Outside Exam Room No. 5, the chart rack was empty, so I assumed my new consult was late. Just in case, I looked back over my shoulder as I passed by the partially open door and glimpsed the lower half of a woman holding a three-ringed binder on her lap. I squinted and took a…
A 52-year-old woman comes to the office complaining of a two-month history of pain and swelling in the small joints of her hands, feet and knees. She says, “Doctor, I’ve been searching the Internet, and I think I have rheumatoid arthritis. I have some questions for you.” The healthcare system in the U.S. is changing…
SAN FRANCISCO—“We haven’t made a lot of progress in ensuring the early diagnosis of spondyloarthritis,” said Walter Maksymowych, MD, FRCP, professor of medicine in the Division of Rheumatology at the University of Alberta and chief medical officer at CaRE (Canadian Research and Education) Arthritis, both in Edmonton. Speaking at the California Rheumatology Alliance 2016 Medical…
SAN FRANCISCO—In a presentation on advances in the treatment of systemic lupus erythematosus (SLE) at the California Rheumatology Alliance 2016 Medical & Scientific Meeting in May, Maria Dall’Era, MD, director of the Lupus Clinic and Rheumatology Clinical Research Center at the University of California, San Francisco, discussed the range of treatments that have been identified…
Although most systemic juvenile idiopathic arthritis patients don’t develop macrophage activation syndrome (MAS), the approximately 10% who do have this serious complication can experience widespread, massive inflammation, debilitating symptoms and even death. To improve understanding of MAS among physicians and advance efforts to develop effective therapies to treat it, a panel of 28 international pediatric…
Recognizing that gaps often occur in the transition process for young adults as they transition from pediatric to adult healthcare, in particular for youth with special healthcare needs, the American College of Physicians’ (ACP’s) Council of Subspecialty Societies (CSS), of which the ACR is a member, initiated a project and engaged several medical specialty organizations…
Take the challenge. CPT: 99213 Diagnosis Codes: M05.79, M17.12, Z79.1, Z79.899 Rationale to code this encounter as 99213: History—The history of present illness was extended. The review of systems was comprehensive, and two of the three past, family and social history were documented. This makes the history level comprehensive. Eight systems were examined. This makes…
Level 3 Established Patient E&M Visit A 43-year-old patient is seen in the office for a follow-up visit of her RF-positive rheumatoid arthritis and primary osteoarthritis of the left knee. The patient is on sulindac, methotrexate and folic acid. At her last visit, the patient’s methotrexate dose was increased, which has greatly reduced her pain….
Can We Stay Forever Young? May your heart always be joyful And may your song always be sung May you stay forever young Forever Young —Bob Dylan Beneath the rubric of orphan diseases reside some rare conditions and others that are extraordinarily uncommon. These are the diseases that most physicians either never to get to…
Ethical issues that arise in the average rheumatology practice and in clinical research are often straightforward. The AMA Code of Medical Ethics and the Office Practice and Procedures Manual offer useful information.1 In research, the Protocol and Investigators Agreement spells out who you can enroll and how the trial must be conducted. But still—even when…