A 17-year-old woman presents with chronic finger pain experienced over six months that is worse in the mornings. On physical exam, the patient has no joint swelling, pain on range of motion or limitation of range of motion in any of her finger joints. She has a tender, subcutaneous, firm, flesh-colored nodule on the lateral…
James Franklin Fries was born on Aug. 25, 1938, in Normal, Ill. His mother taught middle school English and his father was a college business professor. Jim graduated from Stanford University in 1960 with a major in philosophy, and received his MD at Johns Hopkins UniÂversity, Baltimore, in 1964. He pursued internal medicine and rheumatology…
Payer audits and coding scrutiny are in full swing after an influx of fraudulent claims during the COVID-19 pandemic. Make sure your coding practices are in compliance to protect your revenue.
Pulmonary nodules are comÂmon; most are benign, but the differential diagnosis is broad and includes life-threatening possibilities.1 Our patient is a former smoker who has a history of a complex autoimmune disease and multiple pulmonary nodules. This case was challenging, but clinical, radiographic and histologic clues helped lead to the correct diagnosis. Case Presentation The…
Retroperitoneal fibrosis (RPF) is a rare condition characterized by aberrant fibroinflammatory tissue developing in the retroperitoneum. This disorder was initially called Ormond’s disease. RPF may be idiopathic or secondary to other conditions. Idiopathic RPF is a part of the disease spectrum of chronic periaortitis due to its typical periaortoiliac localization. Idiopathic retroperitoneal fibrosis is a…
Intra-articular venous malformations of the knee are an uncommon cause of knee pain in children. Presenting symptoms of this rare subtype of venous malformation often include nonspecific pain and joint swelling, which may be episodic, and accompanied by limited range of motion. The signs and symptoms can mimic juvenile idiopathic arthritis (JIA). Timely diagnosis of…
Polyarteritis nodosa (PAN) is a systemic necrotizing vasculitis that typically affects medium-sized muscular arteries. The clinical subsets of PAN are idiopathic, generalized, secondary hepatitis B virus (HBV) associated and cutaneous PAN. These clinical subsets are important because of their therapeutic implications. Virtually any organ system can be affected in generalized PAN, but this vasculitis tends…
The 1999 Institute of Medicine report To Err Is Human gave a sobering depiction of the magnitude and consequences of medical error.1 The report concluded that approximately 98,000 people die in hospitals annually due to preventable medical errors. Of all the errors detailed in this report, diagnostic errors have since been determined to be the…
Spondyloarthropathy (SpA) can be difficult to diagnose, with rheumatologists sometimes relying on classification criteria designed for clinical trials. Research examines how the use of MRIs affects the finding of bone marrow edema and the diagnosis of axial SpA.
Research has found dual-energy computed tomography (DECT) may be a non-invasive and cost-effective option to help rheumatologists more accurately diagnose gout.