Recognizing the need to provide guidance on the current disparate management of polymyalgia rheumatica (PMR), the American College of Rheumatology (ACR), in collaboration with the European League Against Rheumatism (EULAR), recently published the first international set of recommendations for the screening, treatment and management of PMR.1,2 Specifically, the recommendations offer guidance on the use of…
Patient-Centered Care Model for RA Flares Could Improve Self-Management of Symptoms
A recent trend to incorporate patient-reported outcomes (PROs) in clinical research, and ultimately clinical practice, is a response to the need to better measure and treat what patients truly care about, and adapt to the changing healthcare environment, which increasingly includes patient satisfaction as a key metric for overall quality of care, a metric tied…
New Gout Criteria from the ACR/EULAR Focus on Clinical Trials, Global Standards
Gout affects nearly 4% of American adults, causing joint inflammation, pain and crystal deposits that may lead to bone erosion over time. At least five different classification criteria for gout are used worldwide, creating potential discrepancies in clinical trial enrollment and eventual results. An international panel of investigators collaborated to create new, standardized gout classification…
Sjögrens Syndrome: The Need to Bridge Patient Symptoms & Objective Findings
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…
Improve RA Care with Vitamin D
Background Autoimmune diseases, such as rheumatoid arthritis (RA) and systemic lupus erythematous, occur when the body attacks its own tissue because it cannot differentiate between self and non-self. This is mainly through deregulation of the immune system. Vitamin D has been known to play a critical role in bone mineralization and bone health. Activated vitamin…
Rheumatology Case Report: When Moyamoya Disease Mimicks Primary Central Nervous System Vasculitis
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…
Arthritis Power App Can Help Patients Monitor Symptoms, Improve Office Visits
For the past 16 years, the website, creakyjoints.org, founded by arthritis patient Seth Ginsberg and social entrepreneur Louis Tharp, has offered arthritis patients and their families a safe online community where they can receive meaningful support and education. In March, the online portal added a new initiative—Arthritis Power, the first-ever patient-led, patient-generated, app-based research registry…
Rheumatologist Nathan Wei, MD, Focuses on Alternatives to Surgery for Athletes
Nathan Wei, MD, FACP, FACR, admits that he didn’t exactly agree with the amount certain things were encouraged in his family. “Aspects such as academics and music were focused on so much,” he says. “I wanted to break out from that upbringing. I wanted to add in more of what I wanted to do.” And…
Rheumatology Coding Corner Answer: Coding for a Knee Injection
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
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…
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