A 32-year-old female patient comes in for an initial visit. She is self-referred and complains of pain, numbness and color changes in her fingers when exposed to cold. The patient reports that her right distal index finger, left distal index finger and fourth right finger turn white and blue with pain and numbness when exposed…
Search results for: musculoskeletal disease
Clazakizumab for Adults with Active PsA
This is the first clinical trial of an IL-6–targeted therapy in PsA. Clazakizumab may be an effective treatment option for musculoskeletal aspects of PsA, but because of the lack of a dose response in this study, further studies are required to confirm the appropriate dose. The safety profile is consistent with the pharmacology of IL-6 blockade and prior clinical experience with this antibody in rheumatoid arthritis…
E-Health, Telemedicine Pose Challenges, Offer Benefits for Patients with Arthritis
A 52-year-old woman comes to the office complaining of a two-month history of pain and swelling in the small joints of her hands, feet and knees. She says, “Doctor, I’ve been searching the Internet, and I think I have rheumatoid arthritis. I have some questions for you.” The healthcare system in the U.S. is changing…
Rheumatology Coding Question: Level 3 Established Patient Evaluation and Management Office Visit
Level 3 Established Patient E&M Visit A 43-year-old patient is seen in the office for a follow-up visit of her RF-positive rheumatoid arthritis and primary osteoarthritis of the left knee. The patient is on sulindac, methotrexate and folic acid. At her last visit, the patient’s methotrexate dose was increased, which has greatly reduced her pain….
Milestones of Rheumatology Education
In 2013, a collaboration began to advance the training and assessment of fellows. The result: A uniform set of educational reporting milestones for all internal medicine subspecialties was developed. Key stakeholders were then asked to develop a list of entrustable professional activities (EPAs), a set of responsibilities any specialist should be able to perform, for their subspecialties. The ACR’s Next Accreditation System working group developed 14 EPAs for rheumatology…
3D Printing in Rheumatology Holds Promise for External Devices, Joints
When Abby Paterson, PhD, started her doctoral work in product design and technology at Loughborough University in the United Kingdom in 2009, she says 3D printing was little known by clinicians or the general public. Now, the technology is seemingly everywhere. For Dr. Paterson, the advancing science has led to a promising project focused on…
Conformational Flexibility in HLA-B27 Provides Clues to Development of Ankylosing Spondylitis
Understanding how human leukocyte antigen (HLA) class I molecule B27 promotes spondyloarthritis has intrigued researchers for four decades. Although the association between the single gene variant HLA-B27—specifically some of its subtypes—with ankylosing spondylitis (AS) is particularly strong, how HLA-B27 directly influences disease development has not yet been clearly explained, although hypotheses continue to be generated….
Precision Medicine Latest Initiative in War on Autoimmunity, Rheumatic Illnesses
It’s been said that there is no greater bully pulpit than the American presidency. Linking the force of moral persuasion to this most powerful office—one that is capable of issuing executive orders and bypassing the wishes of Congress or rousing public opinion in favor of or against bills that are in the process of being…
Implementing Successful Care Management Programs for High-Cost Patients
As healthcare delivery increasingly moves from volume-based care to value-based care, providers are needing to adopt new practices to meet what is now commonly referred to as the triple aim of healthcare delivery—improving the patient experience of care (which includes satisfaction and quality), improving the health of populations and reducing cost.1 Among the most difficult…
Addressing the Rheumatology Workforce Shortage
In 2008, the American College of Rheumatology Workforce Study Advisory Group published a comprehensive rheumatology workforce analysis.1 It concluded: Based on assessment of supply and demand under current scenarios, the demand for rheumatologists is expected to exceed supply in the coming decades. Strategies for the profession to adapt to this changing health care landscape include…
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