The patient was a 48-year-old woman who saw her primary care physician for a flu-like illness three months prior to admission. Her symptoms initially improved, but recurred one month later; she was treated symptomatically, and again symptoms resolved. Two months later, she presented to an outside facility’s emergency department with fever to 103ºF, with associated…
New research reinforces the hypothesis that the gut microbiome triggers mucosal and systemic immune responses in patients with rheumatoid arthritis. The research, published in Arthritis & Rheumatology May 2017, found that subgroups of patients with RA have differential immunoglobulin G (IgG) or IgA immune reactivity with Prevotella copri, an intestinal microbe that appears to be…
Editor’s note: The new Pillar Talk column is developed by the ARHP Executive Committee in an effort to share information about ongoing activities related to our four pillars: Education, Practice, Research and Advocacy. The ARHP Practice Committee is committed to addressing the current needs and evolving practice opportunities for health professionals working in rheumatology. A…
A 66-year-old woman returns to the office for a follow-up visit. She is seen by the physician assistant (PA) for her rheumatoid arthritis. She is experiencing burning pain in her right knee, and she reports that after going for her morning walk, she rates the pain at a 6 on a scale of 10. She…
As medical professionals, we understand the impact quality research can have on how we care for our patients. The extensive adoption of electronic health records (EHRs) has enabled the collection of big data in rheumatology. This has provided a new and unique opportunity for the rheumatology community to conduct in-depth research into how patients are…
A 66-year-old female patient returns to the office complaining of swelling and a burning pain in her right first toe. She rates the pain level at a 9 out of 10. She currently takes an over-the-counter non-steroidal anti-inflammatory drug (NSAID), but it has done little to alleviate the pain. This is her second episode this…
Take the challenge. CPT: 99214-25, 89060, 20600-RT ICD-10: M10.271, T50.2X5A, I10 This is an established outpatient visit. This encounter is coded as 99213, because it included: History—Detailed: The history of present illness is extended, the review of systems is extended, and the past medical and social histories are documented. Examination—Detailed: Seven organ systems are examined….
CHICAGO—Sherine E. Gabriel, MD, MSc, professor of medicine at Rutgers Medical School in Newark, N.J., and a past president of the ACR, presented an overview of cardiovascular disease and rheumatology on a Saturday morning to a room overflowing with rheumatologists attending the ACR’s State-of-the-Art Clinical Symposium in April. She noted that physicians have known for a…
CHICAGO—A clustering of cases in Lyme, Conn., in 1975 led to the discovery of Lyme disease. Allen C. Steere, MD, professor of medicine at Harvard Medical School in Boston, investigated that outbreak, and he shared his knowledge of Lyme disease with rheumatologists gathered at the ACR’s State-of-the-Art Clinical Symposium in April. He explained that Lyme arthritis…
CHICAGO—On a Saturday morning in Chicago, Chester V. Oddis, MD, director of the Myositis Center at the University of Pittsburgh, explained to a crowded room of about 500 rheumatologists attending the ACR’s State-of-the-Art Clinical Symposium in April how best to use myositis autoantibodies in clinical care. He began with an overview of the different types of…