In a recent study, researchers examined synovial fluid and non-inflamed tophi from the acutely inflamed joints of patients with gout, finding that monosodium urate (MSU) crystals trigger a distinct physiological NETosis pathway that coats MSU crystals in DNA that persists in tissues as gouty tophi…
Search results for: Ultrasound
Tips for Diagnosing & Treating Shoulder & Low Back Pain
SAN DIEGO—At two sports medicine talks at the 2017 ACR/ARHP 2017 Annual Meeting last November, two rheumatologists discussed shoulder impingement and low back pain. First, Andrew Concoff, MD, a rheumatology and sports medicine specialist at St. Jude Medical Center in Fullerton, Calif., gave these five shoulder impingement tips: Physical exams may not be very useful…
Rheumatologist Fellow Works in India Via ACR Exchange Program
In November 2017, I went to Lucknow, India, where I would spend my time as an exchange fellow at the Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPIMS) as part of the ACR International Visiting Fellows Exchange Program. Where I Come From I completed my medical degree at Mahatma Gandhi Missions Medical College, Navi Mumbai…
Case Report: Metoprolol-Induced Arthralgia
Various drugs are known to cause musculoskeletal symptoms, such as arthralgias, myalgias, drug-induced lupus and serum sickness.1 In the rheumatology world, the most commonly recognized drugs that can cause musculoskeletal symptoms are hydralazine, minocycline, fluoroquinolones and, recently, the dipeptidyl peptidase 4 (DPP-4) inhibitor class of medications. Although beta blockers also have a noted side effect…
Rheumatoid Arthritis Research Advances
SAN DIEGO—In a roundup of current research in rheumatoid arthritis (RA) presented at the 2017 ACR/ARHP Annual Meeting Nov. 3–8, Mark C. Genovese, MD, professor of medicine in the Division of Immunology and Rheumatology at Stanford University, Palo Alto, Calif., urged his audience to reflect on the impact therapy advances have made on RA. “In…
International Rheumatology Training Challenges & Innovations
SAN DIEGO—Rheumatologists train in quite different ways depending on their global region, said panelists at a session sponsored by the International League of Associations for Rheumatology (ILAR) held at the 2017 ACR/ARHP Annual Meeting in San Diego on Nov. 7. Four association presidents shared training disparities and efforts to bridge gaps. EULAR: Consistency Challenges The…
Rheumatology Coding Corner Answer: Bilateral Knee Injections
Take the challenge. CPT codes: 20611-LT, 20611-RT, J7326x2 or 20611, 20611-50, J7326x2 ICD-10: M17.0 Coding Rationale The CPT code 20611 is for an arthrocentesis, aspiration and/or injection, major joint or bursa (e.g., shoulder, hip, knee or subacromial bursa with ultrasound guidance, with permanent recording and reporting). The code is billed twice because this was a…
Rheumatology Coding Corner Question: Bilateral Knee Injections
A 68-year-old male patient returns to the office for his scheduled bilateral knee injections for primary osteoarthritis. The patient rates the pain in his right knee at an 8 on a scale of 10, and the pain in his left knee at a 7. He was in the office a week before, but the practice…
New Recommendations Guide Imaging in Large-Vessel Vasculitis
NEW YORK (Reuters Health)—Patients with suspected large-vessel vasculitis (LVV) should undergo early imaging, the European League Against Rheumatism (EULAR) advises in a new report presenting a dozen evidence-based recommendations for the use of imaging in primary LVV. Ultrasound should be the first choice for giant-cell arteritis (GCA), while MRI should take precedence for Takayasu arteritis…
ACR in Action: A Look at ACR Activities That Support Your Practice
Rheumatologists working in every practice setting face a number of challenges that can seem insurmountable. How do you cost-effectively manage administrative burdens? How do you establish an efficient and effective approach to capturing quality metrics? How do you maintain the critical elements of the care you provide, such as diagnostic musculoskeletal ultrasound and patient access…
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