As of Jan. 1, 2019, the Centers for Medicare & Medicaid Services (CMS) will implement several coding and documentation policies to provide immediate burden reduction to providers. The 2019 Medicare Physician Fee Schedule Final Rule (MPFS) released Nov. 1, 2018, by the CMS contained significant changes to the Medicare Part B coding and documentation policies…
Search results for: synovitis
Post-Traumatic Osteoarthritis: Managing OA That Develops After Joint Injuries & Reconstructive Surgery
CHICAGO—Joint trauma is one of many potential drivers of osteoarthritis disease activity and structural progression. In Post-Traumatic OA: Pathogenesis, Clinical Evolution and Management, a session at the 2018 ACR/ARHP Annual Meeting, experts discussed the effects of sports and other injuries on even young patients’ joints. Post-traumatic osteoarthritis (OA) may account for 12% of hip, knee…
Nonsurgical Therapies for Knee OA Pain: From Medications to Bracing to Exercise, What Works & What Doesn’t
CHICAGO—Many nonsurgical therapies are available for knee osteoarthritis pain, but they vary greatly in effectiveness. “How should I proceed and figure out what to do with our patients?” asked David T. Felson, MD, MPH, professor of medicine at Boston University School of Medicine, during OA Management Without Surgery in 2018, a session at the 2018…
Emerging Treatments for OA: New Therapies Target Joint Pain, Not Just Structural Damage
CHICAGO—Are effective treatments for osteoarthritis (OA) on the horizon? In Emerging Treatments for Osteoarthritis at the 2018 ACR/ARHP Annual Meeting, experts discussed potential therapies to address OA structural progression, pain and inflammation. With an aging population and rising obesity rates, “we can expect the prevalence of osteoarthritis will only increase,” said Anne-Marie Malfait, MD, PhD,…
Case Report: Acne Drug Leads Patient to Retinoid Hyperostosis
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…
Interferon Score Predicts AI-CTDs
People with autoimmune connective tissue diseases produce antibodies against nuclear antigens up to 10 years before they develop clinical features. Anti-nuclear antibodies (ANAs) are also very common, and a small percentage of ANA-positive patients progress to clinical autoimmunity. The question: Is there a reliable way to screen at-risk patients before they develop active autoimmunity and…
Gene Therapy for OA
Background & objective: One of the major challenges in the treatment of chronic joint diseases, such as osteoarthritis (OA), is the need to provide sustained bioavailability of a therapeutic agent within the joint. Systemically administered drugs cannot sufficiently reach the synovial space, and intra-articularly injected agents are cleared from the joint fluid rapidly by the…
Study Finds Correlations Between Synovial Tissue & Gene Expression
Rheumatoid arthritis (RA) can be typed, grouped and categorized in different ways, and subgroup identification could help guide future research and treatment strategies based on which subtypes respond to which treatment. A new study explored an approach associating gene expression profiling with histologic analysis of synovium samples to define RA subtypes and then examined how…
Case Report: A Patient Presents with Rare, Fulminant SAPHO Syndrome
Synovitis, acne, pustulosis, hyperostosis and osteitis (SAPHO) syndrome is a heterogeneous, inflammatory, musculoskeletal disease. The disease is an insidious, sterile osteitis with associated skin and synovial inflammation.1 Diagnosis can prove challenging, but a thorough clinical history, high clinical suspicion and imaging techniques can help clinch it. The below case reveals a rare, fulminant presentation of…
Nivolumab-Induced Arthritis
Immune checkpoint inhibitors (ICIs) are increasingly used to treat a variety of malignancies, leading to better cancer treatment outcomes and patient survival. However, the emergence of autoimmunity has been a major adverse event resulting from ICI use. Below, we describe a patient who experienced a flare of preexisting psoriasis and new-onset severe psoriatic arthritis after…
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