Lancet has several reports on low back pain (LBP) as a major problem worldwide, largely because of the aging population. Low back pain is the leading cause of disability worldwide.

Three reports from JAMA Internal Medicine demonstrate favorable trends with less opioid use when cannabis became legal.

You see them from the corner of your eye, standing with a kyphosis in the waiting room. They are filling out their paperwork, standing up because sitting is just not pleasant. You are the rheumatologist with an  interest in ankylosing spondylitis (AS) and spondyloarthritis, so more likely than not, the patient with the bent spine is going to be your next new patient. In the back of your mind you are hoping that they are not so far along so

Abhishek et al have written on the results of an international survey of crystal arthritis experts and identified the unmet needs  regarding calcium pyrophosphate crystal deposition (CPPD) - research, classification, diagnosis and management.CPPD is a highly prevalent condition with a range of manifestations that may lead to pain, synovitis and joint damage, especially in the elderly.

Laparoscopic gastric band (LAGB) surgery was associated with significant decreases in knee pain from osteoarthritis (OA), with the greatest improvements seen among those whose body mass index (BMI) had the greatest decreases and among younger patients, researchers reported.

Sasha D just doesn’t like me.  I’ve seen her four times in the clinic, and each visit was a tense battle of misunderstandings, with both of us leaving dissatisfied or worse. The failing wasn’t in the diagnosis, but rather the malalignment of our goals and inability to listen. Despite my efforts, my words, the diagnoses and treatment suggestions haven’t been well received.  

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. News on drug regulatory decisions, fenofibrate and gout, Still's disease, TB and infection rates, SpA and hidradenitis suppurativa, and predicting methotrexate non-responders.

The journal Bone reports that given excess calcium intake may not be entirely free from unintended health consequences, it's important to undestand trends in calcium supplement use. 

Investigators from Glasgow and Oxford have identified changes in genomic architecture, represented by a chromosome conformation signature, that can predict nonresponse to methotrexate in early rheumatoid arthritis patients.Recognizing that studies show 35–59% of RA patients do not achieve clinically meaningful responses after starting MTX, they sought to identify a pattern of genetic changes in 59 early RA patients that would predict poor

Stopping methotrexate for 2 weeks after the administration of flu vaccine led to improved immunogenicity without increasing disease activity among patients with rheumatoid arthritis (RA), a prospective Korean study showed.

Lancet reports the results of the FIELD (Fenofibrate Intervention and Event Lowering in Diabetes) study - where fenofibrate was shown to reduce uric acid by 20%, gout events by nearly 50% and may be useful in preventing gout in diabetes.  In the study, 9795 adults (age 50–75 years) with type 2 diabetes were randomized to receive fenofibrate 200 mg per day or placebo and followed for up to 5 years.

Recently, I was invited to apply for an open seat on the American Board of Internal Medicine (ABIM), the large organization that certifies physicians in the United States. Part of the process is to write a personal statement on my views of the ABIM mission and what I would like to accomplish.  

CNN reports that a new congressional analysis of Medicare drug pricing shows the prices of the 20 most commonly prescribed brand-name drugs have risen nearly 10 times the annual rate of inflation in the past five years.

The journal Stroke has published a trial wherein the use of subcutaneous IL-1Ra (anakinra) was shown to reduce the peripheral inflammatory response in those with an acute ischemic stroke. (Citation source: http://bit.ly/2uoNXEL)

Chronic pain and depression are intimately linked, but Japanese researchers have found that up to 12% of knee osteoarthritis (OA) may develop depression and that such patients should be screened for depression over time.