In several U.S. states, Blue Cross/Blue Shield and other insurers have dropped or are considering dropping coverage of hyaluronic acid injection—or viscosupplementation—for patients with knee osteoarthritis. The decision appears to be based on guidelines published by the American Academy of Orthopaedic Surgeons in 2013, which at that time specified that research had not found hyaluronic…
Search results for: knee pain
Patient Education Videos Help Them Understand & Manage Their Disease
Videos designed to help patients understand and manage chronic rheumatologic diseases can lead to gains in clarity about the disease duration, symptoms, medications, and the importance of regular visits with a physician. A study published in a recent issue of Arthritis Care & Research looks at the development and impact of three educational videos for…
Learn to Spot Neuropathic Arthropathy Mimicking RA
Rheumatoid arthritis (RA) is characterized by polyarthritis, especially involving hands and wrists. Without treatment, RA usually evolves to articular deformities. Unfortunately, although rheumatoid deformities are characteristic, they are not pathognomonic, and we should be aware of possible mimics.1 Neuropathic arthropathy (NA), similar to other diseases, such as hemochromatosis, psoriatic arthritis, calcium pyrophosphate deposition disease, Jaccoud…
A Comprehensive Review of NSAID Cardiovascular Toxicity
Non-steroidal anti-inflammatory drugs (NSAIDs) are the most used drugs for acute and chronic pain. More than 30 billion doses of NSAIDs are consumed annually from more than 70 million prescriptions.1 Despite their common use, NSAIDs are not free of serious toxicities. In the pre-Vioxx (rofecoxib) era, gastrointestinal toxicity was the primary concern for many NSAIDs….
Can Rheumatologists Get More Systematic about Psychosocial Care?
A recent position statement by the Society of Behavioral Medicine (SBM) concludes that patients with persistent pain need better access to psychosocial care in all healthcare settings.1 The SBM offers 10 health policy recommendations for improving such access, including removing system-related barriers, providing referral tools, reimbursing for evidence-based psychosocial approaches, prioritizing generalist-level and specialist pain…
Flare Risk Increases When Medication Is Stopped Prior to Arthroplasty
After total hip or knee arthroplasty, flares are common in patients with rheumatoid arthritis (RA), according to a recently published study.1 Higher disease activity at baseline appears to be linked to flares, but use of such medications as biologics and methotrexate did not independently predict flaring. “Contrary to the notion that patients with established RA…
Case Illustrates the Difficulty Diagnosing Granulomatosis with Polyangiitis
Granulomatosis with polyangiitis (GPA) was first described in the British Medical Journal in 1897 by Scottish otolaryngologist Peter McBride.1 GPA is a relatively rare, systemic necrotizing vasculitis that can make diagnosis challenging. The incidence has been estimated anywhere between two and 12 cases per million.2 GPA mainly affects adults between the ages of 45 and…
Fed Up with Rising Costs, Big U.S. Firms Dig Into Healthcare
SAN JOSE, Calif., (Reuters)—At its Silicon Valley headquarters, network gear maker Cisco Systems Inc. is going to unusual lengths to take control of the relentless increase in its U.S. healthcare costs. The company is among a handful of large American employers who are getting more deeply involved in managing their workers’ health instead of looking…
Healthcare Providers Should Encourage Exercise for OA Patients
A systemic review supports the ideas that exercise benefits the physical and mental health of patients experiencing pain related to hip and/or knee osteoarthritis (OA). Overall, research indicates that patients who exercised had slightly lower rates of pain and greater physical function, as well as slightly improved self-efficacy and social function…
Rheumatology Coding Corner Question: Billing for an Inflectra Infusion
A 68-year-old female patient returns to the office for a second round of Inflectra (infliximab-dyyb) infusion for her rheumatoid arthritis with rheumatoid factor of multiple joints without organ or systems involvement. She reports pain, stiffness and swelling in her left and right knees and right elbow and rates the pain at a 9 on a…
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