Ted Mikuls, MD, MSPH, Stokes-Shackleford professor of rheumatology, vice chair for research, internal medicine at the University of Nebraska, discusses interventions and treatments that could prevent lower extremity amputation for people with gout.
Ted Mikuls, MD, MSPH, Stokes-Shackleford professor of rheumatology, vice chair for research, internal medicine at the University of Nebraska, led a study that showed that heightened foot care and surveillance may have led to the lower rate of lower extremity amputation (LEA) among people with diabetes. Here, he explains how interventions and treatments could prevent LEA for people with gout, and that people being considered for LEA may not know they have gout.
Transcript
Are there standards of care that people with gout but without diabetes need to prevent lower extremity amputation?
There really aren't standards in terms of what should be done with someone with gout without diabetes in terms of a frequency of a foot exam and such. I think the main message is that, for patients who are being considered for lower extremity amputation—and that's often people who have non-healing wounds on their feet, may have suspected osteomyelitis or deep infection of the bone or soft tissues of the foot, or even other places of lower extremity—I think for those patients, this study maybe should make providers take pause. Ask yourself the question: could this patient have gout? Could gout intervention or gout treatment make a difference for this patient? I think if you take time to answer those questions and you're definitive in your questions, a patient's going to be better off in the end and I think that's the take home.
Bridging Education Gaps in Treatment for Scarring Alopecia With Innovative Approaches
March 28th 2025Crystal Aguh, MD, FAAD, Johns Hopkins School of Medicine faculty, highlights the critical need for comprehensive education on hair loss across diverse hair types, stressing the importance of understanding inflammatory pathways for developing targeted therapies.
Read More
Navigating Sport-Related Neurospine Injuries, Surgery, and Managed Care
February 25th 2025On this episode of Managed Care Cast, we speak with Arthur L. Jenkins III, MD, FACS, CEO of Jenkins NeuroSpine, to explore the intersection of advanced surgical care for sport-related neurospine injuries and managed care systems.
Listen
Strategies for Improving Patient Access to Dermatology Care
March 22nd 2025Elizabeth Jones, MD, FAAD, highlights the persistent issue of insurance companies favoring expensive, newer medications over equally effective generics in dermatology, emphasizing the time-consuming prior authorization process and advocating for patient partnerships and systemic improvements.
Read More
Redefining Long COVID Care With Personalized Treatment
March 20th 2025To mark the 5-year anniversary of the COVID pandemic, The American Journal of Managed Care® spoke with Noah Greenspan, DPT, PT, CCS, EMT-B, cardiopulmonary physical therapist and director of the Pulmonary Wellness and Rehabilitation Center in New York City.
Read More