CHICAGO—At Hot Topics in Myositis, a session at the 2018 ACR/ARHP Annual Meeting, three experts discussed new classification criteria for idiopathic inflammatory myopathies (IIM) and offered practical primers on overlap myositis conditions and inclusion body myositis (IBM). New Myositis Classification Criteria After a 10-year development process, the new EULAR/ACR Classification Criteria for Adult and Juvenile…
Idiopathic inflammatory myopathies are heterogenous, acquired immune-mediated muscle diseases. Over the past decade, immune-mediated necrotizing myopathy has been recognized as a subcategory of idiopathic inflammatory myopathy characterized by myofiber necrosis in the absence of prominent inflammatory cells.1 Autoantibodies against signal recognition particle (SRP) and 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR) are thought to be associated with the…
CHICAGO—The 2018 ACR/ARHP Annual Meeting session on genetic mimics of rheumatic disease began with a description of a patient who presented with the symptoms of childhood-onset lupus but instead had a well-defined genetic disease: lysinuric protein intolerance (LPI). Lindsay Burrage, MD, PhD, assistant professor of molecular and human genetics at Baylor College of Medicine, Houston,…
CHICAGO—John H. Stone, MD, MPH, director of clinical rheumatology at Massachusetts General Hospital, Boston, took the stage at the 2018 ACR/ARHP Annual Meeting to present, for the first time, a draft of new classification criteria for IgG4-related disease (IgG4-RD), a project supported by both the ACR and EULAR. Even though it was the last day…
CHICAGO—David A. Isenberg, MD, academic director of rheumatology, University College London, presented the ACR Systemic Lupus Erythematosus (SLE) State-of-the-Art Symposium at the 2018 ACR/ARHP Annual Meeting. Dr. Isenberg began by noting lupus is now widely covered in the news, but singer Selena Gomez has probably done the most to increase awareness of the disease; her…
CHICAGO—Physicians from the University of Chicago presented an intriguing case of Sweet’s syndrome for the Clinical Pathological Conference during the 2018 ACR/ARHP Annual Meeting. Pankti Reid, MD, MPH, a rheumatology fellow at the University of Chicago, introduced the case of a white man who, in 2017, came under the care of the University of Chicago….
Sara Alehashemi, MD, MPH, recalls the first time she ever stepped foot on a badminton court. It was back in 2003, when she was a 24-year-old medical school student at Hormozgan University of Medical Sciences (HUMS) in Iran. She was completing a rotation in orthopedic surgery and had been teamed up with another medical student…
A 60-year-old man returns for a follow-up related to his diagnoses of rheumatoid arthritis and chronic gout of his right ankle and foot, without tophi. He reports the gout flares have subsided in his ankle. He takes 450 mg of allopurinol daily. He has rheumatoid factor-positive rheumatoid arthritis, which previously affected multiple sites, without organ…
Which modifier is used when there is a separate and/or identifiable reason to bill for both an evaluation and management code and a procedure code? -25 -24 -51 -59 Which modifier is used to indicate that bilateral procedures were done on a patient? -50 -LT/RT Both a and b None of the above A 68–year-old…
CHICAGO—In systemic lupus erythematosus (SLE), most types of severe pulmonary manifestations are relatively rare, but it’s crucial they be caught because of the potentially dire consequences, said Richard Silver, MD, professor in the Rheumatology Division at the Medical University of South Carolina, Charleston, at the 2018 ACR/ARHP Annual Meeting. Pulmonary Manifestations Parenchymal disease—seen in the…