NEW YORK (Reuters Health)—A Dutch study confirms that reduced serum levels of insulin-like growth factor-1 (IGF-1) are associated with increased fracture risk in elderly women, but not men. In an Aug. 31 online paper in the Journal of Clinical Endocrinology & Metabolism, Dr. N.C. van Varsseveld, of VU University Medical Center, Amsterdam, and colleagues noted that…
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Diagnostic Imaging in Patient with Left Hip Pain: Findings
View the question. Findings/Diagnosis The AP radiograph of the left hip (see Figure 1) shows periarticular, well-defined erosions of the left hip (white arrow) without joint space narrowing or osteophytes. There is no fracture. There are surgical clips and a calcified mass in the right hemipelvis (black ellipsis), representing a failed renal transplant. The coronal STIR…
EULAR 2015: RA Research Shows Imperfect Guidelines, Suggests Strategies with Biologics
ROME, Italy—Even with classification criteria that have been updated and refined over time, rheumatoid arthritis is still a diagnosis that ultimately has to be made with clinical judgment, said Ronald van Vollenhoven, MD, PhD, professor of medicine and chief of clinical therapy research in inflammatory diseases at the Karolinska University in Sweden. His remarks came…
Fellow’s Forum Case Report: Aneurysm in Takayasu’s Arteritis
A healthy 30-year-old Indian male was performing his routine workout in the gym when he developed giddiness and transient blackouts. He thought it was due to exercising excessively. Over the next month, he developed a low-grade fever and started feeling lethargic, to the extent that he was unable to exercise or work. He was admitted…
The ACR’s State-of-the-Art Clinical Symposium: Rheumatologists Weigh in on Tough-to-Treat Cases, Paget’s Disease, Imaging
CHICAGO—A 49-year-old woman has had RA for eight years. She has a rheumatoid factor reading of 35, an aCCP reading of 160, erythrocyte sedimentation rate of 42, plus erosions. She has been on methotrexate. She tried etanercept for six months, but then it stopped working. She was on 40 mg of adalimumab weekly, but it…
Rheumatologist Alain Alvarez, MD, Brings Passion for Dance to Medical Practice
There can be a rhythm to rheumatology. At least that’s what Alain Alvarez, MD, can sometimes find. Listening, assessing, helping. It can be a successful dance when doctor and patient become partners, hoping to lead each other forward. When you consider this, it might be little surprise that Dr. Alvarez is also a dance teacher….
Diagnostic Imaging in Patient with Atraumatic Left Shoulder Pain: 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 A 56-year-old man with end-stage renal disease on peritoneal dialysis presents…
Diagnostic Imaging in Patient with Atraumatic Left Shoulder Pain: Findings
View the question. Findings/Diagnosis The AP radiograph of the left shoulder (see Figure 1) shows erosions of the proximal humeral and glenoid articular surfaces (black arrows) without joint-space narrowing. There is a well-defined marginal erosion with overhanging edge at the junction of the proximal humeral articular surface and rotator cuff insertion on the greater tuberosity (ellipse)….
Rheumatology Coding Corner Answer: Sacroiliac Injection with Office Visit
CPT codes: 99214-25, 27096, J3301 x1 ICD-9: 720.2, 720.0, 787.02 ICD-10: M46.1*, M45.9*, R11.0 This encounter is coded as 99214 because it includes: Detailed history; Comprehensive examination—eight systems counted; and Medical decision making—moderate complexity (established problem, new problem with no additional workup; new prescription drug ordered). Keep in mind, the CT guidance is an inclusive…
EULAR 2015: What’s New in RA Research
ROME, Italy—Even with classification criteria that have been updated and refined over time, rheumatoid arthritis (RA) is still a diagnosis that ultimately has to be made with clinical judgment, said Ronald van Vollenhoven, MD, PhD, professor of medicine and chief of clinical therapy research in inflammatory diseases at the Karolinska University in Sweden. His remarks…
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