SAN FRANCISCO—T follicular helper (Tfh) cells are emerging as an important subset of cells now recognized as important to facilitating an adaptive immune response. Developed during dendritic cell priming in vivo, these cells represent one subgroup among many of effector cells that result after naive CD4+T cells differentiate. Other well-known subgroups include Th1 cells, Th2…
SAN FRANCISCO—Evolving research into the pathogenesis of rheumatoid arthritis (RA) is increasingly showing that rather than a single causative dysfunctional pathway leading to disease, multiple pathways are involved, the study of which can shed additional light on what is occurring in a person’s body prior to developing symptoms of disease. Saying it another way, no…
Chronic pain can be one of the biggest challenges that patients and their physicians face. Rheumatology patients are no stranger to pain, and when pain goes beyond the scope of what rheumatologists can treat, collaboration with a pain specialist is common. “I refer patients to pain management when there is no underlying inflammatory condition, usual…
A patient returns for a follow-up visit of their chronic idiopathic gout without tophi with complaints of pain and tenderness. After a thorough examination, the rheumatologist treats the patient for an acute flare of the left knee. How is this coded? M1A.1620, M10.062 M1A.1620 M10.061 M10.062 From ICD-10 coding guidelines, what are the steps to…
Take the challenge. D—Even though the patient’s chief complaint is for a follow-up of chronic idiopathic gout without tophi, the patient is presenting with an acute flare of idiopathic gout of the left knee. Acute gout and chronic gout have specific coding guidelines, because they each have an Excludes 1 note. This indicates they are…
It was sixth grade, and Pierre Moeser—now a rheumatologist in St. Peters, Mo., who had already lived in his share of countries, saw a kid’s stamp collection displaying seemingly endless nations. Then and there, he got hooked on philately, “which is not just studying stamps, but also postal history and related items,” says Dr. Moeser….
Over the past several years, the ACR has ramped up its efforts in advocacy. Under the leadership of the Government Affairs Committee, many ACR staff, members and their patients, considerable progress has been made moving priority issues forward in 2015. A few highlights from 2015 include: The Patients’ Access to Treatment Act (PATA) was introduced…
One of your first clinical assignments as a medical student was likely to have been the lung exam. Its key descriptors may still resonate in your mind: inspection, palpation, percussion and auscultation. Proudly parading down the hospital corridors, your newly purchased stethoscope snugly tucked inside your lab coat pocket, you carefully place its cold metal…
The problem that dogs the work of all of those treating patients with antiphospholipid syndrome (APS) is the apparent lack of knowledge of the syndrome, both by the general public, as well as by swaths of the medical fraternity. Perhaps it was ever thus—a syndrome less than 40 years old could be described as new,…
The Case A 41-year-old woman was referred to the dermatology clinic for a three-month history of tender lesions on her elbows and around the joints of her hands. Her medical history was notable for seropositive, non-erosive rheumatoid arthritis (RA), which was being treated with 5 mg prednisone daily, 10 mg methotrexate weekly by mouth, 200…