(Reuters Health)—Older people who eat the most fiber are at lower risk of developing knee pain and stiffness due to osteoarthritis (OA), new research shows.1 Diets rich in fiber from plant-based foods have clear health benefits, such as lower cholesterol, better-controlled blood sugar and a healthier weight, but most people in the U.S. don’t eat…
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Demand for Arthritis Care in America Outstrips Supply of Practicing Rheumatologists
May is National Arthritis Awareness Month. The ACR is committed to ensuring that arthritis and rheumatologic diseases are at the forefront of public awareness—and that better, safer treatments reach Americans in need. Fortunately, the federal government is also doing its part and has just released a major report on the national impact of arthritis. A…
How MACRA Has Affected Physician Compliance
In recent years, providers and practice groups have been worrying about Meaningful Use (MU) and gaining knowledge on using certified electronic health record (EHR) technology to avoid payment penalties, earn incentives and increase practice efficiency. Now, with the release of the final rule for MACRA payment reform, physicians will have two options for payment paths:…
Surgery Won’t Help Degenerative Knee Problems
(Reuters Health)—Arthroscopic surgery won’t cure chronic knee pain, locking, clicking, a torn meniscus or other problems related to knee arthritis, according to a panel of international experts. Every year, more than two million people with degenerative knee problems have arthroscopic surgery. But guidelines published May 10 in the British Medical Journal recommend against the procedure…
Lifetime Risk of Hand Arthritis May Be More Than 40%
(Reuters Health)—A new study finds that as many as four in 10 people may develop hand osteoarthritis. Among women, researchers found the lifetime risk was 47% while for men it was about 25%. Obese people also had 11% higher lifetime risk than those who were not obese. Hand osteoarthritis can cause disability and problems with…

How Gout Patients Can Stay on Target with the Go for Six Campaign
Gout patients need to lower their uric acid levels to 6.0 mg/dL or below and maintain that level. According to N. Lawrence Edwards, MD, MACP, MACR, an education campaign has been raising awareness of this fact and helping gout patients…
Cracking, Popping Joints May Foretell Arthritis
(Reuters Health)—Grating, cracking or popping sounds around joints may predict future arthritis, especially in the knees, according to a recent U.S. study. Among thousands of people with no knee pain who were followed for three years, one quarter had noisy knees yet they made up three quarters of the cases of symptomatic knee arthritis that…

Fellows Forum Case Report: Neuromyelitis Optica
Case Presentation The patient was a 42-year-old African American female diagnosed with systemic lupus erythematosus (SLE) based on the findings of polyarthritis, malar and discoid rash, fatigue, positive double-stranded DNA (dsDNA) ribonucleoprotein and Smith antibodies, and low serum complement levels. Her SLE had been well controlled on hydroxychloroquine 400 mg daily, oral methotrexate 25 mg…

Diagnosis of Acute Gouty Arthritis Obscured by Anchoring Bias
A 56-year-old African American man presents to the emergency department with polyarthralgias and a fever of 103ºF. One month prior to admission, he presented with right knee pain and swelling. Blood cultures grew S. epidermidis. He was treated for presumed septic arthritis complicated by MSSE bacteremia. He was treated with meropenem and a prolonged course…

Use Time Component When Coding Counseling, Coordination of Care Visits
Although there are seven components for the levels of evaluation and management (E/M) services, most encounter levels are coded on the basis of the history, examination and medical decision making (MDM), which are the key components extracted from documentation in the medical record. However, when counseling and coordination of care for a patient are the…
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