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This CT scan demonstrates a mass causing partial occlusion of the esophagus.

Case Report: An Adult-Onset Still’s Disease Mimic

Theodore Korty, DO, Ken Baxa, DO, Kiren Sahni, DO, Adam Grunbaum, DO, & Maria Soto-Aguilar, MD  |  July 18, 2019

A 53-year-old man was hospitalized for pericarditis, abdominal lymphadenopathy of unknown origin and non-bloody diarrhea. He was admitted for four days, and then he was discharged home without incident. Two months after his initial presentation, he was readmitted for the evaluation of several new issues, including symmetric arthralgias, hypovolemia with associated electrolyte abnormalities and concurrent…

The ACR Maps the Future of the RISE Registry

Paula Marchetta, MD, MBA  |  July 18, 2019

In the first scene of the Broadway stage adaptation of Harper Lee’s To Kill a Mockingbird, young Scout contemplates two words she has heard in the courtroom: “All rise,” and wonders if they really are meant to elevate the minds of all those present for the proceedings. That instruction—“All rise”—serves as a leitmotif throughout the…

Paying Attention

Philip Seo, MD, MHS  |  July 18, 2019

I knew I was about to be schooled. That’s what I thought when I first started to read the Twitter feed of Erin D. Michos, MD, MHS, an associate professor of medicine in the Division of Cardiology at Johns Hopkins University, Baltimore. I have a Twitter account, but as a general rule, I use it…

David M. Phillips / Science Source

Lyme Arthritis: Presentation, Diagnosis & Treatment

John N. Aucott, MD, & Sheila L. Arvikar, MD  |  July 18, 2019

A 52-year-old man living in greater Boston with a history of hyper­tension presented at our rheumatology clinic with bilateral knee pain and swelling. He had been in his usual state of health until four months earlier when he developed right knee pain and swelling without an incipient trauma, which did not improve with non-steroidal anti-inflammatory…

Exercise Therapy Benefits Patients with Knee & Hip OA

Lara C. Pullen, PhD  |  July 18, 2019

A meta-analysis confirms prior research suggesting exercise therapy benefits patients with knee and hip osteoarthritis (OA). The study found greater improvements in pain, function, performance and quality of life in patients with milder, as opposed to more severe, OA…

ACR’s Delegation to the AMA: How We Can Continue to Advance Rheumatology

Gary Bryant, MD, FACR  |  July 17, 2019

The House of Delegates (HOD) is the policy-making body of the American Medical Association (AMA), and twice a year, representatives of all seated specialties, service societies and state medical associations review hundreds of resolutions to determine which will become AMA policies. Once those policies and priorities are determined or updated, we benefit from the AMA…

Step Therapy Legislation in the States: Navigating a Varied & Complex System

Joseph Cantrell, JD  |  July 17, 2019

As the practice of step therapy grows more pervasive throughout the insurance industry, the protocols become increasingly confusing to navigate. Steps vary from insurer to insurer based on plan type, and formulary differences are too often based on economic incentives rather than outcome-based medicine. Patients are often left hanging in the balance while physicians’ offices…

CMS 2018 MIPS Performance Feedback, Final Score & Targeted Review Now Available

From the College  |  July 17, 2019

Your 2018 MIPS performance feedback and final score from the CMS are now available on the Quality Payment Program website. To learn more about performance feedback, view the frequently asked questions document from the CMS. The payment adjustment you will receive in 2020 is based on your score for the 2018 performance year. If you…

White House Scraps Proposal to Lower U.S. Drug Prices

Caroline Humer  |  July 14, 2019

(Reuters)—The Trump administration on Thursday scrapped one of its most ambitious proposals for lowering prescription medicine prices, backing down from a policy that would have required health insurers to pass on billions of dollars in rebates they receive from drugmakers to Medicare patients. The decision represents a new setback to President Donald Trump’s efforts to…

Upadacitinib + Methotrexate & Other csDMARDs in RA Patients

Michele B. Kaufman, PharmD, BCGP  |  July 12, 2019

A post-hoc analysis showed upadacitinib is safe and effective for treating RA patients when used with methotrexate or non-methotrexate csDMARDs…

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