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Search results for: methotrexate

Rheumatology Coding Answer: Deconstructing Evaluation and Management Codes

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Take the challenge. Answers: B: No—Only the treating physician can take the HPI. The medical assistant is allowed to take the review of systems. If the documentation indicates the treating physician did not take the HPI, the insurance can deny the claim as not medically necessary. B: No—If the high-risk medication is not assessed and…

The Future of Pediatric Rheumatology Grounded in Evolution of Childhood Arthritis and Rheumatology Research Alliance

Yukiko Kimura, MD, & Laura E. Schanberg, MD  |  

Pediatric rheumatology was formally recognized as a specialty in 1991 by the American Board of Pediatrics. Prior to this time, children with rheumatic diseases were treated by a hodgepodge of providers. In addition to providers who had training as pediatric rheumatologists, general pediatricians, adult rheumatologists, allergist-immunologists, orthopedists, pediatric infectious disease specialists and others treated children…

Rheumatology Case Report: Systemic Capillary Leak Syndrome and Rheumatoid Arthritis

Alexis Smith, MD, & Angus Worthing, MD, FACP, FACR  |  

Systemic capillary leak syndrome (SCLS) is a very rare disorder, characterized by recurrent episodes of severe hypotension, hypoalbuminemia and hemoconcentration.1 Attacks of SCLS occur in three phases: 1) prodrome; 2) hypovolemia with weight gain; and 3) hypervolemia with fluid overload and polyuria often complicated by pulmonary edema. Often, compartment syndrome can lead to rhabdomyolysis as…

Infection Greater Worry Than Flare: Collaborative Guideline Offers Guidance to Prevent Joint Replacement Complications & Failure

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WASHINGTON, D.C.—Total joint arthroplasty is one of the most common surgical procedures performed on adults with end-stage arthritis. One recent estimate showed that 2.5 million individuals in the U.S. are living with a total hip replacement and 4.7 million are living with knee replacements. For their patients with inflammatory arthritis, rheumatologists and orthopedic surgeons must…

TNF Inhibitor Tied to Lower Cardiovascular Risk in Psoriasis

Lorraine L. Janeczko  |  

NEW YORK (Reuters Health)—Psoriasis patients treated with tumor necrosis factor-alpha (TNF) inhibitors may have a lower risk of major cardiovascular (CV) events than those treated with methotrexate (MTX), according to a new study. “The findings do not surprise me. TNF inhibitors control inflammation better than methotrexate,” lead author Dr. Jashin J. Wu of Kaiser Permanente…

Rheumatologists Should Discuss with Patients Use of Immunomodulatory Agents During Pregnancy

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The decision to continue or discontinue immunomodulatory medications during pregnancy is a difficult one for both patients and physicians. On the one hand, when left untreated, rheumatic conditions can cause harm to an unborn child, as well as to the pregnant mother. On the other hand, medications can be harmful to a developing fetus. In…

Veteran Rheumatologist Dr. Raymond Scalettar Recounts 60 Years of Practice, Growth of Specialty

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“Yes sir.” That was the response of Raymond Scalettar, MD, DSc, FACP, when his commanding officer told him the U.S. Army wanted him to switch specialties—from gastroenterology to rheumatology. There was only one problem. Dr. Scalettar wasn’t exactly sure what that would entail. That was the mid-1950s. Back then, rheumatology was barely out of the womb. Residency…

2015 Treatment Recommendation Updates for Psoriatic Arthritis Address Comorbidities, New Medications

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In May, the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) published its recommendations for the treatment of psoriatic arthritis (PsA).1 The updated recommendations represent advances in drug development and availability since previous recommendations published in 2009, as well changes in treatment paradigms and the importance of associated aspects of the disease.2…

Rheumatology Fellowship Work in Ethiopia Reveals Gaps in Practical Management of Rheumatic Diseases

Mary Abraham, MD, MBA, with Frehyiwot Ayele, MD  |  

The first month of my last year of rheumatology fellowship began in Addis Ababa, Ethiopia, at Black Lion Hospital, a tertiary university medical center, where I [Dr. Mary Abraham] started an Emory-sponsored global health rotation. Although a very different beginning to my fellowship year, my experiences at Black Lion reminded me of my passion to…