In June 2014, 10 members of a church group returned to St. Louis from Haiti, where they had contracted chikungunya virus (CHIKV), a mosquito-transmitted alphavirus previously unknown in the Western hemisphere that produces inflammatory arthritis symptoms. Because CHIKV-related arthritis mimics seronegative RA, a group of clinicians, immunologists, virologists and geneticists at the Washington University in…
The U.S. Food and Drug Administration (FDA) has toughened the existing warnings for nonsteroidal anti-inflammatory drugs (NSAIDs) due to their stroke and myocardial infarction (MI) risk increase.1 Due to a continual review of these products, FDA is requiring label updates for all prescription NSAIDs. Over-the-counter (OTC) NSAIDs already list the increased risk of MI and…
“Each project adds new knowledge that brings us a little closer to the cure,” Joan Bathon, MD, of Columbia University Medical Center, says of the Rheumatology Research Foundation’s 8th Annual Investigators’ Meeting in San Diego. Dr. Bathon was one of more than 30 investigators who presented the latest progress on research funded by the Foundation’s…
The Annual Meeting Planning Committee believes the best ideas come from our members! We need your input in developing educational content that best suits the needs of our target audience. Take advantage of an opportunity to share your ideas with your colleagues by submitting a proposal for the 2016 ACR/ARHP Annual Meeting. The deadline to…
Nathan Wei, MD, FACP, FACR, admits that he didn’t exactly agree with the amount certain things were encouraged in his family. “Aspects such as academics and music were focused on so much,” he says. “I wanted to break out from that upbringing. I wanted to add in more of what I wanted to do.” And…
A brief has been filed with the U.S. Supreme Court that, if the court decides to hear the case, could have wide-ranging implications for online medical care and the limits of a physician’s First Amendment right to free speech. Medical Advice Via e-Mail Institute for Justice Senior Attorney Jeff Rowes filed the brief at the…
Musculoskeletal (MSK) ultrasound is a valuable imaging modality for the practicing rheumatologist and provides an efficient tool with high diagnostic value in the evaluation of patients with musculoskeletal complaints. The use of MSK ultrasound has evolved in the U.S. due to the emergence of less-expensive, portable ultrasound units, which provide high-quality gray-scale and power Doppler…
On any Thursday from 7 p.m. to 8 p.m., you can find Robert H. Shmerling, MD, playing tag, basketball or even roughhousing with a group of children at Second Step, a transitional living program that offers victims of domestic violence in the Boston area a safe place to live and opportunities to go back to…
Receipt of an unsolicited communication that a sweepstakes award has been won may con some people (especially, but not limited to, those underprivileged or undereducated as to legalities), but can’t fool all of the people all of the time. The names of the organizations and products involved are often marketing tool inventions, which imply special…
For the past 16 years, the website, creakyjoints.org, founded by arthritis patient Seth Ginsberg and social entrepreneur Louis Tharp, has offered arthritis patients and their families a safe online community where they can receive meaningful support and education. In March, the online portal added a new initiative—Arthritis Power, the first-ever patient-led, patient-generated, app-based research registry…
Take the challenge. CPT: 20611-LT, J7325 X 1 ICD-9: 715.16—Osteoarthritis, localized, primary, lower leg ICD-10: M17.12—Unilateral pri- mary osteoarthritis, left knee Note: When billing for 20611—Arthrocentesis, aspiration and/or injection, major joint or bursa (e.g., shoulder, hip, knee, subacromial bursa), with permanent recording and reporting, there must be a permanent photograph of the needle placement in…
Coding for a Knee Injection A 68-year-old female patient with primary osteoarthritis of the left knee returns to the office for her scheduled hyaluronan injection. The patient reports that her knee is a little tender, but on a scale of 1–10, it is a 4. She is stiff in the morning for 10–20 minutes. The…
Maximize your meeting experience by taking advantage of the following resources: Mobile App—Create a personalized schedule, receive meeting alerts, submit session evaluations, search maps and more. Session Tracker—A printed resource you can use to record your hours of participation as you go. The session tracker will be available on site and online. Searchable Abstract Site—Search…
Advance Registration Ends Wednesday, Oct. 21 Time is running out to register at advance rates for the 2015 ACR/ARHP Annual Meeting, to be held Nov. 6–11 in San Francisco. Attendees will receive firsthand access to the latest innovations, research and clinical applications transforming rheumatic disease care. Expand your knowledge into new areas of rheumatology by…
Mark Your Calendars The 2015 ACR/ARHP Annual Meeting in San Francisco is just around the corner, and it’s time to start planning for what is sure to be a busy week! Below are a few events hosted by the government affairs team you don’t want to miss. Legislative Update Sunday, Nov. 8, 9:00–10:00 a.m. In…
In an age of constant change and regulations, one thing remains the same in coding and billing: If it’s not documented, it wasn’t done. This is the main rule for documentation. Good documentation is and always has been the foundation of accurately capturing a provider’s work and the patient’s condition, management and treatment. Introduced by…
Imagine you’ve just heard a compelling presentation urging all ACR members to contribute to RheumPAC, the ACR’s political action committee. RheumPAC’s mission is to support politicians who support issues important to rheumatologists. You are impressed by the role RheumPAC has played in a number of issues you support. Just as you’re writing a check, you…
Physician burnout is high and climbing. A 2015 report published by Medscape showed that nearly half (46%) of physicians surveyed responded that they were experiencing burnout; that number is up from 39.8% reported in a similar survey in 2013.1 These physicians experience the tell-tale signs of burnout: loss of enthusiasm for work (or emotional exhaustion),…
A new survey of more than 3,600 adults living with rheumatoid arthritis (RA) shows that a patient’s perception of their disease and treatment, as well as their relationship with their healthcare professional, can positively impact the management of their disease. The RA NarRAtive survey, created and sponsored by Pfizer, is part of an international initiative…
Co-morbidities in patients with rheumatoid arthritis and related autoimmune diseases often warrant a multidisciplinary approach to treatment. When it comes to inflammatory and fibrotic lung conditions in these patients, collaboration between pulmonary/critical care specialists and rheumatologists is essential, say two rheumatologists recently interviewed by The Rheumatologist. Both followed their rheumatology fellowship training with additional fellowships…
Rheumatic diseases, such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) and vasculitis, can affect the body in many ways, but perhaps the most serious is the increased risk of heart disease for many patients. As the risk of atherosclerosis in autoimmune disease patients gains increased attention, rheumatologists and cardiologists are collaborating more often to…
Telling an employee that they need to improve does not conjure up warm, fuzzy feelings. In fact, many employers dread it and may get gun shy. After all, an employee could take it the wrong way, and the constructive criticism could be ill received. “This is a legitimate fear, because many people have given constructive…
Fibromyalgia syndrome (FMS) is a condition characterized by widespread pain, abnormal pain processing, sleep disturbance and fatigue. It is commonly associated with psychological distress and co-morbid conditions. Impaired cognition is common in individuals with FMS, and is often referred to as fibrofog.1 According to the U.S. Centers for Disease Control and Prevention, the prevalence of…
Methotrexate has long been a cornerstone of therapy in rheumatoid arthritis. Two new, injectable methotrexate products may help some RA patients for whom oral methotrexate is not as effective or causes adverse effects. Rasuvo and Otrexup are prefilled, auto-injection devices that allow patients to give themselves subcutaneous injections of methotrexate without having to use a…
Editor’s note: Welcome to the first installment of Experiences in Advocacy, a special series authored by ACR members detailing personal experiences in advocacy. We need rheumatologists to join the American Medical Association (AMA). Here’s why, and how to do it. Having participated in your delegation for over a decade, I have seen major improvements in…
Gregory Barton, PhD, professor of immunology and pathogenesis, University of California, Berkeley, talked about research on the innate immune system and a key protein involved in the trafficking of a subset of toll-like receptors (TLRs) during FOCIS 2015 in San Diego. To keep the body healthy, the immune system responds constantly to foreign cellular invaders…
How the immune system reacts to potential harm, such as lack of oxygen and inflammation, depends greatly on the human body’s metabolic processes and pathways, according to speakers at FOCIS 2015 in San Diego this past June. During a session devoted to metabolism and the immune system, researchers talked about recent studies that shed light…
The field of rheumatology took center stage when a handful of speakers discussed trends and research during a disease-oriented session of the 2015 Federation of Clinical Immunity Societies (FOCIS 2015) conference held in San Diego in June. Neutrophils in SLE Mariana Kaplan, MD, chief of Systemic Autoimmunity Branch at the National Institute of Arthritis and…
Two of the great traditions of medicine are the curbside and party consults. In the former, participating physicians informally discuss an especially difficult diagnostic problem. During the latter, a patient will approach the doctor to ask about some possible medical problem and what they should do about it. The advent of the Internet has brought…
How do you tell a story 50 years in the making? How do you capture 50 years of achievements, moments, personal and professional relationships, and careers shaped? How do you define the exact moment collaborative and integrated care teams became the rule—not the exception—in rheumatology? To journey through the milestones that have led to the…
The differences between Caucasian and minority patients with lupus are striking: In almost all aspects of the disease, black, Hispanic and many Asian lupus patients do poorly compared with their white counterparts. Although racial disparities in outcomes in the practice of medicine are widespread, the scope and degree of the differences in lupus is, with…
“Worst of all is the pain in my calves,” she said. “It feels like burning deep inside.” So began my first encounter with a 69-year-old woman who was referred to rheumatology clinic for evaluation of two months of constitutional symptoms and a positive ANCA test, which had been ordered by her primary care doctor. Her…
Prior to the widespread use of bisphosphonates for the management of osteoporosis, multiple myeloma and metastatic cancer to the skeletal system, osteonecrosis of the jawbones was an infrequent condition seen after radiation for oral cancers (osteoradionecrosis) and in chronic odontogenic infections.1 Since the mid-2000s, osteonecrosis of the jawbones has been noted to occur as a…
For 30 years, the Rheumatology Research Foundation has been working to advance research and training to improve the health of people with rheumatic diseases. The past three decades are replete with the achievement of significant milestones and extraordinary accomplishments. Funding Research, Training The Foundation’s efforts began in 1985 when it was established by the ACR….
Updated Oct. 22, 2015 (revised to delete inaccurate statistics) The cold, hard facts: This year’s rheumatology fellowship applicant pool resembles those of prior years. It is extremely diverse; every continent is represented, save Antarctica. It is somewhat larger, due in part to the growing influx of graduates from the cluster of Caribbean-based medical schools, where…