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Best of 2021: Jack of All Subspecialties

Jack Cush, MD

It's great to be a rheumatologist, but boy, it's getting harder and harder. You have to be a jack of all trades. You have to be good at cardiovascular disease, osteoporosis, vaccination, inflammatory bowel disease - it just never ends. This and more, as Dr. Cush summarizes more than a dozen journal articles, news reports and questions + cases.

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Best of 2021: EULAR Guidelines on Intraarticular Therapy

Jack Cush, MD

EULAR has published evidence-based recommendations on the use of intra-articular therapies (IAT) based on the literature review and recommendations of a multidisciplinary international task force. These IAT recommendations apply to adult patients with peripheral arthropathies.

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Telemedicine.MD.Computer.phone (keep)

Telehealth Diet and Exercise Benefits Knee Osteoarthritis

Jack Cush, MD

Annals of Internal Medicine has reported the results of a randomized clinical trial showing that telehealth-delivered exercise and diet programs improved pain and function in knee osteoarthritis patients who were overweight.  While both were beneficial, exercise had a greater effect than die

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Duloxetine added to usual analgesics failed to improve pain in 132 hip or knee OA pts by WOMAC pain scores: 1) Dulox + usual care vs 2) Usual care showed no diff in pain at 3 mos or 12 mos. https://t.co/9gR2PNVrPl

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Dr. John Cush RheumNow ( View Tweet)

RESTORE trial: yet another failure for PRP injections for knee #OA. Study of 288 Knee oA over 50 years - knee pain scores of −2.1 vs −1.8 on an 11-point scale (range, 0-10) and no difference between PRP and PBO at 12 moshttps://bit.ly/3pqldWU

Dr. John Cush RheumNow ( View Tweet)

Metanalysis of 11 studies, 46 819 participants shows low quality evidence that knee extensor muscle weakness is assoc w/ increased the odds of knee osteoarthritis in women (OR 1.85)and men (OR 1.43); also radiographic knee OA https://t.co/Md7eODvsIy

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Dr. John Cush RheumNow ( View Tweet)

NYC Hosp for Special Surgery is the 1st to use a "smart" knee arthroplasty - TKR with a smart sensor capable of monitoring steps, speed, range of motion & other knee functions fed back to the orthopedist = called Persona IQ, FDA authorized https://t.co/QR49JC7oCz

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Dr. John Cush RheumNow ( View Tweet)

What are the advantages and disadvantages of #ultrasound-guided intra-articular injections? Check out this slide👇from Lt.Col/Dr. Arjun's lecture: #iracon21 #IRACON2021 @2021Iracon @APLAR_org #mskus #rheumatology https://t.co/mhq9OgBk7a
sheila RHEUMarampa ( View Tweet)
CBD in Hand OA and PsA: Dr. Richard Conway ( @RichardPAConway) reviews abstract #1456 presented at the #ACR21 annual meeting. https://t.co/o3jMFMMgZF

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Dr. John Cush RheumNow ( View Tweet)

Geriatric Rheumatology:Improving care of aging patients Dr.Kathryn Dao ( @KDAO2011) moderates a panel w/ Drs.Una Makris, Katherine Wysham, Sebastian Sattui + Devyani Misra, as they discuss aspects of improving care of/outcomes for aging patients. #ACR21 https://t.co/lF3yUZBEkd https://t.co/hYufA8ptqj

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Dr. John Cush RheumNow ( View Tweet)
Targeting the HUGE dilemma!🎯 #Psoriatic vs Erosive #OA PsA 👉 Fluffy bone formation(enthesitis of phalanges) 👉 Marginal erosions(vs central) 👉 Many jts in same digit(ray inv) 👉 Periarticular SOFT tissue swelling (dactylitis). 👉 NOT much hand OA #ACR21 RadiologyBootCamp https://t.co/OQLPoeRLny
Ashima Makol MD AshimaMakol ( View Tweet)
Live from #ACR21: Learning about osteoarthritis from Dr. Marc Hochberg. "Don't use the term degenerative joint disease." -much more involved. I like this figure of the multiple different phenotypes. #ACRAmbassador https://t.co/UwU4vCmYXa
Jilaine Bolek Berquist BolekBerqui ( View Tweet)
OA oral session - abstract 1904 Devin Driscoll (mentor @tuhina_neogi) presenting data from MOST: Evaluation of Neuropathic-like Symptoms and Objective Signs of Neuropathy Post-Knee Replacement #ACR21 https://t.co/APZAJdHH5M
Rheum Cat rheum_cat ( View Tweet)
Quick plug: not all joint pain in ICI-treated pts needs reflex steroids eg OA can get exacerbated by ICI Rx (ICI-aOA) call rheum, hold the PNL & save tumor response @ReidMDMPH @got_rheum @lovetolearn27 +me #ACR21 ABST1518 @RheumNow our paper @jitcancer https://t.co/InespbOn6m https://t.co/HSjtGrwePE

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David Liew drdavidliew ( View Tweet)
Watch my video of #ACR21 Abstract 1456, a double blind RCT of CBD for hand OA and PsA @RheumNow https://t.co/p0IiYzYe2m

Richard Conway RichardPAConway ( View Tweet)

My video comment on the cannabidiol (CBD) double-blinded RCT in hand OA/inactive PsA #ACR21 for @RheumNow Great work by @Joner_MD et al & kudos to funders @PsoriasisDK @Gigtforeningen @AalborgUH @aalborguni giving us data to answer a question often asked https://t.co/e0mO0SriUu https://t.co/9DveN4jLls

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David Liew drdavidliew ( View Tweet)

Interesting results where cannabidiol NEG results in RCT in hand OA and PsA. ? Throw out the ‘pot’with the dish water? Did it stimulate appetites? Was pain the same but interference less? Abst#1456 #ACR21 @RheumNow https://t.co/rnz82Paxkr

Links:

Janet Pope Janetbirdope ( View Tweet)

CBD for pain in hand OA/inactive PsA: - works in animal models (many things do) - other neg RCTs didn't use CBD itself - DBRCT: 12w continuous, n=136, min dropout Result: does absolutely nothing I bet big money it will be tried again & again @Joner_MD #ACR21 ABST1456 @RheumNow https://t.co/lZLVrgrKST
David Liew drdavidliew ( View Tweet)
If you need a #knee replacement move out of Ontario. More income disparity of access to #TKR in Ontario vs Pennsylvania. Lack of universal #healthcare in 🇨🇦. Oh Canada we fail. @RheumNow #ACR21 abst#1037 https://t.co/kobUlT3Ugr
Janet Pope Janetbirdope ( View Tweet)
Oral Calcitonin not recommended for OA - studies did not show efficacy Strontium Ranelate study below was considered a positive study in KOA with efficacy but had Cardiovascular toxicity - now off the market. https://t.co/gcYH9xoxeo
Bella Mehta bella_mehta ( View Tweet)
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