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Reefer Madness (12.12.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news, journal and regulatory reports from this past week on RheumNow.com.  B cell drugs in SLE and ITP, biomarkers in GCA & PSS and great videos by APPs.

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Medical Cannabis for Pain Management

Jack Cush, MD

Recent research and publications have underscored the use, efficacy, safety and limitations to the use of cannabis for arthritis and pain patients.

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I Can't Believe it's Not Seronegative Rheumatoid Arthritis?!

Daric A. Mueller, PA-C

In rheumatology, we're no stranger to uncertainty. In any diagnosis of seronegative rheumatoid arthritis, it's always our invitation to reconsider the diagnosis. 

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Evaluation of Rheumatic Complaints

Jack Cush, MD

Dr. Cush provides a systematic approach to evaluating musculoskeletal and rheumatic complaints in clinical practice.

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Low Dose Naltrexone for Fibromyalgia Pain - Use it or Lose it?

Jack Cush, MD

Medscape recently reviewed off-label use of low dose naltrexone (LDN) in fibromyalgia (FM) and found it is deemed effective by some clinicians and patients, but 1) there is no FDA indication for LDN use in FM and 2) the data supporting its use is limited.

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Turkey Tryptophan (11.28.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and reports from this past week on RheumNow.com, including reports on FDA resurrections, FM seasonal worsening, and do you fight switch or swap biologics in PsA TNFi nonresponders?

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Coccyx and Sacrococcygeal Joint Disorders

Jack Cush, MD

Pain from coccygeal or sacrococcygeal disorders is rare, often presenting as a diagnostic challenge. Coccygeal pain is often mistaken for lumbosacral, pelvic, or gastrointestinal disorders.

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APP Pearls “You must assess sleep and mood- without this, even if you control all inflammation, you will not control pain and fatigue!” - Christine Stamatos, NP, DNP, RN

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Lilly announced phase 3 RCT TRIUMPH-4, where Retatrutide, a new GIP, GLP-1 & glucagon recpt agonist, was given to obese (BMI >35), knee osteoarthritis pts *without diabetes*. Wt loss at 68 wks was 28.7% with reduced WOMAC pain scores of -4.5 points (75.8%) https://t.co/73yIyvwRtL
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QD Clinic: Weakness with Fibromyalgia ack Cush, MD and Leilani Law, APN, Dallas, TX, discuss a case about weakness with fibromyalgia and how to best treat the complaints she presents with. This APP QD clinic is presented as part of RheumNow's "Mission: APP Partners in Care" https://t.co/OHeTdemtra
Dr. John Cush RheumNow ( View Tweet)
Medical Cannabis for Pain Management Recent research and publications have underscored the use, efficacy, safety and limitations to the use of cannabis for arthritis and pain patients. https://t.co/kxTDqbzpgg https://t.co/fBumEAgISU

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Dr. John Cush RheumNow ( View Tweet)
The countdown is on! ⏱️ Drs. Jack Cush & Artie Kavanaugh are previewing what’s coming to RheumNow Live 2026 in Dallas (Feb 7–8) – and you don’t want FOMO on this one. ✅ Register now at https://t.co/4UQlqwujiR 🔥Early bird pricing ends December 15 – Get the inside scoop on https://t.co/K6kxX2oDtu

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Dr. John Cush RheumNow ( View Tweet)
Low Dose Naltrexone for Fibromyalgia Pain - Use it or Lose it? Medscape recently reviewed off-label use of low dose naltrexone (LDN) in fibromyalgia (FM) and found it is deemed effective by some clinicians and patients, but 1) there is no FDA indication for LDN use in FM and 2) https://t.co/RgRRHU9ZRo
Dr. John Cush RheumNow ( View Tweet)
JAMA Case Challenge - Painful Hand Swelling With Finger Contractures 56-yoF w/ BL hand contractures, 15 mos BL hand pain/swelling/stiffness. No or partial relief w/ ibuprofen, 30 mg prednisone, MTX 10-20 mg/wk. All labs were normal. Whats the Dx? https://t.co/lZ0NHX5Y56 https://t.co/JC04E3JUxB

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Dr. John Cush RheumNow ( View Tweet)
Coccyx and Sacrococcygeal Joint Disorders Pain from coccygeal or sacrococcygeal disorders is rare, often presenting as a diagnostic challenge. Coccygeal pain is often mistaken for lumbosacral, pelvic, or gastrointestinal disorders. This review presents the epidemiology, https://t.co/zrGDwULms5
Dr. John Cush RheumNow ( View Tweet)
ICYMI: Inflammatory vs. Noninflammatory Pain https://t.co/3nJ2NZYTQY https://t.co/7FuSYzkX2G

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Dr. John Cush RheumNow ( View Tweet)
Turkey Tryptophan (11.28.2025) Dr. Jack Cush reviews the news and reports from this past week on RheumNow, including reports on FDA resurrections, FM seasonal worsening, and do you fight switch or swap biologics in PsA TNFi nonresponders? https://t.co/cnxxwqwyTE https://t.co/82zugQnp2Y

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Dr. John Cush RheumNow ( View Tweet)
Coccyx and Sacrococcygeal Joint Disorders Pain from coccygeal or sacrococcygeal disorders is rare, often presenting as a diagnostic challenge. Coccygeal pain is often mistaken for lumbosacral, pelvic, or gastrointestinal disorders. This review presents the epidemiology, https://t.co/u4w3b915my
Dr. John Cush RheumNow ( View Tweet)
BASDAI scores elevated in Fibromyalgia - 58 FM pts were surveyed wtih FIQ, SSS, BASDAI. BASDAI was ≥ 4 points in 91.4% of FM (vs 13% controls (p < 0.001). BASDAI correlated w/ the FIQ (pain, fatigue, stiffness) & SSS scores (r = 0.88, p < 0.00). Could BASDAI be used in FM? https://t.co/M0tI8wjzh4
Dr. John Cush RheumNow ( View Tweet)
Obesity-inflammation axis in PsO & PsA: obesity is assoc w/ less remission& poorer drug responses; possibly from adipokines, biomechanical stress, gut dysbiosis, etc. Notably, weight loss can improve both psoriatic disease course and response to therapy. https://t.co/cZbeu0zfmR https://t.co/EoCTNKk265

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Dr. John Cush RheumNow ( View Tweet)
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