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Clinical Skills


Erosive Hand Osteoarthritis Portends Worse OA

Oct 06, 2021

An erosive hand osteoarthritis (EOA) study from the Osteoarthritis Initiative shows that EOA is more common in older women and is strongly linked to further progressive, articular structural damage.

This was a longitudinal cohort study of 3,365 individuals without prevalent erosive hand OA at

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Interested in becoming a rheumatologist? It’s interview season! Dr. Kathryn Dao (@KDAO2011 ) shares tips for the interviewer AND the candidate. #RheumNow #RheumTwitter

Diagnostic Delay in Half of Psoriatic Arthritis Patients

Sep 07, 2021

 A Mayo Clinic/ Olmsted County study of psoriatic arthritis (PsA) patients has shown that more than half (55%) of PsA patients had a diagnostic delay of > 2 years, and that this delay has not improved over time.

A retrospective, population-based cohort examined incident adult PsA

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RheumNow Podcast – COVID Marching Amidst the Madness (8.27.2021)

Aug 26, 2021

We have a lot of news, information and approvals to review and discuss, though I need to begin with what's weighing heavily on my mind. After, we'll dive into what we learned this week.

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The Predictive Value of Morning Stiffness

Aug 25, 2021

A prospective study evaluated the value and associations with morning stiffness in patients with clinically suspect arthralgia, and found that the presence of morning stiffness increases the odds of inflammation (as detected by CRP and MRI synovitis).

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RheumNow Podcast – Driving in Pain (8.20.2021)

Aug 20, 2021

You know, I'm a very good driver. We all think we're great drivers - but consider what it's like to drive in pain: would you be a good driver? Also, I want you to consider the diagnosis of calcium pyrophosphate dihydrate disease (CPPD). But first, let's look at a study out of Scotland, looking

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Oligoarticular vs. Polyarticular Psoriatic Arthritis

Aug 19, 2021

A psoriatic arthritis (PsA) cohort analysis reveals many similarities and few distinctions between those who present with oligoarticular and polyarticular PsA.

A total of 402 PsA patients from the University of Toronto PsA clinic (1978 - 2018) were included. Oligoarthritis was defined

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EULAR Points on Managing Difficult Rheumatoid Arthritis

Aug 19, 2021

A EULAR task force has promulgated several points to consider in managing difficult-to-treat RA. These "points" are unique in directing the rheumatologist's attention to the potential for misdiagnosis and the impact of comorbid conditions on what is perceived as poorly controlled RA.

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hip, OA, AVN

Osteonecrosis in Lupus

Jul 15, 2021

A single center analysis of systemic lupus erythematosus (SLE) patients found symptomatic osteonecrosis (ON) in nearly 10%.

Researchers analyzed data from 912 SLE patients admitted to the hospital (1981 to 2012).  Of these 912 SLE patients, 97 had symptomatic ON with an overall

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Arthritis as a Harbinger of Pediatric Cancer

Jul 15, 2021

Lancet Rheumatology has published a cohort analysis showing that a small but significant subset of children presenting with arthralgia or arthritis may have a pediatric malignancy.

This multicentre study sought to identify articular presentations of children manifesting

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back, LBP, spine, AS

Is Pre-Clinical Spondyloarthritis a Real Risk?

Jul 12, 2021

A study of first-degree relatives (FDRs) of HLA-B27-positive axial spondyloarthritis (axSpA) patients shows clinical or imaging features of spondyloarthritis in up to 32% subjects, regardless of HLA-B27 status.

Historically, it has been suggested there is a 20% risk of ankylosing

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burnout work overworked

ICYMI: Rheumatologists Rank 2nd in Physician Burnout

Jul 06, 2021

The 2021 Medscape Survey on Physician burnout ranks rheumatology second, just behind Critical Care medicine.

The survey included over 12,000 physcians from 20 specialties. While 42% of MDs claimed to be burnt-out, Rheumatologists claimed this 50% of the time. The top 3 this year were Critical

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Neuropsychiatric Events Common in Lupus

Jun 30, 2021

Neuropsychiatric (NP-SLE) or CNS lupus events range from mild to severe; several recent studies have noted that NPS lupus is common and should be screened for.

A metanalysis of the literature finds 22 studies wherein the mean frequency of NPSLE ranged from 10.6% to 96.4%. When researchers with

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RheumNow Podcast - Speak Up! (6.18.2021)

Jun 18, 2021

Dr. Jack Cush talks on education, engagement and the challenge of speaking up, if not first!

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artificial intelligence machine learning computer

Artificial intelligence brings clarity to early bony changes in inflammatory arthritis

Jun 16, 2021

Subtle early bony changes in inflammatory arthritis can be hard even for experienced rheumatologists to interpret, even though they have traditionally been considered to become disease-defining as they progress. As computational techniques have become more sophisticated and more accessible,

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pregnant, pregnancy, mother, fertility

Current approach to lupus and pregnancy

Jun 14, 2021

All of us are extremely cautious with lupus patients when it comes to pregnancy. Presentation 6888 (Common issues in pregnancy management in lupus and anti-phospholipid syndrome by Dr. Rebecca Fischer-Betz) was an excellent overview of our current approach to lupus and pregnancy. 

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DAPSA PsA measure

Q-DAPSA for Measuring Disease Activity in PsA

Jun 10, 2021

Given its multiple domains, there remains much discussion over the best disease activity scoring method in PsA. The proverbial "holy grail" would be a measure that is quick, intuitive, domain comprehensive and validated.

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I write more about this for @RheumNow - it’s powerful to know that AI can accurately tell the difference between RA, PsA, and healthy controls on the basis of the bony surface at MCP 2: @maier_ak @FAU_Germany OP0145 #EULAR2021 (ping @DrCMcMaster)
Would you use #Telemedicine (TM) to follow-up #SLE patients post #COVID? Dr So showed in an RCT (N=122),patient satisfaction and time-to-review were better in TM vs Face-to-Face. Although none had COVID, >pts in TM were hospitalised and trend to⬆️FU #EULAR2021 #POS1164 @RheumNow
Additional results from @rheum_covid trainee survey re: Telemedicine presented in AB0674: 📱dramatic ⬆️ in telemed (13% to 83%) during pandemic 📱limited training and supervision 📱trainees felt telemed negatively impacted supervision & clin teaching quality #EULAR2021
Presented results from @rheum_covid Trainee Survey today at #EULAR21 (POS0051): 👎🏼 trainees felt multiple domains in clinical care & research were negatively impacted by pandemic 🔥 50% felt burntout with 68% with ⬆️ of work related stress 🗣@SuAnnYeoh1, @rheumed & team
Prof. Alten outlined the value of patient-reported outcomes for clinical practice! How do you collect patient-reported outcomes - PRO - in your rheumatology clinic? #EULAR2021 @RheumNow
Feet, foot

Foot Pain Commonly Overlooked in RA

MedPage Today
Jun 01, 2021

Foot pain is a common but underappreciated symptom of rheumatoid arthritis (RA) and can be associated with worse disease, European researchers found.

In a cohort of 320 patients with RA, 69% reported foot or ankle pain, according to Morten Bilde Simonsen, PhD, of Aalborg University in

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DASH study: ?effect of diet on BP in 459 adults given 1) USA diet; 2) Fiber, fruits, Veggie (FFV) or 3) DASH diet. Compared to typical American diet, DASH diet (less so FFV) reduced mean SUA 0.25 mg/dl (P=.004); moreso w/ higher SUA levels
RNL, over, microphone

RheumNow Live 2021 Now Available for All

May 14, 2021

RheumNow Live (RNL) for 2021 was held March 20 - 21 in Fort Worth, TX, and now all can partake in the meeting - by video, podcast or by signing up for Tuesday Nite Rheumatology (TNR).

RNL has finished its 3rd year as a hybrid meeting, with the live meeting streamed to hundreds at home

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