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Clinicopathologic conferences in Arthritis Care & Research.

This year, several issues of Arthritis Care & Research have included a clinicopathologic conference. Such publications, known in the professional vernacular as CPCs, are a time-honored approach to the teaching of medicine. CPCs were made famous by their appearance in The New England Journal of Medicine, beginning in 1923 and continuing to the present (1). However, the tradition of CPCs dates back even further; such exercises were proposed first in 1900 by Walter B. Cannon, then a Harvard medical student and later a renowned physiologist (2). During the first years of the 20th century, CPCs were honed to a high art through the teaching of Dr. Richard C. Cabot, an internist at the Massachusetts General Hospital (3) (Figure 1). Long after Cabot died in 1939, the weekly CPC exercises at the Massachusetts General Hospital were termed “Cabot Rounds.” Rheumatic diseases lend themselves well to presentation in CPC formats. This is demonstrated in part by the frequency with which rheumatologic diagnoses comprise “the answer” in The New England Journal of Medicine cases. Yet CPCs have never been a consistent feature of rheumatology journals. We hope that the regular addition of a CPC to Arthritis Care & Research will serve as a compelling avenue for the description of clinical challenges and scholarly writing about patients. All CPCs published in Arthritis Care & Research will be peer-reviewed by experts on the disease in question. Arthritis Care & Research CPCs will be modeled on those in The New England Journal of Medicine in many respects. There is one exception: the “Discussant” in Arthritis Care & Research CPCs—who remains “in the dark” until the revelation of the diagnosis—will be the reader. The diagnosis might be derived by a variety of methods: by the classic CPC conclusion, an autopsy; by a revealing biopsy of an involved organ; through specialized or routine laboratory investigations or genetic analyses; on the strength of radiologic findings; or simply by careful history taking or a meticulous physical examination. In addition to discussions that emphasize the thought process underpinning the correct diagnosis, we will also consider for publication cases in which the diagnosis is straightforward but the more difficult clinical questions relate to management. We anticipate that multidisciplinary expertise will be a hallmark of many CPCs published in Arthritis Care & Research. Whenever possible, the CPCs will emphasize new ideas in medical science that shed light upon the approach to diagnosis, disease management, or an emerging aspect of pathophysiology. We welcome queries about John H. Stone, MD, MPH: Boston, Massachusetts. Address correspondence to John H. Stone, MD, 55 Fruit Street, Boston, Massachusetts. E-mail: jhstone@partners.org. Submitted for publication May 29, 2008; accepted June 20, 2008. Figure 1. Dr. Richard C. Cabot in front of the Bulfinch Building (Massachusetts General Hospital archives). Arthritis & Rheumatism (Arthritis Care & Research) Vol. 59, No. 11, November 15, 2008, 1538–1539 DOI 10.1002/art.24192 © 2008, American College of Rheumatology