This book is for postgraduate fellows, internists, and students interested in rheu- tology. It contains real cases and is designed to stimulate thought and further reading in this rapidly evolving specialty. I have included a series of common and uncommon cases that I have seen over the past decade in a busy consultative practice and have inserted up-to-date ref- ences and questions you may be asked on ward rounds or in clinic. My hope is that it will be a useful adjunct for physicians preparing for examinations or entering the field and will stimulate further interest. I would like to acknowledge my mentors Pierre Bouloux, MD, Tom Cooney, MD and thank Atul Deodhar, MD for his careful review of the manuscript. This book is dedicated to my parents and wife Batool who have made many sacrifices for which I remain eternally grateful. Brooklyn, NY Yousaf Ali v Contents Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v Self Assessment Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141 vii Question 1 A 56-year-old female presents with arthralgias and fatigue. Lab work is unrema- able apart from normocytic anemia and Howell Jolly bodies on peripheral smear. Her examination reveals a blistering rash on the elbows.

From the reviews:

"Designed for postgraduate students and students trying to learn more about rheumatology, this little volume becomes wonderful bedtime reading for the comprehensive therapist … . Its perspective broadly reviews the field and provides the seasoned experience of an expert rheumatologist." (William H. Wehrmacher, Comprehensive Therapy, 2009)

"This … book is a self assessment tool for rheumatology, focusing on common and uncommon diseases based on the experiences of a seasoned rheumatologist. … It has been written for postgraduate fellows, internists, and medical students. … This is one of the … self assessment books in the field and will serve as a helpful guide for rheumatologists in training and in practice for self assessment and improving their core knowledge." (Aisha Shaikh, Doody’s Review Service, May, 2009)