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Like so many inflammatory conditions, complex regional pain syndrome (yes, there's growing evidence it's inflammatory) demands early treatment. Yet it is devilishly difficult to recognize its initial stages. Here are the signs, and an algorithm for management.

New in the non-rheumatology journals, much about pain: A review based on 2012 fibromyalgia guidelines from Canada, a viewpoint on safe use of opioids, the evidence to back spinal pain interventions. Also: fast-track arthroplasty, and more newfound genes.

A discovery that patients with fibromyalgia showed signs of small fiber impairment not present in depressed patients or controls may point to the first objectively measurable alteration of the peripheral nervous system in this disorder.

An obese woman in her 30s with a fibromyalgia, depression, polycystic ovarian syndrome, and diabetes has gradually worsening midline back pain. Would you be able to make this "great save"?

An obese woman in her thirties with a history of fibromyalgia syndrome, depression, polycystic ovarian syndrome, and diabetes mellitus presents to her local emergency department with 1 week of gradually worsening midline back pain.

New biomarkers are identifying an increasing number of women with spondyloarthritis, contrary to the idea that the disease affects mostly men. New research shows that severity and inflammatory lesions differ between the sexes.

Test your skills about the management of parotid swelling, fatigue, and peripheral neuropathy in Sjögren syndrome with these case examples presented by Frederick Vivino MD,


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