Vasculitis is a group of chronic inflammatory diseases in which the blood vessel is the target of an immune reaction. They can be secondary to connective tissue disease, idiopathic or due to infection, neoplasm or drugs.1 Primary angiitis of the central nervous system (PACNS) is a rare syndrome characterized by inflammatory cell infiltration and necrosis…
One of my fellows could take better care of his patients if it weren’t for the attendings getting in his way. Or so he tells me. I can hear the howls of protest already. This statement isn’t fair—it is too broad, it doesn’t fairly depict the nuances of the situation or his point of view. First,…
Winston Churchill once said, “There is nothing wrong with change, if it is in the right direction.” So—with this, our first presidential column of 2019—we are bringing you news of a change or two. First, ARHP, our health professionals’ membership division, has changed its name to the Association of Rheumatology Professionals, or ARP. This new…
The ACR & the National Psoriasis Foundation (NPF) have published a joint Guideline for the Treatment of Psoriatic Arthritis (PsA). The guideline will serve as an aid to practitioners managing active PsA in patients.
A 76-year-old Caucasian male with a history of abdominal aortic aneurysm repair five years earlier presented with three months duration of worsening periumbilical abdominal pain associated with nausea, non-bloody emesis, decreased appetite, fatigue and a 40 lb. weight loss. He denied having fever, chills, night sweats, temporal headaches, vision loss, chest pain, shortness of breath and…
Bob and Jan Richardson’s separate paths to physical therapy and rheumatology involve wrestling and horses—although not at the same time. Their intertwining stories also involve a fair amount of serendipity. Mr. Bob Richardson For Bob Richardson, PT, MEd, the path started in the late 1950s, when he was wrapping up a fulfilling college wrestling career…
BETHESDA, MD—Rheumatologists from the National Institutes of Health (NIH) and from Jerusalem, Israel, have identified deficiency of adenosine deaminase 2 (DADA2) as an important cause of familial polyarteritis nodosa, which tends to present in childhood and can manifest with hematologic, immunologic and inflammatory signs, says Chip Chambers, MD, founder and president of the DADA2 Foundation….
CHICAGO—Reproductive health can be a concern for patients with rheumatic diseases, and practitioners in both disciplines often work closely together. The Reproductive Health in Rheumatic and Musculoskeletal Diseases Guideline, a draft of new clinical recommendations developed by an ACR-convened group for pregnant women, post-menopausal women, lactating women, and women and men trying to conceive or…
CHICAGO—Could the addition of a pharmacist to rheumatology care teams improve patient satisfaction, decrease staff burnout or reduce medication-related problems? Three panelists in Integrating Pharmacists into the Workforce, a session at the 2018 ACR/ARHP Annual Meeting, shared positive experiences with this interdisciplinary care model. Less Burnout, More Satisfaction Ten years ago, the Arthritis Treatment Center…
Rheumatologists may benefit from the decentralized technology that makes cryptocurrency possible: blockchain. According to Anh L. Ngo, MD, MBA, using blockchain in healthcare may increase payment and purchasing efficiency and revolutionize EHR management…
CHICAGO—When it comes to correctly diagnosing joint pain in children, “things take time,” said Michael L. Miller, MD, quoting Danish physicist and poet Piet Hein. Children with pain but normal physical examinations may need to return to the clinic for repeat evaluation over several months. “I often tell parents that laboratory tests may help in…
CHICAGO—Although rare, when a patient has both primary immune deficiency and autoimmune disease, the combination can lead to life-threatening complications requiring careful, long-term therapy. In When Immune Deficiency and Autoimmunity Coexist, a session at the 2018 ACR/ARHP Annual Meeting, M. Eric Gershwin, MD, the Jack and Donald Chia professor of Medicine and chief of Rheumatology,…
Big data can benefit rheumatology research. But according to experts at the 2018 ACR/ARHP Annual Meeting, the data must first be accessible, interoperable and shareable…
CHICAGO—With an ever-strengthening foundation beneath the pathophysiology and prediction of rheumatoid arthritis (RA), the field may soon focus more intently on prevention, an expert said at the 2018 ACR/ARHP Annual Meeting. The session also covered the latest in remission targets and therapy de-escalation. RA Prevention Kevin Deane, MD, PhD, associate professor of medicine and principal…
CHICAGO—Many nonsurgical therapies are available for knee osteoarthritis pain, but they vary greatly in effectiveness. “How should I proceed and figure out what to do with our patients?” asked David T. Felson, MD, MPH, professor of medicine at Boston University School of Medicine, during OA Management Without Surgery in 2018, a session at the 2018…
CHICAGO—Are effective treatments for osteoarthritis (OA) on the horizon? In Emerging Treatments for Osteoarthritis at the 2018 ACR/ARHP Annual Meeting, experts discussed potential therapies to address OA structural progression, pain and inflammation. With an aging population and rising obesity rates, “we can expect the prevalence of osteoarthritis will only increase,” said Anne-Marie Malfait, MD, PhD,…
CHICAGO—To drive home the importance of how social determinants can make or break a person’s health, Jillian Rose, LCSW, MPH, the director of community, engagement, diversity and research at the Hospital for Special Surgery in New York City, told a story about a gardener planting flowers at the 2018 ACR/ARHP Annual Meeting. In the story,…
CHICAGO—Diagnostic and treatment tips on Sjögren’s syndrome from the experts at the 2018 ACR/ARHP Annual Meeting.
Ever wonder how magicians know what card you pulled out of the deck, make objects vanish or unlink and link solid metal rings? Christopher Morris, MD, knows how these tricks are performed, but he won’t tell you. A rheumatologist who has been in private practice for 25 years at Arthritis Associates, Kingsport, Tenn., he has…
It should not be a surprise to anyone that the U.S. is facing a national opioid crisis. It may be a surprise, however, that the federal government recently passed a law to address this crisis—a law that may have a profound impact on many healthcare facilities, some of which are not involved in the substance…
CHICAGO—In October, the Rheumatology Research Foundation recognized 153 award and scholarship recipients at an awards luncheon, held in conjunction with the 2018 ACR/ARHP Annual Meeting. The annual event celebrates the accomplishments of rheumatology professionals who have received funding from the Foundation. In congratulating the award recipients, Foundation President Abby Abelson, MD, emphasized the impact the…
As physicians, we play an important role in the well-being of patients and serve as advocates to ensure our patient receives adequate healthcare services. Unfortunately, many of the policy decisions that govern our medical practices are made by bureaucrats with inadequate input from physicians. Certain constraints placed on the way we should practice medicine have…
As of Jan. 1, 2019, the Centers for Medicare & Medicaid Services (CMS) will implement several coding and documentation policies to provide immediate burden reduction to providers. The 2019 Medicare Physician Fee Schedule Final Rule (MPFS) released Nov. 1, 2018, by the CMS contained significant changes to the Medicare Part B coding and documentation policies…
A 68-year-old female Medicare patient with a diagnosis of primary osteoarthritis of the left knee returns to a practice for her third injection in a series of knee injections. She reports being able to resume her after-dinner walks, which last for 30–40 minutes at least twice weekly. She denies fevers or any rashes. She has…
Take the challenge. CPT: 20611-LT, J7325-EJ ICD-10: M17.12, E66.01, Z68.41 Coding/Billing Rationale No evaluation and management (E/M) code was added because there was no significant and/or separate identifiable reason for an E/M service to be billed with this scheduled visit for her series of injections. The joint injection was billed with ultrasound guidance due to…
Editor’s notes: A memorial service for Nadia is being planned for Jan. 16, 2019, from 4:30-6:00 p.m. at Johns Hopkins Bayview Asthma and Allergy Center, Richard A. Grossi Auditorium, 5301 Hopkins Bayview Circle, Baltimore. To honor her life and the impact she made on the Division of Rheumatology, Johns Hopkins is establishing the Dr. Nadia D….
In a study, RA patients taking upadactinib monotherapy experienced less pain and morning joint stiffness than methotrexate-treated patients…
The FDA has approved halobetasol propionate lotion as a topical treatment for plaque psoriasis…