CPT: 20611-LT, J7325 X 1 ICD-9: 715.16—Osteoarthritis, localized, primary, lower leg ICD-10: M17.12—Unilateral primary 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 the patient’s medical chart….
How to Manage Patients with Giant Cell Arteritis and Polymyalgia Rheumatica
WASHINGTON, D.C.—From diagnosis questions to infection risk to treatment decisions, handling giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) comes with a range of challenges for clinicians. Speaking in the ACR Review Course at the 2016 ACR/ARHP Annual Meeting, an expert—Rebecca Manno, MD, MHS, assistant professor of medicine in rheumatology at Johns Hopkins, as well…
How to Diagnose Shoulder Pain
WASHINGTON, D.C.—A 70-year-old woman had been diagnosed with rotator cuff disease three years earlier and received an array of treatments. What she hadn’t received was an X-ray. She’d had an MRI, and her doctor—not an orthopedist or a rheumatologist, but a primary care physician—had zeroed in on degenerative changes in her rotator cuff. The problem,…
Assessing Autoimmune Disease Symptoms in Silicone Breast Implant Recipients
My nurse, Joanne, took me aside before I began my next consult. “Room No. 5, breast implant patient. Her lawyer organized the records.” She handed me a hefty three-ring notebook organized by color-coded tabs. “Her attorney called just now,” Joanne raised an eyebrow, “and told me to tell you that, to save time, he highlighted…
Fellow’s Forum Case Report: Waldenström Macroglobulinemia
A 73-year-old white male presented with a one-day history of a cold, painful, right foot. The foot had a blue discoloration to it, particularly the toes. The emergency physician suspected an atheroembolic cause, given this patient’s age and history of coronary artery disease. However, the patient also reported a one-year history of painful pallor in…
Research Underscores Need to Assess Oral Health in Patients with Systemic Sclerosis
Oral health is not frequently considered within the sphere of a rheumatologist’s practice. However, recent results published by the Canadian Scleroderma Research Group (CSRG) point out the importance of assessing oral health in patients with systemic sclerosis (SSc). Result of 3-Year Grant Between 2008 and 2011, 163 patients with SSc and 231 controls were entered…
Racial Bias Found in Pain Assessment, Management, Treatment Recommendations by Clinicians
In the world of evidence-based medicine, basing diagnosis and treatment decisions on belief instead of data seems anachronistic. And yet … clinicians are human, and humans live in culture, and culture is formed by beliefs, and beliefs (consciously or unconsciously) drive perception and, often, action. So a new study shining a light on racial bias…
Is Fibromyalgia Overdiagnosed?
Are too many patients diagnosed with fibromyalgia? The co-authors of one new study believe that close to 75% of patients who have received a clinical fibromyalgia diagnosis do not meet the 2010 Preliminary American College of Rheumatology (ACR) Criteria for Fibromyalgia.1 They say these patients are false-positive and may be taking treatments they don’t need….
Diagnostic Criteria, Classification Lacking for Vasculitis; New Research in Treatment for Systemic Sclerosis
LONDON—Despite the detailed terminology for describing vasculitis established by the Chapel Hill Consensus (CHC) in 2012, the field badly needs better classification and diagnostic criteria for the group of diseases, an expert said in a presentation at the Annual Congress of the European League Against Rheumatism (EULAR 2016). It’s a topic that is now being…
Pain Linked to Inflammatory Lesions in Knee Osteoarthritis
Inflammation in the knee was found to be associated with development of pain sensitization in recent research with a cohort from the Multicenter Osteoarthritis Study (MOST). This research finding may indicate that targeting of inflammation could help reduce pain severity in knee osteoarthritis (OA). Tuhina Neogi, MD, PhD, says that her and her colleagues’ research,…
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