The Medicare Payment Advisory Commission (MedPAC) makes recommendations to Congress on Medicare policy including physician payments and patient access issues. These recommendations can directly impact rheumatology care coverage and rheumatologist reimbursement. Representatives of the ACR and partners recently met with new MedPAC Executive Director James E. Mathews, PhD, to discuss appropriate recognition of rheumatology care…
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Telehealth Is Helping the Underserved
For many uninsured and underinsured patients in Yuba City, Calif., seeing a rheumatologist used to mean taking a day off from work and driving 108 miles, roundtrip, to the University of California Davis Medical Center. That changed this year when patients were offered the option of having a telemedicine consultation with a rheumatologist as part…
Experts Discuss Proposed Giant Cell Arteritis Risk Tool
A proposed model to predict the risk of giant cell arteritis (GCA) prior to a temporal artery biopsy could help triage patients and guide decision making about the need for biopsy or monitoring (see Figure 1). There’s no specific biomarker for GCA, and GCA can be a “diagnostic conundrum, especially when it presents in an…
Rheumatology Coding Corner Question: RA Follow-Up with Imaging
History A 39-year-old woman returns for follow-up for her rheumatoid arthritis. She has positive rheumatoid factor, but no organ or systemic involvement. She has joint swelling and pain in her left hand, right elbow and right knee. Her pain is at an 8 on a 10-point scale. She states the pain is worse in the…
Poor Sleep Quality During Menopause Tied to Increased Inflammation
(Reuters Health)—Middle-aged women who get poor quality sleep have elevated levels of inflammatory markers, suggesting their risk for heart disease and other illnesses may be increased, U.S. researchers say. Based on sleep monitoring and blood tests of 295 women, most of whom were past menopause, researchers found those who had trouble falling asleep or who…
Nonopioid Medication May Be as Effective as Opioids for Chronic Pain
A recent study compared the efficacy of opioids with nonopioid pain treatments in patients with chronic back pain and hip or knee osteoarthritis. After 12 months, researchers found that treatment with opioids was not superior to treatment with nonopioid medication, with only minor differences in patients’ functional responses to the medications…
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…
Opioids No Better Than NSAIDs for Chronic Back or Arthritis Pain
(Reuters Health)—Acetaminophen, ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs) are better than opioids at easing the intensity of chronic pain in the back, knees or hips, a U.S. experiment suggests. And opioids are no better than these other drugs at reducing how much pain interferes with daily activities, such as walking, working, sleeping or enjoying…
The Why & What of the ACR’s Clinical Practice Guidelines
With the support of its membership, the ACR publishes clinical practice guidelines in multiple disease areas based on the best available clinical and scientific data. These aim to support health professionals treating rheumatology patients to give the best possible care. Like any set of medical guidelines, ACR guidelines are based on evidence of several different…
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