Wednesday, 14 Nov 2018


Why Not Just Kick the TNFi Habit?

Why do we use TNF inhibitors as our first biologic choice?  Is it the evidence of efficacy, access, safety, and drug retention, or is it a prescriber habit that merits critique?  

RheumNow Anniversary Perspective

Dr. Jack Cush provides a perspective on the first year anniversary of - a site dedicated to delivering the wisdom, art and science of Rheumatology. 

KOLs Predict: What Will the Next Year Bring?

A new subspecialty may emerge. New drugs will be approved (but it will be difficult for patients to get coverage for them). And an American team will win the World Series. All these and more: here are predictions for 2017 and beyond from rheumatologists across the country and around the world.


"A Touch of Humanity": Seven Perspectives on RheumNow

"Making the complex simple, the simple useful, and the opaque crystal clear." Rheumatologists (plus one non-rheumatologist) from around the world weigh in on RheumNow's impact over the past year. 

Why My Patients Sit Where They Sit

Where do your patients sit? Have you noticed they don't usually sit where you expect them to? What's up with that, and is there a psychology behind one's choice of seating? This curious observation may portend the nature of the physician-patient relationship or, at the very least, impact the layout of your next clinic.

Do's and Don'ts of Vaccination: a (Very) Brief Guide for Rheumatologists

The five do's and don'ts when it comes to vaccinating your patients. 

A New Look at Old Pictures

Google Images is a treasure trove of photos and drawings about medicine. The pictures of RA, though, look as if nothing happened in the last 90 years: the field stagnant, gold the gold standard, biologicals never invented, ulnar deviation rampant and joint destruction inevitable. If early recognition of inflammatory disease is at the crux of modern treatment, why show end-stage disease except as a warning?

“Doctors Don’t Get Sick”

We physicians are clearly better at defining “too sick to work” in our patients than we are for ourselves.  After pondering this ill issue, I’ve come up with some wisdom, goofiness and facts.

Midlife Plateau

Despite regular attendance at medical meetings and despite fulfilling regulatory requirements for our specialty, I’m not sure how much I learn that changes the way I practice medicine. So I recently persuaded a colleague to come and coach me, inviting him to observe me for a morning in clinic. This was the first time I had been observed in this way since I was a medical student. A little daunting, but after a while I largely forgot he was there. Then he gave me some feedback. 

Smoking and Rheumatoid Arthritis

Why don't rheumatologists send their smoker patients to smoking cessation programs or use aids for cessation? Do we think it is not our problem?

Polymyalgia Rheumatica: An Interval Look at Management Questions


Despite an often fairly characteristic pattern of signs and symptoms, there are significant diagnostic challenges with polymyalgia rheumatica. The reason is that similar clinical features can be also observed in other diseases mimicking PMR, including infectious and malignancies, elderly-onset rheumatoid arthritis, giant cell arteritis, chondrocalcinosis or myositis, to mention some of the most important differential diagnoses.  

Time for a Paradigm Change in Rheumatoid Arthritis

How many clues are needed for a rheumatologist to know something is wrong with the therapeutic soup he/she is trying to concoct?  One patient's tale leads to rethinking the RA treatment paradigm.