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Articles tagged with "Diagnosis"

Auto-Injectable Methotrexate: New Treatment Option for RA

Susan Bernstein  |  October 14, 2015

Methotrexate has long been a cornerstone of therapy in rheumatoid arthritis. Two new, injectable methotrexate products may help some RA patients for whom oral methotrexate is not as effective or causes adverse effects. Rasuvo and Otrexup are prefilled, auto-injection devices that allow patients to give themselves subcutaneous injections of methotrexate without having to use a…

Crowdsourcing: The Modern Consult Equivalent

Kurt Ullman  |  October 13, 2015

Two of the great traditions of medicine are the curbside and party consults. In the former, participating physicians informally discuss an especially difficult diagnostic problem. During the latter, a patient will approach the doctor to ask about some possible medical problem and what they should do about it. The advent of the Internet has brought…

Case Report: Interstitial Lung Disease with Positive ANCA Test

Sara Tedeschi, MD  |  October 13, 2015

“Worst of all is the pain in my calves,” she said. “It feels like burning deep inside.” So began my first encounter with a 69-year-old woman who was referred to rheumatology clinic for evaluation of two months of constitutional symptoms and a positive ANCA test, which had been ordered by her primary care doctor. Her…

Reforms Needed to Address Medical Diagnostic Errors

Julie Steenhuysen  |  September 23, 2015

CHICAGO (Reuters)—Most Americans will fall victim to at least one diagnostic error in their lifetime, and when this occurs, it often can be deadly, according to a new report released on Tuesday by the Institute of Medicine, which advises the U.S. government and policymakers. The report called for greater emphasis on improving diagnoses in the…

Figure 1: Hematoxylin & Eosin Staining

Systemic Lupus Erythematosus Without Kidney Involvement: A Case Report

Paul Hoover, MD, PhD, & Lindsey MacFarlane, MD  |  September 15, 2015

A 35-year-old female with a history of systemic lupus erythematosus (SLE) without kidney involvement was admitted to our hospital with low-grade fevers, headache, increasing lower extremity edema and elevated blood pressure. History She was first diagnosed with SLE as a teenager when she developed oral ulcers and pleuritic chest pain and tested positive for anti-Smith…

Diagnosing, Treating IgG4-Related Disease

Mary Beth Nierengarten  |  September 15, 2015

In diagnosing and treating a disease that is rapidly gaining recognition worldwide since it was first recognized in Japan in 2003, 42 experts from 10 different countries recently collaborated to discuss and review the current experience and data on IgG4-related disease. The result is the “International Consensus Guidance Statement on the Management and Treatment of…

Rheumatology Coding Corner Question: Level 3 Visit with Primary Diagnosis of Osteoarthritis

From the College  |  September 15, 2015

Level 3 Visit with Primary Diagnosis of Osteoarthritis A 36-year-old patient presents with unilateral primary osteoarthritis of the left hip. She reports her groin pain as 7 on a scale of 1–10. When she tries to straighten her left leg, she experiences increased groin pain. She is currently taking over-the-counter medication to relieve the pain,…

Rheumatology Coding Corner Answer: Level 3 Visit with Primary Diagnosis of Osteoarthritis

From the College  |  September 15, 2015

CPT codes: 99213 Diagnosis Codes: ICD-9: 715.15, 278.01 ICD-10: M16.12, E66.01, Z68.41 This encounter is coded as 99213 as follows: History—The history of present illness was extended. The review of systems was comprehensive, and no past family social history was documented. This makes the history level expanded problem focused. Examination—There were eight systems examined. This…

RA Diagnosis Uses Lab Tests, Clinical Insight to Rule Out Lyme

Charles Radis, DO  |  August 18, 2015

What struck me first as I walked by the exam room where Lynn P. sat was the swelling in her fingers and wrists. The bloated hands rested unnaturally on her thighs, palms up, fingers slightly flexed. Her strawberry-blond curls were offset by a high-neck, loose-fitting, burgundy sweater. Her pale skin matched her trim slacks. She had…

Diagnostic Imaging in Patient with Left Hip Pain: History

Jennifer L. Demertzis, MD  |  August 18, 2015

Editor’s note: In this recurring feature, we first present a series of images (this page) for your review, and then a brief discussion of the findings and diagnosis (p. 63). Before you turn to the discussion, examine these images carefully and draw your own conclusions. History For the discussion, click here. A 55-year-old man on…

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