Friday, 15 Dec 2017


How Do I Treat Symptomatic Interstitial Lung Disease in Scleroderma?

Will the results of two recent large scleroderma lung studies finally inform us on how to manage interstitial lung disease in systemic sclerosis?  

Diabolical Negativism

Our inner thoughts are usually negative, critical or pessimistic. Negative thinking is ubiquitous, and may be responsible for indecision or ill-choices.  How to identify it and deal with it in patient care is an unsavory challenge often left undone.

Week in Review - 20 Feb 2016

Highlights of Rheumatology news for the week ending 20 Feb 2016.

The Week in Review - 13 February 2016

Video highlights from last week's reports, news and tweets on

Why T2T is Too Risky for Some Patients

My colleagues indulged me in a small experiment. I set before them $100 in cash and offered each of them a choice: take the $100, or flip a coin for a 50% chance to win a certain amount of money that they could specify. They would tell me the minimum amount of money I needed to offer in order to prefer the coin flip over taking the $100. What does this have to do with treat-to-target?

Methotrexate: Where it All Began

It’s somewhat bizarre that a designer drug from over 65 years ago would become the cornerstone of treatment for rheumatoid arthritis in the 21st century. When Sidney Farber designed a molecule that would interfere with folate metabolism in the middle of the 20th century, he was looking for a ubiquitous antimetabolite to treat cancer. Farber was actually quite concerned with the potential side effects of a drug that competitively inhibits folate metabolism. That is part of the reason he combined the “met” for metabolism with an “x”. The x was found on poison bottles and he thought it wise to include it in the name of this agent.


The Week in Review: 5 February 2016

Dr. Cush reviews highlights from last week's news and research in rheumatology.

It Took Me 30 Years to Learn This About Rheumatoid Arthritis

I’m alot better at RA in the last 10 years than I was when I started to practice 30 years ago. RA has not changed, but tools, knowledge and treatments have progressed admirably. Decades have taught me that many aspects of RA were wrongly taught, misunderstood or not apparent when I first started in rheumatology in 1984. Here are 10 things I've learned.

70 & Up

Four men and 4 women, 5 joint replacements, 4 knee arthroscopies, 2 cancers and 6 bad attitudes were not enough to deter the inspiration and perspiration required of us last weekend. So how did we do? And yes, there are pictures. 

Pushy Patients

Do your patients challenge you? Do you live up to their expectations? How many steps do you have to climb to be better?

Patients Believe Lab Tests More Than Doctors

Patients believe that a lab result is a numeric true representation their biology and a pivotal arbiter of wellness, yet physicians often dismiss such results as hanging chads in a meaningless election. Why do patients believe their labs moreso than their doctor? 

How to Handle Latex Allergies and Biologics

What to do when a patient has a latex allergy and you prescribe an injectable biologic (many having latex allergy as a contraintication)?