Rheumatoid vasculitis with rheumatoid arthritis of shoulder
ICD-10 M05.21 is a billable code used to indicate a diagnosis of rheumatoid vasculitis with rheumatoid arthritis of shoulder.
Rheumatoid vasculitis is a serious complication of rheumatoid arthritis (RA) characterized by inflammation of blood vessels, leading to ischemia and tissue damage. In this case, it specifically affects the shoulder joint, which is composed of the humerus, scapula, and clavicle, allowing for a wide range of motion. Patients may present with joint pain, swelling, and stiffness, alongside systemic symptoms such as fatigue and malaise. The pathophysiology involves immune-mediated damage to the vascular endothelium, resulting in vasculitis that can compromise blood flow to the shoulder joint, exacerbating the inflammatory process of RA. Clinically, patients may experience limited range of motion, weakness, and functional impairment in daily activities. The combination of rheumatoid arthritis and vasculitis necessitates a comprehensive treatment approach, including disease-modifying antirheumatic drugs (DMARDs), corticosteroids, and possibly biologics to manage both joint and systemic manifestations.
Orthopedic documentation should include imaging studies (e.g., X-rays, MRIs) to assess joint damage, functional assessments to evaluate range of motion, and detailed notes on joint swelling and tenderness.
Common scenarios include surgical interventions for joint repair or replacement, and management of acute exacerbations of joint pain.
Joint-specific considerations include documenting the extent of joint damage and any surgical history related to the shoulder.
Rheumatologic documentation must include laboratory tests for inflammatory markers (e.g., ESR, CRP), disease activity scores, and assessments of systemic involvement.
Scenarios often involve managing flare-ups of RA and monitoring for complications such as vasculitis.
Systemic involvement must be documented, including any organ systems affected by vasculitis.
Functional assessments should evaluate mobility, strength, and the need for assistive devices, along with rehabilitation goals.
Rehabilitation scenarios may include post-surgical recovery or therapy for joint stiffness and pain management.
Mobility limitations should be clearly documented, including the impact on daily activities and quality of life.
Used for joint aspiration in cases of swelling and pain due to rheumatoid vasculitis.
Document the joint involved, the reason for the procedure, and any findings during the aspiration.
Orthopedic and rheumatologic considerations include the need for imaging guidance and assessment of joint fluid.
Key symptoms include joint pain and swelling, systemic symptoms like fatigue, and signs of ischemia in affected areas, such as the shoulder, leading to functional limitations.