Post-Traumatic OA A 70-year-old female patient comes in for a follow-up visit for pain and stiffness in her left hip. She injured her hip in a skiing accident three years before and reports the X-rays at that time showed no fractures. Due to no obvious fracture at the time, she was given ibuprofen and advised…
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Survey: Patient-Doctor Relationship Can Positively Affect RA Management
A new survey of more than 3,600 adults living with rheumatoid arthritis (RA) shows that a patient’s perception of their disease and treatment, as well as their relationship with their healthcare professional, can positively impact the management of their disease. The RA NarRAtive survey, created and sponsored by Pfizer, is part of an international initiative…
Dual-Trained Rheumatologists Take Multidisciplinary Approach to Their Patients
Co-morbidities in patients with rheumatoid arthritis and related autoimmune diseases often warrant a multidisciplinary approach to treatment. When it comes to inflammatory and fibrotic lung conditions in these patients, collaboration between pulmonary/critical care specialists and rheumatologists is essential, say two rheumatologists recently interviewed by The Rheumatologist. Both followed their rheumatology fellowship training with additional fellowships…
Bone Loss Common in Suspected Spondyloarthritis
NEW YORK (Reuters Health)—More than 40% of patients with early inflammatory back pain suggestive of axial spondyloarthritis (SpA) show bone loss over the course of two years, according to French researchers. SpA is known to be associated with bone loss at the spine and the hip and an increased risk of vertebral fractures. To investigate…
Does Insomnia in Patients with Knee OA Affect Pain?
New research explores the correlation between insomnia and pain in patients with knee osteoarthritis (OA). After conducting a multimodal sleep study, researchers from Johns Hopkins University in Baltimore uncovered a combined effect between catastrophizing and disturbed sleep, resulting in increased pain sensitivity, specifically central sensitization, for knee OA…
Preparing Immunocompromised Patients for Risks of Traveling Abroad
Summer is a season for travel, so if your immunocompromised patients plan to journey to regions where there are outbreaks of infections, such as chikungunya, tuberculosis, typhoid, yellow fever or other diseases, communication and preparation may prevent serious health events. “The world teems with disease-causing organisms, and almost every infection is more serious in the…
Rheumatology Coding Corner Question: Level 3 Visit with Primary Diagnosis of Osteoarthritis
Level 3 Visit with Primary Diagnosis of Osteoarthritis A 36-year-old patient presents with unilateral primary osteoarthritis of the left hip. She reports her groin pain as 7 on a scale of 1–10. When she tries to straighten her left leg, she experiences increased groin pain. She is currently taking over-the-counter medication to relieve the pain,…
Rheumatology Coding Corner Answer: Level 3 Visit with Primary Diagnosis of Osteoarthritis
CPT codes: 99213 Diagnosis Codes: ICD-9: 715.15, 278.01 ICD-10: M16.12, E66.01, Z68.41 This encounter is coded as 99213 as follows: History—The history of present illness was extended. The review of systems was comprehensive, and no past family social history was documented. This makes the history level expanded problem focused. Examination—There were eight systems examined. This…
Diagnostic Imaging in Patient with Left Hip Pain: History
Editor’s note: In this recurring feature, we first present a series of images (this page) for your review, and then a brief discussion of the findings and diagnosis (p. 63). Before you turn to the discussion, examine these images carefully and draw your own conclusions. History For the discussion, click here. A 55-year-old man on…
Diagnostic Imaging in Patient with Left Hip Pain: Findings
View the question. Findings/Diagnosis The AP radiograph of the left hip (see Figure 1) shows periarticular, well-defined erosions of the left hip (white arrow) without joint space narrowing or osteophytes. There is no fracture. There are surgical clips and a calcified mass in the right hemipelvis (black ellipsis), representing a failed renal transplant. The coronal STIR…
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