Mirtazapine has been prescribed off-label to fibromyalgia patients who have not responded to other treatments. However, a recent systemic review found no difference between mirtazapine and placebo for these patients, and any potential benefits from mirtazapine may not outweigh its potential harm, including drowsiness, weight gain and liver damage…
The FDA has approved subcutaneous tocilizumab for treating active systemic juvenile idiopathic arthritis in pediatric patients as young as 2 years old…
Patients with lumbosacral radiculopathy syndrome (LRS) may wonder if physicality of their jobs contributed to the development of their symptoms. A recent systematic review sought to identify LRS work-related risk factors. Researchers found that bending and lifting of the trunk, both alone and in combination, may contribute to LRS…
“I think I’m mentally sharper when I have been exercising and taking care of myself,” says Chris Phillips, MD, a rheumatologist in solo practice in Paducah, Ky. Dr. Phillips has recognized these benefits since high school, when he began participating in competitive sports. Four years ago, Dr. Phillips was competing against 40 other cyclists in…
A patient with rheumatoid arthritis (RA) comes to your office and needs a medication. You prescribe it, and the patient’s insurance plan covers it. The patient begins the medication and slowly but surely feels better. Prescribing drugs for a patient should be this simple but rarely is, thanks to the high cost of drugs and…
1. A 45-year-old female patient with a diagnosis of primary osteoarthritis returns to the office for her second scheduled injection of sodium hyaluronate (Supartz). The nurse takes the patient’s vitals: weight is 185 lbs., height is 5’2”, and temperature is 98.2°F. The patient is prepped and given the injection. How should this encounter be coded?…
Mounting evidence suggests that humans have a complex and integrated mind-body system. Knee problems may affect the spine and other body parts, but also the mind—and vice versa. This is the wisdom of Ayurveda, the 3,000-year-old traditional medicine from India. A team of researchers from Germany recently undertook a study, titled “Effectiveness of an Ayurveda…
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…
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…
Systemic lupus erythematosus (SLE) is a leading cause of death among young women, according to an August 2018 study in Arthritis & Rheumatology.1 To help determine where SLE ranks among causes of death, Eric Y. Yen, MD, and Ram Raj Singh, MD, conducted a population-based study using nationwide mortality counts for all female residents of…