A 66-year-old female patient returns to the office complaining of swelling and a burning pain in her right first toe. She rates the pain level at a 9 out of 10. She currently takes an over-the-counter non-steroidal anti-inflammatory drug (NSAID), but it has done little to alleviate the pain. This is her second episode this…
Search results for: Primary care
The Walk from the Waiting Room
For a rheumatology practice, rooming time can be leveraged to improve efficiency and patient care. Christie Bartels, MD, MS, and colleagues have studied this time frame and developed data-based tips and tools to decrease variation among staff and streamline practices…
Rheumatologists Treating Patients with HIV Face Treatment, Diagnostic Challenges
Rheumatologists treating HIV patients in 2017 must think through many important factors as this population ages. As we continue to learn, rheumatologists must consider important drug–drug interactions, relatively uncommon rheumatological presentations of HIV, as well as specific diagnostic challenges. Working closely with infectious disease specialists is the best way to achieve optimum care for this…
Ultrasound Can be Useful in Diagnosing Gout
The presence of synovial monosodium urate monohydrate (MSU) crystals is the gold standard for diagnosing gout. But a new study, funded in part by the ACR and led by rheumatologists, including Alexis Ogdie, MD, MSCE, evaluated the effectiveness of ultrasound in diagnosing it. The study found that ultrasound can be useful in discriminating gout from non-gout….
Tips for Managing Young Adult Rheumatology Patients
Often, young adults (18–23 years old) with rheumatic illness demonstrate poor adherence to treatment regimens, lack advocacy skills and have inadequate knowledge about diagnosis and treatment.1 Patients presenting at a transition clinic are typically comfortable with having their parents continue to be centrally involved with their care, but this is a time in life when…
Rheumatologists Respond to Prescription Opioid Analgesic Crisis
The alarming statistics on prescription opioid overdoses are well known to medical professionals, thanks to the Centers for Disease Control and Prevention (CDC)’s widely cited finding that deaths from opioid analgesics have increased fourfold since 1999.1 Half of all fatal drug overdoses now involve opioids prescribed by a doctor. Meanwhile, a lack of rigorous research…
Step Therapy and Biosimilar Substitution Top the Priority List for the Rheumatology Association of Iowa
A little more than three years ago, rheumatologist Michael Brooks, MD, FACP, FACR, Cedar Rapids, Iowa, turned years of discussion into something tangible: He and his colleagues got the paperwork and financial requirements in order and officially started the Rheumatology Association of Iowa. “We had been trying to get something going statewide in terms of…
A Moving Target: Cardiovascular Risk & Rheumatic Disease
For patients with rheumatic disease, general treatment guidelines for managing cardiovascular risk are suboptimal, says Katherine Liao, MD. A patient’s level of disease activity and inflammation affect their risk…
How to Survive MACRA
The year 2015 brought the end of the much-maligned Sustainable Growth Rate (SGR), sometimes known as the “doc fix.” The SGR established limits on Medicare reimbursement for physicians, and each year, physicians and those lobbying on their behalf were forced to stave off drastic cuts to their payments. “The SGR was Congress’s attempt to control…
Diagnosis of Acute Gouty Arthritis Obscured by Anchoring Bias
A 56-year-old African American man presents to the emergency department with polyarthralgias and a fever of 103ºF. One month prior to admission, he presented with right knee pain and swelling. Blood cultures grew S. epidermidis. He was treated for presumed septic arthritis complicated by MSSE bacteremia. He was treated with meropenem and a prolonged course…
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