Immune checkpoint inhibitors (ICIs) targeting the cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) or programmed cell death protein 1 (PD-1) axes have revolutionized therapy and improved survival in advanced cancers. However, these immune system modulators also lead to immune-related adverse events (IRAEs).1,2 In clinical trials, IRAEs mainly involved the gastrointestinal tract, skin, endocrine glands, liver and lung,…
People with or at risk for symptomatic knee osteoarthritis (OA) may be assigned to four depression subtypes with distinct clusters of depressive symptoms that may affect pain and disability over time, according to a new study in Arthritis Care & Research.1 Four depression subtypes were identified in the study using the Center for Epidemiologic Studies…
Autoinflammatory diseases are genetically diverse, but clinically similar, conditions distinct from autoimmune illnesses, such as systemic lupus erythematosus or rheumatoid arthritis. Clinically, they are defined by recurrent episodes of inflammation that follow a characteristic pattern each time they occur. Some have a set length of time during which fever, peritonitis or arthritis manifest. Others are…
A 52-year-old man living in greater Boston with a history of hypertension presented at our rheumatology clinic with bilateral knee pain and swelling. He had been in his usual state of health until four months earlier when he developed right knee pain and swelling without an incipient trauma, which did not improve with non-steroidal anti-inflammatory…
Kim Steinbarger, PT, MHS, knows how physical and occupational therapy can make a difference for patients with rheumatic diseases. Ms. Steinbarger was just two years into her career as a physical therapist (PT) when she was diagnosed with rheumatoid arthritis (RA) in 1991. “I’ve seen how regular exercise serves as an important tool in managing…
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—Joint trauma is one of many potential drivers of osteoarthritis disease activity and structural progression. In Post-Traumatic OA: Pathogenesis, Clinical Evolution and Management, a session at the 2018 ACR/ARHP Annual Meeting, experts discussed the effects of sports and other injuries on even young patients’ joints. Post-traumatic osteoarthritis (OA) may account for 12% of hip, knee…
By the time Kelly Conway was diagnosed with rheumatoid arthritis (RA) in 2007, she had already been living with symptoms of the disease for 23 years. Her first symptom appeared when she was 14—knee pain that was incorrectly diagnosed as tendonitis. Over the years, she has experienced fevers and sore joints. She was diagnosed with…
Palindromic rheumatism (PR) was first described in 1944 as “unique in its nature of recurrent, transient episodes of excruciatingly painful inflammation of articular and periarticular tissues, followed by periods without symptoms.”1 Unfortunately, it is becoming evident this entity is more frequent than we thought.2 PR is easily ignored or misdiagnosed due to its character (i.e.,…
Scenario 1 History: A 45-year-old male patient with sero-negative rheumatoid arthritis affecting multiple sites, but with no organ or systems involvement, comes for a follow-up visit. The patient reports swelling of the left knee with throbbing left knee pain. He rates the severity of his pain at an 8 on a 10-point scale. The pain…