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Search results for: fever

Rheumatology Coding Corner Question: Level 4 New Patient Visit

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A 32-year-old female patient comes in for an initial visit. She is self-referred and complains of pain, numbness and color changes in her fingers when exposed to cold. The patient reports that her right distal index finger, left distal index finger and fourth right finger turn white and blue with pain and numbness when exposed…

New Criteria Released for Macrophage Activation Syndrome in Juvenile Idiopathic Arthritis

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Although most systemic juvenile idiopathic arthritis patients don’t develop macrophage activation syndrome (MAS), the approximately 10% who do have this serious complication can experience widespread, massive inflammation, debilitating symptoms and even death. To improve understanding of MAS among physicians and advance efforts to develop effective therapies to treat it, a panel of 28 international pediatric…

Rheumatology Coding Corner Question: Physical Examination with Infliximab Infusion

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A 12-year-old male established patient with inflammatory bowel disease with associated juvenile spondyloarthropathy returns to the office for a follow-up visit for his infliximab infusion. The patient reports moderate pain in his right hip after walking for extended periods of time or after sports activities. He denies any other joint pain and denies any joint…

Rheumatology Case Report: Concomitant Lupus with Features of Scleroderma, Castleman Disease

Kwabna Parker, MBBS, Sireesha Datla, MD, & Nancy Soloman, MD  |  

We report a case of a 27-year-old woman who was initially diagnosed with systemic lupus erythematosus (SLE), had features of scleroderma and was subsequently found to have lymph node biopsy consistent with multicentric Castleman disease (MCD). She also had serologic evidence of acute Epstein-Barr virus (EBV) infection (vs. reactivation of EBV). The occurrence of MCD…

Arthritis Patients Lack Knowledge about Safe Use of Biologics

Will Boggs, MD  |  

NEW YORK (Reuters Health)—Many patients with arthritis lack the knowledge to use their biologic treatments safely, researchers from France report. “Some patients are at risk of poorly managing their biologic therapy, especially patients living alone, in a large city, patients with low education level, or (patients who are) unemployed,” Dr. Anne-Christine Rat from CHU de…

Rheumatoid Arthritis & Autoimmune Glomerulonephritis

Rheumatoid Arthritis & Autoimmune Glomerulonephritis

Diana M. Girnita, MD, PhD, Shahzad Safdar, MD, & Avis Ware, MD  |  

Rheumatoid arthritis (RA) is rarely associated with renal manifestations, but secondary amyloidosis due to chronic inflammation is reported to be the etiology of renal dysfunction in many cases of RA.1,2 The discovery of biologic therapy, with TNF-alpha inhibitors in particular, made a huge difference in the disease course and prognosis of RA patients. However, TNF-alpha…

2015 ACR/ARHP Annual Meeting: Genetically Complex Auto-Inflammatory Diseases

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SAN FRANCISCO—Early in his career, Daniel Kastner, MD, PhD, scientific director at the National Human Genome Research Institute, saw a 24-year-old patient with a lifelong history of recurrent fever and severe episodes of arthritis. A colleague told him it was most likely familial Mediterranean fever (FMF). There was little then known about its mechanisms, and…

Rheumatology Coding Corner Question: Billing for Trigger Point Injection, Office Visit

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A 35-year-old established female patient returns to the office for a follow-up visit for her diagnosis of fibromyalgia. She complains of pain, stiffness and swelling in her left and right shoulders and her neck. The pain is considerably worse in the morning. She denies any fever, cough or dyspnea. The physician performs a problem-focused exam….