A 68-year-old female Medicare patient with a diagnosis of primary osteoarthritis of the left knee returns to a practice for her third injection in a series of knee injections. She reports being able to resume her after-dinner walks, which last for 30–40 minutes at least twice weekly. She denies fevers or any rashes. She has…
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How to Proceed When Kids Present with Joint Pain but Normal Exams
CHICAGO—When it comes to correctly diagnosing joint pain in children, “things take time,” said Michael L. Miller, MD, quoting Danish physicist and poet Piet Hein. Children with pain but normal physical examinations may need to return to the clinic for repeat evaluation over several months. “I often tell parents that laboratory tests may help in…

A Step Further: Results from the 1st ACR/ARHP Annual Meeting Walking Challenge
With more than 152,000 taken steps in four days, top honors in the first-ever ACR/ARHP Annual Meeting Walking Challenge go to Mark Phelan, MD…

The 2018 ARHP Merit Awards & ACR Distinguished Fellows
CHICAGO—At the 2018 ACR/ARHP Annual Meeting in October, the ACR and the ARHP honored a group of distinguished individuals who have made significant contributions to rheumatology research, education and patient care. This month, The Rheumatologist speaks with the winners of the ARHP Merit Awards about their individual contributions to advancing rheumatology. You’ll also find interviews…

Annual Meeting Speakers Review Studies Ranging from Opioids to Fibroblasts
CHICAGO—Findings on opioid efficacy, serum urate in osteoarthritis and arthrocentesis headlined the top research of the year discussed in the first half of a session at the 2018 ACR/ARHP Annual Meeting. The second half covered basic science findings, including summaries of new insights into the gender bias in autoimmune diseases, platelet microparticles in scleroderma and…

Arthralgias in Children: What to Do When Kids Present with Joint Pain
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…
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…
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