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A 68-year-old woman with a medical history significant for psoriatic arthritis was found to have an enlarged, painful lump on her left hip 15 months after intramedullary rod placement for a left subtrochanteric femur fracture sustained in a fall. Histopathological findings showed rice body formation (RBF) with concurrent H. parainfluenza. RBF is a relatively rare arthropathy of a subset of chronic inflammatory disease such as rheumatoid arthritis or tuberculous arthropathy. RBF associated with psoriatic arthritis or orthopedic hardware placement has been reported in a handful of cases in the literature but there has not been any definitive evidence for RBF as a result of Haemophilus parainfluenza infections and is a rather unusual characteristic of this case.

Heart failure is a heterogeneous clinical syndrome with a variety of causes, risk factors, and pathology. The challenge in using biomarkers to assess and guide management of heart failure is that no one biomarker is sufficient to encompass all heart failure phenotypes. We also know that a large number of factors influence biomarker levels, including age, renal function, obesity, and other concurrent conditions. The majority of drug therapies and titrations were developed before the development of biomarkers, but recent guidelines support its use in the diagnosis of acute heart failure and in certain instances to guide therapy. This chapter summarizes the data on cardiac biomarkers and its use in diagnosing and managing heart failure.