As rheumatologists, we have a love-hate relationship with the corticosteroid prednisone, a feeling many of our patients share. It’s our most effective medication to quickly shut down an overactive immune system. When we have a patient with life- or organ-threatening autoimmune disease—severe lupus affecting the kidneys or vasculitis causing hemorrhage in the lungs, for example—large…
A typical patient with a rheumatic disease needs a multifaceted treatment approach to address comorbidities, minimize disability, promote quality of life and improve survival. To achieve these outcomes, rheumatology research has evolved from examining a single treatment to studying the best treatment approaches. Examples of these strategy trials include how to best combine pharmaceutical therapies,…
A 70–year-old female patient with rheumatoid arthritis affecting multiple joints who is rheumatoid-factor positive but without organ or system failure returns for her third infliximab infusion. She is scheduled to receive 500 mg of the drug. How should this encounter be coded? 96413, 96415, J1745 x 50; ICD 10: M05.79 96413, 96415, J1745 x 50;…
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…
Higher anxiety levels in postmenopausal women may put them at increased risk of fracture and should be considered when assessing a woman’s risk of osteoporosis as well. This is the conclusion of a study recently published in the journal Menopause that looked at the role of anxiety in bone health.1 Specifically, the study examined the…
Traditional X-rays, move over—there may be a new gold standard for joint imaging to assess even the smallest changes that can signal the onset of arthritis, as reported recently in the journal Scientific Reports.1 Utilizing the combined expertise of radiologists, rheumatologists and engineers, University of Cambridge researchers developed an algorithm to monitor the joints of…
In summer 2017, I was a few months post-partum when I received an email announcing applications for the ACR’s Advocacy 101 program. It would take only a few days, but I asked my division director if it would be worth the time commitment. He questioned the career benefits of advocacy, but encouraged me to apply…
NEW YORK (Reuters)—Walmart and Home Depot, two of the top 10 U.S. employers, have embraced a health insurance strategy that punishes drugmakers for using discount cards to keep patients from switching or stopping their medications. Large U.S. companies have started tightly managing how employees and their family members use these popular discount, or copay, cards…
Sen. Susan Collins (R-Maine) is the recipient of the ACR’s 2018 Award for Public Leadership in Rheumatology. Sen. Collins has championed several pieces of legislation that support rheumatologists and rheumatology patients, and she has taken part in multiple efforts to address ongoing concerns in rheumatology. “Sen. Collins has consistently worked both sides of the aisle…
I attended medical school in the 1960s, when Dr. Lawrence Weed reinvented the medical record to organize and leverage the physician’s patient evaluation for clarity and quality of care—what he dubbed “the problem-oriented medical record.”1,2 My internal medicine house officer training at Massachusetts General placed a high value on efficient, effective medical records and communication…