Chronic insomnia is a common complaint for patients with rheumatic diseases and conditions. In fact, sleep disturbances are among the most common symptoms of both fibromyalgia and rheumatoid arthritis (RA), with more than 50% of chronic pain patients reporting sleep disturbances. Pain combined with insomnia can lead to a vicious cycle, says Ruth Gentry, PhD,…
Diagnostic Imaging in Patient with Soft Tissue Calcification: Findings
View the question. Findings/Diagnosis The radiographs demonstrate diffuse sheetlike and tumefactive calcifications throughout the subcutaneous tissues, muscle and fascia of the pelvis and right hand. The underlying bones and joint spaces appear normal. The differential diagnosis for soft tissue calcification is extensive and includes metabolic disturbances (particularly of calcium and phosphate), trauma (e.g., injection sites,…
Diagnostic Imaging in Patient with Soft Tissue Calcification: History
Editor’s note: In this recurring feature, we first present a series of images (this page) for your review, and then a brief discussion of the findings and diagnosis. Before you turn to the discussion, examine these images carefully and draw your own conclusions. History These radiographic images are of a 25-year-old woman with a known…
COPA Genetic Mutation Identified in Lung Disease, Arthritis
Researchers from California and Texas have identified a new genetic syndrome that is characterized by systemic autoimmune disease of the lung and joints. The syndrome is driven by a genetic variant of a vesicular transport protein and is the first documented association between intracellular transport and autoimmunity. Levi B. Watkin, PhD, postdoctoral fellow at Baylor…
How Celebrities, Senators, Dietary Supplements Muddle Medicine
It’s disheartening to stand by and watch helplessly as your patient dies a slow, painful death. In spring 1990, I had the misfortune of living through such a distressing experience. Strange happenings in New Mexico & Japan Ellen was a bookkeeper in her late 40s, living quietly in suburban Boston. For years, she hid a…
ACR/ARHP Annual Meeting Research Abstract Submission Tips
The American College of Rheumatology (ACR) and the Association of Rheumatology Health Professionals (ARHP) invite you to submit an abstract and take advantage of the opportunity to have your work peer reviewed by experts in rheumatology. Reasons to Submit Opportunity for Publication—The Annual Meeting draws thousands of abstracts submitted by rheumatology professionals from around the…
Rheumatology Research Foundation Funding Aids Researcher’s Career
For 30 years, the Rheumatology Research Foundation has been funding research and advancing treatments. During that time, Leonard L. Dragone, MD, PhD, received a Foundation award to help look for new strategies to treat autoimmune and inflammatory diseases in mouse models. Then, he was working as an assistant professor of pediatrics and immunology at the…
Pain Perception May Depend on Multiple Immediate-Environment Stimuli
Can merely crossing your fingers change the way your brain perceives pain when you touch different stimuli with three fingers? Perhaps so, according to a new study by UK-based researchers, when taken into context with the immediate environment. Changes in posture could potentially provide a way to influence chronic pain if basic science results lead…
Rheumatology Coding Corner Question: Trigger-Point Injections for Fibromyalgia
A 65-year-old established female patient returns to the office for a follow-up visit for her diagnosis of fibromyalgia. She complains of pain, stiffness and swelling in her left hand, elbow and neck that is persistent since her last visit. The pain is considerably worse in the morning. She denies any fevers, cough or dyspnea. The…
Rheumatology Coding Corner Answer: Trigger Point Injections for Fibromyalgia
Take the challenge. CPT codes: 99213-25, 20553, 73120/LT Diagnosis: ICD-9 7291 ICD-10 M79.7 Coding for trigger-point injections continues to create a lot of confusion on proper coding guidelines. Keep in mind, two CPT4 codes can be used for trigger-point procedures: 20552—Injection(s); single or multiple trigger point(s), one or two muscle(s); and 20553—Single or multiple trigger…
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