New research examined the use of transcranial direct current stimulation over the dorsolateral prefrontal cortex of the brain to modulate attention in patients with fibromyalgia. The study found that the active current increased heat pain threshold and tolerance. However, a regression analysis showed the effect on executive attention appeared to be independent of the effect on pain…
Recommendations for Sjögren’s Syndrome: How to Address Biologics & Musculoskeletal Pain
The clinical practice guidelines for managing Sjögren’s syndrome, developed by the Sjögren’s Syndrome Foundation with the ACR, were designed to improve quality and consistency of care. In total, 19 recommendations were agreed on, which include managing the rheumatic and systemic aspects of the disease. Recommendations include a decision tree for the use of DMARDs for inflammatory musculoskeletal pain, use of self-care measures and exercise to reduce fatigue, and the use of rituximab in selected clinical settings for oral and ocular dryness…
Alterations in the Microbiome Are Associated with Changes in Bone Quality
By treating mice with antibiotics, researchers found that alterations in the gut microbiome impaired the mechanical properties of bone and depleted splenic B and T cell populations. The researchers suspect the decrease in bone strength resulted from the change in the immune system…
How to Leverage Physical Therapy & Technology to Help Patients Stay Fit & Decrease Pain
For patients living with rheumatic diseases, the benefits of physical therapy and exercise cannot be overstated. “Working with a physical therapist provides a chance for careful evaluation of how the patient is moving and experiencing pain,” says Maura Iversen, BSc, PT, DPT, SD, MPH…
Dermatology Consults May Cut Hospital Stays, Readmissions
NEW YORK (Reuters Health)—Inpatient dermatology consultations were associated with shorter hospital stays and reduced readmissions in a U.S. medical center and may do the same elsewhere, researchers in Ohio suggest. “A few decades ago, patients with severe psoriasis, drug reactions, blistering diseases and even severe eczema would be admitted to the hospital under close dermatology…
When Starting Biologics for RA, Disease Severity Predicts Likelihood of Remission
NEW YORK (Reuters Health)—After starting biologic therapy for rheumatoid arthritis (RA), patients with higher disease activity at baseline achieved greater improvements in measures of disease activity than those with lower levels of disease, but they were less likely to achieve remission or even low disease activity, according to a new real world analysis of registry data….
Rheumatology March Coding Corner Answer: Pediatric Rheumatology Consult
Take the challenge. CPT: 99203 This encounter is coded as 99203, because it included: History—The history of present illness was extended. The review of systems was complete, and the past medical, family and social were documented. This makes the history comprehensive. Examination—Expanded detailed. Medical decision making—The diagnosis was a new problem with no additional workup…
Rheumatology March Coding Corner Question: Pediatric Rheumatology Consult
A 13-year-old black male, described by his mother as a very active and energetic child, is referred to a pediatric rheumatologist. His chief complaint is muscle pain in both legs, which he has experienced for the past three weeks. His mother is a patient of an adult rheumatologist at this clinic and is quite concerned….
Draft Criteria for ANCA-Associated Vasculitis Released
WASHINGTON, D.C.—Rheumatologists do not have up-to-date diagnostic and classification criteria for vasculitis, a group of diseases that involves inflammation of the blood vessels, said experts speaking at the 2016 ACR/ARHP Annual Meeting session, Classification Criteria for ANCA-Associated Vasculitis. The most recent classification criteria were published by the ACR in 1990, and since then, new disease…
Clinical Trial Data Provides Insight into Muscle Biology, Myositis, Myopathies
WASHINGTON, D.C.—Ongoing investigation into the disease mechanisms of inflammatory myopathies is generating needed information for the development of potential future therapeutic targets, and current data from clinical trials have shed light on myopathy concerns in different cohorts of patients. These issues were all discussed in a session titled Muscle Biology, Myositis, and Myopathies I during…
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