More Comorbidity in Difficult to Treat RA
A systematic review demonstrated that smoking, obesity, fibromyalgia, and depression are significantly associated with difficult-to-treat rheumatoid arthritis (D2T-RA).
Knee pain: JAMA review
- 5% PCP visits knee pain
- Knee OA ~654 million worldwide
- Patellofemoral pain: <40 yrs & physically active; pain on squat
- Meniscal tears in 12% adults (McMurray 61% sensitive; 84% specific; Joint line tender 83% sensitive; 83% specific) https://t.co/2fdpl464mb
Dr. John Cush @RheumNow( View Tweet )
Great Lectures; Great Presentations
Dr. Jack Cush lectures on giving a great presentation; based on 40 years of lecturing in Rheumatology.
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Weight-loss drugs may affect joints directly
A new study from Aarhus University shows that the hormone GLP-1, which is mimicked in medication for diabetes and weight loss, is present in joint fluid. In the long term, this may open up new treatments for arthritis. https://t.co/HkcPUQp05H
Dr. John Cush @RheumNow( View Tweet )
NSAIDs in Inflammatory Bowel Disease?
MedPage Today
At least some patients with inflammatory bowel disease (IBD) can safely use common drugs for musculoskeletal aches and pains, a large study of insurance claims data suggested, contradicting a widespread concern that these products can trigger IBD flares.
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Do patients with chronic pain have double the rates of smoking compared to those without pain? Take this week's RheumIQ quiz to find out.
https://t.co/rmB55KC7Zh https://t.co/ms3G9uBMd5
Links:
Dr. John Cush @RheumNow( View Tweet )
Gabapentinoid use 2008-2018: worldwide there was an annual incr of +17.2% (from 4.2/d to 18.3/d per 10K pop. Highest gaba use in high income countries, 6X higher than lower income (40/d vs 6.1/d) https://t.co/jXjxNj1Uyz https://t.co/GmQJ3UGGw9
Dr. John Cush @RheumNow( View Tweet )
Prescribing Lessons (4.17.2026)
Dr. Jack Cush reviews the news and journal articles from this past week on RheumNow.com.
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Opioids Down, Gabapentins Up
The number of U.S. patients prescribed long-term opioid therapy declined from 2015 to 2023, but co-prescribing of opioids with gabapentinoids increased, prescription data showed.
https://t.co/iXEUfR18Is https://t.co/6DCUvGAW6N
Dr. John Cush @RheumNow( View Tweet )
NHIS 10yr survey of 195,600 Americans shows Chronic pain assoc w/ double rates of smoking & vaping. Smoking decr over time, but always higher in chronic pain pts (17.7% 2014, 13.1% in 2023) than w/o pain (12.5% 2014, 7.5% 2023). E-cigs incr over time, more w/ chronic pain https://t.co/iW7IDwHyJa
Dr. John Cush @RheumNow( View Tweet )
Couldn’t attend https://t.co/4UQlqwujiR 2026?
You can now watch the entire meeting On Demand.
This high-impact program features leading experts discussing:
• RA outcomes and pathogenesis
• Obesity, inflammation, and rheumatic disease
• Treatment decisions in Psoriatic https://t.co/A3wb3pzbl3
Links:
Dr. John Cush @RheumNow( View Tweet )
Itch is common in Scleroderma (SSc) and not related to Dz duration. Study of 2173 Pts (~20K itch assessments), 87 F; mean age 55 yrs; 40% w/ diffuse SSc. Itch (moderate 4/10) seen in ~35% at all times https://t.co/QnT8d0xA5Z https://t.co/yEgB6ImDTi
Links:
Dr. John Cush @RheumNow( View Tweet )
Opioids Down, Gabapentins Up
The number of U.S. patients prescribed long-term opioid therapy declined from 2015 to 2023, but co-prescribing of opioids with gabapentinoids increased, prescription data showed.
In 2023, 4.2 million people had an active long-term opioid therapy episode, defined as a period of opioid
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From 2015 to 2023, long-term opioid therapy declined in the USA. Approximately 4 million to 5 million patients were prescribed long-term opioid therapy in 2023. Long term opioid use remains a challenge https://t.co/N5s7mYvXSw https://t.co/YHdTbHLB4q
Dr. John Cush @RheumNow( View Tweet )
COMMON - Incidental Rotator Cuff Abnormalities on MRI
In this cross-sectional study of 602 Finnish adults undergoing bilateral shoulder magnetic resonance imaging (MRI) and clinical assessment, found abnormalities in nearly everyone over age 40yrs, regardless if asymptomatic or symptomatic.
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Phase 1b trial shows transdermal Curcumin Gel (VAS-101) in was effective in Knee Osteoarthritis. Enrolled 60 KOA pts 45–75 yrs Rx w/ PBO or gel qd x 28d w/ signif improvement in pain & KOOS scores https://t.co/yNiNocZxa4 https://t.co/3W7j1bIvBc
Dr. John Cush @RheumNow( View Tweet )
There is very little evidence that kinesio taping has any true benefits in patients with musculoskeletal disorders https://t.co/3HIJOljacA https://t.co/Xz1YvQtHGs
Dr. John Cush @RheumNow( View Tweet )
What's it like to have RA? MARY: "I can manage the pain, the exhaustion, and side effects of the meds. The hard part is grief. I grieve for me, the adventurer that decided what she wanted and boldly went after it, no matter what. I trusted myself to handle whatever came. Now https://t.co/GakWIy2XCt
Dr. John Cush @RheumNow( View Tweet )
TENS Efficacy in Fibromyalgia
A randomized clinical trial of transcutaneous electrical nerve stimulation (TENS) in fibromyalgia showed meaningful improvement in pain for 6 months when combined with physical therapy (PT).
https://t.co/Gm81FWoTQN https://t.co/2gq2cDFUh7
Dr. John Cush @RheumNow( View Tweet )
What's it like to have RA? LISA: "It only took me three short years to go from rock climbing to a power wheel chair and that stage of the disease was frightening and painful and you feel hopeless and as if your life plan is being stolen from you. Once I was able to start https://t.co/d49htc8k4m
Dr. John Cush @RheumNow( View Tweet )
What's it like to have #RA? PATTY "To find patients or doctors who can talk intelligently about RA is a welcomed relief. However, I prefer that those around me not know about me and my RA. I hope they don’t notice the changes in my hands or shoes or that I cannot wear my usual https://t.co/OQbXJrcyPp
Dr. John Cush @RheumNow( View Tweet )
Moral Distress (3.27.2026)
Dr. Jack Cush reviews the journal reports and news from RheumNow. This week we discuss moral distress, FM in PsA, Lyme Vax is back & hidden but tangible benefits of the MDHAQ.
https://t.co/LdNcsUcHc2 https://t.co/tRYeDhQ3hC
Dr. John Cush @RheumNow( View Tweet )
TENS Efficacy in Fibromyalgia
A randomized clinical trial of transcutaneous electrical nerve stimulation (TENS) in fibromyalgia showed meaningful improvement in pain for 6 months when combined with physical therapy (PT).
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Rush University MDHAQ surveys done on 1,337 pts (excluding primary FM), identified 30% w/ anxiety, 24% depression, 25% fibromyalgia, & 44% w any 3 of these. In this 44%, HIGHER pain (7 vs 4) and RAPID3 (17 vs 8.2) vs those without FM, anxiety, or depression (p< 0.001). https://t.co/xbOKeZj5cm
Dr. John Cush @RheumNow( View Tweet )
Moral Distress (3.27.2026)
Dr. Jack Cush reviews the journal reports and news from RheumNow.com. This week we discuss moral distress, FM in PsA, Lyme Vax is back & hidden but tangible benefits of the MDHAQ.
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Dr. Cush provides a systematic approach to evaluating musculoskeletal and rheumatic complaints in clinical practice.
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I have been investigating the mechanisms of antinuclear antibody (ANA) expression in SLE since 1978. In this pursuit, I have followed the advice of my first division chief, Dr. Ralph Snyderman, a great academician. Ralph told me to identify a research focus and make it mine. I think I have done reasonably well in my mission so you can imagine my surprise (and excitement) when, for the Lupus 2025 meeting in Toronto, I was asked to conduct a Meet the Professor session on the Type 1 & 2 model for SLE.
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I recently heard of a secondary school assignment wherein students were challenged to “bury” a word that was no longer useful or appropriate. Their exercise has now evolved into an unofficial RheumNow task force to retire diagnostic terms that have grown into misuse in rheumatology and medicine.
How did we decide which words should perish? And by what criteria? Who has the final say?
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