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An official publication of the ACR and the ARP serving rheumatologists and rheumatology professionals

Articles tagged with "Diagnosis"

Sjögrens Syndrome: The Need to Bridge Patient Symptoms & Objective Findings

Sjögrens Syndrome: The Need to Bridge Patient Symptoms & Objective Findings

Robert I. Fox, MD, PhD, & Carla M. Fox, RN  |  

Despite a generation of advances in molecular biology, a huge gap exists between the Sjögren’s syndrome (SS) patient’s description of their symptoms and the objective findings. Current issues include: Many SS patients are misclassified as either rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE), even within rheumatology clinics. Frequently, the sickest SS patients with extraglandular…

Rheumatology Case Report: When Moyamoya Disease Mimicks Primary Central Nervous System Vasculitis

Joey Kim, MD, Megha Patel-Banker, MD, Matthew Abramson, MD, Mehwish Bilal, MD, Sanjay Godhwani, MD, Asha Patnaik, MD, Heidi Roppelt, MD, & Qingping Yao, MD  |  

Case report: A 60-year-old Hispanic male with poorly controlled hypertension was sent from the primary care clinic for evaluation of malignant hypertension with a systolic blood pressure above 200 mmHg. His symptoms at the time of presentation included episodic confusion, worsening vision and an unsteady gait. A head computed tomography (CT) scan showed a subacute…

Diagnostic Criteria Released for Neuromyelitis Optica Spectrum Disorders

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Recent updates to criteria used for diagnosing neuromyelitis optica (NMO) are aimed at helping physicians make the differential diagnosis of this disorder differentiating it from other inflammatory disorders—a diagnosis that can be difficult given the presenting symptoms that can mimic a number of other conditions, such as multiple sclerosis. Published in July 2015, the new…

Fellows’ Forum Case Report: Palmar Fasciitis & Polyarthritis Syndrome

Naveen Raj, DO, MPH, Marc Kesselman, DO, & Barry Waters, MD  |  

Case report: A 78-year-old Caucasian female presented to our outpatient rheumatology clinic with pain in her bilateral shoulders, hands and knees that began suddenly one month earlier. She admitted to stiffness in her hands lasting several hours, and expressed an inability to extend her fingers. She denied fever, rashes, jaw claudication, headache or visual changes….

Musculoskeletal Ultrasound: A Valuable Tool for Diagnosing Rheumatic Illnesses

Musculoskeletal Ultrasound: A Valuable Tool for Diagnosing Rheumatic Illnesses

Khushboo Sheth, MBBS, & Christopher Scola, MD  |  

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…

Rheumatology Coding Corner Answer: Coding for a Knee Injection

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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…

Rheumatology Coding Corner Question: Coding for a Knee Injection

From the College  |  

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…

Dual-Trained Rheumatologists Take Multidisciplinary Approach to Their Patients

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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…

Auto-Injectable Methotrexate: New Treatment Option for RA

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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…