In Part 1 of this series, we covered the vital role of medical decision making in determining the final level to bill for a patient encounter. Medical decision making is the key component in coding because it reflects the intensity of the provider’s cognitive labor. This implies that there’s an unseen component involved in the…
MADRID—Researchers say that whole-body MRI could yield an earlier diagnosis of spondyloarthropathy (SpA) in patients with early inflammatory joint symptoms, according to findings presented in a poster session at the Annual European Congress of Rheumatology (EULAR). The approach could lead to earlier treatment and better outcomes, they say. Investigators at the University of Leeds recruited…
MADRID—The anti-IL6 “nanobody,” vobarilizumab, produced mixed results when used with methotrexate (MTX) and compared with MTX and placebo, according to results of a 24-week, double-blind Phase 2b study of patients with rheumatoid arthritis (RA), which were presented in an abstract session at the Annual European Congress of Rheumatology (EULAR). The drug missed its primary endpoint…
MADRID—Tofacitinib (a JAK inhibitor) used with methotrexate (MTX) is not inferior to adalimumab (a TNF inhibitor) in rheumatoid arthritis (RA) patients who’ve had an inadequate response to MTX alone, according to results of a Phase 3B/4 trial presented in a session at the Annual European Congress of Rheumatology (EULAR). The findings came in a one-year…
Treat-to-target is a widely used approach for rheumatoid arthritis, in which rheumatologists prescribe treatments to reach established benchmarks of disease activity.1 Is it time for a similar approach for fibromyalgia treatment, even though its pathogenesis, disease-activity measures and treatment algorithms are less well understood? Three fibromyalgia researchers present their case in a new paper, “Treat-to-Target…
A 22-year-old Indian male presented to the emergency department with hemoptysis. A month prior, he had presented to an urgent care center complaining of cough with occasional episodes of blood-tinged sputum in the morning. He was diagnosed with community-acquired pneumonia based on a chest X-ray without laboratory testing and was prescribed levofloxacin. A few days…
Rheumatoid arthritis (RA) is a systemic autoimmune disease associated with erosive destruction of diarthrodial joints. Patients who are seropositive are more prone to developing extra-articular manifestations, such as rheumatoid lung, rheumatoid nodules and others. With the development of disease-modifying anti-rheumatic drugs (DMARDs), the incidence and severity of these extra-articular manifestations has declined. Below, we describe…
Wider awareness and understanding of the more than 100 different rheumatic diseases is a vital element in our work as rheumatologists and rheumatology health professionals. Stimulating interest and engagement among lawmakers, patient groups and the public at large is essential to successful advocacy efforts, as well as the overall future of our specialty. This September,…
Steady hands, nerves of steel: The endoscopic transphenoidal hypophysectomy is a delicate neurosurgical procedure. Using a three-dimensional microscope and a powerful magnetic resonance imaging machine to guide them, the surgeon must meticulously dissect the throat tissues, navigate through the palate and the sinuses to reach the base of the skull where the pea-sized master gland,…
In recent years, scientists and clinicians have learned a great deal about autoantibodies occurring in idiopathic inflammatory myopathies (IIMs). These new discoveries have reshaped our understanding of distinct clinical phenotypes in IIMs. Scientists continue to learn more about how these autoantibodies shape pathophysiology, diagnosis, disease monitoring, prognosis and optimum treatment. Moving forward, these autoantibodies will…