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Steven R. Goldring, MD, Discussant

JAMA. 2000;283:524-531.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

INTRODUCTION

DR PARKER: Mrs J is a 55-year-old woman with moderately severe rheumatoid arthritis (RA) that was diagnosed in 1985 after several years of intermittently swollen and painful joints. Due to her illness, she retired from her profession as a restaurateur. She still experiences daily pain in her joints and is facing surgery on her feet. She is married, lives in the Boston suburbs, and has managed care insurance.

Mrs J first noted pain and swelling in her wrists and knees. Later, she experienced morning stiffness, pain, and disfigurement of her hands and feet. After years of symptoms, she was referred to a rheumatologist who made the diagnosis of RA. She did not have adequate clinical responses to oral or intramuscular gold, methotrexate, penicillamine, hydroxychloroquine sulfate, or cyclosporine, mostly because of adverse effects. She took minocycline for 3 months, allowing her to taper her prednisone dosage, . . . [Full Text of this Article]

MRS J: HER UNDERSTANDING AND PERCEPTIONS

DR C: HER UNDERSTANDING AND PERCEPTIONS

AT THE CROSSROADS: QUESTIONS FOR DR GOLDRING

Diagnosis and Epidemiology

Pathology

Pathogenesis

Disease Assessment and General Treatment Strategies

Treatment Approaches

Medications

QUESTIONS AND DISCUSSION

Author Affiliation: Dr Goldring is Associate Professor of Medicine, Harvard Medical School, and Chief of Rheumatology, Beth Israel Deaconess Medical Center and New England Baptist Hospital, Boston, Mass.

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