Rheumatoid arthritis (RA) can be defined as a chronic autoimmune systemic inflammatory condition characterized by symmetrical polyarthritis. Typically, patients present with pain, stiffness and warmth of the affected joints. The condition can result in extra-articular features, adding to disability, and may eventually lead to premature death, especially if not treated early and appropriately.1,2 Over the…
Diagnosing rheumatoid arthritis (RA) early in the disease process is ideal, because treatments are more likely to be effective and less damage will occur. Guidelines from the American College of Rheumatology (ACR) and the European League Against Rheumatism (EULAR) state that using newer biologic medications, in addition to more aggressive dosing of traditional medications, is…
View the question. Findings/Diagnosis An anteroposterior (AP) radiograph of the right foot shows hallux valgus of the first metatarsal phalangeal (MTP) joint, erosive changes at the first and fifth metatarsal bones and degenerative changes at the fourth and fifth metatarsal-cuboid joints. An AP radiograph of the left foot shows extensive erosive and degenerative changes at…
Editor’s note: In this recurring feature, we first present a series of images (this page) for your review, and then a brief discussion of the findings and diagnosis. Before you turn to the discussion, examine these images carefully and draw your own conclusions. History A 33-year-old woman with a 16-year history of systemic lupus erythematosus…
What is the ICD-10 guideline to code for osteoporosis without a current pathological fracture? There is no rule. Code for the osteoporosis, and code for the pathological fracture. Code for the osteoporosis from the M81._ category, and code for the history of a pathological fracture. None of the above is correct. How many characters are…
Take the challenge. C—The guideline for coding from category M81._ is that an additional code is needed if the physician has knowledge that the patent had a past pathological fracture. The code for personal history of (healed) pathological fracture is Z87.310. B—Osteoporosis with a current pathologic fracture is one of the few ICD-10 codes that…
NEW YORK (Reuters Health)—Almost half of juvenile idiopathic arthritis (JIA) patients treated with etanercept achieve minimal disease activity after one year of treatment, according to new findings. Younger patients and those who did not require corticosteroid treatment were more likely to have an excellent response, Dr. Kimme Hyrich of the University of Manchester in the…
When investigating the role of epigenetic modifiers in inflammatory response, researchers found that Tet2 acts at the chromatin level to help resolve inflammation in both dendritic cells and macrophage, repressing the transcription of IL-6…
NEW YORK (Reuters Health)—Too many women who aren’t at risk for osteoporosis are being screened for the disease, and too many women who don’t need osteoporosis treatment are getting it, new research suggests. “In our health system the overtreatment of osteoporosis was common, and this was partly due to the fact that a lot of…
“The lived experience with RA is itself a valuable form of expertise,” writes Dr. Liana Fraenkel, MD, MPH, and her colleagues in their latest research. To examine the value of this expertise and how it can be incorporated into clinical practice guidelines, researchers developed 18 questions for which two panels—one physician dominated and one comprising entirely patients—would develop recommendations. For a majority of these questions, the patient panel made the same recommendations as the physician panel, with similar recommendation strengths…