Over the course of a month, you diagnose systemic sclerosis in two newly evaluated patients. Their responses to the news could not be more different. Patient 1 is a previously healthy 55-year-old man who is an avid bicyclist and skier. He presents with a several-month history of rapidly progressive skin tightening extending to the proximal…
SAN FRANCISCO—To unravel the mysteries of how autoimmunity begins in the body and, one day, to interrupt that process, rheumatology researchers are exploring the role of neutrophils, especially when they form and release neutrophil extracellular traps (NETs). At a panel discussion on Nov. 6, 2015, held at the American College of Rheumatology’s Basic Research Conference,…
SAN FRANCISCO—“Interstitial lung disease is the last bastion of great medicine,” according to Paul Noble, MD, chair, Department of Medicine, director, Women’s Guild Lung Institute, Vera and Paul Guerin Distinguished Chair in Pulmonary Medicine, Cedars-Sinai Medical Center, Los Angeles. Making it great medicine, he said, are the many things still unknown about this disease. In…
SAN FRANCISCO—Two hundred years ago, physicians knew nothing about what caused various forms of arthritis. Today, we have more clues about what may trigger rheumatic diseases, but still can’t pinpoint the culprits that set scores of inflammatory conditions in motion. Researchers discussed some of the background and recent findings that point to what immunologists call…
SAN FRANCISCO—Let’s say your radiologist comes to you and says that an angiogram gives a diagnosis of CNS vasculitis on four patients, all with acute onset of headache and stroke: One is a 25-year-old woman who is three months pregnant. Another is a 50-year-old man using excessive doses of nasal decongestants. Another is a 40-year-old…
When the code that you need is not clear Just keep this poem quite near If you’re struck by a parrot Just grin and bear it ICD-10 has you covered my dear. W61.02XA Struck by parrot, initial encounter And if you’re ever struck by a cow I don’t even want to know how Rest assured:…
At the 2015 ACR/ARHP Annual Meeting in San Francisco in November, the ACR and the ARHP honored a group of distinguished individuals who have made significant contributions to rheumatology research, education and patient care. In the December 2015 issue, The Rheumatologist reported on the ACR’s awards. This month, we speak with the ARHP winners about…
Rheumatoid arthritis (RA) can be defined as a chronic autoimmune systemic inflammatory condition characterized by symmetrical polyarthritis. Typically, patients present with pain, stiffness and warmth of the affected joints. The condition can result in extra-articular features, adding to disability, and may eventually lead to premature death, especially if not treated early and appropriately.1,2 Over the…
Diagnosing rheumatoid arthritis (RA) early in the disease process is ideal, because treatments are more likely to be effective and less damage will occur. Guidelines from the American College of Rheumatology (ACR) and the European League Against Rheumatism (EULAR) state that using newer biologic medications, in addition to more aggressive dosing of traditional medications, is…
View the question. Findings/Diagnosis An anteroposterior (AP) radiograph of the right foot shows hallux valgus of the first metatarsal phalangeal (MTP) joint, erosive changes at the first and fifth metatarsal bones and degenerative changes at the fourth and fifth metatarsal-cuboid joints. An AP radiograph of the left foot shows extensive erosive and degenerative changes at…