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Glucocorticoid Injections in Knee Osteoarthritis
A randomized clinical trial of 60 patients found that glucocorticoid injections into the infrapatellar fat pad (IPFP) did not significantly reduce pain scores in patients with inflammatory knee osteoarthritis (compared to placebo).
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Obesity and Low Back Pain
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EurekAlert!
A large patient population study finds weight gain, increases risk for low back pain - the risk increased 7% for every BMI unit or 10 pounds over ideal weight.
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Assess Reproductive Health in SLE Clinic Visits
Due to the complexity of SLE, rheumatology providers should take an active role in assessing reproductive health, providing education on how SLE may affect pregnancy, and taking a collaborative, multidisciplinary approach with the patient’s gynecologist.
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Adult co-twin study of 1261 pairs, 1/2 Rx w/ metformin. Although metformin Rx Twin had higher BMI, they had significantly less incident peripheral OA (adjusted HR 0.60; 0.44–0.82). @ 10 yrs, 6.7% of treated twins, vs 9.7% of non-treated twins had incident OA, with difference of https://t.co/7KpiGssFSo
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Systematic review of Difficult-to-treat RA (D2T-RA): 23 articles, 27,987 RA pts from 13 countries - pooled prevalence of D2T-RA was 11.7% (10.9% overall; 13.2% in b/tsDMARDs-treated RA). 47% D2T-RA had persistent inflammatory refractory RA (PIRRA). Prevalence decreased w/ https://t.co/0Gatzbfxid
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Anti-mitochondrial M2 Ab (AMA-M2) in 987 IIM pts-- 55 (6%) were AMA-M2 positive. AMA-M2+ had signif. higher rates of polymyositis (56% vs 23.5%), GGT, alk phos levels, & 3 fold more cardiac involvement (60 vs 13%) (arrhythmias, CHF, pulm HTN (31-56%), but no effect on survival https://t.co/WYWeDpiYOh
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DPC - direct primary care offices run by nurse practitioners - states that allow independent NP practices have NPs opening DPC offices, that operate under a membership model, with pts paying for access to the office services, tests, and imaging. Over 2,300 DPC offices currently
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APP Pearls “Steroids: Set a stop date upfront, educate on side effects, and teach "every milligram matters." Prevents dependence and eases tapering” - Barbara A. Slusher, MSW, PA-C, DFAAPA, DipACLM
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Congratulations to Dr. Proton Raman - a world class rheumatologist and research scientist!!! https://t.co/ofzGLsofi0
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Best of 2025: 2025 BSR Guideline for Treatment of Axial Spondyloarthritis
The British Society of Rheumatology's 2025 Guidelines for treating axSpa focus on both axial and extra-musculoskeletal issues like uveitis, psoriasis, and IBD. They evaluate the effectiveness and safety of https://t.co/fxFcqy13g7
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Comorbidity and Health Management: Tuesday Night Rheumatology
Join panelists Vanessa Hill, NP-C, Lindsay Tom, PA-C, Barb Slusher, MSW, PA-C and Jack Cush, MD as they discuss comorbidity and health management in rheumatic disease.
https://t.co/3KMgBW1Q4W https://t.co/4dVfKd7uy5
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UK study of 1846 RA pts starting a b/tsDMARDs, ~30% on steroids & majority (2/3) continued use over the first year of new novel treatment. This suggests these aer either severe RA pts or that we are not vigilant in limiting/weaning/stopping steroids in RA patients - which is it? https://t.co/7NWeAWTjSy
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Lupus Guidelines 2025
Monica Richey, ANP, New York, reviews the 2025 ACR lupus guidelines as part of RheumNow's "Mission: APP Partners in Care" campaign during the month of December.
https://t.co/D1LE1H4zyi https://t.co/myPnT3ibKd
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Japan retrospective study of 38 RA pts who developed MTX assoc lymphoproliferative disorder (LPD) - 22 w/ spontaneous regression (SR) vs 16 non-SR (w/ 5 deaths). non-SR Pt had higher LDH levels at Dx & lower lymphocyte recovery 1 mo. post MTX withdrawal & higher mortality risk https://t.co/SsBQRxFvD1
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APP Pearls “It’s okay not to “fix” the complaint right away. Validate the patient, then watch and wait when appropriate. The urge to intervene quickly without confidence can be dangerous. See the patient back, keep listening, & continue good history-taking” - Jeannette Hart PA-C
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JAMA teaching case: 57 yoF w/ RA Rx w/ HCQ, NSAID, TNFi (ETN -->ADA) develops a new rash - pruritic vesicles/papular on neck, mouth, ears, chest, hands w/ some becoming ulcerated plaques, ESR >100. WHAT TO DO? A) steroids; B) stop ADA; C) Benadryl or D) Read more? Pt had https://t.co/DQpeUOC5I3
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Best of 2025: Variability of Guidelines on the Perioperative Use of DMARDs in Rheumatic Diseases Patients
Despite advances in treatments reducing the need for major surgery, many rheumatic disease patients still require surgery while on DMARDs. A review of perioperative https://t.co/LHClCUvHrb
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APP Pearls “It’s important to explain the difference between an overreactive immune system vs. a weakened immune system” - Miguel Rodriguez, ANP
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Best of 2025: ERS/EULAR guidelines for CTD-related interstitial lung disease
The ERS and EULAR have published clinical practice guidelines for the evaluation and management of CTD associated ILD in two simultaneous publications in the European Respiratory Journal and Annals of https://t.co/ceGCQjkmJV
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"It's suppose to be hard, if it wasn't hard everyone would do it. Hard is what makes it great! - Tom Hanks in "League of Their Own"
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