Search results for: fever

Rheumatology Coding Corner Question: Office Visit for Chronic Idiopathic Gout

From the College | August 17, 2015

Follow-up Visit with Time A 62-year-old male patient returns to the office for a follow-up visit for chronic idiopathic gout without tophi. The patient’s present uric acid level is 4.0, and he is now taking allopurinol 450 mg per day. Previously, he was taken off indapamide due to an increase in his uric acid. He…

Polymyalgia Rheumatica Misdiagnosis Results in Positive Outcome

Hiroshi Watanabe, MD, PhD | July 14, 2015

In late February 2011, a 68-year-old woman visited the rheumatology outpatient clinic. She had been congenitally healthy and had been a field athlete in her early days. Beginning in early January 2011, she became aware of pain in her neck and both shoulders, with pain spreading to her lower back and thighs. She also became…

The ACR’s State-of-the-Art Clinical Symposium: Patients with Scleroderma, Lung Disease May Benefit from Aggressive Therapy

Thomas R. Collins | July 14, 2015

CHICAGO—Scleroderma patients with pulmonary arterial hypertension (PAH) might benefit from more aggressive therapy, an expert in the field said in a session on lung involvement in rheumatic diseases at the American College of Rheumatology’s 2015 State-of-the-Art Clinical Symposium in May. Newer trials—the SERAPHIN trial on macitentan, GRIPHON on selexipag, and AMBITION on an ambrisentan/tadalafil combination—show…

The ACR’s State-of-the-Art Clinical Symposium: Rheumatic, Malignant Disease Mimics Call for Diligence from Rheumatologists

Thomas R. Collins | July 14, 2015

CHICAGO—David Daikh, MD, PhD, professor of medicine at the University of California San Francisco and chief of the Rheumatology Division at the San Francisco VA Medical Center, said the overlap between malignant disease and rheumatic disease means rheumatologists should stay aware that more may be going on than just a rheumatic disorder. He made his…

Many Healthcare Providers Come to Work Sick

Kathryn Doyle | July 7, 2015

(Reuters Health)—Many doctors, nurses, midwives and physician assistants come to work sick even though they know it puts patients at risk, a new survey hints. Many said they don’t call in sick because they don’t want to let colleagues or patients down by taking a sick day, and they were concerned about finding staff to…

Antirheumatic Drugs May Be Linked to Pulmonary Toxicity & More

Michele B. Kaufman, PharmD, BCGP | June 24, 2015

At a recent symposium, Kristin Highland, MD, reported on the use of antirheumatic treatments, specifically methotrexate, and their connections with pulmonary toxicity in patients.

Eosinophilia: A Diagnostic Evaluation Guide for Rheumatologists

Praveen Akuthota, MD, Aryeh Fischer, MD, & Michael E. Wechsler, MD | June 15, 2015

Clinical Vignette A 45-year-old woman with long-standing asthma and chronic sinusitis has new-onset peripheral neuropathy, arthralgias, fatigue, progressive dyspnea and a nonproductive cough. She has never smoked and has no environmental exposures. Her medications include an albuterol metered-dose inhaler (which she uses daily); an inhaled corticosteroid, montelukast; and ibuprofen (which she takes occasionally). She is…

Rheumatology Coding Corner Question: Trigger-Point Injections for Fibromyalgia

From the College | June 15, 2015

A 65-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 hand, elbow and neck that is persistent since her last visit. The pain is considerably worse in the morning. She denies any fevers, cough or dyspnea. The…

Melioidosis: What Rheumatologists Need to Know

G.C. Yathish, MD, Taral Parikh, MD, Parikshit Sagdeo, MD, Balakrishnan Canchi, MD, and Gurmeet Mangat, MD | May 15, 2015

Burkholderia pseudomallei, the causative agent of melioidosis, is endemic in Southeast Asia and northern Australia.1 In recent years, the incidence of melioidosis has increased worldwide. Septic arthritis is a rare, but well-recognized, manifestation of melioidosis. Case Report A 49-year-old woman with known diabetes was admitted elsewhere with uncontrolled diabetes and fever. She was found to…

Plaquenil: From Malaria Treatment to Managing Lupus, RA

Charles Radis, DO | May 15, 2015

In 1984, I wrote my first prescription for the antimalarial drug, hydroxychloroquine (Plaquenil), for a 28-year-old woman with SLE. She was considerably overweight, with inflammatory arthritis and a photosensitive rash, and I worried that oral corticosteroids would tip her over into diabetes. I presented the case to my attending, Steven Malawista, MD, at the Yale…