In 1866, Adolf Kussmaul, an internist, and Rudolf Maier, a pathologist, published the classic characterization of what eventually became known as polyarteritis nodosa.1 It was the first scientific clinical characterization of a noninfectious vasculitis. As such, it became a paradigmatic point of contrast to other types of vasculitides that were later described. Their description also…
This past June, a 64-year-old man with a history of psoriatic arthritis and severe arthritis appeared at our clinic for his regular follow-up with concerns about a letter from his insurance company. The letter stated the company wouldn’t pay for the patient’s secukinumab (i.e., Cosentyx) prescription anymore and suggested he take ixekizumab (i.e., Taltz) instead,…
NEW YORK (Reuters Health)—In Lyme-endemic areas, synovial fluid white blood cell (WBC) count isn’t very helpful in distinguishing septic from Lyme arthritis of the hip, a new study suggests. Use of newer-generation Lyme disease diagnostics are necessary to avoid the “under- and overdiagnosis of Lyme arthritis at the time that initial management decisions must be…
(Reuters)—An experimental rheumatoid arthritis drug developed by Eli Lilly and Co. and Incyte Corp. poses serious risks of deadly blood clots at higher doses, U.S. Food and Drug Administration staff says, the latest setback to a treatment regulators declined to approve last year. New data provided by the companies in a resubmission of their marketing…
NEW YORK (Reuters Health)—The RANKL inhibitor denosumab is superior to the bisphosphonate risedronate in increasing bone-mineral density (BMD) at the lumbar spine in patients just starting or continuing steroid therapy, according to 12-month results of a 24-month randomized controlled study. “Glucocorticoid-induced osteoporosis is the most common form of secondary osteoporosis and increases the risk of…
Time certainly flies, and 2018 marks the second year that rheumatologists who see Medicare patients are operating under the new Quality Payment Program (QPP) created by the Medicare Access & CHIP Reauthorization Act (MACRA). MACRA repealed the Fee-for-Service model under the Sustainable Growth Rate (SGR) formula and transitioned Medicare reimbursement to a system more overtly…
Understanding your compensation is critical before you decide to accept a job. In the world of medical practices or groups, however, this understanding is even more essential, because a wide variety of compensation structures for physicians exists. These compensation models can dictate not only what a physician will make in the near future, but also…
Several years ago, Ed Herzig, MD, and his wife, Andrea (Andi), spent one week on a Smithsonian cruise that traveled along the western part of the Amazon river, the world’s second longest river, which cuts across seven South American countries. They actually swam in the river, fished for piranha and spotted primitive Peruvian river villages….
You see a patient for the first time to establish care for Sjögren’s disease. She complains of dry eyes, dry mouth and diffuse arthralgias. You do not appreciate any synovitis on physical exam. Of note, you are the fourth rheumatologist she has seen during the past year. Toward the end of the clinic visit, she…
Studying the way patients with knee osteoarthritis walk and changes to footwear are helping patients under the care of Najia Shakoor, MD, and colleagues take control of their pain and possibly delay disease progression…