A 35-year-old established female patient returns to the office for a follow-up visit for her diagnosis of fibromyalgia. She complains of pain, stiffness and swelling in her left and right shoulders and her neck. The pain is considerably worse in the morning. She denies any fever, cough or dyspnea. The physician performs a problem-focused exam….
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The ACR Announces Research Agenda for 2016–2020
Future rheumatology-specific research should focus on the definition of new therapeutic targets, improving the understanding of existing therapies, engaging patients in their care and more, according to a recent assessment by the ACR’s Committee on Research…

The ACR Addresses the FDA about the Safe Adoption of Biosimilars in the U.S.; Plus Tofacitinib Approved for RA & Romosozumab May Reduce Fracture Risk
The ACR has continued its advocacy to ensure the safe adoption of biosimilars in the U.S., most recently addressing an FDA public hearing. Also, the FDA has approved tofacitinib for RA, and a clinical trial of romosozumab for patients with osteoporosis met its primary endpoint…

Do Bisphosphonates Increase Risk of Carpal Tunnel Syndrome?
In a large-scale study, researchers demonstrated that the use of bisphosphonates in postmenopausal women is associated with an increased risk of carpal tunnel syndrome, in addition to other known risks (e.g., incapacitating bone, joint and/or musculoskeletal pain, and osteonecrosis of the jaw)…
Parents Often Catch Hospital Errors Doctors Missed
(Reuters Health)—Parents often catch medical errors that their child’s doctor missed, according to a U.S. study that suggests families may be an untapped resource for improving hospital safety and preventing mistakes. Roughly one in 10 parents spotted mistakes that physicians did not, according to the study of safety incidents observed on two pediatrics units at…

The Effect of Tofacitinib on Live Vaccine Responses
New research indicates that vaccination for the herpes zoster virus in patients with rheumatoid arthritis starting tofacitinib appears to be both safe and useful. Rheumatologists may want to check the patient’s pre-existing immunity status prior to administering the vaccine…
U.S. Senate Moves Closer to Confirming Califf to Lead FDA
WASHINGTON (Reuters)—The U.S. Senate on Monday moved closer to confirming Dr. Robert Califf to lead the U.S. Food and Drug Administration, overriding opposition from several senators who had sought to block a vote on the issue. In a procedural move designed to prevent the opponents from blocking the confirmation indefinitely, the Senate voted 80 to…
Rheumatology Coding Corner Questions: ICD-10 Coding Guidelines, Conventions Refresher Quiz Part 2
A patient returns for a follow-up visit of their chronic idiopathic gout without tophi with complaints of pain and tenderness. After a thorough examination, the rheumatologist treats the patient for an acute flare of the left knee. How is this coded? M1A.1620, M10.062 M1A.1620 M10.061 M10.062 From ICD-10 coding guidelines, what are the steps to…
Rheumatology Coding Corner Answers: ICD-10 Coding Guidelines, Conventions Refresher Quiz Part 2
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…

What Listening to Lungs Might Teach About Rheumatic Disease
One of your first clinical assignments as a medical student was likely to have been the lung exam. Its key descriptors may still resonate in your mind: inspection, palpation, percussion and auscultation. Proudly parading down the hospital corridors, your newly purchased stethoscope snugly tucked inside your lab coat pocket, you carefully place its cold metal…
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