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Opening Day Report
The opening of ACR2 Convergence was a hit for all who signed up and viewed in. The day included the presidential address by outgoing president Dr. David Karp (UT Southwestern) and a keynote talk and interview with Dr. Seema Yasmin (Stanford).
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Towards better assessment and management of multimorbidity
Appropriate assessment and management of comorbidities and multimorbidity in patients with RA is vital for overall health and well-being of the patient, as well as to encourage treatment adherence, and address social, psychological and quality of life factors.
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"The time for young people is now! You are not the future, you are the present; you can make a difference. You may be scared, but take the opportunities and be purposeful." -Dr. A Alakija on the role of young rheumatologists in global health disparities
#ACR21 @ACRheum @yodifiji
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Dr. Marvisi presented a case: refractory MPA relapsed w/prednisone < 25 mg/day. Genetic studies c/w VEXAS. Is MPA/vasculitis part of VEXAS? The experts say: Maybe- VEXAS is such a new entity, there may be a common pathway (e.g NFkB affected by ubiquination, IL-6 role) #ACR21 https://t.co/kEOsruJ8DE
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She was considered a "high risk hire" b/c of her accent, being young, and being a mother of 3 children who still needs her. -Dr. Graciela Alarcon, a giant in rheumatology,talked about her life in the Global Women Leaders in Rheumatology #ACR21 @ACRheum @rheumnow #strongwomen https://t.co/Oxmy8ruIZF
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Solutions to the Gender Gap:
👉treat gender equality as an innovation challenge requiring innovative solutions
👉create culture where people feel personally responsible for change (not coerced)
👉implement action plans to support behavioral changes with measurable targets
#ACR21 https://t.co/BrExrHx1S7
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My typo: * patience (but "patients" are needed too for a rheum career)
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Drs. Alarcon, Hajjaj-Hassouni, Aggarwal, and March are trailblazers for #WomeninRheum. Sage advice: "The people who open doors may be you." "Sometimes, you have to create your own opportunity." "Push your ideas, don't just watch." #ACR21 @acrheum
@LauraLewMad11 moderates panel https://t.co/gxmjntDQst
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Dr. P Krause (FDA/CBER Deputy Dir., Office of Vaccine Research and Review) on #COVIDvaccine in kids:
👉Children respond to vaccine better than adults; can use lower doses
👉the lower dose will mitigate safety concerns
(FDA gave EUA for Pfizer vaccine for 5-11 yo) #ACR21 https://t.co/Z7kcYQKZ8S
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RheumNow’s expanded coverage of the #ACR21 meeting is sponsored in part by @Novartis. All content chosen by RheumNow & its Faculty.
Dr. John Cush RheumNow ( View Tweet)
👉 anti-CK Ab may be a cause of #LongCovid syndrome
👉found in patients with autoimmune (SLE/Sjogrens) and can affect dz severity.
👉has not been seen in children
2/2
#ACR21
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Role of anti-CK antibodies:
👉⬆️susceptibility to severe mycobacterial dz & opportunistic infx (similar to HIV)
👉causes an indeterminate quantiferon (no response to mitogen)
👉initiated by infx➡️anti-Noc2 Ab➡️cross react with IFN➡️IFN-Ab
👉⬆️severity of #COVID19 #ACR21 1/2 https://t.co/5NHQpwQw6X
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“At the end of the day, the one treatment that will save the most lives will be the vaccines. That’s the homerun!”
– Dr. R Cron, pediatric rheumatologist on reviewing treatments for hyperinflammation and #COVID19 @UABRheum #ACR21 #VaccinateOurKids https://t.co/dL1buLkMkM
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In case you missed it. @ACRheum #COVIDvaccine guidance v 4.0 for Rheum patients & what's added:
👉3rd dose recommend, timing relative to meds (as before)
👉mRNA booster preferred if initial doses were mRNA
👉mAb as PrEP/Rx for high risk pts
https://t.co/R8K8WeZBMt
TheDaoIndex KDAO2011 ( View Tweet)
answer: CPPD.
👉CPPD can look like OA but can be more aggressive.
👉Look for chondrocalcinosis at the triangular ligament, pubic symphyis, superiolateral femoral head
👉A common cause of scapholunate widening
👉CPPD loves the patellofemoral joint (knee joint may be spared) https://t.co/wgYjJwYvb0
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DECT (dual energy CT) very helpful to distinguish gout from other crystals and give volumetric measurements using color-coded images... So do we need to do arthrocentesis to diagnose gout anymore? #ACR21 https://t.co/kn2IpXP870
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Pearls on gout:
👉Gouty tophi can appear in the L spine and destroy the facet joints
#ACR21 Radiology Bootcamp with Dr. Brindle. https://t.co/ml2uI9f10v
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Ouch! Patients with AS can fracture with minor trauma
#ACR21 Radiology Bootcamp https://t.co/1piKvKUM2w
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#ACR21 Radiology Bootcamp-- pretty helpful if you're studying for #ABIMRheumBoards
Do you know how to distinguish sacroiliitis from pseudo-sacroiliitis? https://t.co/btS8mm8yH8
TheDaoIndex KDAO2011 ( View Tweet)
👉Get contrast if ordering an MRI to eval for inflamm. arthritis
👉Heel spur vs. enthesitis? Look for erosions at dorsum of calcaneus & other signs of inflamm
👉DISH vs. axial PsA? DISH➡️contiguous bony ossific'n up anterior margin of the vertebral bodies; PsA not cont.
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