ROME, Italy—The role of ACPA positivity in osteoarthritis is coming more into focus, with results from recent studies by researchers in Germany showing that ACPA positivity apparently works in concert with rheumatoid factor positivity to enhance bone erosion and that ACPA-positive patients show signs of bone erosion before they have clinical signs of arthritis. The…
ROME, Italy—The traditional approach to trials to assess new biomarkers and related treatments has largely been inefficient, and a better strategy is needed to make stratified treatment available for patients more quickly, an expert said at EULAR 2015, the annual congress of the European League Against Rheumatism (EULAR). Mahesh Parmar, PhD, director of the Medical…
ROME, Italy—The medical environment is increasingly adapting to the possibilities of optimizing care by individualizing medical treatment and tailoring treatment to disease phenotypes. Data suggest that individualizing exercise therapy, an important treatment modality for rheumatic and musculoskeletal diseases, can help control disease, maximize function, minimize functional barriers and decrease the risk of co-morbidity.1,2,3 Personalizing exercise…
ROME, Italy—The explosion of imaging technology has made it more important than ever to establish a standardized way in which imaging can and should be used in clinical practice, an expert said in a session at EULAR 2015, the annual congress of the European League Against Rheumatism (EULAR). Marie-Antonietta d’Agostino, MD, PhD, professor of rheumatology…
ROME, Italy—The European League Against Rheumatism (EULAR) annual congress (EULAR 2015) was a much-anticipated event, with more than 14,000 delegates attending from far and wide. The Health Professional Standing Committee was particularly delighted to have planned a program that provided the latest in research terms but also an eclectic mix of valuable topics for health…
In diagnosing and treating a disease that is rapidly gaining recognition worldwide since it was first recognized in Japan in 2003, 42 experts from 10 different countries recently collaborated to discuss and review the current experience and data on IgG4-related disease. The result is the “International Consensus Guidance Statement on the Management and Treatment of…
Every day, rheumatology patients live with the realities of having a chronic disease that requires a lifetime of treatment. This knowledge can be an emotional burden, and some people deal with it better than others. Emerging research is showing that those patients who exhibit emotional control are better able to cope and ultimately experience a…
Dr. Simon Helfgott’s essay, “Barking at the Moon,” in the July 2015 issue of The Rheumatologist, about the unintended consequences of EHRs (electronic health records) prompted me to share my experience regarding the newly recognized KeMo disease. Keyboarding and mouse-clicking (KeMo) activity now consumes about 50% of the medical clinician’s day, as the modern EHRs…
Level 3 Visit with Primary Diagnosis of Osteoarthritis A 36-year-old patient presents with unilateral primary osteoarthritis of the left hip. She reports her groin pain as 7 on a scale of 1–10. When she tries to straighten her left leg, she experiences increased groin pain. She is currently taking over-the-counter medication to relieve the pain,…
CPT codes: 99213 Diagnosis Codes: ICD-9: 715.15, 278.01 ICD-10: M16.12, E66.01, Z68.41 This encounter is coded as 99213 as follows: History—The history of present illness was extended. The review of systems was comprehensive, and no past family social history was documented. This makes the history level expanded problem focused. Examination—There were eight systems examined. This…