We just learned that Dr. Brown passed away at his home Sunday night, Dec. 1. We are reposting this recent story in his honor. He will be missed.
Tips for Diagnosing Metabolic Myopathies
When evaluating patients with possible myopathic symptoms, rheumatologists must consider a rare, but important, group of inherited disorders: the metabolic myopathies. However, their diagnosis often remains a challenge. Early recognition of these primary metabolic myopathies is essential to help prevent disease morbidity and mortality from rhabdomyolysis. Here, we focus on the metabolic myopathies that present…
Stealing Time
I knew I shouldn’t look. I was driving 60 miles per hour, heading north on I-95, trying to get to the George Washington Bridge before dusk. It takes a certain fatalism to drive through New York City if you are not a native. Ninety percent of the drivers sharing the road with you know exactly…
Our New Executive Vice President Discusses His Aspirations for the ACR
I was honored to be invited by Paula to write this column about my aspirations for the ACR’s future. As one might expect, I am also humbled by the prospect of trying to encapsulate the vision that has already been so elegantly provided by ACR leadership and its board of directors: “As the leading authority…
Case Report: Can Salt-&-Pepper Skin Mean Systemic Sclerosis?
Systemic sclerosis (SSc) is a multi-system connective tissue disease in which skin and internal organ fibrosis are associated with an obliterative micro-vasculopathy and a degree of inflammation.1 Patients often report it takes one to three years from the appearance of the first signs and symptoms before they receive a diagnosis. The signs and symptoms of…
Intensive, Personalized Learning
During the 2019 ACR/ARP Annual Meeting, the new Meet the Professor Workshops and sessions will feature hands-on training on state-of-the-art topics…
Case Report: Does a Rapid-Onset Neck Mass Have Rheumatic Origins?
A 54-year-old African American man arrived at the emergency department with the acute onset of a tender mass on the left side of his neck. It had been getting progressively larger for the preceding two days. History & Examination His history included chronic right hip osteoarthritis with two surgeries performed five years prior. At his…
New ACR Open Rheumatology Journal Delivers Science to Wide Audience
The ACR’s newest journal, ACR Open Rheumatology (ACROR), launched in 2019 with all articles published in full online. The journal publishes high-quality, rigorously peer-reviewed articles on original investigations in rheumatology research, including basic science, clinical science, epidemiology, health outcomes and education, as well as commentaries and reviews. Open access is on the rise. A 2017…
Can REVEAL Tool Predict Survival in SSc-Related Pulmonary Arterial Hypertension?
A prognostic tool developed to predict survival in patients with various forms of pulmonary arterial hypertension (PAH) is fairly accurate in predicting survival outcomes for many patients with PAH related to systemic sclerosis (SSc-PAH), according to a new study. However, the prognostic accuracy is less reliable for SSc-PAH patients with the highest risk of death….
The Role of Autoreactive B Cells in Rheumatoid Arthritis
The body uses B cells to produce antibodies that can fight off infection by invading antigens and bacteria. But in rheumatoid arthritis (RA), the immune system produces autoantibodies that work against the body’s proteins to attack joint tissues. Researchers believe this process is helped along by autoreactive B cells that live in bone matter and…
Case Report: Diagnosing, Treating Hepatitis B-Linked Polyarteritis Nodosa
Hepatitis B virus (HBV) associated polyarteritis nodosa (PAN) is an increasingly rare vasculitis in developed countries due to advances in HBV vaccination and antiviral therapy. However, the condition does persist, and rheumatologists should consider it when evaluating vasculitis cases. Below, we discuss a case that illustrates the varied clinical presentations PAN can encompass. A high…
Do a Lack of Information & Social Support Affect Lupus Outcomes?
Patients with systemic lupus erythematosus (SLE) need better appraisal and more informational and social support, according to a new study on health-related quality of life in these patients.1 The phenomenological study, comprising qualitative interviews with patients in the Lupus Clinic at the Washington University School of Medicine, St. Louis, Mo., also found a need for…
To Understand Lupus, Study the Gut
Researchers who devote their time to studying lupus are accustomed to considering environmental stimuli such as sunshine and cigarettes. But according to Gregg J. Silverman, MD, a professor in the Department of Medicine and in the Department of Pathology at the New York University (NYU) School of Medicine and co-director of the Musculoskeletal Center of…
New Study Asks Why Lupus Patients Don’t Take Their Hydroxychloroquine
Hydroxychloroquine (HCQ) therapy may effectively manage systemic lupus erythematosus (SLE) in many patients, but that doesn’t mean patients will take it as often as they should. In fact, results from a recently published study found that about half of SLE patients were not adherent.1 The study was led by Lucy H. Liu, MD, MPH, a…
Study Finds Chronic Opioid Use Doubled in Rheumatoid Arthritis Patients
The prevalence of chronic opioid use among patients with rheumatoid arthritis (RA) doubled between 2002 and 2015, especially among patients with severe pain or on antidepressants, according to a new study.1 The study adds to prior data reporting trends in chronic opioid use in RA patients.2,3 Severe pain was the strongest predictor for use of…
Study: Screen Hospitalized Lupus Patients for Venous Thromboembolism
When patients with lupus are hospitalized, they should be screened and likely treated for venous thromboembolism, researchers of a nationwide study say. In May, ACR Open Rheumatology published results of the large retrospective study spanning several years. Researchers analyzed trends in mortality, morbidity and hospitalization from venous thromboembolism (VTE), specifically among patients diagnosed with systemic…
Probing the Role of Genes & Microbiome in Ankylosing Spondylitis & RA
Researchers know human leukocyte antigen (HLA) molecules affect susceptibility to disease in general, and immunological disease in particular. In the case of ankylosing spondylitis (AS), the risk is primarily associated with HLA-B27, with smaller effects from other HLA alleles. Current thinking is that AS is caused by the presence of a genetically primed host because…
Study Says Sjögren’s Patients Have a High Specificity for a Novel Antibody
An antibody previously un-recognized in patients with Sjögren’s syndrome may shed new light on the pathophysiology of one of the most troubling and disabling symptoms in many of these patients. Investigators at Johns Hopkins University, Baltimore, found the anti-calponin 3 antibody had a high specificity for Sjögren’s syndrome, particularly among patients with neuropathies.1 “There is…
Case Report: Elderly White Woman Presents with Recurrent Skin Lesions
Recurrent cutaneous eosinophilic vasculitis (RCEV) is a rare autoimmune condition characterized histologically by necrotizing small vessel vasculitis of the skin and almost exclusive eosinophilic infiltration without any systemic involvement.1 Frequently, there is associated peripheral eosinophilia, and a prolonged course of glucocorticoids is required for treatment. To date, only a few RCEV cases have been reported….
If It’s Broken, Fix It: Can an Automated System Predict Short-Term Fracture Risk?
A clinician’s ability to determine which patients are at greatest risk for hip or other fracture is improving with the use of algorithm-based fracture risk calculators…
No Gain with Pain: Exercise & Physical Function in Patients with Rheumatic Disease
Pain can deter patients with rheumatic disease from engaging in physical activity. But the latest research shows exercise helps reduce pain, & other influences may also affect patients’ activity levels, particularly after surgery…
Dr. Jim O’Dell: Rheumatologist, & Master Artisan
As a young child, Jim O’Dell, MD, spent hours with his grandfather in his basement, making bird houses and bird feeders. “My grandfather, who was a woodworker, was one of the most influential people in my life,” Dr. O’Dell says. “He probably cringed at the crude things I made, but he certainly never let me…
Summer 2019’s Awards, Appointments & Announcements in Rheumatology
Betty Diamond, MD, Recognized as Distinguished Fellow by American Association of Immunologists At its annual meeting in May in San Diego, the American Association of Immunologists (AAI) recognized Betty Diamond, MD, as a distinguished fellow. Dr. Diamond is professor and head of the Center for Autoimmune, Musculoskeletal and Hematopoietic Diseases at the Feinstein Institutes for…
Filgotinib Promising for RA
Research shows filgotinib may be safe and effective for treating rheumatoid arthritis. The drug’s manufacturer is expected to be submit a new drug application for filgotinib to the FDA in 2019…
Baricitinib: Early vs. Late Treatment Outcomes in RA Patients
Recent research found that RA patients who began treatment with baricitinib experienced greater improvement from baseline than patients who began treatment with methotrexate…
Otilimab Begins Phase 3 Clinical Studies for RA
In a four-part clinical trial program, researchers are assessing the safety and efficacy of otilimab with placebo in RA patients, along side conventional treatments, such as tofacitinib, and DMARDs…
Rheumatology Research Foundation Hosts Annual Investigators Meeting
The Rheumatology Research Foundation hosted the 13th annual Investigators Meeting in Washington, D.C., June 22‒23. The meeting provides Foundation-funded researchers with an opportunity to share updates on their studies, network, exchange ideas and collaborate on future projects to advance treatments and cures for rheumatic diseases. More than 50 rheumatology professionals were in attendance, with presentations…
RheumPAC Advocates for Dept. of Defense Arthritis Research Funding
RheumPAC is the ACR’s non-partisan political action committee, which promotes the needs of rheumatology providers and patients. Advocacy efforts often focus on legislation to improve the day-to-day clinical care of rheumatology patients, such as establishing clinical exceptions to step therapy requirements and reforming the prior authorization process. In addition, the ACR and RheumPAC recognize the…
Best Practices for Onboarding New Physicians
A lot of effort goes into recruiting the best provider into a practice, but missteps during the onboarding process have the potential to leave the provider feeling unsatisfied and the practice dealing with turnover. Although it is one more task to add to an already full plate of things to do at a practice, comprehensive…
Coding Corner Question: Is This Shoulder Ultrasound Billable?
A 32-year-old male patient with rheumatoid arthritis affecting multiple joints without rheumatoid factor returns to the office for a follow-up visit with the nurse practitioner (NP). The patient states his overall pain has improved since his previous visit, although he rates the severity of his right shoulder and right wrist pain at a 5 on…
Coding Corner Answer: Is This Shoulder Ultrasound Billable?
Take the challenge. Answer: No, if billed as incident-to for the NP. Note: The patient’s current insurance carrier is Blue Cross Blue Shield of Massachusetts (BCBS of MA). Under BCBS of MA, nurse practitioners and nurse practitioner primary care providers are not allowed to perform or interpret radiology services. Therefore, the physician would have to…