A 56-year-old African American man presents to the emergency department with polyarthralgias and a fever of 103ºF. One month prior to admission, he presented with right knee pain and swelling. Blood cultures grew S. epidermidis. He was treated for presumed septic arthritis complicated by MSSE bacteremia. He was treated with meropenem and a prolonged course…
By treating mice with antibiotics, researchers found that alterations in the gut microbiome impaired the mechanical properties of bone and depleted splenic B and T cell populations. The researchers suspect the decrease in bone strength resulted from the change in the immune system…
In the good old days, physicians routinely made house calls. The decision to visit the literal bedside of a patient was practical: hospital services were primitive and often offered too little benefit to justify an emergency journey by the patient. These physicians carried leather bags, sometimes called Gladstones, that were filled with instruments for eventualities…
Bone health in general, and osteoporosis in particular, is among the most common conditions seen in rheumatology practices. The ACR recently joined the National Bone Health Alliance (NBHA) to reach out to other stakeholders. “In 2004, the Surgeon General of the United States published a report on osteoporosis that discussed in depth the gaps in…
Oral health is not frequently considered within the sphere of a rheumatologist’s practice. However, recent results published by the Canadian Scleroderma Research Group (CSRG) point out the importance of assessing oral health in patients with systemic sclerosis (SSc). Result of 3-Year Grant Between 2008 and 2011, 163 patients with SSc and 231 controls were entered…
Two sets of guidelines—one on managing anti-rheumatic drugs perioperatively for patients undergoing total hip and knee replacements, and another that updates glucocorticoid-induced osteoporosis prevention and treatment strategies—will be featured in sessions at the 2016 ACR/ARHP Annual Meeting this month. The Sessions Sunday, Nov. 13, 2:30–3:30 p.m.: Glucocorticoid-Induced Osteoporosis Prevention and Treatment: A New ACR Clinical…
Humpty Dumpty sat on a wall Humpty Dumpty had a great fall All the king’s horses and all the king’s men Couldn’t put Humpty together again. —Mother Goose I feel like a female Humpty Dumpty. Recently I took a great fall, and now I am in the process of being put together again. I was…
FDA Restricts Fluoroquinolone Use The U.S. Food and Drug Administration (FDA) has twice previously communicated safety information about systemic fluoroquinolones—in August 2013 and July 2008. The safety issues of this medication class described in its latest Drug Safety Communication were also discussed at a November 2015 FDA Advisory Committee meeting.1 The FDA is now advising…
Etanercept Submitted for Chronic, Severe Plaque Psoriasis in Children The U.S. Food and Drug Administration (FDA) has accepted the supplemental Biologics License Application for etanercept (Enbrel) for treating pediatric patients with chronic, severe plaque psoriasis.1 The application was submitted in early January 2016 and is based on results of a one-year Phase 3 study with…
Take the challenge. CPT: 99213-25, 77085 ICD-10: Diagnosis M81.0, Z79.52 The encounter is coded as 9913 as follows: History—The history of the present illness was extended. The review of systems was complete, and the past medical history was documented. This makes the history detailed. Examination—The examination was expanded problem focused. Medical decision making—The diagnosis was…