“Treat to target regardless of disease activity level” tops the list of recommendations for both early and established RA in the 2015 Guideline for the Treatment of Rheumatoid Arthritis. The guideline addresses six major topics, including DMARDs, glucocorticoids and biologics, and includes 74 recommendations. These recommendations are not prescriptive, and the treatment decisions should be made by physicians and patients together…
Pulse-Echo Ultrasound Useful for Osteoporosis Screening
NEW YORK (Reuters Health)—Pulse-echo ultrasound is a useful method for point-of-care osteoporosis screening, researchers from Finland report. “To effectively increase diagnostic coverage, this kind of device should be in every primary or occupational healthcare unit,” Dr. Janne P. Karjalainen from the University of Eastern Finland in Kuopio tells Reuters Health by email. Currently, osteoporosis is…
SLE—It’s in the Genes
In a large-scale genome-wide association study, researchers mapped 10 new SLE-associated loci and found aberrantly regulated gene expression networks may be behind SLE development…
Autoimmune Diseases Common in Patients with Vitiligo
NEW YORK (Reuters Health)—Patients with vitiligo commonly have other autoimmune diseases, according to a cross-sectional study. “Vitiligo is a systemic disease with multiple comorbidities,” Dr. Iltefat Hamzavi from Henry Ford Hospital in Detroit, Mich., told Reuters Health by email. “The number of patients with neurologic diseases and inflammatory disease was much higher than we anticipated.”…
Diagnostic Clues, Tips Useful for Differentiating RA and Lyme Disease
RA vs. Lyme I am writing to comment on your interesting and useful article that appeared on the front page of the August issue of The Rheumatologist, “RA vs. Lyme,” by Charles Radis, DO. Arriving at a definite diagnosis of active RA early on is often not an easy task. The author of this article…
New Gout Criteria from the ACR/EULAR Focus on Clinical Trials, Global Standards
Gout affects nearly 4% of American adults, causing joint inflammation, pain and crystal deposits that may lead to bone erosion over time. At least five different classification criteria for gout are used worldwide, creating potential discrepancies in clinical trial enrollment and eventual results. An international panel of investigators collaborated to create new, standardized gout classification…
Rheumatology Coding Corner Answer: Proper Coding for Post-Traumatic Osteoarthritis
CPT: 99213, 73500-RT, 73500-LT ICD-10: M16.52 This E/M service entailed: The history is detailed; The examination is expanded problem focused; and The medical decision making is of low complexity. The X-ray reviewed was for radiologic examination, hip, unilateral: one view for the left hip and for the right hip. M16.52—The diagnosis identifies unilateral post-traumatic osteoarthritis…
Rheumatology Coding Corner Question: Coding for Post-Traumatic Osteoarthritis
Post-Traumatic OA A 70-year-old female patient comes in for a follow-up visit for pain and stiffness in her left hip. She injured her hip in a skiing accident three years before and reports the X-rays at that time showed no fractures. Due to no obvious fracture at the time, she was given ibuprofen and advised…
Sjögrens Syndrome: The Need to Bridge Patient Symptoms & Objective Findings
Despite a generation of advances in molecular biology, a huge gap exists between the Sjögren’s syndrome (SS) patient’s description of their symptoms and the objective findings. Current issues include: Many SS patients are misclassified as either rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE), even within rheumatology clinics. Frequently, the sickest SS patients with extraglandular…
Bronchial Tissue Immune Activation Seen in Early Rheumatoid Arthritis
NEW YORK (Reuters Health)—Patients with untreated early rheumatoid arthritis (RA) show signs of immune activation and local inflammation in their bronchial tissues, researchers from Sweden report. Previous studies have shown that patients with RA have shared citrullinated epitopes in the lungs and joints, as well as anticitrullinated protein antibodies (ACPA) in bronchoalveolar lavage (BAL), suggesting…
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