WASHINGTON, D.C.—For patients with osteoarthritis and other age-related musculoskeletal diseases, treatment with mesenchymal stem cells may soon offer a potent way to slow and repair degenerative signs of disease. This is the goal, a goal that is moving from the laboratory to the clinic as results from ongoing randomized clinical trials show the safety and…
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,…
Electronic Medical Records Have Mixed Impact on Quality, Quantity of Healthcare
The widespread implementation of electronic medical records (EMRs) and electronic health records (EHRs) has significantly changed the quality and quantity of healthcare for both the better and the worse. The digitalization of medical records provides comprehensive documentation of all events and actions associated with an individual’s medical care. Likewise, legibility, accountability and credibility are greatly…
RheumPAC Contributions Needed in 2017 to Educate Federal Policymakers about Rheumatology Concerns, Interests
2016 was an impactful year for ACR advocacy efforts. Last month we reviewed our advocacy accomplishments in 2016, accomplishments that benefited 100% of our members. However, more than 95% of ACR and ARHP members had not invested in RheumPAC by the conclusion of the 2016 ACR/ARHP Annual Meeting. Each year, many of the same dedicated…
Rheumatology Coding Answer: Deconstructing Evaluation and Management Codes
Take the challenge. Answers: B: No—Only the treating physician can take the HPI. The medical assistant is allowed to take the review of systems. If the documentation indicates the treating physician did not take the HPI, the insurance can deny the claim as not medically necessary. B: No—If the high-risk medication is not assessed and…
The Future of Pediatric Rheumatology Grounded in Evolution of Childhood Arthritis and Rheumatology Research Alliance
Pediatric rheumatology was formally recognized as a specialty in 1991 by the American Board of Pediatrics. Prior to this time, children with rheumatic diseases were treated by a hodgepodge of providers. In addition to providers who had training as pediatric rheumatologists, general pediatricians, adult rheumatologists, allergist-immunologists, orthopedists, pediatric infectious disease specialists and others treated children…
Rheumatology Case Report: Systemic Capillary Leak Syndrome and Rheumatoid Arthritis
Systemic capillary leak syndrome (SCLS) is a very rare disorder, characterized by recurrent episodes of severe hypotension, hypoalbuminemia and hemoconcentration.1 Attacks of SCLS occur in three phases: 1) prodrome; 2) hypovolemia with weight gain; and 3) hypervolemia with fluid overload and polyuria often complicated by pulmonary edema. Often, compartment syndrome can lead to rhabdomyolysis as…
How Hospital Design Can Promote Better Patient Outcomes
A storm has been brewing down the street from my office. It is a David & Goliath dispute, pitting young children and their families against a renowned pediatric institution, Boston Children’s Hospital. It concerns the fate of a half-acre swath of green space, the Prouty Garden, replete with meandering paths, fountains and a towering redwood…
Rheumatology Drug Updates: Celecoxib and Cardiovascular Safety Trial Results Reviewed
Nonsteroidal anti-inflammatory drugs (NSAIDs) have been used therapeutically since the 1960s.1 Evidence of adverse cardiovascular outcomes led to the withdrawal of the selective COX-2 inhibitor rofecoxib in September 2004, when the question of cardiovascular safety of NSAIDs first came into the limelight.2 Valdecoxib (Bextra) was subsequently withdrawn from the market in April 2005 due to…
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