Most Clinicians Do Not Order MRI/CT for Nonspecific Low Back Pain

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Low back pain (LBP) is a highly prevalent public health problem. Not surprisingly, imaging of LBP is also an expensive and often overused diagnostic tool.  

Early Intervention with Corticosteroids and IVIG is Crucial in Kawasaki Disease

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The current JAMA Pediatrics issue has published a report showing that adjunctive corticosteroid therapy yielded significantly fewer coronary artery complications compared with intravenous immunoglobulin therapy alone, particularly among high-risk patients with Kawasaki disease.

Higher Lupus Disease Activity in First Year Postpartum

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Most women with systemic lupus erythematosus (SLE) have no or little disease activity during pregnancy, but experience greater disease activity or overt flares during the first year postpartum, a Norwegian study has found.

Review of Herpes Zoster with Immunosuppression and Autoimmune Disease

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Researchers from the University of British Columbia reported on their systematic review and meta-analysis of risk of herpes zoster (HZ) in patients receiving biologics, DMARDs and/or corticosteroids for autoimmune diseases.

Low-Molecular Weight Heparin Does Not Reduce Pregnancy Complications

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A Lancet meta-analysis has reviewed the preventative effects of low-molecular-weight heparin (LMWH) on placenta-mediated pregnancy complications include pre-eclampsia, late pregnancy loss, placental abruption, and birth of a small-for-gestational-age (SGA) neonate.

Michelle Petri Reviews New Therapies for Lupus

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In this video, Michelle Petri, MD, director of the Hopkins Lupus Center at Johns Hopkins University, discusses recent successes and challenges in the treatment of systemic lupus erythematosus, with clinical trials results ranging from "wildly positive" to "completely negative."

My Take on New Ocular Screening Guidelines for Plaquenil

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A recent article published by the American Academy of Ophthalmology presented new recommendations for screening of patients being managed with hydroxychloroquine that changed the previous monitoring paradigm. More importantly, it has repositioned hydroxychloroquine from one of the safest medications that rheumatologists use to a drug that can have potentially significant ocular morbidity (if used in doses greater than 5 mg per kilogram and or for prolonged periods of time).

First Degree Relatives and the Risk of Spondyloarthritis

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The risk of developing ankylosing spondylitis (AS) if you are HLA-B27+ and a first degree relative is often said to be 20%.

Long-Term Outcomes of Aromatase Inhibitor Arthralgias

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Aromatase inhibitors (AI) are often given in the setting of estrogen receptor-positive (ER+) breast cancer therapy.

Those with Osteoporotic Fractures are Going Untreated

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The International Osteoporosis Foundation (IOF) reports that nearly 80% of those who have already suffered a broken bone due to osteoporosis remain unprotected against the risk of further disabling fractures.

The Arthritis Spectrum after Lyme Infection - Something New

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Symptoms attributed to chronic Lyme disease are the bane of a rheumatologist’s existence. We often see patients referred for a variety of nonspecific complaints that do not resolve after antibiotic therapy, including the so-called post-Lyme disease syndrome.

NSAIDs Pose a Dose-Related Risk for Heart Failure Hospitalizations

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BMJ has reported the results of a case-control study that analyzed the risk of hospitalization from heart failure associated with the use of NSAIDs amongst healthcare databases from four European countries (the Netherlands, Italy, Germany, and the United Kingdom).

Demyelinating Disease is a Rare Complication of TNF Inhibition.

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A recent review has shown that tumor necrosis factor-α inhibitors (TNFi) rarely cause MS-like disorders.

Anabolic Abaloparatide Looks Promising in Osteoporosis Fracture Prevention

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The osteoporsis therapeutics arena is starting to fill with new drugs and novel mechanisms of action.

CDC Reports 31 Million Older Americans Don't Get Adequate Exercise

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The Sept.16th issue of MMWR reports that many Americans over age 50 are not getting sufficient exercise, thereby increasing their risk for falls, fractures and comorbidities, if not premature death. (Citation source http://buff.ly/2cPAcq9)

New Shingles Vaccine Effective for up to Four Years

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In the current issue of the NEJM, a Herpes zoster subunit vaccine was reported to be highly effective in adults - specifically in 2 studies (ZOE50 and ZOE70) targeting adults over age 50 and over age 70 years. (Citation source: http://buff.ly/2cMng17)

Adalimumab Lowers Risk of Uveitis Flares in Visual I Study

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Rheumatologists may encounter patients with intermediate, posterior and pan-uveitis as part of certain rheumatic diseases such as Behcet’s, but more frequently may be called on to co-manage these patients with steroid sparing agents.

CPAP Use Fails to Prevent CV Events in Sleep Apnea Patients

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There are numerous health hazards associated with obstructive sleep apnea (OSA), including an increased risk of cardiovascular events.

RheumNow Week in Review – 2 September 2016

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Dr. Jack Cush reviews highlights from this week in RheumNow:

Flares Portend Damage in Rheumatoid Arthritis - Time for a New Strategy?

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Disease flares are common in rheumatoid arthritis (RA), often causing patients to seek additional care, if not medication.

The frequency of flares varies amongst studies in different populations.  But the consequence of flares has only recently been studied.