Delmar's guide to laboratory and diagnostic tests 3rd
Essential Imaging in Rheumatology by 
Challenging Cases in Rheumatology and Diseases of the Immune System by Look for other books in the catalog.
Not finding what you need? Having trouble using one of our resources? Please let us know.
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Video & Multimedia Sources
Resources for this case include:
Textbook Suggestions (look left)
Frequently Used Resources
Videos & Multimedia
PubMed Search Tips -- Quickly Getting to the Evidence on Treatment
Resources for DDX Mnemonics
Two key textbooks for the background on arthritis are Harrison's & Cecil Medicine.
 A very nice section on RA and its signs, symptoms, & manifestations. |
 Check out the section on RA for details on epidemiology, genetic factors, clinical course, & more. |
Quick link to some of your favorite information resources.
Drug Resources
Some of your questions for this case include better understanding of the medications used or potentially used. This information could come from a variety of resources, from textbooks to Google searches. However, Clin Pharm & Micromedex have the seal of approval from the UCSD Healthcare System for patient care. It is a good idea to get used to using one of them.
In either of these resources look up information by specific drug (e.g., salsalate or rantidine or adverse effects of steroids) or use the disease to find a list of drugs for that diagnosis (Micromedex).
National & Government Organizations
Guidelines and concensus statements, while not always a systematic review, review the existing literature and are considered a high level of evidence.
This week, the key organization to know is the American College of Rheumatology. It provides resources for health professional education and research including publishing guidelines on treatment & diagnosis.
Find the Evidence about Treatment
With your EBMI skills firmly intact, you have options for using that knowledge in your PubMed Searching. What's the highest level of evidence for clinical studies? Usually a randomized controlled trial (unless a systematic review or meta-analysis is available).
PubMed Tip: Search for rheumatoid arthritis drug therapy (or use other terms more appropriate for your query) & apply filters to narrow down the 30K articles.
Find the Evidence about Treatment #2
Cochrane Library Tip: Database of Systematic Reviews - get right to synthesized research with this resource, whether it is an overview or systematic reviews about using corticosteroids or Tocilizumab or herbal therapy for arthritis.
- Search using the disease and depending upon your questions, use terms like
- treatment, therapy, drugs, or specific names of the drugs.
- There are lots of results for this type of search unless you specify a drug name.
Looking up information about the results of lab tests are mostly background questions. The following resources are easy to use tools to find very reliable information about the normal values, reference ranges, and more.
Henry's Clinical Diagnosis and Management by Laboratory Methods by 
Ferri's Clinical Advisor by 
Pocket Guide to Diagnostic Tests by Delmar's Guide to Laboratory and Diagnostic Tests by Need to work on the DDX for the case?
Symptoms and differential diagnostic information is often buried in a number of our resources. However, a few tools (both online and for your smart phone/PDA) have special tools to help with this process. Also, there is an app for that - DigitalDDX - created locally by a couple of faculty clinicians.
Passing along a Tip from Dr. Gates regarding a DDX & Symptom Checker
Dr. Gates has found a very helpful text within Access Medicine - Symptoms to Diagnosis: An Evidence Based Guide. Presented through a series of cases of patients complaining of a specific issue, then walks you through buiding the DDX and prioritizing it, and making the diagnosis. Unlike the interactive tools that give you list, this text helps explain the thinking process. Topics include a variety of non-specific complaints from low back pain to weight loss to GI bleeding, to abdominal pain. Check out Chapter 1 as an overview of the diagnostic process.
The books we have include one that helps explain the thinking process (Symptom to Diagnosis) with topics that include a variety of non-specific complaints from low back pain to weight loss to GI bleeding, to abdominal pain. One book has a list of mnemonics (Collins' book) as well as the symptom info. Another book (Syed & Rasul's book) is organized by body areas and the last one (DDX of Common Complaints) focuses on the most common symptions and presents the way a doctor might pursue to diagnosis (images & tests).
Also listed below are some of the interactive DDX tools and their advantages.
Symptom to Diagnosis by 
Differential Diagnosis in Internal Medicine by 
Differential Diagnosis in Primary Care by 
Differential Diagnosis in Primary Care by 
Differential Diagnosis of Common Complaints by Online Look-up Tools
DDX Resources
Perhaps your questions this week deal with understanding the different symptoms the patient mentioned. What do they indicate? Without some good hunches it is hard to move forward. There are a number of differential diagnositc tools to help with the process. You may also find mnemonics helpful as well as the following website.
