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Robert W Ike

University of Michigan, Internal Medicine, Faculty Member

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Dr. Ike was raised by a Michigan GM family, finishing his teens in Vicksburg, a little farming community where they knew how to have a good time. His big brain carried him though UofM Honors College, Microbiology Grad School, the University of Chicago Pritzker School of Medicine, Barnes Hospital, and finally a rheumatology fellowship back at UofM where he was offerred a job, with the express mission of developing arthrocopy as a tool for the rheumatologist. This consumed his early years and he developed a taste for "certain technical procedures appropriate to our specialty", becoming the go-to guy for difficult arthrocenteses, joint washout, ultrasound guided procedures, and biopsies of salivary gland, muscle, skin, and synovium. On the side, interests dipped into osteoporosis and exercise, infectious arthritis, the spondyloarthopathies, and osteo- and crystal-induced arthritides. Since retiring from clinical practice in 2019, he's kept active with medical writing, doing what he can to teach the lessons he's learned to new generations.
Supervisors: From medical school, I count Irv Rosenberg, Leon Resnekov, Lou Cohen, and Leif Sorenson. From fellowship and beyon I could Giles Bole, Bill Castor, Tom Schnitzer, and and Bill Arnold
Phone: 734-474-6728
Address: 1611 Harbal Drive
Ann Arbor, Michigan 48105

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Papers by Robert W Ike

Who Let This Flea in My Operating Room? Editorial

Surgical Procedures for the Non-Surgeon: A Rheumatology Perspective

Make it Add Up, Doc

Sjögren’s disease activity associates with cardiovascular disease and monoclonal gammopathy: a university cohort study of disease activity and comorbidities

Clinical rheumatology, Feb 7, 2024

What Bedside Skills Could the Modern Rheumatologist Possess? Part II. “Certain Technical Procedures”

JCR: Journal of Clinical Rheumatology, 2024

Rheumatologists have never been reluctant to adopt procedures that might enhance their diagnostic... more Rheumatologists have never been reluctant to adopt procedures that might enhance their diagnostic or therapeutic powers. Their propensity to penetrate the joints of the patients they were treating set them apart from the general internist. Since the 1980s, when a chance to look inside the joints they were treating attracted a few rheumatologists, other things that could be done at the bedside emerged with now an array of bedside procedures that could be part of a rheumatologist's skill set. Besides gains in diagnosis and/or therapy, each constitutes a chance to restore the physical contact between physician and patient, riven by factors of the last decade, such as electronic medical records and COVID. With such contact so important to satisfaction of the patient and physician alike, acquisition of proficiency in certain technical procedures described herein offers one path to begin restoring rheumatology to the richly fulfilling practice it once was.

A Review of Benign Subcutaneous Emphysema Following Knee Arthroscopy

Book Publisher International (a part of SCIENCEDOMAIN International), Oct 4, 2021

Regarding Arthroscopy

Jcr-journal of Clinical Rheumatology, Apr 1, 2022

Background/Objective Rheumatologists' interest in arthroscopy began before the 1980s, when ma... more Background/Objective Rheumatologists' interest in arthroscopy began before the 1980s, when many era practitioners began to take up the procedure in earnest. Some of the important players in pre–World War II explorations of arthroscopy were rheumatologists, and the father of modern arthroscopy Makei Watanabe counted many rheumatologists among his postwar students, who were publishing about arthroscopic insights into rheumatic conditions in the 1960s and 1970s. We chose to review this evolution to demonstrate the diverging interests of rheumatologists and orthopedists in arthroscopy and emphasize the chances for reconciliation and cooperation. Methods involve our personal recollection and review of the literature. Results Guidelines for the practice of arthroscopy were published by the American Rheumatism Association (now the American College of Rheumatology) 7 years before similar guidelines appeared from the Arthroscopy Association of North America. American rheumatologists ceased arthroscopy when controlled trials showed no effect in osteoarthritis beyond placebo and biologics for synovitis virtually eliminated situations in which synovectomy might be considered. The research potential of arthroscopy has been realized mainly by European rheumatologists, although the ultrasound-guided biopsy is supplanting arthroscopy as means to secure synovium for investigation, despite the advantages of the latter, such as the ability to obtain larger amounts of tissue, select tissue based on macroscopic appearance, sample multiple area in the same joint, and deliver the potentially therapeutic effect of washout. New miniscopes suitable for office use could restore some of the lagging interest in arthroscopy for investigation. Orthopedists have generally been resistant to rheumatologists doing arthroscopy but would not be sharing any turf with rheumatologists using the miniscope. Conclusions We hope that we orthopedists and rheumatologists could be friends as we enter this new phase of arthroscopy as we use the technique for different purposes.

Scleromyxedema with systemic involvement mimics rheumatic diseases

Arthritis & Rheumatism, Jul 1, 1986

Instructional videos on labial salivary gland biopsy available

International Journal of Rheumatic Diseases, Jun 14, 2023

How to Wash Out a Knee

Journal of biomedical research & environmental sciences, Sep 1, 2021

Case differences in the problem solving strategies of medical students and physicians

PubMed, 1988

Using a broad range of written patient management problems, this study examined 1) the influences... more Using a broad range of written patient management problems, this study examined 1) the influences of three medical information-gathering processes (history-taking, physical examination, and diagnostic studies) on the formulation of the differential and principal diagnosis by 175 medical students and 2) the extent to which the information-gathering processes used by the students paralleled the emphasis that experienced clinicians placed on these same processes. Results suggested that in 11 of 14 cases, the students appeared to be relying on specific information-gathering strategies in the formulation of the differential diagnosis, and that there were both similarities and differences in the relative emphases that these processes received from students and physicians.

Synovial Biopsy in the Diagnosis of Crystal-Associated Arthropathies

Jcr-journal of Clinical Rheumatology, Jan 19, 2019

Still Consider the Source

The New England Journal of Medicine, Oct 6, 2005

Fever is a manifestation of many infectious, collagen vascular, and malignant diseases. The weigh... more Fever is a manifestation of many infectious, collagen vascular, and malignant diseases. The weight loss and generalized weakness probably indicate a systemic disorder; his joint discomfort suggests an inflammatory arthritis. Arthritis can be a sign of either a rheumatic disorder (such as rheumatoid arthritis, psoriatic arthritis, systemic lupus erythematosus, vasculitis, or crystal-induced arthritides) or a nonrheumatic systemic disease (such as

Will rheumatologists ever pick up the arthroscope again?

International Journal of Rheumatic Diseases, Jul 29, 2021

Corticosteroid responsive puffy hands and occult vasculitic neuropathy: RS3PE plus?

PubMed, 1993

Agranulocytosis in Sjögren's syndrome: Two case reports and analysis of 11 additional reported cases

Seminars in Arthritis and Rheumatism, Apr 1, 2002

To report 2 patients who presented with agranulocytosis that was found to be immune-mediated and ... more To report 2 patients who presented with agranulocytosis that was found to be immune-mediated and associated with occult primary Sjögren&#39;s syndrome (primary SS) and to identify and study similar cases reported in the literature. Two patients encountered in 2 large medical centers over a period of 5 years were studied in detail. All reported cases of agranulocytosis in primary SS identified through a MEDLINE search were reviewed. Two patients presented with marked systemic symptoms alone or associated with recurrent infections. Agranulocytosis with either a pattern of maturation arrest or a hypercellular reactive bone marrow was found and was associated with &quot;acute phase&quot; markers, hypergammaglobulinemia, a small paraprotein peak, and high rheumatoid factor titers. A diagnosis of immune-mediated agranulocytosis associated with an occult primary SS was established and was successfully treated with intravenous immunoglobulins or prednisone. Both patients subsequently developed skin vasculitis. This rare association of agranulocytosis and Sjögren&#39;s syndrome was identified in 11 other cases and was the presenting manifestation of primary SS in 10 of 13 (77%) patients. Agranulocytosis should be recognized as a rare but well-established association of primary SS. Bone marrow neutrophil production may be affected, or neutrophils may be destroyed in the circulation, by both humoral and cellular immune-mediated mechanisms. Agranulocytosis or neutropenia should be added to the varied hematologic manifestations of primary SS and may be its presenting feature and an important clue to diagnosis.

Risk factors for disability among U.S. adults with arthritis

Journal of Clinical Epidemiology, 1991

Chemical Ablation as an Alternative to Surgery for Treatment of Persistent Prepatellar Bursitis

The Journal of Rheumatology, Jun 30, 2009

Comparing information-gathering strategies of medical students and physicians in diagnosing simulated medical cases

Academic Medicine, Feb 1, 1990

Bacterial arthritis

Current Opinion in Rheumatology, Jul 1, 1998

Reports pertinent to bacterial arthritis in 1997 included two large, multi-year surveys of joint ... more Reports pertinent to bacterial arthritis in 1997 included two large, multi-year surveys of joint infection in patients from defined European health districts, noting trends including the declining incidence of gonococcal arthritis and an increasing number of prosthetic joint infections. Children with infected joints generally fare better than adults despite having proportionately more infections due to gram-negative organisms, of which Hemophilus influenzae comprises an ever smaller portion as the fastidious Kingella kingea is emerging. Joint infections remain an uncommon complication of immunodeficiency due to HIV, with responsible agents, affected sites, and clinical course also influenced by certain HIV comorbidities such as intravenous drug user and hemophilia. The rare immunodeficient patient with hypogammaglobulinemia retains a nearly unique susceptibility to joint infection with mycoplasmas, which can cause considerable morbidity if not promptly recognized and treated. Polymerase chain reaction can detect remnants of bacteria in the face of negative conventional cultures, but inoculation of synovial fluid into blood cultures bottles may be a more immediate and practical method to increase the yield in suspected septic arthritis.

Who Let This Flea in My Operating Room? Editorial

Surgical Procedures for the Non-Surgeon: A Rheumatology Perspective

Make it Add Up, Doc

Sjögren’s disease activity associates with cardiovascular disease and monoclonal gammopathy: a university cohort study of disease activity and comorbidities

Clinical rheumatology, Feb 7, 2024

What Bedside Skills Could the Modern Rheumatologist Possess? Part II. “Certain Technical Procedures”

JCR: Journal of Clinical Rheumatology, 2024

Rheumatologists have never been reluctant to adopt procedures that might enhance their diagnostic... more Rheumatologists have never been reluctant to adopt procedures that might enhance their diagnostic or therapeutic powers. Their propensity to penetrate the joints of the patients they were treating set them apart from the general internist. Since the 1980s, when a chance to look inside the joints they were treating attracted a few rheumatologists, other things that could be done at the bedside emerged with now an array of bedside procedures that could be part of a rheumatologist's skill set. Besides gains in diagnosis and/or therapy, each constitutes a chance to restore the physical contact between physician and patient, riven by factors of the last decade, such as electronic medical records and COVID. With such contact so important to satisfaction of the patient and physician alike, acquisition of proficiency in certain technical procedures described herein offers one path to begin restoring rheumatology to the richly fulfilling practice it once was.

A Review of Benign Subcutaneous Emphysema Following Knee Arthroscopy

Book Publisher International (a part of SCIENCEDOMAIN International), Oct 4, 2021

Regarding Arthroscopy

Jcr-journal of Clinical Rheumatology, Apr 1, 2022

Background/Objective Rheumatologists' interest in arthroscopy began before the 1980s, when ma... more Background/Objective Rheumatologists' interest in arthroscopy began before the 1980s, when many era practitioners began to take up the procedure in earnest. Some of the important players in pre–World War II explorations of arthroscopy were rheumatologists, and the father of modern arthroscopy Makei Watanabe counted many rheumatologists among his postwar students, who were publishing about arthroscopic insights into rheumatic conditions in the 1960s and 1970s. We chose to review this evolution to demonstrate the diverging interests of rheumatologists and orthopedists in arthroscopy and emphasize the chances for reconciliation and cooperation. Methods involve our personal recollection and review of the literature. Results Guidelines for the practice of arthroscopy were published by the American Rheumatism Association (now the American College of Rheumatology) 7 years before similar guidelines appeared from the Arthroscopy Association of North America. American rheumatologists ceased arthroscopy when controlled trials showed no effect in osteoarthritis beyond placebo and biologics for synovitis virtually eliminated situations in which synovectomy might be considered. The research potential of arthroscopy has been realized mainly by European rheumatologists, although the ultrasound-guided biopsy is supplanting arthroscopy as means to secure synovium for investigation, despite the advantages of the latter, such as the ability to obtain larger amounts of tissue, select tissue based on macroscopic appearance, sample multiple area in the same joint, and deliver the potentially therapeutic effect of washout. New miniscopes suitable for office use could restore some of the lagging interest in arthroscopy for investigation. Orthopedists have generally been resistant to rheumatologists doing arthroscopy but would not be sharing any turf with rheumatologists using the miniscope. Conclusions We hope that we orthopedists and rheumatologists could be friends as we enter this new phase of arthroscopy as we use the technique for different purposes.

Scleromyxedema with systemic involvement mimics rheumatic diseases

Arthritis & Rheumatism, Jul 1, 1986

Instructional videos on labial salivary gland biopsy available

International Journal of Rheumatic Diseases, Jun 14, 2023

How to Wash Out a Knee

Journal of biomedical research & environmental sciences, Sep 1, 2021

Case differences in the problem solving strategies of medical students and physicians

PubMed, 1988

Using a broad range of written patient management problems, this study examined 1) the influences... more Using a broad range of written patient management problems, this study examined 1) the influences of three medical information-gathering processes (history-taking, physical examination, and diagnostic studies) on the formulation of the differential and principal diagnosis by 175 medical students and 2) the extent to which the information-gathering processes used by the students paralleled the emphasis that experienced clinicians placed on these same processes. Results suggested that in 11 of 14 cases, the students appeared to be relying on specific information-gathering strategies in the formulation of the differential diagnosis, and that there were both similarities and differences in the relative emphases that these processes received from students and physicians.

Synovial Biopsy in the Diagnosis of Crystal-Associated Arthropathies

Jcr-journal of Clinical Rheumatology, Jan 19, 2019

Still Consider the Source

The New England Journal of Medicine, Oct 6, 2005

Fever is a manifestation of many infectious, collagen vascular, and malignant diseases. The weigh... more Fever is a manifestation of many infectious, collagen vascular, and malignant diseases. The weight loss and generalized weakness probably indicate a systemic disorder; his joint discomfort suggests an inflammatory arthritis. Arthritis can be a sign of either a rheumatic disorder (such as rheumatoid arthritis, psoriatic arthritis, systemic lupus erythematosus, vasculitis, or crystal-induced arthritides) or a nonrheumatic systemic disease (such as

Will rheumatologists ever pick up the arthroscope again?

International Journal of Rheumatic Diseases, Jul 29, 2021

Corticosteroid responsive puffy hands and occult vasculitic neuropathy: RS3PE plus?

PubMed, 1993

Agranulocytosis in Sjögren's syndrome: Two case reports and analysis of 11 additional reported cases

Seminars in Arthritis and Rheumatism, Apr 1, 2002

To report 2 patients who presented with agranulocytosis that was found to be immune-mediated and ... more To report 2 patients who presented with agranulocytosis that was found to be immune-mediated and associated with occult primary Sjögren&#39;s syndrome (primary SS) and to identify and study similar cases reported in the literature. Two patients encountered in 2 large medical centers over a period of 5 years were studied in detail. All reported cases of agranulocytosis in primary SS identified through a MEDLINE search were reviewed. Two patients presented with marked systemic symptoms alone or associated with recurrent infections. Agranulocytosis with either a pattern of maturation arrest or a hypercellular reactive bone marrow was found and was associated with &quot;acute phase&quot; markers, hypergammaglobulinemia, a small paraprotein peak, and high rheumatoid factor titers. A diagnosis of immune-mediated agranulocytosis associated with an occult primary SS was established and was successfully treated with intravenous immunoglobulins or prednisone. Both patients subsequently developed skin vasculitis. This rare association of agranulocytosis and Sjögren&#39;s syndrome was identified in 11 other cases and was the presenting manifestation of primary SS in 10 of 13 (77%) patients. Agranulocytosis should be recognized as a rare but well-established association of primary SS. Bone marrow neutrophil production may be affected, or neutrophils may be destroyed in the circulation, by both humoral and cellular immune-mediated mechanisms. Agranulocytosis or neutropenia should be added to the varied hematologic manifestations of primary SS and may be its presenting feature and an important clue to diagnosis.

Risk factors for disability among U.S. adults with arthritis

Journal of Clinical Epidemiology, 1991

Chemical Ablation as an Alternative to Surgery for Treatment of Persistent Prepatellar Bursitis

The Journal of Rheumatology, Jun 30, 2009

Comparing information-gathering strategies of medical students and physicians in diagnosing simulated medical cases

Academic Medicine, Feb 1, 1990

Bacterial arthritis

Current Opinion in Rheumatology, Jul 1, 1998

Reports pertinent to bacterial arthritis in 1997 included two large, multi-year surveys of joint ... more Reports pertinent to bacterial arthritis in 1997 included two large, multi-year surveys of joint infection in patients from defined European health districts, noting trends including the declining incidence of gonococcal arthritis and an increasing number of prosthetic joint infections. Children with infected joints generally fare better than adults despite having proportionately more infections due to gram-negative organisms, of which Hemophilus influenzae comprises an ever smaller portion as the fastidious Kingella kingea is emerging. Joint infections remain an uncommon complication of immunodeficiency due to HIV, with responsible agents, affected sites, and clinical course also influenced by certain HIV comorbidities such as intravenous drug user and hemophilia. The rare immunodeficient patient with hypogammaglobulinemia retains a nearly unique susceptibility to joint infection with mycoplasmas, which can cause considerable morbidity if not promptly recognized and treated. Polymerase chain reaction can detect remnants of bacteria in the face of negative conventional cultures, but inoculation of synovial fluid into blood cultures bottles may be a more immediate and practical method to increase the yield in suspected septic arthritis.