It’s no secret to any health professional, including rheumatologists, that smoking cigarettes or using other tobacco-based products is unhealthy. Yet how does smoking specifically affect rheumatic diseases, and what are some of the newest findings in this area? What role do e-cigarettes have in the smoking risk landscape? Those are the sorts of questions asked…
On Feb. 9, 2019, protesters gathered at the Guggenheim Museum in New York City to lead a march down Fifth Avenue to the Metropolitan Museum of Art.1 As a general rule, news from the world of art is not a topic discussed in these pages, but if you indulge me for just a little bit…
The ACR recognizes that data are more important now than ever. As we enter what has been called the Fourth Industrial Revolution—a period of digitalization in which technology is embedded everywhere in our everyday lives—we are not just hearing constantly about the importance of data and its capabilities, we are experiencing it every day, firsthand…
Editor’s note: In this recurring feature, we first present a series of ultrasound images for your review, and then a brief discussion of the findings and diagnosis. Before you scroll to the discussion, examine these images carefully and draw your own conclusions. History A 2-year-old boy with a history of multiple strokes and vertebral artery…
Results of a recent study in Arthritis & Rheumatology fail to clarify whether urate-lowering therapies may potentially reduce mortality risk in patients with gout.1 The study also underscores the fact that many physicians are not following the ACR guideline to help their patients achieve target serum urate levels. Partly because of this, it remains unclear…
Anti-citrullinated protein antibodies (ACPAs) are now viewed as critical diagnostic and prognostic markers for rheumatoid arthritis (RA). Research into the pathophysiology of these autoantibodies has proven to be a ripe area of investigation, opening up many promising avenues for better understanding the etiology and pathogenesis of RA. Ultimately, work utilizing these autoantibodies may also allow…
A growing body of research is elucidating the role of intestinal microbiota in several autoimmune diseases, including rheumatoid arthritis (RA). Research published in December 2018 Arthritis & Rheumatology increases our understanding of the “extent and nature of mucosal immune activation during preclinical arthritis.”1 The research objective, according to the report, was to “dissect intestinal mucosal immune…
We spend a good portion of our day in front of screens—televisions, computers, tablets, phones and more. Social media (#SoMe) use has been on the rise, and its marriage to medicine seems inevitable. Merriam-Webster, aka America’s most trusted online dictionary, defines social media as forms of electronic communication through which users create online communities to…
At the close of my first year in fellowship, a co-fellow opened a packed cabinet behind her desk, and untold volumes of methodically annotated medical articles burst forth. Impressed not only by her diligence but also by the sheer volume of paper, I made a mental note to read more and to read more efficiently….
Paul Adam, MSW, has long been passionate about research, but it was attending ACR/ARHP meetings that solidified his decision to pursue it in his social work career. “I would get Arthritis Care & Research every month and look for articles pertaining to what I did, and go to the [ACR/ARHP] Annual Meeting and see a…
CHICAGO—The treatment of patients with juvenile idiopathic arthritis (JIA) is historically directed by clinical subtype. During a session at the 2018 ACR/ARHP Annual Meeting, speakers addressed the biological classification and treatment of JIA, discussing draft guidelines and recommendations, the impact of computer modeling on identifying JIA subtypes and subgroups of chronic arthritis. Guidelines & Recommendations…
CHICAGO—Medications have frequently been implicated as a cause of musculoskeletal complaints, including persistent arthralgias, arthritis and myalgias.1 The list of offending agents is diverse, and the degree of symptoms is variable. In the world of transplant recipients, this list is exhaustive and includes immunosuppressive agents (cyclosporine, tacrolimus); myeloid growth factors, such as G-CSF; antibiotics (quinolones);…
CHICAGO—Physicians from the University of Chicago presented an intriguing case of Sweet’s syndrome for the Clinical Pathological Conference during the 2018 ACR/ARHP Annual Meeting. Pankti Reid, MD, MPH, a rheumatology fellow at the University of Chicago, introduced the case of a white man who, in 2017, came under the care of the University of Chicago….
CHICAGO—Held during the 2018 ACR/ARHP Annual Meeting, the ACR Review Course covered a wide range of topics for rheumatologists—from advances in pain and rheumatic disease management to the intersection of rheumatology and neurology. Session speakers shared insights, as well as state-of-the-art approaches to diagnosis, management and treatment. Inflammatory Myopathies Julie J. Paik, MD, MHS, assistant…
CHICAGO—Because the epigenome has been implicated in a variety of rheumatic conditions, a Basic Research Conference was convened on Epigenetics in Immune-Mediated Disease in conjunction with the 2018 ACR/ARHP Annual Meeting. Melanie Ehrlich, PhD, professor of human genetics and genomics at Tulane University School of Medicine, New Orleans, opened the conference. She has a long…
CHICAGO—At the 2018 ACR/ARHP Annual Meeting, Allen C. Steere, MD, delivered the Rheumatology Research Foundation Memorial Lecture honoring the late Charles M. Plotz, MD: Linking Gut Microbial Immunity with Autoimmunity in Joints in Patients with Rheumatoid Arthritis. Dr. Steere is professor of medicine at Harvard Medical School, Boston, and director of translational research in rheumatology…
CHICAGO—Ken Smith, MD, PhD, professor of medicine at the University of Cambridge, England, gave an update on anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) at the 2018 ACR/ARHP Annual Meeting. Although vasculitis tends to be defined first by vessel size, the clinical differentiation between the forms is not reliable, explained Dr. Smith. For example, granulomatosis with…
CHICAGO—Josef S. Smolen, MD, professor of internal medicine and chair of the Department of Rheumatology, Vienna General Hospital, Austria, presented the prestigious Paul Klemperer, MD, Memorial Lecture at the 2018 ACR/ARHP Annual Meeting. Dr. Smolen, whose work is frequently cited, created the treat-to-target strategy for rheumatoid arthritis (RA). Dr. Smolen began by noting a simple…
CHICAGO—Can non-drug interventions improve the lives of patients with scleroderma? Janet L. Poole, PhD, OTR/L, professor and director of the Occupational Therapy Graduate Program of the School of Medicine, University of New Mexico, Albuquerque, addressed this question when she presented the ARHP Distinguished Lecture at the 2018 ACR/ARHP Annual Meeting. She discussed the challenges faced…
CHICAGO—The session on the topic of pediatric uveitis at the 2018 ACR/ARHP Annual Meeting began with a presentation by Debra A. Goldstein, MD, professor of ophthalmology and director of the Uveitis Service at the Feinberg School of Medicine, Northwestern University, Chicago. To a room packed with rheumatologists, she explained, “Most of what I am going…
CHICAGO—David A. Isenberg, MD, academic director of rheumatology, University College London, presented the ACR Systemic Lupus Erythematosus (SLE) State-of-the-Art Symposium at the 2018 ACR/ARHP Annual Meeting. Dr. Isenberg began by noting lupus is now widely covered in the news, but singer Selena Gomez has probably done the most to increase awareness of the disease; her…
CHICAGO—Antiphospholipid antibody syndrome (APS) mainly affects young women, but can also affect men. APS patients test positive for multiple antibodies, including lupus anticoagulant (LAC), anti-cardiolipin and/or anti-beta2-glycoprotein I. These antibodies are diagnostic of APS, and they place the patient at increased risk for thrombosis and, in women, pregnancy morbidity. Women with LAC or those who…
CHICAGO—“We have got to get over this hump. We have got to try new stuff,” said Jacqueline M. Fritz, RN, MSN, CNS, to the audience gathered on the final day of the 2018 ACR/ARHP Annual Meeting, referring to the subject of biosimilars. Ms. Fritz, the owner and coordinator of education at the Medical Advancement Center…
CHICAGO—John H. Stone, MD, MPH, director of clinical rheumatology at Massachusetts General Hospital, Boston, took the stage at the 2018 ACR/ARHP Annual Meeting to present, for the first time, a draft of new classification criteria for IgG4-related disease (IgG4-RD), a project supported by both the ACR and EULAR. Even though it was the last day…
CHICAGO—At the 2018 ACR/ARHP Annual Meeting, rheumatologist project volunteers for the ACR’s Collaborative Initiatives talked about their efforts to educate primary-care providers, patients and families in their communities about systemic lupus erythematosus (SLE). Their goal is to facilitate timely diagnosis and treatment of lupus, especially in underserved communities. Health Disparities Health disparities, or differences in health…
CHICAGO—“You never know when things might happen,” began Kamala M. Nola PharmD, MS, vice chair and professor in the Department of Pharmacy Practice at Lipscomb College of Pharmacy, Nashville, at the 2018 ACR/ARHP Annual Meeting. Dr. Nola explained that on May 1, 2010, the Arthritis Foundation Arthritis Walk held on her university’s campus was moved…
CHICAGO—The 2018 ACR/ARHP Annual Meeting session on genetic mimics of rheumatic disease began with a description of a patient who presented with the symptoms of childhood-onset lupus but instead had a well-defined genetic disease: lysinuric protein intolerance (LPI). Lindsay Burrage, MD, PhD, assistant professor of molecular and human genetics at Baylor College of Medicine, Houston,…
CHICAGO—The Gout and Hyperuricemia scientific session at the 2018 ACR/ARHP Annual Meeting opened with a talk by Tony R. Merriman, PhD, a research professor at the University of Otago, New Zealand. His talk focused on molecular epidemiology, with an emphasis on the interactions between genes and environmental exposures, and their contributions to gout. Dr. Merriman…
CHICAGO—Keith Winthrop, MD, MPH, professor of public health and preventive medicine at the Oregon Health & Science University School of Medicine, Portland, Ore., began the vaccination session at the 2018 ACR/ARHP Annual Meeting with a review of vaccination timing and targets. He presented a clinically relevant snapshot of the vaccines rheumatologists should consider and emphasized…
CHICAGO—Two experts presented insights on the diagnosis and treatment of low back and hip pain, including a refresher course on the mechanical structures involved, in Anatomy in a Day: Demystifying Low Back Pain and Lateral Hip Pain: New Patho-Anatomical Perspectives, a session at the 2018 ACR/ARHP Annual Meeting. Low Back Pain Avoid using such terms…
CHICAGO—The osteoporosis session at the 2018 ACR/ARHP Annual Meeting opened with a discussion by Kenneth Saag, MD, MSc, professor of medicine at the University of Alabama, Birmingham, in which he highlighted adverse events associated with osteoporosis medications. Dr. Saag began his presentation by emphasizing that, above all, the audience should keep in mind that the…
Sara Alehashemi, MD, MPH, recalls the first time she ever stepped foot on a badminton court. It was back in 2003, when she was a 24-year-old medical school student at Hormozgan University of Medical Sciences (HUMS) in Iran. She was completing a rotation in orthopedic surgery and had been teamed up with another medical student…
A clinical trial in RA patients has established the pharmacokinetic similarity of ABP 798 and rituximab…
Health Canada has approved Erelzi, which is biosimilar to Enbrel (etanercept), for treating psoriatic arthritis in adults…
The Rheumatology Research Foundation’s strong financial health and commitment to accountability and transparency have earned yet another four-star rating from Charity Navigator, America’s largest independent charity evaluator. This is the 10th consecutive time the Foundation has earned this top distinction. Only 1% of charities have ever received 10 consecutive four-star evaluations, indicating the Foundation outperforms…
The ACR Committee on Journal Publications announces the search for the position of editor in chief of Arthritis & Rheumatology. The official term of the next Arthritis & Rheumatology editorship is July 1, 2020–June 30, 2025; however, some of the duties of the new editor will begin during a transition period starting April 1, 2020….
This year’s RheumPAC members are excited to build on their 2018 accomplishments. In 2018, we raised $144,000 from 323 individual investors. Thank you to everyone who invested and to those who supported advocacy for ACR/ARP, its members and our patients. We also introduced a new way for non-individuals (e.g., rheumatology practices, state and local rheumatology…
Join us for the Rheumatology Documentation and Coding Workshop taking place during the 2019 State-of-the-Art Clinical Symposium, Friday, April 5 in Chicago. The Rheumatology Documentation and Coding Workshop will take a deep dive into the new Medicare coding and documentation requirements for evaluation and management coding, medical decision making and specificity in diagnosis coding. Due…
What does a new patient experience as symptoms develop and diagnosis is confirmed? The ARP Practice Committee is developing persona-based case studies to help answer this and other questions. The latest topic is juvenile idiopathic arthritis…
A 60-year-old man returns for a follow-up related to his diagnoses of rheumatoid arthritis and chronic gout of his right ankle and foot, without tophi. He reports the gout flares have subsided in his ankle. He takes 450 mg of allopurinol daily. He has rheumatoid factor-positive rheumatoid arthritis, which previously affected multiple sites, without organ…
Take the challenge. CPT: 20611-LT, J7325-EJ ICD-10: M17.12, E66.01, Z68.41 CPT: 99213 ICD-10: M1a.0710, M05.79 History—The history of present illness was extended. The review of systems was extended, and two past family social history elements were documented. This makes the history level detailed. Examination—Five systems were examined. This makes the exam level detailed. Medical decision…