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,…
The evaluation of a child with arthralgia who has a normal physical examination provides a challenge to rheumatologists. Here are some insights into assessing and treating children with musculoskeletal pain syndromes…
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…
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…
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…
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,…
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…
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…
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…
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…