CHICAGO—Reproductive health can be a concern for patients with rheumatic diseases, and practitioners in both disciplines often work closely together. The Reproductive Health in Rheumatic and Musculoskeletal Diseases Guideline, a draft of new clinical recommendations developed by an ACR-convened group for pregnant women, post-menopausal women, lactating women, and women and men trying to conceive or…
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Case Report: Lymphocytic Vasculitis of the Central Nervous System
Vasculitis is a group of chronic inflammatory diseases in which the blood vessel is the target of an immune reaction. They can be secondary to connective tissue disease, idiopathic or due to infection, neoplasm or drugs.1 Primary angiitis of the central nervous system (PACNS) is a rare syndrome characterized by inflammatory cell infiltration and necrosis…
The 2018 ARHP Merit Awards & ACR Distinguished Fellows
CHICAGO—At the 2018 ACR/ARHP Annual Meeting in October, the ACR and the ARHP honored a group of distinguished individuals who have made significant contributions to rheumatology research, education and patient care. This month, The Rheumatologist speaks with the winners of the ARHP Merit Awards about their individual contributions to advancing rheumatology. You’ll also find interviews…
VA Study Tracks Biologics Usage, Finds Dramatic Patient-Age Difference
Patients under the care of the U.S. Veterans Affairs who were older, non-white and had more comorbidities were less frequently given biologic initiation therapy to treat their rheumatoid arthritis (RA), according to a recent study. Researchers sought to identify predictors of greater use of biologic therapies, as well as factors associated with persistent use of…
Do Not Get Us Started on Acthar
As rheumatologists, we have a love-hate relationship with the corticosteroid prednisone, a feeling many of our patients share. It’s our most effective medication to quickly shut down an overactive immune system. When we have a patient with life- or organ-threatening autoimmune disease—severe lupus affecting the kidneys or vasculitis causing hemorrhage in the lungs, for example—large…
Can Integrated Care Lead to Better Outcomes?
A typical patient with a rheumatic disease needs a multifaceted treatment approach to address comorbidities, minimize disability, promote quality of life and improve survival. To achieve these outcomes, rheumatology research has evolved from examining a single treatment to studying the best treatment approaches. Examples of these strategy trials include how to best combine pharmaceutical therapies,…
Coding Corner Questions: A Drug Administration Quiz
A 70–year-old female patient with rheumatoid arthritis affecting multiple joints who is rheumatoid-factor positive but without organ or system failure returns for her third infliximab infusion. She is scheduled to receive 500 mg of the drug. How should this encounter be coded? 96413, 96415, J1745 x 50; ICD 10: M05.79 96413, 96415, J1745 x 50;…
Case Report: Acne Drug Leads Patient to Retinoid Hyperostosis
Presentation A 26-year-old man with a history of acne vulgaris and hidradenitis suppurativa presented to our rheumatology clinic with persistent back pain and stiffness of three years’ duration. He described bilateral low back pain that was worse when he arose in the morning and at night when he was trying to sleep. In a similar…
Anxiety Is an Independent Risk Factor for Bone Fractures
Higher anxiety levels in postmenopausal women may put them at increased risk of fracture and should be considered when assessing a woman’s risk of osteoporosis as well. This is the conclusion of a study recently published in the journal Menopause that looked at the role of anxiety in bone health.1 Specifically, the study examined the…
New Joint Space Mapping Technique Doubles Diagnostic Sensitivity for Osteoarthritis
Traditional X-rays, move over—there may be a new gold standard for joint imaging to assess even the smallest changes that can signal the onset of arthritis, as reported recently in the journal Scientific Reports.1 Utilizing the combined expertise of radiologists, rheumatologists and engineers, University of Cambridge researchers developed an algorithm to monitor the joints of…
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