ACR Convergence 2025| Video: Rheuminations on Milestones & Ageism

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Noridian Updates Tendon Injections Guidelines for Jurisdiction F

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Effective May 22, 2017 Noridian has updated the Local Coverage Determination (LCD) coding guidelines for CPT procedures 20552, injection(s); single or multiple trigger point(s), 1 or 2 muscle(s) and 20553, injection(s); single or multiple trigger point(s), 3 or more used to affect therapy for a pathological condition. Noridian states the goal of the updated diagnostic…

MicroRNAs Provide Insight into Bone Metabolism

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A recent study examined the functional variants within microRNAs that affect bone metabolism and possibly bone disorders. Researchers found overexpression of microRNAs may contribute to the osteoporotic phenotype, and the gene targets associated with two specific osteoblast-expressed microRNAs may be critical in osteoporosis…

Rheumatology Coding Corner Question: Billing Infusion Procedure with JW Modifier

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An 82-year-old female established patient diagnosed with ankylosing spondylitis in multiple joints returns to the office for her second infliximab infusion. She denies any fevers, cough or concurrent illness. Her joint pain is 7 on a scale of 1–10. She complains of achy pain in the cervical, lumbar and sacral regions of her spine. She…

Rheumatology Case Report: Bullous Lesions in Patient with Lupus

Mitali Sen, MD, Corrado Minimo, MD, & Ruchika Patel, MD  |  

Systemic lupus erythematosus (SLE) is a heterogeneous disease associated with multiple acute or chronic cutaneous manifestations, including the relatively rare category of bullous lupus. The development of vesiculo-bullous lesions may be associated with a high morbidity, hence they warrant an urgent investigation, including a skin biopsy to identify the diagnosis and initiate prompt treatment. With…

Brodalumab Approved for Plaque Psoriasis, Plus Baricitinib Effiicacy Studied for RA

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Brodalumab Approved for Plaque Psoriasis The U.S. Food and Drug Administration has approved brodalumab, a monoclonal antibody that targets interleukin 17 (IL‑17).1,2 Brodalumab (Siliq) was approved for treating moderate to severe plaque psoriasis in adults who are candidates for systemic therapy or phototherapy and have failed to respond to, or have lost response to, other…

Fellows Forum Case Report: Neuromyelitis Optica

Atul Kapila, MD, Tayseer Haroun, MBBS, & Jayanth Doss, MD  |  

Case Presentation The patient was a 42-year-old African American female diagnosed with systemic lupus erythematosus (SLE) based on the findings of polyarthritis, malar and discoid rash, fatigue, positive double-stranded DNA (dsDNA) ribonucleoprotein and Smith antibodies, and low serum complement levels. Her SLE had been well controlled on hydroxychloroquine 400 mg daily, oral methotrexate 25 mg…

Straightforward Approach Can Help Rheumatology Health Professionals Engage with Fibromyalgia Patients

Terence Starz, MD, on behalf of the ARHP Practice Committee  |  

“I have pain all over my body” is a challenging response after you’ve asked a new patient what brings them in for their visit. You immediately suspect that this patient has fibromyalgia. The prevalence of fibromyalgia in the U.S. is 5 million people, and it is among the most common conditions in many rheumatology practices….

Diagnosis of Acute Gouty Arthritis Obscured by Anchoring Bias

Diagnosis of Acute Gouty Arthritis Obscured by Anchoring Bias

Sneha Patel, MD, Monica Mohile, MD, & Arundathi Jayatilleke, MD  |  

A 56-year-old African American man presents to the emergency department with polyarthralgias and a fever of 103ºF. One month prior to admission, he presented with right knee pain and swelling. Blood cultures grew S. epidermidis. He was treated for presumed septic arthritis complicated by MSSE bacteremia. He was treated with meropenem and a prolonged course…