A 52-year-old woman comes to the office complaining of a two-month history of pain and swelling in the small joints of her hands, feet and knees. She says, “Doctor, I’ve been searching the Internet, and I think I have rheumatoid arthritis. I have some questions for you.” The healthcare system in the U.S. is changing…
Although most systemic juvenile idiopathic arthritis patients don’t develop macrophage activation syndrome (MAS), the approximately 10% who do have this serious complication can experience widespread, massive inflammation, debilitating symptoms and even death. To improve understanding of MAS among physicians and advance efforts to develop effective therapies to treat it, a panel of 28 international pediatric…
Level 3 Established Patient E&M Visit A 43-year-old patient is seen in the office for a follow-up visit of her RF-positive rheumatoid arthritis and primary osteoarthritis of the left knee. The patient is on sulindac, methotrexate and folic acid. At her last visit, the patient’s methotrexate dose was increased, which has greatly reduced her pain….
The ACR has been at the forefront of helping rheumatologists meet practice demands, including federal reporting requirements. The first registry that helped meet these requirements was the Rheumatology Clinical Registry (RCR), and it facilitated quality reporting, but required manual entry of required data. More recently, ACR has contracted with FIGmd to create a tool that…
Clear. Complete. Concise. These three Cs describe ideal patient record keeping, which is why they are among the key reasons to implement a clinical documentation information (CDI) program into your rheumatology practice. Not only will CDI help you accurately document the full picture of each patient’s clinical status, but it also promotes high-quality care and…
All eyes are on the new physician fee schedule proposed by the Centers for Medicare & Medicaid Services (CMS), which will be finalized this year and go into effect Jan. 1. The ACR is reviewing the proposal and will be providing comments and recommendations to CMS. And many rheumatologists have payment and coding questions: Will…
Researchers have developed procedures and assessed their efficacy for the use of ultrasound images to measure the inter-rater reliability of the measurement of structural changes in the tendon of patients with supraspinatus tendinopathy. The standardized procedures proved useful in evaluating patients…
The FDA is strengthening its warning that canagliflozin and dapagliflozin may increase the risk for acute kidney injury in some patients. Also, the FDA has issued a warning that patients should not exceed recommended doses of loperamide due to increased risks of serious cardiac events…
Ethical issues that arise in the average rheumatology practice and in clinical research are often straightforward. The AMA Code of Medical Ethics and the Office Practice and Procedures Manual offer useful information.1 In research, the Protocol and Investigators Agreement spells out who you can enroll and how the trial must be conducted. But still—even when…
The benefits of exercise therapy for individuals with knee osteoarthritis (OA) are well known. The ACR strongly recommends both aquatic exercise and land-based aerobic and resistance exercise for managing knee OA.1 A recent Cochrane systematic review and meta-analysis concluded that high-quality evidence supports the use of exercise to reduce pain and improve physical function and…