OP/Bone

3-year, RCT of Mediteranean diet vs usual care in 924 older adults w/ metabolic syndrome & BMI > 27. Med. diet shows signif wt loss (3.4% vs 0.4%), w/ improved BMD (by DEXA) at year 3, especially in women. https://t.co/mllx6l1QnM https://t.co/I5e8PXX2oX

Links:

Dr. John Cush @RheumNow( View Tweet )
3-year, RCT of Mediteranean diet vs usual care in 924 older adults w/ metabolic syndrome & BMI > 27. Med. diet shows signif wt loss (3.4% vs 0.4%), w/ improved BMD (by DEXA) at year 3, especially in women. https://t.co/mllx6l1QnM https://t.co/CulO1Sschf

Links:

Dr. John Cush @RheumNow( View Tweet )
Managing CKD in Lupus Nephritis Dr. Hans-Joachim Anders explores how to treat LN patients with chronic kidney disease, balancing disease control and renal preservation. 🎯 Don’t miss these expert pearls. 👉 Full update on RheumNow: https://t.co/frHvcd1xMw #LupusNephritis https://t.co/VedtGaHkMj

Links:

Dr. John Cush @RheumNow( View Tweet )
Pitfalls in sacroiliitis imaging: Bone marrow edema may also be seen in young-middle-aged postpartum women, & athletes & kids (ongoing bone growth) & w/ advancing age (DJD) https://t.co/bwS047wlmI https://t.co/FvWlEcZ5JP

Links:

Dr. John Cush @RheumNow( View Tweet )
Finish Birth Cohort followed since 1986, who were asymptomatic, found abnormal MRI knee findings, esp cartilage defects in the patellofemoral (56%) & tibiofemoral joints (25%) joints. Small/doubtful patellofemoral (52%) & tibiofemoral (17%) osteophytes seen. Most w/ High BMI. https://t.co/LHqmRHM5wF
Dr. John Cush @RheumNow( View Tweet )
Japan IORRA RA registry shows from 2011 to 2023, despite better Rx & control & less pred, Fractures went up in RA. From 2011 to 2023- DAS resmission 38 to 65%, bDMARD use 14 to 42%, GC use 38 to 22%, OP Rx 32 to 38%; But all FX incr 47 to 53/1000 Pys. https://t.co/cgz0Gkasai https://t.co/D2Uro7mEAT

Links:

Dr. John Cush @RheumNow( View Tweet )
Japan IORRA RA registry shows from 2011 to 2023, despite better Rx & control & less pred, Fractures went up in RA. From 2011 to 2023- DAS resmission 38 to 65%, bDMARD use 14 to 42%, GC use 38 to 22%, OP Rx 32 to 38%; But all FX incr 47 to 53/1000 Pys. https://t.co/cgz0Gkasai https://t.co/ziZr3BegDz

Links:

Dr. John Cush @RheumNow( View Tweet )
Osteoarthritis Initiative (OAI) longitudinal study analyzed 1075 #OA knees (1/pt) in 96 mo. MRI study to predict outcomes. Infrapatellar fat pad (IPFP volume & signal) predicted future knee replacement & long-term damage. IPFP correlated w/ cartil. volume & BM lesions; Not Sxs. https://t.co/Xsju7JdEVE
Dr. John Cush @RheumNow( View Tweet )
Osteoarthritis Initiative (OAI) longitudinal study analyzed 1075 #OA knees (1/pt) in 96 mo. MRI study to predict outcomes. Infrapatellar fat pad (IPFP volume & signal) predicted future knee replacement & long-term damage. IPFP correlated w/ cartil. volume & BM lesions; Not https://t.co/VrLfiSGWGA
Dr. John Cush @RheumNow( View Tweet )
Full read review of falls and fragility fractures in the elderly. https://t.co/WuQ6oIKTH0 https://t.co/fXnZFxaO28

Links:

Dr. John Cush @RheumNow( View Tweet )
VitD_1.jpg

Vitamin D for Prevention of Disease

Jack Cush, MD

JAMA has published a clinical guideline on the use of vitamin D to prevent disease in children and adults. Guideline committee experts, included adult and pediatric endocrinology, internal medicine, obstetrics/gynecology, nutrition, and epidemiology) advise that healthy nonpregnant persons

Read Article
Enzyme Porcupine inhibition of Wnt signaling is a promising treatment forsclerosteosis - rare Dz caused by SOST mutations & loss of functional sclerostin. Results in high bone mass & skeletal overgrowth (Sxs of facial paralysis, hearing loss, incr intracranial pressure https://t.co/Bgr5zoHyMG
Dr. John Cush @RheumNow( View Tweet )
Enzyme Porcupine inhibition of Wnt signaling is a promising treatment forsclerosteosis - rare Dz caused by SOST mutations & loss of functional sclerostin. Results in high bone mass & skeletal overgrowth (Sxs of facial paralysis, hearing loss, incr intracranial pressure https://t.co/9DYO82quiC
Dr. John Cush @RheumNow( View Tweet )
EMA's EudraVigilance (safety) database study of 10,319 MTX reports (age: 62 yrs, 73% F). Adverse rxns (ADR): 365 kidney & 1,082 liver related. MTX renal ADRs were older, w/ comeds (NSAIDs, Tylenol, metamizole, steroids). More deaths w/ renal ADRs than liver(21% vs 6%); mostly w/ https://t.co/tQ9PSOTtyx
Dr. John Cush @RheumNow( View Tweet )
JAMA Staphylococcus aureus Review - s. aureus bacteremia leads to septic arthritis (7%), vertebral osteomyelitis (≈4%) - bacteremia (≥48 hs) has 39% 90-day mortality risk https://t.co/1UQoz7JDPU https://t.co/xTAkakv2he

Links:

Dr. John Cush @RheumNow( View Tweet )
JAMA Staphylococcus aureus Review - s. aureus bacteremia leads to septic arthritis (7%), vertebral osteomyelitis (≈4%) - bacteremia (≥48 hs) has 39% 90-day mortality risk https://t.co/atao3mF32L https://t.co/oMSJVNKvJN

Links:

Dr. John Cush @RheumNow( View Tweet )
yoga, mindfulness

Mindfulness and CBT improve chronic low back pain

EurekAlert!

Behavioral interventions were associated with reduced pain and daily opioid use and improved function and quality of life for up to 12 months among adults with opioid-treated chronic low back pain, according to a new randomized clinical trial.

Read Article
EMA approved a record 28 biosimilars in 2024 for cancer, osteoporosis, macular degeneration, and immune-related diseases like plaque psoriasis, ulcerative colitis, and Crohn’s disease https://t.co/NNzKRalLvF https://t.co/nfX082a7ON

Links:

Dr. John Cush @RheumNow( View Tweet )
Consensus on Bone Turnover Biomarkers in Osteoporosis A new consensus paper, published by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO), the International Osteoporosis Foundation (IOF), and the https://t.co/lq1odNBLdZ
Dr. John Cush @RheumNow( View Tweet )
hip.THR_.jpg

Joint Implant Metals May Be Leaking

MedPage Today

Patients with metal-containing joint replacements had significantly higher concentrations of cobalt in their cerebrospinal fluid (CSF) relative to patients without arthroplasties, researchers reported.

Read Article
Lab work

Consensus on Bone Turnover Biomarkers in Osteoporosis

EurekAlert!

A new consensus paper, published by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO), the International Osteoporosis Foundation (IOF), and the International Federation of Clinical Chemistry and Laboratory Medicine (

Read Article
hip.fracture.jpg

Peripheral Nerve Blocks for Hip Fractures

Jack Cush, MD

JAMA reviews the use of peripheral nerve block with hip fractures as an effective pain management strategy that can be performed by credentialed clinicians outside of the operating room.

Hip fractures are common, especially in older adults (≥65 years), and may include a 1-year mortality

Read Article
obesity.back_.jpg

Targeting Obesity in Rheumatic Disease Patients

Jack Cush, MD

Sattar et al. has published an informative overview of the effect of obesity on rheumatic and musculoskeletal diseases (RMDs). They estimate that nearly 70% of RMD patients are overweight or obese.

Read Article
bone%20dense.jpg (keep)

Increasing Prevalence of Osteoporosis

Jack Cush, MD

Research published in Osteoporosis International studied NHANES data showed increasing trends in osteoporosis in the United States of America. The key findings showed statistically significant results.

Read Article
Japanese study of hip replacements (THA) - #RA pts undergoing THA at higher risk for dislocation and reoperation. Retrosp database study of THA - matching 3,951 RA vs 11,853 OA. w/ RA incr risk of dislocation (OR 2.8) & reoperation (OR: 2.25). No diff infx, Fx, VTE, death… https://t.co/Mz8niRlFaa https://t.co/mgcXTnw5Al
Dr. John Cush @RheumNow( View Tweet )

Recent Blogs

Unpopular opinion: spinach can be bad for you

Lara El Khoury, MD
pro con unsure opinion thumbs debate
PMR might be one of the most rewarding diagnoses to make in real practice: the patient comes to you in severe debilitating pain, and you prescribe steroids, giving them their lives back! As much as this impressive response makes your intervention appear almost magical, there is the often-forgotten story about the implications of such a diagnosis and treatment on patients' daily lives.  Read Post

ICYMI: Telemedicine Bloopers and Successes

Kathryn H. Dao, M.D.
mom.athome.multitasking.jpg
At my COVID home command center, I feel pretty prepared for everything. From here, I can run my practice, manage and home-school 3 children and keep the family afloat.  I have 2 computers: one for telemedicine/business meetings and one for e-learning lessons/school updates that teachers and school administrators email me throughout the day for my children.  As a no-nonsense, organized mom and doctor, I felt ready to handle any issues that would arise.  Read Post
×