Since it was first reported in 1916, a correlation between inflammatory myopathies and cancer has been noted in several studies. Population studies have confirmed this relationship, and the phrase cancer-associated myopathy has entered the vernacular. Over the past decade, research efforts have shifted toward revealing associations between autoantibodies and clinical phenotypes. One subset of auto-antigens…
There are moments that the words don’t reach There is suffering too terrible to name You hold your child as tight as you can And push away the unimaginable —Lin Manuel Miranda A friend of mine was killed a few days ago. By the time you read this column, the scars will have already started…
Every year at the end of January, ACR and ARP volunteers gather in Atlanta to learn more about a subject we seldom are taught in any formal way in our professional training: leadership. The 2019 Leadership Development Conference took place on Saturday, Jan. 26 and offered participants a unique opportunity to step away from their…
As we turn the corner on the second decade of biologic use for rheumatic disorders, a reappraisal of approach in our communication with patients is due. In practice, the impact these agents have on patients’ lives justifies the friction rheumatologists face when connecting patients to them. You can understand why older rheumatologists who apprenticed on…
The ACR–Indian Rheumatology Association (IRA) International Fellows Exchange Program was developed in 2016 to foster scientific collaboration between members of the ACR and junior rheumatologists representing the IRA. I was lucky enough to be selected to participate in this exchange initiative, and I can’t thank these two organizations enough for working together to provide this…
LONDON (Reuters)—Scientists exploring what may trigger chronic fatigue syndrome (CFS) have found clues in the way some people’s immune systems respond to interferon alpha.1 The researchers used the drug to create a model of the disease in people without CFS but with hepatitis C. Many patients who receive interferon alpha experience extreme fatigue during treatment,…
Education with recommended first-line care may not improve pain outcomes in patients with acute low back pain. When comparing patients who received education with those who received professional consultation without information or advice, researchers found patient education was no more effective than placebo at reducing depression or incidence of chronic low back pain…
CHICAGO—Is erosive, inflammatory osteoarthritis (EOA) a separate condition from osteoarthritis (OA)? Roberta Ramonda, MD, PhD, a rheumatologist at the University of Padova, Italy, spoke at the 2018 ACR/ARHP Annual Meeting on the clinical presentation of EOA and how it differs from OA. EOA is characterized by a frequent aggressive clinical course and occurs most often…
CHICAGO—Joint trauma is one of many potential drivers of osteoarthritis disease activity and structural progression. In Post-Traumatic OA: Pathogenesis, Clinical Evolution and Management, a session at the 2018 ACR/ARHP Annual Meeting, experts discussed the effects of sports and other injuries on even young patients’ joints. Post-traumatic osteoarthritis (OA) may account for 12% of hip, knee…
With more than 152,000 taken steps in four days, top honors in the first-ever ACR/ARHP Annual Meeting Walking Challenge go to Mark Phelan, MD…
CHICAGO—In the Thieves Market session at the 2018 ACR/ARHP Annual Meeting, rheumatologists from around the country presented a slate of challenging cases that emphasized the importance of clinical persistence and attention to detail, and the need to consider diagnoses that might not be common or obvious. Three of them are summarized below. (Look for more…
CHICAGO—The path to the discovery of cortisone—a top-selling, important drug, with dozens of indications—was complicated by failure, false moves, desperation and obsession. The tale, recounted in the Philip Hench, MD, Memorial Lecture: Crossroads of History & Hope: Discovery & First Use of Cortisone for RA at the 2018 ACR/ARHP Annual Meeting in October, is an…
CHICAGO—In systemic lupus erythematosus (SLE), most types of severe pulmonary manifestations are relatively rare, but it’s crucial they be caught because of the potentially dire consequences, said Richard Silver, MD, professor in the Rheumatology Division at the Medical University of South Carolina, Charleston, at the 2018 ACR/ARHP Annual Meeting. Pulmonary Manifestations Parenchymal disease—seen in the…
CHICAGO—Resolving conflict doesn’t start with clever strategizing, but with understanding the bigger picture and the factors that led to conflict in the first place, from cultural differences to resistance to change, an expert said at the 2018 ACR/ARHP Annual Meeting in a session about how to be a better leader. “To me, what’s often missing…
CHICAGO—Once methotrexate enters a cell through the reduced folate carrier (RFC), which thinks it is picking up folate, the drug is polyglutamated. It is this polyglutamate methotrexate that provides the actual clinical effect. These methotrexate polyglutamate “species” are added and lost over time, but it’s a slow process. What difference does it make whether a…
CHICAGO—The correct dosing of hydroxychloroquine (HCQ) for systemic lupus erythematosus (SLE) is a concern of all rheumatologists. Petros Efthimiou, MD, clinical professor of medicine at New York University, New York City, opened the Great Debate of the 2018 ACR/ARHP Annual Meeting by stating, “Today, we will be discussing a critical clinical problem that affects everyone’s…
CHICAGO—The body of literature on immunosuppressive drugs used to treat cancer and autoimmune diseases is growing, helping bring some clarity to their effects on the immune system and how well they work in patients. This has helped refine the questions that further research must answer, said an expert at the 2018 ACR/ARHP Annual Meeting. The…
CHICAGO—The pre-clinical rheumatology curriculum at the University of North Carolina (UNC) School of Medicine, Chapel Hill, used to consist mainly of portions of a musculoskeletal course, with up to only three instructional hours, and not always with a rheumatologist in the room with students. Systemic autoimmune diseases were never fully discussed in any of the…
CHICAGO—Suleman Bhana, MD, a rheumatologist at New York-based Crystal Run Healthcare, calls himself a “technology nerd,” but judging by his review of tech tools at the 2018 ACR/ARHP Annual Meeting, you don’t have to geek out to embrace technology in your rheumatology practice. You just have to like simplicity and saving money. “We have a…
CHICAGO—Every minute, it seems, a new digital tool is introduced in medicine. Whether it’s a new digital measuring stick, a new data-crunching system or a new app, the tech tools form an endless convoy of options. But are they worth it? Will they really help you do your job better? Will they help patients feel…
Yolanda López López, MD, MA, a rheumatologist in Bayamón, Puerto Rico, says she’s been writing “forever.” But when she was in high school, several teachers, counselors and others persuaded her against selecting writing as a profession or even getting a college degree in literature because she wouldn’t be able to earn a comfortable living. At…
2018 Evelyn V. Hess Award The Evelyn V. Hess Award is given annually to recognize the exceptional contributions of a clinical or basic researcher whose body of work has advanced the understanding of the science of lupus treatment. At a reception during the 2018 ACR/ARHP Annual Meeting in Chicago, the Lupus Foundation of America presented…
In a recent study, ixekizumab proved safe and effective in treating adults with psoriatic arthritis (PsA) and plaque psoriasis compared with adalimumab…
The FDA has approved Truxima (rituximab-abbs), which is biosimilar to Rituxan (rituximab), for treating adults with CD20-positive, B-cell non-Hodgkin’s lymphoma…
Patients who develop neuropsychiatric symptoms of SLE have a small nucleotide polymorphism (SNP) in an intron in a Ca++ ion channel gene that influences some, but not all, events regulated by Ca++. The SNP appears to influence activation induced apoptosis rates and cytokine production, specifically IL-4, in a disease- and genotype-specific manner…
One aspect of the Rheumatology Research Foundation’s work is recruiting more people into the field, and it starts by building interest in rheumatology among the best and brightest medical and graduate students. The Foundation is fueling the pipeline of rheumatology professionals by supporting students, residents and fellows in a number of ways, such as with…
Out of the turmoil of 2018 came a number of significant victories for the rheumatology field, all of which are thanks to the ACR’s volunteers, who spearheaded communication with policymakers. We are thrilled to share these successes and look forward to working with you in an even more productive 2019 (view this larger on our…
Early last fall, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) released its OIG Work Plan for fiscal year 2018–2019, which is a two-year framework for the audits, inspections, evaluations and investigative activities planned in support of its vision, mission, and strategic goals and objectives to maintain HHS program integrity….
Which modifier is used when there is a separate and/or identifiable reason to bill for both an evaluation and management code and a procedure code? -25 -24 -51 -59 Which modifier is used to indicate that bilateral procedures were done on a patient? -50 -LT/RT Both a and b None of the above A 68–year-old…
Take the challenge. 1. A—Modifier -25 is defined as a significant, separately identifiable evaluation and management (E/M) service by the same physician or other qualified healthcare professional on the same day of the procedure or other service. It is to be placed on the E/M visit only because it attests to the payer there is…