(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…
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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…
Obesity Associated with Increased Inflammatory Markers in Rheumatoid Arthritis
NEW YORK (Reuters Health)—Obesity and higher fat mass are associated with increased levels of inflammatory markers in women with rheumatoid arthritis (RA), researchers report. “Physicians should recognize that C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) are affected by obesity in patients with and without rheumatoid arthritis, especially in women,” Dr. Michael D. George from the University of…
How to Leverage Physical Therapy & Technology to Help Patients Stay Fit & Decrease Pain
For patients living with rheumatic diseases, the benefits of physical therapy and exercise cannot be overstated. “Working with a physical therapist provides a chance for careful evaluation of how the patient is moving and experiencing pain,” says Maura Iversen, BSc, PT, DPT, SD, MPH…
Rheumatology March Coding Corner Question: Pediatric Rheumatology Consult
A 13-year-old black male, described by his mother as a very active and energetic child, is referred to a pediatric rheumatologist. His chief complaint is muscle pain in both legs, which he has experienced for the past three weeks. His mother is a patient of an adult rheumatologist at this clinic and is quite concerned….
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