The evaluation of a child with arthralgia who has a normal physical examination provides a challenge to rheumatologists. Here are some insights into assessing and treating children with musculoskeletal pain syndromes…
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2019 Changes to E/M Documentation
As of Jan. 1, 2019, the Centers for Medicare & Medicaid Services (CMS) will implement several coding and documentation policies to provide immediate burden reduction to providers. The 2019 Medicare Physician Fee Schedule Final Rule (MPFS) released Nov. 1, 2018, by the CMS contained significant changes to the Medicare Part B coding and documentation policies…
Big Data Drives New Research
Big data can benefit rheumatology research. But according to experts at the 2018 ACR/ARHP Annual Meeting, the data must first be accessible, interoperable and shareable…
Low Muscle Density & Physical Function in Patients with RA
Low muscle density due to the accumulation of intramuscular fat has been observed in RA patients and is associated with higher disease activity. New research sought to understand the relationship between muscle density, physical function and strength independent of body composition, including such factors as total and visceral adiposity. The results: Compared with healthy controls, low muscle density in RA patients was associated with low muscle mass, excess adiposity and greater disability…
Post-Traumatic Osteoarthritis: Managing OA That Develops After Joint Injuries & Reconstructive Surgery
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…
Emerging Treatments for OA: New Therapies Target Joint Pain, Not Just Structural Damage
CHICAGO—Are effective treatments for osteoarthritis (OA) on the horizon? In Emerging Treatments for Osteoarthritis at the 2018 ACR/ARHP Annual Meeting, experts discussed potential therapies to address OA structural progression, pain and inflammation. With an aging population and rising obesity rates, “we can expect the prevalence of osteoarthritis will only increase,” said Anne-Marie Malfait, MD, PhD,…
Managing Multiple Rheumatic Diseases: How One Patient Copes with Her Disabilities & Advocates for Others
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…
Rheumatoid Arthritis & Exercise Avoidance
“Don’t believe everything you think,” said Allan Lokos, the founder and guiding teacher of the Community Meditation Center located in New York City’s upper west side. These words may be especially important for those dealing with chronic pain, finds new multicenter research. The study, “Trajectories of Fear-Avoidance Beliefs on Physical Activity Over Two Years in…
Case Report: Acne Drug Leads Patient to Retinoid Hyperostosis
Presentation A 26-year-old man with a history of acne vulgaris and hidradenitis suppurativa presented to our rheumatology clinic with persistent back pain and stiffness of three years’ duration. He described bilateral low back pain that was worse when he arose in the morning and at night when he was trying to sleep. In a similar…
Turmeric: The Evidence for Therapeutic Use for Arthritis
During a recent divisional grand rounds presentation, I asked a room full of my colleagues how many of them had been asked about turmeric by a patient within the past year, month, week or day. Most hands remained up by the end of the exercise. During a recent trip to New York City, I was…
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