LONDON—New research shows that the synovial compartment appears to have a special role in the chronic nature of rheumatoid arthritis (RA), providing refuge for plasma cells and giving them an ideal environment in which to produce antibodies against citrullinated protein antigens (ACPA). The findings were presented at the Annual Congress of the European League Against…
Is Fibromyalgia Overdiagnosed?
Are too many patients diagnosed with fibromyalgia? The co-authors of one new study believe that close to 75% of patients who have received a clinical fibromyalgia diagnosis do not meet the 2010 Preliminary American College of Rheumatology (ACR) Criteria for Fibromyalgia.1 They say these patients are false-positive and may be taking treatments they don’t need….
Evidence Needed to Support Marijuana Use for Pain Relief in Rheumatologic Conditions
With the chronic pain and other health issues that many rheumatology patients face every day, it’s natural for rheumatologists and their patients to wonder if cannabinoid treatments are of any help. At this point, there is insufficient evidence to recommend cannabinoid treatments to manage rheumatic diseases, according to a review article published in the May…
Tacrolimus Use for Lupus Nephritis Raises Debate over Role in North American Population
The following summary regarding use of tacrolimus (TAC) in lupus nephritis highlights a number of debatable points. Although the role of TAC in lupus nephritis remains unproved for North American populations, it might be an excellent option in some clinical situations. These situations include lupus flare during pregnancy and also for lupus nephritis when the…
Rheumatology Coding Corner Answer: Gout Visit for Established Patient
CPT: 99213, 89060 ICD-10: M10.072 Coding Rationale This is an established outpatient visit. The encounter is coded as 99213 because it included: History—Expanded problem-focused history. The history of present illness was brief, the review of systems was extended and the past medical and social history was documented. Examination—Detailed. There were seven organ systems examined. This…
Rheumatology Coding Corner Question: Gout Visit for Established Patient
A 55-year-old female patient returns to the office with complaints of gout pain. She is complaining of swelling and a burning pain in her left toe. She has been taking an over-the-counter NSAID to treat the pain, but this has done little to alleviate it. This is her second flare this year. The patient denies…
Do Fatty Acids Underlie Rheumatoid Arthritis Pathology?
According to a new study, patients with aggressive rheumatoid arthritis (RA) have lower levels of non-esterified fatty acids, which coincide with an enhanced Th1 response. Researchers suggest that lower EPA and DHA at the onset of RA may exacerbate inflammation, and fatty acids may become a novel therapeutic target for the disease…
New Kits Address Pediatric-to-Adult-Care Transition
The transition from pediatric to adult care can be a rocky one. For many rheumatology patients, any problems in the move can cause gaps in care. To address this issue, the American College of Rheumatology (ACR) joined the American College of Physicians’ (ACP) Pediatric to Adult Care Transitions Initiative. The Initiative is a project spearheaded…
Anti-TNFs in Early Puberty May Improve Growth in Pediatric IBD
NEW YORK (Reuters Health)—Anti-TNF drugs are more likely to improve growth in children with inflammatory bowel disease (IBD) if they’re given in the earlier stages of puberty, new findings show.¹ Children who achieve remission are also more likely to have satisfactory growth, the research team reported online on Sept. 21 in the Journal of Pediatric…
The Role of Benign Joint Hypermobility in Functional Pain Disorders
Physicians have been puzzled by the role of benign joint hypermobility syndrome in the development of gastrointestinal disorders and other autonomic symptoms and co-morbidities. However, new research found that benign joint hypermobility syndrome only minimally affects autonomic abnormalities…
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