion of this session, the participant should be able to: ^COMP

1. Appreciate the role of a diagnostic thyroid scan or ultrasound.
2. Evaluate a patient for hyperthyroidism.
3. Prescribe therapeutic options for patients diagnosed with hypothyroidism.

Disorders of Calcium Metabolism.

Upon completion of this session, the participant should be able to: ^COMP

1. Outline the causes of hypercalcemia.
2. Recommend diagnostic testing for hyperparathyroidism.
3. Recognize secondary hyperparathyroidism.

Day 4

Spondyloarthropathies.

Upon completion of this session, the participant should be able to: ^{EBM, COMP}

1. Distinguish the clinical features of the different spondyloarthropathies to improve diagnostic accuracy.
2. Utilize clinical features, laboratory studies, and radiological studies to make a diagnosis of axial spondyloarthropathy.
3. Prescribe pharmacologic agents according to ACR and EULAR recommendations and evidence-based results from clinical trials for patients with spondyloarthropathies.

Rheumatologic Procedures.

Upon completion of this session, the participant should be able to: ^{GL, COMP}

1. Use techniques for appropriate indications for intra-articular and soft tissue injections in rheumatology.
2. Employ appropriate pharmacologic and non-pharmacologic therapies including injections for painful joints as per the ACR recommendations and the various sited rheumatologic and META analysis studies.

Male Hypogonadism.

Upon completion of this session, the participant should be able to: ^COMP

1. Outline the classic causes of male hypogonadism.
2. Appreciate the entity of adult onset hypogonadism.
3. Describe the risks and benefits of testosterone use and apply toward decision making when reviewing treatment options.

Polycystic Ovary Syndrome.

Upon completion of this session, the participant should be able to: ^COMP

1. Recognize the distinguishing features of PCOS.
2. Prescribe appropriate laboratory tests to evaluate women with hirsutism.

Describe the non-reproductive aspects of PCOS.

Day 5

Septic Arthritis.

Upon completion of this session, the participant should be able to: ^{GL, EBM, COMP}

1. Determine the risk factors associated with septic arthritis.
2. Utilize the British Society of Rheumatology Guidelines for management of the hot swollen joint in adults to differentiate septic arthritis for other causes of acute monoarticular arthritis.
3. Utilize epidemiological and clinical clues to determine bacterial etiology in patients with septic arthritis.

 Lyme Disease and Other Topics in Rheumatology.

Upon completion of this session, the participant should be able to: ^{EBM, GL, COMP}

1. Apply CDC and Infectious Diseases Society of America Guidelines for the diagnosis, treatment, and prevention of Lyme disease.
2. Evaluate skin rashes as manifestations of systemic diseases.
3. Using the Guidelines of the Bone Research Society of the United Kingdom to prescribe appropriate therapy for patients with Paget’s disease of the Bone.

 Vasculitis.

Upon completion of these sessions, the participant should be able to:

1. List the various types of vasculitis as defined by the Chapel Hill consensus conference.
2. Identify the clinical and diagnostic criteria of giant cell arteritis.

Case Studies.

Upon completion of these sessions, the participant should be able to:

1. Apply the concepts presented in the Rheumatology section of this conference to effectively deal with cases presentations

Identify several less common causes of musculoskeletal symptoms and signs.