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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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The Cartel is Coming for Rheumatology

Eric Dein, MD

"What Do Blockbuster Drugs & The Black Market All Have in Common?" asked Dr. Madelaine Feldman at RheumNow Live 2025. They thrive, she explained, on market exclusivity "... until they don't." At first glance, the pharmaceutical marketplace may not appear like a crime drug ring, but Dr. Feldman of Tulane University described how sinister forces of market manipulation have negatively impacted patient care for years.

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Participation is Up! (1.31.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. We also have two call-in cases on "Ask Cush Anything".

Be sure to join in the fun at RNL 2025 next weekend - Gong Show Karaoke; what will you sing?

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Proinflammatory Diet Increases Gout Risk

MedPage Today

Some dietary habits are worse than others when it comes to gout risk for women, a large study indicated.

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Weak Data (1.24.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from RheumNow.com, and features Dr. Charity Dean, the Keynote speaker at RheumNow Live 2025, and why she is an inspiration.

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Do Rheumatologists Follow 2020 ACR Guidelines on Gout?

Jack Cush, MD

Schlessinger and colleagues report that US Rheumatologists generally adhere to and agree with the 2020 American College of Rheumatology (ACR) Guideline for the Management of Gout, although knowledge gaps and practice variance exists.

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Alive in 2025 (1.10.2025)

Jack Cush, MD

Dr. Jack Cush brings in the new year with a review of the latest from RheumNow.com

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Does Colchicine Lower Gout Mortality Risk?

Jack Cush, MD

Data from a large UK database finds that gout patients starting urate-lowering therapy (ULT) will benefit from added colchicine prophylaxis by having fewer cardiovascular events.

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2nd Opinions in Rheumatology https://t.co/R4CjJHEaL4 https://t.co/0quDwdANyU

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Dr. John Cush RheumNow ( View Tweet)
Systematic review of colchicine and pregnancy in #FMF pts included 25 studies. Miscarriage was not increased w/ colchicine in FMF (RR 0.87). Birth defects were similar to unexposed pts (range 0.6% to 4.0%). Colchicine showed no effects (men/women) on fertility. 1 study reported… https://t.co/axiH9jhEJr https://t.co/oBpew71fZw
Dr. John Cush RheumNow ( View Tweet)
Indigenous peoples of the Pacific, particularly those of Polynesian descent, have a high prevalence of hyperuricaemia and gout. Gout in Indigenous peoples of the Pacific is severe, associated with family history and is experienced at a relatively young age.… https://t.co/phf5RRkJzE https://t.co/q4VO34Ea5z
Dr. John Cush RheumNow ( View Tweet)
Available the first time: https://t.co/4UQlqwujiR 2025 On Demand! On Demand gives you access to all lectures, Q & A panels, and STEP talks, and all speaker slides and handouts — all packed with insights you won’t find anywhere else. Non-CME, practical, and finally here.… https://t.co/qZb8OKjPpw https://t.co/Exr8u6QkNc

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Dr. John Cush RheumNow ( View Tweet)
Pregnancy is 🔥 inflammatory Hard to interpret MRI of SI joints in setting of pregnancy Ideally, don't score MRI during pregnancy or 1 year afterwards, would be affected by the pregnancy If needed for clinical eval, focus on structural lesions like erosions #RNL2025 @RheumNow

Eric Dein ericdeinmd ( View Tweet)

Proinflammatory Diet Increases Gout Risk Some dietary habits are worse than others when it comes to gout risk for women, a large study indicated. https://t.co/DS6JDfJZI4 https://t.co/U3Xwq96oGj

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Dr. John Cush RheumNow ( View Tweet)
SubAnalysis of STOP Gout Trial: 277 pts w/ CKD received either allopurinol or febuxostat. Most achieved SUA goal (79% vs 81%), fewer allopurinol pts had gout flares (32% vs 45%; P=0.02); AKI only seen stage w/ 3 CKD (allopurinol > febuxostat) https://t.co/wwfVCei4Ej https://t.co/W8Y7KxcSd4

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Dr. John Cush RheumNow ( View Tweet)
Open label trial of starting MTX in 11 uncontrolled gout pts previously Rx w/ IV pegloticase (PEG 2-27x) showed if gout pts failed PEG monotherapy, only 1/11 (9%) showed a good response to adding MTX w/ PEG. MTX must be started w/ PEG initiation to work https://t.co/aoBtyIRbQe https://t.co/RNe03O6Z1N

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Dr. John Cush RheumNow ( View Tweet)
Febuxostat (ULORIC) is discontinued by the manufacturer in the USA. This week an FDA update on drug shortages list announced Uloric has been discontinued. Takeda sited dropping sales, generic competition, and CV safety concerns in the last decade. GENERIC febuxostat should still… https://t.co/QcUNCUFfvJ https://t.co/oBdwkcN177
Dr. John Cush RheumNow ( View Tweet)
post hoc analysis of 4 registration trials of pegloticase, show rates of MACE and Thromboembolic Events were Infrequent (<1.5%; 35.4 events/1000 PY), similar to general gout population (31.7 events/1000 person-years) https://t.co/v6ZqtL4yB2 https://t.co/NA0j20Oew2

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Dr. John Cush RheumNow ( View Tweet)
Population survey study of 933 gout pts (mean 58 yrs, 76% male,80% white) found total gout flare burden = 6.6 gout flares per year. Nearly 72% of gout flares were not reported, pretreated or prevented. Those less likely to report flares were young, less school, lower CCI, less… https://t.co/Z7KWk1YEFH https://t.co/0jDGNMOKjj
Dr. John Cush RheumNow ( View Tweet)
Does Colchicine Lower Gout Mortality Risk? Data from a large UK database finds that gout patients starting urate-lowering therapy (ULT) will benefit from added colchicine prophylaxis by having fewer cardiovascular events. https://t.co/89BXT5OnVS https://t.co/N4IQzRpcPk

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Dr. John Cush RheumNow ( View Tweet)
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