The ACR Insurance Subcommittee is working to address specialty pharmacy requirements for in-office treatments, elimination of consultation codes and other coverage and reimbursement challenges.
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Update on the Management of Takayasu Arteritis
A rare form of large vessel vasculitis, Takayasu arteritis persents with no clear patterns, with patients experiencing vascular symptoms, as well as such systemic symptoms as fever and weight loss. A systematic literature review found evidence to guide rheumatologists in monitoring and treating their patients with Takayasu arteritis…

Tips for Exploring Tough Topics with Teens with Rheumatic Disease
ATLANTA—Managing teenage patients may present challenges for pediatric rheumatologists and rheumatology professionals not only because of their often complex, rare conditions, but because teenagers are, well, teenagers. Teens may experiment with sexual intercourse, alcohol use, tobacco or vaping e-cigarettes to fit in with their peers, even if these habits have serious health consequences, according to…

Case Report: Obliterative Bronchiolitis in Rheumatoid Arthritis
A 59-year-old woman with rheumatoid arthritis (RA) presented to our pulmonary clinic for progressively worsening dyspnea of five years’ duration. She described progressively worsening dyspnea after a few minutes of walking on level ground. In addition, she noted worsening pain and morning stiffness of the wrists, knees and metacarpophalangeal (MCP) joints, with subcutaneous nodules. She…

Sjögren’s Syndrome in Kids: Diagnostic Challenges & Treatment Options
A 14-year-old girl is referred to your office for fatigue and arthralgias. While you’re obtaining her past medical history, she divulges that she has had four episodes of bilateral parotitis, each lasting two weeks. An otolaryngologist evaluated her. She lacked sicca symptoms, had a normal complete blood count (CBC), normal inflammatory markers and a negative…

Ethics Forum: 3 Ways to Resolve Conflict When Children Refuse Treatment
In the middle of a busy clinic I go to see my next patient, a 16-year-old girl with a swollen knee. I had seen her the week before and, after discussing the options regarding treatment of her arthritis, had organized a joint injection for today. As I walk in the door she emphatically informs me,…

ACR/EULAR Release New Classification Criteria for IgG4-Related Disease
Immunoglobulin G4-related disease (IgG4-RD) can cause fibroinflammatory lesions in nearly any organ, and diagnosis is challenging. ACR/EULAR classification criteria for IgG4-RD have been developed and validated in a large cohort of patients. These criteria have performed well in tests and should contribute substantially to future clinical, epidemiologic and basic science investigations.

Seq & Ye Shall Find
I nodded, gravely. I was recently privileged to attend a symposium on eosinophils. I realize that this sounds odd. And it was odd, mainly because I’m not an eosinophil expert. Still, they were in need of someone who knew something about eosinophilic granulomatosis with polyangiitis, so I managed to sneak in through the back door….
Tears of Knee Ligaments & Meniscus Carry Highest Arthritis Risk
(Reuters Health)—Young adults who have had knee injuries are much more likely than uninjured peers to develop knee osteoarthritis (OA) by middle age, especially if they have broken bones or torn connective tissue, a recent study suggests. Cruciate ligament injuries were associated with a 19.6% greater risk of knee osteoarthritis, the study found. Meniscal tears…
New ACR/EULAR IgG4 Classification Criteria Introduced
Immunoglobulin G4-related disease (IgG4-RD) can cause fibroinflammatory lesions in nearly any organ. Correlation among clinical, serologic, radiologic and pathologic data is required for diagnosis. ACR/EULAR classification criteria for IgG4-RD have now been developed and validated in a large cohort of patients…
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