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Stills,continuum

Unmet Needs in Still’s disease

Jack Cush, MD

In February 2023, an expert consensus panel of pediatric and adult rheumatologists met to address challenges in Still’s disease (SD), including systemic juvenile idiopathic arthritis and adult-onset SD. They addressed four main topics: (1) early recognition and diagnosis of SD; (2) pathogenetic pathways and possible biomarkers for diagnosis and response; (3) refractory disease and risk factors, and (4) treatment of SD and its complications.

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2025 BSR Guideline for Treatment of Axial Spondyloarthritis

Jack Cush, MD

The British Society of Rheumatology has published its 2025 Guidelines for the Treatment of Axial Spondyloarthritis (axSpA); addressing axial and extra-musculoskeletal manifestations including acute anterior uveitis, psoriasis and IBD.

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Osteoarthritis Risky Business (4.18.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and Journal reports from this week on RheumNow.com.  Osteoarthritis patients have unique risks and synovial fluid WBC numbers can tell you when to worry about septic arthritis in gout and pseudogout patients.

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DNA,genetics,sequencing

Genetic Sequencing in Rheumatology

Jack Cush, MD

Genetic sequencing as a research and diagnostic tool has expanded in medicine and rheumatology. An interesting review in Arthritis and Rheumatology suggests that despite currently modest use, there will be an expanded role for genetic sequencing in the field of rheumatology. 

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AI,genes

Genetic Analysis of Asymptomatic Antinuclear Antibody Positive Patients

Jack Cush, MD

A large scale genomic population study found antinuclear antibodies (ANA) in up to 14% of the population; most with ANA are asymptomatic, and ANA production is not associated with significant genetic risk. 

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Genomics and Future Drug Targets for Osteoarthritis

EurekAlert!

A Nature article details the results of an osteoarthritis, genome-wide association study meta-analyses across up to 489,975 cases and 1,472,094 controls, establishing 962 independent associations, 513 of which have not been previously reported.

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Distinguishing Septic and Gouty Arthritis

Jack Cush, MD

A single center, retrospective review of patients undergoing knee joint fluid aspirations for presumed crystalline arthritis (CA) showed that synovial WBC may provide a useful diagnostic marker for SA with an optimal threshold of 50,000 cells/mm3.

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Predictors of Developing RA

Jack Cush, MD

A prospective cohort study of seropositive arthralgia patients demonstrated that baseline characteristics and labs can be used to predict which arthralgia patients are at highest risk of developing rheumatoid arthritis (RA).

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EMR Messaging Woes (4.11.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news, journal reports and regulatory approvals from this past week on RheumNow.com

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Study of 104 RA-ILD pts found that (31.7%) RA-ILD patients were ANCA positive (29/31 were p-ANCA+). compared to ANCA neg, ANCA+ RA-ILD had more respiratory Sxs, ANA positivity, worse PFTs, more acute exacerbations of ILD, more bronchietasis & honeycombing https://t.co/vZODUW9tSX https://t.co/6WUbSoOyOm

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Dr. John Cush RheumNow ( View Tweet)
Incr. neutrophils in RA synovium correlates w/ higher Dz activity and poorer Rx responses. Study of 55 #RA pts, 1/3 (17) enriched for synovial PMNs - these correlated w/ DAS28--CRP, synovial inflammation, and CD3+/CD68+ cell counts https://t.co/zz59w8MMUU https://t.co/R7Ruyab0wj

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Dr. John Cush RheumNow ( View Tweet)
Ultrasound lesions of dactylitis associ w/short-term development of PsA. Study of 64 PsO +arthralgia pts. IUS PD synovitis & B mode enthesitis predicted PsA Dx (p < .001) w/ an accuracy of 89.1 %, a sensitivity of 86.7 % and a specificity of 89.8 %. https://t.co/KoXMmoxXhP https://t.co/tj2NxKDkqh

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Dr. John Cush RheumNow ( View Tweet)
Genetic Sequencing in Rheumatology Genetic sequencing as a research and diagnostic tool has expanded in medicine and rheumatology. An interesting review in Arthritis and Rheumatology suggests that despite currently modest use, there will be an expanded role for genetic

Dr. John Cush RheumNow ( View Tweet)

Predictors of Developing RA A prospective cohort study of seropositive arthralgia patients demonstrated that baseline characteristics and labs can be used to predict which arthralgia patients are at highest risk of developing RA. These studies underscore the influence of https://t.co/wpSHDfwCL7
Dr. John Cush RheumNow ( View Tweet)
Genetic Analysis of Asymptomatic Antinuclear Antibody Positive Patients A large scale genomic population study found antinuclear antibodies (ANA) in up to 14% of the population; most with ANA are asymptomatic, and ANA production is not associated with significant genetic risk. https://t.co/Ltqf1yaaoy
Dr. John Cush RheumNow ( View Tweet)
AutoAbs & protein signatures evolve as pts go from Preclinical to established RA. Pts vs controls distinguished w/in 5 yrs of Dx best by iCCP3, RFIgA, RFIgM; and 104 proteins differentially expressed & gene analyses showed 21 pathways enriched ≤5 years of Dx. https://t.co/u8abvqNtnX
Dr. John Cush RheumNow ( View Tweet)
Full read state of the art review of treatments for Axial Spondyloarthritis Concluding unmet needs: -Suboptimal Tx Response - Limited Drug Options - No Biomarkers - Extra-Axial Dz - Non-Inflammatory Pain https://t.co/K3oqRCgTCP https://t.co/rkX2givwF8

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Dr. John Cush RheumNow ( View Tweet)
AutoAbs & protein signatures evolve as pts go from Preclinical to established RA. Pts vs controls distinguished w/in 5 yrs of Dx best by iCCP3, RFIgA, RFIgM; and 104 proteins differentially expressed & gene analyses showed 21 pathways enriched ≤5 years of Dx. https://t.co/EWwpvrduJz
Dr. John Cush RheumNow ( View Tweet)
Full read state of the art review of treatments for Axial Spondyloarthritis Concluding unmet needs: -Suboptimal Tx Response - Limited Drug Options - No Biomarkers - Extra-Axial Dz - Non-Inflammatory Pain https://t.co/K3oqRCgTCP https://t.co/IPn09jMFM2

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Dr. John Cush RheumNow ( View Tweet)
RA Prevention through Deep Immunophenotyping Researchers at the University of Colorado have identified pathogenic immune phenotypes in at-risk populations for RA. They have found the expansion of specific T cell subtypes, in the at-risk group, and postulate this could lead to https://t.co/AEo0GOr7Kn
Dr. John Cush RheumNow ( View Tweet)
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