Various drugs are known to cause musculoskeletal symptoms, such as arthralgias, myalgias, drug-induced lupus and serum sickness.1 In the rheumatology world, the most commonly recognized drugs that can cause musculoskeletal symptoms are hydralazine, minocycline, fluoroquinolones and, recently, the dipeptidyl peptidase 4 (DPP-4) inhibitor class of medications. Although beta blockers also have a noted side effect…
If you are a news junkie, then you know that a tick-tock is a story that relies heavily on chronology, counting down the events of the day, in order, as inexorably as the ticking clock. These types of timeline stories have become very popular in the fast-paced world of modern politics, in which readers eat…
Rheumatology is a small specialty, but the ACR has a large footprint in terms of activities and impact. The ACR’s remarkable success can be attributed to effective collaboration between a highly professional and talented staff and a large number of volunteer members. Under the direction of the Board of Directors, the activities and strategic initiatives…
Systemic lupus erythematosus (SLE) can present in many ways and can be difficult to diagnose. Its association with celiac sprue has been only rarely documented, but has appeared in several case reports. When presenting together, it can be difficult to distinguish the underlying disease, because SLE itself has been known to cause malabsorption. This case…
The ARHP is pleased to announce the relaunch of its highly successful online Fundamentals of Rheumatology Course (FRC). This updated version is earning high marks from users and reviewers for ease of navigation, choice of presentation formats, depth of research and separate learning activities (i.e., modules) for the care of adult and pediatric patients. According…
Rheumatologists spend so many years treating the same patients, sometimes they start to feel like family. But for some doctors, it’s more than a feeling. The specialty attracts its fair share of relatives who can compare rheumatic notes, discuss complex cases and provide a built-in resource for advice. Brothers. Cousins. Fathers and daughters. In-laws. Husband…
In November 2017, I went to Lucknow, India, where I would spend my time as an exchange fellow at the Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPIMS) as part of the ACR International Visiting Fellows Exchange Program. Where I Come From I completed my medical degree at Mahatma Gandhi Missions Medical College, Navi Mumbai…
From working a temp job in the shipping department to organizing teacher training, maintaining an antebellum mansion and learning the ins and outs of professional medical practice, David Haag has had a career in membership societies that has been anything but boring. And as of this March, he finds himself in pursuit of his next…
SAN DIEGO—At the 2017 ACR/ARHP Annual Meeting this past November, three researchers discussed the latest ANCA-associated vasculitis (AAV) research, including studies on AAV pathogenesis, therapies and remission maintenance. In the Philip Hench, MD, Memorial Lecture, J. Charles Jennette, MD, chair in pathology and laboratory medicine at the University of Carolina at Chapel Hill in Chapel…
SAN DIEGO—Treatments do exist that can improve the prospects of a patient with the rare disease amyloidosis, but only if clinicians keep the disease in mind and treat the patient before it’s too late, an expert said at the 2017 ACR/ARHP Annual Meeting this past November. He also discussed research that may be close to…
SAN DIEGO—Since the identification of the autoinflammatory disease, familial Mediterranean fever (FMF), researchers have identified an alphabet soup of other autoinflammatory diseases with genetic underpinnings, from PAPA (pyogenic arthritis with pyoderma gangrenosum and acne) to NIAID (NLRP1-associated autoinflammation with arthritis and dyskeratosis) to TRAPS (TNF receptor-associated periodic syndrome). The torrent of discoveries, brought about largely…
SAN DIEGO—New insights into how scleroderma and myositis may be linked with cancer have led to intriguing questions that could impact patient care, experts said at the 2017 ACR/ARHP Annual Meeting in November. Understanding the relationship between cancer and rheumatic diseases is important because rheumatologists are seeing more and more patients with both diseases, and…
SAN DIEGO—At the 2017 ACR/ARHP Annual Meeting this past November, an expert said researchers are making progress in identifying drugs that can correct problems with transcriptional programming, which, if perfected, could go a long way toward harnessing more fully the power of genetics knowledge and directing it toward patient care. The session also delved into…
SAN DIEGO—At two sports medicine talks at the 2017 ACR/ARHP 2017 Annual Meeting last November, two rheumatologists discussed shoulder impingement and low back pain. First, Andrew Concoff, MD, a rheumatology and sports medicine specialist at St. Jude Medical Center in Fullerton, Calif., gave these five shoulder impingement tips: Physical exams may not be very useful…
SAN DIEGO—In a presentation on what rheumatology nurses should know in their daily practice about disease-modifying anti-rheumatic drugs (DMARDs) at the 2017 ACR/ARHP Annual Meeting Nov. 3–8, Jessica Farrell, PharmD, highlighted the importance of educating and counseling patients about the range of treatments and applications for rheumatologic conditions. Dr. Farrell, a clinical pharmacist at the…
SAN DIEGO—The Next Accreditation System, the newest process for evaluating medical residency and fellowship programs and their participants, including future rheumatologists, was implemented in 2014 by the Accreditation Council for Graduate Medical Education (ACGME). The system introduced specialty-specific milestones designed to reflect significant points in professional development. Milestones are defined by ACGME as a rubric…
SAN DIEGO—To manage patients with systemic lupus erythematous (SLE), rheumatologists must be aware of potentially serious complications affecting many organ systems. On Nov. 7 at the 2017 ACR/ARHP Annual Meeting, two experts offered insights on cardiovascular and hematological complications of lupus. Myocardial Disease in Lupus Lupus patients are at increased risk for heart-related complications, especially…
SAN DIEGO—Treatment strategies for systemic lupus erythematosus (SLE) have changed a great deal over the years, but progress has been slow and inadequate. According to a 2011 survey, many patients with lupus still report that they have a low quality of life due to their health problems.1 Rheumatologists face the challenge to develop more successful…
SAN DIEGO—Will rheumatologists soon be able to use data from genetics and genome-wide association studies to more accurately predict disease and develop new therapies for rheumatic diseases? At a Nov. 5 session at the 2017 ACR/ARHP Annual Meeting, experts shared their views on how to glean this useful knowledge from genomics studies. The cost to develop…
SAN DIEGO—What are the predisposing genes that suggest who will develop active systemic lupus erythematosus and who will stay healthy? Decades of research data help rheumatologists clarify this picture, says Argyrios N. Theofilopoulos, MD, professor of immunology and microbiology at Scripps Research Institute in La Jolla, Calif. At his Nov. 5 lecture at the 2017…
SAN DIEGO—In a session at the 2017 ACR/ARHP Annual Meeting, Kam Nola, PharmD, MS, professor in the College of Pharmacy and vice chair in the Department of Pharmacy Practice at Lipscomb University in Nashville, Tenn., updated participants on new medications and new indications for rheumatology treatments and safety labeling changes approved by the U.S. Food…
SAN DIEGO—Recent research tells us more about giant cell arteritis (GCA) to help rheumatologists more accurately diagnose and effectively treat patients with this type of vasculitis. On Nov. 6 at the ACR/ARHP Annual Meeting, three experts explored the latest findings on GCA pathogenesis, diagnostic approaches, imaging modalities and growing treatment options. GCA: What’s Really Happening?…
SAN DIEGO—A hormone secreted by the parathyroid gland is both a builder and a destroyer of bone in humans, with important implications for a variety of conditions treated by rheumatologists. In the Oscar Gluck, MD, Memorial Lecture at the 2017 ACR/ARHP Annual Meeting Nov. 3–8, Henry Kronenberg, MD, chief of the Endocrine Division at Massachusetts…
SAN DIEGO—Increasingly, technological advances are placing new tools into the hands of office-based rheumatologists. And they don’t have to cost a lot in capital equipment outlays by the medical group, because some of the best advances can be accessed via the device that is already in most doctors’ pockets, their smartphone. Smartphone technology gets more…
Joan M. Von Feldt, MD, MSEd, loves fashion—everything from the feel of natural fabrics and the fit of a well-crafted garment to mixing and matching colors and textures. As a professor of medicine at the University of Pennsylvania and editor in chief of the Journal of Clinical Rheumatology, she enjoys being well dressed and, like…
Despite our best efforts and modern interventions, we still have patients in the intensive care unit with organ failure. Although renal failure can be mitigated by dialysis, patients with cardiac or respiratory failure secondary to active autoimmune disease raise difficult clinical and ethical issues. Two recent cases, both with organ failure, led us to examine…
Paul A. Bacon, MD, professor emeritus of the University of Birmingham’s Department of Rheumatology, died on Jan. 5, 2018. The news of his passing saddened those who had the good fortune to know and collaborate with him. He was admired for his indefatigable dedication to measurement in rheumatic disease, especially vasculitis, as well as to…
The FDA recently expanded the indications for ferumoxytol injections to include the treatment of adults with iron-deficiency anemia…
The FDA is seeking to limit the number of loperamide doses per package due to reports of heart-related problems and death from the misuse and abuse of the treatment…
The Rheumatology Research Foundation has appointed Abby G. Abelson, MD, with the Cleveland Clinic to serve as president. She begins a two-year term alongside the new vice president, S. Louis Bridges Jr., MD, PhD, with the University of Alabama at Birmingham (UAB). Drs. Abelson and Bridges are highly accomplished leaders in the field of rheumatology…
A recent Politico article outlined the looming agenda facing Congress as 2018 begins: Fund the government, raise the debt ceiling, modify spending caps, address healthcare subsidies, allocate additional funds for disaster relief, and address the status of millions of undocumented young immigrants.1 Amid all that activity, the ACR, through its Government Affairs Committee (GAC) and…
Despite continuous movement to streamline the prior authorization process, physician practices are still struggling with jumping through hoops to have procedures and medications covered. A prior authorization (PA) is the process insurance carriers have in place to approve or reject prescriptions based on plan formulary. The PA process is important in ensuring appropriate and cost-effective…
On Nov. 4, a 55-year-old female patient presents to the office for a follow-up visit for injection of the left knee for osteoarthritis. This is her third of three injections that were preauthorized through Oct. 31. She reports pain and swelling in her left knee and rates the pain at an 8 on a 10-point…
Take the challenge. CPT codes: 20611-LT, 20611-RT, J7326x2 or 20611, 20611-50, J7326x2 ICD-10: M17.0 Coding Rationale CPT Codes: 20610-LT, J7325x16 ICD-10 Code: M17.12 This claim is rejected by the insurance carrier because the injection was outside of the preauthorization window that ended on Oct. 31. Most insurance carriers enforce their preauthorization dates for procedures. In…