Dr. John Cush RheumNow
6 years 2 months ago
Virtual Video Joint Exam Pearl #5: The worst/most ineffective Virtual visits done with the Patient (or MD) driving in their CAR for the virtual visit!! Amazingly I have had a half dozen of these & requested the patient pull over so I could deliver a rheum Citation.
Dr. John Cush RheumNow
6 years 2 months ago
Virtual Video Joint Exam Pearl #5: Its easier to see gouty Tophi and rheumatoid nodules than nail changes of PsA or subtle rashes. For Rashes and oral lesions its BEST to have the patient take multiple pix with the cell phone and send them in by EMR or Email.
Dr. John Cush RheumNow
6 years 2 months ago
Virtual Video Joint Exam Pearl #4: Professor Paul Emery was right! THe MCP squeeze (done by the patient) and MTP squeeze is fairly predictive of RA/inflammatory arthritis AND outperforms the "Finger" (distal hand) squeeze. Hence the MCP/MTP is my main squeeze!
Dr. John Cush RheumNow
6 years 2 months ago
Virtual Video Joint Exam Pearl #3: Despite cam setups designed to do upper extremity exams, patients can easily move cams and limbs to examine spinal movt, gait, knee, ankle and foot problems with great accuracy.
Dr. John Cush RheumNow
6 years 2 months ago
Virtual Video Joint Exam Pearl #2 : Despite being in my video on the Virtual joint exam; asking the patient to show you their fist (AKA fist bump the camera) to see potential MCP swelling has thus far been a largely useless maneuver...but it looks good on cam...
Dr. John Cush RheumNow
6 years 2 months ago
Virtual Video Joint Exam Pearl #1: pain elicited by cervical lateral bending (in someone w/ otherwise normal Cx ROM) is highly correlated with Tender trigger points in the neck region (hence #FM)
Dr. John Cush RheumNow
6 years 2 months ago
After a career of doing over 90,000 joint exams, Iv now done about 140 VIRTUAL Video joint exams and while I think Im pretty good at it....Im really a burgeoning amateur. Never the less here are my Virtual Joint Exam Pearls (thus far....)
Dr. John Cush RheumNow
6 years 2 months ago
Retrospective study of 20 RA pts w/ resolved hepatitis B (HBcAb+; HBsAg neg). 16/20 were Rx w/ tocilizumab & 8/20 w/ tofacitinib (nearly all HBsAb+). 25% recv antiviral Rx w/in 2 yrs of TCZ or Tofa; 6 had mild LFT elevations & No one had HBV reactivation https://t.co/EeFXo7mLhQ
JAMA Internal Medicine has posted an Editor's note on the use of hydroxychloroquine for COVID-19; noting the sequence of dysfunction since the president promoted its use on March 21, 2020, when he said “What do you have to lose? I’ll say it again: What do you have to lose? Take it.”.
If you’re looking for some great advice to consider or rebuke, here is the generous guidance of nearly two dozen leaders in rheumatology who sincerely offer you their wisdom and best wishes.
Dr. John Cush RheumNow
6 years 2 months ago
A large Latin American SLE cohort was studied; 66 (5.6%) had familial SLE & 1110 (94.4%) sporadic SLE: Familial SLE was more often associated with discoid LE (OR 1.97) & CNS dz (OR 1.65), more MSK Dz. No group difference in Disease activity https://t.co/4Lak2q4QJn
Dr. John Cush RheumNow
6 years 2 months ago
Systematic literature finds a connection between ankylosing spondylitis (AS) and dementia (RR 1.19 [95% CI 1.01‐1.41]). From a total of 6562 articles reviewed, only 4 met criteria - analysis included 156418 pts. Cause? inflammation, inactivity?
Dr. John Cush RheumNow
6 years 2 months ago
The RheumNow Podcast is up - Top 13 Rheumatology Centers in the US; anakinra & colchicine in COVID, unload the loading dose, CB2 in Scleroderma. Watch it here>> https://t.co/5LIIi7Pwg1 or listen to the podcast here>> https://t.co/5LIIi7Pwg1
Dr. John Cush RheumNow
6 years 2 months ago
Spanish registry of 3679 SLE pts finds 13.6% had polyautoimmunity (SLE plus another autoimmune Dz), Dx as thyroiditis (8%), Sjogrens (14%) secondary APS (14%). Incr odds in female, w/ ILD, Raynauds, SSA/SSB/RNP but LESS w/ antimalarial drugs [0.50] https://t.co/duTqepvmLR
A study from 2 gout clinics implementing different treatment strategies has shown that a treatment strategy that aims to strictly achieve low uric acid (UA) results in a higher a rate of targetd serum UA lowering and less gout flares.
