Take the challenge. D—Even though the patient’s chief complaint is for a follow-up of chronic idiopathic gout without tophi, the patient is presenting with an acute flare of idiopathic gout of the left knee. Acute gout and chronic gout have specific coding guidelines, because they each have an Excludes 1 note. This indicates they are…
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Case Study in Dermatology: Tender Papules on Elbows, Hands in RA
The Case A 41-year-old woman was referred to the dermatology clinic for a three-month history of tender lesions on her elbows and around the joints of her hands. Her medical history was notable for seropositive, non-erosive rheumatoid arthritis (RA), which was being treated with 5 mg prednisone daily, 10 mg methotrexate weekly by mouth, 200…

Rheumatologists, Physical Therapists Partner to Offer Patients Pain Relief, Improved Quality of Life
When rheumatoid arthritis (RA) left Stefanie Gluckman fighting chronic pain and relegated to a wheelchair, she turned to Lori Rubenstein Fazzio, DPT, PT, MAppSc, YTRX, of Mosaic Physical Therapy in Los Angeles, for relief. Dr. Rubenstein Fazzio knows what it’s like to suffer from excruciating pain. After sustaining career-threatening injuries in a horseback accident in…

2015 ACR/ARHP Annual Meeting: Stroke Risk Elevated after Herpes Zoster Infection Among Patients with Autoimmune Disease
SAN FRANCISCO—The risk of stroke after herpes zoster (HZ) infection is elevated in the period immediately after infection in patients with autoimmune diseases, according to a study presented at the 2015 ACR/ARHP Annual Meeting.1 The findings were presented in a scientific session, called Discover 2015, that highlighted new research. In another study from the session,…

Online Portals Can Function as Important Physician–Patient Communication Tools
Patient portals are online programs and applications that help patients and physicians interact. Although there are many different implementations, most will have some sort of messaging component to help with communication between the doctor and the patient, as well as access to at least some elements of the chart, such as test results. “Patients should…
VA Musculoskeletal Education Pilot Program Helps PCPs Treat Patients
To improve access to quality of care for patients with osteoarthritis and other musculoskeletal pain, the U.S. Department of Veterans Affairs (VA) launched a continuing education program designed to strengthen the musculoskeletal knowledge and skills of primary care providers (PCPs). In the program’s initial trial in 2012, 19 physicians were trained on exams, treatments and joint injections. Two years after course completion, some participants increased the number of intraarticular corticosteroid injections at their clinics without needing to refer patients to specialists…

Opioid Investigated to Treat Acute & Chronic OA Pain; Plus New RA Treatment & More
In Phase 2 trials, the oral opioid, CR845, has proved promising in treating pain in patients with hip and knee osteoarthritis. Olokizumab is being investigated to treat RA, and in Canada, adalimumab has been approved to treat polyarticular JIA in 2–4 year-olds…

FDA Approves New Drugs for Pain
FDA Updates Belbuca, buccal-administered buprenorphine, has received U.S. Food and Drug Administration (FDA) approval for treating severe chronic pain.1 The dosage form is a dissolving film that is absorbed through the inner lining of the cheek for chronic pain management. It’s expected to be commercially available in the first quarter of 2016. Seven dosage strengths…

The ACR/ARHP Award Winners Discuss Their Contributions to Rheumatology
At the 2015 ACR/ARHP Annual Meeting in San Francisco in November, the ACR and the ARHP honored a group of distinguished individuals who have made significant contributions to rheumatology research, education and patient care. In the December 2015 issue, The Rheumatologist reported on the ACR’s awards. This month, we speak with the ARHP winners about…
New Blood Thinner ‘Antidote’ to Help Doctors Move Past Warfarin
NEW YORK (Reuters)—A new class of blood thinners that competes with widely used warfarin should get a boost next year when an “antidote” that can reverse the medications’ effects in an emergency is expected to enter the market, according to top U.S. heart doctors and investors. Xarelto, from Bayer AG and Johnson & Johnson, and…
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