The idiopathic inflammatory myopathies (IIM) encompass eight categories: 1) dermatomyositis (DM) in adults, 2) juvenile dermatomyositis, 3) amyopathic DM, 4) cancer-associated DM, 5) polymyositis, 6) immune-mediated necrotizing myopathy, 7) inclusion body myositis, and 8) overlap myositis.1 These categories help classify the myopathies based on clinical and histologic features. The incidence of IIM is estimated at…
Seq & Ye Shall Find
I nodded, gravely. I was recently privileged to attend a symposium on eosinophils. I realize that this sounds odd. And it was odd, mainly because I’m not an eosinophil expert. Still, they were in need of someone who knew something about eosinophilic granulomatosis with polyangiitis, so I managed to sneak in through the back door….
ACR Insurance Subcommittee Focuses on Coverage & Reimbursement
On behalf of the ACR, I wish you happiness, prosperity and, above all, good health in this new decade. Now that the holidays are behind us and 2020 has launched, the ACR’s dedicated volunteers and staff are working collaboratively to achieve many ambitious initiatives to ensure the College’s dynamic and bright future. A few weeks…
New ACR/ARP Committee Members Are Ready to Work
Volunteering is a great way to give back and can be truly meaningful. Myriad worthwhile causes exist, so it can be hard to choose among them, but donating time to ACR and ARP committees helps promote rheumatology practice and brings awareness to rheumatic diseases. The College relies on volunteers to help achieve strategic priorities, promote…
PAD4 Antibodies May Help Predict Treatment Response in Rheumatoid Arthritis
A study published in Arthritis & Rheumatology highlights how the presence of autoantibodies to peptidylarginine deiminase (PAD) may eventually be used to influence treatment decisions in the management of rheumatoid arthritis (RA), sharpening our understanding of disease subtypes.1 Although follow-up prospective studies are needed, these findings underline some intriguing areas for future investigations in immunobiology….
Case Report: Possible Overlapping Vasculitis & Ulcerative Colitis
A 42-year-old man with a history of ulcerative colitis (UC), primary sclerosing cholangitis (PSC) and chronic sinusitis was referred to a rheumatologist to evaluate for a possible diagnosis of systemic vasculitis. This patient had developed new skin lesions, gingival hypertrophy and ulcerating tracheobronchitis, concerning for possible granulomatosis with polyangiitis (GPA). Since 1994, the patient had…
Sjögren’s Syndrome in Kids: Diagnostic Challenges & Treatment Options
A 14-year-old girl is referred to your office for fatigue and arthralgias. While you’re obtaining her past medical history, she divulges that she has had four episodes of bilateral parotitis, each lasting two weeks. An otolaryngologist evaluated her. She lacked sicca symptoms, had a normal complete blood count (CBC), normal inflammatory markers and a negative…
Case Report: Obliterative Bronchiolitis in Rheumatoid Arthritis
A 59-year-old woman with rheumatoid arthritis (RA) presented to our pulmonary clinic for progressively worsening dyspnea of five years’ duration. She described progressively worsening dyspnea after a few minutes of walking on level ground. In addition, she noted worsening pain and morning stiffness of the wrists, knees and metacarpophalangeal (MCP) joints, with subcutaneous nodules. She…
What Happens When Patients Have Access to Their Clinician’s Notes?
Navigating the healthcare system and its processes can seem overwhelming to patients. If patients understand why their clinician recommended something, know how and when to take medications, and why they shouldn’t skip a dose—or 10—they may not feel so out of control. Sharing examination notes with patients can be helpful to many patients who struggle…
My Experience at the 2019 Rheumatology Research Workshop: Opportunity to Meet Peers & Role Models
I had the opportunity to attend the Rheumatology Research Workshop in Washington, D.C., in June 2019. Held annually, this two-day meeting is run by the ACR Early Career Investigators (ECI) Subcommittee and is geared toward trainees at all levels (fellows, residents and medical students) and junior faculty with an interest in a rheumatology research career….
A Report from 2 ACR/EULAR Exchange Participants
Since 1998, the ACR/European League Against Rheumatism (EULAR) Exchange Program has supported junior academic rheumatologists, rheumatology professionals and health professionals in rheumatology in traveling from Europe to the U.S., and vice versa, to exchange clinical and research skills, expertise and knowledge. The program is designed to recognize outstanding early career faculty in rheumatology research, so…
Tele-Rheumatology Offers Lots of Benefits
ATLANTA—With growing demand for access to rheumatologists in rural areas, a shortage in the number of rheumatologists and the ability to use technology as a bridge to patients in remote areas, telemedicine seems like a smart option. And it certainly can be, experts said at a 2019 ACR/ARP Annual Meeting session in November. But a…
What Should Providers Do to Address Polypharmacy?
ATLANTA—In a session at the 2019 ACR/ARP Annual Meeting, Susan Chrostowski, DNP, assistant clinical professor at Texas Woman’s University College of Nursing, Dallas, told the audience that she’d had a visit with a patient and asked how he was doing. “Not too good,” he said, explaining that his chest hurt. “What’s the matter with your…
Make Rehab Fun: Virtual Reality & Therapeutic Gaming
Using virtual reality in rehabilitation can have benefits—as long as it is properly understood. In fact, some evidence suggests benefits from the judicious use of immersive virtual reality with patients with rheumatic diagnoses. People tend to have a lower perception of effort compared with actual exertion and lower reports of pain with longer time to exhaustion.
Tips for Engaging Your Pediatric Research Patients
ATLANTA—Around 2002, when Vincent Del Gaizo’s son was just 15 months old, he was hospitalized in an intensive care unit and, weeks later, was diagnosed with systemic juvenile idiopathic arthritis (JIA). “We had the same 8 trillion questions that all parents have when their child is diagnosed with a condition you’ve never heard of: ‘Is…
Emerging Biomarkers for Lupus
ATLANTA—When it comes to identifying reliable biomarkers that can predict worsening illness or help point to proper treatment, it’s hard to imagine a more vexing disease than systemic lupus erythematosus (SLE), said Jill P. Buyon, MD, director of the Lupus Center at New York University Langone Medical Center, in the 2019 ACR/ARP Annual Meeting session…
Tips for Exploring Tough Topics with Teens with Rheumatic Disease
ATLANTA—Managing teenage patients may present challenges for pediatric rheumatologists and rheumatology professionals not only because of their often complex, rare conditions, but because teenagers are, well, teenagers. Teens may experiment with sexual intercourse, alcohol use, tobacco or vaping e-cigarettes to fit in with their peers, even if these habits have serious health consequences, according to…
Beyond Drugs: ACR/AF Guideline Update for Hand, Knee & Hip OA Emphasizes Exercise
Guideline authors discussed therapeutic options for patients with hand, knee and hip OA in a session at the 2019 ACR/ARP Annual Meeting.
Clinical Pearls for Diagnosing & Treating Sjögren’s Syndrome
ATLANTA—Dry eyes and mouth are common symptoms in the general population. When patients report these symptoms to their primary care provider and other consultants, it may prompt a referral to a rheumatologist to rule out Sjögren’s syndrome. However, as discussed in the 2019 ACR/ARP Annual Meeting session, Sjögren’s Syndrome: Beyond the Dryness, evaluation of this…
Baby on Board: The Rheumatologist’s Role in Family Planning for Patients with Lupus
For patients with lupus, family planning discussions are vital to achieving positive pregnancy outcomes & maintaining overall health…
The Educator’s Toolbox: How Clinicians Can Master the Art of Teaching & Giving Effective Feedback
Insights into how to effectively teach & communicate feedback to students were offered in this Annual Meeting session…
Tips for Smoothing the Time-Consuming Prior Authorization Process
ATLANTA—Obtaining prior authorization to ensure services or prescription drugs are covered by a patient’s health plan consumes staff time, and delays or denials may cause patients to abandon treatment, according to speakers at the 2019 ACR/ARP Annual Meeting. In a session on Nov. 10, the experts shared tips to smooth the process. Train Staff on…
GPA & Relapsing Polychondritis Discussed
Challenges related to diagnosing chondritis are discussed.
How to Work with Sales & Marketing Representatives in Your Practice
Sales and marketing representatives can add tremendous value to your practice: They can generate consistent business by leveraging contacts who have services that can be referred to your practice. However, the services a sales and marketing representative provides are subject to significant scrutiny under the federal Anti-Kickback Statute and state equivalents. For this reason, the…
Ethics Forum: 3 Ways to Resolve Conflict When Children Refuse Treatment
In the middle of a busy clinic I go to see my next patient, a 16-year-old girl with a swollen knee. I had seen her the week before and, after discussing the options regarding treatment of her arthritis, had organized a joint injection for today. As I walk in the door she emphatically informs me,…
Anifrolumab Promising for SLE
Recent research has found a higher does of anifrolumab may benefit patients with moderate to severe SLE…
Pegloticase & Methotrexate Combination Therapy May Benefit Patients with Uncontrolled Gout
Patients with uncontrolled gout may benefit from a combination of pegloticase and methotrexate therapy, according to a small, retrospective study…