A 55-year-old male patient diagnosed with generalized osteoarthritis and diagnosed with end stage renal failure (ESRD) 20 months previously presents to the office to see the rheumatologist. The patient has a commercial insurance plan and Medicare. Which carrier is primary for this visit? Commercial insurance carrier Medicare You do not know because it is not…
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Are Opioid Contracts Helpful or Harmful?
The opioid epidemic in the U.S. has destroyed thousands of lives and torn families apart. According to the Centers for Disease Control and Prevention, an average of 130 people in the U.S. die each day from an opioid overdose. From 1999 to 2017, more than 700,000 died as a result of drug overdoses. In 2017,…

Research Sheds Light on Scleromyxedema, a Rare Skin Disorder
Scleromyxedema is a rare, mucinous skin disorder of unknown origin, one of a number of conditions that mimic systemic sclerosis. Although cases of scleromyxedema remain rare, a better understanding of its mechanisms of action could have implications for the research and treatment of scleroderma and related autoimmune conditions, says Laura K. Hummers, MD, ScM, co-director…

Insights into Interstitial Lung Disease in Rheumatoid Arthritis Patients
MADRID—Rheumatoid arthritis (RA) is among the most common autoimmune diseases in the U.S., affecting approximately 1.3 million U.S. adults.1 Although tremendous treatment advances have been made in recent years, one extra-articular manifestation of RA that continues to pose a challenge with regard to detection and management is interstitial lung disease (ILD). At the 2019 European…

Why You Should Consider Adding a Dietitian to Your Team
A patient with rheumatoid arthritis (RA) asks if diet can help ease their symptoms. Or maybe a patient with severe knee osteoarthritis (OA) seeks diet advice because they want to lose weight and relieve pressure on their joints. Although there’s no specific nutrition plan for patients with rheumatic diseases, research has shown many dietary factors…

Study Examines How Depression Subtypes May Stem from Osteoarthritis
People with or at risk for symptomatic knee osteoarthritis (OA) may be assigned to four depression subtypes with distinct clusters of depressive symptoms that may affect pain and disability over time, according to a new study in Arthritis Care & Research.1 Four depression subtypes were identified in the study using the Center for Epidemiologic Studies…

How to Improve Opioid Prescribing in an Outpatient Clinic
More than 72,000 Americans died from opioid overdoses in 2017, according to the National Institutes of Health.1 The impact of the opioid epidemic has affected many levels of patient care and, as a result, healthcare systems are responding to escalating death rates, new legislation and the possibility of compromised patient safety in a multitude of…

Case Report: A Patient Develops Scleroderma Renal Crisis
Scleroderma renal crisis (SRC) is a life-threatening complication of systemic sclerosis. SRC occurs in 2–15% of patients with diffuse sclerosis and usually within the first five years from the time of diagnosis. Risk factors for SRC include, but are not limited to, early diagnosis, corticosteroid or cyclosporine use, and the presence of anti-RNA polymerase III…

Case Report: Cardiac Tamponade in a Rheumatoid Arthritis Patient
Rheumatoid arthritis (RA) is a chronic systemic autoimmune inflammatory disease. Although RA develops its central pathology within the synovium of diarthrodial joints, many non-articular organs can be involved, particularly in patients with severe joint disease.1 Although most patients are asymptomatic, cardiac involvement is relatively common and includes rheumatic heart nodules, pericarditis (30–50%), pericardial effusion and…

Ethics Forum: What Are Conflicts of Interest?
Results from an ethics survey presented to attendees at the 2018 ACR/ARHP Annual Meeting highlight the complexities and challenges of assessing potential conflicts of interest.
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