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The RheumNow Week in Review – 11 August 2017

The RheumNow Week in Review caps the week's news every Friday. Dr Jack Cush reviews the news, journal reports and important events from the past week in rheumatology.  This week's news highlights include new data on the incidence of arthritis, lag times in patient referral, criteria for referral and why/how weather change affects arthritis pain.

  1. Finland RA Incidence 41/100k; SpA 36/100K; ReA 8/100k; undiff arthritis 39/100K. P gingivalis assoc w/ ACPA, men https://t.co/cGyc9mMaIF
  2. RA Lag times from Sx to 1st DMARD 11.8mo; 1st Sx to 1st MD 3.1 mo; MD to Rheum referral 2.1 mo; Rheum to Dx 2.9 mo https://t.co/j2HHSTrcgY
  3. Anti-TIF1-gamma Ab assoc cancer w/ myositis (78% sens; 89% specificity), but rarely w/ cancer, paraneoplastic syndr. https://t.co/Yd1O2MVVG1
  4. "Prednisone is the best drug we have, and prednisone is the worst drug we have"- Peter A. Merkel, MD
  5. The Vast majority of patients w/ chronic hepatitis C can safely receive etanercept and other TNFi https://t.co/8ER67gRQHA
  6. Tanezumab (MAb against nerve growth factor) is being fast-tracked by FDA as a non-opioid pain reliever. https://t.co/ZXJnS7CmE4
  7. Good review of Scleroderma & PSS ILD. 5 Yr mortality of PSS+ILD is 82–90%. https://t.co/UR8oADk6E3
  8. Doctors shouldnt do TEXT medicine OR Email medicine; these are incomplete, chancy, convenient but inaccurate- Phone medicine not much better
  9. Joint Pain Linked to Increasing Temperature, Not Rainfall 
  10. Criteria for Early Referrals from Primary Care
  11. MSK Ultrasound Now Standard for Rheumatology Training

 

Disclosures: 
The author has received compensation as an advisor or consultant on this subject

Rheumatologists' Comments

I have had a chance to observe the use of US by my younger colleagues who are very adept with the technology while I have been doing in locums work. I would say that US can help reduce diagnostic uncertainty in regards to inflammatory arthritis including “undifferentiated arthritis”, crystal-induced arthritis, unexpected anatomy or pathology and challenging aspirations and injections of joints and soft tissue structures (carpal tunnel, tendons, bursa, etc). US is an additional tool that decreases uncertainty in a timely manner. While not a “game-changer”, US appears to be a very useful tool with both diagnostic and therapeutic applications that make our lives a little bit easier. It’s also fun to do with immediate gratification!

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