Original tools & interactive learning · Olga Goodman, MD
Explore & Practice
Clinical cases, open demonstrations, simulations and practical tools. Find a topic, check its access and take the next step in your learning.
On-call rheumatology · Free open demo
Rheumatology On Call: Six Hospitals
Free open demo. Six hospitals. Twenty calls. One rheumatologist. Work through day and night shifts, judge urgency, choose the response and review explanations linked to Professional Essentials and True Rheumatic Emergencies.
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Professional interactive learning · English
Myositis
RC-08 · Weakness, ptosis and breathlessness after cancer immunotherapy
Open quiz →Early Autoimmunity
Four Visits
Expert professional quiz: an integrated RA-pathway case across incidental seropositivity, arthralgia, palindromic attacks and persistent synovitis. English. Professional access required.
Open quiz →Criteria Are Not a Diagnosis
Expert professional quiz: what classification criteria are for — the 2010 RA entry requirement, arthralgia risk criteria, SLE attribution and the 2016 Sjögren set. English. Professional access required.
Open quiz →One Drug, Many Questions
Expert professional quiz: hydroxychloroquine as recommendation, prevention-trial drug, comparator and mechanistic probe — and its safety monitoring. English. Professional access required.
Open quiz →Three Questions at the Door
Expert professional quiz: explaining an unresolved assessment — reassurance, attribution, cohort figures and return triggers. English. Professional access required.
Open quiz →Four Charts That Disagree
Expert professional quiz: reading discordant serology, histology, ultrasound and function without ranking the tests. English. Professional access required.
Open quiz →One Word on the Scan
Expert professional quiz: what an imaging report must specify, subclinical synovitis and non-progression, and matching the test to the organ. English. Professional access required.
Open quiz →Is Seronegative Milder?
Expert professional quiz: why seronegative cohorts disagree — definitions, recruitment, Ro52 reporting and referral enrichment. English. Professional access required.
Open quiz →The Report, Line by Line
Expert professional quiz: composition versus validation of a multianalyte CTD panel, the 2025 T-cell study and transfer of older performance estimates. English. Professional access required.
Open quiz →Raynaud at the Door
Expert professional quiz: VEDOSS denominators, discordant Scl-70, capillaroscopy versus other imaging, and the scope of ILD screening. English. Open demo; no registration required.
Open quiz →Three Women Before Pregnancy
Expert professional quiz: anti-Ro/La pregnancy, PATCH, aPL without APS, guideline disagreement and lupus-anticoagulant testing on anticoagulation. English. Open demo; no registration required.
Open quiz →Two Years, Four States
Expert professional quiz: an integrated two-year case across isolated ANA, UCTD with arthritis, silent proteinuria and pregnancy planning. English. Professional access required.
Open quiz →Audit the Note
Expert professional quiz: auditing a clinic note against the documentation prompts — state, target, ownership, triggers and off-label status. English. Professional access required.
Open quiz →The Biopsy Report
Expert professional quiz: focus-score arithmetic, tissue denominators, expert review, and lip biopsy versus a focal gland lesion. English. Professional access required.
Open quiz →Quiet Disease, Moving Numbers
Expert professional quiz: serologically active, clinically quiescent SLE — two cohorts, hydroxychloroquine continuation and dosing, renal surveillance. English. Professional access required.
Open quiz →Whose Recommendation Is It?
Expert professional quiz: which body recommends what, for whom — ACR, EULAR, BSH, SMFM, BSR, NICE and ACR/CHEST. English. Professional access required.
Open quiz →Who Was Actually Studied?
Expert professional quiz: matching patients to the enrolled populations of APIPPRA, ARIAA, StopRA, TREAT EARLIER, PALABA, SMILE and PATCH. English. Professional access required.
Open quiz →Three Results, Three Assays
Expert professional quiz: anti-dsDNA methods, Scl-70 platforms, SSA reporting, repeat serology and ANA reporting. English. Professional access required.
Open quiz →Same Test, Different Clinic
Expert professional quiz: how prevalence and selection shape negative predictive value, with worked arithmetic. English. Professional access required.
Open quiz →The Subgroup Temptation
Expert professional quiz: subgroup, post hoc and mechanistic findings in TREAT EARLIER, USEFUL and JOQUER. English. Professional access required.
Open quiz →Run the Numbers
Expert professional quiz: crude proportions, endpoints and time points in APIPPRA, ARIAA, StopRA, TREAT EARLIER and PALABA. English. Professional access required.
Open quiz →Organ Before Antibody
Advanced professional quiz: unexpected myositis, Scl-70 and ANCA results; ILD screening scope; organ disease before the complete syndrome. English. Professional access required.
Open quiz →The Sister Wants a Test
Advanced professional quiz: testing well relatives, lifestyle evidence, VITAL and the threshold for preventive treatment. English. Professional access required.
Open quiz →Permission to Stop
Advanced professional quiz: reducing repetitive testing and visits without losing targeted surveillance or a route back. English. Professional access required.
Open quiz →Fifty Percent of What?
Advanced professional quiz: absolute versus relative risk, NNT, discrimination versus calibration and time-to-event reporting. English. Professional access required.
Open quiz →Seronegative Is Not a Diagnosis
Advanced professional quiz: negative RF/anti-CCP with objective synovitis, expanded antibody panels and what each claim requires. English. Professional access required.
Open quiz →Keep the Denominator
Advanced professional quiz: VEDOSS denominators, Sjögren markers, aPL primary prevention and anti-Ro/aPL pregnancy. English. Professional access required.
Open quiz →A Label Is Not a Forecast
Advanced professional quiz: incomplete lupus and UCTD — SMILE, organ assessment, hydroxychloroquine scope and safety, USEFUL, quiescent SLE. English. Professional access required.
Open quiz →Delay Is Not Prevention
Advanced professional quiz: APIPPRA, ARIAA, ALTO, StopRA, TREAT EARLIER and PALABA read within their populations and endpoints. English. Professional access required.
Open quiz →Before the First Swollen Joint
Advanced professional quiz: at-risk RA states, EULAR/ACR arthralgia risk criteria, CCP level and negative ultrasound. English. Professional access required.
Open quiz →Two Reports, Four Questions
Advanced professional quiz: intended use, validation population and endpoint for AVISE CTD and the adjusted MBDA score. English. Professional access required.
Open quiz →Juvenile Spa
Beyond the Joint Count
Open quiz →The Eye That Stays Quiet
Open quiz →The Unowned Result
Open quiz →Refractory to What
Open quiz →Which Domain Decides
Open quiz →The Class Shortcut
Open quiz →After the Lead-In
Open quiz →One Class, Several Agents
Open quiz →A Stated Purpose
Open quiz →No Shared Ladder
Open quiz →More Than the Total
Open quiz →The Question Before the Probe
Open quiz →Bright Is Not Always Edema
Open quiz →Name the Decision
Open quiz →The Convenient Explanation
Open quiz →The Quiet Back
Open quiz →Map Before the Label
Open quiz →A Few Doppler Pixels
Open quiz →The Traveling Denominator
Open quiz →The Unexplained Acronym
Open quiz →Spa
The SpA Trap House
Six rooms of diagnostic and treatment traps across axial, peripheral, psoriatic, reactive, IBD-associated and juvenile spondyloarthritis. Four languages, 14 tasks and a final debrief.
Open quiz →Rheumatoid Arthritis
Club Synovium — Closing Time
Difficult-to-treat RA, treatment switching, tapering and lung disease. Intermediate to advanced.
Open quiz →Club Synovium — Conditions of Entry
Pregnancy, reproductive planning, infection screening and treatment safety. Intermediate to advanced.
Open quiz →Club Synovium — The Floor Plan: Synovial Biology & Treatment Switching
Map synovial cells, autoantibodies and structural damage, then reason through treatment switching. Intermediate to advanced; foundational biology review included. Supplementary exam preparation and MOC knowledge review.
Open quiz →Club Synovium — The Back Office: Conventional DMARDs & Safety
Practise conventional DMARD mechanisms, weekly methotrexate safety, monitoring and immunogenicity. Foundation to intermediate; includes advanced safety distinctions. Supplementary exam preparation and MOC knowledge review.
Open quiz →Club Synovium — Door Security: Cytokines & Targeted Therapy
Match cytokines to pathways and advanced therapies, then apply mechanisms to clinical safety choices. Foundation to intermediate; includes advanced clinical cases. Supplementary exam preparation and MOC knowledge review.
Open quiz →Six Organs, One Plan
An older man with active RA, a stent, a melanoma, mild ILD, falling eGFR and a fracture: each organ reshapes the plan.
Open quiz →The Vaccines Can Wait
Before rituximab, a plan to vaccinate “later” opens a course of infection, monitoring and blood-count decisions.
Open quiz →The Long Way to a Label
One woman’s course from methotrexate to a difficult-to-treat referral: what does each step of her record actually show?
Open quiz →A Voice Worn Thin
Quiet joints, three months of hoarseness and a referral that already names the cause: what comes first?
Open quiz →Readout or Relapse
Night sweats, broken sleep and a rising composite score on a biologic: what changed, and what is still only a hypothesis?
Open quiz →Twice as Often as Placebo
A headline promises the most effective RA drug yet: which question did its trial actually answer, and for whom?
Open quiz →Not Equivalent Choices
An approved implant, an advertised infusion and a trial drug: which is a real option for a refractory patient?
Open quiz →The Diet Doing the Work
Her stiffness eased on a restrictive diet and online supplements, and now she wants to stop methotrexate. What can that improvement settle?
Open quiz →Five Hours Too Long
A hot knee, swollen wrists and a low blood pressure: does the usual order of samples before antibiotics still hold?
Open quiz →Stop Everything, Says the Form
A knee replacement form asks rheumatology to stop all immunosuppressants: which instruction should actually go back?
Open quiz →A Label from the Ward
After pneumonia, a discharge letter calls her frail; today her wrists are swollen. Which record should set the plan?
Open quiz →Five Years by Whose Rule
Active RA, a breast cancer history and a referral that sets a five-year wait: what does the chapter actually ask for?
Open quiz →Named by the Tissue
Nephrotic proteinuria after years of active RA, a raised serum amyloid A, and a referral that has already decided.
Open quiz →Quiet Joints, Shrinking Frame
Her joints are quiet, but she is shorter, her back hurts and she needs her arms to stand: where does the bone plan start?
Open quiz →What the Score Leaves Out
A young smoker with active RA has a low ten-year estimate: what can the number settle, and what can it not?
Open quiz →Low pH, Known RA
Fever and a new effusion on methotrexate, with a fluid that looks rheumatoid: what can the result settle today?
Open quiz →A Letter, a New Pen
Ten weeks after a formulary move to a biosimilar, her hands ache and a note says nocebo: what can be concluded yet?
Open quiz →A Score Without a Mechanism
Her CDAI has doubled on full adherence, but the knee, the wrist and the aching hands may not share one cause.
Open quiz →An Old Film, a New Limit
Remission-range scores, erosions filmed five years ago and a falling function score: what can the old film explain?
Open quiz →A Remission Made of Units
A clinic template reports DAS28-CRP remission from today's inputs: is the number a measurement or an artefact of entry?
Open quiz →Rescued, Not Treated
Mid-pregnancy, repeated prednisone bursts hold back active RA: what should the plan do now, and after the birth?
Open quiz →The Letter Before IVF
A fertility clinic asks rheumatology to stop leflunomide before stimulation: what does finishing that task actually require?
Open quiz →The Ferritin That Reassured
Quiet joints, a falling hemoglobin and a ferritin within range: which explanation has actually been earned?
Open quiz →The Eye Sets the Pace
Quiet joints, a painful red eye and an ankle ulcer: which findings decide how fast, and by whom, she is assessed?
Open quiz →One Skipped Dose
A travel letter proposes skipping one tocilizumab dose before a live vaccine: what sets the interval, and who should set it?
Open quiz →Three Good Years, Then Pain
After years of remission on etanercept, his hands hurt again: has the drug stopped working, or has the problem changed?
Open quiz →The Week-24 Booking
Twenty-two weeks after a first rituximab course, her joints are unchanged and B cells absent: what should decide the next course?
Open quiz →The Heart Changes the Choice
Active RA on optimized methotrexate meets class III heart failure: what does the chapter make of the next biological step?
Open quiz →An Option, Not an Order
Methotrexate has not controlled his synovitis, and a registrar reads RACAT as a mandate: what does the trial oblige?
Open quiz →An Allergy Called Nausea
New, highly active RA and a chart that says “methotrexate allergy”: which first strategy, and which guideline says what?
Open quiz →Nine Quiet Years
Stable on weekly methotrexate for years, she starts an antibiotic, then develops ulcers and fever: what comes first?
Open quiz →Against, but for What?
A guideline sentence about methotrexate meets mild, stable RA-ILD and joints in remission: what does it actually ask of you?
Open quiz →The Opacity Behind the Assay
Before rituximab, a positive assay, a cough and an anti-HBc result each demand a different action. Which comes first?
Open quiz →Failed, or Just Stopped?
A referral lists three failed biologics and asks for a fourth: what has to be settled before the next prescription?
Open quiz →Scores Between the Courses
Remission-range scores at every visit, prednisone courses in between and a wish to cut back: is she ready to taper?
Open quiz →A Pill for Convenience
A high-risk patient asks for an oral JAK inhibitor: what do the trial, the labels and her own history actually settle?
Open quiz →The Safest Biologic?
After methotrexate and a TNF inhibitor, IL-6 blockade or abatacept: which problems should decide, and what does each drug ask of you?
Open quiz →The Bridge That Stayed
Six months after a short prednisone bridge, swelling returns at every reduction: what should the next decision address?
Open quiz →Ten Milligrams on Mondays
A referral calls methotrexate a failure after five months at a low dose: what was actually received, and what comes first?
Open quiz →One Component Short
Three Boolean components are met and one is not: what should the unmet patient global lead to at this review?
Open quiz →A Quiet CRP, a Hot Knee
On a JAK inhibitor, a normal CRP meets a newly swollen knee: which question can the number settle?
Open quiz →Rescue Is Not a Plan
Prednisone for most attacks, kidney disease and tamoxifen: planning past the next rescue.
Open quiz →An RF With a History
A positive RF, a raised ALT and an old exposure: which mimic to test before the label sets.
Open quiz →Short of Six
Six swollen joints, two negative antibodies, a score below six: what serostatus can and cannot decide.
Open quiz →Quiet Joints, Unquiet Neck
Doppler in remission, a request to stop the biologic, a neck before anesthesia: what imaging can settle.
Open quiz →Erasing the Edema
Bone edema on MRI, a “newly documented” erosion on a report: which finding should change treatment?
Open quiz →The Number and the Question
A low CRP, a high RF and a rising creatinine at one visit: which question does each number answer?
Open quiz →Prescribed but Not Started
Methotrexate on the letter, not yet in the patient: what a baseline must settle before day one.
Open quiz →Remission at 28 Joints
A remission score in the letter, swollen forefeet on examination: what the 28 joints leave out.
Open quiz →Immunotherapy Ended Last Spring
New hand synovitis months after nivolumab stopped: whose explanation is it, and who decides?
Open quiz →It Worked on Prednisone
Shoulders better on steroids, wrists still swollen: what a brisk response can and cannot settle.
Open quiz →Response Is Not Proof
It settled on methotrexate, so it must be RA: what an early response can and cannot tell you.
Open quiz →Quiet on Methotrexate
Six years of methotrexate, one negative RF, a quiet examination: what the record still has to show.
Open quiz →Which Outcome Did You Treat?
Less pain, the same antibody, the same attacks: judging treatment against the reason it was started.
Open quiz →Normal on Tuesday
Attacks that leave nothing behind, an antibody in the letter: what the record still has to capture.
Open quiz →Between Delay and Prevention
An antibody result, two trial headlines and a sister’s study: what prevention evidence can and cannot carry.
Open quiz →One Trial, Several Readings
A headline count, a primary outcome and a subgroup signal: placing each result where it belongs.
Open quiz →Days Gained, Events Counted
Two abatacept results arrive in different currencies: what each one measures and what it cannot claim.
Open quiz →A Borrowed Probability
A positive antibody, a trial figure from the news, and what a risk number can and cannot say about one person.
Open quiz →A Target Is Not a Test
What each drug blocks, what a biopsy trial showed, and what it would take to let tissue choose.
Open quiz →Who Does the Damage
Synovial cells, their positions and signals, and what each finding does and does not license.
Open quiz →Upstream of the Joint
Genes, smoking, lung and gums: what each line of evidence can and cannot tell a worried relative.
Open quiz →The Fellow’s Arithmetic
A confident total, a drafted letter, and the question of what a classification number can carry.
Open quiz →A Label Too Early
A positive antibody, an eager referral and a recommendation that stops at the border of arthritis.
Open quiz →The Letter and the Hands
Normal tests on paper, soft swelling under the fingers: which evidence decides.
Open quiz →Ibd Associated Spondyloarthritis
Club Lumen — The Other Rooms
Explore extra-articular disease, surgery, pregnancy and long-term care in IBD-associated spondyloarthritis. Intermediate to advanced.
Open quiz →Club Lumen — One Drug, Two Organs
Match treatment to gut and joint domains, and interpret discordant responses in IBD-associated spondyloarthritis. Advanced.
Open quiz →Club Lumen — Relief Without Collateral
Balance symptom relief, rehabilitation and treatment safety in IBD-associated spondyloarthritis. Advanced.
Open quiz →Club Lumen — Not Every Pain Is the Gut’s
Recognise diagnostic mimics and interpret tests and imaging in IBD-associated spondyloarthritis. Advanced.
Open quiz →Club Lumen — Two Timelines
Distinguish gut and joint timelines, clinical phenotypes and screening in IBD-associated spondyloarthritis. Intermediate.
Open quiz →Scleroderma
Four Emergencies, One Weekend
The on-call phone does not wait for the educational questionnaire.
Open quiz →The Trial That Wasn't Recruiting
An old announcement and a new hope walk into a clinic.
Open quiz →Phase III Is Not a Result
A trial's phase tells you where it is, not where it will land.
Open quiz →Borrowed Conclusions
The abstract said “improved.” Improved what, in whom, compared with what?
Open quiz →Tired Is Not a Diagnosis
“Fatigue” is where the history begins, not where it ends.
Open quiz →A Line Down the Forehead
Small patient, deep questions.
Open quiz →Preconception Is a Verb
Plans made before conception beat plans made in the emergency room.
Open quiz →A Label in One Organ
Approved for the lungs does not mean approved for everything.
Open quiz →The Graph With One Dot
One data point is a dot, not a trend.
Open quiz →Limited Is Not Mild
A subset tells you where the skin is, not how worried to be.
Open quiz →The Reset-Button Brochure
CAR-T, stem cells and a very glossy leaflet.
Open quiz →One Label Too Many
Collecting diagnoses is not the same as clarifying care.
Open quiz →The Watermelon and the Diet
Not every scleroderma stomach is just dysmotility.
Open quiz →A Troponin With an Alibi
The muscle did it. Maybe.
Open quiz →DETECT Is Not a Verdict
An algorithm with an eligibility list — and a patient who ignored it.
Open quiz →The DLCO Dropped. Now What?
One number, several suspects.
Open quiz →Softer Skin, Same Fist
The skin score improved. The jar is still closed.
Open quiz →Scl-70 Says Who?
A positive result is a question, not a verdict.
Open quiz →The Patch, the Pill and the Pressure
Two vasodilators walk into a blood pressure.
Open quiz →Cold Fingers and a Calculator
VEDOSS is a map of a cohort, not a fortune teller.
Open quiz →Unlabelling
A diagnosis made six years ago still has to earn its keep.
Open quiz →Thick Fingers, Thin Nerves
Paraproteins have skin in the game.
Open quiz →Blisters Before the Thickening
Porphyrins can imitate fibrosis — in daylight.
Open quiz →The Oncologist's Phone Call
A taxane and a checkpoint inhibitor walk into a rheumatology clinic.
Open quiz →Transplant, Then Tight
Anti-Scl-70 is not a passport to systemic sclerosis.
Open quiz →The Prayer That Does Not Close
Waxy hands, quiet nailfolds, no Raynaud.
Open quiz →The Scan Before the Skin
Ask what went into the vein eight weeks ago.
Open quiz →Papules in a Row
When mucin dresses up as sclerosis and brings a paraprotein to the party.
Open quiz →The Neck Came First
A frozen upper back is not sclerodactyly's cousin.
Open quiz →Hard Forearms, Soft Fingers
The disease that trains for marathons and spares the hands.
Open quiz →Lupus
Every Digit Counts
Doses, intervals, thresholds and trial figures that change what happens next.
Play →Right Data, Wrong Conclusion
Labs, biopsies, trials and trajectories: spot the conclusion the data cannot carry.
Play →Your Move, Doctor
Short cases across the disease course: choose the next action, then defend it.
Play →Three Rulebooks, One Kidney
Where ACR, KDIGO and EULAR agree, diverge, or simply count differently.
Play →Enrolled, Excluded, Approved
What each trial enrolled, what each label permits, and where they part.
Play →Beyond the Protocol
Pregnancy, dialysis, transplant and the pipeline: where standard answers stop.
Play →Clocks and Plateaus
Read the trajectory, explain the plateau, and stop only with a plan.
Play →The Parallel Plan
Pressure, vaccines, prophylaxis and interactions: the treatment running beside immunosuppression.
Play →Subgroups and Small Print
Membranous lesions, targeted drugs and the trial details that change decisions.
Play →Backbone and Taper
Pick the backbone, count every gram, and plan the taper on day one.
Play →Mimics and Milestones
Name the second process, then set targets the kidney can actually meet.
Play →Below the Class Line
Class, indices, interstitium and vessels: reading the whole lupus nephritis biopsy.
Play →The Needle’s Question
When to biopsy, when to repeat, and what the tissue can answer.
Play →The Baseline Gambit
Screen, quantify and weigh thresholds before kidney disease announces itself.
Play →Kidney Before Class
Read the renal phenotype and its biology before trusting a class label.
Play →Spot Ratio, Timed Truth
Building a reliable baseline and moving to tissue
Open quiz →Beyond the Usual Patient
Pregnancy, kidney failure, transplantation and the evidence still to come
Open quiz →Flare, Plateau or Underexposure?
Relapse definitions, adherence evidence and the order of de-escalation
Open quiz →Protection With Precise Numbers
Blood pressure, SGLT2 inhibition, hydroxychloroquine, bone and infection
Open quiz →Doses Received, Not Doses Written
Exposure, nadirs and labels behind conventional and targeted therapy
Open quiz →Heavy Protein, Two Preferences
Matching the initial regimen to proteinuria, extrarenal disease and class
Open quiz →A Missed Target Is Not a Prognosis
Goals, response definitions and the asymmetry of twelve-month proteinuria
Open quiz →Not Every Lupus Kidney Is Lupus Nephritis
TMA, APS, drugs and the alternatives that change treatment
Open quiz →Twenty-Four and Twelve
Reading every layer of the lupus nephritis biopsy
Open quiz →Same Class, Different Kidneys
Activity, damage and reserve, and what mechanisms can and cannot tell you
Open quiz →Three Years by Whose Clock?
Treatment duration, pregnancy timing and planning beyond the first response
Open quiz →Protection Counts as Treatment
Hydroxychloroquine, antiproteinuric therapy and safety before immunosuppression
Open quiz →The Plateau Before the Milestone
Explaining an incomplete response before escalating
Open quiz →Milestones on Different Clocks
Reading a proteinuria trajectory against named targets
Open quiz →Forty Milligrams Is a Ceiling
Writing the steroid taper on the day treatment starts
Open quiz →Labels Before Infusions
What belimumab, voclosporin and obinutuzumab each require
Open quiz →Membranous by the Numbers
Pure class V, mixed patterns and the limits of the evidence
Open quiz →Two Constraints, One Regimen
Choosing a combination when kidney function and blood pressure narrow the field
Open quiz →The Class Is Not the Clock
Activity, chronicity and what the class number misses
Open quiz →Normal Creatinine, Active Sediment
When a proteinuria threshold should not delay the biopsy
Open quiz →Promise Versus Proof
Reading interferon blockade, cytokine targets, CAR T-cell therapy and pipeline news without confusing promise with renal benefit.
Open quiz →Goals the Team Can Use
Updating prognosis, weighing activity against reserve, and writing treatment goals that include the conditions of care.
Open quiz →Beyond the Standard Adult
Children and adolescents, paternal exposure, fetal surveillance and antiphospholipid status in pregnancy.
Open quiz →Dose Received, Not Dose Written
Mycophenolate exposure, cyclophosphamide protocols, fertility protection and safe azathioprine use.
Open quiz →From Immune Complex to Scar
Deposit location, intrarenal immunity and resident-cell injury — and why mechanisms are not yet bedside biomarkers.
Open quiz →After the First Response
Treatment duration and withdrawal, pregnancy planning, advanced CKD and transplantation.
Open quiz →Reading the Response Curve
Response definitions, EULAR milestones, divergent markers and structured reassessment before rescue therapy.
Open quiz →Protect the Kidney, Protect the Patient
Blood pressure, SGLT2 inhibition, hydroxychloroquine, Pneumocystis prophylaxis, vaccines and interaction review.
Open quiz →Targeted Therapy by the Label
Belimumab, voclosporin and obinutuzumab: dose rules, safety warnings and what each trial did and did not show.
Open quiz →Membranous, Mixed or Something Else
Pure class V, mixed proliferative–membranous disease and the limits of class-specific evidence.
Open quiz →Building the Induction Regimen
Matching the conventional backbone, the add-on and the glucocorticoid plan to the lesion and the patient.
Open quiz →Not Every Kidney Problem Is LN
TMA, antiphospholipid disease, ANCA, drug exposures and the common alternatives in a patient who already has SLE.
Open quiz →Beyond the Diagnosis Line
Specimen adequacy, class definitions, activity and chronicity indices, and what a class number misses.
Open quiz →Ask the Tissue a Question
Initial and repeat kidney biopsy: thresholds, timing, safety and the decision the result must inform.
Open quiz →Before the Creatinine Moves
Surveillance, a reproducible baseline and when a numerical threshold should not delay a renal work-up.
Open quiz →Rheumatic Emergencies
Case Stakes · Progressive breathlessness in lupus despite normal blood pressure
Decide what she needs in the first hour — and what she must not be given.
Play →Case Stakes · Creatinine doubling every three days, platelets of 48 — and a plan written around a trial that excluded her
Decide what is injuring the kidney — one process or two — and what the trial on the board actually studied.
Play →Case Stakes · A soft abdomen, a lactate of 1.9 and low complement — labelled 'lupus enteritis' before the arterial phase was run
Decide whether a soft abdomen is reassuring, and what the CT has and has not answered.
Play →Case Stakes · A finger that stayed white overnight, a radial pulse you can feel — and a clinic slot in 48 hours
Decide whether this is a worse Raynaud attack or threatened tissue — and what 48 hours would cost.
Play →Case Stakes · Ninety seconds of darkness in one eye, a CRP of 7 — and a biopsy slot on Thursday
Decide what a blackout that resolved means, and what has to happen before Thursday — and before the other eye.
Play →Case Stakes · No fever, CRP 6 — and a platelet count that has lost two-thirds of itself in a week
Decide what the quiet CRP is hiding, and what you must compare against before you believe any single number.
Play →Case Stakes · In remission on paper, with a saturation of 97% — and breathing you can hear from the door
Decide what the noise means, and what must not be done to a patient who is breathing through a hole the width of a straw.
Play →Case Stakes · Normal CK, negative ANA — and a lung that is getting worse by the day
Decide how dangerous this lung is, and what must happen in parallel this week — not in three.
Play →Case Stakes · No hemoptysis, a normal first hemoglobin, and oxygen that keeps going up
Decide what this is until proven otherwise — and what the anticoagulant does and does not explain.
Play →Case Stakes · A creatinine inside the range, and a slope that is not
Decide how fast this kidney is moving — and what must happen before the biopsy report exists.
Play →Case Stakes · A normal reading, a sick patient
Decide what she has until proven otherwise — and what must start before the picture is complete.
Play →After the Acute Phase
The crisis is over; the discharge plan is not. Relapse, retesting, tapers—and whose name is on each.
Play →Right Place, Right Team
A referral letter is not a team: match each emergency to the place and people who can actually rescue it.
Play →When Treatment Is the Trigger
Twelve emergencies where the usual suspect is on the drug chart — or holding the catheter.
Play →Infection in the Room
Fever, cultures, crescents and pus: infection is rarely the only guest, and rarely absent.
Play →Case Files
Synthetic patients, real decisions — and no case arrives with its diagnosis on the folder.
Play →Anticoagulation Crossroads
Where thrombosis and bleeding share a bed, and the heparin order is never just a checkbox.
Play →Steroids: Friend or Foe
The drug that saves an eye can tip a kidney into crisis — the trick is knowing which emergency you are in.
Play →Imaging Decisions
A scan answers only the question you asked — and only if the patient survives the trip to the scanner.
Play →What the Test Can't Tell You
Normal, negative, pending: three words that have delayed more emergencies than any missing reagent.
Play →Numbers That Matter
Twelve emergencies, plenty of thresholds — and most are alarms, not permission to wait.
Play →GCA with Threatened Vision
The curtain lifted, the CRP fell, the headache eased — and none of that clears the eye.
Play →MAS / Secondary HLH
Where a 'normal' platelet count can be the most alarming number on the chart.
Play →Catastrophic APS (CAPS)
A third organ, a week and a biopsy — CAPS waits for none of them, and neither should you.
Play →Cardiac Tamponade
The blood pressure is normal, the triad is incomplete, and the heart is still not filling. Bet accordingly.
Play →Fulminant Autoimmune Myocarditis
The ejection fraction is 58%. The AV block does not care. Bet on the physiology, not the number.
Play →Critical Airway Obstruction
Stridor at rest does not wait for the saturation to drop — and neither should you.
Play →Rapidly Progressive Myositis ILD
The lungs will not wait for the antibody panel — or for the CK to rise.
Play →Diffuse Alveolar Hemorrhage
Blood in the alveoli rarely announces itself. Bet on what you would do before the hemoptysis arrives.
Play →Rapidly Progressive Glomerulonephritis
A normal creatinine, a negative ANCA, no hemoptysis — and the kidney is still on the clock.
Play →Scleroderma Renal Crisis
A normal blood pressure, a “mild” creatinine rise — and a kidney that will not wait for the biopsy.
Play →Dermatology Rheumatology
Dermatology–Rheumatology V · Reactions, infection and mimics
Assess drug eruptions and systemic toxicity, skin infection during immunosuppression, malignancy, autoimmune blistering and neutrophilic dermatoses.
Play →Dermatology–Rheumatology IV · Purpura, vasculitis and lupus
Work through purpura, biopsy decisions, cryoglobulinemia, urticarial vasculitis, occlusive vasculopathy and difficult cutaneous lupus decisions.
Play →Dermatology–Rheumatology III · Fibrosis and myositis
Distinguish morphea and fibrosing mimics, interpret skin changes in systemic sclerosis, and assess dermatomyositis skin phenotypes and aesthetic care.
Play →Dermatology–Rheumatology II · Psoriasis and treatment
Choose treatment across skin, joint and bowel domains; assess paradoxical reactions, pustular psoriasis, SAPHO and treatment safety.
Play →Dermatology–Rheumatology I · Skin clues
Recognize skin and mucosal clues in psoriatic arthritis, systemic sclerosis, dermatomyositis, lupus, Sjögren disease and reactive arthritis.
Play →Clinical Challenge
Acute Presyncope with a Slow Wide-QRS Rhythm — Clinical Challenge
An original interactive cardiology case by Olga Goodman, MD: acute presyncope, a slow wide-QRS rhythm, staged ECG interpretation, management traps, and a rheumatology bonus round. Free and open to everyone.
Open quiz →An ECG That Changes the Next Step — Clinical Challenge
An original, open-access interactive ECG case that tests clinical decision-making.
Open quiz →Weak, nauseated, and the rhythm is changing
Open quiz →Rheumatology
Endocrinology–Rheumatology
Bone fragility and its treatment; Glucocorticoids and the adrenal axis; Thyroid, diabetes and pituitary; Calcium, phosphate and crystals; Reproductive endocrinology in rheumatology.
Play →Oncology–Rheumatology
Arthritis and polymyalgia on checkpoint inhibitors; Muscle, heart and glands on checkpoint inhibitors; Paraneoplastic and malignancy-related mimics; CAR-T and cell therapy in autoimmune disease; Cancer treatment meets rheumatology.
Play →Infectious diseases–Rheumatology
Hot joints under immunosuppression; Mycobacteria; Viruses and the joints; Opportunistic and endemic infections; Infections that look rheumatic.
Play →Pregnancy and rheumatic disease
Lupus and nephritis in pregnancy; Contraception and fertility preservation; Antiphospholipid syndrome in pregnancy; Assisted reproduction and high-risk disease; Drugs, delivery and lactation.
Play →Hematology–Rheumatology
Macrophage activation and secondary HLH; Neutropenia, Felty and large granular lymphocytes; Cytopenias and haemolysis in lupus; Clones, gammopathy and Castleman; Drug-related cytopenia and coagulopathy.
Play →Ophthalmology–Rheumatology
Anterior uveitis, SpA and the gut; JIA-associated uveitis; Sclera, cornea and orbit; Drugs and the retina; Systemic uveitis and masquerades.
Play →Neurology–Rheumatology
Brain vessels and their mimics; Neuropsychiatric lupus and attribution; Peripheral nerve and ganglion; Systemic disease in the nervous system; Treatment, infection and the nervous system.
Play →Gastroenterology–Rheumatology
IBD-associated spondyloarthritis; Systemic sclerosis: gut and nutrition; Liver at the rheumatology interface; Gut safety of rheumatology drugs; Gut mimics and systemic links.
Play →Nephrology–Rheumatology
Lupus nephritis: detection and tissue; Lupus nephritis: treatment over time; ANCA and anti-GBM glomerulonephritis; Tubulointerstitial disease and mimics; Kidney safety, CKD and transplantation.
Play →Pulmonology–Rheumatology
ILD: diagnosis and first-line choices; Progression, monitoring and antifibrotics; Airways, pleura and respiratory muscles; Acute respiratory emergencies; Drug toxicity and infection.
Play →Clinical Rounds
Clinical mini-exams with instant explanations, a timed or untimed mode, and pause-and-resume.
Play →Red Flags
Spot the safety issue: monitoring, infections, vaccines and treatment risks. A rheumatology quiz with virtual chips and explanations.
Play →The Target
Match the medicine to its target and mechanism. A rheumatology quiz with virtual chips, timed questions and explanations.
Play →The Wager
How much would you stake on what you know? A rheumatology quiz with virtual chips, timed questions and explanations.
Play →Spondyloarthritis
Spondyloarthritis III · Complex cases
Advanced differential diagnosis, treatment failure, comorbidities, paediatric disease and evidence interpretation.
Play →Spondyloarthritis II · Clinical decisions
Distinguish mimics, read disease activity scores and choose therapy across skin, eye, gut, pregnancy and joint domains.
Play →Spondyloarthritis I · Foundations
Axial and peripheral SpA, psoriatic and reactive arthritis: diagnosis, imaging, treatment and safety.
Play →Club Sacroiliac — The Long Game
Plan long-term axial spondyloarthritis care: tapering, relapse, fracture risk and life-stage decisions. Intermediate to advanced.
Open quiz →Club Sacroiliac — The Eye and the Gut Choose First
Choose axial spondyloarthritis therapy across eye, gut, skin and comorbidity domains. Advanced.
Open quiz →Club Sacroiliac — Change Is Not State
Separate disease activity, improvement, function and structural damage in axial spondyloarthritis. Advanced.
Open quiz →Club Sacroiliac — Bright, but Whose?
Interpret sacroiliac imaging, recognise mimics and avoid overcalling inflammation in axial spondyloarthritis. Advanced.
Open quiz →Club Sacroiliac — Two Labels, One Spine
Distinguish radiographic and non-radiographic axial spondyloarthritis, classification thresholds and diagnostic evidence. Intermediate.
Open quiz →Dish
Diagnosis Made. Now What?
No disease-modifying drug, a small exercise trial and a lot of clinical judgement. Seven rounds on goals, analgesia, bone health and follow-up that means something.
Play →Swallow, Airway, Cord
Anterior osteophytes, a posterior ligament that ossifies, an anaesthetist who needs warning. Seven rounds on cervical DISH, dysphagia, myelopathy and procedures.
Play →Low Energy, High Stakes
A ground-level fall, a rigid spine, a normal-looking radiograph. Seven rounds on why the mechanism lies and the first examination isn't the last.
Play →Bridge or Syndesmophyte?
DISH, axial spondyloarthritis or spondylosis — and the mimics that borrow DISH's coat. Seven rounds where study design is part of the diagnosis.
Play →The Fourth Vertebra
Resnick–Niwayama, early-phase CT criteria, MrOS — and the discipline of not counting a bridge that isn't in the frame. Seven rounds on recognizing DISH.
Play →DISH III · Complex cases
Complex DISH decisions across trauma, airway and surgery; special populations, long-term care and critical appraisal of evidence.
Play →DISH II · Clinical decisions
Resolve DISH mimics and coexistence, choose investigations and manage fracture risk, dysphagia, myelopathy and procedures.
Play →DISH I · Foundations
Recognise DISH, interpret imaging, plan conservative care and identify trauma, swallowing and neurological red flags.
Play →Choose a case. Work through the decision.
Open demos are free. Paid modules show a public preview; full exercises require Professional access or a valid Discovery Pass.
← ProfessionalsProfessional access options →Professional Library →
Choose a topic below. Search and access filters stay selected as you browse.
Peripheral / undifferentiated SpA
Clinical cases from the professional peripheral and undifferentiated SpA collection.
One Label, Three Questions
Phenotype, disease context and diagnostic confidence in peripheral and undifferentiated SpA. Case-based self-assessment for healthcare professionals.
Open the quiz →Reviewed
The Domain Record
Phenotyping arthritis, entheses, dactylitis and extra-musculoskeletal disease before choosing treatment. Case-based self-assessment for healthcare professionals.
Open the quiz →Reviewed
Criteria in Their Place
Peripheral and axial classification, the 2025 ASAS–SPARTAN revision and the separate task of clinical diagnosis. Case-based self-assessment for healthcare professionals.
Open the quiz →Reviewed
Before You Call It a Flare
Infection, crystals, other inflammatory disease and mechanical mimics of peripheral SpA. Case-based self-assessment for healthcare professionals.
Open the quiz →Reviewed
Reading the Score
DAPSA44, enthesitis and dactylitis measures, and what a number does and does not say about the patient. Case-based self-assessment for healthcare professionals.
Open the quiz →Reviewed
First Moves
Local therapy, NSAIDs, glucocorticoids and rehabilitation at the start of peripheral SpA care. Case-based self-assessment for healthcare professionals.
Open the quiz →Reviewed
The Limits of Conventional DMARDs
Sulfasalazine, methotrexate and leflunomide: what the trials tested and what they did not. Case-based self-assessment for healthcare professionals.
Open the quiz →Reviewed
Three Trials, Three Questions
ABILITY-2, CRESPA and SPARTACUS: what each TNF-inhibitor trial can and cannot tell you. Case-based self-assessment for healthcare professionals.
Open the quiz →Reviewed
Borrowed Evidence
IL-17, IL-23, JAK and TYK2 inhibition: direct, PsA-derived and extrapolated evidence in peripheral SpA. Case-based self-assessment for healthcare professionals.
Open the quiz →Reviewed
One Patient, Several Organs
Choosing treatment when joints, entheses, skin, bowel, eyes and reproductive plans compete. Case-based self-assessment for healthcare professionals.
Open the quiz →Reviewed
When the Label Moves
Reassessing peripheral SpA over time: new associations, a changing phenotype and alternative diagnoses. Case-based self-assessment for healthcare professionals.
Open the quiz →Reviewed
Still Hurting
Persistent symptoms: separating ongoing inflammation, damage, mechanical load, another disease and other pain contributors. Case-based self-assessment for healthcare professionals.
Open the quiz →Reviewed
Stepping Down
Defining remission, and distinguishing dose reduction, withdrawal and drug-free disease control. Case-based self-assessment for healthcare professionals.
Open the quiz →Reviewed
What Will Happen to Me?
Prognosis as a set of trajectories: inflammatory control, function, participation and treatment burden. Case-based self-assessment for healthcare professionals.
Open the quiz →Reviewed
The Safety Plan
Infection screening, acute illness, vaccination, surgery and shared care around immunomodulatory treatment. Case-based self-assessment for healthcare professionals.
Open the quiz →Reviewed
What Was Counted?
Denominators, case definitions and referral settings behind the numbers quoted for peripheral SpA. Case-based self-assessment for healthcare professionals.
Open the quiz →Reviewed
From Pathway to Prescription
What tissue biology can and cannot tell you about treating synovium, enthesis and digit. Case-based self-assessment for healthcare professionals.
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A Test for a Decision
Choosing laboratory, microbiological and safety tests by the decision each one is meant to serve. Case-based self-assessment for healthcare professionals.
Open the quiz →Reviewed
Reading the Image in Context
Ultrasound, MRI and radiography: lesion, technique and the limits of what a study establishes. Case-based self-assessment for healthcare professionals.
Open the quiz →Reviewed
When Circumstances Change the Plan
Pregnancy, lactation, paternal exposure, older age, cardiovascular risk and a history of cancer. Case-based self-assessment for healthcare professionals.
Open the quiz →Reviewed
IBD-associated SpA
Clinical reasoning across bowel and joint disease: diagnosis, urgent assessment, treatment and follow-up.
The Bowel Is Quiet; the Back Is Not
RV-IBD-01: Assess each organ before choosing a shared treatment strategy. A six-decision IBD-associated SpA (enteropathic arthritis) case for clinicians.
Open the quiz →Reviewed
A Hot Knee Without Fever
RV-IBD-02: Recognize septic arthritis risk before attributing a new effusion to IBD-SpA. A six-decision IBD-associated SpA (enteropathic arthritis) case for clinicians.
Open the quiz →Reviewed
New Pain After the Switch
RV-IBD-03: Separate temporal association, loss of prior control and adverse-drug causality. A six-decision IBD-associated SpA (enteropathic arthritis) case for clinicians.
Open the quiz →Reviewed
Diarrhea and Arthritis: Keep Both Timelines
RV-IBD-04: Evaluate infection and possible IBD without forcing one explanation too early. A six-decision IBD-associated SpA (enteropathic arthritis) case for clinicians.
Open the quiz →Reviewed
The Incidental Sacroiliac Finding
RV-IBD-05: Translate an imaging observation into an appropriate clinical question. A six-decision IBD-associated SpA (enteropathic arthritis) case for clinicians.
Open the quiz →Reviewed
Hip Pain After Repeated Steroid Courses
RV-IBD-06: Consider osteonecrosis, fracture and infection before treating presumed hip arthritis. A six-decision IBD-associated SpA (enteropathic arthritis) case for clinicians.
Open the quiz →Reviewed
New Diarrhea During IL-17 Inhibition
RV-IBD-07: Investigate infection and IBD while reviewing a potentially consequential treatment exposure. A six-decision IBD-associated SpA (enteropathic arthritis) case for clinicians.
Open the quiz →Reviewed
Recognize the Phenotype, Find the Disease
CSQ-IBDSPA-FIND. Open professional IBD-associated SpA (IBD SpA, enteropathic arthritis) demo quiz and interactive module: phenotype recognition, DETAIL and IBIS-Q, referral and bidirectional case finding. English.
Open the quiz →Reviewed
Tests That Answer a Question
CSQ-IBDSPA-TESTS. Professional IBD-associated SpA (IBD SpA, enteropathic arthritis) quiz and interactive module: Calprotectin interpretation, NSAID confounding, targeted investigations and urgent diagnostic pathways. English. Standard professional access.
Open the quiz →Reviewed
One Plan, Two Organs
CSQ-IBDSPA-THERAPY. Professional IBD-associated SpA (IBD SpA, enteropathic arthritis) quiz and interactive module: Treatment choices across bowel, axial and peripheral domains, molecule-specific evidence and safety. English. Standard professional access.
Open the quiz →Reviewed
Name the Failure Before You Switch
CSQ-IBDSPA-DISCORD. Professional IBD-associated SpA (IBD SpA, enteropathic arthritis) quiz and interactive module: Discordant gut and joint responses, primary non-response, reactive drug monitoring and treatment switching. English. Standard professional access.
Open the quiz →Reviewed
When the Timeline Misleads
CSQ-IBDSPA-TIMELINE. Professional IBD-associated SpA (IBD SpA, enteropathic arthritis) quiz and interactive module: Treatment timelines, vedolizumab, new bowel symptoms, paradoxical reactions and dual targeted therapy. English. Standard professional access.
Open the quiz →Reviewed
Quiet Bowel, Recurring Heel Pain
CR-IBD-101 · A negative screening score, a persistent complaint, and the decision that follows. IBD-associated spondyloarthritis · Professional clinical reasoning.
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The Spine Improved. The Bowel Did Not.
CR-IBD-102 · A class name is not a treatment decision. IBD-associated spondyloarthritis · Professional clinical reasoning.
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Low Drug, High Antibodies, Quiet Joints
CR-IBD-103 · A reactive drug-monitoring result in a patient with two diseases. IBD-associated spondyloarthritis · Professional clinical reasoning.
Open the quiz →Reviewed
Six Weeks After the Switch
CR-IBD-104 · A product change, new symptoms, and what the timing does and does not prove. IBD-associated spondyloarthritis · Professional clinical reasoning.
Open the quiz →Reviewed
Everything Is Controlled. The Diarrhoea Is Not.
CR-IBD-105 · Persistent symptoms with no inflammatory target. IBD-associated spondyloarthritis · Professional clinical reasoning.
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New Arthralgia, a Rash and a Positive ANA
CR-IBD-106 · Serology alone does not make a syndrome. IBD-associated spondyloarthritis · Professional clinical reasoning.
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Before the First Injection
CR-IBD-107 · Unexplained bowel symptoms and a planned targeted therapy. IBD-associated spondyloarthritis · Professional clinical reasoning.
Open the quiz →Reviewed
What the Second Drug Is For
CR-IBD-108 · Starting infliximab with an immunomodulator in a patient with two diseases. IBD-associated spondyloarthritis · Professional clinical reasoning.
Open the quiz →Reviewed
The Usual Urgency, or Something Else
CR-IBD-109 · A new symptom in a patient whose baseline already includes bowel urgency. IBD-associated spondyloarthritis · Professional clinical reasoning.
Open the quiz →Reviewed
Which Drug to Stop
CR-IBD-110 · De-escalation after sustained remission in two organs. IBD-associated spondyloarthritis · Professional clinical reasoning.
Open the quiz →Reviewed
Reactive arthritis
Clinical reasoning from the first swollen joint to persistent disease and treatment evidence.
A Trigger Is Not a Diagnosis
Phenotype, infection evidence and causal link are three separate claims.
Explore the quiz →Reviewed
Read the Whole Pattern
Joints, entheses, digits, eyes and skin — without waiting for the textbook triad.
Explore the quiz →Reviewed
Triage Before Attribution
At the first visit, a treatable joint infection matters more than a completed checklist.
Explore the quiz →Reviewed
If This Result Is Positive, I Will…
A defined question, the right specimen, and a result that can change care.
Play the open demo →Reviewed
An Image Is Not a Verdict
Imaging locates inflammation or damage; it rarely names the cause.
Explore the quiz →Reviewed
Two Tracks, One Plan
Treat the infection for its own indication and the inflammation for its severity.
Explore the quiz →Reviewed
Treat the Organism, Then the Joint
Eradication, transmission and partner care have clear purposes — whatever the joints do.
Explore the quiz →Reviewed
A Small Trial, Carefully Read
A positive signal in a selected population is neither a standard regimen nor a reason for dismissal.
Explore the quiz →Reviewed
Not by the Calendar Alone
Escalation follows demonstrable inflammation and its consequences.
Explore the quiz →Reviewed
Borrowed Evidence, Labeled as Such
A case report, a cohort and a randomized trial are not equivalent evidence.
Play the open demo →Reviewed
The Course Is Learned, Not Read
Follow the inflammation, the person's function and the diagnosis — not one laboratory number.
Explore the quiz →Reviewed
Which Process Has Returned?
A familiar patient does not guarantee a familiar cause.
Explore the quiz →Reviewed
Compatibility Is Not Interchangeable
Conception, pregnancy, breastfeeding and paternal exposure are four different questions.
Explore the quiz →Reviewed
Preserve the Other Differential
Children and immunocompromised patients need their own framework, not a stretched adult one.
Explore the quiz →Reviewed
When the Label Does Harm
Some infection-associated arthritides need a different diagnosis altogether.
Explore the quiz →Reviewed
Start With the Decision
A broad panel cannot substitute for aspiration, an exposure history or a defined alternative diagnosis.
Explore the quiz →Reviewed
Direct Is Not the Same as Certain
The strength of a treatment claim cannot exceed the design and population behind it.
Explore the quiz →Reviewed
What Must Happen Next?
The decisive question is often the next action, not the name of the disease.
Explore the quiz →Reviewed
Three Claims, Three Kinds of Evidence
The syndrome, the infection and the causal link are documented separately.
Explore the quiz →Reviewed
Rest Is a Dose, Not a Plan
Restore movement while inflammation is being treated.
Explore the quiz →Reviewed
Look Where It Is Concealed
Skin, mucosa and the back-pain history each need a deliberate examination of their own.
Explore the quiz →Reviewed
One Plan, Named Owners
An infection regimen belongs to a syndrome, a jurisdiction and a person responsible for follow-up.
Explore the quiz →Reviewed
The Prescription Is Half the Plan
A conventional DMARD is started together with its schedule, its monitoring and its review date.
Explore the quiz →Reviewed
A Trial You Can Review
Before the first dose: screening, a baseline, a review date and the conditions for stopping.
Explore the quiz →Reviewed
A Model Is Not a Test
Mechanisms of persistence explain the disease; they do not yet select a treatment for the individual.
Explore the quiz →Reviewed
Early autoimmunity / UCTD
Professional access
Burden of Proof
One patient, two years, and a first note she set out to disprove. Follow Vera through diagnostic uncertainty, treatment decisions and evolving evidence in early autoimmunity and UCTD.
Open the case →Added
Psoriatic arthritis
Domains, diagnostic boundaries, treatment decisions and longitudinal follow-up.
Same Molecule, New Name
Biosimilars, interchangeability and the switch the patient did not choose
Open quiz →The Box on the Box
JAK inhibitors in PsA after ORAL Surveillance
Open quiz →Small Patients, Big Labels
Paediatric psoriasis: approvals by age, screening by age
Open quiz →Palms, Soles and a Pack a Day
Palmoplantar pustulosis is a neighbour, not a synonym
Open quiz →One Kinase Over
TYK2 inhibition: what the label says, and what it does not borrow
Open quiz →A Holiday From the Biologic
Withdrawal, relapse and retreatment — what the data allow you to promise
Open quiz →The Scale Is a Domain Too
Body weight, risk, response and dosing — without blame
Open quiz →Red All Over
Erythroderma in a patient with psoriasis: a systemic emergency
Open quiz →A and F
Dual IL-17 blockade, the trial numbers and the reason for the switch
Open quiz →Candida Knocks Twice
Infection screening and the side effects written on the label
Open quiz →Drops After a Sore Throat
Guttate psoriasis, streptococci and the knee in the room
Open quiz →When Topicals Fail
Small body surface, big burden — and who calls it mild
Open quiz →PDE4, Inside and Out
Apremilast's small print and a cream with the same target
Open quiz →Methotrexate for Two Audiences
Skin, joints and the dose both specialists argue about
Open quiz →Heart of the Plaque
Severe psoriasis, a young heart and who owns prevention
Open quiz →Same Pathway, Different Address
Why clear skin is not proof of a quiet spine
Open quiz →Nine Months, Two Domains
Psoriasis, PsA and a pregnancy plan that reads the labels
Open quiz →Mind the Gut, Mind the Mood
When the history changes the mechanism — or the molecule
Open quiz →Skin in the Game
Head-to-head trials and the domain the patient actually cares about
Open quiz →Three Prescribers, One Plaque
Drug-provoked psoriasis and the discipline of attribution
Open quiz →Pustules With a Fever
Generalized pustular psoriasis is not a PsA flare
Open quiz →The TNF Paradox
When the drug that treats psoriasis seems to cause it
Open quiz →PEST Control
Screening psoriasis for arthritis without fooling yourself
Open quiz →Nails Know First
The nail unit, the DIP enthesis and what counts
Open quiz →Look Under the Cap
Hidden-site psoriasis, risk and what it does not prove
Open quiz →Club Enthesis — The Night Manager’s Ledger
Assess treatment failure, switching, targets and evidence boundaries. Advanced clinical reasoning.
Open quiz →Club Enthesis — Beyond the Dance Floor
Connect comorbidities, reproductive planning and surgery to treatment choices. Intermediate to advanced.
Open quiz →Club Enthesis — Who Is Really at the Door?
Apply classification, differential diagnosis and imaging in clinical context. Intermediate to advanced.
Open quiz →Club Enthesis — Six Rooms, One Guest
Explore six PsA domains, activity, damage and patient impact. Foundation to advanced.
Open quiz →Club Enthesis — The IL-23 Lounge
Match drug targets to mechanisms and clinical choices in psoriatic arthritis. Foundation to advanced.
Open quiz →Psoriatic Arthritis Clinic
Open quiz →A Score Can’t Repair the Input
Open English demo: a CASPAR warm-up, an evidence note and six questions on diagnosis and classification. Free without registration or payment.
Play the open demo →Reviewed
When the hands and ankles tell different stories
An author-archive professional PsA case: compare clinical activity with hand, foot and ankle structural findings and discuss the documented treatment decision.
Preview / member access →Reviewed
The Heel Has Four Addresses
Professional PsA quiz: localize posterior heel pain, interpret entheseal ultrasound and distinguish inflammation from structural change.
Preview / member access →Reviewed
Read the Plate, Then the Patient
Ultrasound, MRI and radiographs in psoriatic arthritis: a clinical warm-up and six questions on lesion definitions, technical limits and clinical correlation.
Preview / member access →Reviewed
The Axial Question
A clinical warm-up and six questions on axial PsA: AXIS, HLA-B27, CRP, MRI patterns and the limits of borrowed evidence.
Preview / member access →Reviewed
Count What the Target Counts
Check DAPSA and cDAPSA inputs, MDA and VLDA, improvement versus target attainment and discordant findings.
Preview / member access →Reviewed
Beyond the Joints
A clinical warm-up and six questions on uveitis, bowel symptoms, infection screening, metabolic health and comorbidities in PsA.
Preview / member access →Reviewed
Prognostic Is Not Predictive
A clinical warm-up and six questions on PsA mechanisms, prognostic and predictive biomarkers, interception studies and AI models.
Preview / member access →Reviewed
Classify the Failure Before You Switch
A clinical warm-up and six questions on classifying PsA treatment failure, access problems, refractory definitions and treatment targets.
Preview / member access →Reviewed
Plan the Transition, Not the Stop Date
A clinical warm-up and six questions on pregnancy planning in PsA, treatment clearance, unintended exposure, breastfeeding and postpartum activity.
Preview / member access →Reviewed
Damage, Activity, Impact
Separate current activity, accumulated damage and patient impact in the author case RV-PsA-01.
Preview / member access →Reviewed
The Pregnancy Formulary
Professional PsA quiz on preconception intervals, washout, TNF inhibitors, breastfeeding, NSAIDs and infant vaccines.
Preview / member access →Reviewed
The Surgical Calendar
Professional PsA quiz: continue, withhold and restart medicines around surgery using the relevant procedure-specific guidance.
Preview / member access →Reviewed
First Line, Next Line
Professional PsA quiz: compare initial-treatment guidance, match active domains and interpret response without confusing it with remission.
Preview / member access →Reviewed
Oral Is a Route, Not a Safety Class
Professional PsA quiz: interpret JAK warnings, TYK2 evidence, newer oral options and vaccination in an individual benefit–risk discussion.
Preview / member access →Reviewed
The Axis and the Organs
Professional PsA quiz: match axial treatment evidence with uveitis, IBD and cancer history, and distinguish dedicated trials from post hoc findings.
Preview / member access →Reviewed
Swollen Now, Eroded Already
A professional quiz on case RV-PsA-01: separate current inflammation, accumulated structural damage and functional impact.
Preview / member access →Reviewed
A Switch Is Not Yet an Outcome
A professional quiz on case RV-PsA-01: what a biologic switch establishes and what only follow-up can show.
Preview / member access →Reviewed
Non-radiographic axial SpA
Referral, MRI interpretation, treatment evidence and outcomes.
Quiet Is Not Gone
Open quiz →Pregnancy Is Not a Treatment
Open quiz →“Still Tired” Is Not a Measurement
Open quiz →Difficult Is Not Refractory
Open quiz →Ready Is Not the Same as Waiting
Open quiz →Remission — Which Kind?
Open quiz →Write It So It Can Be Revised
Open quiz →Now, Not Next Month
Open quiz →Bridging Is a Shape
Open quiz →Two Pains, One Patient
Open quiz →Below the Line Is Not “Early”
Professional nr-axSpA quiz: radiographic category, early disease, progression and burden.
Preview / member access →Reviewed
A Referral Is Not a Verdict
Professional nr-axSpA quiz: referral patterns, HLA-B27, CRP, diagnostic confidence and imaging.
Preview / member access →Reviewed
Name the Joint, Name the Sequence
Before calling an MRI negative, establish what was examined.
Preview / member access →Reviewed
Bright, but Whose?
Postpartum change, loading, osteitis condensans ilii, fracture and infection on sacroiliac MRI.
Preview / member access →Reviewed
Progression Is One Outcome
Reading cohort numbers, risk factors and remission without inventing a personal percentage.
Preview / member access →Reviewed
Two NSAIDs Are a Trial, Not a Sentence
Professional case quiz on initial and advanced treatment of nr-axSpA: NSAID trials, exercise, csDMARDs and glucocorticoids, objective inflammation and the move to advanced therapy.
Preview / member access →Reviewed
The Eye and the Gut Choose First
Professional case quiz on choosing and changing advanced therapy in nr-axSpA: uveitis, IBD and psoriasis, response assessment, primary and secondary failure, and switching.
Preview / member access →Reviewed
Change Is Not State
Professional case quiz on monitoring nr-axSpA: ASDAS states and change thresholds, BASDAI, CRP handling, imaging in follow-up, and tapering after sustained remission.
Preview / member access →Reviewed
Plan Before the Positive Test
Professional case quiz on pregnancy in nr-axSpA: TNF inhibitors, NSAID timing, JAK and IL-17 inhibitors, breastfeeding, infant live vaccines and postpartum assessment.
Preview / member access →Reviewed
Read the Entry Criteria
Professional case quiz on reading nr-axSpA trial evidence: entry criteria, endpoints, placebo response, head-to-head and structural data, and JAK inhibitor safety considerations.
Preview / member access →Reviewed
A Difference Is Not a Test
Professional case quiz on emerging biomarkers in nr-axSpA: intended use, anti-CD74 antibodies, polygenic risk scores, molecular response signatures, prognostic vs predictive markers and surrogate endpoints.
Open demo →Reviewed
A Precise Number Is Not a Validated One
Professional case quiz on imaging innovation and artificial intelligence in nr-axSpA: deep-learning reconstruction, synthetic CT, external validation, treatment-response prediction, flare models and molecular imaging.
Preview / member access →Reviewed
Promising Is Not Proven
Professional case quiz on emerging treatments in axSpA: sonelokimab S-OLARIS, ERAP1 inhibition, the negative IL-23 trial, INFAST, classification frameworks and a framework for adopting innovation.
Preview / member access →Reviewed
The Wrong Scan and the Gut
Professional integrated case quiz on nr-axSpA with negative HLA-B27, normal CRP, a lumbar MRI instead of a sacroiliac MRI, psoriasis and newly diagnosed Crohn's disease.
Preview / member access →Reviewed
A Taper Is a Plan, Not a Countdown
Professional integrated case quiz on long-term nr-axSpA care: tapering after sustained control, dosing arithmetic, C-OPTIMISE, recapture after recurrence, a change in radiographic category, and the chapter's worksheets.
Preview / member access →Reviewed
Crystal arthritis
Gout, CPPD, microscopy, comorbidity and treatment decisions.
Case Files
Ten interactive cases and one illustrated patient, reopened for the detail you might have walked past.
Play →Second Look
Re-examining the diagnosis, finding the second pain generator, and knowing when a drug has earned its stop date.
Play →Words Matter
Letters, problem lists, consent and flare plans — the sentence that protects the patient, or misleads the next doctor.
Play →On Call
Post-operative knees, nil-by-mouth patients, falling eGFR and the discharge letter — crystal disease after hours.
Play →Read the Film
Erosions, calcifications, double contours and crowns — what the image shows, where, and what it cannot prove.
Play →Off the Template
The young, the very old, women, the post-operative and the dialysis patient — crystal disease away from the classic picture.
Play →The Pill List
Colchicine meets the statin, allopurinol meets the thiopurine — reading the whole medicine list before writing one more line.
Play →Who Said It?
Guideline, label, criteria or trial — who says what about crystal disease, and how much weight it carries.
Play →By the Numbers
Milligrams, weeks, targets and trial results — the figures that change a prescription.
Play →Masquerade
What dresses up as gout, CPPD or apatite disease — and what crystal disease dresses up as.
Play →Constraints First
Kidneys, heart, graft and pill list decide the plan — and one patient can carry more than one arthritis.
Play →Apatite and the Shoulder
The crystal the microscope misses, the procedures worth discussing honestly, and the shoulder that destroys itself.
Play →No Dissolving Agent
Calming acute and chronic CPPD without promising to clear the deposits — and the neck that impersonates meningitis.
Play →Chondrocalcinosis Is a Finding
Incidental, acute, chronic or riding on osteoarthritis — and when an early deposit is asking for a metabolic work-up.
Play →Not Refractory Yet
Before pegloticase: the diagnosis, the dose, the adherence — and a conversation about food that leaves blame out.
Play →The Slow Climb
Genotype first, a low start, a deliberate climb — and the cardiovascular question asked properly.
Play →Treat to Target
Who needs urate lowering, what number counts as success, and how to keep patients on a drug that pays off slowly.
Play →Beyond the Big Toe
Proving gout where it doesn't look like gout, and choosing the flare drug the patient can actually take.
Play →Under Polarized Light
What the needle, the microscope and the scanner can prove — and where each one goes quiet.
Play →Crystals Are Not an Alibi
Three crystals, one inflammatory pathway — and one infection you must never talk yourself out of.
Play →Three Patients, One Allele
HLA-B*58:01 before allopurinol: whom to test, what a positive or negative result changes, and what it never replaces.
Open quiz →Uricase Without Methotrexate
Pegloticase when methotrexate cannot be used: what the label allows, what the trial implies, and how to judge success.
Open quiz →A Rash on Day Eighteen
A suspected allopurinol reaction in severe CKD: stopping, rechallenge, flare versus reaction, and what comes next.
Open quiz →The Pain That Outlived the Target
When symptoms persist after gout is controlled: drug response, a different pain generator, and imaging for a defined question.
Open quiz →A Plan Written Before the Flare
Rescue treatment for gout flares: review after repeated courses, the colchicine regimen, combinations, and keeping urate lowering going.
Open quiz →Three Deposits, One Patient
Gout, CPP and calcific tendinopathy in one person: precise labels, what urate lowering can and cannot reach, and what the trials changed.
Open quiz →The Headline in Her Hand
Gout amid CKD, diabetes and coronary disease: which benefit claims hold, and how to prescribe for the whole patient.
Open quiz →A Number Before Every Infusion
Pegloticase decisions in tophaceous gout: who qualifies, G6PD, methotrexate, oral drugs, flares, stopping rules and trial limits.
Open quiz →The Honest Version
Reading the cardiovascular trials on febuxostat for a man who cannot take allopurinol.
Open quiz →Two Years at the Starting Dose
A tolerated dose that never moved is not an allopurinol failure — and a genotype is not a pass.
Open quiz →One Flare and a Stone
Urate lowering after a first flare: indication, target, early flares, stones and the place of probenecid.
Open quiz →The Last Lever
IL-1 blockade for gout flares: infection first, label limits, renal interval, trial evidence and the urate plan.
Open quiz →One Wrist, Four Constraints
Choosing flare therapy when kidney function, anticoagulation, diabetes and a recent macrolide all narrow the options.
Open quiz →Signal and Substrate
From NLRP3 and IL-1β to the bedside: what crystal biology justifies in a first gout flare, and what it does not.
Open quiz →No Crystals, No Podagra
Proving gout when the tap is dry or negative: which test answers which question, and which negatives reassure no one.
Open quiz →Nine Days After the Needle
A hot knee in proven gout: the infection pathway, a scant sample, and what microscopy can and cannot settle.
Open quiz →The Antibody That Changes Nothing
Open quiz →When This Knee Flares
Open quiz →The Drug Worked. The Skin Objected.
Open quiz →A Quiet Neck in a Crystal Patient
Open quiz →Fifty-Five Is Early
Open quiz →The Hands Tell a Different Story
Open quiz →The Lateral View Finds More
Open quiz →Normal Blood, Abnormal Film
Open quiz →CRYS-06 · Refractory — or never really treated?
Four interactive clinical sequences through a difficult gout treatment course. Original figures, immediate explanations, three scored attempts and a final review. By Olga Goodman, MD.
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CRYS-05 · Neither gout nor pseudogout
Four clinical referrals, two stages and nine decisions. Bank your points or risk the next answer in this original interactive case by Olga Goodman, MD.
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CRYS-04 · The urate-lowering year
One patient, twelve months and six decisions. Choose your difficulty at each fork in this original interactive case by Olga Goodman, MD.
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CRYS-03 · Too young for pseudogout
A recurrent hot joint at 52. Allocate a limited investigation budget and assess eight clinical statements in this original interactive case by Olga Goodman, MD.
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CRYS-02 · The crystal bench
Interpret synovial-fluid crystals, use limited lifelines and decide what each result means for the patient. Original interactive case by Olga Goodman, MD.
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CRYS-01 · The knee at 2 a.m.
A febrile hot knee, chronic kidney disease and a complex medication list. Weigh the evidence and choose a plan in this interactive case by Olga Goodman, MD.
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CRYS-07 · Fever, a stiff neck and an 81-year-old
An older patient with fever and severe neck pain. Balance the burden of investigations and assess eight statements in this Compass case by Olga Goodman, MD.
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CRYS-08 · The graft and the gout
A kidney transplant recipient with recurrent gout: trace the causes and choose treatment through two question chains. An Ember case by Olga Goodman, MD.
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CRYS-09 · Gout at 23
A young woman with recurrent gout and kidney disease in her family. Follow six clinical decisions on three difficulty trails. An Ascent case by Olga Goodman, MD.
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CRYS-10 · Two post-operative joints
Two postoperative patients, four decisions each. Interpret the aspirates and choose treatment and prevention in this Lifeline case by Olga Goodman, MD.
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One patient, three patterns: gout, probable CPPD and erosive hand OA
An illustrated clinical case of established tophaceous gout, a separate MCP pattern suggesting CPPD, and bilateral index-DIP erosive osteoarthritis.
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Sjögren’s disease
Diagnosis, systemic disease, organ complications and treatment reasoning.
Two Percent and a Doppler
A number is only as good as the pregnancy it was measured in.
Open quiz →Dry Eyes, Wet Promises
A Schirmer strip is not a regeneration certificate.
Open quiz →“Treat the Sjögren’s”
Three words that cannot be assessed.
Open quiz →The Cough That Wasn’t ILD
Spirometry alone is a sentence with the verb missing.
Open quiz →Purpura, Foot Drop and a Cold Tube
The specimen went for a walk in January.
Open quiz →The Creatinine Alibi
Filtration was never asked the right question.
Open quiz →Burning Feet and a Bottle of B6
“Normal EMG” is not a synonym for “normal nerves”.
Open quiz →The Reassuring Scan
Ninety-two percent of what, exactly?
Open quiz →Four Points and a Lip
Classification arithmetic is easy; the denominator is where it bites.
Open quiz →The Negative That Wasn’t
A laboratory report is a document, not a verdict.
Open quiz →Glands, Pregnancy and a Sense of Proportion
Advanced professional Sjögren’s disease (Sjogren syndrome) quiz and interactive module: preservative-free tears, pilocarpine, cevimeline, systemic therapy for dryness, acoltremon (COMET), anti-Ro/SSA pregnancy counselling, congenital heart block (CHB), PATCH and STOP BLOQ.
Open quiz →Follow the Organ, Not the Antibody
Advanced professional Sjögren’s disease (Sjogren syndrome) quiz and interactive module: screening ultrasound, lymphoma warning features, AAO 2025 hydroxychloroquine (HCQ) retinal screening, PFT intervals, cryoglobulinaemic neuropathy, ACA and pulmonary arterial hypertension (PAH) surveillance.
Open quiz →The Evidence Behind the Prescription
Advanced professional Sjögren’s disease (Sjogren syndrome) quiz and interactive module: JOQUER, RepurpSS-II, TRACTISS, nintedanib for progressive ILD, neuropathic pain, tubulointerstitial nephritis (TIN), and strong recommendations with very low certainty.
Open quiz →Name the Lesion Before You Treat It
Advanced professional Sjögren’s disease (Sjogren syndrome) quiz and interactive module: PFTs and HRCT, UIP and LIP with nodules, distal renal tubular acidosis (dRTA), cryoglobulins, vasculitic neuropathy, and parotid gland biopsy.
Open quiz →Classification Is Not Diagnosis
Advanced professional Sjögren’s disease (Sjogren syndrome) quiz and interactive module: 2016 ACR/EULAR weights and exclusions, SSA-negative profiles, isolated SSB, anticentromere antibodies (ACA), small-fibre neuropathy with normal NCS, and childhood phenotypes.
Open quiz →CSC-003 · Margaret’s next treatment decision
Open quiz →Open demo
Burning Feet at Fifty-Nine, Expert Level: Three Years of Decisions
Eight expert-level encounters in systemic Sjögren’s disease: neuropathy, cryoglobulinemic vasculitis, renal disease, lymphoma, pulmonary amyloid and antibody deficiency.
Open the case →Reviewed
Open demo
A Violinist’s Cold Fingers, Expert Level: Three Years of Decisions
Eight expert-level encounters in ACA-positive Sjögren’s disease: diagnostic uncertainty, Raynaud’s, primary biliary cholangitis, systemic sclerosis overlap, renal crisis and pregnancy.
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SJD-01 · Dry, tired and swollen
← Sjögren’s quizzesDiagnostic pathwayExplore & PracticeOpen quiz in full window ↗Next: Case 2 · Dry to the bone → SJD-01 · Professional learning · EnglishAuthored by
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SJD-02 · Dry to the bone
An interactive Sjögren’s clinical quiz: dry eye, dry mouth, pilocarpine, candidiasis and fatigue. Two runs with lifelines and explanations.
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SJD-03 · Referred as “seronegative Sjögren’s”
Prioritise investigations for seronegative sicca and test the referral diagnosis. An interactive clinical case by
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SJD-04 · Six visits, six domains
Choose organ-directed treatment across six Sjögren’s visits: arthritis, vasculitis, gland swelling, cytopenias, ILD and biologic therapy.
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SJD-05 · The gland that stayed
A Sjögren’s clinical quiz on lymphoma predictors, persistent parotid swelling, biopsy, MALT staging, treatment and transformation.
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SJD-06 · She could not stand up
Order the urgent response to hypokalaemic paralysis, investigate distal renal tubular acidosis, and plan continuing renal care.
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SJD-07 · At the ILD meeting
Take a seat at the multidisciplinary ILD meeting: weigh the findings, judge the proposed decisions, and test your reasoning.
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SJD-08 · Forty weeks with anti-Ro
Plan care across an anti-Ro-positive pregnancy: arrange the clinical steps before conception, during fetal surveillance and after delivery.
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SJD-09 · Numb, unsteady, and not weak
Recognize neurological patterns, choose the next investigation and weigh treatment decisions in two clinical question chains.
Play the open demo →Reviewed
SJD-10 · Dry since the fourth cycle
Assess new dryness during cancer immunotherapy, weigh treatment decisions and revisit the case in rheumatology follow-up.
Play the open demo →Reviewed
Muscle diseases & myositis
Antisynthetase disease, inflammatory myopathy and non-immune mimics.
MYO-A01 · Antisynthetase syndrome without myositis
An original clinical sorting exercise by Olga Goodman, MD: 11 case cards on antisynthetase syndrome without myositis, antibody reliability and competing explanations.
Play the open demo →Reviewed
MYO-M01 · Reading the myositis antibody panel
Audit a consult note about a positive myositis antibody panel. Identify interpretation errors and the missing investigation in this interactive quiz by Olga Goodman, MD.
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MYO-A02 · Which synthetase, which patient
Match six antisynthetase antibodies to their characteristic clinical phenotypes in this interactive professional learning quiz by Olga Goodman, MD.
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MYO-A03 · Antisynthetase ILD over two years
Manage anti-PL-12 antisynthetase ILD across three visits over two years. An interactive branching clinical case by Olga Goodman, MD.
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MYO-M02 · Dermatomyositis and cancer: who to screen, how hard
Assess a muscle-disease presentation, compare the evidence and work through clinical decisions.
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MYO-M03 · Statin, high CK, weakness that outlasts the statin
Assess a muscle-disease presentation, compare the evidence and work through clinical decisions.
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MYO-M04 · “Refractory polymyositis” after 50
Assess a muscle-disease presentation, compare the evidence and work through clinical decisions.
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MYO-M05 · On high-dose prednisone and getting weaker
Assess a muscle-disease presentation, compare the evidence and work through clinical decisions.
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MYO-M06 · Ptosis, troponin and CK after immunotherapy
Assess a muscle-disease presentation, compare the evidence and work through clinical decisions.
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MYO-N01 · Asymptomatic hyperCKemia: when to stop
Assess a muscle-disease presentation, compare the evidence and work through clinical decisions.
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MYO-N02 · The dystrophy that looked like myositis
Assess a muscle-disease presentation, compare the evidence and work through clinical decisions.
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MYO-N03 · Breathless when lying flat, weak hips
Assess a muscle-disease presentation, compare the evidence and work through clinical decisions.
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MYO-N04 · Exercise, cramps, dark urine
Match six histories of exercise intolerance, myoglobinuria and rhabdomyolysis to their most likely causes. An original clinical reasoning matchboard by Olga Goodman, MD.
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MYO-N05 · Drugs that hurt muscle in the rheumatology clinic
Sort 12 drug–muscle scenarios into direct toxic myopathy, drug-triggered immune myopathy, or symptoms without myopathy. A clinical reasoning quiz by Olga Goodman, MD.
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MYO-N06 · Sudden weakness in Sjögren’s
Follow five diagnostic checkpoints in acute flaccid weakness, revising the working diagnosis as evidence arrives. A clinical reasoning quiz by Olga Goodman, MD.
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MYO-M07 · Refractory dermatomyositis skin
A confidence-calibration case on refractory dermatomyositis skin disease, evidence for systemic treatment, safety and CDASI interpretation. Authored by Olga Goodman, MD.
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MYO-M08 · Which antibody, which overlap
Match six antibodies to characteristic overlap-myositis phenotypes. An interactive clinical reasoning quiz by Olga Goodman, MD.
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MYO-M09 · The myositis heart: when to look
A stepwise cardiac assessment in AMA-M2 myositis: when troponins, rhythm monitoring and cardiac MRI provide enough evidence to act. An interactive case by Olga Goodman, MD.
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MYO-N07 · Aching or weak?
An interactive clinical reasoning case: distinguish pain and stiffness from true weakness, and update the working diagnosis as evidence arrives.
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MYO-N08 · Ptosis that isn’t myasthenia
A clinical interview challenge: choose six questions to distinguish mitochondrial CPEO from ocular myasthenia and other causes of ptosis.
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Vasculitis
Organ threats, diagnostic alternatives and treatment decisions.
One Changed Finding
A protocol is not a prescription — and brown is not burning.
Open quiz →The Virus Under the Nodule
Right guideline, wrong patient.
Open quiz →Purpura on Cycle Three
Four routes, one rash, zero reflex scans.
Open quiz →Lips, Hands and a Normal Echo
Counting to four is not the whole math.
Open quiz →The Ear, the Marrow and the Rash
Two labels, one clone, and a calf nobody examined.
Open quiz →Plaques That Stayed
Color is not fire.
Open quiz →Worse After the First Infusion
Not every early deterioration is drug failure.
Open quiz →Three Drugs, Three Trade-offs
No ladder, no podium — just safety questions.
Open quiz →The Belly Speaks First
Purpura is the headline; bilious vomiting is the breaking news.
Open quiz →More Than an Aphtha
The mouth healed. The eye did not get the memo.
Open quiz →Quiet Joints, Loud Skin
A low DAS28 does not grade an ulcer.
Open quiz →Blue on Dapsone
Not every new symptom is the disease getting bored of treatment.
Open quiz →Fever, Purpura and a Valve
ANCA is evidence, not a prescription.
Open quiz →Ears First
Two ANCAs, one question nobody asked.
Open quiz →Under the Livedo
When the superficial punch comes back polite.
Open quiz →Cold Bench, False Calm
A negative result can be a handling story.
Open quiz →Hives With a Memory
An antihistamine can quiet the itch, not the kidney.
Open quiz →The Kidney Does Not Itch
The rash fades; the urine keeps talking.
Open quiz →The Most Impressive Lesion
Photogenic is not the same as diagnostic.
Open quiz →The Report Said LCV
A histology report is not a confession.
Open quiz →Club Arteria — Who Started It?
Investigate infection, drug exposure and genetic or clonal disease as drivers of secondary vasculitis. Advanced.
Open quiz →Club Arteria — Aorta, Eye and Ear
Separate cause, inflammatory activity and structural damage in isolated aortitis and Cogan syndrome. Advanced.
Open quiz →Club Arteria — Brain and Nerve
Distinguish primary CNS vasculitis and vasculitic neuropathy from mimics, and separate activity from damage. Advanced.
Open quiz →Club Arteria — Six Days of Fever
Recognise Kawasaki disease, interpret coronary findings and choose the next management step. Intermediate–advanced.
Open quiz →Club Arteria — Ulcers Are a Clue
Organ-specific reasoning in Behçet disease: eye, neurologic, vascular and mucocutaneous presentations. Advanced.
Open quiz →Club Arteria — Follow the Organ
Recognise organ threats and match EGPA treatment to the clinical problem. Advanced vasculitis training.
Open quiz →Club Arteria — Complement, Cold and Crescents
Work through anti-GBM disease, IgA vasculitis, cryoglobulinaemia, urticarial and skin-limited vasculitis. Intermediate to advanced.
Open quiz →Club Arteria — Wall, Lumen, Flow
Separate vessel-wall activity, luminal damage and flow in Takayasu arteritis and polyarteritis nodosa. Advanced.
Open quiz →Club Arteria — The Eye Cannot Wait
Recognise visual threats and interpret diagnostic and treatment evidence in giant cell arteritis. Advanced.
Open quiz →Club Arteria — The Antibody Is Not the Diagnosis
Practise clinical reasoning, diagnosis and treatment decisions in GPA and MPA. Advanced vasculitis training.
Open quiz →Rheumatology On Call: Vasculitis
Every call concerns vasculitis, established or suspected, in an adult or a child. Each caller already has a plan, and usually one detail that makes it look safe. The chart often says more than the caller did. Choose the reply you would give on the phone.
Open quiz →Professional access
Granulomatosis with Polyangiitis: Three Years of Decisions
Follow one patient with GPA through diagnosis, treatment and follow-up: twelve encounters across three years.
Open the case →Added
Professional access
Takayasu Arteritis: Four Years of Decisions
Follow one patient with Takayasu arteritis through twelve encounters across four years of clinical decisions.
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Professional access
Polyarteritis Nodosa: Forty Months of Decisions
Follow one patient with polyarteritis nodosa through twelve encounters across forty months of care.
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Professional access
Anti-GBM Disease: Twenty Months of Decisions
Follow one patient with anti-GBM disease through twelve encounters across twenty months of care.
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Professional access
Giant Cell Arteritis: Two Years of Decisions
Follow one patient with giant cell arteritis through twelve encounters across two years of clinical decisions.
Open the case →Added
Open demo
A Polymyalgia That Did Not Behave: Thirty Months of Decisions
An atypical giant cell arteritis journey: one patient, twelve encounters and thirty months of clinical decisions, starting with a polymyalgia that does not follow the expected course.
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Professional access
EGPA, Expert Level: Eighteen Months of Decisions
An expert-level EGPA clinical journey: one patient, eight encounters and eighteen months of decisions across two parts.
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Professional access
Cryoglobulinemia, Expert Level: Two Years After a Negative Test
An expert-level cryoglobulinemic vasculitis journey: one patient, eight encounters and two years of clinical decisions across two parts.
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Professional access
Fever in a Five-Month-Old, Expert Level: Three Years of Decisions
An expert-level Kawasaki disease journey: one infant, eight encounters and three years of clinical decisions across two parts.
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Professional access
A Swollen Leg at Twenty-Six, Expert Level: Two Years of Decisions
An expert-level Behçet disease journey: one young man, eight encounters and two years of clinical decisions across two parts.
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Professional access
A Red Eye and a Ringing Ear, Expert Level: Two Years of Decisions
An expert-level Cogan syndrome journey: one young woman, eight encounters and two years of clinical decisions across two parts.
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Professional access
Hives That Stayed, Expert Level: Three Years of Decisions
An expert-level hypocomplementemic urticarial vasculitis journey: one woman, eight encounters and three years of clinical decisions across two parts.
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Professional access
A Line in the Pathology Report, Expert Level: Three Years of Decisions
An expert-level isolated aortitis journey: one man, eight encounters and three years of clinical decisions after an elective heart operation.
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Professional access
A Foot Drop Blamed on the Spine, Expert Level: Two Years of Decisions
An expert-level NSVN journey: one woman, eight encounters and two years of decisions, from a surgical booking to a second diagnosis.
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Demo · Free after registration
Purpura After a Cold, Expert Level: Two Years of Decisions
An expert-level IgA vasculitis demo: one man, eight encounters and two years of kidney and cancer-care decisions.
Open the case →Added
Professional access
Blue Fingertips, Expert Level: Two Years of Decisions
Eight expert-level encounters in rheumatoid and secondary vasculitis: distinguish inflammation from emboli, manage infection risk and reassess treatment over two years.
Open the case →Added
Professional access
Lumps Under a Rash, Expert Level: Two Years of Decisions
Eight expert-level encounters tracing cutaneous arteritis, systemic PAN and new skin lesions: choose the right biopsy, distinguish infection from relapse and reassess treatment.
Open the case →Added
Free after registration
A Stroke at Twenty-Four, Expert Level: Thirty Months of Decisions
Eight expert-level encounters in DADA2: early stroke, genetic interpretation, marrow failure, family screening and transplantation over thirty months.
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Professional access
Red Ears at Sixty-Eight, Expert Level: Three Years of Decisions
Eight expert-level encounters in VEXAS: UBA1 testing, thrombosis, steroid-sparing treatment, infection, marrow failure and transplantation over three years.
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Professional access
Dark Ears at Forty-One, Expert Level: Two Years of Decisions
Eight expert-level encounters in cocaine- and levamisole-associated vascular disease: ear purpura, neutropenia, nasal destruction, pulmonary-renal syndrome and treatment safety.
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Professional access
A Headache on Cycle Four, Expert Level: One Year of Decisions
Eight expert-level encounters in cancer-associated vascular disease: threatened vision, checkpoint inhibitor and pegfilgrastim attribution, rechallenge, nephritis and embolic complications.
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Professional access
Back Pain and Two Swollen Kidneys, Expert Level: Two Years of Decisions
Eight expert-level encounters in IgG4-related periaortitis and vascular Q fever: obstructed kidneys, tissue diagnosis, aortic measurements, infected aneurysm and graft surveillance.
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Professional access
A Red Eye at Twenty-Seven, Expert Level: Three Years of Decisions
Eight expert-level encounters in ocular Behçet disease: retinal vasculitis, angiographic remission, steroid complications, pregnancy and biologic immunogenicity.
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Professional access
Pain in the Right Lower Abdomen, Expert Level: Two Years of Decisions
Eight expert-level encounters in intestinal Behçet disease: ileocecal ulcers, tuberculosis assessment, perforation, postoperative recurrence, CMV and a new ocular threat.
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Professional access
A Headache That Kept Building, Expert Level: Thirty Months of Decisions
Eight expert-level encounters in neuro-Behçet disease: cerebral venous thrombosis, threatened vision, anticoagulation, Listeria, parenchymal inflammation and rehabilitation.
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A new headache at 72
Separate diagnostic signals from distractions, then judge management decisions in a presentation with threatened vision.
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Blood in the lungs, casts in the urine
Order the workup and management of a pulmonary–renal presentation, with explanations for each step.
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Nodules, a foot drop and a pressure of 172
Choose investigations within a limited budget, interpret the findings and commit to a diagnosis and plan.
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Asthma that stopped being asthma
Choose a difficulty at each fork and reassess an evolving respiratory and cardiac presentation.
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The biopsy label
Reconsider what a skin-biopsy label explains, weigh the laboratory findings and choose the next step.
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Four referrals, four confident labels
Reassess four confident labels through infection, exposures, acquired disease and vascular complications.
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The pulse she never noticed losing
Follow one patient over four years: diagnosis, remission induction, persistent claudication and pregnancy planning.
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Twenty-four hours
Work through the first twenty-four inpatient hours: sort the findings, then accept or reject proposed orders.
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Scattered infarcts, a normal ESR
Choose investigations within an invasive-risk budget, weigh competing explanations and commit to a diagnosis and plan.
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The surgeon's footnote
Interpret an unexpected finding after aneurysm repair, then decide what it means for treatment and follow-up.
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The clot that was not a clotting problem
Choose a difficulty at six organ-based forks: mouth and skin, eye, veins, arteries, brain and gut.
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The pill she has taken for four years
Work through four gates: recognise the pattern, assess organ severity and decide what to continue, stop or avoid.
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A voice, an eye, and the price of prednisone
Build a treatment plan within a cumulative glucocorticoid-toxicity budget, then review the trade-offs.
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Hives that leave a bruise
Follow the clues from wheal morphology to complement findings, then reconsider the diagnosis and treatment choices.
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The consult from the infusion suite
Sort the findings in an oncology consultation, then accept or reject proposed management decisions.
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A foot drop, then a hand
Order the steps from neurological deficits to biopsy, diagnosis and treatment, then revisit the plan as the clinical picture changes.
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Symptoms that would not settle on 15 mg
Follow six decision points across a year: reassess symptoms, select imaging and weigh treatment changes.
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Twenty months into remission
Reassess fever, changing test results, treatment timing, vaccination and plans for pregnancy during remission.
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An ulcer on a clock
Spend a limited budget of days on investigations while an ulcer progresses, then commit to a diagnosis and plan.
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The hearing that will not come back
Order time-sensitive decisions across four stages: the first 72 hours, the first month, vascular assessment and persistent hearing loss.
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Heart & vessels
Cardiovascular presentations and clinical reasoning in rheumatic disease.
Cardio-rheumatology VI · Valves, aorta and vasculitis
Distinguish infectious from inflammatory valve disease and evaluate aortitis, large-vessel vasculitis and their mimics.
Play →Cardio-rheumatology V · Cardiovascular prevention
Estimate atherosclerotic risk and weigh the cardiovascular effects of NSAIDs, colchicine, urate-lowering drugs and immunomodulators.
Play →Cardio-rheumatology IV · Rhythm and conduction
Assess conduction disease and drug-induced arrhythmia, and choose monitoring or device therapy in cardiac sarcoidosis and amyloidosis.
Play →Cardio-rheumatology III · Complex cases
Set priorities when vasculitis, pulmonary vascular disease, renal crisis, thrombosis or microangiopathy create competing treatment demands.
Play →Cardio-rheumatology II · Clinical decisions
Choose the next step when rhythm disturbances, large-vessel disease or kidney dysfunction complicate cardiovascular care.
Play →Cardio-rheumatology I · Foundations
Recognize pericardial and myocardial disease, assess pulmonary hypertension and heart failure, and weigh cardiovascular risk in treatment decisions.
Play →The Curtain Lifted — Professional clinical detective
Giant cell arteritis with threatened vision: emergency assessment, treatment decisions and follow-up.
Open quiz →Review in Forty-Eight Hours — Professional clinical detective
Critical digital ischemia in systemic sclerosis: urgent assessment, rescue treatment and safe handoff.
Open quiz →A Perfectly Normal Blood Pressure — Professional clinical detective
Cardiac tamponade in lupus: baseline blood pressure, emergency drainage and post-drainage decisions.
Open quiz →The Usual Suspect — Professional clinical detective
A twelve-stage clinical detective: hydroxychloroquine, suspected adverse effects and competing explanations.
Open quiz →Two Prescriptions for One Tablet — Professional clinical detective
A twelve-stage clinical detective: gout with heart failure and chronic kidney disease: duplicate colchicine prescriptions, interactions and urate-lowering decisions.
Open quiz →The Wrong Group — Professional clinical detective
A twelve-stage clinical detective: pulmonary hypertension in systemic sclerosis: screening, hemodynamic classification, treatment selection and reassessment.
Open quiz →Three Letters, Three Organs — Professional clinical detective
A twelve-stage clinical detective: checkpoint inhibitor overlap: myositis, myocarditis and neuromuscular weakness, emergency treatment and recovery.
Open quiz →Zero Point Three — Professional clinical detective
A twelve-stage clinical detective: eosinophilic myocarditis in EGPA, cardiogenic shock, biopsy, induction treatment and recovery.
Open quiz →Cardiac Cleared — Professional clinical detective
A twelve-stage clinical detective: HFpEF in rheumatoid arthritis, a reassuring cardiac letter, treatment safety and cardiovascular prevention.
Open quiz →The Interrupted Warfarin — Professional clinical detective
A twelve-stage clinical detective: pulmonary embolism, antiphospholipid syndrome, chronic thromboembolic disease and interrupted anticoagulation.
Open quiz →Three Pillows and a Normal Saturation — Professional clinical detective
A twelve-stage clinical detective: orthopnea in antisynthetase myositis, respiratory muscle weakness, hypoventilation and a reassuring oximeter.
Open quiz →The Ejection Fraction of Thirty-One — Professional clinical detective
A twelve-stage clinical detective: heart failure in lupus, an ejection fraction of 31%, treatment safety, thrombus and recovery.
Open quiz →The Fourth Relapse — Professional clinical detective
A twelve-stage clinical detective: recurrent pericarditis, tamponade, colchicine, steroid dependence and IL-1 inhibition.
Open quiz →The Block at Thirty-Eight — Professional clinical detective
A twelve-stage clinical detective: complete AV block, myocardial inflammation, imaging, biopsy and device decisions.
Open quiz →Two Pains, One Chest — Professional clinical detective
A twelve-stage clinical detective: rheumatoid arthritis, two patterns of chest pain, non-obstructive coronary arteries and treatment decisions.
Open quiz →Who Stole Her Breath? — Professional clinical detective
A twelve-stage clinical detective: systemic sclerosis, breathlessness, pulmonary hypertension, atrial flutter and renal crisis. Free after registration; no paid subscription required.
Open quiz →What Did He Take? — Professional clinical detective
A twelve-stage clinical detective: rhythm disturbances, medicines, and a patient who does not know what he took.
Open quiz →The troponin testifies: fact or myth? — Professional quiz
Two rounds of fact-or-myth cards, explanations and an optional bonus round.
Open quiz →The stopwatch keeps score: fact or myth? — Professional quiz
Two rounds of fact-or-myth cards, explanations and an optional bonus round.
Open quiz →The ejection fraction objects: fact or myth? — Professional quiz
Two rounds of fact-or-myth cards, explanations and an optional bonus round.
Open quiz →The discharge summary talks back: fact or myth? — Professional quiz
Two rounds of fact-or-myth cards, explanations and an optional bonus round.
Open quiz →A catheter under pressure: fact or myth? — Professional quiz
Two rounds of fact-or-myth cards, explanations and an optional bonus round.
Open quiz →The red pen on call: fact or myth? — Professional quiz
Two rounds on the pericardium and myocardium, with explanations and an optional bonus round. Free after registration; no paid subscription required.
Open quiz →RC-10 · Daily fever, a fleeting rash and shock in a young woman
Open quiz →RC-40 · Ascending aortic aneurysm and exertional angina with raised inflammatory markers
Open quiz →RC-39 · Breathlessness and bilateral lung shadowing after a treatment change
Open quiz →RC-38 · Marked eosinophilia, breathlessness and systemic emboli
Open quiz →RC-37 · Worsening breathlessness after pulmonary hypertension treatment
Open quiz →RC-36 · Recurrent thrombosis despite apparently therapeutic home INR readings
Open quiz →RC-35 · Hypertension and proteinuria at 29 weeks in a woman with lupus
Open quiz →RC-34 · Collapse with brief jerking in a woman with lupus
Open quiz →RC-33 · Pleuritic chest pain and breathlessness during rheumatoid arthritis treatment
Open quiz →RC-32 · Fever, rash and chest pain after a new gout medicine
Open quiz →RC-31 · Breathlessness and rising potassium after treatment for a painful toe
Open quiz →RC-30 · Migratory arthritis, malabsorption and culture-negative endocarditis
Open quiz →RC-29 · Arterial dissections, easy bruising and a family history
Open quiz →RC-28 · Lifelong burning pain, proteinuria and a thickened heart
Open quiz →RC-27 · Hand arthropathy, diabetes and new cardiomyopathy
Open quiz →RC-26 · Red eyes, rapidly declining hearing and a new murmur
Open quiz →RC-25 · Myocardial infarction and beaded arteries in a woman without risk factors
Open quiz →RC-24 · Retiform purpura, neutropenia and episodic chest pain
Open quiz →RC-23 · Rest pain and digital ulcers in a young smoker
Open quiz →RC-22 · Leg pain, breathlessness and periaortic tissue on CT
Open quiz →RC-21 · Multiorgan failure after interruption of anticoagulation
Open quiz →RC-20 · Recurrent thrombosis with fever, skin lesions and anemia
Open quiz →RC-19 · Palpitations and presyncope in diffuse systemic sclerosis
Open quiz →RC-18 · Worsening hypoxemia after pulmonary hypertension treatment
Open quiz →RC-17 · Joint pains, pleuritic chest pain and breathlessness in heart failure
Open quiz →RC-16 · Fever, night sweats and breathlessness during biologic therapy
Open quiz →RC-15 · Breathlessness in a young woman with MCTD planning pregnancy
Open quiz →RC-14 · Stiff hands, a ruptured biceps tendon and breathlessness
Open quiz →RC-13 · Fever, migrating joint pains and a new murmur
Open quiz →RC-12 · Severe hypertension, abdominal pain and a foot drop
Open quiz →RC-11 · Breathlessness and palpitations in a young woman with lupus
Open quiz →RC-09 · Syncope and a slow pulse with migrating joint pains
Open quiz →RC-07 · A new murmur and recurrent painful ear swelling
Open quiz →RC-06 · Purpura, weight loss and rising creatinine
Open quiz →RC-05 · Progressive breathlessness in a woman with lupus · Demo
Open quiz →RC-04 · A fourth episode of pleuritic chest pain · Demo
Open quiz →RC-03 · Weakness and falling blood counts after pericarditis treatment · Demo
Open quiz →RC-02 · Ascites and leg swelling in rheumatoid arthritis · Demo
Open quiz →RC-01 · Chest tightness and an unexpected CT finding · Demo
Open quiz →Crucible · CR-RC-001
All 16 casesNext case → All 16 casesNext case →
Play the open demo →Reviewed
Crucible · CR-RC-002
Work through a cardiovascular clinical case: review evidence, interpret findings and assess the proposed plan.
Play the open demo →Reviewed
Crucible · CR-RC-003
Work through a cardiovascular clinical case: review evidence, interpret findings and assess the proposed plan.
Preview / member access →Reviewed
CR-RC-004 · Clinical case challenge
Work through a cardiovascular clinical case: review evidence, interpret findings and assess the proposed plan.
Preview / member access →Reviewed
CR-RC-005 · Clinical case challenge
Work through a cardiovascular clinical case: review evidence, interpret findings and assess the proposed plan.
Preview / member access →Reviewed
CR-RC-006 · Clinical case challenge
Work through a cardiovascular clinical case: review evidence, interpret findings and assess the proposed plan.
Preview / member access →Reviewed
CR-RC-007 · Clinical case challenge
Work through a cardiovascular clinical case: review evidence, interpret findings and assess the proposed plan.
Preview / member access →Reviewed
CR-RC-008 · Presyncope and a slow pulse
Work through a cardiovascular clinical case: review evidence, interpret findings and assess the proposed plan.
Preview / member access →Reviewed
CR-RC-009 · Clinical case challenge
Work through a cardiovascular clinical case: review evidence, interpret findings and assess the proposed plan.
Preview / member access →Reviewed
CR-RC-010 · Clinical case challenge
Work through a cardiovascular clinical case: review evidence, interpret findings and assess the proposed plan.
Preview / member access →Reviewed
CR-RC-011 · Clinical case challenge
A three-stage clinical reasoning challenge: headache, blurred vision, and discrepant blood pressures in a young woman.
Preview / member access →Reviewed
CR-RC-012 · Clinical case challenge
An original three-stage cardio-rheumatology case by Olga Goodman, MD. Review evidence, interpret findings and assess a proposed treatment plan.
Preview / member access →Reviewed
Rheumatic emergencies
Recognize time-sensitive presentations and organize immediate priorities.
The Number That Misleads
Recognizing a threatened airway in GPA when the saturation, the systemic disease and the sound itself look reassuring.
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Added
Swelling, Scar or Collapse
Matching treatment to the mechanism of airway narrowing in GPA and relapsing polychondritis.
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Added
Above or Below the Lesion
Airway planning, devices, transfer and extubation in rheumatic airway disease.
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Before the Third Organ
Recognizing catastrophic APS while the pattern is still incomplete — and what classification can and cannot decide.
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Added
The aPTT Is Not the Heparin
Anticoagulation in catastrophic APS: lupus anticoagulant, anti-Xa monitoring, heparin-induced thrombocytopenia and bleeding.
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Added
When First-Line Is Not Enough
Combination therapy for catastrophic APS, its evidence, and what to check before calling the disease refractory.
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Not Every Microangiopathy
Catastrophic APS among its dangerous alternatives: immune TTP, complement-mediated TMA, renal crisis, HELLP and a second mechanism.
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Added
Trigger, Mimic or Both
Infection and catastrophic APS together: parallel treatment, contextual clues and the conditions of the first combination.
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Added
From the Clinic, Not Through It
The first assessment of suspected catastrophic APS: destination, four parallel tasks and the place of biopsy.
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Added
Rounds and the Road Home
Reassessing catastrophic APS during treatment, and the plan that goes home with the patient.
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Pain Is Not Perfusion
Recognizing and reassessing a threatened digit when pulses, pain scores and colour can all mislead.
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Rescue by the Label
IV iloprost, PDE5 inhibitors, nitrates and the oral drugs that cannot hold a threatened digit.
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Not Only Vasospasm
Embolism, vasculitis, thrombosis, infection and iatrogenic causes behind an ischemic finger in a patient with known SSc.
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Before the Blood Appears
Recognizing diffuse alveolar hemorrhage before the pattern is complete.
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Reviewed
Two Organs, One Differential
Pulmonary–renal syndrome: what to send together, and what must not close the question.
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Reviewed
Proof Without Delay
Bronchoscopy, hemosiderin, CT and biopsy: what each can confirm, and what none should postpone.
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Reviewed
Conditions Before Doses
Induction for immune alveolar hemorrhage: the published regimens, and the limits printed beside them.
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Reviewed
One Procedure, Three Decisions
Plasma exchange in alveolar hemorrhage: why the cause changes the answer.
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Reviewed
Everything at Once
The first assessment of suspected alveolar hemorrhage: parallel work, clear ownership, a usable handoff.
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Reviewed
The Second Look
Reassessing alveolar hemorrhage during treatment: the trajectory, not the first result.
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Reviewed
Lupus, Fever and a Bloody Lavage
Alveolar hemorrhage in active lupus: two processes at once, and recommendations that are conditional.
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Reviewed
Branches of Their Own
Pregnancy, thrombosis and limited resources: the situations that need an explicit additional plan.
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Reviewed
No Time for Confirmation
Anti-GBM disease in the first hours, and the plan that follows once the patient is stable.
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Reviewed
Rescue Without Proof
Local hemostatic agents, imlifidase and avacopan in alveolar hemorrhage: what has been tried, what is proven, and what has changed.
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Writing the Exchange
Once plasma exchange is chosen for alveolar hemorrhage: the prescription, the drugs around it, and what the 2026 analyses add.
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Added
Not Primary Vasculitis
Alveolar hemorrhage with a cause outside primary vasculitis: drugs, infection, endocarditis, antiphospholipid syndrome and renal crisis.
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Added
Dose, Route and the Clock
The first glucocorticoid decision in GCA with visual symptoms: which regimen, which route, and what must not wait.
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Added
One Negative Test
ESR, CRP, ultrasound, biopsy and IL-6 blockade: what each result can and cannot settle in suspected GCA.
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Added
Not Every Visual Loss Is Arteritis
Retinal artery occlusion, stroke, the painful red eye and retinal detachment beside a GCA suspicion.
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Added
Scores Are Not Gates
HLH-2004, HScore and the MAS classification criteria in a deteriorating adult: what each was built for, and what it cannot hold back.
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Added
Roles, Not Regimens
Glucocorticoids, anakinra, IVIG, ciclosporin, etoposide and emapalumab in MAS: what each drug is for, and the conditions around it.
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Added
Find the Driver
Infection, EBV and lymphoma behind secondary HLH: treating the inflammation without losing the cause.
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Added
The Scan That Did Not Ask
Recognizing threatened bowel in vasculitis when lactate, the examination and the first CT all look reassuring.
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Added
Four Mechanisms
Arterial, venous, low-flow and inflammatory bowel injury — and why each asks the receiving team a different question.
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Added
Less Pain, More Danger
Reassessment after treatment, second-look surgery and the record that follows a mesenteric emergency.
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Added
Two Routes to the Same Emergency
Pump failure and electrical instability in suspected myocarditis — and the findings that must not close the assessment.
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Added
Treatment Follows the Phenotype
Matching immunosuppression to lupus, EGPA, eosinophilic, giant-cell and checkpoint-inhibitor myocarditis.
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Added
What Else Is Failing
Coronary, embolic, mechanical and infectious emergencies beside suspected myocarditis — and the plan after stabilization.
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Added
A Normal Number, a Dangerous Slope
When the creatinine is still inside the reference range and the kidney is already in trouble. RPGN professional quiz.
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Crescents Name No Cause
A positive ANCA and a crescentic biopsy still leave the most important question open. RPGN professional quiz.
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Tissue and Treatment, Together
The biopsy is essential. Whether treatment waits for it depends on the cause. RPGN professional quiz.
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One Syndrome, Five Pathways
The label is the same. The first treatment is not. RPGN professional quiz.
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Exchange Is Three Decisions
Plasma exchange is urgent in one disease, a judgment in another and unsupported as a reflex in the rest. RPGN professional quiz.
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Conditions Before Doses
A reference regimen becomes an order only after someone has checked what it depends on. RPGN professional quiz.
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After the Retraction
A guideline option whose pivotal trial has been withdrawn needs a different conversation. RPGN professional quiz.
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Tapering Under Watch
A reduced steroid regimen and a stubborn antibody titer both call for reassessment, not reflex. RPGN professional quiz.
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When the Standard Plan Does Not Fit
Pregnancy, infection, missing services and atypical serology each change the route. RPGN professional quiz.
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After the Acute Phase
Stabilization ends the emergency and opens the follow-up questions. RPGN professional quiz.
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Unknown Stays Unknown
The recognition tool organizes what has been assessed, and keeps visible what has not. RPGN professional quiz.
Professional subscription or valid temporary access
The Transfer Is Not a Lab Request
Suspected RPGN leaves the clinic the same day, with a handoff someone has accepted. RPGN professional quiz.
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What the Module Does Not Claim
Knowing the status of a source is part of using it. RPGN professional quiz.
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Four Steps at Once
Threats, baseline, parallel studies, and the plan for treatment and tissue. RPGN professional quiz.
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Lupus at Full Speed
Rapidly progressive lupus nephritis sits at the edge of what the trials studied. RPGN professional quiz.
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Two Values and a Clock
The creatinine helper answers one narrow question, and only when the interval is known. RPGN professional quiz.
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Anti-GBM Without the Lungs
The disease does not need hemoptysis, and the treatment does not wait for a titer. RPGN professional quiz.
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Choosing the Induction
Rituximab or cyclophosphamide is a decision with stated inputs, and safety work on either side. RPGN professional quiz.
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What the Deposits Say
IgA, infection, complement and monoclonal proteins can all sit behind a crescentic biopsy. RPGN professional quiz.
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Day Six on the Ward
Improvement on treatment is a trend to keep checking, and a change in it is a new question. RPGN professional quiz.
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Risk Is Not Futility
Dialysis at presentation, unfavorable histology and risk scores: what they predict, and what they do not decide.
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The Medication History
Drug-associated glomerulonephritis, treatment already started, and lupus with microangiopathy: when the cause changes the plan.
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Same Saturation, More Support
Recognizing rapidly progressive myositis-associated ILD when the saturation, the CK and the first antibody test all look reassuring.
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Combination With a Safety Plan
Upfront combination treatment in myositis-associated RP-ILD: how many agents, which conditions, and which combinations to avoid.
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Not Every Opacity
Infection, embolism, edema, hemorrhage, aspiration and air leak in a patient with myositis and worsening lungs.
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What Changed?
Blood pressure and creatinine are read against the patient's own baseline.
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Reviewed
A Normal Reading, a Sick Patient
Findings that should not reassure.
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Reviewed
One Syndrome, Several Diseases
Thrombotic microangiopathy is a syndrome, not an etiologic diagnosis.
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Reviewed
Not Every Failing Kidney
Kidney failure in systemic sclerosis is not always renal crisis.
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Reviewed
Before the Picture Is Complete
First assessment, disposition and tests that run alongside treatment.
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Reviewed
Start Now, Dose Deliberately
ACE inhibition: the priority, the evidence and the published regimens.
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Reviewed
How Fast Is Too Fast?
Choosing a blood-pressure trajectory by organ injury and perfusion.
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Reviewed
Check Before You Give
Nitrates, glucocorticoids, and a creatinine rise that is not a stop signal.
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Reviewed
Watch the Patient, Not the Number
Monitoring, kidney replacement therapy and special situations.
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Reviewed
The Long View
Recovery, transplantation timing and what prevention cannot promise.
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Reviewed
Who Is at Risk, and When
Risk factors, timing and home monitoring for early recognition.
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Reviewed
A Vascular Disease of the Kidney
What the biopsy shows, what it predicts, and why the treatment is not immunosuppression.
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Reviewed
When the ACE Inhibitor Is Not Enough
Add-on agents: what each document lists, and what the labels add.
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Reviewed
Two Patients at Once
Renal crisis or preeclampsia — and what to do while the question is open.
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Reviewed
After the Crisis
Discharge, long-term outcome and the questions transplantation raises.
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Reviewed
When the Crisis Does Not Settle
Persistent microangiopathy, complement inhibition and plasma exchange — and what the evidence can bear.
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After the Delivery
When hypertension, hemolysis and kidney injury do not resolve postpartum.
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Reviewed
Beyond the Kidney
Brain, retina, heart and lung in scleroderma renal crisis.
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Reviewed
Potassium on an ACE Inhibitor
Severe hyperkalemia during treatment of SRC: what to give, what to check, and where the documents disagree.
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Reviewed
The Label and the Protocol
Renal dosing, dialysis and interactions: where prescribing information and SRC guidance part.
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Reviewed
An Attractive Target
Bosentan and zibotentan in scleroderma renal crisis: a sound biological rationale, small studies, and what they cannot carry.
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What the Number Can Carry
Cohort figures in scleroderma renal crisis: denominators, designs, and the questions they cannot answer.
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Not Early, Not Known
Renal crisis outside the expected profile: no prior diagnosis, long-standing disease, limited skin involvement.
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Added
Filling Before Pressure
Recognizing tamponade when blood pressure, neck veins, effusion size and the echo report all look reassuring.
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Added
The Bridge and the Drain
Supporting a patient with tamponade until drainage — and choosing the drainage route by cause.
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After the Needle
Reassessment after pericardial drainage, and attribution of the effusion in SLE, systemic sclerosis and beyond.
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Added
Scleroderma renal crisis: sort the pattern
Card sorting · 12 presentations
Open demo · No registration
Reviewed
Pneumonia that keeps bleeding: diffuse alveolar hemorrhage
When to act · 6 sequential clues
Open demo · No registration
Reviewed
Rapidly progressive glomerulonephritis
When to act · 6 sequential clues
Professional subscription or valid temporary access
Reviewed
Thrombocytopenia, schistocytes and confusion after interrupted anticoagulation
Update the diagnosis · 5 checkpoints
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Reviewed
Persistent high fever in an adult with Still's disease on immunosuppression
Update the diagnosis · 5 checkpoints
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Reviewed
Rising oxygen need, normal CK, subtle hands
Confidence check · 8 statements
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Reviewed
Critical digital ischemia in rheumatic disease
Card sorting · 12 presentations
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Reviewed
New headache after 70: the question that changes the visit
Focused interview · 14 questions · choose up to 6
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Reviewed
Critical airway obstruction in GPA and relapsing polychondritis
Clinical matching · 6 matches
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Reviewed
Fulminant autoimmune myocarditis
Confidence check · 8 statements
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Reviewed
Pleuritic chest pain and a normal blood pressure in lupus
When to act · 6 sequential clues
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Reviewed
Abdominal pain on glucocorticoids in polyarteritis nodosa
Update the diagnosis · 5 checkpoints
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Reviewed
Headache and blurred vision in a 47-year-old woman with systemic sclerosis
Headache and blurred vision in a 47-year-old woman with systemic sclerosis. A three-stage professional challenge: diagnosis, key findings and harmful interpretations.
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Reviewed
Breathlessness and a falling hemoglobin in a 29-year-old woman with lupus
Breathlessness and a falling hemoglobin in a 29-year-old woman with lupus. A three-stage professional challenge: diagnosis, key findings and harmful interpretations.
Professional subscription or valid temporary access
Reviewed
Fatigue, weight loss and a rising creatinine in a 67-year-old man
Fatigue, weight loss and a rising creatinine in a 67-year-old man. A three-stage professional challenge: diagnosis, key findings and harmful interpretations.
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Reviewed
Confusion, breathlessness and a falling platelet count four days after surgery
Confusion, breathlessness and a falling platelet count four days after surgery. A three-stage professional challenge: diagnosis, key findings and harmful interpretations.
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Reviewed
Eight days of unremitting fever in a 24-year-old woman with lupus
Eight days of unremitting fever in a 24-year-old woman with lupus. A three-stage professional challenge: diagnosis, key findings and harmful interpretations.
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Reviewed
Worsening breathlessness and sore fingertips in a 44-year-old man
Worsening breathlessness and sore fingertips in a 44-year-old man. A three-stage professional challenge: diagnosis, key findings and harmful interpretations.
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Reviewed
A painful, discoloured finger for five days in a 52-year-old woman with systemic sclerosis
A painful, discoloured finger for five days in a 52-year-old woman with systemic sclerosis. A three-stage professional challenge: diagnosis, key findings and harmful interpretations.
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Reviewed
Two brief episodes of visual loss in one eye in a 76-year-old man
Two brief episodes of visual loss in one eye in a 76-year-old man. A three-stage professional challenge: diagnosis, key findings and harmful interpretations.
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Reviewed
Noisy breathing in a 41-year-old woman treated for asthma for eight months
Noisy breathing in a 41-year-old woman treated for asthma for eight months. A three-stage professional challenge: diagnosis, key findings and harmful interpretations.
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Reviewed
Severe abdominal pain with a soft abdomen in a 58-year-old man with polyarteritis nodosa
Severe abdominal pain with a soft abdomen in a 58-year-old man with polyarteritis nodosa. A three-stage professional challenge: diagnosis, key findings and harmful interpretations.
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Reviewed
Chest tightness and near-fainting in a 31-year-old woman three weeks after a diagnosis of Still's disease
Chest tightness and near-fainting in a 31-year-old woman three weeks after a diagnosis of Still's disease. A three-stage professional challenge: diagnosis, key findings and harmful interpretations.
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Reviewed
Breathlessness and a fast pulse in a 63-year-old man with rheumatoid arthritis
Breathlessness and a fast pulse in a 63-year-old man with rheumatoid arthritis. A three-stage professional challenge: diagnosis, key findings and harmful interpretations.
Professional subscription or valid temporary access
Reviewed
Breathlessness, anemia and a rising creatinine in a 55-year-old woman with systemic sclerosis
Breathlessness, anemia and a rising creatinine in a 55-year-old woman with systemic sclerosis. A three-stage professional challenge: diagnosis, key findings and harmful interpretations.
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Reviewed
Blood-streaked sputum and breathlessness in a 71-year-old man taking apixaban
Blood-streaked sputum and breathlessness in a 71-year-old man taking apixaban. A three-stage professional challenge: diagnosis, key findings and harmful interpretations.
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Reviewed
Ten days of malaise and falling urine output in a 72-year-old woman
Ten days of malaise and falling urine output in a 72-year-old woman. A three-stage professional challenge: diagnosis, key findings and harmful interpretations.
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Reviewed
Confusion and worsening blood tests five days after caesarean delivery
Confusion and worsening blood tests five days after caesarean delivery. A three-stage professional challenge: diagnosis, key findings and harmful interpretations.
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Reviewed
Fatigue and easy bruising in a 27-year-old man with Still's disease taking tocilizumab
Fatigue and easy bruising in a 27-year-old man with Still's disease taking tocilizumab. A three-stage professional challenge: diagnosis, key findings and harmful interpretations.
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Reviewed
Three weeks of fever and breathlessness in a 36-year-old woman after two courses of antibiotics
Three weeks of fever and breathlessness in a 36-year-old woman after two courses of antibiotics. A three-stage professional challenge: diagnosis, key findings and harmful interpretations.
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Reviewed
Three painful, blackening fingertips in a 58-year-old woman with no rheumatic history
Three painful, blackening fingertips in a 58-year-old woman with no rheumatic history. A three-stage professional challenge: diagnosis, key findings and harmful interpretations.
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Reviewed
Sudden loss of vision in the left eye of a 79-year-old woman
Sudden loss of vision in the left eye of a 79-year-old woman. A three-stage professional challenge: diagnosis, key findings and harmful interpretations.
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Reviewed
Pain & Fatigue · Professional journeys
Professional access
The Border Clinic
Sixteen referrals at the border of rheumatology: labels that arrive before the patient, and the chart detail that decides.
Open the case →Reviewed
Professional access
Two Truths
One patient over thirty months: an incidental ANA, ME/CFS with PEM, POTS, sleep apnoea, and the inflammatory arthritis that arrived in year two.
Open the case →Reviewed
CASCADE · Mechanisms & simulations
Mechanism journeys, evidence appraisal and staged therapeutic decisions.
Explore the mechanism · CASCADE
Follow extracellular IL-23 receptor blockade through an animated, seven-step molecular walkthrough.
Open activity →Oral IL-23 receptor blockade: evidence & clinical boundaries · CASCADE
Connect the mechanism with real psoriasis evidence, safety interpretation and the limits of a treatment indication.
Open activity →Break the Loop: Saphnelo (anifrolumab) in SLE · CASCADE
CAS-SAPHNELO-SLE-001. Professional CASCADE module on systemic lupus erythematosus (SLE), Saphnelo/anifrolumab, type I interferon receptor blockade, evidence, patient selection and practical treatment considerations.
Open the module →Daniela: What Comes Next?
Work through a three-stage SLE clinical reasoning case: identify Daniela’s priorities, weigh the medical facts, and rank treatment options for lupus that remains active on standard therapy.
Open the module →Reviewed
Daniela: The First 52 Weeks
Guide Daniela through a year of Saphnelo (anifrolumab) treatment in this SLE simulation. Make decisions about vaccination, infusion reactions, prednisone tapering, infections, home injections and follow-up, then review the illustrated course.
Open the module →Reviewed
George: psoriasis, joint symptoms & treatment decisions · CASCADE
A three-stage clinical reasoning case: patient preferences, uncertain joint symptoms and conditional treatment plans.
Open activity →Reviewed
AnnaMaria: CD19 CAR-T mechanism and SLE learning simulation
Explore an animated CD19 CAR-T mechanism, a fictional lupus-nephritis case and a clearly labelled simulated-data exercise by Olga Goodman, MD.
Play the open demo →Reviewed
Carmen: refractory SLE clinical reasoning · CASCADE
Work through a three-stage refractory-SLE clinical reasoning simulation: patient priorities, medical facts and scenario-specific strategy ranking.
Play the open demo →Reviewed
VELSIRA · Branded Interactive Education Demo
A fictional branded oral IL-23R scenario demonstrating Olga Goodman MD’s interactive educational design. Available for custom commissions, brand adaptation and licensing.
Preview / member access →Reviewed
George · VELSIRA Commercial Case Demo
A three-stage fictional VELSIRA case by Olga Goodman, MD. Explore priorities, clinical drivers and treatment reasoning. Available for custom development, sponsored education and licensing.
Preview / member access →Reviewed
Melissa · VELSIRA Ranked-Decision Commercial Demo
A fictional VELSIRA case by Olga Goodman, MD: three stages, ranked choices, visual feedback and engagement scoring. Available for commissioned and sponsored education.
Preview / member access →Reviewed
Sjögren’s: a 31-step Cascade mechanism journey
A 31-step professional Cascade walkthrough of systemic Sjögren’s disease, treatment and BAFF-axis mechanisms.
Play the open demo →Reviewed
B-cell treatment reasoning in Sjögren’s · CASCADE
RheumaView · Olga Goodman, MD Explore patient priorities, disease features and mechanism-based treatment reasoning through a three-stage fictional case.
Preview / member access →Reviewed
CSC-001 · Maria’s next treatment decision
A CASCADE interactive case: recurrent joint and skin symptoms, TYK2 mechanisms, a simulated trial and treatment reasoning.
Preview / member access →Reviewed
CSC-002 · Melissa · Interactive learning design
An original interactive learning demonstration by Olga Goodman, MD.
Preview / member access →Reviewed
Understand symptoms. Prepare for a visit.
Original tools and printable worksheets in English, Russian, Spanish and Polish.
Gout
The Trial of Uric Acid
Be the jury: six charges against uric acid. Open demo—start without an account.
Open quiz →Make Every Minute Count
Prepare your flare diary, medicine list and questions—and leave with a written plan.
Open quiz →She’s Got Gout
How gout appears in women: menopause, finger joints and diagnostic clues.
Open quiz →Why Me? Genes, Family and Gout
Explore heredity, family history and common misconceptions about gout.
Open quiz →Move It!
Activity, gradual weight loss, hydration and common exercise myths — learn what helps with gout.
Open quiz →Pack Your Bags
Flights, medicines, hydration and a flare plan: prepare for a holiday with gout.
Open quiz →Firefighters and Fire Marshals
Put out the flare and remove the fuel: learn the different jobs of gout medicines.
Open quiz →The 2 a.m. Mystery
Why gout often strikes at night: temperature, hydration, sleep apnea and common myths.
Open quiz →The Uric Acid Bathtub
The tap, the drain and why the tub overflows: production, kidney removal, food and medicines.
Open quiz →The Big Toe at Midnight
A sudden, painful toe at night. Learn the basics of gout in a warm-up and six questions.
Open quiz →The Gout Menu
Which drinks and dishes nudge uric acid up — and which may help?
Open quiz →Flare Night
What helps — and what backfires — when a gout flare strikes.
Open quiz →The Long Game
Uric acid numbers, targets — and why gout treatment is a marathon, not a sprint.
Open quiz →Gout: Myth or Fact?
Six popular beliefs about gout — can you tell which ones hold up?
Open quiz →Kings, Quills & Microscopes
A playful tour through 2,500 years of gout history.
Open quiz →Cppd
Confessions of a Knee
An 81-year-old knee explains CPPD crystals, flares, tests and everyday care.
Open quiz →Pseudogout: Myth or Fact?
Test common beliefs about CPPD, treatment, infection and activity.
Open quiz →The Report Decoder
Decode effusion, chondrocalcinosis, tophus and other terms in gout and CPPD reports.
Open quiz →Meet Pseudogout
Gout’s lesser-known cousin — calcium crystals, knees and wrists.
Open quiz →Needles vs Rhomboids
Gout or pseudogout? Spot the difference between two crystal troublemakers.
Open quiz →Crystal Detectives
How doctors confirm gout and pseudogout — needles, light and imaging.
Open quiz →Pseudogout: Clues & Connections
What pseudogout can hint at — and how people live well with it.
Open quiz →Nraxspa
Evidence or hype?
Sort health claims by evidence and potential harm, then practise checking what you read online.
Open quiz →Ready for take-off
Plan medicines, vaccines, movement and practical support for a long flight with nr-axSpA.
Open quiz →Talking about axSpA: fact or myth?
Sort fact from myth about discussing axSpA with family, partners and employers, and asking for support.
Open quiz →Vaccines and infections on treatment
Explore vaccination planning, live and non-live vaccines, and signs of infection during treatment for nr-axSpA.
Open quiz →When the back still hurts, step by step
Put the steps in order to review persistent pain, try medicines safely and plan a difficult day with nr-axSpA.
Open quiz →Looking ahead with nr-axSpA
Explore progression, mobility, work, remission and long-term follow-up with nr-axSpA.
Open quiz →Your back, your heart
Explore cardiovascular risk, NSAIDs, JAK inhibitors and heart-attack warning signs with nr-axSpA.
Open quiz →Bones, posture and falls
Use a 15-minute visit to explore bone density, inflammation, exercise and fall prevention in nr-axSpA.
Open quiz →Fatigue, sleep and mood: fact or myth?
Explore fatigue, sleep, mood, pacing and practical ways to seek support with nr-axSpA.
Open quiz →Flare or not — and what now?
Sort flare situations by urgency, then explore movement, NSAIDs and treatment planning.
Open quiz →Living with a biologic, step by step
Put practical steps in order: starting a biologic, home injections, surgery, travel and infection.
Open quiz →Beyond the spine
Explore enthesitis, dactylitis, psoriasis, eye and bowel symptoms in nr-axSpA.
Open quiz →Half an hour to move
Build a 30-minute movement routine and explore exercise and physiotherapy for nr-axSpA.
Open quiz →Everyday life with nr-axSpA: fact or myth?
Explore everyday habits, smoking, movement, diet, work and common myths about nr-axSpA.
Open quiz →Now, today, or at the next visit?
Sort urgent symptoms and prepare your questions, medicines and results for the next visit.
Open quiz →Is the treatment working?
Track symptoms, review treatment response and plan the next steps with your care team.
Open quiz →The treatment toolbox
Explore exercise, anti-inflammatory medicines, targeted therapy and individual treatment choices for nr-axSpA.
Open quiz →Putting the diagnosis together
Explore how symptoms, blood tests and imaging fit together in diagnosing nr-axSpA.
Open quiz →“Non-radiographic”: fact or myth?
Explore what nr-axSpA means, what X-rays can tell us, and why symptoms matter.
Open quiz →Experimental Therapies
Between the regulator and the internet
How to weigh approval, research and online claims.
Open quiz →Experimental therapy: fact or myth?
A balanced look at promise, uncertainty and follow-up.
Open quiz →The right patient, the right moment
How suitability, timing, expectations and follow-up shape a choice.
Open quiz →A specialist — or a weekend course?
What sound expertise involves beyond learning a procedure.
Open quiz →PRP: it starts before the needle
Technique begins with diagnosis and a review of medicines.
Open quiz →Heart Vessels
The headline confesses: fact or myth? — Patient quiz
Two rounds of fact-or-myth cards, explanations and an optional bonus round.
Open quiz →The heart’s raincoat: fact or myth? — Patient quiz
Two rounds of fact-or-myth cards, explanations and an optional bonus round.
Open quiz →A crowded neighbourhood: fact or myth? — Patient quiz
Two rounds of fact-or-myth cards, explanations and an optional bonus round.
Open quiz →The oracle on your fingertip: fact or myth? — Patient quiz
Two rounds of fact-or-myth cards, explanations and an optional bonus round.
Open quiz →A word from the heart: fact or myth? — Patient quiz
Two rounds of fact-or-myth cards, explanations and an optional bonus round.
Open quiz →Low home blood pressure readings and morning headaches in a woman with Takayasu arteritis
Open quiz →Swollen ankles and rapid weight gain in a man with rheumatoid arthritis and heart failure
Open quiz →A request to change blood thinner in a woman with antiphospholipid syndrome
Open quiz →Palpitations and a raised 'heart' blood test in a man treated for myositis
Open quiz →Feeling well three weeks into treatment for pericarditis
Open quiz →Three days of sharp chest pain in a young woman with lupus
Open quiz →A statin offer and a bottle of red yeast rice in a man whose rheumatoid arthritis has settled on tocilizumab
Open quiz →Five months after heart inflammation in a woman with lupus who is planning a race and a pregnancy
Open quiz →A woman with rheumatoid arthritis reads the warning on her medicine after a long trip
Open quiz →A new headache and a brief dimming of vision in a woman taking prednisone for polymyalgia rheumatica
Open quiz →Another gout flare in a man with high blood pressure who distrusts a medicine he was offered
Open quiz →Out of breath with a normal oxygen reading
Open quiz →A borderline risk score and a question about prevention
Open quiz →Feeling well again and planning a pregnancy
Open quiz →A sharp breath and a swollen calf
Open quiz →Chest tightness on the walk uphill
Open quiz →Skipped beats in a man with muscle inflammation
Open quiz →Swollen ankles and a night propped on pillows
Open quiz →Slower on the stairs, year after year
Open quiz →Chest pain that returned after the tablets were stopped
Open quiz →Sharp chest pain that eases when leaning forward
Open quiz →Psoriatic Arthritis
Reading the Headline
Psoriasis and PsA studies: endpoints, numbers and fair comparisons
Open quiz →What Is the Test For?
Biomarkers, ‘personalised’ panels and what a result can really tell you
Open quiz →Inside the Plaque
Immune signals, skin, joints and bone — explained without a switchboard
Open quiz →The Long Medical File
Psoriatic disease with cancer, infections or other illnesses in the history
Open quiz →More Than Birthdays
Psoriatic disease in later life: several conditions, one workable plan
Open quiz →Handing Over the Folder
Psoriasis and arthritis that started in childhood: moving into adult care
Open quiz →Planning for Two
Psoriatic disease, pregnancy plans and medicines for both partners
Open quiz →Move It Your Way
Exercise, work and everyday life with psoriatic disease
Open quiz →Skin Clear, Joints Still Sore
Persistent symptoms: what ‘the treatment did not work’ really means
Open quiz →Day One Notes
Newly diagnosed with psoriatic arthritis on top of psoriasis: the first steps
Open quiz →Itch at Three A.M.
Fatigue, sleep and mood with psoriatic disease
Open quiz →The Supplement Aisle
Food, supplements and the microbiome — what helps and what only sells
Open quiz →Better Joints, Same Arteries
Heart and metabolic health alongside psoriatic disease
Open quiz →The Same Ruler
How to tell whether treatment for psoriatic disease is working
Open quiz →Twice the Risk of What?
Weighing medicine risks against the cost of waiting
Open quiz →Map Before Medicine
Choosing treatment when psoriasis and joints both have a vote
Open quiz →No Single Test
How psoriatic arthritis is diagnosed when you already have psoriasis
Open quiz →Check Behind the Ears
Hidden psoriasis, heels, toes and nails — what to show the doctor
Open quiz →Not a Countdown
Psoriasis, the risk of arthritis and what is worth writing down
Open quiz →Wider Than the Skin
Psoriasis, psoriatic disease and the map your doctor is drawing
Open quiz →My Psoriatic Arthritis
Follow Marta through 23 decisions over thirty months: before diagnosis, the first year of treatment and life beyond. You are the patient. Explanations lead to the detailed patient guides.
Open quiz →Surgery, travel, infection: before, during, after
Three situations where timing is everything. Put each timeline in order.
Open quiz →Dr Google: how to spot a miracle cure
The internet knows everything — including a lot that isn’t true. Eight campfire stories for building a healthy sense of doubt.
Open quiz →Pregnancy and family planning
PsA and a baby can absolutely go together — with a plan. Four doors for future parents, both of them.
Open quiz →Talking to your doctor: fact or myth?
A visit lasts minutes, PsA lasts much longer. Ten cards on getting the most out of those minutes.
Open quiz →Work and joint protection
Fingers that type, a heel that commutes and a limited budget of effort. Choose the changes that make the working day kinder.
Open quiz →Pain, stress and mood
The joints and the head talk to each other all day long. Eight campfire stories about that conversation.
Open quiz →Fatigue and sleep: recharging the battery
“Just tired” isn’t the whole story. Five stops about where the energy goes — and how to get it back.
Open quiz →Movement is medicine
Heels, back, fingers, pain and motivation: five stops on the way to the summit. No marathon required.
Open quiz →Heart, sugar, liver: PsA’s travel companions
Inflammation doesn’t stay in the joints. Four doors about the conditions that like to travel with PsA — and how to keep them in check.
Open quiz →Smoking and alcohol: an honest chat
No lectures — just facts around the campfire (the only smoke we recommend).
Open quiz →Weight, food and inflammation
Energy for changes is limited. Spend it on what really works — and skip what only works on the label.
Open quiz →Eyes and gut: fact or myth?
PsA is related to a few neighbours outside the joints. Ten cards on which signals deserve a call — and which can wait.
Open quiz →Shields up: infections and vaccines on treatment
Modern treatment calms an over-eager immune system. Here is how to keep your defences strong at the same time — five stops on the way up.
Open quiz →Injection day: fact or myth?
The fridge, the pen, the airport and the forgotten dose. Ten cards to make injection day routine — not drama.
Open quiz →Methotrexate, the friendly way
One of the most-used medicines in rheumatology. Eight questions to make friends with it — and keep it safe.
Open quiz →Meet the medicine families
Tablets, pens, letters and numbers — who is who in PsA treatment? Four doors, a lifebuoy included.
Open quiz →The road to target
Treatment is not a lottery ticket — it is a route with checkpoints. Put the steps in the right order.
Open quiz →Detective work: how PsA is diagnosed
You are the doctor for a day. The budget is limited — choose the tests that really help.
Open quiz →Skin, nails and scalp: the clues
Why does a rheumatologist want to look at your nails and scalp? Four doors of friendly detective work.
Open quiz →Name that symptom
Inflammation or wear and tear? Wait and see, or call today? Eight everyday stories around the campfire.
Open quiz →The five faces of psoriatic arthritis
A mountain hike past every spot where PsA likes to show up: joints, tendon attachments, whole fingers, the back — and skin with nails.
Open quiz →Psoriatic arthritis: myth or fact?
Ten cards, ten popular beliefs. Let’s sort the truth from internet folklore.
Open quiz →Branches of the Family Tree
Genes, children, pregnancy and the dinner table: what psoriatic arthritis means for the whole family.
Open quiz →Aim for the Bullseye
Modern psoriatic arthritis care has a target. Here's how patient and doctor aim together — and which moves send the arrow wide.
Open quiz →The Flare Line-Up
Stress, a sore throat, a scratch, a cigarette: which suspects really stir psoriatic disease — and which have an alibi.
Open quiz →A Pencil in a Cup
What X-rays, ultrasound, MRI and blood tests can — and can’t — tell you about psoriatic arthritis.
Open quiz →Fingertip Forensics
The same knobbly finger can belong to very different stories. Learn to read the pattern.
Open quiz →The Whole-Body Group Chat
Skin and joints aren’t the only members — eyes, heart and mood are in the chat too.
Open quiz →Achilles’ Heel
Pain where tendons anchor to bone — and a back that hates the sofa more than the gym.
Open quiz →The Case of the Sausage Toe
Skin, nails and one very puffy toe: how psoriasis drops hints about the joints.
Open quiz →Living with disease
Fifteen Minutes
A follow-up visit is fifteen to twenty minutes long, and most of it can be spent reconstructing what happened — or deciding what happens next. Bet before you see the task.
Play →Food Is Not a Pill
What food can change, where the evidence differs by diagnosis, and why a beautiful supplement schedule can still be wrong. Bet before you see the task.
Play →Non Rheumatic Conditions
Controlled, Still Not Well
The examination looks better, the blood tests behave, and everyday life still feels difficult. Four words that are not interchangeable, and what to do with the gap. Bet before you see the task.
Play →The appointment, prepared
How to make a short follow-up visit count and bring the most useful information.
Open quiz →One change at a time
How to give a treatment a fair trial when several things could affect symptoms.
Open quiz →Gadgets, oxygen and jars
How to weigh devices and supplements when evidence, cost and safety all matter.
Open quiz →Long COVID and other look-alikes
How symptoms after COVID can overlap with ME/CFS, and why the pattern matters.
Open quiz →Bendy joints: what it does and doesn’t mean
When joint flexibility causes symptoms — and when it is simply a trait.
Open quiz →Burning, tingling, or a limb that changes colour
When local nerve symptoms or colour changes deserve a closer look.
Open quiz →When a child’s pain turns up the volume
A family-centred look at amplified pain, school and practical support.
Open quiz →Severe ME/CFS: care that comes to you
How care can adapt when travel and ordinary appointments are not possible.
Open quiz →When the plan stalls
A practical way to ask for reassessment when progress has stopped.
Open quiz →Who’s steering my care?
Who can coordinate care when pain and fatigue cross specialties?
Open quiz →New treatments: open, curious — and well informed
Questions to ask about new and experimental treatment options.
Open quiz →Dizzy when standing: POTS and friends
How to discuss symptoms on standing and assess them with a clinician.
Open quiz →Pacing: you’re the CFO of your energy
How to budget activity, notice limits and preserve a reserve.
Open quiz →PEM: the crash that arrives late
Why delayed worsening after activity can change the plan.
Open quiz →ME/CFS: more than “I’m tired”
How ME/CFS differs from ordinary fatigue and why the pattern matters.
Open quiz →Fibromyalgia medicines: fewer surprises
What is approved, what to ask and how to stop safely
Open quiz →A fibromyalgia plan you can actually live with
Goals, movement, sleep and skills — without heroics
Open quiz →Fibromyalgia: a real diagnosis, no magic test
How the diagnosis is made — and what it does not mean
Open quiz →Not everything is “just my fibro”
When a new symptom needs urgent help
Open quiz →Fatigue, sleepiness, weakness or pain?
The same “I can’t” can have different mechanisms — and lead to different investigations
Open quiz →Treatment & medicines
Risk, Compared With What?
The leaflet lists what the medicine can do. Nobody prints a leaflet for the disease. A game about biologics, targeted pills and the arithmetic of 'twice the risk'. Bet before you see the task.
Play →Fast and Slow
Why the new medicine isn't working yet — and why that is usually the calendar, not the medicine. Bet on what you know before you see the task.
Play →Vasculitis
Inflamed Pipes
Vasculitis is a family, not one disease, and the exact type, the organs involved and what is active today matter more than the label. Bet before you see the task.
Play →One Rash, Two Diseases
When you already have a diagnosis, the next rash still needs a fresh look.
Open quiz →Blood Thinner Bingo
Clots and bleeding can live in the same disease.
Open quiz →The Injection Is Not the Rescue
A monthly shot and a rescue inhaler have different jobs.
Open quiz →Asthma Plus Something
When the inhaler is only part of the story.
Open quiz →Fever, Flare or Something Else?
Not every new problem is the old disease coming back.
Open quiz →The Number That Went Up
A lab value is a clue, not a steering wheel.
Open quiz →Not Everyone's Aspirin
Two rare conditions, two opposite worries.
Open quiz →The Gene That Arrived Late
A genetic change you were not born with.
Open quiz →The Vaccine Calendar Moved
One infusion, and suddenly the calendar needs a rewrite.
Open quiz →Peeling Fingers and a Second Scan
The skin peels. The heart question does not.
Open quiz →The Missing Pulse
A young woman, a tired arm and two different blood pressures: the vasculitis of the body’s main highway.
Open quiz →The Cold That Wouldn’t Leave
Crusts, nosebleeds, a blocked ear and a strange urine test: when a “cold” is really small-vessel vasculitis.
Open quiz →Spots You Can Feel
A child, a rash on the legs, a sore tummy: what IgA vasculitis is — and which rash can’t wait.
Open quiz →The Headache That Can’t Wait
Over 50, a new headache, a tired jaw: when the artery at your temple deserves same-day attention.
Open quiz →Pipes of Every Size
Vasculitis means inflamed blood vessels — and which vessels are inflamed changes everything.
Open quiz →Scleroderma
Raynaud’s and Systemic Sclerosis: What Changes the Plan?
Cold-related colour changes need context; a risk assessment is not a prediction of inevitable disease.
Open quiz →Slower on the stairs, year after year
Open quiz →More Than Skin Deep
The word means hard skin; the diagnosis needs more precision than that. Organ checks, cold fingers and the one medicine cabinet to leave closed. Bet before you see the task.
Play →Call Today, Not Next Month
A cheat sheet for the moments that can't wait.
Open quiz →The Antibody and the Mammogram
A risk signal is not a diagnosis — and not a reason to skip screening.
Open quiz →Puffy Fingers and a Phone Camera
Your phone may be the most useful medical device you own.
Open quiz →The Stem-Cell Shop
Not all stem cells come with evidence. Some come with a price tag.
Open quiz →Promising Is Not Proven
Between a headline and your prescription there are several steps.
Open quiz →One Jar at a Time
The goal isn't a number. It's opening the pickles.
Open quiz →The Folder of Everything
Three kilograms of paper, zero answers — let's fix that.
Open quiz →Growing Up With a Line
Children are not small adults — and neither is their morphea.
Open quiz →The Patch With a Mind of Its Own
Morphea is its own story — not a trailer for another one.
Open quiz →One Antibody, Not Two Diseases
Extra test results are not extra diagnoses.
Open quiz →Tired, Pregnant and at the Dentist
Life keeps happening. Plan it with your team.
Open quiz →Never Borrow a Regimen
Your friend's treatment fits your friend.
Open quiz →Small Meals, Big Clues
Your stomach is sending messages. Read them.
Open quiz →Your Normal Is the Baseline
A “normal” number can be abnormal for you.
Open quiz →The Heart Has Its Own Calendar
Symptoms don't wait for the annual appointment.
Open quiz →Two Tests, Two Questions
A picture of the lungs and a measure of how they work.
Open quiz →Calcium Isn't From the Cheese
The lumps are real. The cheese is innocent.
Open quiz →Warm Hands, Cool Head
Gentle warmth helps. A heroic hairdryer does not.
Open quiz →The Antibody Is Not a Horoscope
It hints at what to watch, not at what will happen.
Open quiz →Limited Doesn't Mean Lite
A word about where the skin is, not how serious things are.
Open quiz →Asking the Question Again
A six-year-old diagnosis still has to show its paperwork.
Open quiz →Thick Fingers, Tired Tongue
When a blood protein borrows the skin for a disguise.
Open quiz →Sun, Blisters and Tight Skin
A summer problem that was never about the summer.
Open quiz →The Medicine Timeline
Two cancer treatments, one set of tight legs, and a phone call between two doctors.
Open quiz →After the Transplant
New tight skin, dry eyes, a sore mouth — and an antibody that gets the wrong idea.
Open quiz →Hands That Will Not Pray Flat
Waxy fingers, quiet nail-folds, and a clue about the eyes.
Open quiz →The Dye From the Scan
Eight weeks ago a scan. Today, legs like tree bark.
Open quiz →Bumps in a Row
Tiny waxy beads, a thickening face, and a blood protein that wants attention.
Open quiz →The Stiff Collar
A neck that will not look up, and hands that have no complaints.
Open quiz →The Marathon Arms
Hard forearms, happy fingers, and a sample that has to go deep.
Open quiz →Myositis
Weak, Tired or Sore?
Three words people use for one another, an enzyme that is not a strength test, and the stairs as a diagnostic instrument. Bet before you see the task.
Play →You Can't Rush a Kiln
A potter learns that recovery from myositis is a slow firing: what is expected along the way, and what is worth telling the team.
Open quiz →The Patchwork Quilt
Cold fingertips, gritty eyes and a thimble that no longer fits: when myositis shares the quilt with another autoimmune disease.
Open quiz →The Forecaster's Umbrella
A TV weather presenter learns that a “higher chance” is not a storm: myositis and cancer, explained calmly.
Open quiz →The Balloon Pilot's Checklist
A balloon pilot, a cough that won't leave and a preflight checklist: why myositis teams look after the lungs and the heart, not just the muscles.
Open quiz →The Hairdresser's Itch
A salon owner, a scalp that won't stop itching and a sunny front window: the skin side of dermatomyositis, up close.
Open quiz →Express or Regular Mail?
A mail carrier learns to sort his symptoms: what needs a call today, and what goes in the diary for the next visit.
Open quiz →The Brachiosaurus Climb
A dinosaur fan, a librarian mom and a notebook of clues: how juvenile dermatomyositis shows up in children — and why acting early matters.
Open quiz →The Lighthouse Stairs
Rest is best? Not for muscles with myositis. How a lighthouse guide got back to the top — one step, one chair and one notebook at a time.
Open quiz →The Tenor and the Teacup
Coughing at tea breaks, tea through the nose, a gurgly voice: which swallowing signs your myositis team needs to hear about.
Open quiz →The Captain's Knots
Tricky knots, stubborn jars and knees that give way: the slow, particular story of inclusion body myositis.
Open quiz →The Unfinished Waltz
A ballroom dancer, a huge CK number and weakness that didn't stop when the medicine did.
Open quiz →Antibody Passports
A passport officer learns that myositis antibodies carry ID cards — with hints about where doctors should look next.
Open quiz →The Muscle Detective's Kit
A crime novelist, “liver tests” with an alibi and a line-up of witnesses: how doctors actually prove myositis.
Open quiz →Weak, Tired or Just Stiff?
A retired carpenter, a creaky morning and a chair test: how doctors tell true weakness from its look-alikes.
Open quiz →The Myositis Family Tree
A librarian who loves family trees discovers that myositis has relatives of its own — and that knowing the exact branch matters.
Open quiz →Mechanic’s Hands
Cracked fingertips, a dry cough and cold fingers: when myositis speaks through the lungs and the skin.
Open quiz →Stairs, Chairs and Hairbrushes
Myositis weakness hides in ordinary moments. Learn where to look — and what a CK test can tell you.
Open quiz →The Lilac Eyelids
A florist, a purple rash and a van that got harder to climb into: when the skin points to the muscles.
Open quiz →Lupus
The Daily Dose
Sun, sport, scans and sniffles: small daily choices that protect your kidneys.
Play →The Scenic Route
Chronic kidney disease, dialysis, transplant: a road with options, not a forecast.
Play →Kidneys & Cradles
Contraception, fertility, pregnancy and after: plans that keep the kidneys in view.
Play →Tiny Sample, Big Story
Before, during and beyond the report: a biopsy has more to tell.
Play →Pillbox Diplomacy
Fine print, timing and two teams: keep your medicines working together at home.
Play →Ping! A New Result
A number lands in your portal: read it wisely, then make the right move.
Play →Ask Away
The right question at the right moment turns a visit into a plan.
Play →Month by Month
Your first year with lupus nephritis, minus the guesswork: what happens when, and why.
Play →Jargon, Decoded
The words on your reports, labels and portal, translated into plain language.
Play →Heard It Somewhere
Popular beliefs about lupus nephritis, checked against what is actually true.
Play →Timing Is Everything
Pregnancy plans and long-term kidney options: what to discuss, and when.
Play →Salt, Cuffs & Questions
Home habits that help your kidneys, and a visit that ends with a plan.
Play →Flare or Impostor?
Sort emergencies from same-day calls, and real flares from clever look-alikes.
Play →Better by Degrees
Bet on the trend, not the single number, and see how response is measured.
Play →Seatbelts On
Infections, vaccines and check-ups: build a safety plan that actually works.
Play →Who’s On Duty?
Seven rounds to learn which medicine does which job in lupus nephritis.
Play →The Game Plan
Every medicine on your list has a job — meet the whole team.
Play →Behind the Roman Numeral
A tiny sample, a detailed report — let’s read between the lines.
Play →Lab Sheet Detective
Read the numbers as clues in context, not as verdicts.
Play →The Silent Filter
Kidneys rarely complain out loud — here’s why checks still matter.
Play →Family Plans and Long-Term Choices
Contraception, a male partner on treatment, aspirin in pregnancy, temporary dialysis and conservative kidney care.
Open quiz →Signals That Need Action
Clots, sepsis, warning signs after pregnancy, home blood-pressure technique and a plan for days when you are ill.
Open quiz →More About the Medicines
Cyclophosphamide, anti-CD20 treatments, diuretics, infection screening and prevention — what each one is for.
Open quiz →The Day of the Biopsy and After
How a kidney biopsy is done, which warning signs need prompt help afterward, and what the report’s numbers mean.
Open quiz →Results Between Visits
A result in the portal, an unexpected urine sample, creatinine and eGFR categories: how to read the numbers calmly.
Open quiz →Planning Ahead
Pregnancy planning, medicines to review before conception, and what chronic kidney disease, dialysis and transplantation mean.
Open quiz →Everyday Habits, Better Visits
Pain relievers, salt, supplements and scans — and how to leave an appointment with a plan you can use.
Open quiz →When Something Changes
Emergency signs, same-day advice, and why a change is a reason to investigate rather than to self-treat a “flare.”
Open quiz →Is the Treatment Working?
Trends, partial and complete response, monitoring intervals and why feeling well is only part of the picture.
Open quiz →Making Treatment Safer
Infections, vaccines, eye checks and drug monitoring: a usable safety plan rather than a list of warnings.
Open quiz →Different Drugs, Different Jobs
Hydroxychloroquine, mycophenolate, calcineurin inhibitors, targeted treatments and kidney-protective medicines.
Open quiz →How the Plan Fits Together
Why several medicines may each have a job, why the steroid plan matters, and why treatment continues after improvement.
Open quiz →What a Biopsy Can Tell
Why a small tissue sample can change treatment, how to prepare for it, and how to read class, activity and chronicity.
Open quiz →Reading Your Lab Report
Urine protein, creatinine, eGFR, units and immune blood tests: what each number can and cannot tell you.
Open quiz →Quiet Kidneys Can Still Need Attention
What lupus nephritis is, why it can be silent, and why regular urine checks matter when you feel well.
Open quiz →Osteoarthritis
Lighter, But Is It Better?
The scale is down, the knees hurt less, morning stiffness has eased. Did the weight-loss injection treat the arthritis? Partly, maybe — the honest answer depends on what actually improved. Bet on the right question.
Play →The Whole Joint
Osteoarthritis is more than worn cartilage, an X-ray cannot measure pain, and no advertised procedure has to be tried before you ask about surgery. Bet before you see the task.
Play →The Right Person, the Right Hands
Two friends, the same question — and why the answers should differ
Open quiz →A Gift from Birth
Placental tissue in medicine — a century of history and a new chapter for joints
Open quiz →Stem Cells: Hope, Hype and Homework
A billboard promises new cartilage in one visit. What would a careful specialist say?
Open quiz →PRP: What's in the Tube?
Your own blood, a centrifuge — and why no two PRPs are quite alike
Open quiz →Can a Joint Be Coaxed to Heal?
PRP, cells, placental tissue — a first map of regenerative options
Open quiz →Is It Time for a New Joint?
Two neighbors, two opposite pieces of advice — and one knee to decide about
Open quiz →When Hand OA Runs Hot
Red, swollen finger joints — and an X-ray shaped like a seagull
Open quiz →The Scary-Sounding Back Report
“Degenerative disc disease” — a diagnosis, or just a description?
Open quiz →Where Does a Hip Really Hurt?
A sore knee, a stubborn sock — and a joint that hides
Open quiz →Every Pound Counts
Why small changes on the scale make a big difference to your knees
Open quiz →The X-ray Isn't the Whole Story
“Bone on bone” sounds scary. What does the report really mean?
Open quiz →Knobby Knuckles
Bumps on the fingers, a sore thumb — and a family resemblance
Open quiz →Motion Is Lotion
Why resting a sore knee “to save it” can backfire
Open quiz →More Than Wear and Tear
What osteoarthritis really is — told through one knee
Open quiz →Rheumatology
Is This a Rheumatology Problem?
Rheumatology is far more than painful joints — skin, eyes, lungs, kidneys, vessels and muscles can belong to one illness. But not every ache, positive test or “arthritis” on a scan is a lifelong rheumatology appointment. Bet on the right door.
Play →Dr Google
Leaflets, forums, headlines and chatbots: how to read about your medicines and keep your nerve.
Play →Life Goes On
Sport, food, sun, travel, surgery, family — what a rheumatic diagnosis changes, and what it doesn't.
Play →What Remission Means
Flares, fatigue, tapering and the word 'forever' — what to expect from a well-treated disease.
Play →Positive ≠ Sick
ANA, rheumatoid factor, HLA-B27 and friends: what a positive result does and does not mean.
Play →Fact or Fear
What people believe about their medicines — and what the evidence says.
Play →Safe Hands
The handful of habits that make strong medicines quiet ones.
Play →The Long Game
Why the medicine that feels slow is the one that wins.
Play →The Flag
Why a (!) on your report is a question, not a verdict.
Play →Crystal Arthritis
Crystal Clear
Different crystals, look-alike attacks, and Benjamin Franklin arguing with his own foot. Gout is not a verdict on your dinner, and CPPD is not a reason to give up cheese. Chips first, crystals second.
Play →Good Questions
A short appointment rewards a good question — learn which one to ask, and when.
Play →Between Attacks
The attack is the loud part; the weeks in between are where you quietly win.
Play →Where Crystals Hide
The big toe is only the front door — time to search the rest of the house.
Play →Not Everything Is Gout
Gout is a diagnosis, not an alibi: learn when an ache deserves its own hearing.
Play →Three Crystals
Three crystals walk into a joint — and each one leaves with a different plan.
Play →Kidneys, Heart & Crystals
Gout chats with your kidneys, your heart and your medicine cabinet — learn to chair the meeting.
Play →Needle, Scan, Number
A needle, a scan and a number each claim to know the whole story — find out which part each one actually knows.
Play →The Shoulder Pebble
A tiny calcium pebble, a very loud shoulder — and seven rounds on what actually helps.
Play →Calm Knees
Your knees have crystals; you have a plan. Let's see who's in charge.
Play →The Other Crystal
Not gout, not fake, and not your cheese board's fault: meet calcium pyrophosphate.
Play →Not a Royal Disease
Kings got the blame, kidneys and genes did the work — meet the real cast behind gout.
Play →Gout at the Table
No food police, no guilt trip — just what your plate and glass really do to uric acid.
Play →Pill Talk
Your medicine list, interviewed: what each pill does and which questions it is happy to answer.
Play →Under Six
The crystals took years to move in. The eviction is polite, daily and under six.
Play →Night Shift
Gout never books an appointment — learn to run the 2 a.m. shift with a plan instead of panic.
Play →Crystal Myths, Live on Air
Listener claims about gout, food, tests and follow-up — fact or myth?
Open quiz →Three Labs, One Story
Reading results in context: units, dates, attack timing, scans and what a review looks at besides a number.
Open quiz →Three Boxes for Ruth
A week of family notes, three shoeboxes and the guide’s exact urgency levels.
Open quiz →The Crystal Scoreboard
Gout, CPPD and a calcific shoulder at one bridge table: which crystal, where, and which long-term plan.
Open quiz →The Whole Crossword in One Minute
Crystals, tests, the two jobs of gout treatment, CPPD and the shoulder, and your next visit — in one quick tour.
Open quiz →Antonio’s Gout Shelf
Shelf and basket decisions from the chapter’s practical eating pattern for gout.
Open quiz →Names Like Orchids
Febuxostat, probenecid, infusions: what each one does, and what to ask before it joins your list.
Open quiz →Who Plays What Part?
One medicine with two jobs, a genetic test with fine print and the questions that keep gout treatment in time.
Open quiz →Nothing to Show?
When the swelling leaves before the visit: what to write down, what to bring and what to ask.
Open quiz →Three Letters, Different Addresses
Gout, CPPD and calcium deposits: why the name on the envelope matters.
Open quiz →Is the Lesson Over?
What progress looks like, when to call sooner and when a new pain deserves a fresh look.
Open quiz →Coach Frank’s Comeback Plan
Movement, weight, fluids and medicines in the calm weeks between gout attacks.
Open quiz →The Shoulder That Said No
A calcium deposit near a tendon: what it means, what helps and what a scan cannot tell you.
Open quiz →The Great Milk Rescue
Why cutting calcium does not starve CPP crystals — and what matters instead.
Open quiz →Not Gout Like My Brother
Why CPPD looks like gout in a flare but needs its own long-term plan.
Open quiz →Fourteen Little Doors
Interactions, rashes and the right questions for every gout medicine on your list.
Open quiz →Balancing the Uric Acid Books
Why gout doses get adjusted, what a “normal” flag can miss, and why patience pays off.
Open quiz →Small Joint, Big Alarm
Why gout is called autoinflammatory, and why it needs two kinds of treatment.
Open quiz →One Test That Settles It?
What uric acid, joint fluid and scans can — and cannot — tell you.
Open quiz →Which Timetable Today?
When a hot, swollen joint needs same-day care, emergency care or a fresh look, even after years of gout.
Open quiz →Rheumatoid Arthritis
The Pattern, Not the Checklist
Rheumatoid arthritis rarely announces itself with a perfect list of symptoms: sometimes it's a toothbrush that's hard to grip or shoes that pinch across the front. You don't need to prove the diagnosis — just describe what changed. Bet on the pattern.
Play →More Than a Spreadsheet
Targets, review visits and what to report sooner in the first months of RA treatment.
Open quiz →A New Doctor, a New Plan?
When a new rheumatologist suggests a change: what it does and does not mean.
Open quiz →Sore After the Move
Flare, strain or something else — and how fast to act.
Open quiz →I Came Prepared!
Turning a stack of notes into a follow-up visit that really works
Open quiz →Pumpkin Season
A new combination: what is harmless, what needs a call, and what stays with the team.
Open quiz →Flagged — Now What?
From a flagged value to an agreed plan: tests, medicines, schedules and who acts.
Open quiz →The Clinic in the Video
A hopeful video, a clinic abroad — and the questions that come before any decision.
Open quiz →Back on the Bike
A hand operation with RA: the medicine plan, everyday aids, shoes and a gradual way back.
Open quiz →One Plan for Rosa
When RA meets diabetes: one list, clear roles and a plan that fits real life.
Open quiz →Two Lines, One Plan
An unexpected pregnancy on RA treatment — the call, the steroids, the leflunomide question and life after birth
Open quiz →Ad, Trial or Treatment?
Telling an approved treatment, a research product and an advertisement apart.
Open quiz →A Letter, a Jab, a Plan
Vaccines during RA treatment: planned with the team, not copied from a general leaflet.
Open quiz →One Stubborn Knee
Joint injections, anti-inflammatories and steroid effects: the less obvious points
Open quiz →Options on the Table
Biologics, JAK inhibitors and what to weigh besides the timetable.
Open quiz →Methotrexate: The Fine Print
Feeling unwell after a dose, injections, blood tests, family plans and warning signs
Open quiz →Everything’s the Same, Doctor
Turning a month of ups and downs into a follow-up visit that actually helps
Open quiz →A Bag of Good Intentions
Supplements, diet printouts and alcohol advice — checked against your own RA treatment
Open quiz →Scissors, Shoes and Stamina
Practical ways to protect your hands, feet and working day with RA.
Open quiz →Who Holds the Whole Plan?
RA alongside other conditions: one list, clear roles and a plan you can actually follow
Open quiz →Planning for Baby
RA medicines, pregnancy, breastfeeding and the baby’s vaccines — planned ahead together
Open quiz →Now, Today, or Wait?
When a new symptom or a methotrexate mix-up should not wait for the next visit
Open quiz →Colds, Jabs and a Suitcase
Illness, vaccines and treatment pauses with RA — by plan, not by rumour.
Open quiz →All Good — So Why Test?
Activity checks, safety checks, trends — and who acts on your results
Open quiz →Flare or Something Else?
Describe the change, tell a flare from other causes, and pick how fast to act.
Open quiz →Behind Every Switch
Inflammation, side effects or access — different reasons call for different changes.
Open quiz →The Magic Tablets
Steroids, anti-inflammatory medicines and joint injections: relief with a plan
Open quiz →Beyond the Scary Headline
Biologics, JAK inhibitors and the questions worth asking before you start.
Open quiz →Many Tablets, One Plan
Hydroxychloroquine, sulfasalazine, leflunomide — and why combinations are used
Open quiz →Methotrexate, Sorted
The weekly rule, folic acid, interactions, alcohol and family planning
Open quiz →Is It Working Yet?
Goals, review checkpoints and patience with a plan in the first months of RA treatment.
Open quiz →The thread lost by mid-afternoon
Ivo, a bookbinder in his sixties, has rheumatoid arthritis (RA).
Open quiz →The frame, the springs or the fabric?
Dorota, an upholsterer in her fifties, never replaces a sagging armchair on sight: it may be the frame, the springs or the fabric, and you look before you replace.
Open quiz →Calm water, still watched: fact or myth?
Lena, in her forties, keeps a lock on a canal: her job is to hold the water at a steady level through small, watched adjustments.
Open quiz →Quiet joints, a path that still aches
Henrik, a mountain hut keeper in his fifties, has had quiet joints for a while; at his last appointment the word “remission” was used.
Open quiz →Not everything is the joints, not everything is hormones
Margit, a choir director in her early fifties, has lived with rheumatoid arthritis (RA) long enough to know how her joints behave.
Open quiz →Notifications before the explanation
Mira, an air-traffic controller in her thirties, has had swollen knuckles for some weeks, and a rheumatologist is working out why.
Open quiz →More than the knuckles
Bruno, a theatre set carpenter in his forties, heard the words “rheumatoid arthritis” a few weeks ago, somewhere between a dress rehearsal and an opening night.
Open quiz →The hallmark and the whole piece: fact or myth?
Agnes, a jeweller in her forties, appraises stones for a living, and she knows that a hallmark tells you one thing and the whole piece tells you another.
Open quiz →The question that opens the door
Teodor, a museum guide in his sixties, has learned that the right question opens a room, while a vague one earns you a tour of the gift shop.
Open quiz →One crossing at a time
Ruth, a ferry pilot in her fifties, spends every crossing reading what changes — wind, current, visibility — and writing it in the log.
Open quiz →Between two appointments
Lucia, a school bus driver in her forties, has puffy knuckles, hands that are slow to get going in the morning, a referral to rheumatology and an appointment that is still some weeks down the road.
Open quiz →Words worth more than their pronunciation
Stefan, a radio announcer in his sixties, has read out storm warnings, election results and the surnames of foreign conductors without a single stumble.
Open quiz →Heard in the back seat: fact or myth?
Nora is in her fifties and has driven a taxi for most of her adult life; rheumatoid arthritis (RA) is a recent addition to her paperwork.
Open quiz →Three cameras, one hand
Simon, a wedding photographer in his fifties, owns three cameras and is asked every week which one is the best.
Open quiz →A diagnosis in pencil
Felix, a proofreader in his forties, is professionally uneasy about any sentence that is not finished.
Open quiz →A forecast is not a calendar
Iris, a beekeeper in her thirties, plans her season by the long-range forecast and knows its limits: it tells her what kind of summer to prepare for, not what Tuesday will be like.
Open quiz →Four signals on one report: fact or myth?
Hugo, in his sixties, spent his working life in a railway signal box, where a lamp meant something only if you knew which line it belonged to.
Open quiz →A map, not a stamp
Vera, a cartographer in her forties, has swollen knuckles that are making fine pen work harder.
Open quiz →What the mornings are telling you
Emil, a watchmaker in his forties, has noticed that his own hands now need winding up in the morning: the fingers that seat hairsprings all day take their time before they will close around a screwdriver.
Open quiz →What is actually out of tune?
Sofia, a piano tuner in her fifties, earns her living by finding the one string that is off and leaving the others alone.
Open quiz →Spa
The Back Story
We lost the tail long ago; the coccyx stayed and still anchors the pelvic floor. The rest of the back story — sacroiliac joints, heels, eyes and an inflamed family of diseases — is what this round of chips is about.
Play →Peptides
One Word, Many Molecules
“Peptide” is a chemical family, not a treatment: it includes established medicines and promising research compounds, each with its own evidence. Neither hype nor dismissal — just the right question for the right molecule. Place your chips.
Play →Peptides: a promising therapy, chosen with care
A careful conversation about the specific peptide, suitability, evidence and follow-up.
Open quiz →Cell Therapies
What's in the Vial?
“Stem-cell treatment” is not one treatment: source, processing, contents and route change the decision. Real promise deserves a high standard of judgment, not a lower one. “Young”, “natural” and “regenerative” are adjectives, not ingredients. Chips first.
Play →The product’s passport — and an honest talk about risk
Product quality, personal risks and why prescribed treatment should not be stopped on your own.
Open quiz →A promising field, the right question
Ask whether a specific product has evidence for the problem it is meant to address.
Open quiz →Who should advise you?
Why one named clinician should take responsibility when a complex condition and a cell product are involved.
Open quiz →Every rope has a name: what exactly is being offered?
Tell living cells, products made from cells or tissue, and platelet preparations apart.
Open quiz →Tests & diagnosis
A Curve Is Not a Diagnosis
“Straightening of the normal cervical lordosis” sounds like a verdict on your neck. It's a description of a curve on one image — the beginning of interpretation, not the end. Learn to read the rest of the report. Bet first.
Play →Creatinine & Co.
A red flag on the lab report, a number that depends on your muscles, and a urine colour you should never explain away at home. Bet before you see the task.
Play →Dish
Small Fall, Big Deal
A rigid spine doesn't do 'minor'. Seven rounds on which new symptoms with DISH can wait for a routine visit, which can't — and how to walk in prepared.
Play →Bridges Stay, Life Moves
The bony bridges aren't going anywhere. You are. Seven rounds on movement, everyday tricks, medicines and procedures with DISH.
Play →Read the Picture
X-ray, CT, MRI: three cameras, three different questions. Seven rounds on what images of DISH can answer — and what they politely can't.
Play →Stiff, Not Stuck
Your back has opinions. Seven rounds on turning stiffness and pain from DISH into a story a clinician can actually use.
Play →Decode the Report
A four-letter word turned up in your X-ray report — and no, not that kind. Seven rounds on what DISH means, and what it doesn't.
Play →The Candle-Wax Spine
A stiff back, a chance X-ray finding — and a condition with a long name
Open quiz →Early Autoimmunity
Name Pending
UCTD, incomplete lupus, “at risk” — diagnoses still in beta. Bet on reading the label without reading your future into it.
Play →Notifications: Now, Soon or Later
Your body sends notifications all day. Most are spam, a few are urgent. Bet on sorting the inbox without missing the one that matters.
Play →The Scan Found Something
Modern scanners can see almost everything — including things that were never a problem. Bet on knowing which pictures matter.
Play →Read the Fine Print
Lab reports are written in a dialect of their own. Learn the vocabulary before you learn to panic.
Play →Everyone's an ANA Expert
Your aunt, your coworker and a forum thread from 2011 all have theories about your positive test. Bet that you know better.
Play →Series Finale: The Big Ideas
Ten fresh situations that bring together what the series has explored.
Open quiz →Review: Now, Soon or at the Review?
Ten changes someone might notice — sort each one by how quickly it needs attention.
Open quiz →Review: Words That Appear in Reports
Small words such as “incidental”, “equivocal” or “trace” can change how a result reads.
Open quiz →Review: Match the Test to the Question
Ten short situations from across the series — which investigation actually answers each one?
Open quiz →Review: Things People Say About Positive Tests
Ten everyday sayings about test results — which ones hold up, and which don't?
Open quiz →Oliver's Story: An Invitation to a Prevention Study
A fictional story: weighing a research invitation calmly — what it offers, what it asks and what stays the same.
Open quiz →Lidia and Kira: Cold Fingers in the Family
A fictional story: a mother with lupus, a teenager with white fingers, and keeping each one's story separate.
Open quiz →Greta's Story: A Private MRI That Found “Something”
A fictional story: a scan without a clear question, and how to put its findings back in context.
Open quiz →Omar's Story: Swollen Joints, Negative Antibodies
A fictional story: when the joints tell a clearer story than the blood tests.
Open quiz →Hannah's Story: A Report on Friday Night
A fictional story: an expanded lupus panel arrives on the patient portal before anyone has explained it.
Open quiz →Barbara's Story: A Positive ANA at 68 and Gritty Eyes
A fictional story: connecting dryness, medicines and one antibody — without assuming they're the same thing.
Open quiz →Eva's Story: Five Quiet Years and Fewer Visits
A fictional story: stepping back from routine checks with a plan, not a leap of faith.
Open quiz →The Name That Lies Twice
Lupus anticoagulant: usually no lupus, and no anticoagulant in the body. Meet medicine’s most misleading name.
Open quiz →Paul's Story: All Tests Negative, Still Not Well
A fictional story: negative tests narrow the question, and each symptom gets its own explanation.
Open quiz →Rheumatoid Factor: Internal Affairs
An antibody that investigates other antibodies — with a name that promises more than it can prove.
Open quiz →Julia's Story: A Letter That Says “UCTD”
A fictional story: living with a name that describes today’s pattern, not a forecast.
Open quiz →The Smoke Alarm Called ANA
It shrieks at real fires — and at burnt toast. Learn to tell the difference.
Open quiz →Laura's Story: Attacks That Come and Go, and Two Positive Antibodies
A fictional story: recording the attacks, sorting out her hand symptoms and noticing when the pattern changes.
Open quiz →Nina's Story: A Clotting-Test Surprise Before Surgery
A fictional story: an antiphospholipid finding, a planned operation and a family history — kept in proportion.
Open quiz →Victor's Story: A Positive ANCA After a Chest Infection
A fictional story: an unexpected result, a careful look for organ involvement, and a plan with a reason.
Open quiz →Tom's Story: Breathless on the Hills
A fictional story: when the lungs lead, the organ question comes first — and a negative ANA doesn't close it.
Open quiz →Adam's Story: Psoriasis, a Swollen Toe and an ANA “Just in Case”
A fictional story: telling the finding that matters from the one that simply happened to be tested.
Open quiz →Marta's Story: A Positive ANA, Cold Fingers and a Pregnancy Plan
A fictional story: one plan that keeps today's findings, pregnancy questions and ordinary life apart.
Open quiz →Family History and Prevention: What Can You Act On?
Family history can inform a plan without becoming a forecast for every relative.
Open quiz →When Can Follow-up Become Less Intensive?
Observation needs a purpose, a review point and a route back to care.
Open quiz →Negative Tests, Persistent Symptoms: What Comes Next?
A negative result changes the assessment — how much depends on the test, the condition and the findings.
Open quiz →Your Next Visit: Findings, Questions and a Plan
Prepare one useful conversation — complete only what matters to you.
Open quiz →Psoriasis and Joint Symptoms: Recognising Early PsA
This pathway relies on symptoms, examination and imaging — not on a single antibody test.
Open quiz →A Positive ANCA: The Pattern, Not Just the Number
The same test label can appear in very different situations — the presentation guides the next step.
Open quiz →Myositis Antibodies: When the Lungs Come First
A targeted panel can reveal a useful pattern — but the organ findings decide what it means.
Open quiz →Antibodies and Pregnancy: Plan Early, Without Assuming the Worst
SSA/Ro and aPL can matter for pregnancy even when the mother feels well — and each follows its own pathway.
Open quiz →Antiphospholipid Antibodies Without APS: When Does Prevention Matter?
A positive aPL result is not a diagnosis; prevention depends on the whole profile.
Open quiz →Raynaud’s and Systemic Sclerosis: What Changes the Plan?
Cold-related colour changes need context; a risk assessment is not a prediction of inevitable disease.
Open quiz →Lupus Follow-up That Leaves Room for Life
Useful monitoring has a purpose, a timetable and a clear route back to care.
Open quiz →Lupus Treatment: Treat, Maintain or Prevent?
Before deciding about a medicine, name the problem it is meant to address.
Open quiz →Feeling Well, Organ Checks and the Right Test
Feeling well is reassuring — but an objective abnormality still needs to be explained.
Open quiz →Lupus Tests and AVISE: Making the Result Useful
Sensitive testing helps most when the clinical question and the next decision are clear.
Open quiz →ANA, Incomplete Lupus and UCTD
Words that describe today's findings — without predicting who you are or what comes next.
Open quiz →Can RA Be Prevented? Reading the Studies
Delay, prevention and the size of a benefit — how to read what trials show.
Open quiz →Early Treatment or Observation?
The decision depends on what is present now — and what treatment is meant to achieve.
Open quiz →Attacks That Come and Go, Arthritis That Stays
A quiet examination between attacks doesn't erase the history.
Open quiz →When Results Don't Agree
A blood marker, a pain score and a scan measure different things — here's how to read a mismatch.
Open quiz →“Seronegative” and Sensitive RA Panels
What a negative RF and anti-CCP do — and don't — settle, and when a broader panel helps.
Open quiz →“Subclinical”: Reading an Imaging Finding
A small finding, findings that align, risk with uncertainty — what a scan adds, and what it can't.
Open quiz →Joint Pain: Ultrasound, MRI and X-ray
Imaging can reveal important inflammation — and it needs careful interpretation.
Open quiz →RA Antibodies Without Arthritis
RF, anti-CCP and “at risk”: a reason to look closer, not a diagnosis.
Open quiz →Similar Findings, Different Decisions
One ANA result, three fictional people, three reasonable plans.
Open quiz →Living Well While the Diagnosis Is Uncertain
Your symptoms deserve attention. Your life deserves room beyond the results.
Open quiz →Observation Is a Plan Too
What a good monitoring plan contains, what's worth writing down — and when not to wait.
Open quiz →Early Biomarkers and Advanced Panels
What extra testing can add — and why every panel needs a clear question.
Open quiz →Which Test Answers Which Question?
ANA, RF, anti-CCP, ESR, CRP, urine tests and scans — each one is good at a different job.
Open quiz →Positive Test: Finding, Risk or Disease?
The same result can mean different things in two different people.
Open quiz →The Words Your Doctor Uses
Arthralgia, subclinical, UCTD, “at risk”: what these words mean — and what they don't.
Open quiz →Sjogren
The Pipeline & the Miracles
Breakthrough designation, phase III, 'approved in one country', stem cells and gland regrowth. Seven rounds on reading a treatment headline without buying a ticket you cannot use.
Play →Follow-up Without Panic
Feeling reasonably well is not a reason to vanish — and 'stable' is not a synonym for 'cured'. Seven rounds on what gets checked, how often, and which lumps deserve a look.
Play →Pregnancy & Life Stages
Anti-Ro, a baby's heartbeat, a breastfeeding plan, a teenager with swollen glands, a man told it is 'a women's disease'. Seven rounds on Sjögren's across a lifetime.
Play →Food & Myths
No diet cures Sjögren's, and no diet is forbidden by it. Seven rounds on what food can realistically change, which supplements earn their shelf space, and which 'resets' reset only your bank balance.
Play →Fatigue, Pain & Fog
'Tired' is not a diagnosis, and 'your tests are fine' is not a plan. Seven rounds on fatigue, pain that will not read the lab results, brain fog and what the exercise trials really showed.
Play →Treatment Follows the Problem
There is no 'mild to strong' ladder — there is a target, a medicine for it and a date to check. Seven rounds on goals, hydroxychloroquine, organ-directed drugs and why guidelines disagree.
Play →Beyond the Glands
Lungs, nerves, kidneys, skin, blood. Seven rounds on how organs get assessed in Sjögren's — and why 'systemic' does not mean 'everything, always'.
Play →Tears & Saliva
Drops, gels, plugs, pills and a dentist who means it. Seven rounds on eye, mouth and tooth care — and on not becoming a product collector.
Play →Reading the Report
Positive, negative, high, low — a lab report is a text in a foreign language. Seven rounds on antibodies, anticentromere results and what a number can and cannot say.
Play →More Than Dry
Dry eyes are the opening line, not the whole story. Seven rounds on what Sjögren's is, how the diagnosis gets built and which changes deserve a phone call.
Play →My Sjögren’s Disease
Open demo · No registration · CSQ-SJD-PATIENT
Open quiz →Daily Life, Follow-up and Pregnancy
Open demo · No registration · CPQ-SJD-LIFE
Open quiz →What Each Treatment Is For
Open demo · No registration · CPQ-SJD-TREAT
Open quiz →Beyond Dryness
Open demo · No registration · CPQ-SJD-SYSTEMIC
Open quiz →Protecting Eyes, Mouth and Teeth
Open demo · No registration · CPQ-SJD-GLANDS
Open quiz →What Your Tests Can and Cannot Tell You
Open demo · No registration · CPQ-SJD-TESTS
Open quiz →Nine weeks pregnant with Sjögren's disease and a positive anti-Ro antibody test
Open quiz →Hype or Hope?
How to read Sjögren’s research headlines without losing your head — or your eye drops.
Open quiz →One Disease, Many Cookbooks
Why Sjögren’s guidelines differ between countries — and how to use them.
Open quiz →The Case of the Unexpected Antibody
A mystery in one lab report: ACA-positive Sjögren’s, investigated.
Open quiz →Treatment GPS
Before asking “Are we there yet?”, enter a destination.
Open quiz →The Sjögren's Weather Forecast
Mostly dry, with a chance of check-ups. Learn to read the long-range forecast.
Open quiz →For Family and Friends
Ten questions for the people who love someone with Sjögren's — how to understand, help and look after yourself too.
Open quiz →Eye Care Beyond Drops
Ten questions on makeup, contact lenses, eyelid care, eye surgery and check-ups.
Open quiz →Good Nights: Sleep and Sjögren's
Ten questions on what wakes you up at night — and the habits that help you sleep through.
Open quiz →Children and Teens with Sjögren's
Ten questions for parents and families: early clues, tricky diagnosis, school and growing up.
Open quiz →Skin, Hair and Nails
Ten questions on dry skin, itchy spots, cracked lips and the clues doctors find at your fingertips.
Open quiz →Joints, Muscles and Hands
Ten questions on aches, stiffness, cold fingers and clever ways to go easy on your hands.
Open quiz →Work and Study with Sjögren's
Ten questions on desks, screens, meetings and fair adjustments — so the working day works for you.
Open quiz →Sjögren's and Its Autoimmune Relatives
Ten questions on the conditions that often keep Sjögren's company — and the look-alikes doctors rule out.
Open quiz →Your Lab Report, Decoded
Ten questions on the numbers, flags and abbreviations you see after a blood test.
Open quiz →Nose, Throat and Voice
Ten questions on the dry spots people forget — from the nose to the vocal folds, plus a word about hearing.
Open quiz →Research and Clinical Trials: How Progress Happens
Ten questions on how new treatments are tested — and how patients help.
Open quiz →Lungs, Kidneys and Nerves: The Quieter Organs
Ten questions on less visible parts of Sjögren's — and the tests that keep watch.
Open quiz →Mind and Mood: Coping with a Long-Term Condition
Ten questions on brain fog, low mood, worry and the tools that help.
Open quiz →Eating Well: Food, Taste and Swallowing
Ten questions on making meals comfortable, protecting your teeth and separating diet facts from hype.
Open quiz →Your Care Team: Who's Who and When to Call
Ten questions on the specialists who help, regular check-ups and the signs that shouldn't wait.
Open quiz →On the Move: Travel and the Seasons
Ten questions on planes, hotel rooms, winter heating, summer sun and packing smart.
Open quiz →A Short History: Doctors, Dyes and Discoveries
Ten questions on how doctors in London, Königsberg, Paris and Sweden pieced the disease together.
Open quiz →Pregnancy and Family
Ten questions on planning ahead, anti-Ro antibodies and what really passes from parent to child.
Open quiz →Myth or Fact? The Sjögren's Edition
Ten statements you may have heard. Can you tell which are true?
Open quiz →Everyday Life: Energy, Sleep and Movement
Ten questions on pacing, movement, sleep and the small adjustments that add up.
Open quiz →The Diagnosis Puzzle: Tests Explained
Ten questions on the clues doctors put together — from blood tests to a tiny lip biopsy.
Open quiz →Beyond Dryness: The Whole-Body Picture
Ten questions on symptoms that are easy to miss — and the ones worth reporting.
Open quiz →Dry Mouth: Why Saliva Matters
Ten questions on what saliva does, how a dry mouth affects your teeth, and small habits that help.
Open quiz →Dry Eyes: The Secret Life of Tears
Ten questions on how tears work, why Sjögren's dries them out, and simple habits that bring relief.
Open quiz →Sjögren's at a Glance
Ten quick questions on what it is, who gets it, and why it's more than dryness.
Open quiz →Sjögren’s disease · Patient Interactive Journey
Patient Interactive Journey
Past the Headline
Twenty months with Sjögren’s disease for a patient who reads trial registries before breakfast and learns which numbers answer his own questions.
Open the story →Reviewed
Patient Interactive Journey
The Invisible Half
Twenty-two months with Sjögren’s nerves, sleep and brain fog, for a crossword compiler whose problems rarely show on a routine blood test.
Open the story →Reviewed
Juvenile spondyloarthritis · Patient quizzes
Heel, Knee and Homework
In young people, spondyloarthritis often shows up first in the legs and feet — a sore heel, a swollen knee, a sudden dislike of stairs. For teenagers and their families: what to notice, what to ask, and how to keep school and sport in the plan.
Play →Pain & Fatigue
No Single Test
Two years with fibromyalgia, told from the patient’s side: pain, normal tests, a handover, medicines, and the night a new pain was new.
Open the story →Reviewed
Pain & Fatigue
The Crash Arrives Late
Eighteen months of ME/CFS after a virus, told from the patient’s side: the delayed crash, the budget, the watch, the clinic abroad, and a review done right.
Open the story →Reviewed
Pain & Fatigue
The Border
Four years with a spondyloarthritis you were afraid to treat and a pain syndrome that grew beside it: when pain, examination, blood tests and imaging disagree.
Open the story →Reviewed
RV-JSPA-01
Behind the Long Name
Sort fact from myth about what the words “juvenile spondyloarthritis” do, and do not, tell a family.
Open quiz →Added
RV-JSPA-02
What Did You Notice?
True or false: how to notice early changes in a child and describe them, without diagnosing at home.
Open quiz →Added
RV-JSPA-03
Joint, Tendon or Growing Bone
A sore foot holds several close neighbours; see how well you can tell the clues from the conclusions.
Open quiz →Added
RV-JSPA-04
Where the Pain Really Starts
Sort true from false about hip, buttock and back symptoms in juvenile spondyloarthritis.
Open quiz →Added
RV-JSPA-05
Pieces of the Diagnosis
See how history, examination, tests and follow-up come together into a diagnosis.
Open quiz →Added
RV-JSPA-06
Reading the Lab Report
Everyday beliefs about blood tests and HLA-B27 in juvenile spondyloarthritis: which are facts, and which are myths?
Open quiz →Added
RV-JSPA-07
Scans Without the Mystery
True or false: what ultrasound, X-rays and MRI can and cannot tell you in juvenile spondyloarthritis.
Open quiz →Added
RV-JSPA-08
More Than Just Joints
Eye, skin and bowel symptoms belong in the same care plan as the joints. See how well you can connect them.
Open quiz →Added
RV-JSPA-09
Knowing When Not to Wait
A calm look at which changes need emergency help, which need assessment today, and which need a prompt call.
Open quiz →Added
RV-JSPA-10
Three Wishes, One Plan
Fact or myth: what treatment for juvenile spondyloarthritis is trying to achieve, in the clinic and in everyday life.
Open quiz →Added
RV-JSPA-11
Medicines With Different Jobs
NSAIDs, injections and conventional DMARDs in juvenile spondyloarthritis: six everyday situations, and two answers to choose between.
Open quiz →Added
RV-JSPA-12
Biologics Without the Myths
Things people say about biologics, approval, off-label prescribing and biosimilars in juvenile SpA: which are facts, and which are myths?
Open quiz →Added
RV-JSPA-13
A Plan Before You Need It
Choose the better of two answers about vaccines, missed treatment, other medicines and planning ahead in juvenile spondyloarthritis.
Open quiz →Added
RV-JSPA-14
Better, But How?
True or false: how a family and the care team can tell whether treatment for juvenile spondyloarthritis is helping.
Open quiz →Added
RV-JSPA-15
Better, but Still Hurting
Things people say when the inflammation has improved and the pain has not: which are facts, and which are myths?
Open quiz →Added
RV-JSPA-16
Back in the Game
Sport, movement and rehabilitation with juvenile spondyloarthritis: which of these statements are true?
Open quiz →Added
RV-JSPA-17
The Rest of the Week
See how school, friends, sleep and mood find their place in life with juvenile SpA.
Open quiz →Added
RV-JSPA-18
Honest Questions, Clear Answers
Fact or myth: privacy, parties, relationships and medicines while growing up with juvenile spondyloarthritis.
Open quiz →Added
RV-JSPA-19
When the Disease Is Quiet
True or false: what remission means, how treatment changes are decided, and how to think about the future.
Open quiz →Added
RV-JSPA-20
Your Turn to Steer
Pick the better of two answers on growing up with juvenile spondyloarthritis and moving to adult care.
Open quiz →Added
RV-JSPA-21
Before the Results Arrive
Family history, the blood draw and a plan for the results in juvenile spondyloarthritis: six everyday situations, and two answers to choose between.
Open quiz →Added
RV-JSPA-22
From Prescription to Practice
True or false: the practical side of a biologic or targeted treatment for juvenile spondyloarthritis, from the route it is given by to the notes worth keeping.
Open quiz →Added
RV-JSPA-23
Safety on an Ordinary Day
Things people say about routine checks, new symptoms, urgent situations and a teenager’s questions during treatment for juvenile SpA: fact or myth?
Open quiz →Added
RV-JSPA-24
Room for Real Life
School, friendships, fatigue and urgent support with juvenile spondyloarthritis: which of these statements are true?
Open quiz →Added
RV-JSPA-25
On Your Own, Not Alone
Fact or myth: the family's changing role, asking for help, and the practical side of moving to adult care with juvenile spondyloarthritis.
Open quiz →Added
RV-JSPA-26
Better Compared With What?
Six everyday situations around a follow-up visit, two answers each: how a family and the care team judge whether treatment for juvenile spondyloarthritis is helping.
Open quiz →Added
RV-JSPA-27
Which Medicine, Which Job?
Fact or myth: what NSAIDs, joint injections and conventional DMARDs are each meant to do in juvenile spondyloarthritis.
Open quiz →Added
RV-JSPA-28
Better on Paper, Still Sore
True or false: why pain can stay when inflammation improves in juvenile spondyloarthritis, and what a plan that takes both seriously looks like.
Open quiz →Added
RV-JSPA-29
Back in the Game
Six situations from sport, school and physiotherapy, two answers each: staying active with juvenile spondyloarthritis.
Open quiz →Added
RV-JSPA-30
The Quiet Spell
Fact or myth: what remission means in juvenile spondyloarthritis, how treatment changes are agreed, and what to do if symptoms return.
Open quiz →Added
Peripheral / undifferentiated SpA · Patient quizzes
A label with three jobs
Helena, a translator in her forties, can turn a contract into three languages before lunch. Her own referral letter defeats her: “suspected peripheral SpA, previously…
Open quiz →Reviewed
Joint, attachment or the whole toe?
Marta, a pastry chef in her thirties, tells her rheumatologist: “My foot hurts.” Accurate, heartfelt — and about as precise as “something is wrong with the oven.” Her ankle is…
Open quiz →Reviewed
The detective’s notebook
Nina, a florist in her forties, has a knee that swells without asking and a heel that objects to the first steps of every morning. Her first rheumatology visit is short, and even…
Open quiz →Reviewed
Wait, call or go?
Viktor, a tram driver in his fifties, has peripheral SpA and takes an immune-suppressing medicine. His body has a gift for producing something new on a Friday evening, just as the…
Open quiz →Reviewed
HLA-B27, CRP and other famous letters: fact or myth?
Irena audits other people’s accounts for a living, so columns of figures do not frighten her — until her own lab report arrives. Her ankle has been swollen since spring, the CRP…
Open quiz →Reviewed
The fanciest scan doesn’t always win
Leon, a postman in his fifties, walks his whole round on foot, in any weather. His heel hurts where the Achilles tendon attaches, one ankle is swollen, and peripheral SpA is being…
Open quiz →Reviewed
What are we actually aiming at?
Daniel, a barista in his forties, has started a medicine for the persistent synovitis in his ankle. Some weeks in, the ankle is slimmer, the heel still nags, and his sister wants…
Open quiz →Reviewed
Tablets, needles and patience: fact or myth?
Oskar is a baker: up before the birds, on his feet until noon. His knee has been swollen for weeks, his heel objects by the second tray, and the kitchen drawer holds pain…
Open quiz →Reviewed
Evidence, approval, coverage: three different desks
Clara, a court interpreter in her forties, has nonpsoriatic peripheral SpA; NSAIDs have not done enough, and a targeted medicine is now on the table. She came home with three…
Open quiz →Reviewed
A working day on two sore feet
Adam, a hairdresser in his thirties, has peripheral spondyloarthritis: a sore Achilles attachment, a ring finger that swells, and a job done standing up with scissors in hand. His…
Open quiz →Reviewed
What did “better” mean?
Tomasz, a schoolteacher in his fifties, has peripheral spondyloarthritis and inflammatory bowel disease; some months ago he started a medicine chosen in the hope of helping…
Open quiz →Added
Plans change, plans ahead
Eva, a software developer in her early thirties, has peripheral SpA and a treatment that is finally doing its job. The next few years hold a hoped-for baby, a postponed…
Open quiz →Added
The label moved. Did the disease?
Paul, a bus mechanic in his late thirties, keeps a service log for every bus in the depot, each repair dated and explained. His own medical file is less orderly: it starts in a…
Open quiz →Added
When the tests and the pain don’t agree
Rosa, a ward nurse in her fifties, has spent years explaining other people’s results to them. Now her own refuse to agree: her ankle aches after every long shift, the…
Open quiz →Added
Remission, tapering and other words that sound alike: fact or myth?
Gregor conducts a choir. For a good while now his fingers and heels have kept time without complaint, and a question has started humming in the background: does he still need…
Open quiz →Added
What's in a Name? Peripheral, Undifferentiated, Suspected
Three words on a spondyloarthritis (SpA) referral letter answer three different questions.
Open quiz →Added
Joint, Attachment or Whole Toe?
Three peripheral patterns, and why the pattern matters more than where it hurts.
Open quiz →Added
Building the Diagnosis, Clue by Clue
How history, examination, tests and other possible explanations come together in peripheral SpA.
Open quiz →Added
A New Symptom: Can It Wait?
Two questions for every new symptom — and why urgency comes first.
Open quiz →Added
Blood Tests and HLA-B27: What Numbers Can Say
Inflammation, diagnosis or safety? See what each blood test can and cannot tell you.
Open quiz →Added
IBD-associated SpA · Patient quizzes
Gut Feelings
The infection may be over while the knee is still swollen; the bowel may be calm while the back is not. Two conditions where joints keep their own calendar. Bet before the next flare decides for you.
Play →Bowel, joints and spine: how are they connected?
Understand the bowel–joint connection, different symptom timelines and what HLA-B27 can and cannot tell you.
Open quiz →Reviewed
Describing your symptoms: what helps the doctor?
Practise describing stiffness, swelling, back pain and medicine timelines to your care team.
Open quiz →Reviewed
How the diagnosis is made: what can each test show?
Explore what blood tests, stool tests, imaging and joint fluid can show—and their limits.
Open quiz →Reviewed
When is help urgent?
Recognize eye, joint, clot and nerve warning signs and when to seek same-day or emergency care.
Open quiz →Reviewed
Choosing treatment for both the bowel and the joints
Consider movement, pain medicines and coordinated treatment for bowel and musculoskeletal inflammation.
Open quiz →Reviewed
Pain medicines, infections, vaccines and safety tests
Review pain medicines, infection precautions, vaccinations, safety tests and medicine use during pregnancy.
Open quiz →Reviewed
When the bowel and joints respond differently
Consider different bowel and joint responses, persistent pain and reassessment before changing treatment.
Open quiz →Reviewed
Daily life: movement, fatigue, food and work
Explore tailored movement, fatigue, nutrition, low-FODMAP diets and spine safety in daily life.
Open quiz →Reviewed
Different life stages and surgery
Prepare for pregnancy and surgery with coordinated care, and understand joint symptoms after colectomy and pouch symptoms.
Open quiz →Reviewed
Preparing for a shared care visit
Practise setting priorities, describing bowel and joint changes and leaving with a clear shared care plan.
Open quiz →Reviewed
The essentials: bowel, joints and one shared plan
Review the bowel–joint connection, shared care, steroids, pain medicines and individual treatment goals.
Open quiz →Reviewed
Words you will hear at the clinic
Learn the meaning of sacroiliac joints, arthralgia, arthritis, enthesitis and targeted medicines.
Open quiz →Reviewed
Myth or fact? Common beliefs about the bowel and the joints
Check common beliefs about food, supplements, microbiome tests, stopping treatment and the future.
Open quiz →Reviewed
What would you do? Everyday situations
Practise decisions about infection, travel, movement, work and symptoms in a young person with IBD.
Open quiz →Reviewed
Medicines: which problem does each one treat?
Match treatment to bowel, peripheral joint and spinal disease, and review injections, JAK inhibitors and dual targeted therapy.
Open quiz →Reviewed
What Each Test and Medicine Is For
Seven situations about blood and stool tests, persistent pain and medicines that treat the bowel, joints or spine.
Open quiz →Reviewed
Safe Between Visits
Seven situations about urgent symptoms, pain medicines, infections, vaccines, pregnancy planning and surgery.
Open quiz →Reviewed
Early autoimmunity / UCTD
A Diagnosis Without a Name Yet
The letter says “undifferentiated connective tissue disease”. You have a year ahead and ten decisions to make. Some choices help. Some feel sensible at 2 a.m. and make the year harder. In every scene you keep choosing until you find the move that works.
Open the story →Added
Early autoimmunity / UCTD
Everyone Has an Opinion About Your ANA
You have a positive ANA and a diagnosis called UCTD. Within a week, ten advisers have appeared. None of them went to medical school. All of them are certain. Your job is to survive their advice with your sense of humor and your plan intact.
Open the story →Added
Early autoimmunity / UCTD
The Leaflet and Other Horror Stories
Your doctor has suggested a medicine for your UCTD. The box contains thirty tablets and one leaflet. The leaflet unfolds to the size of a tablecloth and has been written by people who have imagined everything. Eight episodes follow. In each of them, fear has a suggestion, and you have a better one.
Open the story →Added
Early autoimmunity / UCTD
Your Body Has Sent You 8 Notifications
Since the diagnosis, your body has started sending notifications. All of them arrive marked urgent. Most of them are a knee. Your task is to tell which ones you can swipe away, which ones go on the list for your doctor, and which one means you stop reading and call for help.
Open the story →Added
Early autoimmunity / UCTD
Your Lab Report Would Like a Word
You open your results. Eight tests are waiting, and each one has a personality. Some want attention. Some are hiding at the back. One is fourteen pages long. Your task is to find out what each of them can actually tell you, and what it only claims to.
Open the story →Added
Early autoimmunity / UCTD
Your Fingers Have Opinions About the Weather
Your fingers have started changing colour in the cold. They do it without warning, in public, and with a strong sense of theatre. This is Raynaud’s. Eight winter episodes follow. In each of them your fingers are dramatic and you are asked to be sensible.
Open the story →Added
Early autoimmunity / UCTD
The Scan Will See You Now
Your joints hurt, your antibodies are positive, and somebody has mentioned imaging. You would like a scan. Any scan. Ideally a large one. Eight scenes follow, featuring an ultrasound, an MRI, an X-ray and a radiology report written in a language that only resembles English.
Open the story →Added
Early autoimmunity / UCTD
Rheumatologist to Human: A Pocket Dictionary
Your doctor speaks fluent Rheumatologist. You speak Human. The visit lasted twenty minutes and you came home with eight words you did not understand, three of which sounded like bad news. This dictionary translates them. In each entry, choose the meaning. The wrong ones are what most of us hear the first time.
Open the story →Added
Reactive Arthritis: What the Name Means
A gentle first look at joint inflammation that follows an infection—with a round of fact or myth.
Open quiz →Reviewed
The Infection Is Over. Why Do My Joints Hurt?
The infection and the inflammation do not always follow the same clock
Open quiz →Reviewed
Where Reactive Arthritis Shows Up
Knee, heel, toe, lower back: learn to connect a symptom with the part of the body it comes from.
Open quiz →Reviewed
Beyond the Joints: Eyes, Skin and More
Reactive arthritis can show up in the eyes, skin, mouth and urinary tract — and some signs should not wait.
Open quiz →Reviewed
Putting the Clues Together
How doctors recognize reactive arthritis when no single test can prove it.
Open quiz →Reviewed
Do I Need Antibiotics?
Treating an infection and calming the joints are two related but separate jobs.
Open quiz →Reviewed
Calming a Hot, Swollen Joint
Reactive arthritis: what treatment for pain and inflammation is meant to do — and what pain relief alone cannot tell you.
Open quiz →Reviewed
When the Arthritis Lingers
A longer course of reactive arthritis: what it means and what a careful second look involves.
Open quiz →Reviewed
Moving Again, Step by Step
Walking, work and exercise while a reactive arthritis flare settles
Open quiz →Reviewed
Reactive Arthritis: Recovery and What Comes Next
How recovery is judged, why symptoms can return, and what follow-up visits are for.
Open quiz →Reviewed
The Gene Marker on Your Test Report
Reactive arthritis: what an HLA-B27 result can tell you and your doctor — and what it cannot.
Open quiz →Reviewed
Gut Germs and a Safer Kitchen
Reactive arthritis: the gut bacteria that can set it off, and everyday food and water habits that lower the risk.
Open quiz →Reviewed
Why Is the Joint Doctor Asking That?
Reactive arthritis: why sexual health is part of the history, what testing involves, and what a result can and cannot tell you.
Open quiz →Reviewed
One Hot Joint: Look-Alikes and the Fluid Test
Reactive arthritis, an infected joint, gout or an injury can look alike — and what having joint fluid taken is really like.
Open quiz →Reviewed
Two Kinds of Red Eye
Reactive arthritis: conjunctivitis versus inflammation inside the eye (anterior uveitis), and how each is checked and treated.
Open quiz →Reviewed
When the Heel Is the Sore Spot
Reactive arthritis: pain where a tendon meets the heel bone — how it feels, how it is checked and how to care for it day to day.
Open quiz →Reviewed
When the Back Joins In
Reactive arthritis: low back and buttock pain, the sacroiliac joints and the spine — clues, scans and what helps.
Open quiz →Reviewed
Making a Short Visit Count
Reactive arthritis: what to write down, what to bring and what to take home from your appointment.
Open quiz →Reviewed
Sulfasalazine and Methotrexate: Everyday Safety
Reactive arthritis that lasts: what living with a disease-modifying medicine involves — schedules, blood tests, what to report.
Open quiz →Reviewed
One Family, Different Members
How reactive arthritis relates to its relatives in the spondyloarthritis family — and how it differs from rheumatoid arthritis.
Open quiz →Reviewed
Skin, Nails and Mouth: Reading the Clues
Scaly patches on the soles and a crumbling nail in reactive arthritis: what they are, what they are not, and how they are looked after.
Open quiz →Reviewed
Reading Your Blood Test Report
What the common blood tests ordered in reactive arthritis can show — and what they cannot.
Open quiz →Reviewed
X-ray, Ultrasound or MRI: Which Picture, Which Question?
What each kind of scan can and cannot show in reactive arthritis — and how to get ready for one.
Open quiz →Reviewed
Worn Out, Not Weak: Tiredness, Sleep and Mood
Why reactive arthritis drains energy, how pain and sleep feed each other, and when mood deserves a mention.
Open quiz →Reviewed
Back to Work, Stairs and the Road
Everyday life while the joints recover from reactive arthritis: work adjustments, a cane, stairs, driving and long trips.
Open quiz →Reviewed
A Steroid Injection Into the Joint: What to Expect
What is in the syringe, how the first days usually go, and which signs after a glucocorticoid (“steroid”) joint injection need attention.
Open quiz →Reviewed
Anti-Inflammatory Pain Medicines, Used Wisely
NSAIDs up close: food, stomach protection, blood pressure, and why the labels of cold remedies matter.
Open quiz →Reviewed
A Biologic Medicine: Before the First Dose
What a TNF inhibitor is, when it is discussed in long-lasting reactive arthritis, and what starting one involves.
Open quiz →Reviewed
Less Common Triggers and Look-Alikes
Beyond the classic germs: what else is linked with reactive arthritis, how firm the evidence is, and what only looks like it.
Open quiz →Reviewed
Helping Someone You Love Through Reactive Arthritis
For partners and family: how much to do, what to say, and how to stay close without wearing yourself out.
Open quiz →Reviewed
The Telling Detail
Three short stories. Discover which details help your doctor understand what is happening.
Говорящая деталь
Три короткие истории. Узнайте, какие детали помогают врачу понять, что с вами происходит.
El detalle que lo dice todo
Tres historias breves. Descubra qué detalles ayudan a su médico a entender lo que le ocurre.
Wymowny szczegół
Trzy krótkie historie. Odkryj, które szczegóły pomagają lekarzowi zrozumieć, co Ci dolega.
Reviewed
The Fifteen-Minute Visit
Find the important details, leave time for the rest of the visit, and prepare your own printable notes.
Визит на пятнадцать минут
Найдите важные подробности, оставьте время для остальных задач приёма и составьте личную памятку.
La consulta de quince minutos
Encuentre los detalles importantes, deje tiempo para el resto de la consulta y prepare sus propias notas para imprimir.
Wizyta na piętnaście minut
Znajdź ważne szczegóły, zostaw czas na resztę wizyty i przygotuj własne notatki do wydruku.
Reviewed
The Visit Starts at Home
Prepare your medicines, results and questions; agree on priorities and leave with a clear plan.
Визит начинается дома
Подготовьте список лекарств, результаты и вопросы; согласуйте приоритеты и уточните план перед уходом.
La consulta empieza en casa
Prepare sus medicamentos, resultados y preguntas; acuerde prioridades y salga con un plan claro.
Wizyta zaczyna się w domu
Przygotuj listę leków, wyniki i pytania; uzgodnij priorytety i wyjdź z jasnym planem.
Reviewed
Two Tuesdays
See how preparing a few details leaves more time for examination, explanations and your questions.
Два вторника
Посмотрите, как подготовка оставляет больше времени на осмотр, объяснения и ваши вопросы.
Dos martes
Vea cómo preparar algunos datos deja más tiempo para el examen, las explicaciones y sus preguntas.
Dwa wtorki
Zobacz, jak przygotowanie informacji pozostawia więcej czasu na badanie, wyjaśnienia i Twoje pytania.
Reviewed
Will This Plan Work on Monday?
Help Maya explain what gets in the way and agree on a plan for real life.
План сработает в понедельник?
Помогите Мае рассказать о препятствиях и согласовать выполнимый план.
¿Funcionará este plan el lunes?
Ayude a Maya a explicar sus dificultades y acordar un plan para la vida real.
Czy ten plan sprawdzi się w poniedziałek?
Pomóż Mai opowiedzieć o przeszkodach i uzgodnić plan możliwy do wykonania.
Reviewed
Learn through quizzes
Choose quizzes about Sjögren’s disease, gout or CPPD, then follow the links to reading. Free after registration; the first five Sjögren’s demos are open to everyone.
Choose a quiz →Учиться через квизы
Выберите квизы о болезни Шёгрена, подагре или CPPD, затем переходите к чтению. Бесплатно после регистрации; первые пять демоквизов о болезни Шёгрена открыты всем.
Выбрать квиз →Aprender con quizzes
Elija quizzes sobre Sjögren, gota o CPPD y siga los enlaces para leer más. Gratis tras registrarse; las primeras cinco demos de Sjögren están abiertas a todos.
Elegir un quiz →Ucz się przez quizy
Wybierz quizy o chorobie Sjögrena, dnie moczanowej lub CPPD, a następnie przejdź do lektury. Bezpłatnie po rejestracji; pierwsze pięć quizów demo o Sjögrenie jest otwartych dla wszystkich.
Wybierz quiz →Reviewed
A Message That Helps the Clinic Answer
A short interactive guide to preparing a clear message for your clinic.
Open the module →Сообщение, на которое клиника сможет ответить
Короткий интерактивный модуль о том, как подготовить понятное сообщение для клиники.
Открыть модуль →Un mensaje que ayuda a la clínica a responder
Una breve guía interactiva para preparar un mensaje claro para su clínica.
Abrir el módulo →Wiadomość, która ułatwia klinice udzielenie odpowiedzi
Krótki moduł interaktywny o przygotowaniu jasnej wiadomości do kliniki.
Otwórz moduł →Reviewed
Heart & Vessels: patient cases
Browse the interactive patient case collection.
Explore patient cases →Сердце и сосуды: случаи для пациентов
Откройте подборку интерактивных случаев для пациентов.
Открыть случаи для пациентов →Corazón y vasos: casos para pacientes
Explore la colección interactiva de casos para pacientes.
Ver casos para pacientes →Serce i naczynia: przypadki dla pacjentów
Otwórz interaktywną kolekcję przypadków dla pacjentów.
Zobacz przypadki dla pacjentów →Reviewed
Medication Guides
Find a medicine already prescribed, check preparation and storage for its form, explore tolerability and important combinations, and print a guide.
Open medication guides →Памятки по лекарствам
Найдите назначенный препарат, проверьте подготовку и хранение конкретной формы, разберите переносимость и важные сочетания, распечатайте памятку.
Открыть памятки →Guías de medicamentos
Busque un medicamento ya recetado, revise la preparación y conservación de su presentación, explore la tolerabilidad y las combinaciones importantes e imprima una guía.
Abrir las guías →Przewodniki po lekach
Znajdź przepisany lek, sprawdź przygotowanie i przechowywanie wybranej postaci, informacje o tolerancji i ważnych połączeniach oraz wydrukuj poradnik.
Otwórz przewodniki →Reviewed
Symptoms & visit planning
Joint symptoms, changes over time, a positive ANA, back pain and questions for your appointment.
Open toolScleroderma visit planner
Organize changes, daily difficulties and priorities in a printable worksheet for your next visit.
Open toolReviewed
Symptoms, activity & the next step
Explore pain, fatigue, upright symptoms and activity-related changes; prepare a timeline for the clinical conversation.
Open toolReviewed
Explore an interactive story.
Follow fictional teaching scenarios in English, Russian, Spanish or Polish.
Sjögren’s disease · Interactive Journeys · Patient stories
Interactive Journeys · Patient stories
First Year with Sjögren's: Marta
Marta is 47, teaches piano in a flat with excellent radiators and lives with Ferdinand, a large ginger cat who believes the piano is a heated bed. Her eyes have felt gritty since autumn and her mouth is dry enough that scales now come with a glass of water. She blames the heating. The heating has no comment.
Open story →Interactive Journeys · Patient stories
First Year with Sjögren's: Daniel
Daniel is 58, a bus mechanic who has fixed everything that ever broke in the depot and does not see why his own body should be different. His eyes sting in the workshop, and for a few weeks the left side of his jaw has been puffy. He lives with Rocket, a dog of no fixed breed and great enthusiasm, who treats every arrival at the door as the event of the century.
Open story →Interactive Journeys · Patient stories
First Year with Sjögren's: Ewa
Ewa is 33, a nurse on a surgical ward, and she and her partner Jan have decided this is the year to try for a baby. Her fingers ache in the mornings, the night shifts leave her flattened for two days, and her eyes feel like they have been open since the previous decade. The flat is supervised by Mochi, a small grey cat who sleeps on whichever document is most important.
Open story →Interactive Journeys · Patient stories
A Week with Sjögren's: Greta
Greta is 41, a video editor, and this week a documentary about lighthouses is due on Friday. She was diagnosed with Sjögren's two years ago; her eyes are the loudest part of it, her mouth a close second. She works at two large screens with a desk fan, a bottle of eye drops and Pixel, a small grey dog who believes every deadline is a walk postponed.
Open story →Interactive Journeys · Patient stories
A Week with Sjögren's: Bruno
Bruno is 62, a retired postman with a Sjögren's diagnosis that is four years old and, until now, mostly about a dry mouth and a drawer of lozenges. He walks six kilometres a day out of habit, reads a patient forum out of curiosity, and lives with his wife Ilse and Admiral, an African grey parrot who repeats whatever was said most recently and most loudly, which this week will be a problem.
Open story →Interactive Journeys · Patient stories
A Week with Sjögren's: Lucía
Lucía is 36, a flight attendant on long-haul routes, and this week she flies a six-day rotation through three time zones. Her Sjögren's was diagnosed last year; it lives mostly in her eyes and mouth, with a fatigue that arrives a day after it was invited. She packs light, except for the eye drops. At home, her cat Ñu — pronounced 'nyoo', named for a wildebeest and built like one — supervises the suitcase and attempts to board it.
Open story →Interactive Journeys · Patient stories
Stable but Not Well: Irene
Irene is 50, a librarian, and knows where everything is — except her own energy. Her Sjögren’s was diagnosed three years ago; her joints are quiet, her blood tests are polite, and her rheumatologist uses the word “stable”. Irene is exhausted, achy and foggy by two in the afternoon. Her beagle Dewey sleeps sixteen hours a day and has never once been called stable.
Open story →Interactive Journeys · Patient stories
Stable but Not Well: Olev
Olev is 64, a retired teacher, and has had Sjögren’s for twenty years. His disease is quiet: no joint swelling, no organ trouble, blood tests his rheumatologist calls boring. But twenty years of dry mouth have cost him eleven teeth, his salivary glands have little left, and his eyes sting no matter how many drops he puts in. His old dog Kalev is fourteen, drools generously, and has never understood why Olev is jealous.
Open story →Interactive Journeys · Patient stories
Stable but Not Well: Sanne
Sanne is 38, an architect, mother of four-year-old twins, and — according to everyone — looks great. Her Sjögren’s was diagnosed two years ago; her blood tests are quiet and her rheumatologist is pleased. Sanne is running on fumes, cannot hold a floor plan in her head past three o’clock, and is quietly furious that nobody can see it. Her partner Theo tries. Her cat Bisou does not try, and is the only one in the house who is never asked how she is.
Open story →Rheumatoid arthritis · Interactive Journeys · Patient stories
Interactive Journeys · Patient stories
First Year with RA: Vera
An interactive patient story about the first year with rheumatoid arthritis. Make decisions, see their consequences and learn alongside Vera.
Open story →Interactive Journeys · Patient stories
First Year with RA: Tomas
An interactive patient story about the first year with rheumatoid arthritis. Make decisions, see their consequences and learn alongside Tomas.
Open story →Interactive Journeys · Patient stories
First Year with RA: Mira
An interactive patient story about the first year with rheumatoid arthritis. Make decisions, see their consequences and learn alongside Mira.
Open story →Interactive Journeys · Patient stories
A Week with RA: Rita’s Flare
A Week with RA: Rita’s Flare. Seven days with rheumatoid arthritis: seven decisions, consequences and explanations.
Open story →Interactive Journeys · Patient stories
A Week with RA: Daniel’s First Week
A Week with RA: Daniel’s First Week. Seven days with rheumatoid arthritis: seven decisions, consequences and explanations.
Open story →Interactive Journeys · Patient stories
A Week with RA: Halina’s Week
A Week with RA: Halina’s Week. Seven days with rheumatoid arthritis: seven decisions, consequences and explanations.
Open story →Interactive Journeys · Patient stories
Remission but Not Well: Viktor
Remission but Not Well: Viktor. Rheumatoid arthritis in remission, but still not feeling well: seven decisions, consequences and explanations.
Open story →Interactive Journeys · Patient stories
Remission but Not Well: Lena
Remission but Not Well: Lena. Rheumatoid arthritis in remission, but still not feeling well: seven decisions, consequences and explanations.
Open story →Interactive Journeys · Patient stories
Remission but Not Well: Nadia
Remission but Not Well: Nadia. Rheumatoid arthritis in remission, but still not feeling well: seven decisions, consequences and explanations.
Open story →Osteoarthritis · Interactive Journeys · Patient stories
Interactive Journeys · Patient stories
First Year with Osteoarthritis: Wojtek
Wojtek is 61. For thirty years he kept the city's buses running; now he keeps a vegetable plot running, which he says is harder because tomatoes do not come with a service manual. His right knee has started to complain. So has Sadza, a black mongrel who considers every slow walk a personal insult.
Open story →Interactive Journeys · Patient stories
First Year with Osteoarthritis: Dolores
Dolores is 58 and has been a seamstress since she was sixteen. Her hands have hemmed wedding dresses, school uniforms and one regrettable set of curtains. Lately the finger joints have grown knobbly and ache by evening, and the scissors have begun to feel heavier than they are. Her cat Hilo sleeps on whatever she is trying to sew, which is at least consistent.
Open story →Interactive Journeys · Patient stories
First Year with Osteoarthritis: Kazimierz
Kazimierz is 67, a retired postmaster who still sorts the household mail by size. His lower back has ached for a year and his neck has lately joined in. He has no pet; he has Zofia, his wife of forty years, who reads every medical report aloud at the breakfast table, in full, with emphasis, whether or not anyone asked.
Open story →Interactive Journeys · Patient stories
A Week with Osteoarthritis: Lidia
Lidia is 64, a retired geography teacher, and lives on the fourth floor of a building whose lift exists only in the architect's drawings. Her right knee has osteoarthritis; her dog Pirat, a one-eyed terrier with the manners of a harbour master, does not. Between them they climb the stairs several times a day, and this is the story of one such week.
Open story →Interactive Journeys · Patient stories
A Week with Osteoarthritis: Piet
Piet is 55 and has made cabinets for thirty-one years in a workshop that smells of oak and coffee. Two years ago his hands were given a diagnosis — osteoarthritis of the finger joints and the base of the right thumb — and the workshop acquired a cat, Schroef, who sleeps in the sawdust bin and audits every dovetail. One week in that workshop, seven decisions, follows.
Open story →Interactive Journeys · Patient stories
A Week with Osteoarthritis: Marisol
Marisol is 59 and has guided coach tours for twenty-two years — cathedrals, old towns, the occasional volcano. Her left hip and the base of her right big toe have osteoarthritis, which she mentions to nobody on the tour. At home she has a tortoise, Galápago, who is thirty-four and has never hurried anywhere, and who she claims as her role model. This week: a six-day tour, fourteen passengers, one hip, one toe.
Open story →Interactive Journeys · Patient stories
The X-ray Says One Thing: Gunnar
Gunnar is seventy, a retired ferry captain who still walks the harbour wall every morning with Kompass, an elderly spaniel who stops at every bollard as if checking the moorings. Gunnar's right knee has clicked for a decade and complains on stairs, but it gets him round the harbour without a fuss. Then a radiology report arrives with the phrase "bone on bone" in it, and suddenly everyone has an opinion about his knee except the knee.
Open story →Interactive Journeys · Patient stories
The X-ray Says One Thing: Rosalind
Rosalind is fifty-two and has run a salon for twenty-six years, which means her right arm has spent most of its adult life above shoulder height holding scissors. At home she is supervised by Scissors, an African grey parrot who has learned the sound of the hairdryer and the phrase "just a trim". For four months her shoulder has hurt when she lifts the arm. The X-ray came back "fine". The shoulder did not get the memo.
Open story →Interactive Journeys · Patient stories
The X-ray Says One Thing: Benedikt
Benedikt is sixty-six and tunes pianos, which is a job done with the fingers, the ears and the neck, in that order of importance and the reverse order of complaint. His hands have had osteoarthritis for ten years and his neck has had opinions for longer. The household is completed by Arpeggio, a tabby who sits on whichever piano is being tuned and corrects the temperament. For a decade the same routine kept everything workable: the splint, the gel, the morning stretch, the evening tablet. This year it stopped.
Open story →IBD-associated spondyloarthritis · Interactive Journeys · Patient stories
Interactive Journeys · Patient stories
First Year with IBD-SpA: Ruben
Ruben is 31, a sous-chef, and has lived with Crohn’s disease for six years. He knows his bowel the way he knows his knives. What he does not know yet is why his right knee has started to puff up and his left heel bites with the first steps of the morning. At home, Paprika, a red dog of uncertain breed and firm opinions, has noticed that the evening walk has become shorter.
Open story →Interactive Journeys · Patient stories
First Year with IBD-SpA: Agnieszka
Agnieszka is 44 and keeps the books for three small companies and one large family. For years her lower back has woken her around four in the morning; she blamed the office chair, then the mattress, then her age. This spring the diarrhoea turned bloody, and a colonoscopy produced two words she had never expected to own: ulcerative colitis. Her cat, Figa, grey and judgemental, sleeps on the exact spot of the back that hurts.
Open story →Interactive Journeys · Patient stories
First Year with IBD-SpA: Samir
Samir is 26, a nursing student, and has had Crohn’s disease since he was fifteen — long enough to have had a stretch of bowel removed last winter. His girlfriend Nour has a stronger stomach than he does and a weaker tolerance for forums. His younger brother Karim owns a symptom-checker app and has, over the years, diagnosed Samir with everything from scurvy to a rare tropical fungus. Karim is nineteen and has never been wrong, according to Karim.
Open story →Interactive Journeys · Patient stories
A Week with IBD-SpA: Ingrid
Ingrid is 39, a dental hygienist, and the owner of a large, opinionated dog called Moose. Three years ago it was ulcerative colitis; last spring a rheumatologist added axial spondyloarthritis to the list. She now has two specialists, two portals, two sets of advice and one back that wakes her at four in the morning. This week both doctors are on the calendar: the gastroenterologist on Monday, the rheumatologist on Thursday.
Open story →Interactive Journeys · Patient stories
A Week with IBD-SpA: Dmitri
Dmitri is 48 and drives the number 14 bus, a route he knows better than his own kitchen. Crohn's disease arrived in his thirties; the peripheral arthritis, mostly knees and ankles, came a few years later and was given the name IBD-associated SpA. He takes a biologic from the gastroenterologist, has a half-used box of prednisone from a flare last winter, and shares a flat with a grey cat called Marshal, who outranks him. This week is not going to be a quiet one.
Open story →Interactive Journeys · Patient stories
A Week with IBD-SpA: Chiara
Chiara is 33 and teaches pastry at a cookery school, which means she spends her working life surrounded by butter, sugar and people who ask whether she is 'allowed' to eat any of it. Crohn's disease was diagnosed at 26; the spondyloarthritis, a stiff lower back and a heel that complains on the first steps of the morning, was named two years ago. Her treatment comes from a gastroenterologist and a rheumatologist who, she suspects, have never met. At home a green parrot called Basilico repeats the word 'gluten' at inappropriate moments, having learned it from her sister.
Open story →Interactive Journeys · Patient stories
Two Organs, One Plan: Helga
Helga is 55 and runs a flower shop with a view of the tram stop. Her Crohn's disease has been in remission on a biologic for years; she barely thinks about it. What she thinks about now is her spine, which no longer bends over the workbench, and a hip that complains on the way up the stairs. The shop cat, Pelargonia, supervises from the ribbon drawer.
Open story →Interactive Journeys · Patient stories
Two Organs, One Plan: Elias
Elias is 36 and picks orders in a warehouse the size of a village. He has ulcerative colitis and IBD-associated spondyloarthritis. The joints have been quiet for a year on a biologic — he can lift, bend and climb the picking ladder. The bowel, however, has started to talk again: more urgency, more blood. His dog Hugo, a beagle of strong opinions, has taken to waiting outside the bathroom door.
Open story →Interactive Journeys · Patient stories
Two Organs, One Plan: Noa
Noa is 42 and teaches history to teenagers who would rather be anywhere else. She has Crohn's disease and axial spondyloarthritis, and by every measure both are controlled: calprotectin normal, scope clean, MRI quiet, CRP flat. She is also so tired that she has started grading papers lying on the floor. Her partner Ravi worries aloud; the tortoise, Pavlova, worries about nothing and moves at roughly Noa's speed.
Open story →Ankylosing spondylitis · Interactive Journeys · Patient stories
Interactive Journeys · Patient stories
First Year with AS: Jonas
Jonas is 29, runs the night shift at a parcel warehouse and shares a one-bedroom flat with Taco, a dog of uncertain breed and very certain opinions about the postman. For about six years his lower back has been "bad": worst at four in the morning, better once he is moving, and labelled posture by everyone who has ever looked at it for thirty seconds. This is the year that label gets replaced.
Open story →Interactive Journeys · Patient stories
First Year with AS: Hanna
Hanna is 38, teaches a class of seven-year-olds, and lives with two cats, Pixel, who sits on whatever she is reading, and Vector, who sits on Pixel. Her back has hurt since she was 23. It has been blamed, over fifteen years, on two pregnancies, a bad chair, stress, "being a teacher", and most recently her left hip, which now hurts too. Last week a blood test came back HLA-B27 positive and she pasted it into a forum at midnight. This is the year the fifteen-year-old question gets an answer.
Open story →Interactive Journeys · Patient stories
First Year with AS: Mateo
Mateo is 24, halfway through a master's in hydrology, and rides a bicycle up hills for pleasure, which his grandmother Pilar regards as a symptom in itself. Two years of back pain that woke him before dawn, one painful heel, and an X-ray later, he has a diagnosis: radiographic axial spondyloarthritis, the thing his search engine calls ankylosing spondylitis. He has already decided what he wants: the strongest drug, today. Pilar has already decided it was the bicycle.
Open story →Interactive Journeys · Patient stories
A Week with AS: Priya
Priya is 34, writes software for a logistics company and was told two years ago that her back pain had a name: radiographic axial spondyloarthritis, the condition her grandmother's doctors called ankylosing spondylitis. She takes naproxen when things are bad, owns a standing desk she is slightly afraid of, and shares a flat with Biscotti, a beagle who believes every walk is a rescue mission.
Open story →Interactive Journeys · Patient stories
A Week with AS: Karl
Karl is 52, drives a lorry between the coast and the capital, and has had ankylosing spondylitis, which his newest letters call radiographic axial spondyloarthritis, since his thirties. For a year and a half a TNF-inhibitor injection every two weeks has kept it quiet enough that he stopped thinking about it. He lives with Diesel, a fourteen-year-old cat who disapproves of early starts and has never once been late for a meal.
Open story →Interactive Journeys · Patient stories
A Week with AS: Amara
Amara is 41, a hospital pharmacist who can recite an interaction table from memory and has not read her own patient leaflet since 2019. Her ankylosing spondylitis, radiographic axial spondyloarthritis on the newer paperwork, has been quiet for two years on an IL-17 inhibitor; she takes naproxen now and then. She shares a flat with Mango, a green parrot with a vocabulary of forty words, most of them unsuitable for a pharmacy.
Open story →Interactive Journeys · Patient stories
Quiet Disease, Loud Life: Beata
Beata is 46, a nurse manager on a surgical ward, and has had radiographic axial spondyloarthritis for eleven years, three of them on a biologic. Her ASDAS has sat in the low range for a year and her CRP is normal. She is also tired by Wednesday, stiff by the end of every shift and sore in a way she has stopped mentioning, because the numbers are fine. At home, a tortoise named Hektor moves at exactly the pace she would like to.
Open story →Interactive Journeys · Patient stories
Quiet Disease, Loud Life: Tadeusz
Tadeusz is 63, a retired railway engineer who still times trains from his balcony out of habit. He has lived with ankylosing spondylitis — radiographic axial spondyloarthritis, as his newer letters call it — for nearly forty years. Several spinal segments are fused, his posture is fixed in a forward stoop, and for the past four years a biologic has kept the inflammation quiet. What is not quiet: a mechanical ache most days, a neck that no longer turns, and a fear of falling that has started to decide where he goes. His cat, Lokomotywa, has no fear of anything and sleeps on the stairs.
Open story →Interactive Journeys · Patient stories
Quiet Disease, Loud Life: Yusuf
Yusuf is 35, head chef at a forty-cover restaurant, and six weeks into being a father. He was diagnosed with radiographic axial spondyloarthritis at 27; a TNF inhibitor has kept his inflammation controlled for five years, his CRP is normal, his spine looks fine from the outside and he moves like a man with nothing wrong. He is also so tired that he once fell asleep standing at the pass. Everyone — his father, his sous-chef, strangers — tells him he looks great. His partner Leyla is the only one who has stopped saying it. The restaurant's resident cat, Zeytin, sleeps on the flour sacks and judges nobody.
Open story →One test. Three stories.
Follow three fictional people with the same positive ANA result and explore how the rest of the picture changes its meaning.
Explore the storyReviewed
What does imaging add?
Explore how ultrasound and MRI fit into the clinical picture when an autoimmune diagnosis is still uncertain.
Explore the storyReviewed
Observation is a plan
Work through follow-up, changing findings and questions to revisit when a diagnosis is not yet clear.
Explore the storyReviewed
Clinical calculators.
Published criteria with interactive scoring and clinical interpretation.
SLE Classification Explorer
2019 EULAR/ACR SLE classification with ANA entry, domain weighting and explicit handling of incomplete findings.
Open toolReviewed
Sjögren Classification Explorer
2016 ACR/EULAR primary Sjögren classification with inclusion routes, exclusions, weighted findings and an explanatory summary.
Open toolReviewed
Vasculitis Classification Suite
2022 ACR/EULAR classification tools for GPA, MPA, EGPA, GCA and Takayasu arteritis, with prerequisites and incomplete-data handling.
Open toolReviewed
Spondyloarthritis — Classification Explorer
Explore the SpA family, criteria entry conditions, seven live checkers, sacroiliitis grading and the historical timeline.
Open toolReviewed
Fibromyalgia criteria calculator
Map painful areas, calculate WPI and SSS, check the 2016 criteria and copy a clinical summary.
Open calculatorReviewed
Clinical decision worksheets.
Original frameworks by Olga Goodman, MD · For professional use.
TIMER · RA therapy after cancer
Structure the reasoning for b/tsDMARD treatment or bounded deferral, identify uncertainty, and generate a dated decision record.
Proposed framework · Not externally validated.
Open TIMERReviewed
Imaging & simulations.
A shared imaging calculator and professional educational resources across RheumaView.
AnnaMaria · CAR-T mechanism
Animated CD19 biology, a fictional SLE case, simulated data and a comprehension quiz.
Start interactive activityReviewed
Carmen · Refractory SLE
A three-stage clinical reasoning simulation: preferences, facts and scenario-specific strategy ranking.
Start interactive activityReviewed
Dose & Perspective
Compare estimated radiation exposure from imaging and place the numbers in context.
Open calculatorReviewed
Crucible™
Physician-authored diagnostic challenges and public demonstrations of clinical reasoning.
Explore resourceCASCADE™
Explore oral IL-23 receptor blockade, interpret real trial evidence and apply clinical reasoning in George’s case.
Open CASCADEReviewed
Medical simulators
Explore the clinical simulation platform, public previews and options for configured educational programs.
Explore resourceShort reasoning & conversation exercises · English
For everyone
All visitors · Thinking challenge · About 1 minute · Open
Observation or explanation?
A hypothetical example: “I changed two things this week and felt better.” What can you conclude from that statement alone?
1. The first change caused the improvement.
That is one possible explanation, but the statement alone does not establish it. The second change, other factors, or ordinary variation might also explain what happened.
2. Improvement occurred; its cause is not established.
Best answer. The observation is that the person felt better. Deciding why requires more information. Separating what happened from our explanation is a useful habit when reading health claims.
3. Both changes were necessary.
The statement does not show that either change was necessary, or that both were. Several explanations remain possible.
For patients & caregivers
Patients & caregivers · Conversation builder · About 2 minutes · Open
Turn a concern into a useful question
Choose a concern below. Use the suggested questions as a starting point for your next conversation with your clinician.
I want to understand a test result.
“What does this result mean in my situation? What can it tell us—and what can it not tell us? Would it change the next step?”
I want to understand a treatment choice.
“What are the options? What benefits and downsides matter most in my situation? How will we know whether the plan is helping?”
I am unsure what happens next.
“What is the next step? When should we review the plan? What changes should prompt me to contact the team, and how should I do that?”
Before your appointment, choose your most important concern and bring your questions. If an explanation is unclear, ask the clinician to explain it again in another way.
Across specialties · Professional cases
Clinical Challenge
Weekly interactive cases, the archive and moderated professional discussion.
Open the current case & archive →SpA learning games · Open demos
Original professional learning games across the spondyloarthritis family. Open without registration.
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