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Fibromyalgia: Diagnosis and Management
Fibromyalgia (FM) affects 4–6% of the U.S. population, with nearly a 2 fold female predominance. Nociplastic pain underlies the pathophysiology of FM. CNS hypersensitization to both painful and non-painful stimuli occurs with little or no tissue pathology. Framing FM as a disorder of CNS processing is critical to diagnosis, treatment approaches and patient buy-in.
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Seronegative RA Disease Activity (7.17.2026)
Dr. Jack Cush reviews the news, journal articles and Gout features from this past week on RheumNow.com.
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ACP Position Paper on Dietary Supplements
More than half of U.S. adults use dietary supplements, yet only a quarter use supplements recommended by a healthcare professional, and current law lets supplements reach the market with no premarket safety evaluation, unlike drugs or food additives.
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Guidelines to Spot Cancer in High Risk Dermatomyositis
MedPage Today
International guidelines can help identify dermatomyositis patients with a particularly high risk for cancer, according to a retrospective single-center U.S. study.
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#THA revisions in 3657 RA vs 446428 OA pts (mean F/U ~7y) find RA has signif incr risk of revision (HR 1.35); espec due to infx (HR 1.48), dislocation (1.87), aseptic loosening (0–3m; 2.81). No diff w/ cemented, cementless, hybrid THA. Age > 65 was main risk factor. https://t.co/iK6pL3QF1W
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Gout TRUST trial compared gout flares in 28 pts assessed biweekly electronically or by phone. Over 12 wk (109 flare periods, 108 electronic & 99 phone assessments) there were 23 flares on electronic surveys and 22 flares on phone surveys (96% agreement; strong concordance, ICC https://t.co/fugYIasf4G
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Systemic sclerosis metanalysis of 31 studies (32,134 pts) shows malignancy risk signif increased (SIR 1.66; CI 1.32 - 2.08). Highest: esophageal, liver, cervical, lung, & Heme (SIR 3.35 - 13.95). 7.4 yr mean from SSc to CA dx. https://t.co/IhxvfkMqkf https://t.co/dTFjD4iqth
Links:
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RheumIQ: True or False: In an international consortium of RA patients, MACE risk was significantly associated with disease activity but not ACPA positivity.
Test your knowledge here: https://t.co/LATb1P18Sh https://t.co/Bs1ReJk0OY
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Hip Replacement Advances
Hip replacement surgery has been a major advance in the management of patients with hip damage and diminishing quality of life. While this review provides new information regarding a new type of hardware (end of article), lets begin with a general https://t.co/ZosOkoawiv
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Rheumatoid arthritis is found in 2-3.8% of gout patients.
For more gout content, follow our Gout: More than Flares campaign at https://t.co/lQoiFjubZJ, https://t.co/moAOVUJjKZ
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QD Clinic: When There's Doubt in Gout
Dr. Eric Dein discusses how imaging was used in correctly diagnosing a mid-foot symptom in gout.
https://t.co/FNI6rlOz1O https://t.co/Xpw98DiEvs
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Saliva and Uric Acid Testing
A recent report from China reaffirms the potential utility of salivary uric acid (UA) testing delivers smartphone-guided, enzyme-free gout screening at home for pennies per test.
https://t.co/VtvJuPNEWA https://t.co/pdBmy5JoQd
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Genicular artery embolization for knee OA does not work in a 12-mos randomized sham-controlled trial of 58 pts. Pain scores improved equally in both groups https://t.co/7wwmzpTaNL https://t.co/8MsRXqKDo2
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Intl consortium (10 EU countries) of 3952 RA pts, 184 MACE events seen 1985-2012. MACE risk signif assoc w/ DAS28 (HR 1.18;1.03-1.35), but NOT RF (HR 1.26; 0.82 to 1.94) or ACPA (HR 1.25; 0.85 to 1.83). RA activity assoc w/ MACE seen in seronegative and double positive https://t.co/RGO5IAM5oL
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Congratulations to Dr. Chandra Mohan and Univ. of Houston for receiving a $4 million NIH grant for a 10-year longitudinal study to identify the earliest biological triggers of autoimmune disease https://t.co/6kMcv9PD5r https://t.co/CsY8QAxrXR
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Retrospective study 1420 newly Dx non-tuberculous mycobacterial (NTM) infx (2012-2024) - 66 (4.6%) Dx w/ RA (55 after RA dx). Having RA + NTM incr risk of Resp. death (HR 4.3) w/ lower 5yr survival (75% vs 93%) partly explained by ILD and sytemic inflamm. https://t.co/6sdR7XwwD7
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Gout Cavalcade (7.10.2026)
Dr. Jack Cush reviews the news, journal articles and regulatory decisions from the past week. July is Gout: More than Flares month.
https://t.co/I1zWdx9fzU https://t.co/EYQ3D9Z42t
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Uric Acid: Is Lower Better?
There is good evidence that a serum urate less than 6 mg/dL is required to meaningfully reduce urate crystal and gout flare burden, but is even lower better and are there any tradeoffs?
https://t.co/W5FsDC5FG0 https://t.co/7mRgkg00uV
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Updated Algorithm for the Management of Restless Legs Syndrome
Diagnose: chronic vs intermittent RLS (no need for polysomnography)
Test Iron levels (& Rx if)
Consider: remove exacerbators; walking/massage/heat; carbidopa/ levodopa; pramipexole or ropinirole; low potency opioids; https://t.co/XdzIipw1X8
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The mortality gap in gout has not improved in 20 years – CV disease is the leading cause of death (2-fold increase).
For more gout content, follow our Gout: More than Flares campaign at https://t.co/xnBVBN5IXZ, https://t.co/c12GmMaatt
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